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PubMedDate not supplied

Patterns of partnership and condom use in two communities of female sex workers in Tanzania.

Two rapid ethnographic studies have found that commercial sex workers (CSWs) and other high-risk women in Tanzania have different categories of partners, ranging from single-time contacts to long and enduring relationships. Since the advent of HIV/AIDS prevention programs in Tanzania in the late 1980s, CSWs and their clients have been aware of the multiple benefits of condom use for the prevention of pregnancy and STDs including HIV. These women often use condoms for the single-time contact. However, since the HIV/AIDS epidemic, casual partners have decreased in number. These days, most of their sexual contacts occur within long-term partnerships, and within these relationships, condom use is rare. Although the message that condoms should be used during high-risk behavior has been largely accepted, the definition of a high-risk relationship needs to be extended from casual partnerships to include multiple long-term partnerships. In addition, men and women's empowerment through education, business, and equal rights needs to be addressed at all levels of society.

Adolescent↗
PubMed1998

HIV-related attitudes and risk behavior of young adolescent mothers.

This article reports on the prevalence of HIV-related risk behaviors among young adolescent mothers. To determine the facilitators and barriers to condom use for young adolescent mothers, a survey of HIV-related knowledge, attitudes and behavior and focus groups was conducted. Young mothers (N = 58) have basic knowledge and some personal concern about HIV, but also hold common misconceptions about HIV and people with AIDS. Despite their anxiety about HIV, almost half rarely or never protect themselves against HIV by using a condom. Although 70% of the sample use hormonal contraceptives, more than one third of the sample have had a second child within an average of 18 months after the birth of their first baby. Personal concern about HIV was significantly associated with consistency of condom use. Because of low rates of condom use and substantial rates of multiple sex partners, STDs and second pregnancies, disadvantaged adolescent mothers are at risk of exposure to HIV. Increased personalized concern for HIV may lead to greater motivations for safer behavior for these mothers. In addition to protecting their own safety, the protection of their child may be an important motivator for safe behavior. Cultural taboos against safe sex and the perception of such behavior as "unfeminine" also need to be addressed for these women.

Adolescent↗
PubMed2003

Sexual knowledge, attitudes, and risk behaviors of students in Turkey.

This survey produced baseline information about student knowledge of sexually transmitted diseases (STDs), their sexual attitudes, and their behavior to help establish control and education programs. The study was conducted at Ege University, Izmir, Turkey, during the 1999-2000 academic year. A total of 2,217 first- and fourth-year students determined by stratified sampling constituted the study group. All students who volunteered to participate completed a questionnaire assessing sociodemographic and knowledge factors, sexual attitudes, behavior, and history of STDs. The rate of students having had sexual experience was 36.6%. Males were more sexually active than females. Most students (71.4%) began sexual activity at ages 15-19 without any difference by gender. Males reported significantly more sexual partners than females. Similarly, the rate of male students never using condoms was significantly higher than females. Condom was the most frequent contraception method, followed by oral contraceptives and withdrawal. Mean score on the knowledge questions was 16.29 (highest score 30). The most widely known STD was HIV infection and AIDS. Students' knowledge of transmission routes, signs and symptoms, and risk groups of STDs was insufficient. Main sources of knowledge were visual and print media, and friends. Most students (84.7%) viewed prevention from STDs as a person's own responsibility. Young people in Turkey are sexually active and tend to engage in high-risk behavior. However, their knowledge on sexual health and sexually transmitted diseases is insufficient. Study results suggest a need for implementation of STD control programs and provision of school sexuality education for adolescents and young adults.

Adolescent↗
PubMed2004

Condom use in multi-partnered females.

