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Sexual activity, condom use and AIDS awareness among adolescent males.

New data from the 1988 National Survey of Adolescent Males indicate that 60 percent of never-married young men ages 15-19 are sexually active. Among 17-19-year-old males living in metropolitan areas, the rate of sexual activity reported in 1988 was 15 percent higher than that reported in 1979. This increase encompasses a rise of 23 percent among black males and 13 percent among nonblack males. Slightly more than half of the sexually active males in the 1988 survey reported that they had used a condom the last time they had had intercourse. Among both black and nonblack youths aged 17-19 living in metropolitan areas, rates of reported condom use at last intercourse more than doubled between 1979 and 1988. Conversely, reported reliance on ineffective methods of contraception or use of no method at last intercourse was 60 percent lower. When first intercourse occurred within two years of the 1988 survey, the odds of using a condom were increased by 110 percent over the odds when intercourse occurred between 1975 and 1982, after controlling for the effects of age at first intercourse, race and ethnicity. The young men in the sample were very knowledgeable about how the human immunodeficiency virus is transmitted, and over three-quarters of the sample did not dismiss the disease as uncommon, nor did they think that using condoms to prevent the spread of AIDS was too much trouble. The rates of condom use were significantly lower than average, however, among young men who had ever used drugs intravenously or whose partners had done so, young men who had ever had sex with a prostitute and those who had had five sexual partners or more in the past year.

Acquired Immunodeficiency Syndrome↗

Observations of scanning electron microscopy detected abnormalities of non-lubricated latex condoms.

To describe surface abnormalities found by scanning electron microscopy of non-lubricated latex condoms, thirty samples of 15 condoms were photographed at low (26-94x), medium (240-940x) and high (> 1000x) magnification. Each sample was initially scanned at low magnification to determine the presence and location of surface abnormalities. Photographs taken at medium and high magnification were of the area most representative of the abnormality. Nine samples (30%) were completely normal at all magnifications. Of the total viewed at low power, 18 (60%) were normal, 11 (37%) revealed ridging and 1 (3%) revealed melting. Of the total viewed at medium power, 14 (47%) were normal, 3 (10%) showed cracking, 2 (7%) showed melting or a combination of ridging and cracking, and 11 (37%) showed ridging. At high power, 10 (34%) were normal, 11 (38%) revealed either melting or a combination of two defects, 5 (17%) showed ridging, and 3 (10%) revealed cracking. Fifteen (50%) of the samples revealed a surface abnormality (cracking or melting) other than ridging. The majority of condoms viewed under scanning electron microscopy revealed surface abnormalities. The implication of the detected abnormalities needs further evaluations. While ridging may represent a minor abnormality associated with condom handling, multiple abnormalities or melting may represent a more significant atypicality.

Condoms↗

Predictors of increased condom use following HIV intervention with heterosexually active drug users.

Research with injection drug users (IDUs), at risk for acquiring and transmitting HIV, has focused primarily on their risky drug practices, with far less attention paid to their risky sex behaviors. The purpose of this study was to determine what variables were associated with an increase in condom use following an HIV intervention with 3357 IDUs in nine cities. Participants reported using condoms during 15% of their sexual encounters prior to the HIV intervention, and during 22% of their sexual encounters six months later. A logistic regression analysis indicated that individuals who increased their condom use were likely to be HIV seropositive (odds ratio OR = 2.49), to have received AIDS information prior to the intervention (OR = 1.28), to have multiple sex partners (OR = 2.14), to be single with multiple sex partners (OR = 1.34), or to have exchanged drugs or money for sex (OR = 1.33). Discussion focuses on the generally low incidence of condom use and the need for increased intervention, particularly among drug users in monogamous relationships and sex workers.

Acquired Immunodeficiency Syndrome↗

Effects of a drinking event on behavioral skills and condom attitudes in men: implications for HIV risk from a controlled experiment.

This study experimentally tested the effects of a drinking event on HIV-related behavioral skills and condom attitudes. Sixty unmarried, heterosexual men were assigned to 1 of 3 conditions (sober, placebo, or alcohol). Participants who consumed alcohol demonstrated lower skill to negotiate for condom use relative to sober controls. More negative condom attitudes were expressed by participants with stronger sex-related alcohol expectancies, especially when these expectancies were triggered by subjective intoxication. Hierarchical regression analyses revealed that the experimental factors accounted for variance in behavioral skills and condom attitudes beyond that explained by known predictors of sexual risk.

