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PubMedDate not supplied

Longitudinal changes in stages of change for condom use in women.

PURPOSE: This study identifies how women naturally progress through the Transtheoretical Model stages of condom use over a 1 year period, using the longitudinal dynamic methodology of latent transition analysis (LTA). DESIGN: As part of a larger study of human immunodeficiency virus risk in women, participants were assessed for their stage of condom use two times, 1 year apart. SUBJECTS: A total of 491 women who completed both assessments of the study were included in this analysis. MEASURES: Stage of condom use was assessed using two questions, which placed women into one of five stages of change for condom use (alpha = .90). RESULTS: Latent transition analysis identified the best-fitting model of naturalistic stage progression, which included both forward and backward movement. Precontemplation and maintenance were found to be the most stable stages (more than 50% of the participants remaining in that stage 1 year later), and the action stage was the least stable (15% remaining in this stage). Transition probabilities for all stages showed a high rate of relapse in the sample. CONCLUSIONS: A high proportion of women will remain within their stage of condom use over a 1-year period if no intervention is introduced. Interventions that are aimed at increasing condom use in women need to incorporate relapse prevention. In addition, the transition probabilities for the stages will help establish reasonable rates of change for intervention programs.

Adult↗
PubMed1999

Male polyurethane condoms do not enhance brief HIV-STD risk reduction interventions for heterosexually active men: results from a randomized test of concept.

The current study examined the effects of a brief HIV risk reduction intervention for men. Participants were recruited (n = 108) from an urban public health clinic and randomly assigned to one of 3 experimental intervention conditions: (1) 3 h HIV-STD risk reduction behavioural skills building latex condom intervention; (2) the same 3 h skills workshop but focused on male polyurethane condoms; or (3) a 3 h HIV education workshop. Results showed all 3 interventions increased AIDS knowledge and positively influenced attitudes, but men who received the polyurethane condom skills intervention were more likely to request condoms at follow ups. In addition, men who received either of the 2 skills interventions evidenced increased condom use at the one-month follow up, with no differences at 3-month follow up. This study is among the first to test a brief HIV risk reduction intervention for men and is the first to test whether polyurethane male condoms enhance HIV risk reduction efforts.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The female condom.

BACKGROUND: The female condom has been available in numerous countries for some years. It was launched in Australia on March 8th, 2000 and is an important addition to the range of barrier contraceptives. OBJECTIVE: This article aims to provide an overview of the female condom to enable GPs and nurse practitioners to advise clients and provide information about its use. DISCUSSION: The female condom is an effective form of contraception. When used correctly it has a failure rate of about 5%, which compares favourably with other forms of barrier contraception. It is important that users are instructed on insertion, in particular the need to guide the penis into the condom. Evidence shows that it reduces the incidence of sexually transmitted infections. There may also be additional benefit in reducing wart virus and herpes transmission, as there is greater protection to the vulva and the base of the penis, when compared with the male condom. The female condom has high user acceptability, and offers advantages in terms of sensitivity and also ease of use by men with erectile dysfunction. It is the only barrier protection under a woman's control, giving protection to the vagina and vulva as well as the cervix.

Australia↗
PubMed2001

Reproductive and contraceptive attitudes as predictors of condom use among women in an HIV prevention intervention.

This study prospectively evaluates the effect of childbearing motivation and contraceptive attitudes on consistency of condom use among at-risk women enrolled in an HIV prevention intervention. Women (age 15-40, 85% African-American) were recruited from homeless shelters, drug treatment facilities, and public housing developments and assigned to standard or enhanced intervention conditions. Among the eligible study group of nonsterilized women with a main partner (n = 312), 24.4% wanted to have a baby at baseline; 43.5% believed their partner wanted them to have a baby. Women who reported a desire for a baby, compared to all others, were less likely to be at a higher level of condom consistency six months later (OR = 0.66; .48-.90). Women who perceived partner support for contraceptive use showed a higher level of condom consistency (OR = 1.20; 1.03-1.41) at 6-month follow-up. Many women in this study wanted to have a baby and this desire interfered with subsequent consistency of condom use. We also found that condom use increased toward consistency of use among women whose partner supported contraceptive use. HIV prevention interventions should include screening for reproductive motivation, so that prevention messages can be tailored to the realities of women's lives. Women who want a baby can be educated about disease prevention in the context of pregnancy planning and linked with appropriate services. Women who want to avoid childbearing can be given messages that emphasize the contraceptive benefits of condom use and that help strengthen partner support.

Adolescent↗
PubMedDate not supplied

The trade-off between hormonal contraceptives and condoms among adolescents.

