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PubMed1993

HIV infection and the meaning of condoms.

Present day meanings associated with condom use among drug-using women and their long term sexual partners include: loss of male protection; violations of constructions of intimacy, fidelity, conjugal bonding, and female identity; illness; and death. Efforts to change condom use patterns must be based on increased vocational, educational, and social opportunities for women. HIV prevention efforts might profit from the design of safer sex interventions informed by the above meanings; intensified mass media campaigns; and a re-contextualization of attitudes, behaviors, and beliefs.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Cost-effectiveness of the female condom in preventing HIV and STDs in commercial sex workers in rural South Africa.

We assessed the cost-effectiveness of the female condom (FC) in preventing HIV infection and other STDs among commercial sex workers (CSWs) and their clients in the Mpumulanga Province of South Africa. The health and economic outcomes of current levels of male condom (MC) use in 1000 CSWs who average 25 partners per year and have an HIV prevalence of 50.3% was compared with the expected outcomes resulting from the additional provision of FCs to these CSWs. A simulation model calculated health and public sector cost outcomes assuming 5 years of HIV infectivity, 1 month of syphilis and gonorrhea infectivity, and FC use in 12% of episodes of vaginal intercourse. Delayed infections and interactions between STDs and HIV were modeled. The simulation was extended to non-CSWs with as few as one casual partner per year. We conducted multiple sensitivity analyses. The program would distribute 6000 FCs annually at a cost of $4002 and would avert 5.9 HIV, 38 syphilis, and 33 gonorrhea cases. This would save the public sector health payer $12,090 in averted HIV/AIDS treatment costs, and $1,074 in averted syphilis and gonorrhea treatment costs for a net saving of $9163. Sensitivity analyses indicate that the economic findings are robust across a wide range of values for key inputs. The program generates net savings of $5421 if HIV prevalence in CSWs is 25% rather than 50.3% and savings of S3591 if each CSW has an average of 10 clients per year rather than 25. A program focusing on non-CSWs with only one casual partner would save $199. We conclude that a well-designed FC program oriented to CSWs and other women with casual partners is likely to be highly cost-effective and can save public sector health funds in rural South Africa.

Condoms↗
PubMed1996

Individual and situational markers of condom use and sex with nonprimary partners among alcoholic inpatients: findings from the ATRISK Study.

Alcoholics in treatment have demonstrated increased rates of HIV risk behavior and infection. This study explored individual and situational variables associated with HIV risk behaviors such as condom nonuse and sex with nonprimary partners reported during structured interviews of 802 male and female alcoholic inpatients. Logistic regression analyses indicated that person variables, sexual history variables, and situation variables were independently associated with sexual risk behavior in the most recent episode. Results of paired t tests revealed that participants who had engaged in sex with both primary and nonprimary partners during the previous 6 months reported significantly more frequent alcohol and condom use in situations involving sex with nonprimary partners. Prevention efforts need to target alcoholic inpatients as a group and, within this group, to focus on both high-risk individuals and high-risk situations.

Adult↗
PubMed1995

Beliefs about condoms in 12/13 and 16/17 year olds.

The present study examined the beliefs and attitudes which surround condoms and their use. Qualitative data in the form of short essays were collected from 12/13 (n = 148) and 16/17 (n = 63) year olds. The results suggest that condoms are conceptualized in terms of a complex set of factual and evaluative factors such as feelings, responsibility and risk and that younger subjects hold more positive beliefs than the older subjects. The results are discussed in terms of models of preventive behaviour and the role of sex education at an early age.

Adolescent↗
PubMed1995

Number of sexual partners, condom use and risk of human immunodeficiency virus infection.

