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PubMed2005

[Permeability to phi chi 174 bacteriophages in polyolephin membrane condoms].

Membranes used for the manufacture of condoms eventually can develop tiny pores, thereby decreasing dramatically their effectiveness as a physical barrier against the transmission of infectious agents. A technique was designed that was based on the ability of bacteriophage viruses to trespass membranes and to infect certain bacteria species, and then developing lysis plaques in the colonies of the host bacteria. The effectiveness of 60 polyolefin condoms in preventing the diffusion of the bacteriophage phi chi 174(ATCC13706-B1), 27 nm diameter, was compared to 20 latex condoms. Physiological conditions such as pressure, pH, superficial tension, length, time of exposure and viral titre were simulated. A pressurization system was designed, in which compressed air was injected simultaneously to ten condoms. Four of the 60 polyolefin condoms and one of the 20 latex condoms were permeable to the virus. Therefore, at least 93% of the condoms evaluated were able to contain the virus. The difference in permeability between the two types of membranes was not statistically significant (P = 0.79).

Bacteriophage phi X 174↗
PubMedDate not supplied

Consistency of condom use for disease prevention among adolescent users of oral contraceptives.

A six-month prospective study examined consistency of condom use for disease prevention among 308 adolescent women who had received a prescription for oral contraceptives at a family planning clinic. Only 16 percent used condoms consistently over a six-month period, yet 30 percent were considered at high risk for sexually transmitted diseases (STDs) because of multiple, sequential or concurrent relationships with male partners. The type of relationship in which the adolescents were involved did not predict consistency of condom use. Consistent condom use was associated with having asked a partner to use a condom, perceiving partner support for condom use, having less frequent sexual intercourse and using oral contraceptives inconsistently. The findings suggest that family planning providers need to more strongly emphasize to adolescents the importance of consistent condom use to protect against STD infection.

Adolescent↗
PubMed1986

Immobilization of sperm by condoms and their components.

Condoms and other rubber products immobilize sperm, but the mechanism is unknown. Sperm motility and eosin Y exclusion were measured following exposure of samples of semen to latex condoms of various types. Sperm motility was markedly reduced by exposure to all latex condoms, but eosin Y exclusion was unchanged. While there appeared to be some variability between semen samples and in time to complete immobilization of all sperm, condoms from one batch were similar. The immobilizing effect was not altered by prewashing the condom with buffer, chelating agent or acid. After immobilization, motility was not recovered by sperm washed in buffer, mixed with normal mid-cycle cervical mucus, or exposed to caffeine or adenosine triphosphate after demembranation with detergent. Studies with components of condoms indicated that raw latex and zinc dimethyl- and dibutyl-dithiocarbamate accelerators immobilized sperm within 30 min. In contrast, silicone rubber had no effect on sperm motility for up to 4 h. Enhancement of the sperm immobilizing effect might improve the contraceptive efficacy of condoms, while a useful non-toxic sperm collecting device for semen analysis, artificial insemination or in vitro fertilisation might be developed by omitting the toxic components from the rubber.

Contraceptive Devices, Male↗
PubMedDate not supplied

A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior.

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

Adolescent↗
PubMed1994

Deduction of the order of sexual assaults by DNA analysis of two condoms.

Differential DNA extraction procedures were performed on two condoms found at a rape scene. One of the condoms was recovered intact (A), while the second condom (B) had apparently ruptured during the alleged attack. Two related suspects (cousins 1 & 2) were identified as the potential semen donors. Condom B contained DNA from the female and from one of the suspects. Condom A contained DNA from the suspect identified on condom B and from an unidentified individual. The presence of DNA from suspect 2 on both condoms led to the deduction that his sexual activity preceded that of the unidentified suspect. The ability to determine such a sequence of events using DNA typing is unusual.

Condoms↗
PubMed1995

'Superstar' and 'model brothel': developing and evaluating a condom promotion program for sex establishments in Chiang Mai, Thailand.

