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PubMed2003

The relationship between condom use, sexually transmitted diseases, and location of commercial sex transaction among male Hong Kong clients.

OBJECTIVE: This study investigated the consistency of condom use and the prevalence of self-reported sexually transmitted diseases (STD) among male Hong Kong commercial sex clients with respect to the geographical location of these transactions. DESIGN AND METHODS: Male clients were identified via three independent, population-based surveys conducted in 1998, 1999, and 2001. A unique confidential telephone system was used to collect sensitive information. RESULTS: Respondents patronizing female sex workers (FSW) in 'mainland China only' or in 'mainland China and other places' were more likely to be inconsistent condom users (28 and 34%) than those patronizing FSW in 'Hong Kong only' (9.1%). A similar pattern was found for self-reported STD in the past 6 months (10.1, 8.1 and 1.0%, respectively). Patronizing FSW in mainland China was associated with a higher prevalence of self-reported STD (adjusted OR 4.16), independent of consistent condom use and other potential confounding factors, including calendar year of survey, age, educational attainment, HIV-related knowledge, perceived efficacy of condom use for HIV/AIDS prevention, number of female sex partners, and the presence of a regular female sex partner in the past 6 months. Clients who had commercial sex both in mainland China and Hong Kong were more likely to use condoms in Hong Kong than in mainland China (paired OR 4.67, < 0.05). CONCLUSION: The geographical location of commercial sexual activity is related to the consistency of condom use, irrespective of the clients engaged in such activity. Prevention programmes need to be aware of how risk behaviour is dependent on local contexts.

Adolescent↗

PubMed2004

Long-term effects of condom promotion programmes for vaginal and oral sex on sexually transmitted infections among sex workers in Singapore.

OBJECTIVES: To evaluate the long-term impact of condom promotion programmes for vaginal and oral sex among female brothel-based sex workers in Singapore. DESIGN: A pre-test/post-test comparison group followed by a time series design was used to compare trends in condom use for vaginal sex and cervical gonorrhoea incidence from 1990 to 2002 across cross-sectional samples of sex workers before and after programme implementation in 1995. The subsequent condom promotion programme for oral sex was evaluated using the interrupted time series with a retrospective pre-test to post-test matched control group design. METHODS: Sex workers completed a questionnaire before and 6 months after participation in educational sessions. Cervical and pharyngeal swabs were taken monthly for cultures for Neisseria gonorrhoeae. RESULTS: Consistent condom use for vaginal sex increased significantly from < 45.0% before 1995 (pre-intervention period) to 95.1% in 2002, with a corresponding decline in cervical gonorrhoea incidence from > 30 to 2/1000 person-months. Adjustment for temporal changes in sociodemographic characteristics did not materially alter the trends. Consistent oral condom use increased significantly from < 50% before 1996 to 97.2% in 2002, with a corresponding decline in pharyngeal gonorrhoea from > 12 to 4.7/1000 person-months. CONCLUSION: The interventions produced sustained high levels of condom use for vaginal and oral sex with corresponding declines in cervical and pharyngeal gonorrhoea incidence.

Adult↗

PubMed2002

Alcohol and condom use: a meta-analysis of event-level studies.

BACKGROUND: Although it is often assumed that drinking alcohol interferes with condom use, studies on this topic have used several different methods and have yielded inconsistent findings. By examining drinking and condom use in specific sexual encounters, the role of alcohol in influencing unprotected intercourse is targeted. GOAL: The goal of the study was to assess the relationship of alcohol use and condom use in discrete sexual encounters using meta-analysis. STUDY DESIGN: Studies in the literature were identified by computerized searches of MEDLINE and PsycINFO and hand searches of reference lists. Summary odds ratios were calculated for all analyses and for subgroups formed according to type of sexual encounter (first, most recent, most recent with a new sexual partner). RESULTS: The association of alcohol use and condom use varied by type of sexual encounter: drinking at first intercourse was associated with decreased condom use (odds ratio [OR], 0.54; 95% CI, 0.44-0.66), but drinking was unrelated to condom use in recent sexual encounters (OR, 1.04; 95% CI, 0.89-1.21) and in recent encounters with new partners (OR, 1.1; 95% CI, 0.92-1.32). CONCLUSION: Drinking is not necessarily linked to unprotected intercourse; the relationship between alcohol use and unprotected sex depends on context and sexual experience of the partners.

