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PubMed1998

Validity and reliability in reporting sexual partners and condom use in a Swiss population survey.

OBJECTIVES: To examine the validity and reliability of indicators of sexual behaviour and condom use in annual telephone surveys (n=2800) of the general population aged 17 to 45 for the evaluation of AIDS prevention in Switzerland. METHODS: A test-retest study with additional focused interviews was conducted on a subsample (n=138) of the respondents aged 17 to 22 years. RESULTS: The subsample included more French speaking respondents (OR: 1.7, CI: 1.1-2.5) and more people in a stable relationship (OR: 2.2, CI: 1.5-3-3) than the initial sample but did not differ in any other way, although no data is available on their attitudes towards sex. The reliability of the indicators considered was high: number of lifetime, casual sex partners in the last 6 months and condom use with them, acquisition of a new steady partner during the year and condom use with this partner, condom use at last intercourse. However, the focused interviews raised questions about the validity of some of these indicators, presumably due to imprecise wording of the questionnaire items. Among sexually active respondents, 12.5% (95% CI: 4.7-25.5) of the men included non-penetrative sex in the definition of 'sexual intercourse', but only 1.9% (95% CI: 0.1-10.3) of the women. The propensity for men of counting acts or partners with whom no penetration had taken place in the total reported sex acts or partners was not significantly associated with any socio-demographic variables. In addition, among the 15 respondents who had reported consistent condom use with casual sex partners at interview, 40% (95% CI: 16.3-67.7) admitted at reinterview that sometimes they also had unprotected sex. CONCLUSIONS: The reliability of reports on sexual behaviour and condom use in this Swiss evaluation survey is good. The indicators derived from the annual surveys are robust measures and the monitoring of trends seems to be based on reliable measurement. However, more research is required on the validity of the data.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Motivations for condom use: do pregnancy prevention goals undermine disease prevention among heterosexual young adults?

Differences in motives for condom use and their implications for understanding frequency of use were investigated in a random, biracial (Black, White) sample of heterosexuals, aged 17 to 25 years (n = 902). Results indicated that sexually active young adults-regardless of race, age, gender, or relationship status-were more likely to use condoms to prevent pregnancy than to prevent disease. Reasons for use mediated the effects of relationship status on condom use per se and moderated the effects of attitudinal and perceptual variables on condom use. Finally, comparisons among condom users motivated by different prevention goals and nonusers (n = 388) revealed that differences among user subgroups were nearly as numerous and, in some cases, more robust than differences between users and nonusers. These findings indicate that condom users comprise distinct subgroups, defined in part by their underlying motives for use, and highlight important conceptual and empirical reasons to distinguish among them.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

College students' reasons for nonuse of condoms within dating relationships.

Two hundred ten heterosexual undergraduates in dating relationships were surveyed about reasons for not using condoms every time for vaginal and anal sex and for increasing or decreasing condom use during their relationships. Half of the respondents reported consistent condom use in the first month of their relationships, while only 34% reported consistent condom use in the past month. Subjective assessments of partner safety and the belief that sufficient measures were being taken to avoid pregnancy were important reasons for condom nonuse. Study results suggest that interventions should emphasize the importance of objectively assessing HIV/STD risk before reducing condom use within relationships. Interventions also need to provide additional information on the riskiness of heterosexual anal sex.

Adolescent↗
PubMed1994

Dimensions of self-efficacy among three distinct groups of condom users.

Condom use self-efficacy can be defined as expectations about one's ability to use condoms under a variety of circumstances. This investigation examined the factor structure of the Condom Use Self-Efficacy Scale (CUSES) in an 18- to 23-year-old college population (N = 339) and tested the ability of the factors to distinguish among three groups of condom users (nonusers, sporadic users, and ritualistic users). Emerging from a principal components analysis were four reliable factors labeled Mechanics, Partner's Disapproval, Assertive, and Intoxicants. Results from a discriminant analysis indicated that sporadic users were best distinguished from ritualistic users by number of sex partners, use of intoxicants, and intensity of alcohol use. The sporadic users had more sex partners, were less confident of their ability to use condoms when intoxicated, and were heavier drinkers than were the ritualistic users. Nonusers were best distinguished from ritualistic users by the factor labeled Assertive. Nonusers were significantly less confident in their ability to discuss condoms and to insist on their use with a sexual partner. Implications of the findings for improving campus-based programs to prevent the spread of human immunodeficiency virus infection and sexually transmitted diseases are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Use of birth control pills and condoms among 17-19-year-old adolescents in Norway: contraceptive versus protective behaviour?

