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PubMed2005

The relevance of cultural factors in predicting condom-use intentions among immigrants from the Netherlands Antilles.

A study into the relevance of cultural factors in predicting condom-use intentions among Antillean migrants in the Netherlands is described in this article. The association between the intention to use condoms with a new sexual partner and a perceived taboo on discussing sex, beliefs about sex education and machismo beliefs on gender and power relationships is addressed. The study was conducted among 346 Dutch Antilleans from a random sample of an Antillean population aged 15-50 years. The response rate was 37.8%. The results showed that condom-use intentions were primarily determined by perceived subjective norms, the perceived taboo on discussing sex, machismo attitudes, gender, age and educational background. Moreover, the respondent's opinion regarding machismo was an effect modificator for the association between condom-use intentions and subjective social norm. It is concluded that, in predicting condom-use intentions, factors specific to the culture of a population contribute significantly to the determinants drawn from the general social-cognition models. It is recommended that future research should use measurement instruments that are adapted to culture-specific beliefs, and should explore the influence of cultural factors on actual condom use. Moreover, interventions promoting condom use among migrant populations should target the cultural correlates of condom use.

Adolescent↗
PubMed2001

Educational level is associated with condom use within non-spousal partnerships in four cities of sub-Saharan Africa.

BACKGROUND: Rates of condom use in sub-Saharan Africa have remained too low to curb HIV/sexually transmitted disease (STD) epidemics. A better understanding of the main determinants of condom use would aid promotion. METHODS: Cross-sectional population surveys were conducted in four cities in sub-Saharan Africa: Yaoundé, Cameroon; Cotonou, Benin; Ndola, Zambia; and Kisumu, Kenya. In each city, the aim was to interview a random sample of 1000 men and 1000 women aged 15--49 years, including questions on characteristics of non-spousal partnerships in the past 12 months. RESULTS: Data on condom use were available for 4624 non-spousal partnerships. In the four cities, the proportion of partnerships in which condoms were used always or most of the time ranged from 23.8 to 33.5% when reported by men and from 10.7 to 25.9% when reported by women. Based on the reports from men, condom use was associated with higher educational level of the male partner in Yaoundé [adjusted odds ratio (aOR) = 1.76] and Ndola (aOR = 2.94) and with higher educational level of the female partner in Cotonou (aOR = 2.36) and Kisumu (aOR = 2.76). Based on the reports from women, condom use was associated with higher educational level of the female partner in Kisumu (aOR = 2.60) and Ndola (aOR = 4.50) and with higher educational level of the male partner in Yaoundé (aOR = 3.32). Associations with other determinants varied across cities and for men and women. CONCLUSIONS: Education was found to be a key determinant of condom use in all four cities. This suggests that educational level increases response to condom promotion and highlights the need for special efforts to reach men and women with low educational attainment.

Adolescent↗
PubMedDate not supplied

Effectiveness of latex condoms as a barrier to human immunodeficiency virus-sized particles under conditions of simulated use.

Condoms were tested in an in vitro system simulating key physical conditions that can influence viral particle leakage through condoms during actual coitus. The system quantitatively addresses pressure, pH, temperature, surfactant properties, and anatomical geometry. A suspension of fluorescence-labeled, 110-nm polystyrene microspheres models free human immunodeficiency virus (HIV) in semen, and condom leakage is detected spectrofluorometrically. Leakage of HIV-sized particles through latex condoms was detectable (P less than 0.03) for as many as 29 of the 89 condoms tested. Worst-case condom barrier effectiveness (fluid transfer prevention), however, is shown to be at least 10(4) times better than not using a condom at all, suggesting that condom use substantially reduces but does not eliminate the risk of HIV transmission.

Contraceptive Devices, Male↗
PubMedDate not supplied

Condoms for men, not women. Results of brief promotion programs.

