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PubMed1993

Condom use and the popular press in Nigeria.

The increased acceptability and use of condoms by men in southwestern Nigeria is reflected in joking references to condoms in the comic-style popular press. Yet these references display an ambivalence about condoms that is mirrored in survey data and in interviews regarding condom use by rural Ekiti Yoruba men. This ambivalence, which is often couched in terms of health, has implications for the acceptance of government-sponsored HIV/AIDS-related educational programs. Because of the irreverence of comic-style newspapers and the 'unofficial' nature of their authority which coincides with popular attitudes about health programs, they have a credibility that could be useful in educating adolescents about sexually-transmitted diseases and HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
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↗
PubMed1997

HIV risk reduction for incarcerated women: a comparison of brief interventions based on two theoretical models.

Although female inmates are seropositive at rates that exceed those of male inmates, few studies, have evaluated HIV risk reduction interventions for incarcerated women. This demonstration project compared an intervention based on social cognitive theory against a comparison condition based on the theory of gender and power. Incarcerated women (N = 90) were assessed at baseline, postintervention, and again 6 months later. Both interventions produced increased self efficacy, self-esteem, Attitudes Toward Prevention Scale scores, AIDS knowledge, communication skill, and condom application skills that maintained through the 6-month follow-up period. Participants in the intervention based on social cognitive theory showed greater improvement in condom application skills, and women in the program based on the theory of gender and power evidenced greater commitment to change. The results suggests brief interventions in prison settings are feasible and beneficial. However, it is not yet known whether the changes will generalize into the natural environment after the women's release into the community.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Psychosocial correlates of adolescents' worry about STD versus HIV infection: similarities and differences.

BACKGROUND: Adolescents' worry (perceived threat) of sexually transmitted diseases (STDs) and HIV infection may have different correlates. This study examined associations between selected psychosocial and behavioral constructs and adolescents' worry about STD and HIV infection. GOAL: To assess levels and correlates of worry about STD and HIV among a high-risk sample of black adolescent females. STUDY DESIGN: High-risk black females (n = 522), enrolled in a randomized, controlled HIV and STD prevention trial, completed a questionnaire and structured interview at baseline. Worry about STD and HIV infection, recent risk behaviors, and several measures potentially related to worry were assessed. RESULTS: Levels of worry for both STD and HIV were low. Recent history of STD infection was associated with STD worry (OR, 4.6) and HIV worry (OR, 2.0). Infrequent communication about sex (OR, 2.0) and low perceived ability to negotiate condom use (OR, 2.0) were related to STD worry; whereas, only partner-specific barriers were related to HIV worry (OR, 1.9). CONCLUSIONS: Despite high risk, adolescents were generally complacent about the threat of infection with STD and HIV. Adolescents' worry about STD and HIV infection had different sets of correlates.

Adolescent↗
PubMed1994

Knowledge, attitudes and activities of male clients of female sex workers: risk factors for HIV.

AIMS: To examine HIV related knowledge, attitudes and practices amongst male clients of female sex workers in New Zealand. METHODS: A sample of 30 clients were contacted in the commercial sex areas of the three main urban centres. A brief structured interview was undertaken by a fully trained interviewer who was herself a sex worker. RESULTS: The respondents were aged between 20 and 60 and came from a range of occupations. A third of them were married. Most visited sex workers quite frequently and vaginal sex was the most common service purchased. Condoms were consistently used with sex workers whereas they were less commonly used with casual partners and almost never used with regular partners. Clients rarely carried condoms and took a passive role in their use with sex workers. Knowledge about HIV transmission was high but perception of HIV risk or fear of infection were low. Many of the respondents travelled both within and outside New Zealand and most used commercial sex services on their travels. CONCLUSIONS: The findings suggest that clients may be a source of HIV infection of both sex workers and their other sex partners. More detailed research is necessary to explore clients' perceptions of HIV risk and the barriers to their wider use of condoms.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Prevalence and correlates of Chlamydia trachomatis among sexually active African-American adolescent females.