This article addresses the relationship between sexual risk behaviour and contraceptive behaviour, and considers whether adolescents who use condoms are practising birth control or STD protective behaviour. The material comprised a representative sample of 3000 Norwegians aged 17-19 years. Data were collected by anonymous self-administered questionnaires. The response-rate was 63%. At the first sexual intercourse 51% of the adolescents used condoms and 7% birth control pills. At the most recent intercourse 31% used condoms and 38% the pill. Use of the pill was widespread among adolescents with high coital frequency and few coital partners. Use of condoms was not particularly widespread among adolescents who reported a relatively large number of coital partners. Irrespective of the number of years they had been coitally active there was no significant difference between those who intended to use condoms at the next sexual intercourse and those who did not as regards their beliefs about condoms as protection against STDs, HIV and unintended pregnancies. The results from this study indicate that the majority of adolescents who use contraception do this for protection against unintended pregnancy and not for protection against STDs. The preference for the pill may make teenagers less prepared to practise STD protective behaviour in specific situations.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Factors associated with Hispanic women's HIV-related communication and condom use with male partners.

To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.

Acculturation↗
PubMed1997

Correlates of condom use among female prostitutes and tourist clients in Bali, Indonesia.

This study examines the commercial sex activity of both tourist client and local prostitute groups in the host country of Indonesia. The study provides a profile of social and behavioural characteristics of foreign tourist men and Indonesian women engaging in commercial sex, using cross-sectional data gathered in the tourist resort town of Kuta, Bali. Univariate statistical analysis and multiple logistic regression are used to assess psychosocial and other factors associated with consistent condom use in commercial sex encounters, drawing from the Health Belief model and social cognitive theory. Results from both respondent groups indicate that condom use is high between tourist clients and female Indonesian sex workers, although not 100% consistent. Beliefs about condom efficacy and effects on pleasure, as well as susceptibility to STD infection were related to condom use for female sex workers. Beliefs about condoms being too much trouble, and self-efficacy were related to condom use for tourist clients.

Adolescent↗
PubMed1994

Viral leakage risk differences in latex condoms.

Through use of a new bacteriophage assay capable of detecting a single viral plaque-forming unit (PFU), viral leakage through multiple replicates of several types of latex condoms has been evaluated. Stocks were used that had been preserved from a previous large study in which viral leakage had been assessed preliminarily in several brands. In the present research, much larger numbers of replicates--on the order of magnitude of 100 condoms per brand--were used. Leakage was demonstrated in single production lots of each of seven brands of condoms. With one notable exception, percent leakage ranged from 0.9 to 22.8%; 100% of the specimens of one profoundly flawed brand leaked. All test condoms were subjected to conditions intended to model these prevailing during coitus. Because the condoms used in this study were aged, current stocks of two widely sold brands were tested for comparison. Of these, 11.8% of one brand leaked, 25.7% of the other. The relevance of the results, which gave a high, albeit physiologically appropriate, challenge to the test brands, is discussed--so too is the significance to condom users of results deriving from a leakage assay of exquisitely high sensitivity.

Bacteriophage phi X 174↗
PubMed1996

Association between use of spermicide-coated condoms and Escherichia coli urinary tract infection in young women.

Diaphragm/spermicide use increases the risk of urinary tract infection (UTI). To determine whether spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990-1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1,904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31% of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (CI) 0.65-1.28) for weekly or less during the previous month to 2.11 (95% CI 1.37-3.26) for more than once weekly. Exposure to spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% CI 0.58-2.05) for use weekly or less to 3.05 (95% CI 1.47-6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products.

Adolescent↗
PubMed1995

AIDS knowledge, risk behaviors, and factors related to condom use among male commercial sex workers and male tourist clients in Bali, Indonesia.

OBJECTIVES: To describe the AIDS/sexually transmitted diseases (STD) knowledge and risk behaviors, and to determine factors related to condom use among male commercial sex workers (CSW) and male tourist clients in Bali, Indonesia. DESIGN: Individual survey interviews were conducted with a sample of 80 male CSW and 100 tourist clients in the Kuta area of Bali. METHODS: Survey interviews included detailed questions on AIDS/STD knowledge, sexual behavior, and psychosocial measures related to risk taking. RESULTS: Most of the male CSW had heard about AIDS and other STD, although some misconceptions about transmission and risks of different sexual practices remained. Both oral and anal intercourse with tourists were common and condom use was far from consistent. Factors related to condom use for anal intercourse with tourist clients were condom beliefs, self efficacy, susceptibility to STD infection, and STD knowledge. Tourist clients were mainly from Australia and Europe and many had paid for sex in other parts of Indonesia as well as in high prevalence countries. Knowledge of AIDS/STD was very good among the tourists and previous experience with STD was common. Factors related to condom use with male CSW were condom beliefs and self efficacy. CONCLUSION: There is a very active and mobile group of male CSW and tourist clients present in Bali. Interventions with these men are needed due to the low level of knowledge about AIDS among CSW, their experience with STD and STD symptoms, and their level of risky sexual behavior.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Condom use among patients attending six sexually transmitted disease clinics in Switzerland.