Three different brief intervention programs to promote condom use were tested among patients in inner-city sexually transmitted disease (STD) clinics. The first, "Condom Skills," focused on teaching mechanical aspects of how to use a condom. The second, "Social Influences," emphasized how to negotiate condom use with one's sexual partner. The third, "Distribution," provided patients with an unlimited number of free condoms, retrievable at local community businesses. Of the 903 subjects whose medical records were reviewed after exposure to the intervention programs, evidence of continued unsafe sexual behavior, documented by subsequent treatment for a new STD, was found for 12.6% of the women and 19.9% of the men. When compared with male control subjects, male study patients had fewer documented subsequent STD reinfections. The relative risk (RR) and 95% confidence interval (CI) values were 0.48 and 0.28, 0.81 for the condom skills group; 0.65 and 0.40, 1.04 for the social influences group; and 0.85 and 0.56, 1.29 for the distribution group. There was no decrease in the incidence of STDs among female patients compared with control subjects; indeed, there was a trend toward increased risk of STDs among women exposed to the Social Influences intervention program. This study demonstrates that brief condom promotion programs can be effective for male STD patients, and that caution must be exercised in promoting condoms to women with a high risk of acquiring STDs. Further research on programs promoting safer sex among these women is needed.

Adult↗
PubMed2001

Acceptability of the female condom among sex workers in Thailand: results from a prospective study.

BACKGROUND: The female condom may provide women with the first female-controlled barrier method that is effective against sexually transmitted diseases, including HIV infection. GOAL: This study evaluated the acceptability of the female condom among sex workers in Thailand. STUDY DESIGN: Data on use and acceptability of the female condom were collected using a structured questionnaire during an 8-week follow-up. RESULTS: Analyses included 148 women who were still in follow-up at week 8. Sex workers used, on average, 2.8 female condoms per week. The overall satisfaction rate with the female condom was 68%, although, among users, 31% had difficulties in device insertion, 37% had pain from the inner ring, and 22% reported itching sensations. The main reason for using the female condom in the future was its perceived safety, and the main reason for not using it would be the client's refusal. CONCLUSION: Two-thirds of the sex workers were satisfied with the female condom. Difficulties at insertion, discomfort during use, and clients' attitude were potential obstacles to the use of the female condom in the future.

Adult↗
PubMed2002

The role of disease-specific infectivity and number of disease exposures on long-term effectiveness of the latex condom.

BACKGROUND: Condom use is a primary prevention strategy for sexually transmitted infections (STIs). Consistent condom use substantially reduces the risk of HIV infection. Similar levels of effectiveness for reducing the risk of other STIs have not been established. Differences in disease-specific infectivity and the number of exposures to an infected partner may explain differences in condom effectiveness. GOAL: The goal was to examine the impact of differing infectivities and increasing numbers of exposures on theoretical condom effectiveness. STUDY DESIGN: Mathematical modeling using estimated disease-specific infectivities and condom failure rates. RESULTS: Condom effectiveness decreases as disease-specific infectivity and the number of exposures to infection risk increase. CONCLUSIONS: Condom effectiveness for decreasing STI risk is influenced by disease infectivity and the number of exposures. Generalizations from studies of relatively uninfectious STIs to highly infectious STIs or from short-term studies to longer-term situations will overestimate condom effectiveness.

Condoms↗
PubMed1999

Study of condom integrity after brief exposure to over-the-counter vaginal preparations.

BACKGROUND: Latex condoms are used as contraceptives and as preventives against sexually transmitted diseases. Latex rapidly and significantly deteriorates when exposed to pure mineral oil and vegetable oil. We wanted to determine if short exposures to readily available over-the-counter (OTC) intravaginal preparations could affect latex condom integrity. METHODS: We compared the mean burst time of test latex condoms, which had 5-minute exposure to various OTC vaginal products, with the mean burst time of control (unexposed) condoms during pressurized air inflation. RESULTS: Baby oil reduced the mean burst time from nearly a minute to just over 11 seconds. One intravaginal moisturizer and two intravaginal antifungal preparations also adversely affected latex condom integrity. Products that weakened latex condoms contained either mineral oil or vegetable oil. CONCLUSIONS: Women who rely on latex condoms should exercise caution if using OTC vaginal products containing either mineral oil or vegetable oil. Such products apparently can decrease condom strength and potentially jeopardize efficacy.

Condoms↗
PubMed2004

Comparison of sexually transmitted disease prevalence by reported level of condom use among patients attending an urban sexually transmitted disease clinic.

