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PubMedDate not supplied

Mexican and Mexican American women in a battered women's shelter: barriers to condom negotiation for HIV/AIDS prevention.

Anecdotal information suggests that, for Hispanic women who are involved with abusive partners, condom use request as an HIV/AIDS sexual risk-reduction behavior may expose the women to risk of both abuse and HIV/AIDS. A qualitative study explored barriers to condom negotiation for HIV/AIDS prevention among Mexican and Mexican American women in abusive relationships. A convenience sample of 14 Mexican and Mexican American women was recruited from a battered women's shelter. A demographic form, a domestic violence assessment form, and audiotaped responses to a semistructured interview guide were used to collect data. Descriptive statistics were used to describe the sample. Audiotaped interviews were transcribed verbatim and submitted to content analysis, which revealed past and present themes of physical, psychological, and sexual abuse of Mexican and Mexican American women who requested condom use by their male sexual partners. Also identified by content analysis was the influence of men's power on women's public, private, and sexual interactions.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Hydronephrosis due to improper condom catheter use.

This report concerns a patient with bilateral hydronephrosis due to a tight external condom catheter retention strap. Urodynamics with fluoroscopy and cystoscopy failed to demonstrate bladder outlet obstruction, urethral stricture, uretero-vesicle junction abnormality, or other explanations for the bilateral hydronephrosis. The hydronephrosis resolved when the external condom catheter retention strap was eliminated. The authors emphasize the importance of patient education to prevent this problem and encourage alertness by clinicians to assess appropriateness of external condom catheter use.

Aged↗
PubMed2000

The timing is never right: Mexican views of condom use.

Unprotected sex is a critical issue in the Hispanic community, with the incidence of new Hispanic acquired immune deficiency syndrome (AIDS) cases three times that of non-Hispanic Whites. The researchers used focus groups to examine: (a) whether newly immigrated Mexican men and women in the Southeast United States discussed human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention with each other, and (b) how condom use was discussed. For the women, communication was safe sex, and for the men, trust was safe sex. Both communication and trust were dependent on timing in the relationship. Participants could not discuss condoms in a new or established relationship because of issues of trust. This study highlights the complexity of HIV/STD prevention and suggests that trust and timing should be considered within the cultural context of condom introduction.

Adult↗
PubMed2001

Educational status and young Dutch gay men's beliefs about using condoms.

The higher levels of HIV risk behaviour that have been found in young gay men with lower socio-economic status (SES, among others defined as educational achievement) may result from unequal effects of safer sex interventions. We conducted semi-structured focus group interviews with an educationally diverse sample of 113 young gay men living in The Netherlands. The objective was to bring to light men's salient ('accessible') beliefs about using condoms since information about beliefs might facilitate the formulation of 'personally relevant' safer sex messages that enhance in-depth message processing. We found several educational differences in the areas of knowledge about HIV preventive behaviour, cognitive schemas about the factors involved in HIV transmission, perceived pros and cons of using condoms, perceived social pressure to use condoms and feelings of being in control of protective action. This may suggest that, for intervention efforts to be effective in motivating the diversity of young gay men to engage in safer sex, interventions should convey tailor-made messages that match recipients' educational degree. Several implications for the formulation of such messages are discussed.

Adolescent↗
PubMed2005

HIV prevention heuristics and condom use among African-Americans at risk for HIV.

The goal of this study was to improve understanding of whether incorrect HIV/AIDS heuristics and characteristics-based risk theories are barriers to HIV prevention among young African-Americans at increased risk for HIV. We explored: (1) the beliefs of men and women regarding disease prevention strategies, and (2) the relationship of such beliefs to safer sexual behaviours. In Phase I, semistructured individual interviews were conducted with both members of 22 heterosexual couples at increased risk for HIV/STIs. Subsequently, in Phase II, structured individual interviews were conducted with another 40 women and 40 men (not couples). Participants in Phase I reported use of condoms and monogamy as major strategies for disease prevention. The beliefs that were endorsed by the largest percentage of Phase II participants were related to the 'known partners are safe partners' and 'trusted partners are safe partners' heuristics. Moreover, stronger endorsement of the 'known partners' heuristic was negatively associated with measures of condom use and pregnancy prevention behaviour. Our findings highlight the need for interventions and programmes to encourage intimate partners to consistently use condoms until both members of the dyad are tested and agree to mutual monogamy.

