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Gender differences in condom use behaviour among students in a Nigerian university.

Within a social cognitive framework, the present study evaluated condom use behaviour in a sample of students at the Faculties of Social Sciences and Arts, University of Ibadan, Nigeria. The study population comprised 262 (62.1%) males and 160 (37.9%) females with a mean age of 24.1 years (SD = 4.5) and mean educational level of 17.36 years (SD = 5.8). Results show that 422 students (representing 55.2%) were sexually active within three months before the study. Seventy seven per cent of students reported ever using a condom, 89% of females reported condom use by a partner, while 70% of males had used condoms during sex with a partner. Regarding the frequency of use, more males (30%) than females (11%) had never used condom. We conclude that the majority of sexually active university students in the study do not use condom. However, the females reported greater consistency of use of condom when compared to the males. Condom use behaviour in this sample did not differ markedly from other college student samples.

Adolescent↗

Correlates of African American college students' condom use to prevent pregnancy, STDs, or both outcomes.

BACKGROUND: The purpose of the current study was to compare African American college students who reported condom use for pregnancy prevention only, disease prevention only, and both pregnancy and STD prevention (i.e., dual prevention) in terms of their AIDS-related health beliefs, conventional sexual behavior, and unconventional sexual behavior. It was hypothesized that dual-prevention adolescents would express more health protective attitudes and behaviors than single-prevention individuals. METHOD: The sample consisted of 171 African American, undergraduate, single, heterosexual, and sexually active students with at least one partner in the past six months and who used condoms. A self-report questionnaire was administered-including items related to demographic and background information, sexual activity, condom use behavior, and knowledge, attitudes, and beliefs about HIV/AIDS, to participants in groups of 10-30 students in university classroom settings. RESULTS: The main between-group differences were in comparisons of pregnancy-prevention-only condom users and dual-prevention condom users. Participants who used condoms to prevent pregnancy only were less likely to be female, perceived themselves to be less susceptible to HIV/AIDS, perceived fewer barriers to condom use, and reported fewer vaginal sex partners. CONCLUSIONS: Intervention programs must address the relation between African American adolescents' beliefs about susceptibility to HIV/AIDS and unintended pregnancy, as well as their views of involvement in monogamous relationships. Integrated prevention services may allow for discussions of similarities and differences in the issues relevant to condom use for pregnancy prevention versus disease prevention.

Acquired Immunodeficiency Syndrome↗

Determinants of condom use among monogamous men in Ondo State, Nigeria.

This study examined the factors that influence condom use among monogamous men in Ondo State, Nigeria. Such information can help improve the design of male-involvement interventions in reproductive health and campaigns to reduce the spread of HIV among the general population. Overall, analysis was restricted to 394 men who were in their first union and reported a monogamous marriage at the time of interview. The analysis used logistic regression models for predicting the effects of selected socioeconomic background characteristics on ever-use of a condom and reasons for its use. Findings showed that 30% of monogamous men had ever used a condom, while about 15% of men were currently using the method. The findings further showed that prevention of pregnancy was a concern among monogamous men, much more than prevention of sexually transmitted infections (STIs), including HIV/AIDS. The logistic regression models indicated that ever-use of a condom was associated with age, education, and having been counselled on family planning, while place of residence, frequency of television-watching, and exposure to family-planning counselling were factors associated with motivation for condom use. Although prevention of pregnancy is a major motivation for condom use, many men would use a condom for protection against STIs and prevention of pregnancy simultaneously. Therefore, programme interventions aimed at promoting the use of condoms among men should convey both pregnancy and STIs/HIV/AIDS-prevention messages in one programme.

Adolescent↗

[In vitro studies of factors possibly influencing the performance of latex condoms].

Male condoms are undoubtedly the best protection against sexually transmitted diseases. The French Military Health Service buys condoms from civilian manufacturers using a public purchasing process. This process includes strict technical analysis that allows selection of the best supplier. In addition each batch of condoms delivered to French armed forces undergoes quality testing in the laboratory of the Armed Services Central Pharmacy before being distributed to troops. Despite these strict control measures, several isss remain unclear. One issue involves the shelf life of condoms stored in warm humid tropical conditions. Another issue involves the effect of lubricants on condom quality. The purpose of this report is to describe a study designed to gain insight into these two issues. This study was conducted by the Armed Services Central Pharmacy in colaboration with the Procuremnt and Central Establishment Directorate. Findings showed that stage conditions have no negative effects on the intrinsic physico-chemial properties of condoms supplied by two different manufacturers. Conversely use of inadequate lubricants (alimentary or cosmetic compounds) appeared to have extremely deleterious effects on condom quality. Laboratory tests showed that lubricants composed mainly of fatty acids dramatically decreased the effectiveness of condoms.