OBJECTIVES: We developed and evaluated a multifaceted AIDS prevention program to increase condom use among sex workers in the city of Chiang Mai, Northern Thailand. SUBJECTS AND METHODS: A year-long intervention targeted sex workers, brothel owners and clients, promoted cooperation between these groups and the public health office and established a free condom supply for sex establishments. Nearly 500 women from 43 establishments took part in the program, encompassing nearly all direct sex workers in urban Chiang Mai. The intervention included repeated small-group training sessions for sex workers in which experienced women ('superstars') acted as peer educators. The 'model brothel' component encouraged all brothel owners in Chiang Mai to insist on mandatory use of condoms by sex workers and to encourage clients to use condoms. Before and after the intervention, specially trained volunteers posing as clients tested a subsample of sex workers to see whether they insisted on condom use. RESULTS: The intervention was well received by sex workers and obtained strong support and cooperation from brothel owners. Before the intervention, only 42% (10/24) of women surveyed by volunteers posing as clients refused to have sex without a condom, even when the client insisted and offered to pay three times the usual fee. Following the program, 92% (72/78) refused; 1 year later, 78% (69/85) refused during the same scenario. CONCLUSIONS: An innovative program directly involving sex workers as peer educators and enlisting the support of brothel owners and operators can result in improved condom use over time. Lessons learned from this program may be applicable elsewhere.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The female condom (Femidom)--a study of user acceptability.

OBJECTIVE: To determine the acceptability of the female condom (Femidom). DESIGN: Questionnaire survey following the use of the Femidom during sexual intercourse. SETTING: Groote Schuur and Somerset Hospitals, Cape Town. PARTICIPANTS: Nurses, secretaries, doctors and domestic staff of Groote Schuur and Somerset Hospitals who volunteered-61 women were recruited, 8 did not use any female condoms, and 1 did not return. Many women refused, mainly because of the unaesthetic appearance of the Femidom and the fact that they had to continue using their regular contraceptive and they did not think their partners would co-operate. OUTCOME MEASURES: Sexual responsivity compared with that without Femidom; acceptability of the method; women's and their partners' enjoyment of using the method; comparison with the male condom; awareness of HIV-AIDS and protective measures that can be used. RESULTS: Of the 52 participants, 23 used all 10 Femidoms issued to them. Thirteen women and 18 of their partners did not enjoy using the method and 9 had problems with it. Sex with the Femidom was the same or better in 51.9%. The Femidom was unacceptable in 32.7%, acceptable in 52% and very acceptable in 13.4%. Compared with the male condom, 50% of women and 44.2% of men considered the Femidom as good or better. Of the 61 women, 59 had heard of AIDS, and awareness of protective measures was good. CONCLUSION: There was resistance to accepting the Femidom, mainly because of its unaesthetic appearance and because women were participating for altruistic reasons. Acceptance and ease of application improved with use. Comments regarding problems and subjects' and their partners' enjoyment varied from extremely positive to extremely negative; 65.4% considered sex using the Femidom acceptable or very acceptable. It is important to inform and obtain co-operation from the male partner. The female condom has been developed as an alternative for women to use if their partners refuse or dislike using male condoms. Perfect use of the Femidom may reduce the annual risk of acquiring HIV by more than 90% in women who are sexually active with an infected male. The efficacy of the female condom has been described as equal to that of the diaphragm. The Femidom will increase the range of choices of contraceptives and prophylactic methods available for protective sex. It should become accepted as a method of contraception and an adjunct to other contraceptive methods as a prophylactic against sexually transmitted diseases and AIDS, particularly in relationships that are not mutually monogamous.

Adult↗
PubMed1999

Mechanical failure of the latex condom in a cohort of women at high STD risk.

BACKGROUND AND OBJECTIVES: Mechanical failure may reduce the efficacy of condoms. Little is known about frequency and determinants of condom failure in groups at high risk of sexually transmitted diseases (STD). GOAL: To measure condom breakage and slippage rates and evaluate potential determinants of failure among women attending a public STD clinic. STUDY DESIGN: Women attending an STD clinic participated in a 6-month prospective study of barrier contraception for the prevention of STD. They completed sexual diaries that were reviewed at monthly follow-up visits. No data were collected from the male partners. Baseline characteristics of the participants and time-dependent behaviors were evaluated as potential determinants of condom failure. RESULTS: Of 21,852 condoms used by 892 women, 500 broke during intercourse (2.3%) and 290 slipped (1.3%). Breakage was more common among young, black, single nulliparae who engaged in high-risk behavior. Slippage was more common among married women with children. Failure rates decreased with condom use, with coital frequency, and with use of spermicides. CONCLUSION: User characteristics and experience are determinants of breakage and slippage, which are often regarded only as the effect of product design flaws. Attention to modifiable determinants of failure may improve user counseling and product labeling.

