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Spermicidal activity of menfegol-coated condom.

The spermicidal activity of menfegol-coated condoms was investigated. Menfegol (P-menthanyl-phenyl-polyxyethylene [8,8] ether) showed strong spermicidal activity at 0.5 mg/ml and higher concentrations. Semen was ejaculated directly into menfegol-coated condoms (20 mg/condom) or uncoated condoms. Immediately after ejaculation, sperm motility and viability were examined. In the menfegol-coated condoms, sperm motility was completely suppressed and no viable sperm were observed. In the uncoated condoms, most of the sperm were alive, although their motility was almost suppressed. These results indicate that the menfegol-coated condom represents a new birth control method in which the contraceptive efficacy of the condom is enhanced by the spermicidal activity of menfegol.

Contraceptive Devices, Male↗

Affiliative preferences, self-change, and adolescent condom use.

PURPOSE: To describe the social comparisons, as measured by affiliative preferences, of Hispanic and non-Hispanic White adolescents who are either contemplating, initiating, or maintaining effective condom use, and to examine whether these preferences vary with stage of change for condom use and behavioral self-esteem. DESIGN: School-based survey of 180 sexually-active, 12th grade students at two public high schools in northern New Mexico. METHODS: Participants anonymously completed structured questionnaires in the classroom. FINDINGS: With few exceptions, respondents preferred to affiliate with others who were similar demographically. Stage of change had a significant main effect on adolescents' affiliative preferences related to condom use. Contemplators wanted to be with peers who used condoms more than they did (upward affiliations), while those in the preparation and maintenance stages wanted to affiliate with those who used condoms essentially the same amount as they did (lateral affiliations). Stage of change also had a significant interaction with behavioral self-esteem in predicting preferred affiliations related to condom use. Among participants in the preparation stage, those with low self-esteem wanted to affiliate with peers who used condoms less than they did (downward affiliations), while those with moderate self-esteem preferred affiliations that were slightly upward. CONCLUSIONS: Social comparison theory was a useful theoretical framework for examining preventive health behaviors. Adolescents' preferences for affiliation with peers varied according to stage of change and behavioral self-esteem. Implications regarding the use of targeted interventions for each stage of change are discussed.

Adolescent↗

Condom use within marital and cohabiting partnerships in KwaZulu-Natal, South Africa.

Traditionally, the major focus of condom-promotion strategies has been on increasing use outside marriage. This study explores the extent and determinants of condom use within marital and cohabiting partnerships in KwaZulu-Natal, South Africa. In focus-group discussions, in-depth interviews, and individual survey responses, knowledge of condoms as an effective method of dual protection against the risk of pregnancy and disease was found to be high. Consistent with numerous other studies, this study found widespread disapproval of condom use within marriage. Only 14 percent of men and 17 percent of women reported consistent or "occasional" condom use. Nevertheless, condom use is much higher among urban, more-educated individuals than among their rural, less-educated counterparts. Apart from education, perceived risk of HIV infection from the partner is the most powerful determinant of use within marital and cohabiting partnerships, particularly for women. Resistance to condoms within marital and cohabiting partnerships is not immutable, however, and women may not be as powerless to protect themselves as is often reported.

Adult↗

Farming with your hoe in a sack: condom attitudes, access, and use in rural Tanzania.

This study examines condom knowledge, attitudes, access, and practices in rural Mwanza, Tanzania. From 1999-2002, six researchers carried out participant observation in nine villagesfor a total of 158 person-weeks. Many villagers perceived condoms negatively for multiple reasons, for example, the method's association with infection or promiscuity, reduced male sexual pleasure, and cultural understandings of meaningful sex. Men controlled the terms of sexual encounters and reported that they would use condoms only with risky partners, but few perceived their partners as such. Use of condoms appeared to be very low, primarily as a result of limited demand, although barriers to access also existed. These qualitative findings contrast with inconsistent survey reports of relatively high condom use in the same population. Intervention efforts should address the tradeoff between possible short- and long-term consequences of condom use, particularly for men, for example, reduced pleasure versus reduced HIV risk. If possible, surveys should assess the validity of reported condom use through comparison with other data, including qualitative findings and distribution/sales records.

Adolescent↗

Sexual patterning and condom use among a group of HIV vulnerable men in Thika, Kenya.