BACKGROUND: To analyse the relation between number of sexual partners, selected sexual habits and the risk of human immunodeficiency virus (HIV) infection. METHODS: We conducted a case-control study nested in a cross-sectional survey conducted among subjects attending sexually transmitted diseases (STD) clinics in Northern Italy. Eligible for the study were 1711 subjects (1259 males, 452 females) who referred themselves for the first time between September 1988 and March 1993 to three STD clinics in Northern Italy for suspected STD or STD treatment. A total of 145 subjects (113 males and 32 females) were HIV positive. RESULTS: In comparison with subjects reporting no or one sexual partner over the 3 years before the interview, the estimated odds ratios (OR) of HIV serum positivity were 1.2 (95% confidence interval [CI]: 0.6-2.3), 0.8 (95% CI: 0.4-1.8) and 0.3 (95% CI: 0.4-2.5) in subjects reporting 2-3, 4-5, and > or = 6 partners, respectively. The results were similar considering separately males and females and in men reporting only homosexual partners. Regular condom use decreased the risk of HIV infection: in comparison with subjects reporting no or occasional use of condoms, the OR of HIV infection was 0.5 (95% CI: 0.4-0.8) for regular users. Considering men only, compared with men with no homosexual intercourse, the OR of HIV infection was 2.3 (95% CI: 1.4-3.9) in those reporting bisexual intercourse and 2.2 (95% CI: 1.2-4.2) in men reporting only homosexual intercourse (among homosexuals). There was no relation between HIV infection risk and receptive anal sex. CONCLUSIONS: The risk of HIV infection does not increase linearly with the number of sexual partners in this population. This is reasonable, as the prevalence of HIV infection in this population is essentially determined by drug use. Caution is needed in the interpretation of these results since the analysis of role of number of sexual partners in male intravenous drug users is impaired by low statistical power.

Adult↗
PubMedDate not supplied

Nonoxynol-9 in lubricated condoms. Results of a study in female prostitutes.

BACKGROUND AND OBJECTIVES: Debate continues on the efficacy and safety of intravaginal nonoxynol-9 for the prevention of horizontal transmission of human immunodeficiency and other sexually transmitted diseases. Little attention has been paid to the effects of nonoxynol-9 contained in the lubricant of many condoms. GOAL: To assess the tolerability of different levels of nonoxynol-9 in condom lubricants. STUDY DESIGN: Pilot, randomized, controlled trial in 70 female prostitutes. RESULTS: There was no association between dose of nonoxynol-9 and reported symptoms or signs of genital tract inflammation; an increased dose of nonoxynol-9 was associated with increased numbers of polymorphonuclear leukocytes on a vaginal wall smear. CONCLUSIONS: There is no recognized simple method of defining inflammation in the female genital tract. Future studies of the effects of low-dose nonoxynol-9 on the female genital tract require highly controlled exposures, plus colposcopy with or without vaginal biopsy to define inflammation.

Condoms↗
PubMed1998

Sex hustling, injection drug use, and non-gay identification by men who have sex with men. Associations with high-risk sexual behaviors and condom use.

OBJECTIVE: To explore differences in demographic characteristies, risk practices, and preventive behaviors among subgroups of men who have sex with men (MSM), including gay- and non-gay-identified MSM, MSM who inject drugs, and those engaging in sex hustling. DESIGN: A secondary analysis of cross-sectional data collected through interviewer-administered questionnaires in a purposive sample of MSM. SETTING: Gay bars, bath houses, adult video arcades, and out-door crusing areas in Denver and Long Beach. PARTICIPANTS: Men who reported oral or anal sex with another man in the past year with oversampling of non-gay-identified MSM. RESULTS: Of 1,290 MSM, 417 (32%) did not gay-identify, 86 (7%) were drug injectors, and 117 (9%) were hustlers. Of drug-injecting MSM, 55% reported sex hustling and 40% of hustlers reported injection drug use. Hustling was associated with higher number of partners, more frequent anal sex with men and women, and less frequent condom use during anal sex with occasional male partners. Hustlers and drug-injecting MSM used condoms less consistently during vaginal intercourse with female partners than did other MSM. CONCLUSIONS: Among MSM, subgroups at particularly high risk for HIV can be identified. Although these subgroups may be relatively small, they may be important epidemiologic links to the larger MSM and heterosexual communities and warrant focused behavioral interventions to prevent the further spread of HIV.

Adult↗
PubMed1999

Sexual experiences and condom use of heterosexual, low-income African American and Hispanic youth practicing relative monogamy, serial monogamy, and nonmonogamy.

