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PubMed1991

Counseling patients on proper use of condoms.

The best condoms are made of latex, are lubricated and coated with a spermicide, and have a reservoir tip. Condoms can protect against conception and sexually transmitted diseases, including acquired immunodeficiency syndrome. When condoms are used properly and in combination with vaginal spermicidal foam, the contraceptive failure rate is as low as 1 percent. Failure is more often due to user error than product defect. Recommendations for the proper use of condoms are presented.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Effect of health education and condom promotion on behavioral change among low socioeconomic prostitutes in Mae Sot, Tak, Thailand.

A study was conducted to determine the effect of preventive educational efforts among 621 female prostitutes in Mae Sot, Tak Province, in 1989. The intensive health education program at a personal level and free condom distribution to the prostitutes began in March and June 1989, respectively. The proportion of prostitutes' sexual partners using condoms increased from 13.5% in January 1989 to 50.4% by December 1989. The reported increase in condom use was supported by the decline in the incidence rate of gonorrhea among the prostitutes during the same period. Anal intercourse was not commonly practised in these women and decreased from 9.7% in January to 1.8% in December 1989. None of the prostitutes interviewed throughout the year reported using intravenous drugs, nor reported having a steady sexual partner who was an intravenous drug user. None out of 248 prostitutes tested in January 1989 were HIV-1 seropositive. After that throughout the year, 15 of 373 (4.0%) additional prostitutes in this area were found to be seropositive on their first test. Ten out of 405 (2.5%) initially-seronegative prostitutes who were subsequently tested at 3-month intervals became seropositive. The effect of health education and condom promotion among our study prostitutes was modest. Similar studies are needed to evaluate the programs in other settings of Thailand, particularly in areas with high prevalence of HIV-1 infection.

Adolescent↗
PubMed1990

[The problem of the effectiveness of condoms against HIV infection].

In several countries the condom is recommended as the most important protection against HIV infection, although there is no proof that the condom is effective against sexually transmitted diseases (STD). Prior to the HIV epidemic the condom was used to prevent pregnancy and to decrease the risk of STD. To prevent a deadly infection such as that with HIV, safe ways of protection are mandatory. Recent studies on HIV prevention show the assumption that condoms provide reliable protection against HIV to be a dangerous illusion. In carefully planned studies the residual risk was 13% and 27% and more respectively.

Adult↗
PubMed1989

[Attitudes of women and men toward condoms].

The authors used a ten-item test of attitudes to condoms for enquiries among 200 patients (100 women and 100 men). The attitudes of women were more frequently negative (22.5%) than the attitudes of men (16%). Women also replied less frequently in a positive way to questions of the test than men (42% as compared with 48.5%). Seventy-two respondents (30 women and 42 men) had no experience with condoms, 92 had a single experience (50 women and 42 men) and only 36 respondents (20 women and 16 men) used at least occasionally condoms frequently. Greater experience with condoms increases the positive evaluation of this contraceptive.

Adolescent↗
PubMed1996

Increasing the use of bleach and condoms among injecting drug users in Denver: outcomes of a targeted, community-level HIV prevention program.

OBJECTIVE: To evaluate the impact of an HIV risk-reduction program among injecting drug users (IDU) in Denver, Colorado. DESIGN: A targeted, community-level intervention study with multiple, time-phased, cross-sectional measurements assessing HIV high-risk behaviors among IDU in intervention and comparison sites. SETTING: Neighborhoods with high IDU prevalence in Denver, Colorado (intervention site) and Long Beach, California (non-intervention comparison site). PARTICIPANTS: Street-recruited IDU who had injected drugs in the previous 30 days and shared injection equipment in the previous 60 days to evaluate the use of bleach to clean injection equipment; or had sexual intercourse in the previous 30 days, to evaluate condom use. INTERVENTION: A prevention program in which peer volunteers were recruited and trained to distribute and discuss intervention kits that included condoms, bleach bottles and role model stories. MAIN OUTCOME MEASURES: Multiple cross-sectional surveys were conducted in the intervention and comparison sites to assess the impact of the intervention on the consistent use of bleach before sharing injection equipment and the consistent use of condoms for vaginal intercourse with steady and occasional partners. RESULTS: Between February 1991 and December 1993, 1997 IDU were interviewed, 890 at the intervention site and 1107 at the comparison site. In contrast to the comparison site, subjects from the intervention site reported significant increases in consistent use of bleach [odds ratio (OR), 2.6; 95% confidence interval (CI), 1.3-5.1; P < 0.001], and consistent use of condoms with occasional partners (OR, 13.6; 95% CI, 3.2-58.0; P < 0.001). CONCLUSION: This targeted, peer-based intervention was associated with significant HIV risk reduction among IDU in Denver and may be useful in other communities at risk for HIV infection.