BACKGROUND/AIM: A composite sample of 37 peer educators and 215 members of self help groups of male informal sector workers in Thika, Kenya, targeting HIV/AIDS prevention, were interviewed about their sexual behaviour, using a customised template, as part of a broader survey on gender attitudes and peer pressure. METHOD: Details on each sexual partner reported by each man over a 12 month recall period included type of partner, months during which sexual relations took place, and condom use. RESULTS: The men reported 471 sexual partners over the recall period, with a range of 0-16 partners, and an average of just under two partners. 8% of men had had no sexual partner, half were monogamous, and 3% had multiple partners with whom they used condoms exclusively, leaving 39% at varying degrees of risk. Condom use increased significantly with reduced intimacy of partner. 16% of men reported having at least one liaison with a female sex worker and two thirds of such liaisons were exclusively protected by condom use. Younger, single men had significantly more partners, but were more likely to use condoms. Duration of membership in self help groups was strongly associated with exclusive use of condoms with casual or FSW partners. Recorded attitudes corresponded somewhat with practice, but the data showed large gaps between the two, and low levels of gender sensitivity. CONCLUSION: There is some evidence that group membership has resulted in increased condom use and partner reduction, but there are doubts as to the extent to which the "ABC" strategy can be successful in stemming the HIV/AIDS epidemic. It may be necessary for interventions to target contextual issues, particularly gender relations, if the approach is to be more successful.

Adult↗

Condom effectiveness for prevention of Chlamydia trachomatis infection.

BACKGROUND/OBJECTIVES: A growing body of evidence is increasingly demonstrating the effectiveness of condoms for sexually transmitted infection (STI) prevention. The purpose of the present analysis was to provide a disease specific estimate for the effectiveness of condoms in preventing Chlamydia trachomatis infection while controlling for known exposure to infection. METHODS: Condom effectiveness for C trachomatis was estimated using a medical record database from a public sexually transmitted disease clinic (n = 1455). Clients were classified as having known exposure to C trachomatis if they presented to the clinic as a contact to an infected partner. RESULTS: Among clients with known exposure, 13.3% of consistent condom users were diagnosed with C trachomatis infection compared to 34.4% of inconsistent condom users (adjusted odds ratio = 0.10; 95% CI: 0.01 to 0.83). Among clients with unknown exposure, there was no observed protective effect of condoms. CONCLUSIONS: This study provides further evidence that condoms are effective in preventing C trachomatis infection by reporting a disease specific estimate and restricting analyses to individuals with known exposure.

Adult↗

Who uses condoms with whom? Evidence from national probability sample surveys.

OBJECTIVES: To explore the changing pattern of condom use from 1990 to 2000; to identify sociodemographic and behavioural factors associated with condom use; and reasons for condom use in 2000. METHODS: Large probability sample surveys administered among those resident in Britain aged 16-44 (n = 13 765 in 1990, n = 11 161 in 2000). Face to face interviews with self completion components collected sociodemographic, behavioural, and attitudinal data. RESULTS: Condom use in the past year among sexually active 16-24 year old men increased from 61.0% in 1990 to 82.1% in 2000 (p<0.0001), and from 42.0% to 63.2% (p<0.0001) among women of the same age, with smaller increases among older age groups. Among individuals reporting at least two partners in the previous 4 week period, approximately two thirds reported inconsistent or no condom use (63.1% (95% CI 55.9% to 69.8%) of the men and 68.5% (95% CI 57.6% to 77.7%) of the women). CONCLUSIONS: Rates of condom use increased substantially between 1990 and 2000, particularly among young people. However, inconsistent condom use by individuals with high rates of partner acquisition may contribute significantly to the recent resurgence in STIs. This group is an important target for intensive and specific sexual health interventions.

Adolescent↗

The biological safety of condom material can be determined using an in vitro cell culture system.

