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PubMedDate not supplied

A sustainable behavioral intervention to increase condom use and reduce gonorrhea among sex workers in Singapore: 2-year follow-up.

BACKGROUND: Prostitution is the most important source of transmission of AIDS and sexually transmitted diseases in Asia. We developed and evaluated the sustainability of an intervention to increase condom use and reduce gonorrhea among brothel-based sex workers in Singapore. The intervention focused on developing sex workers' negotiation skills, educating clients, and mobilizing support from peers and health staff in promoting condom use. METHODS: A pretest-posttest design with one intervention site (n = 124) and another comparable control site (n = 122) was maintained for 5 months followed by a time series design to follow up the intervention group for 2 years. RESULTS: At 5 months, the intervention group improved significantly in negotiation skills and were almost twice as likely as controls to always refuse unprotected sex (adjusted rate ratio 1.90, 95% CI 1.22-2.94). Gonorrhea incidence declined considerably by 77.1% in the intervention group compared with 37.6% in the controls. Consistent refusals of unprotected sex in the intervention group increased from 44.4% at baseline to 65.2% at 5 months, 73.6% at 1 year, and 90.5% at 2 years with a corresponding decline in gonorrhea. CONCLUSION: Sustained condom use with a corresponding decline in gonorrhea was achieved by a behavioral and environmental intervention for sex workers.

Adult↗
PubMed1993

Planned condom use by women with Norplant implants.

This research examines the use of condoms to protect from disease women who selected hormonal implants for contraception. After receiving contraceptive implants, subjects were surveyed regarding their past use of condoms and their plans for using them to inhibit the transmission of HIV and other sexually transmitted diseases in the future. Twenty-one percent of women in the sample had used condoms in the past, but did not plan to use them once they have the implants. While decreasing their risk for unplanned pregnancy, they and/or their partners can be expected to experience an increased risk of exposure to sexually transmitted disease. Contraceptive providers must emphasize to their patients the need for protection from disease, in addition to pregnancy, when prescribing contraceptive methods.

Adolescent↗
PubMed2005

Adolescent relationships and condom use: trust, love and commitment.

Research indicates that people use condoms less often with a regular sexual partner than with a casual partner because they believe condoms are not needed. This article reports qualitative findings from four group meetings and 11 in-depth interviews in which sexually experienced inner-city adolescents aged 14-17 talked about their sexual relationships. Three types of relationships were described: messing, for sex only; boy-girlfriend, a more intense relationship, and "hubby-wifey," which mimics marriage. The four types of relationships differ along four analytic dimensions, which give them meaning: future commitment; public vs. secret; expectation of monogamy; and degree of affection and love. Decisions about condom use are influenced by these dimensions which may be underestimated in theoretical models that focus on individuals, not couples.

Adolescent↗
PubMed2006

Inconsistent condom use with steady and casual partners and associated factors among sexually-active men who have sex with men in Bangkok, Thailand.

HIV/STD risk behavior has not been examined in community samples of men who have sex with men (MSM) in Thailand. The sexually-active sample (n=927) was recruited from bars, saunas, and parks; 20% identified as bisexual and 17% tested HIV-positive. Inconsistent (<100%) condom use was reported by 45% of those with steady partners and 21% of those with casual partners in the prior three months. 21% had heard of effective HIV treatments (n=194), among whom 44% believed HIV was less serious and 36% said their risk behavior had increased after hearing about the treatments. In multivariate analysis, HIV-positive status, gay-identification, getting most HIV information from the radio, believing HIV can be transmitted by mosquito bite, and concern about acquiring an STD were associated with inconsistent condom use during anal sex; slightly older age (25-29 vs. 18-24 years) was associated with more consistent condom use. HIV/STD risk-reduction strategies for MSM in Bangkok should clearly state sexual risk to individuals in this population.

Adolescent↗
PubMed2006

Perceptions towards condom use, sexual activity, and HIV disclosure among HIV-positive African American men who have sex with men: implications for heterosexual transmission.