Adolescent↗
PubMed1989

Condoms and sexual behaviour of young tourists in Copenhagen.

Sleep-in is a summer youth hostel in the center of Copenhagen with 459 beds, which was used for 19,296 overnight stays in July and August 1987. In the summer of 1987, each of the guests, 95% of whom were young tourists, received an envelope with a condom and a written reminder about the use of condoms during sexual relationships. During a period of the summer, 1,229 guests (498 women and 731 men) completed a questionnaire. The results showed that 21% of the men always, and 43% never had condoms in their luggage when travelling and 6% of the women always, and 79% never had condoms in their luggage. Of the 40 men who had sexual contact with Danish girls, 19 had always used a condom. Of the nine men with Danish homosexual contacts, three had always used condoms. Of the four women who had sexual contact with Danish men, none had used condoms.

Adolescent↗
PubMed1991

Comparison of selected college students' and sexually transmitted disease clinic patients' knowledge about AIDS, risk behaviours and beliefs about condom use.

Selected college students and sexually transmitted disease (STD) clinic patients of the same age were compared for knowledge about AIDS, use of condoms, sexual behaviours and intentions to engage in various sexual practices. The Theory of Reasoned Action model was used to elicit beliefs about condom use and significant referents who influence condom-use decision making. Eighty-seven per cent of college students were sexually active. College students had significantly fewer sexual partners in a 30-day period than STD patients, but in a 6-month period the mean number of sexual partners was the same for both groups. Significant difference was found in frequency of condom use for subjects with more than one partner. Of the college student sample, 60% did not use condoms compared with 32% of STD patients. Eighteen per cent of college students reported intention to engage in anal intercourse. No STD patients reported such intention. No statistical difference was found between groups on overall knowledge about AIDS: both groups manifested adequate knowledge of basic AIDS-related facts. Significant differences between groups were found in rank order of beliefs about using condoms as well as those referents who influenced decision making. Beliefs about disease, pregnancy, worry and normative influences of sexual partner and friends had the strongest impact on college students. Sexual partner and mother had a strong influence on STD patients' decision making while 'disease', 'pregnancy', 'decreases feeling' and 'decreases partner's pleasure' were among the beliefs influencing condom use.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Use of condoms in relation to risk behavior among the heterosexual population in Norway].

In a questionnaire survey on sexual behaviour, a random sample of 10,000 Norwegians aged 18 through 60 were asked about use of condoms during their last intercourse. The response rate was 62.7%. Except as regards level of education, the response group was fairly representative of the population with respect to socio-demographic variables. About 12% reported use of condom. Among subjects who reported extra-marital partners, about 7% used condoms (both with their permanent and their extra-marital partner), whereas about 12% of subjects who did not have extramarital sex used condoms. 15% of the single persons reported use of condom. Apparently, the use of condoms is not related to sexual behaviour correlated with risk of HIV-infection, such as the number of partners and knowledge about the partner. Neither is perceived risk, as measured by HIV-testing behaviour, related to the use of condoms.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Condom failure among homosexual men.

Following a postal questionnaire survey of 262 homosexual men carried out to investigate condom use during sexual activity, a sample of 97 men who used condoms during anogenital sex was identified. Thirty-one percent of those who had used a condom during anal intercourse reported at least one incident of condom breakage. When looked at in terms of frequency of individual condom use, it was found that 1 in 27 condoms break during this activity. Examination of the reasons for breakage and a review of the literature indicated that physical stress on the condom is likely to be a major factor in these incidents.

Adult↗
PubMed1994

Young adults, alcohol and condom use: what is the connection?

