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At least 19 recordsLinked to original sources
PubMedDate not supplied

Use of the Retinoid Pregnancy Prevention Program in Canada: patterns of contraception use in women treated with isotretinoin and etretinate.

We sought to describe demographic characteristics of and pattern of contraception use by Canadian women prescribed synthetic retinoids who voluntarily contacted the Motherisk Program in Toronto and to describe the degree of use of the Pregnancy Prevention Program (PPP) for retinoids. Prospectively gathered intake data from isotretinoin-exposed women was statistically compared to that from matched controls selected from our database. Intake data is qualitatively reported for etretinate-exposed women. We included women who voluntarily contacted the Motherisk Program from November 1, 1988, to January 30, 1991, for counseling about reproductive risks of isotretinoin or etretinate. Primary outcome parameters were maternal age, race, marital status, socioeconomic status; gravity, parity, previous miscarriages and elective abortions, maternal tobacco and ethanol exposure, contraception use, and use of PPP (educational components used, patient recollection of warnings). The 26 isotretinoin-exposed women were younger than controls (25.2 [SD 6.7] years vs 28.9 [SD 5.1] years, P = 0.03), tended to be adolescent (30.8% vs. 3.8%, P = 0.014) and sought counselling later in gestation (10.1 [SD 8] weeks vs. 6 [SD 4.2] weeks, P = 0.01). Twenty (77%) knew the drug was teratogenic, yet 10 (38.5%) used no contraception, 6 (23.1%) experienced method failure, and 2 (8%) stopped contraception during isotretinoin therapy. In conclusion, although cognizant of the teratogenicity of isotretinoin, more than one-third of the women in this study used no birth control or experienced contraception failure. In this same group, however, compliance with contraception use appeared to increase in those who saw more of the PPP.

Adult↗
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↗
PubMed1994

Dimensions of self-efficacy among three distinct groups of condom users.

Condom use self-efficacy can be defined as expectations about one's ability to use condoms under a variety of circumstances. This investigation examined the factor structure of the Condom Use Self-Efficacy Scale (CUSES) in an 18- to 23-year-old college population (N = 339) and tested the ability of the factors to distinguish among three groups of condom users (nonusers, sporadic users, and ritualistic users). Emerging from a principal components analysis were four reliable factors labeled Mechanics, Partner's Disapproval, Assertive, and Intoxicants. Results from a discriminant analysis indicated that sporadic users were best distinguished from ritualistic users by number of sex partners, use of intoxicants, and intensity of alcohol use. The sporadic users had more sex partners, were less confident of their ability to use condoms when intoxicated, and were heavier drinkers than were the ritualistic users. Nonusers were best distinguished from ritualistic users by the factor labeled Assertive. Nonusers were significantly less confident in their ability to discuss condoms and to insist on their use with a sexual partner. Implications of the findings for improving campus-based programs to prevent the spread of human immunodeficiency virus infection and sexually transmitted diseases are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Factors associated with Hispanic women's HIV-related communication and condom use with male partners.

To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.

Acculturation↗
PubMed1996

Sexual debut and predictors of condom use among secondary school students in Arusha, Tanzania.

A cross-sectional survey was conducted using interviews among 852 students attending seven secondary schools in the Arusha region, Northern Tanzania, to predict determinants of sexual debut and recent condom use among students. Schools were sampled according to location, school size and ownership criteria. Subjects were randomly sampled within grade-level and gender through use of class registers. Altogether, 528 students were sexually active. Males were more likely than females to report their sexual debut status (82.0% versus 33.3%; OR = 8.78; 95% CI: 6.17-12.49). Among males, incidence of sexual debut increased with grade-level, but decreased according to religious affiliation. None of the socio-demographic predictor variables used in this study had a significant association with sexual debut among females when age was controlled for. Of the sexually active students, 26.8% reported having ever used a condom and 21.5% reported use of condoms during their most recent sexual encounter. Late sexual debut, prolonged duration of dating before intercourse and having only one sex partner were significantly associated with increased condom use during the most recent occasion. Condom use increased with levels of education, but gender was not significantly linked to increased condom use. Condom use was particularly infrequent among casual sex partners. We observed a marked gender difference among students with respect to their sexual debut status, but no such difference was found in relation to condom use.

Adolescent↗
PubMed1994

Evaluation of a targeted AIDS prevention intervention to increase condom use among prostitutes in Ghana.