Adult↗

The effect of condoms in sexually explicit narratives on male sexual arousal.

Research into why people choose not to use condoms despite a growing AIDS epidemic has tapped the attitude that the use of condoms somehow interferes with the progression of the sexual act or lessens sexual pleasure. The current study investigated the effects on male sexual arousal of condom use described in sexually explicit audiotaped narratives. The sexual arousal of 14 male university students was measured physiologically by penile plethysmography and by self-report using a within-subjects design. Subjects listened to 10 audiotaped scripts, half of which included the use of a condom and half of which did not. No significant differences in either physiological or subjective arousal data were found between conditions.

Acoustic Stimulation↗

The effects of post-test counselling on condom use among prostitutes in The Gambia.

OBJECTIVES: To determine the effect of counselling on condom use by prostitutes. DESIGN: Cohort study. SETTING: Field-based study in The Gambia. PARTICIPANTS: Thirty-one (12 HIV-positive and 19 HIV-negative) prostitutes. INTERVENTIONS: Post-test HIV counselling. MAIN OUTCOME MEASURES: Levels of condom use. RESULTS: Overall, counselling had no effect on condom use. CONCLUSIONS: Scarce resources should be directed towards providing condoms in bars rather than counselling.

Cohort Studies↗

Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples.

OBJECTIVE: To investigate the relationship between psychological distress, alcohol, drug and condom use in HIV-serodiscordant heterosexual couples. METHODS: Structured interviews were conducted to collect demographic information, detailed data on psychological distress, drug and alcohol use and sexual behavior. RESULTS: Analyses were based on 106 pairs of sexually active discordant couples. Significant differences among heterosexual condom users and non-users varied according to gender and HIV serostatus. Affect domains of interpersonal sensitivity and hostility were significant, as were the variables of regular drug or alcohol use and combining sex with drugs or alcohol. Employment was strongly associated with condom use in HIV-negative women whose regular sexual partners were HIV-positive men. CONCLUSION: The risk of vaginal sex without condoms in HIV-serodiscordant heterosexual couples may be reduced by specific psychological counseling and attention to drug and alcohol use as risk factors. Further research on the effect of employment of HIV-negative women is required.

Adolescent↗

Condom use and fertility among divorced and separated women.

Sexually active divorced and separated women constitute a significant population at risk for sexually transmitted diseases. With components of the Interaction Model of Client Health Behavior (IMCHB) used as the conceptual framework, a convenience sample (N=254) of women--mostly educated, White, and in their 30s (20 to 49 years)--was examined relative to condom use and individual and social context characteristics. To explore the effect of fertility on condom use, the sample was divided into fertile and infertile subsamples. The IMCHB explained 49% of the variance in infrequent condom use by the fertile women (n=93) and 21% of the variance in less frequent condom use by the infertile women (n=161).

Adult↗

Condom use by Norplant users at risk for sexually transmitted diseases.

BACKGROUND: Norplant is highly effective for long-term pregnancy prevention. Norplant users might not use condoms, and they may acquire human immunodeficiency virus (HIV) and other sexually transmitted diseases as a consequence. GOAL OF THIS STUDY: The goal of this study was to assess condom use among Norplant users at risk for sexually transmitted diseases. STUDY DESIGN: Telephone interviews were conducted with 177 sexually active Norplant users to measure risk for sexually transmitted disease and condom use. RESULTS: According to the measures used in this study, 42% of the study subjects were at risk for sexually transmitted disease and 38% of those at highest risk did not use condoms. CONCLUSIONS: Intervention to protect Norplant users from sexually transmitted disease is indicated.

Adult↗

Predictors of condom use and human immunodeficiency virus test seeking among women living in inner-city public housing developments.

BACKGROUND AND OBJECTIVES: To examine prevalence and predictors of condom use and human immunodeficiency virus (HIV) test seeking among women living in inner-city housing developments. STUDY DESIGN: Between April and June 1994, 671 women living in low-income housing developments in five cities in the United States completed an anonymous self-report questionnaire eliciting information on acquired immune deficiency syndrome (AIDS) risk behavior and characteristics indicative of risk. RESULTS: Most participants were women of color who were economically disadvantaged. Fifteen percent reported multiple sex partners, and 30% of women with one sex partner believed he had sex with someone else in the past year. Predictors of condom use included increased rates of safe-sex negotiation, stronger risk reduction intentions, absence of condom barrier beliefs, and multiple sex partners. Women tested for HIV in the past year were younger, perceived themselves to be at risk for HIV infection, reported more conversations with other women about AIDS concerns, and had condoms readily available. CONCLUSIONS: HIV public health prevention interventions are urgently needed for women who live in low-income urban housing developments.