BACKGROUND AND OBJECTIVES: Persons treated for a sexually transmitted disease have been shown to be at increased risk for human immunodeficiency virus infection. Levels of condom use among these patients are presented, and sociodemographic and behavioral factors associated with self-reported never use of condoms are analyzed. STUDY DESIGN: This was a cross-sectional study of 2,257 patients treated at six sexually transmitted disease clinics in Switzerland between July 1990 and December 1992. RESULTS: Overall, 46.3% of the patients reported that they had never used condoms. Among heterosexual men, this level was 48.3% (n = 1,751), among homosexual and bisexual men it was 21.6% (n = 268), and among heterosexual women it was 60.1% (n = 238). In a logistic multivariate regression analysis, factors significantly associated with never use of condoms among heterosexual men included age over 29 years, not of Swiss origin, low level of education, few partners in the previous 6 months, contraction of the sexually transmitted disease from a stable partner, and not being an injecting drug user. CONCLUSION: These results document the high levels of condoms never being used in this population and highlight the importance of condom promotion activities provided by sexually transmitted disease clinics.

Adolescent↗
PubMed1995

Student opinions of condom distribution at a Denver, Colorado, high school.

Over the past two decades, the reported number of women and men who have had intercourse by age 18 has increased by approximately 20%. Concomitant increases occurred in the incidence of teen-age pregnancies and sexually transmitted diseases (STDs), including HIV. Increasing condom availability within schools has been proposed as one means of preventing the serious potential consequences of unprotected sexual intercourse. Although published surveys report 68% to 75% of adults have supported distributing condoms in schools, little is known about what students think about making condoms available at school. In this survey, high school students in Denver initiated and helped conduct a school-wide survey to assess student opinions about condom distribution in their school. Of 931 high school students responding to the survey, 85% replied that condoms should be distributed in their school, and 76% believed making condoms more accessible would not change the frequency of sexual activity among teens.

Adolescent↗
PubMedDate not supplied

Sexual behaviour and use of the condom by men attending gay bars and clubs in Glasgow and Edinburgh.

How widespread are the safer forms of sexual behaviour reportedly adopted by male homosexuals in recent years? A questionnaire was completed by 173 and 83 gay men attending gay bars and clubs in Edinburgh and Glasgow respectively. Comparisons were made between those who reported using the condom (n = 137, [54%]) and those who did not (n = 119, [46%]). Sixty percent of respondents reported more than 5 partners during the previous year. Condom use was much less common among men with less than 5 years' experience as a practising homosexual. Less than one-fifth of respondents reported always using a condom during anal intercourse. Orogenital contact without a condom was reported by 84% of all respondents, and unprotected anal intercourse by 40%, (over 30% for those who used condoms). About one-third of condom users but only 14% of non-users thought they were at risk of catching HIV because of their sexual behaviour, although 80% of users and 70% of non-users said their lifestyles had been affected by the HIV epidemic. While there were some encouraging signs of behaviour change, unprotected anal sex is still widely practised. Gay bars and clubs represent important venues for conveying the safer sex message.

Adult↗
PubMed2002

The POWER campaign for promotion of female and male condoms: audience research and campaign development.

In this study, we conducted and content analyzed 12 focus groups with women aged 15-25 living in inner city Denver as a process of audience research to develop a male and female condom promotion campaign. We recruited 89 women from school and community sites in central Denver neighborhoods to discuss their knowledge, attitudes, and practices regarding both male and female condoms, then solicited opinions about how to increase knowledge about and familiarity with female condoms, increase positive attitudes toward both male and female condoms, and how to increase access to and use of both male and female condoms. Opinions on these topics drove the development of a targeted media campaign promoting condom use in this population. We report here on the general findings from focus groups and provide details about the campaign the participants helped to develop.

Adolescent↗
PubMed1997

High HIV prevalence, low condom use and gender differences in sexual behaviour among patients with STD-related complaints at a Nairobi primary health care clinic.