Adult↗
PubMed2002

Introductory study on female condom use among sex workers in China.

There is lack of barrier method use among sex workers (SWs) in China. Our objective was to find new ways to introduce female condoms (FCs) among SWs, and to increase knowledge of, support for, and use of this method in this population. We used the intervention study method and provided the SWs of experimental groups with information, education, and communication on FCs and provided them with FCs. We recruited 330 SWs as the participants of the study in Enping City, China. The selected 330 SWs were randomly divided into the experimental group (165 SWs to use female condom) and the others into the reference group (165 SWs to use male condom). Questionnaires were used to evaluate the intervention study. At the end of our study, 15 SWs were lost of follow-up, so only 315 were included in the analysis. After intervention, about 97% of SWs in the intervention group expressed that they would use FC in the future. The rate of SWs who reported liking FC increased from 60% at pre-intervention to 94% at post-intervention. The rate of SWs who considered their clients could accept FC increased from 27% to 92%, and the rate of SWs who were willing to recommend FC to others increased from 19% to 70%. In comparison with the first several uses, during last several uses about 80% of SWs expressed that it became easier to use FC. Our intervention increased knowledge of, positive attitudes towards, and correct use of FC in this population of SWs.

Adolescent↗
PubMed1993

Condom use: a self-efficacy model.

A survey of heterosexually active college students gathered information about condom use, self-efficacy (SE), outcome expectancies, sexual attitudes, peer group influences, acquired immunodeficiency syndrome (AIDS) knowledge, and perceived vulnerability to AIDS. On the basis of A. Bandura's (1986) social-cognitive theory, a structural model with SE as the central mediator was formulated and evaluated with LISREL. This model explained 46% of the variance in condom use from judgments of SE and effects attributable to peers and 53% of the variance in SE from outcome expectancies and peer group influences. Sexual attitudes, AIDS knowledge, and perceived vulnerability did not predict condom use. Most students were well-informed about human immunodeficiency virus (HIV) transmission but reported not feeling at risk, even though many engaged in risky sexual behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Validation of measures of condom and other contraceptive use among women at high risk for HIV infection and unintended pregnancy.

This study assessed the applicability of the transtheoretical model of behavior change (J.O. Prochaska & C.C. DiClemente, 1983, 1984) to the measurement of contraceptive use among 296 women at high risk for HIV infection and transmission. Structural equation modeling suggested that a measure of general contraceptive use could be used to assess use of oral contraceptives and hormonal implants but that measurement of condom use required separate assessments for main and other partners. Self-efficacy (SE) and decisional balance scales were internally consistent for general contraceptive use, for condom use with main partners, and for condom use with other partners. Consistent with research on other health behaviors, SE scores rose significantly across stages, from precontemplation to maintenance, and a shift in decisional balance was observed for 2 of 3 behaviors. This measurement strategy may enhance the ability to evaluate prevention programs for women at risk.

Adolescent↗
PubMed1995

A comparison of the determinants of safe injecting and condom use among injecting drug users.

A sample of 582 injecting drug users were interviewed as part of an evaluation of an AIDS prevention programme for drug users. This paper examines the biographic and predispositional determinants of five HIV preventive behaviours--equipment sharing (not receiving and not giving) and and condom use (with regular partners, casual partners and sex clients). A two-stage sequential approach was adopted for a logistic regression analysis. Initially, to model each of the five preventive behaviours, biographical and drug use variables were entered. In a second set of models, behavioural predisposition factors were included. Age, drug use and prison experience correlate with variables in both models, although not consistently in the same direction. While a predisposition to reject sharing correlates with safer rejecting and condom use, the predisposition to safer sex only correlates with condom use. Needle exchange programmes that only target the individual would seem to be inadequate. To enhance targeted interventions changes in public and agency policy that create a social environment conductive to behaviour change are required.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS, sex and condoms: African healers and the reinvention of tradition in Zaire.

Condoms offer considerable protection against sexual transmission of AIDS. Yet many Africans who are at risk of infection reject condoms as "unnatural." Data from Zaire have been used to examine this culturally constructed category in relation to sexuality, procreation, gender roles, class formation and international health and development policy. Much more than a simple transfer of biomedical technology is involved. Condom use with regular partners raises issues of cultural politics at many levels. "Traditional" African healers represent important social networks with considerable authority in poor urban communities. They are able to reinterpret cultural categories and endow behavior with new meanings. Action-research in Kinshasa was used to explore roles that healers might play in promoting change to safer sex practices.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Introducing the female condom through the public health sector: experiences from South Africa.