BACKGROUND: There is controversy as to the protective effect of condoms in preventing various sexually transmitted diseases (STDs). GOAL: The goal of this study was to assess the association of various levels of condom use with a variety of STD. STUDY DESIGN: We conducted a cross-sectional study of female and heterosexual male visits to an urban STD clinic between 1990 and 2001. METHODS: Prevalence rates were calculated for gonorrhea, chlamydia, trichomonas, recent-onset genital warts, first-episode herpes, and molluscum contagiosum by reported level of condom use over the past 4 months, with adjusted odds ratios (AOR) calculated by logistic regression. RESULTS: Among 126,220 patient visits (39% women and 61% men), condom use over the past 4 months was reported by 54%, with 38% reporting inconsistent use and 16% consistent use. Condom users reported greater sexual risk in the past 4 months than nonusers (ie, new sex partners: 63% vs. 41%, P <0.001; multiple sex partners: 60% vs. 36%, P <0.001). When all condom users were compared with nonusers, there was limited evidence of protection against specific STD. However, when the analysis was restricted to condom users, infection rates were significantly lower in consistent than inconsistent users for both men and women for gonorrhea (AOR, 0.87 and 0.71, respectfully) and chlamydia (AOR, 0.66 and 0.74, respectfully), for trichomonas in women (AOR, 0.87), and for genital herpes in men (AOR, 0.73). CONCLUSIONS: Comparisons of STD between condom users and nonusers are confounded by greater sexual risk in users. Comparing consistent with inconsistent users reduces this confounding, revealing protection for both men and women for nonviral STD and for genital herpes for men.

Adolescent↗
PubMed2006

Condom use in incarcerated adolescent males: knowledge and practice.

BACKGROUND: Information is limited on how well adolescents use condoms and where they learn how. OBJECTIVE: The objective of this study was to determine how often incarcerated males used condoms incorrectly and where, how, and from whom they learned condom use. STUDY: This study consisted of an interviewer-administered survey during intake physicals at a juvenile detention center. Results were based on self-report; condom use models were not used. RESULTS: During usual use among 141 males, errors included failure to secure the condom to the penis on withdrawal (37%), loss of erection before condom removal (18%), and failure to leave space at the tip (14%). Learning occurred at home (27%), school (23%), probation/detention facilities (14%), and community programs (3.4%). Subjects learned from educators/counselors (37%), family (27%), and friends (6.9%). Methods of learning included reading the package insert (45%), demonstrations (39%), explanations (33%), and media (19%). CONCLUSIONS: These adolescents had relatively few condom errors. Common methods of learning correct condom use included observing a demonstration, reading the package insert, and hearing an explanation. The last 2 methods are easy to implement.

Adolescent↗
PubMed2006

Does a choice of condoms impact sexually transmitted infection incidence? A randomized, controlled trial.

OBJECTIVE: The objective of this study was to assess whether providing a choice of condoms would increase condom acceptability, increase self-reported use, and decrease incident sexually transmitted infection. STUDY: We randomized 414 men presenting with urethral discharge in Jamaica to receive either the "standard" clinic condom or a choice of 4 different types of condoms. Men were treated presumptively at enrollment and followed up at 1, 2, 4, and 6 months. RESULTS: Participants in the choice group had a strong preference (P <0.01) for the most popular condom available in Jamaica. This preference did not translate into higher condom use (P = 0.16). The 6-month cumulative probability of first incidence of gonorrhea, chlamydia, or trichomoniasis was slightly higher in the choice group (21%; 95% confidence interval [CI], 15-28%) versus the control group (17%; 95% CI, 11-23%); the difference in the survival curves was not significant (P = 0.35). CONCLUSION: A choice of condoms may increase perceived acceptability but not lead to increased condom use and subsequently lower sexually transmitted infection rates.

Adolescent↗
PubMed1995

Women's beliefs concerning condom acquisition and use.