BACKGROUND: Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen in the United States and disproportionately affects African-American adolescents. The objectives of this study are to determine the prevalence of C. trachomatis and to identify correlates of infection among African-American adolescent females. METHODS: Sexually active African-American adolescent females (n = 522) completed a self-administered survey and structured interview and provided vaginal swab specimens for laboratory assessment of STDs. The relationship among selected psychosocial, behavioral, and biologically confirmed STDs and C. trachomatis was assessed. RESULTS: The prevalence of C. trachomatis was 17.4%. Results of multiple logistic regression revealed that adolescents testing positive for C. trachomatis infection were significantly more likely to test positive for gonorrhea (OR = 5.0; 95% confidence interval (CI) 1.69-14.83); to report nonuse of condoms with a steady partner (OR = 2.4; 95% CI 1.23-4.76); to be in shorter relationships (OR = 2.2, 95% CI 1.13-4.30); and to perceive less parental monitoring (OR = 2.1; 95% CI 1.08-4.15). CONCLUSIONS: Study findings emphasize the need for assessing psychosocial factors, behavioral factors, and the presence of other STDs when determining risk for C. trachomatis. Several of the constructs identified are particularly amenable to behavioral interventions designed to prevent infection.

Adolescent↗
PubMed2003

Behavioral surveillance surveys of the male clients of female sex workers in Hong Kong: results of three population-based surveys.

BACKGROUND: Male clients of female sex workers (FSWs) are an important group vulnerable to HIV infection. GOALS: The goal was to administer and assess behavioral surveillance surveys of male clients of FSWs in Hong Kong. STUDY DESIGN: Three population-based telephone surveys of males aged 18 to 60 were conducted from 1998 to 2001 (n=5159). RESULTS: Of all respondents, about 10.8% to 14% had patronized FSWs in the previous 6 months. Among male clients of FSWs, about 25% did not always use condoms, 4% to 6% had contracted a sexually transmitted disease, 16% had undergone HIV antibody testing, and 20% or more reported having four or more sex partners in the previous 6 months. There was no improvement in condom use over time. Cross-border (from Hong Kong to mainland China) commercial sex was common. CONCLUSION: The level of risk behaviors associated with male clients of FSWs remained substantial. The overall effectiveness and coverage of relevant prevention programs were questioned.

Adolescent↗
PubMed1996

Predictors of African American adolescents' condom use and HIV risk behavior.

This study evaluated predictors of risky and safer behavior in a sample of low-income African American adolescents, assessed their perceptions of the risk associated with their sexual behavior, and examined differences between adolescents who used condoms consistently, inconsistently, or engaged only in unprotected intercourse. African American adolescents (N = 312) completed measures related to AIDS knowledge, frequency of condom use, attitudes toward condoms, and sexual behavior over the preceding 2 months. Multiple regression analyses for the sexually active youths (N = 114) revealed that lower self-efficacy, higher perceived risk, and male gender were associated with high-risk behavior. Positive attitudes toward condoms and younger age had the strongest association with condom use. Consistent condom users were more knowledgeable and held more positive attitudes toward condoms, and nonusers were older. Regardless of their behavior, the adolescents generally did not perceive themselves to be a risk for HIV infection. The findings suggest that precautionary practices (condom use) and high-risk behavior (unprotected sex with multiple partners) may have different correlates. In addition, the data indicate that theoretical models developed with homosexual male populations may also be generalizable to African American adolescents' sexual behavior.

Adolescent↗
PubMed1996

Trends in chlamydia and other sexually transmitted diseases in a university health service.

The incidence of sexually transmitted diseases in a primarily student-based patient population served by a university health service was reviewed because of the perception that the number of positive chlamydia tests was declining. The most striking finding that emerged was that there was, indeed, a persistent and steady decline in the rates of chlamydia infection over the study time period of 1989 to 1994. Other sexually transmitted diseases showed less definite declines or no significant change. The authors evaluated the number of positive chlamydia tests in the health service with symptoms suggestive of chlamydia infection. Of all university health service patients who tested positive for chlamydia, 48.8% were asymptomatic. A majority (75.2%) of the female patients who tested positive on their annual routine family-planning examination were also asymptomatic for chlamydia. Chlamydia-positive men presenting to the health service were far more likely to be symptomatic than were the women who were positive. Overall, a significant decrease in chlamydia occurred over the 5-year period in spite of an increasing enrollment, a fact that could perhaps be attributable to students' increased awareness of the risk of sexually transmitted infections and their use of condoms.

Chlamydia Infections↗
PubMedDate not supplied

[Vaginal virucides against HIV].

