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PubMed1997

Survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers.

This study reports findings from a survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers that live and work in the United States for extended periods of time. Snowball sampling was used to recruit 501 Mexican migrants from five "sending towns" in Jalisco, Mexico, with historically high rates of out-migration to the United States. Results showed that subjects reported few negative beliefs about condom use and high efficacy to use condoms in challenging sexual situations but social norms sanctioning condoms were limited. Results also revealed mixed knowledge of HIV transmission, poor knowledge of condom use, and higher condom use with occasional versus regular sex partners. Forty-four percent of male migrants reported sex with prostitutes while in the U.S., with married men reporting less condoms use with prostitutes than single men. It was concluded that condom promotion efforts with Mexican migrants should concentrate on men to encourage consistent use with occasional sex partners, including prostitutes. AIDS prevention education should be provided with sensitivity to the language needs, limited education, and extreme social and geographic marginality of this highly underresearched Latino population.

Adult↗
PubMed1993

The condom race.

The condom race is a hands-on activity that can help teach young people condom use as part of safer sex practices. Although it is well documented that students know about condom use, they often do not do what they know they should. One possible explanation for this is that the students may lack the skills and confidence they need to have when they use condoms. The condom race offers students a chance to gain skills and confidence in a humorous, nonthreatening way. During the exercise, which is based on the concept of a relay race, students touch, feel, and practice putting condoms on penis models. After participating in the activity, students reported increased confidence in their ability to use, discuss, and carry condoms. The condom race is a quick, amusing, and easy activity.

Adolescent↗
PubMed1996

Sexual debut and predictors of condom use among secondary school students in Arusha, Tanzania.

A cross-sectional survey was conducted using interviews among 852 students attending seven secondary schools in the Arusha region, Northern Tanzania, to predict determinants of sexual debut and recent condom use among students. Schools were sampled according to location, school size and ownership criteria. Subjects were randomly sampled within grade-level and gender through use of class registers. Altogether, 528 students were sexually active. Males were more likely than females to report their sexual debut status (82.0% versus 33.3%; OR = 8.78; 95% CI: 6.17-12.49). Among males, incidence of sexual debut increased with grade-level, but decreased according to religious affiliation. None of the socio-demographic predictor variables used in this study had a significant association with sexual debut among females when age was controlled for. Of the sexually active students, 26.8% reported having ever used a condom and 21.5% reported use of condoms during their most recent sexual encounter. Late sexual debut, prolonged duration of dating before intercourse and having only one sex partner were significantly associated with increased condom use during the most recent occasion. Condom use increased with levels of education, but gender was not significantly linked to increased condom use. Condom use was particularly infrequent among casual sex partners. We observed a marked gender difference among students with respect to their sexual debut status, but no such difference was found in relation to condom use.

Adolescent↗
PubMed2001

Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya.

OBJECTIVE: To measure the impact on sexually transmitted infection (STI) prevalence of a female condom introduction and risk-reduction program at Kenyan agricultural sites. DESIGN: We conducted a cluster-randomized trial to determine whether a replicable, community-level intervention would reduce STI prevalence. METHODS: Six matched pairs of tea, coffee and flower plantations were identified. The six intervention sites received an information/motivation program with free distribution of female and male condoms, and six control sites received only male condoms and related information. Participants were tested for cervical gonorrhea and chlamydia by ligase chain reaction on urine specimens, and vaginal trichomoniasis by culture, at baseline, 6 and 12 months. RESULTS: Participants at intervention (n = 969) and control sites (n = 960) were similar; baseline STI prevalence was 23.9%. Consistent male condom use was more than 20% at 12 months. Consistent female condom use was reported by 11 and 7% of intervention site women at 6 and 12 months. Unadjusted STI prevalence was 16.5 and 17.4% at 6 months, and 18.3 and 18.5% at 12 months, at the intervention and control sites, respectively. Logistic regression models confirmed the null effect of the female condom intervention. CONCLUSIONS: Female condom introduction did not enhance STI prevention at these sites. It is unclear which aspects of the intervention -- STI education, condom promotion, case management -- were associated with decreased STI prevalence from baseline to follow-up.

Adult↗
PubMedDate not supplied

Factors associated with condom use in a high-risk heterosexual population.

The use of condoms has been advocated as a means of preventing the transmission of the human immunodeficiency virus and other sexually transmitted agents. To better understand factors that may influence condom use, 300 heterosexuals were enrolled in a cross-sectional study of patients attending San Francisco's only public sexually transmitted disease clinic. Interviewer-administered questionnaires were conducted. Condom use at last sexual intercourse was examined by logistic regression analysis. Men who used drugs or alcohol at last intercourse and whose partners did not want to use condoms were less likely to have used them; women who were black or Hispanic, who reported difficulty getting their partners to use condoms, or who reported that condoms decrease sexual pleasure also were less likely to have used them. Efforts to increase condom use in this population should target minorities, assist women to negotiate their use, emphasize the dangers of using alcohol and other drugs with sex, and address the perception that condoms interfere with sexual pleasure.