Latex products have long been recognized as a cause of latex protein allergy. The increased usage of latex gloves, with the consequent increased occurrence of latex allergies appears to have escalated with increasing awareness of the transmission of HIV-AIDS and other infections. The use of condoms as a means to prevent the transmission of STD's (sexually transmitted diseases) and HIV-AIDS has been widely promoted. Although extensive testing is done to evaluate the physical quality of condoms, no information is available regarding the biological safety of condoms. This study was undertaken to determine the effects of short-term exposure to physiological levels of condom surface material on cell viability (MTT assay) and cell growth (crystal violet assay). A direct contact cell culture testing method (FDA test method F813-83 used to evaluate the cytotoxic potential of medical materials and devices) was used. The modified test method was found to be a sensitive test system for the evaluation of the biological safety of condoms. This study reveals the importance of evaluating the biological safety of all condoms that are commercially available, because of the potential health risk that may be associated with prolonged use of certain types of condoms.

Cell Culture Techniques↗

Condom use and 'withdrawal': exploring gay men's practice of anal intercourse.

Some gay men who have unprotected anal intercourse avoid ejaculation-they practise 'withdrawal'. Using data collected in 1997 from a sample of Sydney gay men (n=625), we explored the relation between men's practice of ejaculation and their use of condoms. We also investigated whether men who had unprotected withdrawal but not unprotected ejaculation were more likely to think unprotected withdrawal was safe, liked condoms less, liked anal intercourse more, or were more sexually adventurous. Considering separately insertive and receptive anal intercourse with regular and with casual partners, we found that the majority of men who practised unprotected withdrawal also practised unprotected ejaculation. Of those whose only unprotected sex was withdrawal ('true withdrawers'), most never used condoms (they did not also have protected sex with ejaculation). True withdrawers were compared with men who had unprotected ejaculation, who always used condoms, who had no anal sex and who had no partners. Those who were true withdrawers with casual partners were more likely to believe withdrawal was safe; no group effects were found with regular partners. No significant differences in condom attitudes were found. True withdrawers with regular partners liked anal intercourse less than other men, but true withdrawers with casual partners were indistinguishable from those who had unprotected ejaculation. True withdrawers did not differ in sexual adventurousness from other men who had anal intercourse. Most withdrawers avoided anal sex with ejaculation rather than use condoms. Converting them into reliable condom users may be a considerable challenge for health promotion.

Adult↗

Changes in condom use after HIV diagnosis.

We investigated changes in condom use after HIV diagnosis. The study population comprised 78 asymptomatic HIV-infected subjects recruited from a clinic in Oslo, Norway, during 1988-92. In total, 240 follow-up visits were carried out. The response variable was repeated measurements of whether or not condoms were always used during anal/vaginal intercourse at follow-up. The explanatory variables were: time from HIV diagnosis to follow-up, exposure group (heterosexually infected, homosexual men, or infected through injecting drug use), time of HIV diagnosis (before 1987 or later), and history of condom use before HIV diagnosis. Random effects logistic regression analysis was used to study incremental changes in condom use, accommodating an unbalanced repeated measurement design. The use of condoms increased monotonously over time after HIV diagnosis in all exposure groups. Condom use was least likely among injecting drug users, subjects diagnosed before 1987 and subjects without a history of frequent condom use before HIV diagnosis.

Adult↗

Condom use with sex workers and abstinence behaviour among men in Nigeria.

Non-regular, non-cohabiting relationships and condom neglect are known to fuel the HIV/AIDS epidemic in Africa. Reproductive health needs of the men, the major decision-makers in this community, have been grossly neglected in this regard. This exploratory, community-based study assessed condom use among married men when with commercial sex workers (CSWs) and abstinent behaviour when their wives were unavailable for sex. (A CSW is one known to receive payment for sex.) Out of the 3,178 married respondents, 1,755 (55.2%) had ever used condoms. Of this number, 1,296 (73.8%) resided in urban locations while 459 (26.2%) resided in rural areas. Of these men, 137 had used CSWs in the six months prior to the study. Only 63 (46%) of these had used a condom at the last visit. Young age (<30 years) was the only predictor of condom use when with CSWs (p=0.03). Predictors of abstinence behaviour when the wife was unavailable for sex included: primary and secondary education, young age of the wife, low occupational status and monogamy. National HIV/AIDS control programmes should address men's risk-taking behaviour, empowering women to negotiate condom use and reduce long abstinence periods. Continued efforts should be made to reach sex workers and to make condoms much more widely available, acceptable and affordable, especially in rural areas.

Acquired Immunodeficiency Syndrome↗

Psychosocial determinants of sexual activity and condom use intention among youth in Addis Ababa, Ethiopia.