Condoms↗

Attitudes toward condom use and AIDS among patients from an urban family practice center.

As part of an effort to better educate patients about using condoms, a survey was done to assess the sexual practices, attitudes toward acquired immunodeficiency syndrome (AIDS) and condom use by patients who visit an urban family practice center. A self-administered questionnaire was given to 126 patients of whom the majority were black and single. Seventeen percent indicated they had sex with more than one person in the 3 months before the survey. Within the last 5 years, 10% had sex with an intravenous drug abuser, and 6% with someone of the same sex. Fifty percent believed that condoms decrease sexual pleasure for men and 31% thought condoms made sex inconvenient. Twenty-seven percent of those surveyed believed that a man's penis may be too large for a condom and 18% believed that uncircumcised men could not use condoms. Forty-five percent believed they should be screened for human immune deficiency virus exposure. The results highlight attitudes and beliefs that may function as barriers to condom use and should be addressed when encouraging condom use with this population.

Acquired Immunodeficiency Syndrome↗

Inner-city youths and condom use: health beliefs, clinic care, welfare, and the HIV epidemic.

This paper examines questions concerning condom use and determinants of change in use by inner-city youths who appear to be in the direct path of the AIDS epidemic. Detailed information gathered in interviews with 548 youths in 1989-90 and 1991-92, provide a history of change in condom use and HIV-related high-risk behaviors. Condom use as a whole increased with time and age. Positive beliefs concerning condoms and awareness of HIV transmission were determinants of increases in use, and negative beliefs were determinants of decreases. Nevertheless, those youths who engaged in the highest HIV-risk behaviors (prostitution, IV drug use, and male homosexuality) were no more likely than lower-risk youths to increase their condom use. Financial need, indicated by receipt of welfare, appeared to be a significant barrier to increasing condom use. Also noteworthy was the negative association between using health clinics and condom use. Although youths with high-risk behaviors make more clinic visits, those visits do not result in condom use.

Adolescent↗

Condom use for disease prevention among unmarried U.S. women.

Among a nationally representative sample of 932 sexually experienced unmarried women aged 17-44, 41% reported using condoms for protection against sexually transmitted diseases, and 30% said they used condoms for this reason every time or most times they had intercourse. While 67% of unmarried condom users cited disease prevention as their primary motivation for choosing this method, only 4% said contraception was their sole reason for using condoms; the remaining 29% gave both reasons. Condom use for disease prevention appeared most common among young women, never-married women, those with the highest incomes, women at an early stage of their reproductive career, women who had not been surgically sterilized and were not using oral contraceptives, those who believed in the effectiveness of condoms and women who had intercourse infrequently. Results of logistic regression analysis showed that black women and those who believed condoms and spermicides are effective in protecting against disease were about twice as likely as their counterparts to use condoms for disease prevention every time or most times they had sex; women who had intercourse two or more times a week, who used the pill or who had been pregnant were about half as likely as others to do so.

Adolescent↗

Sexual behaviour and negotiation of the male condom by female students of the University of Ibadan, Nigeria.

This study explored the sexual behaviour of unmarried female students of the University of Ibadan, Nigeria, and assessed the extent to which those who were sexually active negotiated and used the male condom. Four focus group discussions were conducted followed by a survey of 354 students. The results show that the mean age of the students was 22.5 years 55.1% had had sexual intercourse; the mean age at first intercourse was 16.5 years. The number of lifetime sexual partners ranged from 1 to 20 with a mean of 3.4; 75% of those who had had sex reported ever using condom; 16.9% and 39% used it during their first and last sexual episodes respectively; only 34.3% used it consistently. Seventy-three per cent had ever negotiated condom use with a partner, but only 41% did so during their last sexual encounter. A significant association was found between condom negotiation and number of sexual partners: Students with fewer life time partners (3.2) had less frequently negotiated condom use than those with more partners (4.3) (P<0.05). Condom negotiators also scored significantly higher (4.6) on a 6-point AIDS Knowledge Score than those who had never done so (4.0) (P<0.05). About a quarter (26.7%) had ever bought a condom, while 38.5% had ever carried it. We conclude that although many female students had sometimes used a condom only a few used it consistently and are therefore at risk of the unintended outcomes of unprotected sex. We propose appropriate interventions to address the problem.

Journal Article↗

Prevention of vaginal trichomoniasis by compliant use of the female condom.

