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PubMed1981

The effect of condom use on squamous cell cervical intraepithelial neoplasia.

Between January 1, 1968, and July 1, 1980, 377 of a total 412 patients with biopsy-proven cervical intraepithelial neoplasia (CIN) were seen in the private office of the authors and followed for more than 6 months after biopsy and the start of treatment. Thirty-five patients were lost to follow-up. Ninety-one were treated primarily by hysterectomy. The 286 patients in whom childbearing function was to be preserved were instructed, as soon as the diagnosis of CIN was confirmed, to use a mechanical barrier (the condom) throughout intercourse. In addition to the use of the condom, 40 of the 286 underwent surgical conization and 107 underwent cryosurgery. All of these 147 patients eventually showed cytologic and colposcopic regression of the disease. One hundred and thirty-nine patients were treated with the condom alone. One hundred and thirty-six of the 139 showed complete regression of the disease. Eighteen (6.2%) of the 286 patients had late recurrences of the disease; 12 of these experienced regression again with the resumption of the use of the condom. No patients showed progression of the disease while using the condom. All grades of CIN proved to be reversible. It is recommended that a mechanical barrier at intercourse be added to any program for conservative treatment of CIN.

Adult↗
PubMed1991

A study of the relationship between tensile testing of condoms and breakage in use.

The ability of the condom wall to maintain its integrity throughout sexual intercourse is critical to its role in halting the spread of major sexually transmissible pathogens including the human immunodeficiency virus. There are three principal in vitro performance tests applied to condoms: a test for freedom from holes, an inflation test, and tensile testing. In this study we subjected condoms that had broken in use to tensile tests in order to determine any correlation between their in vivo and in vitro performance. Condoms which had broken in use showed similar tensile properties to those which had not. All passed all tensile test criteria. Thus, the inclusion of tensile testing in National Standards for condoms is not sufficient to insure strong products.

Contraceptive Devices, Male↗
PubMed1993

A meta-analysis of condom effectiveness in reducing sexually transmitted HIV.

Before condoms can be considered as a prophylaxis for sexually transmitted human immunodeficiency virus (HIV), their efficacy must be considered. This paper reviews evidence on condom effectiveness in reducing the risk of heterosexually transmitted human HIV. A meta-analysis conducted on data from in vivo studies of HIV discordant sexual partners is used to estimate the protective effect of condoms. Although contraceptive research indicates that condoms are 87% effective in preventing pregnancy, results of HIV transmission studies indicate that condoms may reduce risk of HIV infection by approximately 69%. Thus, efficacy may be much lower than commonly assumed, although results should be viewed tentatively due to design limitations in the original studies.

Adult↗
PubMed1992

Self-efficacy, hedonistic expectancies, and condom-use intentions among inner-city black adolescent women: a social cognitive approach to AIDS risk behavior.

The effects on condom-use intentions of an acquired immune deficiency syndrome (AIDS) prevention intervention based on social cognitive theory were investigated among 19 sexually active black adolescent women recruited from an inner-city family planning clinic. The women received the social cognitive intervention designed to increase perceived self-efficacy and favorable outcome expectancies about the hedonistic consequences of using condoms or one of two control interventions: An information-alone intervention designed to increase AIDS knowledge or a general health-promotion intervention designed to provide information about important health problems other than AIDS. All interventions lasted 105 min and involved films and small-group exercises. Participants' evaluations did not differ among conditions. As hypothesized, analysis of covariance indicated that participants in the social cognitive condition reported greater intentions to use condoms than did those in the two control conditions. In addition, participants in the social cognitive condition scored higher in perceived self-efficacy and favorable hedonistic expectancies--the two hypothesized mediators of the intervention effect. Although participants who received the information-alone intervention subsequently had greater AIDS knowledge than did those in the health promotion condition, they did not express greater intentions to use condoms. These results highlight the value of a social cognitive approach to AIDS risk behavior: outcome expectancies regarding the effects of precautionary practices on sexual enjoyment and perceived self-efficacy to implement such practices play an important role in decisions about condom use.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Acceptance and use of the female condom among women with incomplete abortion in rural Tanzania.

BACKGROUND: This study describes the outcome of a postabortion care intervention aimed at introducing the female condom as a means of preventing women from having unwanted pregnancies and sexually transmitted infections (STIs)/HIV. METHODS: Postabortion contraceptive counseling and services were offered to 548 women admitted to the Kagera Regional Hospital for incomplete abortion. The counseling included information about STI/HIV and the use male or female condom. In total, 521 (95%) women accepted contraception. RESULTS: Contraceptive use was assessed 3 months after abortion among 475 (91%) women. The female condom was accepted by 201 of 521 (39%) and was used by 158 of 521 (30%). Women who had experienced an unsafe abortion, had attended secondary school or earned an income were more likely to accept the female condom. The women were generally satisfied with the method, and the majority intended to use it again. CONCLUSION: Postabortion care programs provide an excellent entry point for introducing the female condom as a contraceptive method for the prevention of both repeat unwanted pregnancies and STI/HIV infection.