PURPOSE: Concern about HIV in adolescents and young adults has led a number of investigators to examine the link between drinking and risky behavior, including failure to use condoms. Most of the studies that conclude that this link exists have used global measures of both variables and have not investigated drinking and use of condoms on the same occasion. If drinking leads to low condom use, both behaviors must occur together and the failure to find that they do weakens the hypothesis that they are causally related. METHODS: Data from three separate studies on different adolescent and young adult populations are reported. In each study the relationship between drinking behavior and condom use at last intercourse was examined. RESULTS: Drinking was not related to lower condom use in any of the populations studied. CONCLUSIONS: This negative result implies that the dis-inhibiting effect of alcohol is not a major factor in the failure of young adults to use condoms.

Adolescent↗
PubMed1995

The benefits of school-based condom availability: cross-sectional analysis of a comprehensive high school-based program.

OBJECTIVES: To analyze the benefits of a school-based condom availability program relative to the risks that such a program may incur. METHODS: A confidentially-administered survey instrument was completed by 152 randomly selected high-school students (approximately 14% of the entire student population). RESULTS: The respondents had a mean age of 15.9 years (range: 14-19 years) and a proportionate gender distribution. Ninety-three percent of all respondents had "heard of" the school's program and knew from whom they could receive condoms. Twenty-six percent of the respondents had received condoms from the program with 67% using them. Of those receiving condoms but not using them, more than half did not need them, owing to absence of anticipated sexual activity. Of the nonreceivers, 53% had never had sexual intercourse and 27% received condoms from other sources. The benefit of the program by aiding a sexually-active student was found to be more than three times as great as the risk of encouraging a nonsexually active student to have sexual intercourse (RR = 3.2; 95% C.I. = 2.1, 4.9). The prevalence of sexual activity among all respondents was not significantly higher than the state's average based on gender and age (59.8% vs. 54.5%; z = 1.24, p > .05, n.s.). CONCLUSION: Given the lack of increased sexual activity and the favorable benefit-risk ratio, we conclude that school-based condom availability is successfully utilized by sexually-active adolescents and may be an effective means to reduce potentially harmful outcomes, such as unintended pregnancy and sexually-transmitted diseases.

Adolescent↗
PubMed1996

Factors influencing the intention to use condoms in Quebec sexually-inactive male adolescents.

PURPOSE: The purpose of this study was to determine whether attitudes and other variables would be associated with intention to use condoms in sexually-inactive male adolescents. METHODS: The survey was conducted from April to June 1989 on a sample of 879 sexually-inactive boys aged 12-19 years registered in secondary schools in Laval, Quebec. RESULTS: The major findings of the study were that: (1) information on condoms provided by peers was significantly associated with the intention to use condoms; (2) information provided by schools, while not significant in the final model, was positively associated with younger adolescents' intention to use condoms; and (3) sexually-inactive male adolescents in a less committed couple relationship had a greater intention to use condoms. CONCLUSIONS: The results of this study highlight the importance of peer instructors as a source of information on condoms, as well as that of teachers and health professionals from the school environment. Other channels of communication, however, need to be developed particularly for older sexually-inactive adolescents who may be impervious to this latter source. The findings also underline the necessity to make sexually-inactive adolescents in stable couple relationships more aware of their potential vulnerability to STDs and AIDS should they commence sexual relations.

Adolescent↗
PubMed2005

Effectiveness of female and male condoms in preventing exposure to semen during vaginal intercourse: a randomized trial.