Adolescent↗
PubMed1989

Knowledge of AIDS, use of condoms and results of counselling subjects with asymptomatic HIV2 infection in The Gambia.

A questionnaire administered to subjects seen during a serological survey in The Gambia revealed that knowledge of AIDS and HIV infection was limited. Males, those with a secondary education and people who lived in urban areas had a better understanding but only 17% of women seen in rural areas had any knowledge of the condition. Only 8% of the subjects seen had used condoms in the preceding 12 months; during this time half of them had done so on less than five occasions. Subjects with a secondary education were more likely to have used condoms. A counsellor met 31 asymptomatic seropositive subjects identified during this survey on two occasions. In the majority, the information given caused anxiety rather than modification of behaviour and, at the time of the second interview, only one subject had discussed the situation with the partner and begun using condoms. Some of the cultural factors which may affect the outcome of counselling in an African society are discussed in the light of these findings.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Why communication is crucial: meta-analysis of the relationship between safer sexual communication and condom use.

The purpose of this study was to quantitatively synthesize the growing literature on the relationship between safer sexual communication (SSC) among sexual partners and condom use, and to systematically examine a number of conceptual and methodological moderators of this relationship. Data from 53 articles published in 27 journals met criteria for the study. Fifty-five independent effect sizes coded from samples totaling N=18,529 were meta-analyzed. Results indicate that the mean sample-size weighted effect size of the SSC-condom use relation was r=.22, and a number of conceptual variables were found to moderate this relationship. Specifically, communication about condom use (r=.25) and sexual history (r=.23) had significantly (p<.05) larger effect sizes than communication about safer sex (r=.18). In addition, SSC measures operationalized differently had significantly (p<.05) different effect sizes. From largest to smallest, these were behavioral format (r=.29), intentional format (r=.18), and self-efficacy format (r=.13). Measures that tried to assess persuasion attempts as compared with informational exchanges were not found to have significantly different effect sizes (p>.05). Further, methodological moderators tended to be unrelated to effect size. Implications for the future study of safer sexual communication as well as the importance of emphasizing communication skills in HIV preventive interventions are discussed.

Condoms↗
PubMed1999

Condom availability for HIV/STD prevention.

Condom availability is a structural intervention that increases access to condoms. It is the most important strategy for the prevention of the sexual transmission of HIV/STDs in developing countries. While it is an integral component of many prevention programs, it is considered controversial in high school settings and its role in a variety of HIV/STD prevention interventions has been understudied, understated, and/or unacknowledged. Condom availability as an HIV/STD prevention strategy needs to be reprioritized and should be considered a critical foundation of all programs to prevent the sexual transmission of HIV.

Adolescent↗
PubMed1994

Laparoscopic condom dissection: new technique of retroperitoneoscopy.

The laparoscopic condom dissection is an advancement on the recently described balloon dissection technique of retroperitoneoscopy. It allows a simultaneous balloon dissection and retroperitoneal laparoscopic dissection using a telescope placed inside a condom balloon. In spite of a mild masking effect by the balloon, the clarity of vision was satisfactory, and adequate dissection could be carried out in all five patients in whom the condom was placed deep to the fascia transversalis or Gerota's fascia.

Condoms↗
PubMed2004

Evaluation of a theoretically based AIDS/STD peer education program on postponing sexual intercourse and on condom use among adolescents attending high school.