Adolescent↗

PubMed2005

Factors associated with condom use among youth aged 15-24 years in Brazil in 2003.

OBJECTIVE: To analyse factors associated with the lack of condom use among young people at last sexual intercourse with a steady or casual partner. DESIGN: A cross-sectional study involving 1170 household interviews and designed to build a representative sample of the population of young Brazilian residents aged 15-24 years (2003). METHODS: In the multivariate analysis of data, non-conditional logistic regression modelling was applied to assess the determinants of condom use at last sexual intercourse among young people with steady or casual partners. RESULTS: The overall level of condom use at last sexual intercourse was high (60%), although it was significantly more common in casual sexual partnership. Cohabitation was associated with a lack of condom use in both casual and steady partner encounters. In addition, being female, having less schooling, having no work history, and per capita family income above the minimum wage were factors related to not using condoms in the group of young people who had their last sexual encounter with steady partners. Among young people with casual partners, such factors included a positive history of alcohol use, first sex at 9-16 years of age, inadequate knowledge of AIDS treatability and bereavement related to violence. CONCLUSION: This study confirmed that the determinants of condom use among youth during last sexual intercourse vary according to whether the partner was casual or steady. Prevention campaigns should develop specific messages for each of these contexts.

Adolescent↗

PubMed2004

The sociocultural context of condom use within marriage in rural Lebanon.

Prevalence rates for condom use are low across the Middle East despite limited alternate contraceptive options and growing awareness of sexually transmitted diseases (STDs) and HIV/AIDS. Virtually no research exists to explain this situation and to guide policy development or effective interventions. An analysis of 25 focus-group discussions with married women and men, interviews with service providers, and a survey of 589 women of childbearing age in a rural district of southern Lebanon reveal that a broad and complex set of sociocultural factors influence condom use. In the study area, 7 percent of married women currently use condoms, 24 percent reported ever use, and inconsistent use is common. Condoms are preferred primarily for their lack of physiological side effects. Five factors were found to impede method adoption and sustained use. These include various encumbering beliefs, reduced sexual pleasure, adverse experiences, gender-related fears and tensions, and a residual social stigma attached to condoms. Several strategies are suggested to increase and improve condom use. These issues will assume greater importance as fertility declines further in the region, demand for contraception continues to increase, and STDs and HIV/AIDS become more deeply rooted, as has occurred in other parts of the world.

Adolescent↗

PubMedDate not supplied

Racial differences in parenting dimensions and adolescent condom use at sexual debut.

OBJECTIVES: Parenting style may be a determinant in reducing adolescent risk behavior. Previous studies have relied on a typological parenting approach, with classification into four groups: authoritative, authoritarian, permissive, and neglectful. In this study, two distinct parenting dimensions, demandingness and responsiveness, were examined as independent predictors of adolescent condom use. DESIGN AND SAMPLE: This study used a subsample of the National Longitudinal Study of Adolescent Health (Add Health) that included 153 adolescent-mother pairs. MEASUREMENT: Maternal demandingness and responsiveness were measured using Wave I mother interviews. Logistic regression analyses were used to predict adolescent condom use at sexual debut at Wave II and to assess moderation by gender and race. RESULTS: (1) Maternal demandingness predicted increased likelihood of condom use in African American adolescents but decreased likelihood of condom use in White adolescents; (2) maternal responsiveness did not predict condom use; and (3) gender moderation was not present. CONCLUSIONS: To provide appropriate family counseling, public health nurses need to consider racial differences in contraceptive practices. Education regarding parental supervision practices should be considered as part of nursing interventions intended to increase condom use in African American adolescents.

Adolescent↗

PubMed1997

Condom use in a group of aboriginal women.

This exploratory study investigated the attitudes of Aboriginal women in Darwin to the use of condoms to prevent HIV and other sexually transmitted diseases. An Aboriginal research assistant interviewed twelve women regarding their usage of and attitudes to the male condom and their attitude to the possibility of using a female condom. These women, like their ethnic minority counterparts in Africa and North America, had a fair level of knowledge about HIV, a low level of perceived risk of HIV and other sexually transmitted diseases, infrequent usage of male condoms with their partner, and negative attitudes to the male condom. Their attitude to the female condom was more positive. Educational programs and further research into the attitudes of women in remote communities are recommended.

Adult↗

PubMedDate not supplied

HIV prevention in single, urban women: condom-use readiness.