BACKGROUND: Several case-control studies suggest that the male condom protects women against some sexually transmitted diseases. The female condom is the first barrier device under the woman's control that may be effective in the prevention of sexually transmitted diseases. GOAL OF THIS STUDY: To determine if appropriate use of the female condom decreased the rate of recurrent vaginal trichomoniasis in previously diagnosed and treated women. STUDY DESIGN: One hundred and four sexually active women with vaginal trichomoniasis were treated with metronidazole and assigned to a group using the female condom or a control group during a 45-day period of continued sexual activity. Fifty women served as controls, and 54 women were assigned to use the female condom. RESULTS: Only 20 women used the female condom each time they had sexual intercourse. Reinfection with trichomonas occurred in 7/50 (14%) controls, in 5/34 (14.7%) noncompliant users, and in 0/20 compliant users of the female condom. CONCLUSION: The compliant use of the female condom is effective in preventing recurrent vaginal trichomoniasis.

Adult↗

College students' knowledge about AIDS and attitudes toward condom use.

College students were surveyed to determine their knowledge about AIDS and attitudes toward condom use. Overall scores were high, with a mean of 22.5 on the 28-item true-false questionnaire. Of the 81 percent of respondents who indicated they were presently or had been sexually active, only 40 percent reported using condoms; 87 percent expressed an intention to have vaginal intercourse and 18 percent to have rectal intercourse. From the open-ended questions about condoms, 37 beliefs were elicited and the 10 most frequently mentioned were identified. The majority of subjects reported protection against sexually transmitted diseases and preventing pregnancy as the most important reasons for using condoms. Forty-seven percent also believed condoms important for preventing AIDS. Other significant beliefs about condom use included that they cause less worry, interfere with spontaneous sexual response, decrease pleasure for self and/or partner, are inconvenient and uncomfortable, and decrease feeling. The most significant referents for deciding about condom use were mothers in younger subjects and sexual partners for older subjects. These results indicate the need for influencing attitudes and normative beliefs to change condom use behavior.

Acquired Immunodeficiency Syndrome↗

Condom versus indwelling urinary catheters: a randomized trial.

OBJECTIVES: To compare condom and indwelling urinary catheters in terms of infection risk and patient satisfaction. DESIGN: A prospective, randomized, unblinded, controlled trial. SETTING: An academically affiliated Veterans Affairs Medical Center. PARTICIPANTS: Hospitalized men aged 40 and older who required a urinary collection device. MEASUREMENTS: The incidence of adverse outcomes (bacteriuria, symptomatic urinary tract infection (UTI), or death) and patient device-related satisfaction as determined according to a questionnaire. Dementia status was recorded to assess effect modification by the presence of dementia. RESULTS: Seventy-five subjects were randomized: 41 receiving an indwelling catheter and 34 a condom catheter. The incidence of an adverse outcome was 131/1,000 patient-days with an indwelling catheter and 70/1,000 patient-days with a condom catheter (P=.07). The median time to an adverse event was 7 days in the indwelling group and 11 days in the condom group. After adjusting for other risk factors, it was found that condom catheter use reduced adverse outcomes (P=.04). Patients without dementia who had an indwelling catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die (hazard ratio=4.84, 95% confidence interval=1.46-16.02) as those with a condom catheter (P=.01). Patients reported that condom catheters were more comfortable (P=.02) and less painful (P=.02) than indwelling catheters. CONCLUSION: The use of condom catheters is less likely to lead to bacteriuria, symptomatic UTI, or death than the use of indwelling catheters. This protection is especially apparent in men without dementia.

Adult↗

Psychological determinants of increased condom use and safer sex in homosexual men: a longitudinal study.

A 6-month longitudinal study of psychological variables predictive of condom use and safer sex in homosexually active men was carried out in Adelaide, a city of one million, in a low prevalence area for human immunodeficiency virus (HIV) infection. Return rate of follow-up questionnaires was 60%, with no significant differences between the returners and non-returners on age, sexual behaviour, condom use, or any of the subscales of the instruments used: Adjective Check List (ACL), Profile of Mood States (POMS), General Health Questionnaire (GHQ) and Attitudes toward Condoms scale. Variables associated with increased condom use included personality style, particularly a more assertive and forceful style, which may be important in raising the issue of condom use with partners and promoting condom use in sexual encounters. These data confirm the findings of previous cross-sectional research. Those items significantly associated with change in the Attitude toward Condoms scale are from the subscales measuring Protection from Infection, and Availability, suggesting that these attitudes are those most closely associated with increasing condom use. The variables associated with lack of change to safer sex are consistently those of dysphoric mood state and psychological maladjustment, suggesting that such individuals may need psychological support to assist them to make the change to safer sex. These data support the view that personality and psychological adjustment are important predictors of risk reduction for HIV infection in homosexually active men.

Adolescent↗

Adolescents and condoms. Associations of beliefs with intentions to use.

Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents.

Adolescent↗

Use of condoms as contraceptive and disease preventive measures among residents of Jos, northern Nigeria.

