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In September 2001, a gay man with hepatitis C held as a patient at a high-security psychiatric hospital applied for judicial review of the hospital's policy banning access to condoms for patients. His application was denied by the High Court on 30 October 2001.
Influential leaders are increasingly attacking condoms through HIV-prevention programs that focus on sexual abstinence and marital fidelity. In May 2004 Human Rights Watch (HRW) released a report that examines the impact of these policies in the Philippines, the largest Roman Catholic country in Asia and a major recipient of US HIV/AIDS funding.
This paper summarizes the results of a 2-day workshop to identify the most effective educational strategies to promote use of condoms and spermicides for preventing heterosexual transmission of HIV-1 virus from intravenous drug abusers (IVDA) to their steady, nonintravenous drug abusing (NIVDA) sexual partners. Representatives from health departments, drug abuse treatment centers, academic institutions, service organizations, and the community discussed issues relating to population characteristics, educational strategies and recruitment techniques. A consensus document that identifies the most effective recruitment and intervention strategies was developed. Recruitment issues include locations, recruitment targets, anticipated difficulties, and ethical considerations. The majority of workshop participants agreed that an intervention should target the couple (both IVDA and NIVDA). Intervention concerns encompass obtaining trust, maintaining participation, and identifying guidelines to maximize program impact.
In vitro studies were carried out that indicated that a lubricant system consisting of 0.45 +/- 0.1 ml of silicon fluid containing 6.6% +/- 0.5% by volume of nonoxynol 9 and a spermicidal cream consisting of 0.45 +/- 0.1 ml made up of 63.4% polyethylene glycol 400 and 30.0% polyethylene glycol 3350 containing 6.6% +/- 0.5% nonoxynol 9 was effective in reducing sperm motility and viability. This system was tested in vivo with the use of simulated rupture techniques and was found to be equally as effective. Double-blind preference studies were carried out in vivo which showed that the condom system is convenient and comfortable to use, nonirritating to the vagina or urethral mucosa, and esthetically pleasing to the young, reproductive-age population.
Many brands of latex condoms use a polydimethylsiloxane lubricant. The lubricant viscosity in ten different brands was compared by determining the average chain length through the ratio of the dimethyl to trimethyl peak area obtained after applying the resolution enhancement technique of Fourier self-deconvolution to their diffuse reflectance FT-IR spectra in the area around 800 cm-1.
A telephone survey of 1,592 Hispanic and 629 non-Hispanic white men and women aged 18-49, randomly selected from nine states in the northeastern and southwestern United States, found that married Hispanic men are more likely to have had two or more heterosexual partners in the previous 12 months than are married non-Hispanic men (18% and 9%, respectively). A large proportion of unmarried men (60% of Hispanics and 54% of non-Hispanic whites) report having had more than one partner in the past 12 months. After adjusting for other variables, the odds of having multiple partners are 2.5 times higher among Hispanic men aged 18-24 than among those aged 41-49 and 1.8 times higher among those who live in the Northeast than among those in the Southwest. Highly acculturated Hispanic men are less likely to have multiple partners than are less acculturated men. Among Hispanic women, those who are moderately or highly acculturated are more likely to have multiple partners (odds ratios of 4.9 and 8.4, respectively) than are less acculturated women. About half of men and women with multiple partners report always using condoms with secondary heterosexual partners.
OBJECTIVES: In this article we describe the development and testing of three behavioral interventions to reduce the risk of contracting HIV/AIDS and other sexually transmitted diseases among heterosexually active adolescents. METHODS: The interventions include a comic book, a videotape, and a group skill training curriculum that emphasize skill development--for communicating and negotiating condom use with partners, in addition to providing basic information. Participants included 228 youths sampled in juvenile detention and 168 youths sampled from public health STD and other similar clinics. The samples included both young men and women, and were comprised of African American and European American adolescents, ages 14-19. RESULTS: Examination of the relative efficacy of the interventions at three and six months following intervention show very few differences among conditions, despite the fact that the interventions contained most of the elements that previously have been defined as essential for effective interventions. CONCLUSIONS: In the discussion, we consider possible reasons for this outcome and make recommendations for future research.
External urinary drainage devices are usually considered safe and are in wide clinical use. There are only a few reports of complications arising from their improper use. We present 6 patients who suffered major complications from external condom drainage at home. The etiology and preventive measures are discussed.
OBJECTIVE: To gain a better understanding of ethnic Chinese women's perceptions and experiences of using barrier and rhythm methods of contraception in order to improve contraceptive counseling at abortion clinics. DESIGN: Qualitative descriptive study. SETTING: Urban abortion clinic. PARTICIPANTS: Forty ethnic Chinese women presenting for abortion. METHOD: Data were collected in semi-structured interviews by one interviewer who is fluent in English, Mandarin and Cantonese. Transcribed interviews were systematically analyzed to identify salient themes. MAIN FINDINGS: All of the women interviewed had used condoms (none with spermicide), 20 had used rhythm and 17 withdrawal, usually a combination of two or three of these methods. Many women noted that these methods are under male control and talked about the difficulty negotiating their use with partners. The majority of women using rhythm were unable to correctly identify "safe periods."
A total of 56 male spinal cord injury patients on condom catheter drainage was studied prospectively within 6 months of the injuries for 5 years. Low bladder pressures (filling maximum 35 cm. water and voiding maximum 70 cm. water) were ascertained with video-urodynamics. External sphincterotomy was performed when necessary for detrusor-sphincter dyssynergia. Yearly upper tract imaging, serum creatinine levels and urine cultures were obtained. All patients had colonized urine (asymptomatic) during the entire study period. No patient sustained deterioration of the urinary tract on imaging or by serum creatinine determinations during the 5-year interval. We conclude that asymptomatic bacteriuria is of no consequence to the integrity of the upper urinary tract when low pressures are operant.