Abortion, Induced↗
PubMed2006

The effects of religious affiliation on sexual initiation and condom use in Zambia.

PURPOSE: To determine whether religious affiliation reduces HIV risk among young women in Zambia, and to examine the effects of religious affiliation on sexual initiation and on condom use during first sexual experience. METHODS: Data from a representative probability sample of 5534 women aged 13-20 years was analyzed. The instrument included questions on sexual initiation, condom use during first sex, religious affiliation, and sociodemographic characteristics of respondents. Statistical tests were performed at the bivariate and multivariate levels. Cox proportional hazards and logistic regression were used at the multivariate levels. Standard errors were adjusted for the "clustering" effect found in data from multistage cluster samples. RESULTS: Affiliation with religious groups that excommunicate members for engaging in premarital sex, and that oppose condom use has both positive and negative effects on behaviors that carry the risk of HIV infection; young women affiliated with conservative groups are more likely to delay sexual initiation but less likely to use condoms during first sex. CONCLUSIONS: Denominations that are not only strongly opposed to premarital sex and condom use, but are able to exercise control over adolescents through socialization or the threat of social exclusion, are likely to create conflicting behaviors among adolescents that cancel each other in terms of HIV risk. Overall, these findings suggest that affiliation with conservative religious groups is unlikely to reduce the risk of HIV infection. Additional studies are recommended.

Adolescent↗
PubMed2006

Patterns of oral contraceptive pill-taking and condom use among adolescent contraceptive pill users.

PURPOSE: Imperfect oral contraceptive pill (OCP) regimen adherence may impair contraceptive effectiveness. The purpose of this study was to describe daily adherence patterns of OCP use, to analyze OCP protection on an event level basis, and to examine pill-taking and condom use during method transitions. METHODS: Women (n = 123, ages 14-17 years) completed quarterly interviews to classify OCP method choice into four categories: stable, initiated, stopped, and discordant use. Within each OCP category, daily diaries were used to assess occurrence of coitus, condom use, and patterns of day-to-day OCP use (i.e., consecutive days of OCP use reported with no more than two consecutive days of nonuse). A coital event was OCP protected if pills were used on both the day of the coitus and the day preceding. RESULTS: There were 123 participants who reported at least some OCP use in 210 diary periods (average diary length = 75.5 days). Fifty-three participants categorized as stable users reported 87 diary periods: the average interval of consecutive OCP use in this group was 32.5 days. Among stable users, only 45% of coital events were associated with both OCP and condom use. Over one-fifth of coital events in all groups were protected by no method of contraception. CONCLUSION: Dual use of OCP and barrier contraception remains an elusive goal. The time during OCP adoption or discontinuation is often unprotected by condoms. However, concurrent missed pills and condom nonuse increase pregnancy and infection risk even among stable OCP users. Understanding motivation for method usage may improve education and prevention techniques.

Adolescent↗
PubMed2005

Condom-promotion programme among slum-dwellers in Chandigarh, India.

This study describes high-risk behaviour and condom usage in inhabitants of an urban slum in the Union Territory of Chandigarh, which has a population of about 20,000. A cohort of 375 participants was followed-up before and after an intervention. Half of the married but only one-eighth of the unmarried slum dwellers were using condoms regularly. One-quarter of the study subjects practised high-risk behaviour and this was higher among unmarried (44.88%) than married participants (18.7%). An intervention involving education on condom use and provision of free condoms increased the condom usage rate from 31.73% in the pre-intervention phase to 60% in the postintervention phase.

Adult↗
PubMed2000

How well do male latex condoms work? Pregnancy outcome during one menstrual cycle of use.

To evaluate the contraceptive effectiveness of male latex condoms, we assembled a cohort of 300 women relying on male latex condoms for contraception and followed them prospectively for one menstrual cycle. None of the 234 women who completed the study and reported at least one act of intercourse conceived (one cycle pregnancy rate 0%; 95% CI 0%--2%). Given the pattern of intercourse during the cycle and 3 different sets of conception probabilities for different days of the cycle, we would have expected between 32 and 36 pregnancies if no condoms had been used. Thus, the prevented fraction due to condom use (effectiveness) is 100% and the lower bounds of the 95% CI are between 89% and 90%. For this cohort, male latex condoms were an effective method of contraception. This cost-efficient approach of evaluating contraceptive effectiveness shows promise for post-marketing studies.