The effectiveness of an intervention based upon the theories of Ajzen and Triandis was evaluated among 698 junior and 306 senior high school students. The intervention to juniors was offered by senior students who were trained during a course integrated into the school curriculum. Respondents in the control and experimental groups completed a questionnaire at baseline and 9 months after the program. Compared to junior respondents in the control group, those in the experimental group positively modified their attitude, perceived behavioral control, personal normative beliefs, perceived role beliefs, anticipated regret and intention with respect to postponing sexual intercourse and with respect to condom use, as well as perceived self-efficacy to negotiate both behaviors. Compared to senior respondents in the control group, those in the experimental group showed a significant positive modification of all the above variables except perceived behavioral control (indirect measure), anticipated regret and intention with respect to postponing sexual intercourse. At post-test, seniors in the experimental group were more likely to use condoms on a regular basis than those in the control group. Program effects occurred among both sexes, but a few differences in response were observed among males and females. Results suggest this type of theory-based program is effective in modifying psychosocial variables related to postponing sexual intercourse and related to condom use among adolescents. Personal involvement in designing intervention appears to be effective in modifying the behavior of peer educators.

Adolescent↗
PubMed2003

Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic.

OBJECTIVE: To examine the influence of environmental-structural factors in promoting consistent condom use (CCU) among female sex workers (FSW) and their regular paying partners in the Dominican Republic. METHODS: A cross-sectional survey was conducted with 288 FSW recruited from 41 sex establishments in Santo Domingo from March to June 1998. Sex workers were asked about their sexual behavior, self-efficacy at negotiating safe sex, perceived intimacy with their most recent regular paying partner, and the physical, social and policy environment of the establishment where they worked. Factor and reliability analysis were utilized to develop aggregate measures for self-efficacy (Cronbach's Alpha 0.60), intimacy (Cronbach's Alpha 0.80), and environmental-structural support (Cronbach's Alpha 0.72). RESULTS: Controlling for sociodemographic characteristics of participants in multivariate analyses, environmental-structural support for condom use and HIV/sexually transmitted infection (STI) prevention was a significant predictor of CCU (OR 2.16; CI 1.18-3.97) among FSW and their regular paying partners. Safe sex self-efficacy (OR 2.80; CI 1.31-5.97) and low perceived intimacy with the most recent regular paying partner (OR 7.20; CI 3.49-14.83) were also significantly associated with CCU in multivariate analysis. CONCLUSION: Environmental-structural support for condom use and HIV/STI prevention is a significant predictor of CCU among FSW in the context of regular paying partnerships. Environmental-structural factors, in addition to relational and individual cognitive factors, should be assessed and addressed by behaviorally guided theory, research and interventions related to HIV/STI prevention and female sex work.

Adolescent↗
PubMed1998

Sexually transmitted infections in female sex workers: reduced by condom use but not by a limited periodic examination program.

BACKGROUND AND OBJECTIVES: The sexually transmitted diseases (STD) control program for female sex workers (FSW) in Lima, Peru, provided periodic serological tests for syphilis and cervical smears for gonococci, but not medication for STD or condoms. GOAL OF THIS STUDY: To assess program effectiveness. STUDY DESIGN: We assessed prevalence of current STD and serum antibody to STD pathogens in FSW in relation to program participation and to condom use. RESULTS: Program participation was not associated with significantly reduced rates of current gonococcal or chlamydial infections or Venereal Disease Research Laboratory (VDRL) titers > or =4 with reactive fluorescent treponemal antibody absorption (FTA-ABS). However, regardless of control program participation, consistent condom use was associated with reduced prevalence of gonorrhea, and with significantly reduced seroreactivity for FTA-ABS, C. trachomatis, anti-hepatitis B core (HBc), and anti-human T-lymphotropic virus type I. Anti-HBc was associated with years of receiving penicillin injections for syphilis prophylaxis. CONCLUSION: The scope, quality, and efficacy of STD control programs must be technically appropriate, well managed, and adequately financed. The safety of marginal programs warrants scrutiny.

Adult↗
PubMed2003

Prevention of sexually transmitted diseases (STDs) in female sex workers: prospective evaluation of condom promotion and strengthened STD services.