Despite intensive efforts to promote condoms as a means of preventing the spread of HIV, the rate at which the epidemic is expanding, highlights the need for additional prevention technologies, and in particular methods controlled by women. Virucides are anti-infective substances, formulated as gels, foams, creams, and suppositories and impregnated sponges, for vaginal application. Women will be able to insert them prior to sexual intercourse to protect themselves and their partners from infection with HIV. Unlike condoms, the woman will control them, and their use can be with or without her partner's consent or even knowledge. They will not create a physical barrier to reduce sexual pleasure, and it will be possible to apply them considerably in advance of sex so that there is no interruption to the natural course of events. Virucides will not necessarily be contraceptive; ideally, they will be available in a choice of contraceptive and non-contraceptive versions. Virucides are not intended to replace other prevention measures such as those based on male and female condoms-or vaccines when they become available-but will give people a wider choice of potentially life-saving methods of protection. About 60 candidate virucides are in the development pipeline, representing many different chemical categories and different mechanisms of action against infection. About half a dozen are scheduled to enter large-scale clinical trials in the near future. Virucides offer the prospect of a low-cost, woman-controlled option for self-administered, broad-spectrum protection against multiple HIV strains, other sexually transmitted pathogens and unwanted pregnancy.

Administration, Intravaginal↗
PubMed2006

The role of collectives in STI and HIV/AIDS prevention among female sex workers in Karnataka, India.

This paper evaluates the role of female sex worker (FSW) collectives in the state of Karnataka, India, regarding their facilitating effect in increasing knowledge and promoting change towards safer sexual behaviour. In 2002 a state-wide survey of FSWs was administered to a stratified sample of 1,512 women. Following the survey, a collectivization index was developed to measure the degree of involvement of FSWs in collective-related activities. The results indicate that a higher degree of collectivization was associated with increased knowledge and higher reported condom use. Reported condom use was higher with commercial clients than with regular partners or husbands among all women and a gradient was observed in most outcome variables between women with low, medium and high collectivization index scores. Collectivization seems to have a positive impact in increasing knowledge and in empowering FSWs in Karnataka to adopt safer sex practices, particularly with commercial clients. While these results are encouraging, they may be confounded by social desirability, selection and other biases. More longitudinal and qualitative studies are required to better understand the nature of sex worker collectives and the benefits that they can provide.

Adult↗
PubMed1993

Urban, low-income, African-American and Hispanic youths' negative experiences with condoms. Implications for nursing intervention.

Research suggests that the rate of HIV infection is increasing dramatically in African-American and Hispanic youths who live in low-income, urban areas. Nurses need information about these youths' negative experiences with condoms to intervene effectively in the spread of acquired immune deficiency syndrome. This article discusses negative experiences with using condoms that were reported by a subsample of condom users (n = 975) from a household probability sample of low-income, urban, African-American and Hispanic youths. Condom users were asked about 12 different negative experiences with condoms. Results from this household survey highlight a need for nurses to provide clients with specific directions about how to use condoms correctly and to encourage clients to practice putting on condoms.

Adolescent↗
PubMed1994

Women's protective sexual behaviors: a test of the health belief model.

Heterosexual transmission of the human immunodeficiency virus (HIV) has become a significant health issue for women. The present study describes the extent to which a sample of women from an urban area report making efforts to protect themselves from becoming infected with HIV through several protective sexual behaviors. Secondly, we assess the extent to which adoption of these protective behaviors can be explained by health beliefs and previous HIV testing. Forty-nine percent of the sample reported having used a condom in the past year because of fear of AIDS and 48% reported having carried condoms. Women in this sample perceived themselves to be moderately susceptible to AIDS and they were well aware of the severity of the disease. Women tended to think that protecting themselves from AIDS would not be overly burdensome and that the recommended sexual protective behaviors were highly effective for preventing AIDS. Messages about the severity of AIDS and the effectiveness of protective sexual behaviors seem to be reaching women. Beliefs about personal susceptibility were consistently associated with the adoption of multiple protective behaviors, suggesting that messages emphasizing the ubiquity of risk, especially in demographically high-risk populations, may be particularly appropriate and effective.

Adult↗
PubMedDate not supplied

Changes in university students' AIDS-related knowledge, attitudes and behaviours, 1988 and 1992.