CONTEXT: Adolescents' dual use of condoms and hormonal contraceptives is low, and the motivations underlying their decisions to combine contraceptives are not understood. METHODS: To examine how pregnancy concerns, sexually transmitted disease (STD) concerns and type of sexual partner influence contraceptive use, we recruited 436 sexually experienced adolescents from two clinics. In structured interviews, we asked adolescents to describe their recent partners, their method use, and their pregnancy and STD concerns. Data were analyzed using logistic regression. RESULTS: The odds that adolescents used condoms with main partners were significantly lower among those who used hormonal contraceptives than among nonusers of these methods (odds ratios, 0.4 for young women and 0.3 for young men). With casual partners, no association existed between adolescents' condom and hormonal contraceptive use. Concerns about pregnancy and STDs influenced this association for women with main partners. Among young women who perceived pregnancy as more negative, hormonal contraceptive users had reduced odds of using condoms (0.1). No association existed between use of the two methods among young women whose view of pregnancy was less negative. Young women who perceived themselves to be less at risk of acquiring an STD had reduced odds of using condoms if they were using hormonal contraceptives (0.2). Among young women who perceived themselves to be more at risk of acquiring an STD, no association existed. CONCLUSIONS: Adolescents trade off between hormonal contraceptives and condoms according to partner type and perceived risks. Adolescents' dual-method use may improve if providers tailor counseling to adolescents' perceived risk of STDs and pregnancy, and if they address prevention of both as a related decision.

Adolescent↗
PubMedDate not supplied

Factors associated with maintenance of regular condom use among single heterosexual adults: a longitudinal study.

OBJECTIVE: The aims of this study were to describe behavioural and psychosocial characteristics of single heterosexuals towards regular condom use, and to identify factors associated with the maintenance of this behaviour over time. METHOD: A cohort of 179 single heterosexual adults (83 men and 96 women, mean age: 32 years) was followed over a period of 2 years. The data were collected, by phone interviews, at baseline and 1 and 2 years later. The phone numbers were generated using a random digit strategy. RESULTS: The following changes were observed: over time fewer people were sexually active, but those who were, reported more often having had more than one sexual partner. No significant change was observed regarding condom use. The psychosocial variables remained stable during the study period. To have a favourable intention was the main factor associated with maintenance of condom use. Having had a STD, personal normative beliefs and positive attitude were also associated with regular condom use. DISCUSSION: Promotion strategies should highlight the importance of acting as a responsible person, reinforce the advantages of using condoms, and select strategies that favour the implementation of intention of using condoms.

Adolescent↗
PubMed1992

Teenagers seeking condoms at family planning services. Part II. A provider's perspective.

This study assessed the ability and preparedness of staff at family planning clinics in Durban to assist in AIDS prevention by promoting condom use among teenagers. Staff at 12 randomly selected clinics were interviewed to assess their attitudes towards teenagers seeking condoms, the information imparted on AIDS and condom use, constraints faced in delivering services, and their perceived role in controlling the spread of AIDS. Despite their awareness of AIDS, those interviewed perceived their role to be that of promoting contraception. Condoms were perceived as a poor choice of contraceptive and their use was discouraged. The pamphlets dispensed along with condoms were thought to provide adequate information about condom use. Information on AIDS was given only if the clinic attender initiated discussion on the subject. Most of the clinic staff were keen to discuss other issues during their consultations, but felt constrained by the large numbers of people they had to attend to and the lack of adequate facilities. If family planning services are to play a role in controlling the spread of AIDS, the first step must be to make this function part of the overall policy. For there to be effective counselling on AIDS prevention, in-service training of current staff is required, as well as more staff and improvements in facilities to ensure greater privacy.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Adolescents' self-efficacy to communicate about sex: its role in condom attitudes, commitment, and use.

This study examined whether and how self-efficacy to communicate with parents and peers about sex relate to sexually experienced adolescent males' and females' (N= 144, 112) condom attitudes, intentions, and use. Results showed that males who reported greater self-efficacy to communicate with parents used condoms more frequently; and both males and females who can communicate with peers used condoms more frequently. Self-efficacy to communicate with peers was related to more positive condom attitudes, which in turn were associated with greater condom commitment and use. Greater ability to communicate with parents was also related to greater condom commitment and use among males. These results suggest the importance of designing interventions that give adolescents the skills they need to feel efficacious in their ability to communicate about sex and contraception.

Adolescent↗
PubMed2005

Knowledge of sexually transmitted diseases and condom use among female street sex workers in Padua.