Adolescent↗
PubMed2000

Availability of condoms in urban and rural areas of KwaZulu-Natal, South Africa.

BACKGROUND: Promoting condom use to prevent HIV transmission is futile if condoms are not readily available. GOAL: This study assessed condom availability in clinics, shops, and other outlets in urban and rural South Africa. STUDY DESIGN: Snowball sampling was used to select 70 private-sector and public-sector outlets. One male and one female black fieldworker were posed as clients seeking condoms to assess condom availability and provider attitudes. RESULTS: Condoms were available in nine (100%) public clinics, in five of nine (55%) private doctor's rooms, and in only 5 of 52 (10%) nonhealth outlets. Access was limited in the public sector by clinic opening times, inadequate clinic signs and markings, and by some providers' attitudes. CONCLUSION: A major opportunity to make condoms available in nonhealth outlets in rural areas and urban townships is being missed in South Africa. Above all, the high level of condom awareness is not being matched by easy availability.

Condoms↗
PubMed2003

Use-effectiveness of the female versus male condom in preventing sexually transmitted disease in women.

BACKGROUND: Data are limited on the female condom's effectiveness against STDs. GOAL: The goal was to compare STD rates between women given small-group education on, and free supplies of, either female or male condoms. STUDY DESIGN: Female patients at an STD clinic (n = 1442) were randomly assigned to condom type and followed via medical records for STDs (gonorrhea, chlamydia, early syphilis, or trichomoniasis). RESULTS: In an intention-to-treat analysis, the odds ratio for a comparison of STD occurrence between the female and male condom groups was 0.75 (95% confidence interval [CI], 0.56-1.01), and it did not change with adjustment. In a second analysis among women returning for subsequent screening, incidence rates for the first new postintervention STD per 100 woman-months of observation were 6.8 in the female condom group and 8.5 in the male condom group (rate ratio = 0.79 [CI, 0.59-1.06]). CONCLUSION: Compared with those provided with male condoms alone, women counseled on, and provided with, female condoms fared no worse and experienced a nonsignificant reduction in STDs.

Adolescent↗
PubMed1997

A process evaluation of condom availability in the Seattle, Washington public schools.

In 1993, Seattle began making condoms available in all of its 15 high schools. As part of an evaluation of this program, 16 focus groups with students from 13 high schools were conducted to explore students' perceptions of the school environment, program effectiveness, and suggestions for program improvement. The study also included data from a student survey conducted in 10 high schools. The focus group results revealed that students support school condom availability but have concerns about privacy when obtaining condoms. Students prefer obtaining condoms from baskets in private areas of school-based clinics to obtaining them from vending machines. Students do not believe that having condoms available has affected sexual activity or condom use among students. Recommendations for improving school condom availability include access to free condoms in private locations.

Adolescent↗
PubMedDate not supplied

Predictors of AIDS knowledge, condom use and high-risk sexual behaviour among women in Dar-es-Salaam, Tanzania.

Reducing the number of sex partners and using condoms are the major means for individuals to protect themselves from STDs and AIDS in sub-Saharan Africa. To identify predictors of having only one sex partner in the last year and to assess knowledge and use of condoms among women of reproductive age in Dar-es-Salaam, Tanzania, we interviewed 2285 women at 3 representative family planning clinics between February 1991 and June 1992. After interview, blood and genital specimens were collected for laboratory diagnosis of HIV and other sexually transmitted diseases (STDs). Although knowledge of sexual transmission of AIDS was very high, less than a half of the respondents (42.8%) mentioned use of condoms as an AIDS preventive measure. Younger and more educated women were more likely to mention use of condoms for AIDS prevention, however only 4.6% of women interviewed were regular users of condoms, while 19.8% were occasional users. The majority of women who had never used a condom (57.5%) reported not using condoms because 'men did not like them'. Condom use was positively associated with increasing level of education and increasing number of sexual partners. 14.8% of women reported having more than one sex partner in the last year; this behaviour was more likely among cohabiting women (increased by 210%); HIV-positives (increased by 120%); and among women with STDs (increased by 50%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

Aspects of comfort and safety of condom. A study of two thousand intercourses among volunteer couples.