OBJECTIVE: To understand women's readiness to use condoms and their perceived pros and cons for condom use. DESIGN: Comparative, descriptive design guided by the Transtheoretical Model. SETTING: Data were collected at two urban primary health care centers in western New York. PARTICIPANTS: 364 single urban women with steady (main) or other (casual, concurrent, multiple, new) sexual partners. Most participants were young (mean age of 27 years), economically disadvantaged women of color. MAIN OUTCOME MEASURES: Each participant completed an anonymous questionnaire that included items for the stage of change algorithm, decisional balance of the pros and cons of condom use, sexual history, and HIV risk information. RESULTS: Most women were in the early stages of change (not intending to use condoms), but those with other partners were further along in the stages of change for condom use than those with steady partners. The pros or advantages of condom use differed for these women depending on partner type. The change in the balance between the pros and cons occurred as theoretically predicted for women with steady and other partners. CONCLUSION: Effectiveness of HIV prevention interventions for women may be enhanced if they are tailored to both readiness to change and partner type.

Adolescent↗

PubMed2006

Moderating effects of gender on alcohol use: implications for condom use at first intercourse.

This study examined whether the effects of level of alcohol consumption on condom use at first sex depend on adolescents' gender, utilizing data from Wave I of the National Longitudinal Study of Adolescent Health (Add Health). Compared to girls who did not consume any alcohol, inebriated girls were significantly less likely to use a condom at first intercourse (odds ratio = 0.41, p <or= .001). There was no difference for girls with some alcohol use or for boys, regardless of alcohol use level. Other sociodemographic variables negatively associated with condom use were having a young age at first sex, being Asian American, and living in a stepfamily with one's biological father; mother's education was positively associated with condom use. Adjusted predicted probabilities showed that girls who had first sex younger than 14 years and who were inebriated had the lowest probability of using a condom (p = .384). The results support the hypothesis that alcohol use during sex has a negative effect on condom use at first sex, moderated by gender. Adolescent reproductive health programs that also include alcohol education may prove useful.

Adolescent↗

PubMed2026

Long-acting reversible contraception, condom use and sexually transmitted infections in developing countries: a multi-country serial cross-sectional analysis using demographic and health surveys.

INTRODUCTION: Unintended pregnancy and sexually transmitted infections (STIs) are major public health issues in developing countries. While long-acting reversible contraception (LARC) effectively prevents unintended pregnancy, there is limited evidence from large multinational studies on its association with condom use and STI-related outcomes. This study aimed to investigate the association between LARC use, condom use and STIs among women in developing countries. METHODS: This serial cross-sectional study extracted data from Demographic and Health Surveys (DHS), a series of nationally representative household surveys conducted in developing countries. The analysis included women aged 15 to 49 years, with data on contraceptive methods and demographics. Generalised linear mixed effect models (GLMMs) were used to estimate adjusted prevalence ratios (aPRs) for condom use and self-reported STI-related outcomes, comparing LARC users with both non-LARC users and oral contraceptive users. Subgroup analyses were conducted at the individual level and at the country level. RESULTS: Data from 2 171 884 women across 31 countries were analysed. Overall, the prevalence of self-reported STI-related outcomes was 7.4%, 3.9% of participants used LARC, and 7.5% of participants reported consistent condom use. LARC users were significantly less likely to use condoms compared with non-LARC users (aPR=0.40, 95% CI 0.30 to 0.53) and compared with oral contraceptive users (aPR=0.61, 95% CI 0.48 to 0.78). LARC use was associated with a higher prevalence of STI-related outcomes compared with non-LARC users (aPR=1.19, 95% CI 1.10 to 1.28) and compared with oral contraceptives users (aPR=1.14, 95% CI 1.05 to 1.24). Associations were stronger in low-Human Development Index (HDI) countries, especially among younger women (15-19 years), but were not significant in high-HDI countries. Country-level heterogeneity was observed. CONCLUSIONS: LARC use is associated with reduced condom use and higher self-reported STI prevalence, particularly among younger women and in lower HDI developing countries. These findings support integrating STI prevention into LARC services and promoting dual-method use to prevent both unintended pregnancies and STIs.

Humans↗

PubMed2004

Determinants of inconsistent condom use with female sex workers among men attending the STD clinic in Singapore.