OBJECTIVES: The aim of the present study was to investigate knowledge of sexually transmitted diseases (STDs) and condom use in a population of young female street sex workers from eastern Europe and other non-EU countries based in the Padua area (north-eastern Italy). To assess whether any aspects of their behavior might foster the spread of STDs. STUDY DESIGN: Street sex workers (prostitutes) were approached on the streets or during non-STD medical appointments, their knowledge of STDs and condom use were evaluated. They were asked to answer an anonymous questionnaire comprising 16 questions. RESULTS: 98 of them cooperated. Over one third of the sample frequently did not use a condom. This finding was inversely correlated with their age and educational level. Almost all the street sex workers were aware of AIDS but far less of other STDs. Most were almost totally unacquainted with some of them. We found a statistically significant correlation between condom use and their age, and between condom use and educational level. CONCLUSIONS: Sex workers often engaged in unprotected intercourse with clients, they practiced their profession even in the presence of STD-related symptoms and did not use a condom during intercourse with non-paying partners or pimps. The irresponsible behavior of some Italian paying partners prepared to pay extra for unprotected sex, increases the risk of acquiring STDs. The intercourse with female street sex workers can be considered a risk behavior for contracting STDs.

Adolescent↗
PubMed2005

Assessment of condom use in men and women.

Self-reported condom use is a key variable in surveys of sexual behavior and in studies evaluating interventions to reduce the risk of sexually transmitted infections. This article provides a review of how male condom use has been assessed in research. We critically review a number of methodological issues, including the length of the recall period, terminology, specification of partner variables, validity and reliability of condom use, and use of newer data collection methods such as daily diaries and computer-assisted and online technologies. Assessment of condom use errors and problems, and the role of women in condom use are discussed. Finally, we offer recommendations for improving assessment of condom use in future research.

Arousal↗
PubMedDate not supplied

Perceptions and practices relating to condom use among urban men in Haiti.

This report is based on a survey conducted in 1986-87 of sexually active adult male residents in a low-income community of Port-au-Prince, Haiti. The objectives were to investigate knowledge of and attitudes toward condoms; to evaluate the effectiveness of the existing condom distribution program; and to obtain information that can be used in the design of strategies to increase condom acceptance and use among men throughout Haiti. A final sample of 706 sexually active adult male residents in stable unions, including a specially drawn sample of male partners of condom acceptors, were interviewed in their homes. Although condoms are almost universally known, they are rarely used. The majority felt that the responsibility for family planning should be borne by the woman. Whereas condoms may be of limited popularity for family planning purposes in Haiti, it should be determined whether they might be more acceptable as an effective means of controlling the spread of AIDS and other STDs.

Adolescent↗
PubMedDate not supplied

Applying the theory of reasoned action to AIDS risk behavior: condom use among black women.

This study tested hypotheses regarding attitudinal and normative influences on intentions to use condoms, a practice that would reduce women's risk of sexually transmitted HIV infection. Participants were 103 sexually active unmarried black women undergraduates at an inner-city commuter university, in an area with a high rate of reported AIDS cases among women. Consistent with the theory of reasoned action, multiple regression analysis on women's anonymous responses to a mailed survey revealed that those who registered more favorable attitudes toward condoms and those who perceived subjective norms more supportive of condom use reported firmer intentions to use condoms in the next three months. Key behavioral beliefs related to attitudes centered on the adverse effects of condom use on sexual enjoyment. Key normative influences were respondents' sexual partners and mothers. However, women's own attitudes were a stronger determinant of intentions to use condoms than were their perceptions of normative influences, particularly among women with above-average AIDS knowledge. The results suggest that the theory of reasoned action provides a potentially useful conceptual framework for interventions to change a key AIDS risk behavior among women.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[The prevention of sexually transmitted diseases and AIDS by the use of the condom].

This paper deals with the last literature and examines the most relevant studies of recent years related to condom effectiveness in preventing sexually transmitted diseases (STD), with experimental, epidemiological and seroconversion models. On the basis of these studies, it can be stated that the efficacy of condoms is close to 100 per cent when used correctly and consistently. Condom breakage has been reported in 0.5 per cent of vaginal intercourse and 3.6 to 10 per cent of anal intercourse. Most studies refer low failure rates due to manufacturing defects. Considering all constraints involved in masculine condom use and their implications for women, a female condom has been developed recently. It is not enough to give information or to make condoms available, if all the elements involved in the enhancement or failure of its use are not considered. Sexual education programs are the fundamental strategy in preventing STD and pregnancy.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[How well do condoms protect against HIV infection?].

A review of the literature shows that condoms offer good protection against HIV infection and other sexually transmitted diseases. A series of in vitro experiments demonstrate that quality condoms made of latex are impermeable to HIV. In addition, more than 30 in vivo studies confirm that condoms are highly effective in preventing the transmission of HIV. Condom breakage or slippage is relatively uncommon (1-5%). Most condom failure probably results from incorrect or inconsistent usage. Failures may be minimized by increasing experience, choice of quality condoms and by strictly following instructions for use.