Many women attending sexual health clinics have multiple partners, and determining factors associated with condom use may provide useful information for health promotion strategies. Demographic and sexual data were obtained from computerized records at the Sydney Sexual Health Centre from 1991 to 1999. Females with >2 partners were categorized according to their condom use in the last three months and compared using chi-squared (chi2) tests and logistic regression. Of the 2198 women identified, 22% did not use condoms, 28% reported consistent condom use and 50% inconsistent use. Variables independently associated with failure to use condoms included older age and being in a regular relationship. Women with more partners were more likely to use condoms. Students [odds ratio (OR)=0.7 (95% confidence interval (CI) 0.5-0.9)] and those in employment [OR=0.7 (95% CI 0.5-0.9)] were more likely to use condoms than the unemployed. Focusing health promotion on multi-partnered women who fail to use condoms consistently may help in reducing sexually transmitted infections.

Adolescent↗
PubMed2006

HIV prevalence and trends from data in Zimbabwe, 1997-2004.

BACKGROUND: This paper brings together data from a variety of reports to provide a basis for assessing future steps for responding to and monitoring the HIV epidemic in Zimbabwe. METHOD: Data reported from four antenatal clinic (ANC) surveys conducted between 2000 and 2004, two small local studies in Zimbabwe conducted from 1997 through 2003, four general population surveys from 1999 through 2003, and service statistics covering 1990 through 2004 were used to describe recent trends in HIV prevalence and incidence, behaviour change, and programme provision. RESULTS: HIV prevalence among pregnant women attending ANCs declined substantially from 32.1% in 2000 to 23.9% in 2004. The local studies confirmed the decline in prevalence. However, prevalence continued to be high. Sexual behaviour data from surveys suggests a reduction in sexual experience before age 15 years among both males and females age 15-19 years, and in the proportions of males and females aged 15-29 years reporting non-regular sexual partners in the past 12 months. Reported condom use with non-regular partners has been high since 1999. Condom distribution and HIV counseling and testing increased from 2000 to 2004. DISCUSSION: On the basis of examination of data from a variety of sources, the recent decrease in HIV prevalence may be related to recent reductions in early-age sexual activity and non-regular sexual partnerships and increases in condom use. Comparison of data from sentinel surveillance systems, population based serosurveys, local studies, and service statistics provide increased confidence that a decline in HIV prevalence in Zimbabwe is actually happening in the population.

Adolescent↗
PubMedDate not supplied

Which is more important to high school students: preventing pregnancy or preventing AIDS?

A sample of about 2,900 high school students in greater Miami, Florida, was surveyed to determine their attitudes toward pregnancy prevention vs. AIDS prevention and how these attitudes affect condom use. Female, Hispanic and black respondents were the most likely to consider pregnancy and AIDS prevention to be equally important. White non-Hispanics and males were relatively more likely to believe that preventing pregnancy is less important than preventing AIDS, whereas males and females involved in a steady relationship placed more emphasis on pregnancy prevention than AIDS prevention. The more knowledge about HIV and AIDS a respondent had, the less importance he or she placed on pregnancy prevention, and as the importance of preventing pregnancy declined, so did the frequency of condom use. Males who were in a steady dating relationship and perceived pregnancy prevention as more important than AIDS prevention were the most likely to report using condoms often.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Contraceptive methods and the transmission of HIV: implications for family planning.

Heterosexual transmission is the predominant mode of spread of the Human Immunodeficiency Virus (HIV) in most of the world. Whether the use of hormonal contraceptives, IUDs and spermicides is associated with an increased or decreased risk for HIV acquisition remains controversial. Several mechanisms whereby contraceptive methods may influence the transmission of HIV have been proposed. As contraceptive use increases among women of reproductive age, the group most vulnerable to HIV infection, any associations between contraceptive method and HIV risk become even more important. The available studies of these associations are predominantly cross-sectional and give conflicting results. We review the published evidence for associations between HIV and individual contraceptive methods. At this time no definitive conclusions regarding these associations can be drawn. Further research, especially prospective epidemiological studies and basic biological research on mechanisms of heterosexual transmission and the effect of contraceptives on these mechanisms, is urgently needed.