Condoms are a time-honored and reliable method of protection against pregnancy and sexually transmitted infections. However, their use, and thus their effectiveness, is determined by individual behavior. The purpose of this paper is to report attitudes and salient beliefs related to condom use in a sample of adult women. The study used Ajzen and Fishbein's Theory of Planned Behavior to identify modal, salient beliefs regarding condom acquisition and use as intentional behaviors. The study sample consisted of 58 community women who reported using condoms for contraceptive purposes within the last five years. In face-to-face, audiotaped interviews, open-ended questions were used to solicit beliefs regarding condom acquisition and use. All subject narratives were content-analyzed for recurrent themes. Women cited accessibility and effectiveness in preventing pregnancy and sexually transmitted diseases as both advantages and as factors contributing to the ease of acquisition and use. Disadvantages and factors that might deter condom acquisition and use included embarrassment, objections by male partner, and effect on spontaneity. Overall, subjects exhibited accurate knowledge regarding the benefits of condom acquisition and use. However, it is possible that expressed negative beliefs could take precedence in decision-making and reduce the probability of consistent condom use.

Adult↗
PubMed1989

Condoms as a source of latex allergen and cause of contact urticaria.

To examine the occurrence of latex allergen in condoms and to study the symptoms caused by contact with condoms, 46 patients with latex-glove contact urticaria (LGCU) were investigated. 7 (24%) of the 29 patients with a history of condom use had experienced local swelling and/or pruritus during intercourse, confirming that condoms can cause local symptoms in latex allergic subjects. Prick tests performed on 16 different condom brands showed that 4 brands caused positive reactions in 52-67% of patients. The remaining 12 brands were not as allergenic and 1 brand was totally negative on prick testing. 1 highly allergenic condom brand was examined by high-pressure liquid chromatography (HPLC), which showed similar protein profiles to those detectable in latex gloves and natural rubber. These results show that, in addition to rubber gloves and balloons, condoms should also be considered as possible sources of latex, and that patients with LGCU should be advised to avoid condoms.

Adult↗
PubMed2002

Determinants of condom use among young people in urban Cameroon.

To reduce the prevalence of reproductive health problems among adolescents, governmental and nongovernmental organizations in Cameroon are implementing youth-oriented reproductive health programs. To facilitate the design of effective programs to increase condom use, this study examines survey data on the determinants of having ever used condoms and on current condom use with regular and casual partners among unmarried young people in urban Cameroon. While most adolescents have tried condoms at least once, use remains inconsistent. Parental support, personal risk perception, and self-efficacy are found to be associated with higher levels of condom use. Youth-oriented programs seeking to increase the number of new condom users among the young should promote parental support for condom use and enhance young people's perceptions of personal risk. Programs that work to convince the young that their sexual history can put them at risk of HIV infection and that dispel the myth that HIV risk with regular partners is low may serve to increase personal risk perception. Finally, communications programs should aim to increase adolescents' self-efficacy, particularly in terms of their perceived ability to convince partners to use condoms and to use them correctly.

Adolescent↗
PubMed1989

Allergic reactions to rubber condoms.

With the increased use of condoms, contact dermatitis to rubber is being seen more often. To develop a rubber condom suitable for use by rubber sensitive people, a "hypoallergenic" condom, which is washed in ammonia to reduce the residues of rubber accelerators, has been manufactured. Fifty patients allergic to various rubber accelerators were patch tested with an ordinary condom and the new washed condom. Fifty patients undergoing routine patch test investigation who were not allergic to rubber were also tested as controls. Twenty two of the rubber sensitive patients had a positive reaction to the new rubber condom compared with four of the control patients. Washing rubber condoms in ammonia does not appear to reduce the residues of rubber accelerators sufficiently for their use by rubber sensitive people. A non-allergenic condom is required.

Adolescent↗
PubMed2003

Social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia.

OBJECTIVES: To determine the social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia. METHODS: Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap for HIV screening. RESULTS: Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91, 95% CI: 1.15 to 3.18) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51, 95% CI: 1.01 to 2.26), after adjustment for age, educational level, marital status, number of sexual encounters per week, and knowledge of AIDS/HIV and sexually transmitted infections. The most frequently reported reason for not using condoms with clients was not being able to persuade them (66.7%), while for non-paying partners, the reason was that they loved them (60.0%). CONCLUSION: To complement the government's current programme of client education, 100% condom policy and brothel administrative measures, additional strategies to increase condom use among clients and non-paying partners should be directed at (i) the social policy and community levels to address sex workers' economic and cultural barriers to condom use, and (ii) personal level empowerment through developing sex workers' condom negotiation skills.