We evaluated changes in AIDS-related knowledge, attitudes and behaviours among students in residence at the University of British Columbia based on identical surveys conducted in 1988 and 1992. 493 randomly selected students in each year were sent a self-administered questionnaire on AIDS-related knowledge, fear of AIDS, homophobia, sexual behaviours, and intravenous drug use. AIDS-related knowledge was very high and increasing (p < 0.01) among respondents. Fear of AIDS and homophobia were low in both years. Intravenous drug use was reported by only one student in each year. Sexual activity was reported by 62% of students overall, with 25% of these reporting multiple sexual partners in the previous six months. 23% of sexually active students in 1988 and 40% in 1992 reported usually or always using condoms during intercourse. In spite of high levels of AIDS-related knowledge, a large, although decreasing, proportion of students have multiple partners without barrier protection. Nevertheless, the consistent presentation of the same public health message over several years is associated with substantial improvement in condom use.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Determinants of condom use to prevent HIV infection among youth in Ghana.

PURPOSE: To identify the psychosocial and behavioral factors that influence condom use to reduce the risk of human immunodeficiency virus (HIV) infection among young men in Ghana. METHODS: This study used a cross-sectional design in which data on a community-based sample of 601 young men, 15-24 years of age, were collected by a household survey instrument. For a conceptual framework, the study used constructs from the Health Belief Model (HBM) and Social Learning Theory (SLT) in the Ghanaian context. RESULTS: While 65% of the sexually active male respondents had used condoms at least once, only 25% had used condoms at last intercourse. Findings from multiple logistic regression analysis indicate that perceived susceptibility to HIV infection, perceived self-efficacy to use condoms, perceived barriers to condom use, and perceived social support were significant predictors of condom use. The most important finding, however, is that perceived barriers significantly interacted with perceived susceptibility and self-efficacy. Subjects who perceived a high level of susceptibility to HIV infection and a low level of barriers to condom use were almost six times as likely to have used condoms at last intercourse, compared to others. Similarly, young men who perceived a high level of self-efficacy to use condoms and a low level of barriers to condom use were nearly three times more likely to have used condoms at last intercourse when compared to others. CONCLUSION: These results suggest that HIV prevention programs for youth should emphasize personal vulnerability to acquired immunodeficiency syndrome, instill in youth the self-belief that they can use condoms any time, and address how to overcome barriers to condom use.

Adolescent↗
PubMed1997

Vulnerability on the streets: female sex workers and HIV risk.

In-depth interviews were conducted with 24 purposively selected female sex workers who were perceived to be vulnerable to risks associated with their lifestyle and occupation. Brothel workers were found to be considerably less exposed to risk than the women working on the streets. Client resistance was the major obstacle to women maintaining safe sex practices. Physical threats and coercion from clients, the absence of legal protection for street workers, the workers' extreme social isolation and lack of community support added to the difficulties experienced by women in their attempts to insist on condoms for all sex services. Youth, homelessness and heavy drug use had contributed to women being at times even more vulnerable because they had less capacity to manage situations of potential violence or STD risk. Whether through sex work or in their private relationships, HIV remains a risk for some of these women. This study highlights the dangers associated with illegal sex work. While decriminalization of prostitution would reduce some of the dangers to which women were exposed and increase women's capacity to insist on safe sex practices, it is also important for community education programmes to address men's failure to accept responsibility for condom use when seeking the services of sex workers.

Adolescent↗
PubMed1997

Behavioral risk for HIV infection among adults with a severe and persistent mental illness: patterns and psychological antecedents.

Behaviors associated with transmission of the human immunodeficiency virus (HIV) were measured in a sample of 60 adults with a severe and persistent mental illness (SPMI). Results revealed that 68% had sex in the last year; 13% of men and 30% of women reported two or more male partners, and 24% of men also reported two or more female partners. Condom use was inconsistent. Sex partners were often met in a psychiatric clinic or bar, and a substantial number were injection drug users or known to be non-monogamous. Overall, 48% of men and 37% of women reported at least one risk factor. Hypothesized psychological antecedents of HIV-related risk behavior were also measured, including knowledge, motivation for risk reduction, and self-efficacy regarding risk-reduction. Many participants were misinformed regarding HIV-transmission and risk reduction. Motivational indices indicated that attitudes toward condoms were slightly positive, and that social norms were generally supportive of condom use. However, participants tended to rate themselves at only slight risk for infection, undermining their motivation for condom use. Participants indicated only modest levels of self-efficacy in situations requiring sexual assertiveness. These findings, coupled with the elevated seroprevalence of HIV among persons having a SPMI, point to the need for risk assessment and counseling by mental health care providers.

Adult↗