Condoms↗
PubMed1994

Reasons for condom utilization among high-risk adolescent girls.

Two hundred forty-eight adolescent girls responded to a list of 30 statements describing reasons for using and not using condoms. For 24 of the statements, most adolescents (> 70%) gave the same response regarding why they did or did not use condoms. Therefore, only the six remaining statements were used in further analyses. The relationship between the six statements and psychosexual history, condom use, and sexually transmitted disease (STD) history was examined. Those adolescent girls who had been sexually active longer were more likely to report lack of enjoyment as a reason that they did not use condoms (P < .03), and those adolescents who had been sexually active less time were more likely to report personal (P < .005) and partner (P < .0006) enjoyment of sex with condoms as a reason for using condoms. Longer relationships before intercourse were associated with having condoms available (P < .01) and partner insistence on their use (P < .02). Partner insistence on condom use was related to fewer episodes of sexually transmitted diseases (P = .03). These findings indicate the importance of relationship and partner variables in adolescent girls' perceptions of condom use.

Adolescent↗
PubMed1998

Does additional lubrication affect condom slippage and breakage?

The risk of condom slippage (1.94%) and breakage (0.89%) among 3607 condoms was analysed with respect to the use of additional lubricant. Whether or not lubricant was used, the site at which it was applied and the type of lubricant used were all found to vary significantly with the type of sexual act(s) for which the condoms were used. Little evidence was found for differing effects of type of additional lubricant (water-based, saliva or other) or site of lubricant use (on penis/inside condom, on condom, in vagina/anus). The use of lubricant more than doubles the risk of slippage for vaginal sex. While anal sex is associated with much higher risks of slippage the use of lubricant for this practice actually reduces the risk of slippage to that similar for vaginal sex where lubricant is used. No significant effect of additional lubricant on condom breakage was observed. It is recommended that education messages concerning the use of additional lubricant may need to change to take into account the varied nature of lubricant use practices and the differential effects of lubricant with respect to sexual practices. Specifically, if the use of additional lubricant has little or no impact on condom breakage but increases condom slippage then encouraging its use may be counterproductive if condom users consider slippage to be a reason not to use condoms.

Adult↗
PubMedDate not supplied

Condom use among Hispanic men with secondary female sexual partners.

Greater understanding of psychosocial predictors of the use of condoms among Hispanics is needed in prevention efforts related to the human immunodeficiency virus and sexually transmitted disease epidemics among Hispanics in the United States. A telephone survey was carried out in nine States that have large populations of Hispanics, using a stratified clustered random digit dialing sampling strategy. The survey yielded interviews with 968 Hispanic men ages 18-49 years. Of them, 361 (37.8 percent) reported at least one secondary female sexual partner in the 12 months prior to the interview. Predictors were identified of condom use by those men with their secondary sex partners. Key predictors of the subjects' condom use with secondary partners included carrying condoms; self-efficacy, or a measure of the subject's perceived ability to use condoms under difficult circumstances; positive attitude toward condom use; having friends who used condoms; and lack of symptoms of depression in the week before the interview (R2 = 0.35). Significant predictors of condom carrying were being comfortable in sexual situations, positive attitude toward condom use, and self-efficacy to use condoms. Less acculturated men had more positive attitudes toward condom use and carried them more than did more acculturated men. The researchers found encouraging levels of condom use with secondary sexual partners among Hispanic men with multiple partners. Because of the large proportion of Hispanic men who have multiple partners and the severity of the sexually transmitted disease epidemics in the Hispanic community,health care providers should recommend to Hispanic men that they carry and use condoms,point out the acceptability of men using condoms,and assess and teach basic sexual information in that group. Referral may be appropriate for high risk Hispanic men with symptoms of depression.

Acculturation↗
PubMed1995

Professional HIV risk taking, levels of victimization, and well-being in female prostitutes in The Netherlands.