AIDS Serodiagnosis↗

Self-reported sexual activity and condom use among symptomatic clients attending STD clinics.

BACKGROUND AND OBJECTIVES: A cross-sectional survey of sexually transmitted disease (STD) patients assessed sexual activity and condom use during the time between STD symptom onset and clinic attendance. STUDY DESIGN: Patients were asked to report sexual activity and condom use while STD symptoms were present. Medical records were abstracted for diagnoses. RESULTS: The study population (n = 3025) was predominately African American (75.3%) and male (63.5%), with a mean age of 28.1 years. Sexual activity while experiencing STD symptoms was reported by 39.7% of 2,508 symptomatic patients, 17.2% of whom reported always using a condom. Logistic regression models identified the significant independent determinants of sexual intercourse while symptomatic were duration of symptoms before clinic visit [0-7 days versus 8 or more days, OR = 5.9]; race [African American versus other races (primarily Hispanics), OR = 2.1]; and gender [men versus women, OR = 1.5]. Older age [> or = 30 years versus 18-29 years, OR = 1.5] and higher education attainment [> or = high school versus > high school, OR = 1.5] were the significant factors associated with reporting always using a condom. CONCLUSION: These data suggest patient groups with behaviors likely to enhance STD transmission could be targeted for educational messages.

Adult↗

Sexually transmitted diseases and condom use among female freelance and brothel-based sex workers in Singapore.

BACKGROUND AND OBJECTIVES: Most studies in Asia exclude freelance female sex workers because of difficulties in access and the illegality of their work. Data are lacking on their risk behaviors. GOAL: To compare sexually transmitted disease (STD) rates, condom use, and health screening behavior between freelance and brothel-based sex workers in Singapore. STUDY DESIGN: This is a cross-sectional survey of 111 free-lance sex workers arrested from November 1996 to March 1997 for illicit prostitution and 333 randomly selected brothel-based sex workers. All were tested for STDs. RESULTS: STDs were significantly more prevalent among freelance than brothel-based sex workers (34.8% vs. 24.0%). Inconsistent condom use was significantly higher among freelance than brothel-based sex workers and was significantly associated with younger age, decreasing number of clients, and perception of non-condom use among peers. CONCLUSION: Educational programs to promote condom use should target freelance sex workers and their clients.

Adult↗

Sexual partner change and condom use among urban factory workers in northwest Tanzania.

OBJECTIVE: To describe sexual partner change and condom use at the intake of a cohort study of urban factory workers in Tanzania. METHODS: From October 1991 to March 1992, 926 male and 170 female factory workers were interviewed using a structured, pre-coded questionnaire. Questionnaire reliability was assessed by pre-testing and comparison with results of unstructured interviews and carrying out repeat questionnaires on a sub-sample. RESULTS: Almost half of both men and women had had sexual intercourse by their 17th birthday. The period of premarital sex had an interquartile range of 2 to 10 years in men and 0 to 2.5 years in women. Having had sexual intercourse in the past month with more than one partner was reported by 22% of the men and 5% of the women. Factors associated with multiple partners in men were being born in or near Mwanza Region, having low education and low income, and being married. Condoms had been used in the past month by 3% only, mainly with casual partners. Condom use in men was associated with being young, living in town, being born in Kagera Region, high education and high income, being circumcised, and having causal or steady (non- martial) partners. CONCLUSION: Information, education and communication (IEC) on sexual relationships and condom use should start at an early age, and include education at primary schools. Much sexual partner change appears to occur through steady (non-marital) partnerships, indicating the need for IEC to be expanded beyond groups such as commercial sex workers and their clients.

Adolescent↗

Trends in sexually transmitted diseases and condom use patterns among commercial sex workers in Fukuoka City, Japan 1990-93.