BACKGROUND/OBJECTIVES: Female sex workers and their male clients have been identified as risk groups for the transmission of STDs and HIV. Behavioural interventions targeting clients need to address inconsistent condom use among them. The aim of the study is to assess the sociodemographic, behavioural, and psychological factors associated with inconsistent condom use among clients of sex workers. METHODS: 229 male patients attending the STD clinic in Singapore who reported paying for sex in the previous 6 months were interviewed. Response rate was 91%. RESULTS: Overall, 45% used condoms inconsistently; these clients were more likely to have poor STD knowledge, visit sex workers five or more times in the past 6 months, have lower self efficacy, less favourable social norms for condom use, and more likely to forget condom use when intoxicated (alcohol impaired decision making). CONCLUSIONS: Behavioural interventions for clients need to improve STD/HIV transmission knowledge and focus on improving client's self efficacy in using condoms.

Adolescent↗

PubMed2005

Results of a randomised trial of male condom promotion among Madagascar sex workers.

OBJECTIVES: To test the effect of supplementing peer promotion of male condom use with clinic based counselling, measured in terms of STI prevalence and reported male condom use. METHODS: 1000 female sex workers in Madagascar were randomised to two study arms: peer education supplemented by individual risk reduction counselling by a clinician (peer + clinic) versus condom promotion by peer educators only (peer only). STI testing was conducted at baseline and 6 months. Behavioural interviews were administered at baseline, 2, 4, and 6 months. RESULTS: At baseline, women in the peer only arm had prevalences of 16.0%, 23.6%, and 12.1% for chlamydia, gonorrhoea, and trichomoniasis respectively, with an aggregate prevalence of 38.2%. Baseline STI prevalences for the peer + clinic arm were slightly lower and 34.1% in aggregate. At 6 months, aggregate STI prevalence increased in the peer only arm to 41.4%, whereas the aggregate prevalence diminished slightly to 32.1% in the peer + clinic arm. In logistic regression analyses, the estimated odds ratios (ORs) for chlamydia, gonorrhoea, trichomoniasis, and aggregate STI were 0.7 (95% confidence interval 0.4 to 1.0), 0.7 (0.5 to 1.0), 0.8 (0.6 to 1.2), and 0.7 (0.5 to 0.9) respectively, comparing the peer + clinic arm with the peer only arm. The logistic regression OR for reported condom use with clients in the past 30 days increased from 1.1 at 2 months to 1.8 at 6 months, comparing the peer + clinic arm with the peer only arm, and was 1.4 overall (1.1 to 1.8). Adjustment for baseline factors changed the regression results little. CONCLUSIONS: The impact of male condom promotion on behaviour can be heightened through more concentrated counselling on risk reduction. Persistently high STI prevalence despite increases in reported condom use by sex workers supports the need for multidimensional control programmes.

Chlamydia Infections↗

PubMed1989

Condom use by heterosexuals attending a department of GUM: attitudes and behaviour in the light of HIV infection.

The use of condoms to prevent the further spread of human immunodeficiency virus (HIV) infection is one of the main themes of the government's health education campaign against AIDS. A study of the use of and attitudes towards condoms in 222 heterosexual men and women attending a department of genitourinary medicine (GUM) in central London showed that 55% (50/91) to 59% (41/70) of men or women never, and 6% (6/95) to 15% (14/91) always, used condoms with their regular or non-regular sexual partners. No major differences were found in the use of or attitudes to condoms according to age, sex, social class, or civil status. Attitudes towards the use of condoms were generally negative. These attitudes, in combination with the infrequent use of condoms with regular (and even more with non-regular) sexual partners, must be a cause for concern if the further spread of HIV is to be avoided.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Decreasing STD incidence and increasing condom use among Chinese sex workers following a short term intervention: a prospective cohort study.