Adult↗
PubMed2001

Does penile size in younger men cause problems in condom use? a prospective measurement of penile dimensions in 111 young and 32 older men.

OBJECTIVES: Young men often complain about problems with condom use, but very little information exists about the influence of men's age on penile dimensions and therefore on possible problems in the use of the most important means of contraception in the young. METHODS: We performed a prospective measurement of penile dimensions in 111 men,18 to 19 years old (group A), and in 32 men, 40 to 68 years old (group B). We measured penile length and width in the flaccid state and after visual and manual self-stimulation in group A and after intracavernous injection of prostaglandin E(1) in group B. RESULTS: The mean flaccid length in group A (8.60 cm) and group B (9.22 cm) was significantly different. The mean erect length in group A (14.48 cm) and group B (14.18 cm) was not significantly different. The mean flaccid width at the base was significantly different between group A (3.08 cm) and group B (2.87cm), but the mean flaccid width at the glans was not (group A, 3.02 cm; group B, 3.01 cm). The mean erect width at the base (group A, 3.95 cm; group B, 3.50 cm) and the erect width of the glans (group A, 3.49 cm; group B, 3.32 cm) were significantly different. CONCLUSIONS: Our assumption that the problems young men experience with condom use may be because of smaller penises could not be proved. To address the problems in condom use in younger men, a larger variety of condom sizes and better information about condom use may be useful.

Adult↗
PubMed2006

Fruity, fun and safe: creating a youth condom brand in Indonesia.

DKT Indonesia, a social marketing enterprise, undertook research among young people in Indonesia to develop a strategy to heighten understanding of safer sex and increase the availability and use of condoms among sexually active youth. The centerpiece of this campaign was the launch in 2003 of Fiesta condoms, with a range of flavours, colours, shapes and pricing aimed to appeal to young people. Working with key commercial and NGO partners, distribution has focused on places where young people often congregate and shop. The campaign relies heavily on the media, including TV commercials, radio talk shows, print media and mobile text messaging. DKT has also partnered with MTV, the Staying Alive campaign and other NGO and private sector partners to educate young people on a range of reproductive and sexual health issues. Based on retail audits and focus group discussions, the Fiesta brand has been a success. In three years, it has gained a 10% share of the condom market and helped to increase overall condom sales by 22%. Young people identify Fiesta as "their" brand and have started to use Fiesta condoms in significant numbers.

Adolescent↗
PubMed2001

Social cognitive correlates of sexual experience and condom use among 13- through 15-year-old adolescents.

PURPOSE: To examine the role of self-efficacy, outcome expectancies, and perception of peer attitudes in the delay of onset of sexual activity among 13- through 15-year-old adolescents. We also explored the role of self-efficacy, outcome expectancies, and perception of friends' condom use behavior in explaining the use of condoms among sexually active adolescents. METHODS: This study was part of a larger cross-sectional study to evaluate personal characteristics and maternal factors associated with early initiation of sexual intercourse. Mothers and adolescents were recruited from a community-based organization that offered afterschool and summer programs for youth. Enrollment was limited to adolescents aged 13-15 years and their mothers. Mothers and adolescents completed separate interviews. For adolescents, the interviews included the assessment of the variables in the present study. Each interview lasted about 60 min and was conducted by a trained interviewer. Data were analyzed using descriptive statistics and regression analysis. The average age of the 405 adolescent participants was 13.86 years, and approximately 30% of them had engaged in sexual intercourse. Slightly more than half (56%) of participants were male, and 82% were African-American. RESULTS: Participants who were less likely to believe that their friends favored intercourse for adolescents and who held more favorable attitudes about the personal benefits of abstaining from sex were less likely to have initiated sexual intercourse. Among sexually active adolescents, those who expressed confidence in putting on a condom, and in being able to refuse sex with a sexual partner, and who expressed more favorable outcome expectancies associated with using a condom were more likely to use condoms consistently. CONCLUSIONS: Human immunodeficiency virus and pregnancy prevention programs should emphasize peer influences in both the initiation of sexual intercourse and the use of safer sex practices among sexually active adolescents, as well as personal attitudes about consequences to self and confidence in negotiating safer sex practices with one's partner.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Relative power between sexual partners and condom use among adolescents.