OBJECTIVE: To assess the short- and long-term impact of a 6-month pilot intervention program on condom use among prostitutes in Accra, Ghana. DESIGN: The 4-year prospective study follows-up cohorts enrolled in the intervention in 1987 and 1988, comparing condom use in 1991 with that among a comparison group not enrolled in the intervention. SETTING: The community-based intervention was initiated in Accra, Ghana in 1987. PARTICIPANTS: Self-identified female prostitutes who volunteered participation. INTERVENTION: The educational intervention used local health workers to train and support selected prostitutes to be health educators and condom distributors to their peers. OUTCOME MEASURES: Self-reported condom use with clients. RESULTS: Reported condom use increased dramatically between 1987 and 1988 during the first 6 months of the intervention. In 1991, after 3 years of program relapse, 107 (43%) of the 248 women who had enrolled in 1987 or 1988 were still in prostitution and located for interview. Their level of condom use in 1991 was higher than pre-enrollment but similar to use among prostitutes never enrolled. Sixty-four per cent of those followed-up reported always using condoms with clients in 1991. These 'always users' were more likely to have maintained informal contact with project staff, know that HIV can be transmitted by healthy clients, and report that clients frequently initiate condom use. CONCLUSIONS: Findings support the development of long-range educational strategies that recognize the career longevity of prostitutes, available channels for informal program diffusion, individual changes in condom use over time, and the role of clients in condom negotiation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Condom use among patients attending six sexually transmitted disease clinics in Switzerland.

BACKGROUND AND OBJECTIVES: Persons treated for a sexually transmitted disease have been shown to be at increased risk for human immunodeficiency virus infection. Levels of condom use among these patients are presented, and sociodemographic and behavioral factors associated with self-reported never use of condoms are analyzed. STUDY DESIGN: This was a cross-sectional study of 2,257 patients treated at six sexually transmitted disease clinics in Switzerland between July 1990 and December 1992. RESULTS: Overall, 46.3% of the patients reported that they had never used condoms. Among heterosexual men, this level was 48.3% (n = 1,751), among homosexual and bisexual men it was 21.6% (n = 268), and among heterosexual women it was 60.1% (n = 238). In a logistic multivariate regression analysis, factors significantly associated with never use of condoms among heterosexual men included age over 29 years, not of Swiss origin, low level of education, few partners in the previous 6 months, contraction of the sexually transmitted disease from a stable partner, and not being an injecting drug user. CONCLUSION: These results document the high levels of condoms never being used in this population and highlight the importance of condom promotion activities provided by sexually transmitted disease clinics.

Adolescent↗
PubMed1996

Using the theory of reasoned action (TRA) to understand the decision to use condoms in an STD clinic population.

The theory of reasoned action (TRA) provides useful information when designing health education interventions. In this study, 703 heterosexual STD clinic clients responded to a TRA-based survey. With steady partners, social norms and attitudes toward condom use were significant predictors of intention for both men and women. The interaction of attitude and norm increased prediction for men (R = .64, p < 0.001) and women (R = .70, p < 0.001). With casual partners, attitude was a predictor for men and social norm was a predictor for women. Prior use of condoms increased prediction for men (R = .38, p < 0.001) and women (R = .47, p < 0.001). Findings suggest that, in addition to traditional TRA model variables, the relationship between sexual partners and the individual's prior experience with condom use should be incorporated into attempts to understand this complex, dyadic behavior. Examining specific outcome and normative beliefs also provides important information for intervention design.

Adult↗
PubMed1995

Barriers to condom use among women attending planned parenthood clinics.

Assessed condom use, barriers to condom use, oral contraceptive use, partnership status and STD history in 457 15-30 year-old women attending four family planning clinics. Subjects were classified into three condom use groups: Non Users (37%); Current Users (33%); and Past Users (30%). Factor analysis revealed five barriers to condom use: Partner's Perception, Peer's Perception, Pleasure/Intimacy, Communication, and Low Perceived Need. Multivariate analyses revealed significant group differences on only two barrier factors: Pleasure/Intimacy and Low Perceived Need. Low Perceived Need accounted for 13.5% of the variance in condom use. Women with low perceived need to use condoms were more likely to use oral contraceptives.

Adolescent↗
PubMed1995

The relational determinants of condom use with commercial sex partners in Thailand.