The effectiveness, acceptability and protective aspects of condoms as both contraceptive and disease control measures was evaluated in 168 male residents of Jos in Nigeria. They were aged between 15 and 40 years and were attending the Family Planning Clinic of the Jos University Teaching Hospital. The results showed that the majority (87.5%) of our patients were in the 21 to 30 years age group and most of the clients had used condoms for between 1 to 5 years. A good number of our clients (40.5%) used condom because it protects them against venereal disease while others felt it was safe and effective. The Family Planning Clinic was the main source of knowledge of the condom among our clients (42.9%), and the condom was rated as good or excellent by 137 (81.5%) clients. The only side effect of condom usage which featured prominently among our clients was reduced sexual excitement. The results were compared with studies carried out elsewhere. It was concluded that the condom could be an acceptable and effective form of contraception in this population. The users must, however, be highly motivated so as to use it during every act of coitus for optimal efficacy.

Adolescent↗

Condom breakage during commercial sex in Chiang Mai, Thailand.

Used condoms in 30 female brothels in Chiang Mai, Thailand, during the period from August 1992 to October 1992 were examined for breakage. Data were also collected by interviewing 326 prostitutes who accounted for 65 percent of the total prostitutes providing condoms. The prostitutes had a mean age of 20.6 +/- 3.2 years. Sixty-one percent had no formal education. The median duration of prostitution was 13 months. The average number of clients per day in the past 24 hours and in the past 3 months was 4.4 +/- 2.5 and 5.5 +/- 2.2, respectively. Eighty-eight percent charged between $2 and less than $8 for their sexual service. All refused to practice oral or anal sex during the past 24 hours. Of 5,559 condoms, 298 were used two at a time and 15 were used three at a time. The breakage rate per act of intercourse was 5.9 percent (95% CI = 5.3, 6.5). The breakage per total condoms examined was 5.7 percent (95% CI = 5.1, 6.3). Breakage relating to manufacturing defect, i.e., pinholes, and that relating to use was 0.8 percent (95% CI = 0.6, 1.0) and 5.0 percent (95% CI = 4.4, 5.6), respectively. The probability of breakage when using two condoms at the same time was 3.4 percent (95% CI = 0.5, 6.3). Most of the breakage occurred at the distal part of the condom. There was no difference between the breakage rates of condoms provided by the brothels and those brought by the client; nor was there any difference between manufacturing defect or use. The breakage rate per client as estimated by prostitutes in the past 24 hours corroborated with that assessed by examination.

Adolescent↗

Breakage and slippage of condoms in family planning clients.

Information was obtained from 540 clients on the 3,754 occasions when condoms were used over a one-month period. One or more major problems, breakage, slippage, leakage or a combination of these, occurred in 410 (10.9%) events, involving 217 (40.2%) clients. Breakage occurred in 209 (5.6%) events and slippage in 243 (6.5%). Leakage was almost always associated with breakage or slippage. There was a small group of accident prone clients. Breakage was more common in younger and inexperienced clients and in those who had previously experienced breakage. There were some differences in breakage rates between brands of condoms. Poor fitting condoms and non-spermicidal condoms were associated with more breaks. Other contributing factors included vigorous sex, dryness and tearing with fingernails. Additional lubrication did not protect from breaks and saliva was associated with more breaks than expected. Oil-based lubricants were associated with less breaks than expected. On many occasions (66.0%), clients were aware of the break before ejaculation occurred. Slippage was more common in the inexperienced and in those who had previously experienced slippage. There was no association between brand of condom and slippage but poor fitting condoms were associated with more slips. The most common reason for slippage was the condom being left on too long. Additional lubrication did not affect slippage.

Adolescent↗

Predictors of condom use in sexually active adolescents.

Unprotected sexual intercourse places a substantial number of adolescents at risk for sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infection. While the most effective means of preventing STD/HIV infection among sexually active adolescents is consistent condom use, little is known about the factors that influence their consistent use among adolescents. This study of adolescents (n = 1049, mean age = 16.2 years) found that of the 266 teens who recently became sexually active, only 29% reported using condoms consistently. Consistent condom use was more frequent in males, those with little history of risk behavior and those with stronger intentions to use condoms in the future. Fear and anxiety of HIV, attitudes about risks other than HIV, and other safe behavior intentions were not significantly related to consistent condom use. Although intentions and recent behavior were significantly related, a different group of factors was found to predict intention to use condoms (e.g., perception of condom use by friends, general impulsive attitudes). Identifying and understanding the factors that influence adolescent sexual behavior and intentions is important for developing maximally effective HIV education/prevention programs.

Adolescent↗

Sexual communication is associated with condom use by sexually active incarcerated adolescents.

PURPOSE: Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. METHODS: We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. RESULTS: Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. CONCLUSIONS: Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.

Adolescent↗