Adult↗
PubMed2006

Self-conscious emotions and self-regulation in the promotion of condom use.

Two prospective studies examined the self-regulatory role of anticipated negative self-conscious emotions (ANSCE) in the theory of planned behavior. In Study 1, 147 undergraduates reported condom attitudes, perceived norms, self-efficacy, ANSCE (shame and guilt) should they not use condoms, and intentions to use condoms during the coming 6 weeks. At a 6-week follow-up, ANSCE predicted condom use intentions and behavior and partially mediated the effect of attitudes and norms on both. Study 2 experimentally tested the social nature of self-consciousness in ANSCE; 61 female undergraduates read a scenario priming the private-self or social-self or were assigned to a no-scenario control. They reported condom attitudes, perceived control, ANSCE, condom use intentions, and a 6-week follow-up. ANSCE again predicted condom use intentions. A test of moderated mediation indicated that ANSCE influenced condom intentions more in the social-self condition than in the control condition. Implications of these findings are discussed.

Affect↗
PubMed2005

Towards an understanding of barriers to condom use in rural Benin using the Health Belief Model: a cross sectional survey.

BACKGROUND: HIV/AIDS is the most dramatic epidemic of the century that has claimed over two decade more than 3 million deaths. Sub Saharan Africa is heavily affected and accounts for nearly 70% of all cases. Despite awareness campaigns, prevention measures and more recently promotion of anti viral regimens, the prevalence of cases and deaths is still rising and the prevalence of systematic condom use remains low, especially in rural areas. This study identifies barriers to condom use based on the Health Belief Model (HBM) in Benin, West Africa. METHODS: The study was a cross-sectional survey conducted from June to July 2002. Two hundred fifty one (251) individuals were interviewed using a structured questionnaire adapted from a standardized WHO/GAP questionnaire. A logistic regression was used to identify factors associated with condom use. RESULTS: In spite of satisfactory knowledge on HIV/AIDS transmission, participants are still at high risk of contracting the infection. Sixty three (63) percents of the interviewees reported being able to recognize infected people, and condom use during the last occasional intercourse was declared by only 36.8% of males and 47.5% of females. Based on the HBM, failure to use condom was related to its perceived lack of efficacy [OR = 9.76 (3.71-30.0)] and perceived quality [OR = 3.61 (1.31-9.91)]. CONCLUSIONS: This study identifies perceived efficacy (incomplete protective effect) and perceived utilization-related problem (any reported problem using condoms) as the main barriers to condom use. Hence, preventions strategies based on increasing perceived risk, perceived severity or adequate knowledge about HIV/AIDS may not be sufficient to induce condom use. These data will be useful in designing and improving HIV/AIDS prevention outreach programs in Sub Saharan Africa.

Adolescent↗
PubMed2003

An in vitro study of biological safety of condoms and their additives.

The use of condoms to prevent sexually transmitted diseases, especially HIV, is widely encouraged. Condoms contain latex, nonspermicidal lubricants (such as dimethylsiliconium) and other nonspecified compounds, such as colorants and flavorings. Latex causes allergy reaction in susceptible individuals but little is known regarding the cytotoxic effects of other additives. The objective of this study was to develop a sensitive in vitro system to determine the toxic effects of condom material. The modified L929 FDA method and a more specific cell type, such as the cervical epithelial tumor cell line HeLa, was used. Lubricated (LC), lubricated and flavored (LFC), and lubricated, flavored and colored condoms (LFCC) were evaluated. Washings containing condom surface material were prepared by washing condom fragments in medium for different time intervals. Changes in cell number, viability and lysosome integrity in the L929 and HeLa cell lines was determined using the Crystal Violet, MTT and Neutral Red assays, respectively. The condom type affected cell viability and lysosome integrity, with LC inducing an increase in cell viability and LFC a decrease in lysosome integrity. The HeLa cell line in combination with the MTT and NR assay was themost sensitive in vitro system to determine the toxic effects of condom material.

Animals↗