BACKGROUND: In Perú, a previous study of government-sponsored periodic examinations of female sex workers (FSWs) found no significant impact on rates of sexually transmitted diseases (STDs). GOAL: This study assessed the impact of technically improved periodic STD services on STD prevalence and on consistent condom use (CCU). STUDY DESIGN: The study involved monthly follow-up of 917 FSWs at two STD clinics, with evaluations before and during implementation of strengthened STD services, which included periodic screening and treatment for gonorrhea, chlamydial infection, trichomoniasis, bacterial vaginosis (BV), and syphilis; counseling; and supply of condoms. Outcome analyses were adjusted for participation bias. RESULTS: During 7908 person-months of observation, the prevalences of gonorrhea, chlamydial infection, trichomoniasis, and BV declined significantly and CCU increased significantly, with similar trends in both clinics. During follow-up, gonorrhea, chlamydial infection, trichomoniasis, and BV were negatively associated with follow-up after screening. BV also was positively associated with use of an intrauterine device and negatively with douching. CCU during follow-up was associated with significantly decreased risk of gonorrhea, chlamydial infection, and trichomoniasis. CONCLUSIONS: Strengthened periodic screening for and treatment of confirmed STD, in addition to condom promotion and provision, represent feasible, effective interventions in commercial sex, and time series analyses can provide a useful approach to evaluating new interventions.

Adolescent↗
PubMed1996

High rates of sexual contact with female sex workers, sexually transmitted diseases, and condom neglect among HIV-infected and uninfected men with tuberculosis in Abidjan, Côte d'Ivoire.

To characterize human immunodeficiency virus (HIV) risk practices among men with tuberculosis, and to determine what factors are associated with HIV infection in this population, we conducted a case-control analysis of data collected during enrollment in a prospective cohort study in the two large tuberculosis treatment centers of Abidjan, Côte d'Ivoire. Demographic information and data on risk factors for HIV infection, including history of sex with female sex workers (FSWs) and history of sexually transmitted diseases (STDs), were collected on 490 HIV-infected and 239 HIV-uninfected men diagnosed with pulmonary tuberculosis between 1989 and 1992. HIV-infected men were significantly more likely than uninfected men to have had sex with FSWs in their lifetime [83 versus 63%, odds ratio (OR) 2.9, 95% confidence internal (CI) 2.0-4.2], genital ulcer disease in the past 5 years (38 versus 15%, OR 3.4, 95% CI 2.2-5.2), urethritis in the past 5 years (44 versus 23%, OR 2.6, 95% CI 1.8-3.8), and sex with FSWs in the past year (43 versus 25%, OR 2.3, 95% CI 1.6-3.3); no difference was found in the proportion with at least one non-FSW partner in the past year (84 versus 79%, OR 1.3, 95% CI 0.9-2.0). Among all men, 74% never used condoms, and only 1.4% always used condoms. In a multivariate analysis, sex with FSWs, genital ulcer disease, urethritis, and lack of circumcision were all significantly associated with HIV. This study demonstrates the critical roles of commercial sex, STDs, and condom neglect in fueling the HIV/AIDS epidemic in Abidjan, and illustrates the urgent need for widespread HIV education both in the general population and in men with tuberculosis.

Adolescent↗
PubMed1999

Seroprevalence of HIV among female sex workers in Bangkok: evidence of ongoing infection risk after the "100% condom program" was implemented.

BACKGROUND: After implementation in 1991 of a nationwide campaign to promote condom use during commercial sex, HIV-1 seroprevalence among young men began to decrease in 1994. However, it is unknown to what degree female sex workers (FSWs) have been protected from infection. METHODS: FSWs attending a government clinic in Bangkok in 1997 and 1998 were interviewed, counseled, and tested for evidence of prior syphilis by Treponema pallidum hemagglutination assay (TPHA) and for HIV-1 antibodies. RESULTS: Among the 500 participants, women who began sex work more recently reported less risky sex behavior when they were first potentially exposed to HIV infection, and TPHA reactivity rates were lower among these women. However, their HIV infection rates were higher. HIV seroprevalence was 5.5% among 91 women who began sex work before 1989, 8.0% among 87 women who began during 1990 to 1993, and 12.5% among 322 women who had begun since 1994. CONCLUSIONS: Although condom use is critical to HIV prevention, women in this study who began sex work after the condom promotion campaign was implemented were still at high risk for HIV infection. Additional measures are needed to prevent HIV infection among the many young women who initiate or continue to engage in commercial sex.