OBJECTIVE: To analyze the extent and determinants of condom use with commercial sex partners among lower socioeconomic status groups in the Thai population. DESIGN: Respondents were sampled in Udon Thani, Saraburi and Bangkok in 1992. Completed sample size was 678 women in brothels, 330 male truck drivers and 1,075 men aged 17-45 years. Behavioral data and local sexual network information were collected using structured questionnaires (face-to-face interviews), focus groups and in-depth unstructured interviews. METHODS: Data were analyzed using univariate and multivariate logistic regression. RESULTS: Condom use with commercial partners remains inconsistent. Consistent use was reported by 61% of women in brothels, 25% of truck drivers, and 29% of men in the low-income population. The single strongest predictor of consistent condom use for all groups is type of partnership. Consistent use drops significantly with regular (multivisit) commercial sex partners compared with casual (single visit) commercial partners; adjusted odds of consistent use are 0.22 for women and 0.25 for men. Brothel women report that one in five of their commercial partners is a 'regular', and 20% of the young men who report a commercial partner report a 'regular'. DISCUSSION: The strongest determinant of consistent condom use is the nature of the relational bond between the partners, rather than their individual characteristics, knowledge or attitudes. To raise condom use further, programs will have to move beyond the standard knowledge-attitudes-practices paradigm focus on individual attributes to address the contextual determinants of behavior.

Adolescent↗
PubMed1994

HIV-infected women and sexual risk reduction: the relevance of existing models of behavior change.

This article utilizes constructs of the AIDS Risk Reduction Model (ARRM) to examine condom use in a sample of 215 HIV-infected women in New Jersey. We find evidence that processes affecting condom use in HIV-infected individuals are similar to those found in HIV-negative individuals. Results suggest that partner-related factors are important to consistent condom use in HIV-infected women. Women are more likely to use condoms consistently if they have high perceived power to influence their partner's condom use, have partners who are HIV seronegative, and have partners who do not want more children. Conflicts with the partner decrease the probability of consistent condom use. Also negatively associated with condom use are the woman's use of drugs and/or alcohol and her belief that condoms reduce sexual enjoyment. Implications of these findings for designing interventions for HIV-infected women are considered.

Adult↗
PubMed1994

Prevalence and correlates of AIDS-related behavioral intentions among urban minority high school students.

Using data from a cross-sectional survey of 926 predominantly black and Hispanic ninth through twelfth graders in three New York City public high schools, the explanatory power of theoretically and empirically derived predictors (i.e., demographic, contextual, and cognitive) of intentions to engage in sexual intercourse, to be sexually monogamous, to use condoms during intercourse, and to ascertain intercourse partners' sexual and drug-use histories was compared. One-third of sampled students "definitely" intended to have sexual intercourse in the next year, one-half "definitely" intended to be sexually monogamous, two-thirds "definitely" intended to use condoms during intercourse, and three-quarters "definitely" intended to ascertain intercourse partners' sexual and drug-use histories. In a predictive model including all investigated variables, those variables derived from the cognitive set (i.e., beliefs about susceptibility to getting AIDS, and beliefs about barriers, self-efficacy, norms, and values pertaining to AIDS-preventive actions) were most strongly associated with the four investigated behavioral intentions. However, certain variables derived from the demographic set (i.e., age, gender, race/ethnicity) and contextual set (i.e., previous behavioral involvement, cues, academic failure, substance use) also contributed explained variance to all four intentions.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Women's protective sexual behaviors: a test of the health belief model.

Heterosexual transmission of the human immunodeficiency virus (HIV) has become a significant health issue for women. The present study describes the extent to which a sample of women from an urban area report making efforts to protect themselves from becoming infected with HIV through several protective sexual behaviors. Secondly, we assess the extent to which adoption of these protective behaviors can be explained by health beliefs and previous HIV testing. Forty-nine percent of the sample reported having used a condom in the past year because of fear of AIDS and 48% reported having carried condoms. Women in this sample perceived themselves to be moderately susceptible to AIDS and they were well aware of the severity of the disease. Women tended to think that protecting themselves from AIDS would not be overly burdensome and that the recommended sexual protective behaviors were highly effective for preventing AIDS. Messages about the severity of AIDS and the effectiveness of protective sexual behaviors seem to be reaching women. Beliefs about personal susceptibility were consistently associated with the adoption of multiple protective behaviors, suggesting that messages emphasizing the ubiquity of risk, especially in demographically high-risk populations, may be particularly appropriate and effective.

Adult↗
PubMed1995

Condom awareness and use in the Arusha and Kilimanjaro regions, Tanzania: a population-based study.

A cross-sectional study of condom awareness, perceived availability, and use was conducted using a questionnaire in the Arusha and Kilimanjaro regions in northern Tanzania. The questionnaire was administered to a random sample (n = 1,081) of males and females (15-54 years of age) from four localities in the Arusha, Babati, Moshi, and Same districts. Of the 1,081 respondents, 69.9% knew what condoms are and, of these, 31.7% reported having ever used a condom, while 20.7% stated that they used condoms regularly. Furthermore, of the 756 respondents who knew what condoms are, 62.2% stated that condoms were available in their localities and, of these, 44.1% reported having used condoms regularly. The results suggested that, while the majority of the respondents knew about condoms and stated that condoms were available in their localities, reported regular condom use was low. Age, gender, marital status, occupation, and place of residence appeared to be significant determinants of condom awareness and use, while educational status was not. Although barmaids and professional drivers have been shown to practice high-risk sexual behavior, reported condom use among them was low.