Recent epidemiological studies have shown fairly convincingly that in high-risk populations in sub-Saharan Africa, male circumcision is associated with a reduced risk of HIV infection. Following a consultation at the XIII International AIDS Conference in July 2000 in Durban, there was growing interest in such an intervention. This paper explores what is known about male circumcision, the risks associated with it, its relationship with sexual health, including HIV and other sexually transmitted infections (STIs), and the potential problems with implementing circumcision as an intervention internationally, particularly in traditionally non-circumcising communities and those where access to medical facilities is limited. Proponents of male circumcision as an HIV prevention strategy are convinced and convincing, but circumcision is a surgical procedure with associated risks and has strong religious and cultural significance for many groups. Hence, there are ethical and practical barriers to implementing it as a public health intervention. The evidence suggests that circumcision may reduce the risk of infection, but circumcision does not appear to have any impact on transmission rates from HIV positive men to their partners. Until we know why and how circumcision is protective, exactly what the relationship is between circumcision status and other STIs, and whether the effect seen in high-risk populations is generalisable to other groups, the wisest course is to recommend risk reduction strategies of proven efficacy, such as condom use.
The variety and method of use of condom urinals was reviewed and an investigation conducted to ascertain the problems which arise. Effects arising from material failure and methods of use were disclosed.
BACKGROUND: Vaginal agents which are antiviral and/or inhibit the entry of HIV into the cell could prevent heterosexual transmission of HIV, and protect women who cannot negotiate condom use. METHODS: Four agents have been investigated for activity in vitro and in vivo against SHIV(89.6PD): two anionic polymers, dextrin-2-sulphate (D2S) and PRO 2000 (P2K), and two virucidal agents; a non-ionic detergent, nonoxynol-9 (N9) and a cyclic peptide ionophore, gramicidin-D (GD). All four agents were investigated in rhesus macaques, using an intra-vaginal challenge of two inoculations of 1 x 104 50% tissue culture infectious doses (TCID)50 of SHIV(89.6PD). RESULTS: D2S, P2K, GD and N9 all inhibited SHIV(89.6PD) in vitro. In vivo, three out of four control macaques were infected as judged by viral culture, seroconversion, DNA and RNA PCR; infection was confirmed in four out of eight macaques pre-treated with P2K, two out of four pre-treated with D2S, one out of four pre-treated with N9, two out of four pre-treated with GD and four out of four pre-treated with D2S + GD, a combination additive in vitro. INTERPRETATION: D2S and PRO-2000, novel inhibitors of HIV entry, showed evidence of protection in vivo, comparable to that seen with the virucide, N9. These data, together with the results of phase I and phase II studies in healthy women which have shown minimal toxicity, support plans for a phase III efficacy trial of chemically simple inhibitors of HIV entry with low toxicity, for the prevention of HIV infection in women.
The HIV pandemic continues to spread throughout the world, particularly affecting populations in developing countries. Women now comprise half of those infected. Efforts to limit this scourge need to be maximally implemented. A multi-faceted approach, including the research and advance of microbicides - or 'chemical condoms' - offers promise. Microbicides are self-administered, prophylactic products designed to protect against sexually transmitted pathogens, including HIV-1. Important features include safety, efficacy and user acceptability. This review summarizes some of the important products in the development pipeline.
Standard in vivo biomechanical performance tests and a pilot clinical study of latex external condom catheters (ECCs) and silicone ECCs demonstrated the superior performance of the silicone ECC over that of the latex ECC. The silicone ECC has a self-adhesive that binds more securely to human skin than the self-adhesive of latex ECC. In addition, the moisture vapor transmission through silicone is significantly greater than through latex. The aggressive self-adhesive of the silicone ECC significantly reduced ECC catheter pop-off compared to that of latex ECC. Silicone ECC removal can be facilitated by the application of a warm, wet cloth to the exterior surface of the silicone ECC, which significantly reduces its self-adhesive force. Constant, gentle traction is then applied to the silicone catheter outlet end to achieve atraumatic silicone ECC removal. On the basis of the results of these standardized tests and pilot study, the silicone ECC is recommended for incontinent men without obstructive uropathy.
Heterosexual transmission of human immunodeficiency virus (HIV) continues to increase, especially among injecting-drug users (IDUs) and their sex partners. During 1991, 22% of women with acquired immunodeficiency syndrome (AIDS) in the United States reported having had sex with a male IDU; this risk behavior was second to injecting-drug use (48%) as a transmission category for women. To better understand how to reduce heterosexual transmission of HIV, a study on condom use among male IDUs on the Lower East Side of Manhattan, New York City, was conducted as part of CDC AIDS Community Demonstration Projects. This report summarizes the results of that study.(ABSTRACT TRUNCATED AT 250 WORDS)
We report a case of severe urethral lesion in a male patient with a vascular cerebral stroke. The wrong application of condom catheter without pain or other symptoms developed the urethral lesion.
A study was undertaken to determine whether use of a condom catheter collection system (CCCS) is associated with urinary tract infection (UTI). No UTI developed in 79 episodes of CCCS use in patients who were cooperative or because of paralysis were unable to manipulate the collecting system (mean time per patient, 21.2 days; total number of patient days, 1,677). By contrast, in 15 patients who were identified prospectively as being uncooperative and who repeatedly manipulated the CCS, UTI developed in eight (53.3%) within a mean of 9.6 days. Urethral catheterization in cooperative patients during CCCS use was followed by development of UTI. Repeated interference with the proper use of CCCS and urethral catheterization during CCCS use are associated with an increased risk of UTI.