Professional HIV risk taking (nonconsistent condom use with clients) of female prostitutes in The Netherlands is addressed within the context of (early) experiences with abuse, well-being, coping behavior, job satisfaction, and financial need. Data were gathered from 127 female prostitutes on condom use, financial need, and professional attitude, and on experiences with violence and abuse, physical complaints, psychosocial problems, and coping responses. Violent traumatic experiences were found to relate to more severe complaints and problems, and a higher frequency of emotion-focused coping strategies. A risk-taking protection style (as opposed to consistent condom use and selective risk taking) appeared to be associated with more severe experiences with violence, both in childhood and in adult life, with more frequent dissociation as a coping behavior, and with more psychosomatic complaints. Of all the relationships found, more severe experiences with violence on the job were most strongly related to a higher professional HIV risk.

Adaptation, Psychological↗
PubMed1996

Adolescent sexuality: the gender gap.

The aim of this paper is to determine gender differences as regards adolescent sexuality, in order to improve the adjustment of prevention programmes to boys' and girls' specific needs. Data were collected as part of the Swiss Multicentric Adolescent Survey on Health. Anonymous questionnaires were distributed in school classes among a national representative sample of about 9,300 adolescents (15 to 20 years old). About 45% of the total sample reported a previous sexual experience. Differences between boys and girls were identified by means of bivariate and multivariate analyses. A higher proportion of Swiss girls report intra-family discussions about sexuality, having had a previous sexual experience, having sexual intercourse regularly, having had only one partner, and using contraception regularly. A higher proportion of Swiss boys report positive attitudes towards condoms and using condoms regularly. Variables independently associated with the occurrence of first sexual intercourse before 15 years old also show gender differences, notably as regards health behaviours and social adjustment. The findings suggest that prevention programmes should emphasize, among boys, responsibility in contraception and the need for protection in situations of multipartnership, and among girls, a positive attitude towards condom use and an increased familiarity with condoms presented both in a perspective of contraception and prevention of STDs.

Adolescent↗
PubMed1997

Self-reported factors influencing condom use among clinic attendees.

Data were collected from a convenience sample of 231 urban women seeking health care at a Midwestern women's health care center at a city medical center. Participants responded to 53 items, most taken from the Family Health Center Survey, which was designed to elicit descriptive data related to three major categories: background factors, factors that might influence the decision to use a condom, and knowledge and attitudes that might predict condom acquisition. Knowledge of HIV transmission and safer sex was not a predictor of condom use. Through education and demonstrations of proper condom usage, nurses and other health care providers were influential in persuading adolescents and young adults to use condoms.

Adult↗
PubMed2003

The Bali STD/AIDS study: human papillomavirus infection among female sex workers.

Female sex workers in low priced brothel areas in Denpasar, Bali, Indonesia participated in an intervention study designed to promote condom use and sexually transmitted disease (STD)/AIDS prevention. The intervention provided educational sessions for sex workers, STD treatment for sex workers, condom distribution, and media for clients. The brothel areas were divided into high and low areas for programme effort. The high effort areas received a more intensive behavioural intervention than the low effort areas. A clinic was available for STD treatment in both areas. Behavioural surveys and STD testing were used to evaluate the programmes. About 600 were evaluated for several STDs and completed personal interviews at enrolment and at six-month intervals during the 18-month study. About 50% of women were new to the study at each round. Human papillomavirus (HPV) testing of cervical swabbed specimens, using polymerase chain reaction methodology, was performed at the beginning of the study and 18 months later. Human papillomavirus infection was initially high in these women (38.3%) and declined to 29.7% after 18 months (P <0.01). The prevalence of HPV infection declined with age (P <0.01). HPV infection was associated with a number of STD symptoms that were reported in personal interviews. These associations were stronger in the first time period. Infection with Neisseria gonorrhoeae was associated with HPV infection at baseline (P =0.03). HPV infection declined in the study area with the more intensive educational programme (P <0.01). The prevalence of HPV infection declined over time and was associated with study area and age of woman.

Adolescent↗