Adolescent↗
PubMedDate not supplied

A cross-sectional study on factors including HIV testing and counselling determining unsafe injecting practices among injecting drug users of Manipur.

In India, a steep increase in the prevalence of HIV (0% to 50% within six months) among the IDUs has been reported in Manipur, a north eastern state in 1990. In spite of large scale intervention program like educational campaign and widespread voluntary HIV testing in this state, the infection has quickly spread to the heterosexual population at large. The determinants of risk taking behaviors like sharing of unclean needle among the IDU population has been explored in this paper. A cross sectional study has been carried out among all of the 488 IDUs who attended any detoxification centers and prison during last two years at Imphal, the capital city of this state. Self reported behaviors based on the pre-scheduled interview were recorded and participation rate was satisfactory. The data was compared to a similar survey carried out by us in 1990. Although there has been decline in risk behavior among the IDUs, a logistic regression analysis reveals that unsafe needle sharing behavior is not influenced by the knowledge on HIV transmission, educational status or history of HIV testing or serostatus of the individual. The limitation of cross sectional nature of the study, bias due to collection of data in prison, self reported behavior, possible differences with street samples of the addict are discussed.

AIDS Serodiagnosis↗
PubMed1996

Understanding why heterosexual adults do not practice safer sex: a comparison of two samples.

We assessed why heterosexually active adults did not have "safer sex" with their last sexual partner. Subjects enrolled in HIV education and testing trials at a sexually transmitted disease (STD) clinic and a university student health service (SHS) completed questionnaires about their last sexual partner's risk factors for HIV and whether they had safer sex with this partner. Of the 652 sexually active subjects, 61% reported not having safer sex with their last sexual partner and explained why. Low perceived risk of HIV infection was the most common reason, indicated by 62%, though most knew too little about their partner to ensure the encounter was low risk. Other reasons included condom unavailability (20%), the subject "didn't want to" use a condom (19%), "couldn't stop ourselves" (15%), the partner's influence (14%), and alcohol or drug use (11%). Thirty-one percent of subjects indicated more than one reason for not having safer sex. SHS subjects more often reported that the encounter was low risk for HIV transmission (p = 0.0001), while STD subjects more often reported condom unavailability (p = 0.002) and drug and alcohol use (p = 0.003). We conclude that there are many different factors promoting sexual behavior at risk of infection, combinations of which are important, and that these factors differ between samples. Preventive interventions must focus on the factors most important to the targeted population and may need to consider multiple factors simultaneously.

Acquired Immunodeficiency Syndrome↗
PubMed1996

HIV-related concerns and behaviors among Hispanic women.

Hispanic women whose sexual partners have other sexual partners may be at risk for HIV. A structured interview was administered to 106 Dominican and Puerto Rican women who reported that they knew or suspected that their partner had other partners. A subsample participated in qualitative interviews. The study assessed concern about HIV and predictors of condom use. The majority of women reported that they worried about getting HIV and almost half had been HIV-tested. Most of the women discussed HIV/AIDS concerns with their partners, and one-third reported some condom use. Predictors of condom use were: born in the Dominican Republic/Puerto Rico, having talked with their partner about being tested, and belief that he used condoms with others. Although the women were concerned about HIV, condom use was infrequent. Results suggested methods to address this discrepancy: introducing condoms early in the relationship, developing women-controlled methods, and directly influencing men's behavior.

Adult↗
PubMed1987

Review of lipid-lowering clinical trials in relation to observational epidemiologic studies.

A review of the experimental clinical trials and observational cohort evidence relating serum cholesterol level and its reduction to risks of coronary heart disease (CHD) discloses strong similarities among the quantitative and qualitative relationships found in these studies. Not only are the risk functions similar, but the percent reduction observed is the same as that predicted from the population experience and is proportional to the degree of cholesterol lowering. Furthermore, the risk function is continuous from the highest to the lowest serum cholesterol levels studied. These findings confirm the lipid hypothesis and indicate that lowering serum cholesterol reduces CHD risk. The understanding and control of CHD requires a dual approach: (1) identification and treatment of high-risk individuals, and (2) modification of environmental and behavioral determinants to achieve more favorable distributions of serum cholesterol in populations.

Adolescent↗