OBJECTIVES: Comparison of male condom (MC) vs. female condom (FC) with respect to self-reported mechanical and acceptability problems and semen exposure using prostate-specific antigen (PSA) as an objective biological marker and evaluation of the effect of an educational intervention on self-reported problems and semen exposure, by condom type. DESIGN: Randomized crossover trial. METHODS: Four hundred women attending a family planning clinic in Brazil were randomized and either received in-clinic instruction or were encouraged to read the condom package insert; all used two FCs and two MCs. We measured the rates of self-reported user problems with MC and FC use and the rates of semen exposure during use (assessed by testing vaginal fluid for PSA). RESULTS: The educational intervention group reported fewer problems with either condom as compared with the control group (p = .0004, stratified by condom type). In both groups, self-reported problems were more frequent with FC use than with MC use (p < .0001, stratified by intervention). The educational intervention did not significantly reduce semen exposure. Overall, semen exposure occurred more frequently with FC use (postcoital PSA, > 1 ng/mL; 22%) than with MC use (15%); the difference, however, was small and nonsignificant for high PSA levels (> or = 150 ng/mL; 5.1% for FC vs. 3.6% for MC). CONCLUSIONS: In this study, the FC was less effective than the MC in preventing semen exposure during use and led more frequently to self-reported user problems. Both devices were highly protective against "high-level" semen exposure, as measured by postcoital PSA levels in vaginal fluid. In-clinic education may reduce user problems and increase acceptability and use of both devices.

Adult↗
PubMed1994

Condom promotion, sexually transmitted diseases treatment, and declining incidence of HIV-1 infection in female Zairian sex workers.

The control of sexually transmitted diseases, including HIV-1, among sex workers and their clients in urban areas in developing countries, is considered a valuable and cost-effective intervention to contain the spread of HIV-1. The effect of a programme of STD treatment combined with condom promotion on HIV-1 incidence has so far not been measured. During an intervention including condom promotion, as well as monthly sexually transmitted disease screening and treatment among 531 initially HIV-1 negative female sex workers in Kinshasa, Zaire, 70 became infected with HIV-1 (incidence of 8.0 per 100 women-years [wy]). A decline of HIV-1 incidence was observed over time, from 11.7/100 wy during the first 6 months, to 4.4/100 wy over the last 6 months, 3 years later (p = 0.003). Simultaneously, regular use of condoms with clients went up from 11% to 52% and 68%, after 6 and 36 months of intervention, respectively. Risk factors for HIV-1 seroconversion after multivariate analysis included irregular condom use (RR 1.6 [95% Cl 1.1-2.8]), gonorrhoea (RR 2.5 [1.1-6.4]), trichomoniasis (RR 1.7 [1.1-2.8]), and genital ulcer disease (RR 2.5 [1.1-6.4]), during the probable period of acquisition of HIV-1. In women who attended more than 90% of their clinic appointments, the HIV-1 incidence was 2.7/100 wy compared to 7.1, 20.3, and 44.1 per 100 wy among women who attended 76-90%, 50-75%, and less than 50% of the monthly appointments, respectively (p < 0.0001). These trends remained after controlling for reported condom use and number of clients. This study confirms earlier findings that STDs facilitate transmission of HIV-1 and shows that a clinic-based intervention consisting of STD care and condom promotion can result in a major decline of HIV-1 incidence among female sex workers.

Acquired Immunodeficiency Syndrome↗
PubMed1997

The role of condom motivation education in the reduction of new and reinfection rates of sexually transmitted diseases among inner-city female adolescents.

The purpose of this study was to document the effectiveness of small group condom motivation education in reducing new and reinfection rates of sexually transmitted diseases (STD) among female teenagers. Two hundred and five (205) female adolescents (age 13-20) with a current STD were studied at two sites of a Teen Health Clinic. There were 86 teens in the Study Group and 119 in the Comparison Group. Patients were sampled from December 1992 to July 1993. The patients in the Study Group received a condom motivation class given by the clinic STD educator in small groups of four or more adolescents. The Comparison Group, comparable in age and ethnicity, received treatment for their STD but did not participate in condom motivation classes. All teens were given treatment and condoms. The sample was followed for 6 months. The total number of patients returning with new infections was 21 (14.7%). The total number of patients with reinfections was 14 (9.8%). There were no significant differences between the Study and Comparison Group on return rates, new and reinfection rates or on any socio-demographic variables. The comparison of these groups suggests that a specific condom motivation class has minimal effectiveness in urban teens. However, almost 70% of the teens returned to the clinic for their scheduled visits. It is suggested that adolescent clinics which combine family planning and STD treatment services maintain high client enrollment and therefore may be ideal locations to initiate new and continuous interventions for condom use especially for high risk teens.

Adolescent↗