Disproportionately high HIV/AIDS rates and frequent non-gay identification (NGI) among African American men who have sex with men or with both men and women (MSM/W) highlight the importance of understanding how HIV-positive African American MSM/W perceive safer sex, experience living with HIV, and decide to disclose their HIV status. Thirty predominately seropositive and non-gay identifying African American MSM/W in Los Angeles participated in three semi-structured focus group interviews, and a constant comparison method was used to analyze responses regarding condom use, sexual activity after an HIV diagnosis, and HIV serostatus disclosure. Condom use themes included its protective role against disease and pregnancy, acceptability concerns pertaining to aesthetic factors and effectiveness, and situational influences such as exchange sex, substance use, and suspicions from female partners. Themes regarding the impact of HIV on sexual activity included rejection, decreased partner seeking, and isolation. Serostatus disclosure themes included disclosure to selective partners and personal responsibility. Comprehensive HIV risk-reduction strategies that build social support networks, condom self-efficacy, communication skills, and a sense of collective responsibility among NGI African American MSM/W while addressing HIV stigma in the African American community as a whole are suggested.

Adult↗
PubMed1994

Increase in safe sex among the young and non-monogamous: knowledge, attitudes and behavior regarding safe sex and condom use in The Netherlands from 1987 to 1993.

In 1987, the Dutch STD Foundation started several safe sex campaigns targeting the general population. These campaigns have been accompanied by surveys which were conducted every 6 months. Questions were asked about knowledge, attitudes and behavior. The number of people who regard condom use as being a safe sex practice increased over the years, as did the number of people who know that condoms protect against STDs and AIDs. Surprisingly, no accompanying changes in attitudes occurred. Nevertheless, the number of people saying they have done something to prevent HIV infection increased significantly among the young and non-monogamous. Also, specifically in these groups, both actual and intentional condom use increased remarkably. Although it is encouraging that those towards whom the campaigns were particularly directed, show the largest changes, there are also signs that these behavioral changes are levelling off.

Adolescent↗
PubMed2005

Participation and retention in a study of female condom use among women at high STD risk.

PURPOSE: Differential participation and retention can bias the findings of a follow-up study. This problem was evaluated in a study of barrier contraception among women at high STD risk. The goal of this study was to identify predictors of participation and retention and determine whether they could influence study results. METHODS: Six-month follow-up study of women attending STD clinics. Determinants of participation and retention were evaluated using logistic and proportional hazards models. RESULTS: Agreement to participate was associated with young age, black race, low education and income, older age at first intercourse, the number of lifetime partners, and STD history. Early attrition was associated with young age, non-black race, higher income, lack of interest/commitment to using the female condom, high coital frequency, no STD history, not using a birth control method at baseline, and with inconsistent condom use, high coital frequency, and pregnancy during follow up. CONCLUSIONS: There was little evidence that differential participation influenced the validity of the study. Differential attrition may have biased behavioral measures of intervention effectiveness, but not necessarily measures of condom use effectiveness.

Adult↗
PubMedDate not supplied

Identification of polydimethylsiloxane lubricant traces from latex condoms in cases of sexual assault.

A polydimethylsiloxane (PDMS) liquid is used as a lubricant by many condom manufacturers. Because the use of condoms in sex crimes is likely to increase, a protocol was developed that could extract PDMS and the spermicide nonoxynol-9 from evidence items and separately identify them by Fourier transform infrared spectroscopy. Additionally, at least some discrimination was provided by microscopically identifying insoluble lubricants such as corn starch, lycopodium, silica, and talc which are added to some brands. Desorption chemical ionization mass spectrometry was used to compare the PDMS used by different manufacturers and to detect as little as 20 ng. The protocol was successfully used in two actual cases, one in which the assailant wore a lubricated condom, and a second in which he did not, but claimed to have done so.