Determinants of sexual activity and intentions for condom use were examined guided by the Attitude, Social influences, and Self-efficacy (ASE) model as a theoretical framework. A total of 561 in and out-of-school youth (15-24 years) in Addis Ababa completed a self-administered questionnaire. A third of them reported sexual intercourse in the past and half of the sexually active used condoms during recent intercourse. Being out-of-school, male, aged 20-24 years, alcohol use and khat (amphetamine-like substance) consumption predicted the likelihood of engagement in sexual activity. Of these variables, however, male sex was more associated with reported condom use during recent sexual intercourse. Self-efficacy, skills, and barriers predicted 23% of the variance in intentions to use condoms. Self-efficacy was also associated with past condom use. Psychosocial constructs predicted more variations in condom use intention for males than for females. In general, self-efficacy was found to be the strongest predictor of the constructs, whereas attitude and social influences were the weakest. The study implies that HIV/AIDS prevention programmes for young people in Ethiopia need to emphasize building assertive communication skills in sexual negotiations and condom use. Minimizing the gender gap in sexual relationships forms the cornerstone for such educational strategies.

Adolescent↗

Relationship power, sexual decision making and condom use among women at risk for HIV/STDS.

This study examines the associations among relationship power, sexual decision-making dominance, and condom use within a sample of women at risk of HIV/STDs. Data from face-to-face interviews with 112 women were analyzed to (a) describe who women perceive as more powerful and who makes sexual decisions within their heterosexual relationships, (b) explore the association between relationship power and sexual decision-making dominance, and (c) examine the relationship of power and decision making regarding condom use to condom use behavior. Women were recruited from clinics and community locations in Atlanta, Los Angeles, Oklahoma City and Portland, OR. Participants were 18-25 years of age and were primarily Hispanic and African American. Over half (58.2%) reported that they share power with their partner, 25.5% said they have more power, and 16.4% reported that their partner has more power in their relationship. For the five domains of sexual decision-making examined, over half (50.5%-75.7%) of the women reported that they and their partners make decisions together. A higher percentage of women who perceived that they have more power or share power, as compared to those who perceived that their partners have more power, reported that "I/We" make decisions about birth control use, condom use, whether to have sex, and type of sexual activity. Relationship power was not associated with condom use. Condom use was, however, significantly higher among women who reported that they make decisions about using condoms alone or with their partner as compared to those who reported that their partner makes those decisions.

Adolescent↗

Consistency of condom use among low-income hormonal contraceptive users.

CONTEXT: Hormonal contraceptive users may be at increased risk for HIV and other STDs. An understanding of their decisions and abilities to use condoms is needed to focus intervention programs aimed at improving their protective behaviors. METHODS: Between 1999 and 2001, 426 new users of depot medroxyprogesterone acetate (DMPA) and oral contraceptives were recruited from public clinics providing family planning services to low-income women and surveyed when they began their method and again three months later. Bivariate analyses examined the consistency of condom use across subgroups, and multivariate analyses assessed associations between consistent use and various characteristics. RESULTS: Among women who had used condoms consistently before starting on DMPA or the pill, 54% discontinued consistent use after taking these contraceptives. Overall, 20% of women consistently used condoms with their hormonal method, and such use did not vary significantly by contraceptive type. Seventy-five percent of women in non-monogamous relationships were inconsistent users, though nearly a third had been consistent users prior to beginning a hormonal method. Factors associated with an elevated likelihood of consistent use were the male partner's positive opinion of condoms (odds ratio, 3.3) and the woman's strong belief that condom use is important for vaginal intercourse (3.5) and even if the couple is using another form of birth control (4.1). CONCLUSIONS: Many women at highest risk for disease have a decreased likelihood of using condoms, and disease prevention programs should be customized to target these women. Educational efforts focusing on women's attitudes and negotiation skills may be the best means of increasing dual method use.

Adolescent↗

Barriers to condom use: results from a study in Mumbai (Bombay), India.