Adult↗
PubMed2001

National trends in condom use among at-risk heterosexuals in the united states.

Based on national level surveys, we examined data relevant to the United States' overall effort to prevent the spread of HIV among heterosexual adults. We examined changes in condom use among at-risk heterosexuals over the past decade. The observed increases over time in condom use across all heterosexual at-risk population segments are consistent with the observed (declines) trends in HIV and syphilis in the 1990s. These results and findings from prior studies suggest that U.S. efforts to facilitate condom use and contain HIV and related sexually transmitted disease (STD)-cofactors among adult at risk heterosexuals was succeeding over most of the 1990s. The absence of national level behavioral trend data after 1996, and the ambiguities of HIV spread suggest some caution in projecting trends into this century. National and local efforts need to be directed at sustaining behavioral change and conducting more rigorous studies on population trends in HIV/STD-related behaviors/pathogens.

Adolescent↗
PubMed2001

Brief report: condom use consistency associated with beliefs regarding HIV disease transmission among women receiving HIV antiretroviral therapy.

OBJECTIVE: To ascertain whether condom use consistency is associated with beliefs regarding a decreased likelihood of HIV transmission as a function of taking antiretroviral therapy. DESIGN: Cross-sectional analysis of HIV-positive women from Brooklyn (NY) enrolled in the Women's Interagency HIV Study (WIHS) who were taking any form of antiretroviral therapy at the time of data collection. METHODS: Between February and October, 1999, 145 HIV-positive eligible women participated in a structured, face-to-face interview. Interviews assessed attitudes and behaviors related to antiretroviral therapy and sexual risk behavior in the 6 months since a previous study visit. RESULTS: Over three fourths of the study sample (77%) disagreed with a statement that being on antiretroviral therapy decreases the chances of transmitting HIV to others. After controlling for number of sexual partners and HIV serostatus of partners, women reporting no association between HIV therapy and disease infectiousness were over three times more likely to report consistent condom use (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.2-8.3; p <.05). CONCLUSIONS: Antiretroviral therapy may be associated with increased risk behavior when it is believed that regimens may decrease the risk of disease transmission. Education regarding potential deleterious consequences of inconsistent condom use should be part of ongoing HIV care.

Adult↗
PubMed2003

Adolescent dual use of condoms and hormonal contraception: trends and correlates 1991-2001.

BACKGROUND: Use of condoms with hormonal contraceptive methods (dual use) is recommended for adolescents at increased risk for sexually transmitted infections and pregnancy. GOAL: The goal was to measure the extent of dual use among adolescents, to estimate trends in dual use 1991-2001, to assess factors associated with dual use in 2001, and to develop information useful for prevention programs. STUDY DESIGN: We used 6 Youth Risk Behavior Surveys of 9th-12th graders conducted 1991-2001. Each survey was an independent, nationally representative sample. Sample sizes ranged from 10,904 to 16,262, and overall response rates ranged from 60-70%. We estimated trends in dual use for the 1991-2001 period using linear logistic regression models of dual use on year of survey controlling statistically for grade, sex, and race/ethnic group, and evaluated correlates of dual use with chi-squared analysis. RESULTS: Dual use increased significantly throughout 1991-2001, from 3.2% (95% confidence interval, +/- 0.7%) in 1991 to 7.2% (+/- 0.8%) in 2001. During this period, condom use increased and pill use did not. In 2001, 32% (+/- 2.6%) of all users of hormonal methods (pill or injection) also used condoms. Students in a number of categories had higher rates of dual use: those who were white (8.9% +/- 1.2%), 12th graders (9.2% +/- 1.5%), and those aged 17 and older (8.8% +/- 1.3%). Greater dual use was not associated with increased sexual or drug use risk behaviors. CONCLUSION: Dual use has increased but remains low, especially among those most at risk.

Adolescent↗