In nearly 2,000 intercourses 14 different types of condoms were tested by 80 heterosexual and seven homosexual volunteer couples. The test couples were generally quite experienced in the use of condoms. It appears that the condoms rarely (1.3%) ruptured or slipped off during the actual intercourse. This means that emphasis must be put on consistency and skill in the use of condoms rather on technical improvements in the promotion of condoms as a means of preventing the spread of sexually transmitted infections like HIV. Lubricated condoms and condoms that were not too small were preferred by both users and their partners. Other condom properties were significant but of minor concern for the participants of the study.

Adult↗
PubMed1997

Condom and nonoxynol-9 use and the incidence of HIV infection in serodiscordant couples in Zambia.

We aimed to measure the effectiveness of latex condoms and of nonoxynol-9 [N-9] spermicides, in preventing HIV transmission in heterosexual serodiscordant couples in Lusaka. Each couple was examined at clinic visits scheduled at 3-month intervals for one year or more per couple, or until seroconversion or discontinuation. Couples were given condoms and their choice of 3 N-9 products and advised to use both at every intercourse. Sexual exposure was ascertained from coital logs that recorded coitus and barrier method use. HIV serological testing was done at each clinic visit (ELISA and Western blot if positive). One hundred and ten discordant couples were followed for a mean of 17.6 months. Seventy-eight per cent of coital episodes were protected by condoms, 85% by spermicides and 6.4% were unprotected. Fourteen seroconversions occurred (8.7 infections per 100 couple-years [c-y]). The rate was higher among seronegative men than seronegative women. Among couples who reported using condoms at every intercourse the infection rate was 2.3/100 c-y, compared with 10.7/100 c-y among couples using condoms less consistently (rate ratio [RR] 0.2; 95% confidence interval [CI] 0-1.6). Among couples who reported using N-9 at every intercourse, the seroconversion rate was 6.9/100 c-y; among couples who reported less than full-time N-9 use, the rate was 8.9/100 c-y (RR 0.8; 95% CI 0.2-2.8). Among the subset of female seronegatives, the N-9 RR was 0.5 (95% CI 0.1-3.8). But when we calculated HIV rates according to N-9 consistency in coital acts when condoms were not used, there was no evidence of protection with higher N-9 use. Consistent use of latex condoms reduces the incidence of HIV infection, but the association between N-9 spermicides and HIV is less clear. The current study could not provide compelling data on the impact of N-9 spermicide use on risk of HIV infection. The study's small size, as well as the consistency of concurrent condom use, limited our inferences. Available spermicide products must be studied further.

Adolescent↗
PubMed1999

Correlates of condom use stage of change: implications for intervention.

A telephone survey was used to collect data on attitudes, beliefs, and practices concerning condom use among 812 African Americans with regular sex partners and of reproductive age in Baltimore. Condom use was "staged" according to Prochaska's model of stage of behavioral change. Characteristics of the respondents' sexual relationships, peer characteristics, and demographic and psychosocial characteristics were examined for their association with the stage of condom use. Multiple logistic regression analysis revealed that a partner's reaction to condom use, condom use self-efficacy with the partner, condom use outcome expectancy with the partner, perceived partner risk, length of relationship, sterility, cohabitation, perceived vulnerability to HIV infection and perceived peer norms about condom use were each independently related to staged condom use. Gender differences in the relationship of these independent variables with stages of change were found. Implications for intervention include differential treatment by gender and stage of change. Couples should also be considered for intervention.

Adolescent↗
PubMed1999

AIDS knowledge, condom attitudes, and risk-taking sexual behavior of substance-abusing juvenile offenders on probation or parole.

AIDS knowledge, condom attitudes, and sexual behavior were examined in a sample of 193 substance-abusing juvenile offenders on probation or parole. The majority of these youths reported being sexually active, and many admitted to early onset of sexual activity as well as unsafe sexual practices. Potential predictors of condom use by these juveniles were examined including age, condom use at first sexual experience, number of sexual partners in the last 6 months, locus of control, AIDS knowledge, condom attitudes, perceived risk for AIDS, self-efficacy for avoiding HIV, condom use by peers, delinquency risk, race, and gender. General attitudes toward condoms and the reported use of a condom at first sexual intercourse experience were the only statistically significant predictors of subsequent condom use. The relevance of these findings to the development of AIDS prevention programs for juvenile offenders is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Acceptability of a stage-matched expert system intervention to increase condom use among women at high risk of HIV infection in New York City.