Condoms↗
PubMed1997

Contraceptive practices before and after an intervention promoting condom use to prevent HIV infection and other sexually transmitted diseases among women--selected U.S. sites, 1993-1995.

Because heterosexual contact is the most common mode of human immunodeficiency virus (HIV) transmission among women, development of effective strategies to reduce sexually transmitted HIV infection is critical. In addition, because most women at risk for HIV infection are reproductive aged (14-44 years), effective use of contraceptives is important to prevent unintended pregnancies. Latex condoms used by males, when used consistently and correctly, are highly effective at reducing the risk for HIV infection and other sexually transmitted diseases (STDs); however, hormonal contraceptive methods or surgical sterilization are more effective for preventing pregnancy. One possible effect of encouraging women to use condoms for HIV/STD prevention with their male partners is that women may discontinue use of hormonal contraceptive methods. To assess whether encouraging women to use condoms for HIV/STD prevention affects their contraceptive practices, CDC analyzed longitudinal data on contraceptive methods and condom use for HIV/STD prevention that were collected as part of a randomized trial evaluating HIV-counseling methods during August 1993-June 1995. This report summarizes the findings of the analysis, which indicate that, among reproductive-aged women who were encouraged to use condoms for HIV/STD prevention, consistent condom use for HIV/STD prevention increased among women using each contraceptive method studied. In addition, most women using hormonal contraceptive methods continued to use them after the intervention, and the overall proportion of women protected against pregnancy increased.

Adolescent↗
PubMed1998

Psychosocial risk and protective factors for condom use among female injection drug users.

The authors examined the influences of domains of psychosocial risk and protective factors on male-partner condom use in a cobort of 209 female HIV-positive (HIV+) and HIV-negative (HIV-) injection drug users (IDUs) by use of a cross-sectional, retrospective design. Information collected from a structured questionnaire included data on psychosocial risk and protective factors in the personality, family, and peer domains; HIV status; and condom use. Among HIV+ IDUs, personality risk factors (e.g., unconventionality), family (e.g., low maternal identification), and peer factors were related to less male-partner condom use. Resources and condom availability were associated with greater male condom use with both HIV+ and HIV- IDUs. The psychosocial domains affected male condom use with both HIV+ and HIV- female IDU patients via two different mediational models. The findings suggest the need to use specific psychosocial interventions for risky sexual behavior among HIV+ and HIV- female IDUs.

Adolescent↗
PubMed1998

Should condom use be promoted for contraception to prevent transmission of sexual transmitted diseases and AIDS? ACSF Group. French National Survey of Sexual behavior.

BACKGROUND: This study is an exploration of the relationship between the use of oral contraceptive or intrauterine device and condom use. The results should help us better understand how promoting condoms for contraception as compared to sexually transmitted disease prophylaxis might be an effective way of increasing their use in certain populations. METHODS: Women not involved in stable relationships were selected from the French National Survey on Sexual Behaviour using multi-stage probability sampling. We compared frequency of condom use at the last sexual intercourse by women who were using prescribed contraception with that by women who did not. Odds ratios (OR) were adjusted for age, duration of the relationship, education, type of partner and number of partners in the last 12 months. RESULTS: Overall, no difference was found in the frequency of condom use during the last sexual intercourse by women who were using prescribed contraception compared with women who were not. A more frequent use of condoms tended to be associated with the absence of contraception in relationships of less than three months' duration (adjusted OR: 4.5; 95% CI: 0.7-33.3) and for women of 25 to 34 years of age (adjusted OR: 2.4; 95% CI: 0.8-7.1). CONCLUSION: Many factors other than contraceptive practice influence the use of condoms. Nevertheless, our results suggest that reproductive issue should be taken into account in specific subgroups of the population when developing policies to prevent sexual transmission of HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Choosing condoms.

Condoms for men are currently the most effective of the nonprescription contraceptive methods. They are readily available, simple to use, and relatively inexpensive, and they are not associated with major adverse effects. If used both properly and consistently, condoms can significantly reduce the risk of transmission of HIV and other STDs. The protection offered by the latex condom may be increased by the concurrent use of a vaginal foam or cream containing nonoxynol 9. The practicing pharmacist should know about the variety of condoms available, be able to explain their correct use to maximize effectiveness, and compare condom use with other types of contraceptives. The practitioner should be available to answer patrons' questions and provide counseling on contraceptives and "safe sex" practices.

Choice Behavior↗