BACKGROUND AND OBJECTIVES: To describe (a) demographic characteristics, (b) sexual history, (c) perceived HIV susceptibility, and (d) current sexual behavior, condom use, and alcohol and marijuana use of heterosexual, low-income African American and Hispanic youth categorized as relatively monogamous (n = 577), serial monogamous (n = 171), or nonmonogamous (n = 278). STUDY DESIGN: Data were drawn from personal interviews with a probability sample of low-income youth, age 15 to 24 years, conducted in Detroit in 1991. RESULTS: Many group differences were found. For example, relatively monogamous youth were most likely to be female and Hispanic and to have engaged in unprotected intercourse. Serial monogamous youth were younger and most likely to have used condoms at last intercourse. Nonmonogamous youth initiated intercourse earlier and were most likely to have experienced oral and anal intercourse and to have used alcohol and marijuana. CONCLUSION: Risk reduction programs may need to be tailored differently to accommodate the needs of these three distinct subgroups of youth.

Adolescent↗
PubMed2000

Who's at risk? Men's STD experience and condom use in southwest Nigeria.

Many STD/HIV-prevention programs worldwide assume that individuals' risk of acquiring sexually transmitted diseases, including HIV infection, is highest in the context of commercial sex. To address this assumption, research conducted in urban Southwest Nigeria combined qualitative and quantitative methods to examine men's sexual behavior, condom use, and STD experience in different types of sexual relationships (marital, casual, and commercial). Logistic regression analysis of survey data indicates that number of sexual partners and sex with sex workers are positively and significantly related to STD experience. Follow-up in-depth interviews with clients of sex workers indicate, however, that these men are actually more likely to report having contracted an STD from a casual sex partner than from a sex worker. Men are most uncertain about their vulnerability to STDs with casual partners. Men's condom use is highest in commercial sex, inconsistent in casual relationships, and lowest in marriage. STD/HIV-prevention programs need to address the range of sexual relationships and the meanings and behaviors associated with them.

Adolescent↗
PubMed1994

Religiosity, sexual intercourse and condom use among university students.

There is strong evidence that religiosity among adolescents is associated with delayed onset of sexual activity. However, research on relationships between religiosity and contraceptive practices is limited and inconsistent. This paper provides data from a survey of 374 students aged between 16 and 21 at two Brisbane universities (72.4 per cent response rate). Those who perceived religion to be important in their lives were less likely to have had intercourse. Among the sexually active sample, religious youth did not differ from their peers in recent condom use, the age at which they first used condoms or the rate of partner change. Contrary to several recent assertions in review articles, this and other empirical studies do not show that religious youth are less likely than nonreligious youth to take precautions during sex.

Adolescent↗
PubMed1996

The effect of sex education on adolescents' use of condoms: applying the Solomon four-group design.

A school-based sex education program was developed in order to prevent sexually transmitted diseases and unwanted pregnancies. A Solomon four-group design, with random assignment to the different conditions, was used to evaluate an intervention based on cognitive social learning theory and social influence theory. The main goal of the intervention was to increase use of condoms. A stratified sample of 124 classes (2,411 students) was drawn at random from all the upper secondary schools (high schools/colleges) in one county in Norway. The results indicate a consistent interaction between pretest and intervention, which seems to have an effect on condom use. Pretest or intervention alone did not contribute to this effect. The interaction effect appeared among the students with few sexual partners. Several possible explanations to the observed interaction effect and the implication for future interventions are discussed.

Adolescent↗
PubMed1994

A methodological comparison of survey techniques in obtaining self-reports of condom-related behaviors.

To obtain more accurate accounts of sexual attitudes and practices, researchers must explore innovative ways to overcome the reluctance of individuals to disclose sensitive and perhaps incriminating information about themselves. The differences among selected modes of inquiry and survey techniques used to gather self-reports about sensitive contraceptive behaviors among young adults were examined in this study. Comparisons were made between the randomized response versus the direct-inquiry survey techniques and personal interview versus self-administered modes of inquiry relative to the reporting of sensitive condom-related sexual practices of 352 students at a large northeastern university. Findings indicated that the "controlled-choice" randomized-response technique was less effective in obtaining self-reports about condom-related practices than were direct-inquiry techniques. Recommendations for investigations are proposed.

Adolescent↗
PubMed1999

Closing the condom gap.