PURPOSE: To examine how the relative power of adolescent sexual partners in the domain of emotional intimacy is related to condom use. METHODS: Interviewed 228 adolescents who visited an STD clinic in San Francisco. Adolescents were aged 14-19 years, 69% were female, and they were ethnically diverse. We developed a measure of relative power in the domain of emotional intimacy, by adapting five items from existing measures and developing three items ourselves. The partner who had less desire for emotional intimacy was considered to have more power in that domain. We also measured relative decision-making power. Data were analyzed using logistic regression and Student's t-tests. RESULTS: Adolescents who had more power than their partners in the domain of emotional intimacy were more likely to get their way about condom use than adolescents who had less power in this domain. Decision-making power was not related to whether adolescents got their way about condom use. Young men reported greater emotional intimacy power and greater decision-making power than young women. However, gender was not related to getting one's way about condom use. CONCLUSIONS: The results suggest the importance of assessing relative power in the sexual relationships of adolescents when predicting condom use.

Adolescent↗
PubMed1997

Making the female condom a "reality" for adolescents.

Alarming rates of pregnancy, sexually transmitted diseases, and human immunodeficiency virus infection among adolescents point to the need for expanding contraceptive options for adolescents. The female condom-a female-controlled barrier method that protects both partners from sexually transmitted diseases-marks an important breakthrough in contraceptive technology. This report reviews current research on the efficacy and acceptability of the female condom and considers the feasibility of its use in the adolescent population. Specifically, the authors first consider the factors that affect teenage condom (and other contraceptive) use (efficacy, cost and availability, and acceptability) and then apply the mechanics of the female condom to these issues. Based on this analysis, recommendations for future steps to be taken by researchers, adolescent health practitioners, and the manufacturer of the female condom are presented.

Adolescent↗
PubMed2003

A Guttman scale for assessing condom use skills among college students.

HIV risk-reduction interventions frequently teach correct condom use skills, yet few researchers actually measure those skills. Without measuring condom use skills, it is not possible to evaluate the effectiveness of condom use interventions, or determine what variables may be related to those skills. The Measure of Observed Condom Use Skills (MOCUS) was developed using standard Guttman scaling procedures, and administered to 106 female and 71 male undergraduates. The MOCUS was administered by the primary investigator to each participant individually. Guttman scale analyses demonstrated the MOCUS has acceptable reproducibility. These findings support future use of the MOCUS to assess condom use skills.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Situational correlates of condom use in a sample of African-American drug users who are primarily crack cocaine users.

We studied the situational determinants of condom use for vaginal sex in 151 African-American crack cocaine users in Houston, Texas, using situational presentation (Sitpres) methodology, which uses hypothetical scenarios with randomly generated levels of eight variables across 10 scenarios that may impact the decision to use a condom. Multiple regression showed that variables associated with a high probability of using a condom were older age, how badly the partner wants to use a condom, and how badly the respondent wants vaginal sex. Crack craving or level of intoxication were not correlates. The Sitpres methodology was successfully used by these crack users and data indicated that it was sexual variables, rather than drug-associated variables, that were significantly associated with condom use.

Adolescent↗
PubMed2003

Perceived condom use self-efficacy among at-risk women.

The objectives of this study are to assess the confidence in their ability to use condoms among at-risk women and identify predictors for the women's condom use self-efficacy. Structured interviews were conducted with 250 adult women in Atlanta, Georgia, between August 1997 and August 2000. Overall, the women reported feeling moderately to moderately-strongly confident in their ability to use condoms consistently. Multivariate analysis showed women with higher condom use self-efficacy were significantly younger, experienced childhood neglect, had higher self-esteem, communicated better with their sex partner, and had fewer drug problems. Findings suggest the importance of addressing condom use self-efficacy in HIV risk reduction programs with a specific focus on women and the need to be attuned to tailored needs for specific subgroups such as older women or women who encountered childhood neglect.

Adult↗
PubMed2000

Structure of outcome beliefs in condom use. The Project RESPECT Study Group.

To study the structure of beliefs about condom use outcomes, the authors derived and tested 4 psychosocial hypothetical models: (a) a 2-factor model of the personal and social outcomes of condom use; (b) a 2-factor model of the pros and cons of the behavior; (c) a 3-factor model (i.e., physical, self-evaluative, and social) of outcome expectancies; and (d) a thematic 4-factor model of the protection, self-concept, pleasure, and interaction implications of the behavior. All 4 models were studied with a confirmatory factor analysis approach in a multisite study of 4,638 participants, and the thematic solution was consistently the most plausible. Self-concept and pleasure were most strongly associated with attitudes toward using condoms, intentions to use condoms, and actual condom use, whereas protection and interaction generally had little influence.

Adult↗