OBJECTIVE: To describe the impact of a repeating behavioural intervention focused on preventive education and provision of STD testing and treatment services to female sex workers. METHODS: A prospective cohort study of 966 sex workers (first of its kind in China) was conducted in Guangzhou from March 1998 to October 1999. At each visit information was collected on sexual behaviour, condom use and knowledge about HIV transmission and condom use, education was given, STD were diagnosed, and treatment was provided free of charge. We evaluated trends in condom use, knowledge about HIV transmission and condom use, and STD incidences. Generalised estimating equations were applied to control for repeated measurements. RESULTS: The proportion of consistent condom use increased from the intake through the third follow up visit (from 30% to 81%), as well as the proportion of having good knowledge on HIV transmission (4.3% to 98.6%) and condom use (23.6% to 79.3%). The incidence of gonorrhoea, trichomoniasis, and chlamydia decreased over each follow up visit; from 17.5/100 person years (PY), 22.4/100PY, 65.9/100PY at the first follow up visit to 5.1/100PY, 3.0/100PY, 16.1/100PY at the third follow up visit, for each STD respectively. CONCLUSIONS: STD care and prevention programmes targeting sex workers are feasible in China and, more importantly, intervention consisting of prevention education and STD care is likely to reduce unprotected sexual behaviour and STD incidence in this group at high risk for HIV and other STD infection.

Adult↗

PubMed2004

"Here's what I'd do...": condom promotion strategies proposed by high-risk women in Anchorage, Alaska.

Women drug users are at significant risk of sexually transmitted HIV; however, interventions aimed at increasing condom use by this population have been relatively ineffective. The authors conducted a series of focus groups with 17 current and former drug-using women to identify (a) reasons for using versus not using condoms, (b) intervention strategies they believed would be most effective at increasing condom use, and (c) previous ineffective intervention strategies. Risk of HIV, sexually transmitted diseases, and pregnancy was the main reason given for using condoms. Many factors were identified that limited condom use, including lack of availability, substance use, and cost. Participants enthusiastically endorsed condom availability and AIDS awareness interventions, and suggested that no intervention was a waste of money. The authors discuss the limitations of the suggested interventions and recommend additional research to evaluate the efficacy of these strategies.

Adult↗

PubMed2000

The impact of a culturally appropriate STD/AIDS education intervention on black male adolescents' sexual and condom use behavior.

A culturally appropriate, theoretically based videotape was developed to promote condom use among African American males, ages 15 to 19, attending a municipal sexually transmitted disease (STD) clinic. The videotape's impacts were compared to those achieved by an African American health educator who delivered the same messages during a face-to-face session and by standard care. Data were obtained on participants' (N = 562) condom use knowledge, self-efficacy, and intentions; sexual and condom use behaviors; and perceived risk of infection. At posttest, "videotape" and "health educator" participants demonstrated greater condom use knowledge; "health educator" participants indicated greater self-efficacy and stronger condom use intentions with steady partners. At 6 months, participants in all conditions reported more partners and acts of vaginal intercourse (past month); however, they were more likely to report consistent condom use with steady partners (18% vs. 53%) and casual partners (26% vs. 50%). Perceived risk of infection was lower at the posttest and declined during the study period.

Acquired Immunodeficiency Syndrome↗

PubMed2002

The impact of the work environment on condom use among female bar workers in the Philippines.

The purpose of this research is to examine how condom use is affected by specific aspects of the work environment: (1) social-structural and environmental influences and constraints, (2) mandatory condom use policy, and (3) the level of social influence and reinforcement between manager and employee. A total of 1,340 bar workers and 308 nonestablishment freelance workers comprise the study group. In establishments where a condom use policy exists, female bar workers were 2.6 times more likely to consistently use condoms during sexual intercourse compared with establishments that do not have such a policy in place. The results suggest a need for the development of comprehensive educational policies in all entertainment establishments, including regular meetings with employees, reinforcing attendance at the Social Hygiene Clinic, promoting AIDS awareness, making condoms available in the workplace, and mandating 100% condom use behavior among all employees.

Adolescent↗

PubMed1992

Condom use due to the risk of AIDS. Trends in the general population of Sweden.

This study examines the use of condoms due to the risk of AIDS in the general population of Sweden during 1986-1989. The study is based on annual mail surveys (1986-1989) of random population samples aged 16-44 years - 4000 individuals in each sample. The response rate was 71%. The study indicates that the use of condoms increased significantly during the first years of the study period, particularly among 18-24-year-olds. Roughly the same tendency was observed regarding the perception of personal risk related to HIV infection. In 1988 a positive connection was established between condom use and personal risk perception. Between 1988 and 1989 (as the public interest in the AIDS issue declined) no further increase in condom use was observed but rather a tendency of reversal towards previous levels. Having several sexual partners was not significantly associated with a more frequent use of condoms, nor was the occurrence of casual sexual contacts. In most of the casual sexual contacts reported condoms were not used.

Acquired Immunodeficiency Syndrome↗