The need for condoms is growing as HIV/AIDS and other sexually transmitted infections (STIs) spread. Making condoms more accessible, lowering their cost, promoting them more, and helping to overcome social and personal obstacles to their use would save many lives and reduce the enormous consequences and costs of STIs and unintended pregnancies.

Adolescent↗
PubMed2000

Normative influence on condom use in the personal networks of female cocaine smokers.

Attitudes-norms research (the theories of planned behavior and reasoned action) has been successful in accounting for many types of behavior change. One of the strengths of this approach has been to combine individual beliefs and normative influences in the explanation of behavior change. However, the conceptualization of normative influence in these theories makes very strong assumptions about self-awareness in the selection of normative referents. These assumptions are particularly problematic when applied to female cocaine smokers, who report frequent sex while under duress or while cognitively impaired. In this study the original conceptualization of normative influence and two alternatives (assuming emotion-based and interaction-based selection of normative referents) are operationalized to evaluate stage of change for condom use among women who are heavy crack cocaine users with multiple sex partners. Results show that stage of change for use of condoms with nonmain partners is best accounted for by interaction-based selection of normative referents.

Adult↗
PubMed1991

Bush blasts 'filth' on TV, school condom handouts.

President Bush complained yesterday about the "filth and indecent material" that Americans are exposed to through televised trials. Mr. Bush also criticized programs to combat AIDS that give condoms to teenagers and clean needles to drug addicts. He said such efforts undermine traditional values. He expressed hope that Earvin "Magic" Johnson's revelation that he is HIV positive "will teach people that wayward lifestyles or just kind of unsafe sex at random is not the way it ought to work." Mr. Bush made the comments in a series of satellite television interviews with ABC affiliates in major cities. In an apparent reaction to graphic testimony at the recent Palm Beach rape trial of William Kennedy Smith, Mr. Bush said, "I think the American people have a right to be protected against some of these excesses." Mr. Smith, a nephew of Sen. Edward M. Kennedy, D-Mass., was acquitted last week. The Cable News Network and Court TV provided virtually gavel-to-gavel coverage. Mr. Bush took a dim view of a plan to distribute condoms to juniors and seniors in Philadelphia city high schools as part of a program to combat acquired immune deficiency syndrome. "This is a disease that can be controlled for the most part by individual behavior," Mr. Bush said. "Indeed, I must tell you I'm worried about it. I'm worried about so much filth and indecent material coming in through the airwaves and through these trials into people's homes," he said.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Notice to manufacturers and distributors of condoms, 1987.

This Notice (to manufacturers and distributors of condoms) has been issued in accordance with Articles R. 5045-R 5055 of Chapters 4 (Regulation of Advertising) and 5 (Inspection of Pharmacies) of the French Public Health Code and repeals the Notice published in the Journal Officiel of October 22, 1987 (Annual Review of Population Law, Vol. 14, 1987, Section 220). It specifies the items to be lodged with the file submitted in an application for a license to advertise condoms as a means of preventing the contraction of sexually transmitted diseases.

Advertising↗
PubMed1987

Sale of Condoms Act 1987 (No. 72 of 1987), 27 November 1987.

This Act legalizes the sale of condoms in shops through vending machines installed by a licensed installer and by mail order. It also gives the Publications Classifications Board the right to consider the advertising of condoms and to approve or refuse to approve such advertising. It is to approve advertising only if it is "satisfied that there are medical, hygienic, or social benefits to be gained" from the advertising. Further provisions of the Act set forth licensing procedures and penalties for violation of the Act, among other things.

Advertising↗
PubMed1996

Developmental sophistication among adolescents of negotiation strategies for condom use.

Condoms are an important method of reducing the risk of sexually transmitted disease among sexually active adolescents. This study used a developmental approach to examine the negotiation of condom use. The Interpersonal Negotiation Strategy Interview was administered to adolescents using two vignettes that were focused on the negotiation of "safer sex" behaviors. The sample consisted of 196 girls and 92 boys recruited from their primary care clinic or Job Corps. The mean scores for each problem-solving step were at the subjective, unilateral stage, which indicates that problems are resolved through one-way methods. Current educational strategies and the lack of mutuality in adolescents' sexual relationships influence the level of negotiation skills. Interventions need to be at the appropriate developmental level but also need to encourage progress toward collaborative relationships.

Adolescent↗