Adolescent↗
PubMed2003

Factors associated with condom use among at-risk women students and nonstudents seen in managed care.

OBJECTIVES: Sexually transmitted diseases (STD) research has focused on high-risk populations such as STD clinic patients and college students. This report examines predictors of unprotected sex among nonstudent women seen in primary care. STUDY DESIGN: Data are taken from the baseline survey of an intervention trial testing tailored print materials to encourage condom use. POPULATION: Eligible women were identified from automated databases of two managed care organizations and were ages 18-25, unmarried, heterosexually active in the prior 6 months, and not in a long-term monogamous relationship. OUTCOMES: The frequency of and relative contribution of risk behaviors to occurrences of unprotected vaginal sex were compared among non-full-time students (n=711) and full-time students (n=390). RESULTS: STD risk behaviors were prevalent and had similar associations with unprotected sex in both subsamples. Older age, using hormonal or no usual contraception, and having a "primary" partner increased unprotected sex; partner approval of condoms and having bought or carried condoms decreased unprotected sex. CONCLUSION: While sexually active single women seen in primary care perceive themselves at low STD risk, their risk profiles are similar to those of higher risk populations. Clinic-based interventions that include proactive identification of at-risk women and systems for encouraging safer sex practices are needed.

Adult↗
PubMedDate not supplied

[Social marketing applied to condom promotion: a proposal for intervention in groups at risk for sexually transmitted diseases].

Sexually transmitted diseases (STDs) are an important worldwide health problem. Their association with AIDS an other insidious viral processes have brought them to the foreground of sanitary authorities and general population concern. Often, health services have to struggle with reinfections, which concentrate in pockets of risk that consume large amount of care and constitute an important link in the transmission of these diseases. General publicity have little impact among high risk groups. Thus, it becomes necessary to be more precise and divide into segments the target population we want to reach. Prevention of reinfection in these communities requires the implementation of healthy behaviours through the promotion of a tangible product (condom). Regarding these considerations, social marketing emerges as the right instrument to be used. Through individual focused interviews with prostitutes, homosexual and young promiscuous heterosexual patients from a STDs Prevention, Diagnosis and Treatment Centre, determining factors of the use condoms and related behaviour guidelines have been identified. Also, a social marketing strategy is suggested to prevent these diseases among groups at risk by means of condom promotion.

Adolescent↗
PubMed2006

Promoting condoms in Brazil to men who have sex with men.

DKT International is a non-profit social marketing enterprise whose mission is to provide safe, affordable options for family planning and STI/HIV prevention. In Brazil, DKT sells male and female condoms to mostly lower-income couples nationwide. This paper is about the introduction of a ribbed, lubricated, latex condom called Affair to the Brazilian market in 2000. Sales were initially very low, but based on reports that Affair was well liked by some men who have sex with men, we took the opportunity to give Affair that positioning. We worked with our advertising agency, a local research company and Dignidade, a Brazilian NGO working for the rights of men who have sex with men. Two new products--a baggy condom called Affair Sensation and a complimentary lubricating gel called Affair Personal Lubricant--with new packaging and a promotional campaign were launched in February 2006. The billboard advertisement generated controversy in São Paulo, where the Advertising Council required it to be taken down due to complaints. However, the controversy helped promotion and at the same time generated public debate on sexuality and human rights. Our overall experience has been positive, sales are up and we have received messages of support for the products and their promotion from consumers.

Brazil↗
PubMed2006

Where have all the condoms gone in adolescent programmes in the Democratic Republic of Congo.