Of 22,274 patients > or = 12 years old attending a Nairobi primary health care (PHC) clinic, 1076 (4.8%) had STD-related complaints, of whom 980 underwent assessment of risk factors for human immunodeficiency virus (HIV) infection and infrequent condom use. Gonorrhoea, chancroid, syphilis seroactivity, trichomoniasis, or objective signs of STD were found in 78%, and HIV seropositivity in 15% of men and 19% of women. Most women were married, living with a spouse; while most men were single, or married, but living separated from a spouse. Among married men, last sex was with a female sex worker (FSW) or casual partner for 60% not living with a spouse and 26% living with a spouse (P<0.005). Two or more partners during the past year were reported by 82% of men and 25% of women (P <0.001), and 55% of men and 11% of women reported the last partner was high risk. HIV seropositivity among both genders was associated with numbers of partners, and among women, with being widowed or divorced. Only 3% reported use of a condom with the last partner. Among men whose last sex was with a FSW, 74% said the reason for not using a condom was not having one. Thus, infrequent condom use, low condom availability, and gender differences in behaviour necessitate modifying development policies that separate families; and better coordination between family planning, PHC, and AIDS/STD programmes, with improved supply, social marketing and community-based distribution of condoms in high-risk settings for STD/HIV prevention.

Adolescent↗
PubMed1998

Measuring condom use among sex workers in the Dominican Republic.

The purpose of this paper is to assess the internal consistency of self-reported condom use among sex workers in Puerto Plata and Santo Domingo, Dominican Republic. We examined the responses to questions about condom use among 4 cross-sectional samples of sex workers. We compared measures based on: (1) questions using always-to-never scales; (2) questions about use with the past 5 clients; and (3) questions about use in the past week obtained from a retrospective coital log. In each sample, more women reported 'always' using condoms with clients than with each of the past 5 clients. In 3 of the 4 samples, only about half of the women who reported 'always' using condoms used condoms with the most recent 5 clients and with all clients in the past week. Internal consistency was significantly higher when the comparison was limited to use with the most recent 5 clients and use in the past week. Self-reported measures of condom use can be difficult to interpret. Assessing the internal consistency of several measures of use provides insight into the strengths and weaknesses of each measure.

Condoms↗
PubMed1995

Barriers to condom use among women attending planned parenthood clinics.

Assessed condom use, barriers to condom use, oral contraceptive use, partnership status and STD history in 457 15-30 year-old women attending four family planning clinics. Subjects were classified into three condom use groups: Non Users (37%); Current Users (33%); and Past Users (30%). Factor analysis revealed five barriers to condom use: Partner's Perception, Peer's Perception, Pleasure/Intimacy, Communication, and Low Perceived Need. Multivariate analyses revealed significant group differences on only two barrier factors: Pleasure/Intimacy and Low Perceived Need. Low Perceived Need accounted for 13.5% of the variance in condom use. Women with low perceived need to use condoms were more likely to use oral contraceptives.

Adolescent↗
PubMedDate not supplied

Conflicting advice? Australian adolescents' use of condoms or the pill.

CONTEXT: Teenagers are exposed to two potentially conflicting sexual health messages, one emphasizing the prevention of sexually transmitted diseases (STDs) and the other stressing pregnancy prevention. To protect teenagers from both STDs and unwanted pregnancy, it is important to know what method choices they make and why. METHODS: Data from a 1997 national survey of 3,550 Australian secondary school students were used to examine teenagers' method choice and patterns of advice-seeking about contraception and STD prevention. Logistic regression analyses were conducted to identify factors associated with the exclusive use of condoms or the pill. RESULTS: Virtually all 961 currently sexually active students were using at least one contraceptive method--primarily condoms (78%) or the pill (45%). Some 31% were using condoms exclusively, and 10% were using the pill exclusively. Older students and those who had sought contraceptive advice had elevated odds of using the pill rather than condoms exclusively (odds ratios, 4.4 and 2.6, respectively), while those who had had only casual partners in the last year had a reduced likelihood of exclusive pill rather than condom use (0.1). Furthermore, the more students believed that their peers used condoms, the less likely they were to report exclusive pill use (0.4). Parents were the most frequent source of advice about contraception, followed by physicians and teachers. The most common sources of advice about HIV and other STDs were parents, teachers and then physicians. CONCLUSIONS: Young people must be educated about the distinction between safer sex and contraception, and about how to prevent both STDs and pregnancy. Providing parents with current sexual health information may help to improve young people's sexual health.

Adolescent↗