There is an urgent need to develop and implement effective methods for sexual behavior change to curb the spread of HIV. Condoms remain one of the most effective strategies for achieving this, yet consistent condom use is generally low, especially among those at highest risk. This article describes the acceptability of an interactive computer-based expert system designed to increase condom use in women at high risk of HIV infection. The expert system is based on the transtheoretical stages of change model. Using a computer, participants respond to questions about their attitudes and behavior toward using condoms and receive immediate feedback which is matched to their readiness to use condoms. The women were found to be at all stages of change for condom use, although a large proportion of the women (42%) were at early stages of behavior change because they were considering but not using condoms every time during sex with men. The expert system was found to be acceptable to this high-risk group of women. They almost unanimously agreed that they found the feedback useful, would return to use the system again, and would recommend it to a friend. These findings indicate that traditional intervention strategies which assume individuals are ready to use condoms consistently would be appropriate for only about one third of these women, underscoring the importance and potential utility of stage-matched interventions.

Adolescent↗
PubMed1997

Condom use less likely, high risk behavior more common at Spring break. Safe sex.

According to a Durex Sheik online survey of Panama City Beach, Florida, spring breakers, college students are actually less sexually active during spring break than they are back on campus, despite long-standing perceptions to the contrary. That's the good news. The bad news is that those having sex at spring break are more likely to be doing so with several different partners and less likely to be using condoms than they are back at school. The survey of 664 college students, who responded via beach side computers hooked up to the Internet, showed that 36% of spring breakers hadn't had any sexual encounters during their week at the beach vs. 23% who said they had no such encounters during a typical week at school. 23% said they had one encounter per week during spring break, while 18% had two or three liaisons, 9% had four or five, and 13% had more than five. A closer look at those who had more than five partners per week reveals even more startling figures: 47% said they did not use a condom during any of their encounters during spring break vs. 23% for all spring breakers and 15% for those who were with only one partner. And among those who had more than five partners and for whom alcohol was involved in all of their encounters, a shocking 74% didn't use condoms. "We conducted this survey to better understand sexual attitudes and behavior at spring break," said Catherine Taylor, Durex. "What we found is a small but dangerous group of individuals who are engaging in very risky behavior, supporting the belief that we need to talk to young adults in their own language to teach them how condoms can be a normal part of a healthy intimate relationship." To normalize the acceptance of condoms, two 7-foot-tall Durex condom characters handed out 70,000 free Durex Sheik condom samples in Panama City Beach. Durex Sheik also hosted an event with MTV "Singled Out" star Carmen Electra and conducted a hands-on game in which contestants, racing against the clock, slipped condoms on a demonstrator--blindfolded.

Americas↗
PubMed1992

Vulvovaginitis: promotion of condom use to prevent sexually transmitted disease.

Many studies have suggested that merely warning people about the dangers of sexually transmitted diseases (STDs) and urging the use of condoms as protection will not result in widespread use of condoms. Regular condom use appears to be grounded in knowledge of its effectiveness, perception of STD risk, and belief in a partner's acceptance. But these are not the only barriers to condom use. Negotiating condom use often comes at a sensitive stage in intimate relationships, when individuals prefer to avoid such discussions and simply to trust the powerful and compelling feelings of mutual attraction. This review will consider (1) the effectiveness of condoms in preventing STD transmission, (2) barriers to the use of condoms, and (3) recommended strategies to promote acceptance and use of condoms by heterosexual women.

Condoms↗
PubMed1995

Behavioral training and AIDS risk reduction: overcoming barriers to condom use.

To assess the short- and long-term effects of an AIDS-prevention workshop on undergraduates' attitudes about condom use and AIDS, 31 participants and 31 controls were studied immediately after training sessions as well as three months later. The workshop was aimed at reducing embarrassment to purchase condoms, encouraging positive attitudes about condoms, and promoting knowledge about AIDS. To help students overcome their embarrassment over condom purchases, a behavioral intervention was included allowing students to make condom purchases at nearby drug stores. Results revealed that participants reported less embarrassment over condom purchases after training sessions and that this effect became even stronger over time. Knowledge about AIDS and positive attitudes about condoms also increased immediately after the workshop, but these changes did not persist. Results suggest that AIDS prevention workshops may lead to transient changes unless a specific skill (i.e., condom purchasing) is targeted via behavioral training.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Condom breakage and slippage among men in the United States.

Data on condom breakage and slippage from a nationally representative survey show that the average condom breakage rate experienced by 20-39-year-old men who have used a condom in the preceding six months was 2.7%, and that 1.9% of all condoms used during that time broke. Comparable condom slippage rates are 2.7% and 2.0%, respectively. Condom breakage and slippage appear to be 4-5 times higher among black men than among men of other races. Levels of breakage and slippage are also elevated among low-income men and those who used condoms relatively infrequently in the six months before the survey. The data also indicate that men who engage in high-risk sexual behavior, such as having multiple partners and engaging in anal intercourse, are more likely to experience condom breakage and slippage.

Adult↗