The successful implementation of new public health policy is influenced by provider preparedness and user acceptability of the new intervention. This paper describes the development and implementation of a participatory Training of Trainers (TOT) programme as a precursor to launch the South African government's female-initiated HIV prevention strategies in public health clinics. Three hundred peer-trainees from throughout South Africa were trained through a comprehensive, modular and interactive three-day workshop. The workshop content included: HIV/AIDS knowledge, beliefs and attitudes; values clarification regarding HIV infection and sexuality; sexual desensitization; 'hands-on' training in the use of and introduction of the female condom; and counselling, communication and programme planning skills. The TOT generated a cadre of knowledgeable health care workers for training others and provided a support structure at the service delivery level for ensuring potential users' access to the female condom within each province. Qualitative assessments of the training and trainer debriefing sessions suggest that the training was successful in increasing knowledge and promoting positive attitudes about female condoms. In addition, the expanded repertoire of problem-solving approaches left providers feeling confident about recommending this method to clients.

Attitude to Health↗
PubMed1999

Contrasting strategies used by young people to ensure condom use: some findings from a qualitative research project.

Interviews conducted among 56 young men and women (aged 16-19) reveal two contrasting strategies used to ensure condom use at first intercourse with a new partner. These are defined as verbal communication based strategies (involving some explicit discussion about contraception before intercourse) and non-verbal communication based strategies (where one partner takes responsibility for using condoms without discussing this with their partner). Whilst the former is argued as being the more effective strategy, this paper suggests an important role for the latter, particularly when young people find themselves in situations where initiating discussions about condom use is perceived as being particularly difficult.

Adolescent↗
PubMed1997

Heterosexual behaviour and condom usage in an urban population of Delhi, India.

A survey conducted among the lower-class urban population of Delhi, India to describe the heterosexual behaviour, condom usage and awareness about STDs/AIDS revealed that 4.4% respondents had sex outside/before marriage. Female commercial sex workers, friends and neighbours were the important sexual partners. Heterosexual activity was significantly higher among males, unmarried, literates and middle/higher income groups. Almost half of those who had sex before/outside marriage never used a condom during the sexual encounter. Though only a small fraction of the population was found to be engaged in extra-/pre-marital sex, the overall impact of this may be multifold, given the nature and modes of HIV transmission. The superficial and inadequate knowledge regarding STDs/AIDS among this population, especially among those having extra-/pre-marital sex, indicates an urgent need for appropriately targeted health education and condom promotion activities in the community with an endeavour to increase awareness about STDs and HIV/AIDS and motivate people towards healthy sexual lifestyles.

Adolescent↗
PubMed1997

Sexual relationships, condom use and risk perception among female bar workers in north-west Tanzania.

This paper discusses the background characteristics, sexual relationships, condom use and risk perception of bar workers in Magu district, north-west Tanzania. Bar workers in Magu are geographically mobile. They are not highly educated but probably have a higher level of schooling than average. They are mostly unmarried or divorced. They choose bar work because, given the resources available, it provides them with a good balance between earning their own income and being independent. Although the women are still partially dependent on the financial support provided by sexual partners and sexual relations tend to be based on exchange, bar workers cannot simply be equated with prostitutes. Some have a regular partner and the odd casual partner while others may have large numbers of casual contacts. Regular partners are almost always married and often itinerant. The distinction between regular and casual partners is important and based on the nature and extent of financial support. It is also related to condom use and therefore to risk. Women claim to be able to demand condom use from casual partners but not from regular partners. Although women claim that regular partners can be trusted, they nonetheless admit feeling at risk of AIDS and STDs from these same partners.

Adolescent↗
PubMed1996

Prostitution, condom use, and invasive squamous cell cervical cancer in Thailand.

Cervical cancer is probably caused by a sexually transmitted agent. A case-control study was conducted in three hospitals in Thailand to investigate further the role of male sexual behavior, particularly regarding sexual contacts with prostitutes, in the development of this disease. Data were obtained from interviews with 225 married women with invasive squamous cell cervical carcinoma and 791 hospitalized controls, all of whom reported having only one sexual partner, and from interviews with their husbands. Risk of cervical cancer was strongly related to the women's husbands having visited prostitutes without using a condom when the husbands were less than 30 years old. A strong increasing trend in risk in relation to decreasing frequency of the husbands' condom use with prostitutes was observed, and a weaker increasing trend in risk with husbands' estimated lifetime total number of visits to prostitutes was found. The average latent period between the women's likely initial exposure to a sexually transmitted oncogenic agent and her diagnosis of invasive cervical cancer was about a quarter of a century. Regular use of condoms by customers of prostitutes could reduce the number of invasive cervical cancer cases in the general population of Thailand by at least one fourth.