Decades of mismanagement, combined with the withdrawal of international cooperation and a protracted war, have seriously affected the health system in the Democratic Republic of Congo (DRC) and the health status of the population. As part of a Belgian development cooperation programme, we conducted a study in Kinshasa and Bukavu in April-May 2004 on how a rights-based approach could contribute to an effective and appropriate response to the sexual and reproductive health needs of Congolese adolescents. Access to condom information and supplies was studied in this context. A qualitative methodology was used, consisting of focus group discussions with adolescents and interviews with peer education programme officers. These programmes were supposed to be based on the recognition of adolescent sexual and reproductive health rights and the so-called ABC approach (abstinence, be faithful, condom use). We found, however, that sociocultural barriers and strict obedience to Vatican doctrine prevented adolescents from receiving accurate and comprehensive sexuality education and that condom supplies were blocked by peer education programme officers. The promotion of adolescent sexual and reproductive health rights is the responsibility of States, but the international community, non-governmental and faith-based organisations and donors play an essential role in assisting States in this respect and should never act in violation of adolescents' rights.

Adolescent↗
PubMed2003

Need for intimacy in relationships and motives for sex as determinants of adolescent condom use.

PURPOSE: To investigate the extent to which need for intimacy in relationships and motives for sex are capable of distinguishing between adolescents who always have protected sex and adolescents who do not, with reference to both steady and casual relationships. METHODS: Seven-hundred-and-one adolescents (424 males and 277 females) aged 15 to 23 years filled out a questionnaire assessing determinants of sexual behavior and various outcome behaviors, such as having casual sex and condom use. RESULTS: Two-thirds of the participants (470) were sexually experienced. Discriminant functions using constructs of the Theory of Planned Behavior (attitude, subjective norm, self-efficacy), as well as the need for intimacy in relationships and motives for sex, were found to distinguish significantly between adolescents who always had protected sexual intercourse and adolescents who did not. This was valid both for sex within steady and within casual relationships. Besides a positive attitude and high perceived subjective norms, protected sex with a steady partner was characterized by low scores on the scale for the motive for sex to express love, and on the scale for the need for intimacy in relationships. Consistent condom use with casual partners was related to high self-efficacy, attitude, and perceived subjective norms, as well as a greater need for intimacy in relationships. Gender differences emerged with respects to determinants of (un)safe sex with casual partner(s), in that for males the variables of the Theory of Planned Behavior were most important in distinguishing those who had unsafe casual sex from those who had safe casual sex. For females, on the other hand, the variables concerning the meaning attached to having sex or to the relationship within which sex occurs seemed to be of more significance in explaining (un)safe sex with casual partner(s). However, owing to small subsamples, caution is warranted when interpreting these differences. CONCLUSIONS: In adolescence, the factors which influence the decision to have (un)protected sex depend on the kind of relationship that exists between the partners. In addition, the goals which adolescents pursue with regard to their relationships and with regard to having sex fulfill an important role in the decision-making process whether to use condoms.

Adolescent↗
PubMed2000

Asthma, skin symptoms, and allergy in a condom factory.

BACKGROUND: Cases of occupational asthma have been reported in condom factories in the UK and France, but there has been no epidemiologic study of groups of workers in such factories. This investigation aimed to study the prevalence of symptoms in a Swedish condom factory, to determine groups at special risk, and to suggest preventive measures. METHODS: A questionnaire was mailed to 35 employees, 29 women and six men with mean ages of 37 and 32 years, respectively. All subjects were interviewed by a physician and underwent skin prick test with latex and epicutaneous testing with 39 substances, and blood samples were taken for allergy testing. RESULTS: Phadiatop was positive in 23%, RAST against Lycopodium in 31%, and RAST against latex in one of these 11. Ten subjects (29%) had work-related nose/eye symptoms; of these, eight had positive RAST to Lycopodium; three also had symptoms of occupational asthma and contact urticaria. Only one had positive RAST to latex. Five of the nine subjects with positive Phadiatop also had positive RAST to Lycopodium. All those with RAST positive to Lycopodium had worked in packaging, the area of the factory with the greatest exposure. The results of the patch tests did not correlate with the work-related symptoms. CONCLUSIONS: In a Swedish condom factory, there were a high prevalence of rhinoconjunctivitis and a small number of cases of asthma and contact urticaria caused by allergy to Lycopodium.