OBJECTIVE: To investigate trends in sexually transmitted diseases (STDs) among female commercial sex workers and in their condom use patterns during the period from 1990 to 1993 in Fukuoka, Japan. METHODS: The study group consisted of a total of 824 commercial sex workers who attended an STD clinic to undergo screening for STDs including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV-1 infection during the period from 1990 to 1993. For detection of Chlamydia trachomatis and Neisseria gonorrhoeae, endocervical smear specimens were taken from the women. Blood samples were obtained for serological diagnosis of syphilis, hepatitis B and HIV-1. Commercial sex workers who visited the clinic during the period from November to December of 1993 were interviewed concerning past (1990 and 1991) and recent (1992 and 1993) condom use patterns. RESULTS: The annual detection rates of C trachomatis and N gonorrhoeae declined significantly from 16.3% in 1990 to 12.2% in 1993 (P < 0.0001) and from 1.5% in 1990 to 0.8% in 1993 (P = 0.0096), respectively. There was a remarkable reduction in the annual syphilis infection rate, from 7.5% in 1990 to 0.5% in 1993 (P = 0.0011). The positive rate for the hepatitis B surface antigen in the women ranged from only 0.6% to 1.9% and none were found to be positive for HIV-1 during the 4-year period. During the same period, there was a significant increase in the proportion of commercial sex workers always using condoms from 6.3% in 1990-91 to 25.3% in 1992-93 (P = 0.0023). CONCLUSION: The prevalences of chlamydia, gonorrhoea, and syphilis infections decreased significantly among commercial sex workers in Fukuoka from 1990 through 1993, and no commercial sex workers were HIV-1 seropositive. The reductions in the prevalence of major STDs may be related to the increased use of condoms.

Adolescent↗

Condom beliefs in urban, low income, African American and Hispanic youth.

This article focuses on the condom beliefs of low income, urban African American and Hispanic youth living in the Midwest. The condom beliefs under investigation were derived from prior research with members of this population and through consultation with African American and Hispanic youth and service providers. Significant gender, ethnic, and acculturation differences were found among beliefs related to frequency of condom use in the past year (p < .05). These differences indicated that women, African American respondents, and Hispanic respondents high in acculturation tended to have more neutral or more positive views about condoms than other types of respondents.

Acculturation↗

Contraceptive and condom use adoption and maintenance: a stage paradigm approach.

The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.

Adolescent↗

Determination of factors associated with condom use among women infected with human immunodeficiency virus.

To better understand potential barriers to condom use and the sexual behaviour of women infected with human immunodeficiency virus (HIV), an anonymous self-administered survey was performed on a convenience sample of 83 predominantly single HIV+ women. Most women had only one sexual partner who usually knew of the subject's serostatus. Only a minority of partners (26%) were known to also be HIV infected. Subjects were surprisingly more likely to use condoms with their main partner as opposed to other partners. Factors found to be associated with condom non-use included younger age, low education level, partner HIV+, history of a sexually transmitted disease (STD), and use of drugs or alcohol during sex. Although most subjects indicated the decision was mutual when deciding not to use a condom, 20% stated it a was a partner decision. Future intervention efforts should target these identified high-risk individuals and optimally involve the partners of HIV-infected women.

Adolescent↗

Factors associated with condom use in the male population of Mexico City.

Sexually transmitted diseases (STDs) are an important public health problem, due to their medical, social and economic repercussions. Therefore, more knowledge is needed about the sexual behaviour that promotes their spread, in order to improve control and prevention strategies. Our aim was to determine the frequency of male condom use associated with sexual behaviour factors, a history of and knowledge about STDs in a sample of the male population in Mexico City. During 1994 a cross-sectional epidemiological study was carried out, using multi-stage sampling with conglomerates, in 1377 men from 15 to 49 years old. The mean age was 34.5 years (SD 7.5 years). Mean age at first sexual relations was 17.7 years (SD 2.8 years). The global proportion of condom use during the last sexual relation was 24.6%; use according to type of female sex partner in the last year was 18.8% with regular partners and 62.5% with occasional partners. The principal predictors of male condom use, identified through statistical modelling, were: younger age (<25 years), middle and high education level (>9 years), middle and high socioeconomic level and type of sexual partners (occasional and regular). This population has risk factors for acquiring and transmitting some STDs, such as occasional sexual partners and a history of STDs. Characteristics which are important in relation to male condom use were identified, such as age (younger than 35), education (complete junior high school or more) and type of sexual partners (occasional and regular).

Adolescent↗