Adult↗
PubMedDate not supplied

History of sexually transmitted diseases infection, drug-sex behaviors, and the use of condoms among midwestern users of injection drugs and crack cocaine.

BACKGROUND AND OBJECTIVES: This study describes self-reported histories of sexually transmitted diseases (STD) with respect to gender and ethnicity and examines the factors that influence the use of condoms among heterosexual users of injection drugs and/or crack cocaine. STUDY DESIGN: A cross-sectional design was used to interview 1046 active users of illicit drugs living in Columbus and Dayton, Ohio. RESULTS: STD was common among 29% of the white men, 53.6% of the black men, 55.9% of the white women, and 64.7% of the black women self-reporting previous infection. Among women, stepwise logistic regression showed that cohabitating with a spouse or a sex partner (OR 0.28; 95% CI, 0.06 to 0.77) and exchanging sex for drugs (OR 0.31; 95% CI, 0.11 to 0.88) were associated negatively with always using a condom during vaginal sex in the previous month, whereas exchanging sex for money (OR 4.48; 95% CI, 1.88 to 10.95) was associated positively. Among men, cohabitating with a spouse or a sex partner (OR 0.13; 95% CI, 0.06 to 0.31), having had an STD (OR 0.53; 95% CI, 0.33 to 0.85), and currently using injection drugs (OR 0.52; 95% CI, 0.33 to 0.84) were associated negatively with condom use. CONCLUSIONS: Users of illicit drugs are at high risk for the acquisition and transmission of STD. More research is needed to understand better the sex practices of users of injection drugs and crack cocaine so that appropriate interventions can be developed.

Adult↗
PubMed1998

Human immunodeficiency virus seroprevalence and condom use among female sex workers in Italy.

BACKGROUND AND OBJECTIVES: In two different studies, we evaluated the human immunodeficiency virus (HIV) seroprevalence rate and the condom use in a group of female sex workers working in Italy. STUDY DESIGN: In the first study we collected data on HIV serologic testing of female sex workers; in the second study, we evaluated the use of condoms and high-risk sexual practices by sex workers with their clients and nonpaying partners. RESULTS: Overall, 131 of 802 (16%) were HIV positive: 36 of 558 (6%) professional sex workers and 95 of 244 (39%) sex workers who used intravenous drugs. There was a significant increase of seroprevalence among professional sex workers between 1988 to 1990 and 1991 to 1995 (2% versus 11%, P < or = 0.001), whereas among the sex workers who used intravenous drugs, the increase was not significant (37% versus 40%, P = 0.70). Similarly, the HIV seroprevalence in the Italian professional sex workers is constant in the two periods of time (2% versus 1%). In the second study, 97 of 102 (95%) sex workers reported regular condom use with clients, whereas 63% of sex workers reported they never used them with nonpaying partners. Fourteen sex workers reported having nonpaying partners who used intravenous drugs and 6 reported having nonpaying bisexual partners; 8 of these 20 partners were HIV positive. CONCLUSION: The results of the first study showed a significant increase of seroprevalence among professional sex workers, whereas the high seroprevalence among sex workers who used intravenous drugs was constant. The results of the second study showed that sex workers may be at higher risk for HIV infection through noncommercial sexual intercourses.

Adult↗
PubMed1993

Correlates of condom use and number of sexual partners among high school adolescents.

Factors associated with condom use and number of sexual partners were examined in a statewide sample of public high school students in grades 9-12 (N = 3,893). Data were collected in spring 1990 using the 70-item, self-report Youth Risk Behavior Survey, developed and piloted by the Centers for Disease Control. Composite scores were constructed to measure aggression, physical recklessness, alcohol use, illegal drug use, cigarette use, lack of exercise, and academic self-image. Since simple polychotomous logistic regression models revealed a significant race by gender interaction, multivariate models were run separately for each race-gender group. Odds ratios and 95% confidence intervals were calculated from polychotomous logistic regression of lifetime sexual activity and condom use with their potential correlates. Risky sexual behavior appears to be correlated with a complex of other behaviors that place students at risk. A pattern of declining condom use with increasing number of partners was evident, especially for White students.

Adolescent↗