Adult↗
PubMed1995

HIV risk in intravenous drug users and crack cocaine smokers: predicting stage of change for condom use.

This study examined the utility of the Transtheoretical Model of Change and the AIDS Risk Reduction Model for predicting condom use with not-in-treatment crack cocaine smokers and intravenous drug users. The sample included 265 participants; 99 reported having casual partners and 166 reported having main partners. All participants must have used drugs in the preceding 48 hr and received no drug treatment for at least 1 year. Participants were grouped into 3 stages of change; precontemplation, contemplation, and action. Logistic regression analyses indicated that both the benefits of change and condom assertiveness varied across the stages of change for main and casual partners, whereas the costs of change were important for predicting stage only with main partners. Age was a significant predictor of stage with casual partners, whereas ethnicity and nonherpes sexually transmitted diseases significantly predicted stage with main partners. The utility of the stages of change for choosing intervention strategies and the need for more qualitative and longitudinal research to determine additional predictors of intention to use condoms are discussed.

Adolescent↗
PubMed2006

Remembering the message: the use of a reminder cue to increase condom use following a safer sex intervention.

Condom use interventions may be more powerful if they provide cues to recall safe-sex messages when sexual activity occurs. The authors tested this notion by assigning sexually active introductory psychology students (N = 196) to a standard safe-sex intervention, a safe-sex with reminder intervention, or a control (drinking and driving) intervention. Participants assigned to the reminder intervention were given a "friendship bracelet" to wear and were instructed to have the bracelet remind them of the intervention. In a follow-up session (5-7 weeks later), they were asked questions pertaining to condom use. Of the 125 participants who had engaged in sexual intercourse, condom use at last intercourse was higher in the bracelet condition (55%) than in the standard (27%) or control (36%) conditions. The authors also found that the bracelet remained effective, even when participants were under the influence of alcohol. These findings therefore imply that health intervention programs may be more efficacious if they include strategies such as reminder cues to increase the salience of health information in the appropriate contexts.

Adolescent↗
PubMed2005

Condom use among brothel-based sex workers and clients in Bali, Indonesia.

BACKGROUND: The objective of this paper is to describe the situation among Indonesian sex workers and clients in Bali, Indonesia, through a series of studies conducted during the 1990s. METHODS: Five surveys of sex workers and clients were conducted from 1992 through to 1999. RESULTS: The proportion of female sex workers who have heard about AIDS and condom use has increased tremendously in this area. In 1992-93, 51% of women reported ever hearing of AIDS and this had increased to 97% by 1999 (P < 0.01). Reported condom use with clients increased from 19% in 1992-93 to 78% in 1999 (P < 0.01). However, condom use is still far from 100% and perceived susceptibility towards HIV infection among female sex workers and their male clients remains low. Ineffective preventive strategies such as medication use remain common. HIV infection was very low in this population, although the prevalence of other sexually transmitted infections such as gonorrhea and chlamydia was very high. CONCLUSIONS: Educational interventions have been conducted with the sex workers, but the main source of education for clients has been through the media. Future programs need to develop more focused efforts to reach clients. These interventions may include worksite interventions, mass media campaigns, youth programs or other models.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Condom use among US students: the importance of confidence in normative and attitudinal perceptions.

The author performed a study among U.S. undergraduates to test an earlier conclusion (D. Trafimow, 1994) that confidence in the correctness of one's perceptions of normative pressure to use a condom influences the correspondence between those perceptions and the intentions actually to perform the behavior. Consistent with previous findings (Trafimow), the participants' perceptions of normative pressure strongly predicted their intentions to use condoms only under conditions of extreme normative confidence. Otherwise, their attitudes were better predictors of their intentions to use condoms. In addition, 2 other variables (attitudinal confidence and perceived behavioral control) were found to be unimportant predictors of intentions. Results of a 2nd study suggest that behaviors performed by sexual partners and knowing the sexual partners affected the participants' normative confidence.

Adult↗