The consistent and correct use of condoms coupled with risk reduction education strategies, continue to play an important role in the reduction and prevention of HIV/AIDS transmission. Therefore understanding and incorporating strategies to overcome barriers to condom use in such education and prevention efforts are critical. This is particularly necessary in countries such as India, where HIV/AIDS has become a serious public health crisis. The current study documents and provides preliminary data on the use of condoms, reasons for and barriers to condom use, and sources of information about safer sex practices among a sexually active adult sample of 49 women and 203 men in Mumbai, India. Despite limitations such as the use of a nonrandom sample of participants composed predominantly of young, English-speaking males, the study findings provide some insights into the importance of and the need to address issues of privacy regarding condom purchase and use in India. Most notably, the lack of privacy in stores and the social stigma associated with condom use were indicated as the most significant barriers. These and other study findings suggest the need to ease the social costs and constraints to safe behaviors through increased acceptance of condoms and promotion of their consistent use. This could serve as an important means to curb the epidemic of HIV/AIDS in India.

Adolescent↗

Validating the effects of social desirability on self-reported condom use behavior among commercial sex workers.

Most studies on the transmission of HIV depend upon self-reports of risky behaviors. This study examines if there is social desirability bias with respect to self-reported condom use behavior, assesses the reliability of a self-reported condom use scale, and validates the self-reported findings with clinical sexually transmitted infection (STI) diagnosis for commercial sex workers (N = 1,383) in the Philippines. The reliability of the condom use scale is .81, and results from confirmatory factor analysis indicate that the data fit the model well. Sex workers who reported using condoms consistently had significantly lower rates of sexually transmitted infections compared to those who never used a condom (t = 7.79, p < .01). It was concluded that no social desirability bias existed with the self-reported condom use scale. Furthermore, the condom use measure was found to have a high level of concurrent validity with STI outcomes.

Adolescent↗

[Inconsistent condom use among sexual workers in Ecuador: results from a behavior survey].

OBJECTIVE: Whilst existing data suggests that the HIV epidemic in Ecuador is concentrated amongst men who have sex with men (MSM), there is very little available information on the situation of key populations, i.e. those most at risk of HIV infection and/or transmitting the infection. In particular, there is very little known about sex workers (SWs), their rate of condom use and other behaviors and characteristics with respect to the risk of acquiring sexually transmitted infections (STIs). This study presents findings from a survey carried out with SWs in eight cities in Ecuador. MATERIAL AND METHODS: Using a cross-sectional design, a questionnaire focusing on behaviours, attitudes and socio-economic and demographic characteristics was administered to SWs in eight cities in Ecuador. These eight cities together account for the majority of the population in the country, and they were also identified as the locations with high reported levels of HIV. RESULTS: Information from a total of 2867 SWs was obtained, the majority were captured in their workplaces. Most of SWs interviewed carry out their activities in closed settings dedicated to sex work (i.e. not in the street). The average age of respondents was 28 (95%CI 27-29), and around half of them live with a male partner (married or not). The rate of condom use with the last client was 88% (82% consistently with the last three), whilst with regular partners it was 6%. A high index of life-skills, high socio-economic status and having an official document that allows them to work, were positively associated with condom use with clients (PR [CI95%] 1.40 [1.40-1.40], 1.37 [1.36-1.37], y 7.26 [6.87-7.46], respectively). CONCLUSIONS: Whilst condom use with clients amongst Ecuadorian SWs is high, this diminishes if one analyzes consistent condom use and is notably low with respect to regular partners. Condom use appears to be related to variables that can be linked to interventions, e.g. life-skills and official permission to carry out sex work. It is, therefore, important to tailor interventions for this population so they maximize the likelihood to increase consistent condom use.

Adult↗

Prompting bar patrons with signs to take free condoms.

This study was designed to determine whether signs would prompt bar patrons to avail themselves of free condoms. The intervention at three "gay bars" involved placing a large sign directly above a container of free condoms; the sign gave statistics for the number of people who have died from AIDS in the state and pointed out that condoms can reduce the spread of AIDS. Additional signs placed in the restrooms gave information about safe sex practices and reminded patrons that free condoms could be obtained at a given location in the bar. An ABAB design was used, with a 2-week baseline, 2-week treatment with signs present, 2-week reversal with no signs, and 2-week reinstatement of treatment with signs present. For all three bars combined, 748 condoms were taken with signs present and 510 condoms were taken with signs absent. Overall, when signs were present, the number of condoms taken increased by 47%.

Acquired Immunodeficiency Syndrome↗