Abstract
Globally, and in the United States (U.S.) specifically, rates of reported sexually transmitted infections (STIs) have been steadily increasing and are especially high among youth aged 13–25 years. Using condoms correctly and consistently is an effective STI prevention measure for sexually active youth, yet public health endeavors tend to focus only on condom use consistency. Directly measuring condom application is challenging and expensive. Alternative tools evaluate this behaviour, but little evidence exists on the appropriateness of these instruments in measuring application skills. This systematic review and meta-analysis examined the association between condom application skills and self-efficacy. We conducted a search of several databases as well as unpublished works. Studies were included if they were in English, examined youth aged 13–25 years, and were available between 1992 and 2019. The authors screened 630 titles and abstracts for initial inclusion criteria. A full-text review of 30 studies was conducted. The authors included 19 studies in the systematic review and 5 studies were included in the meta-analysis. Both a fixed- and random-effects model (Q = .2321, I2 = 0%) yielded a medium-sized statistically non-significant association (r = 0.217) between skills and self-efficacy. Despite the small sample size, findings suggest that skills and self-efficacy may not be as interchangeable as previously assumed when assessing condom application. Implications for future research are discussed.
Highlights
The occurrence of sexually transmitted infections (STIs) are high, with an estimated 127.2 million, 86.9 million, and 6.3 million new incidents of chlamydia, gonorrhoea, and syphilis, respectively, in 2016 [1]
The purpose of this study was to examine the association between condom application skills and condom use self-efficacy in youth aged 13–25 years reported in both published and unpublished studies
While the current literature reports that interventions including a condom skills training component are effective, few studies report an outcome involving a skills assessment, opting instead to report consistency of condom use over time [34, 91, 92]
Summary
The occurrence of sexually transmitted infections (STIs) are high, with an estimated 127.2 million, 86.9 million, and 6.3 million new incidents of chlamydia, gonorrhoea, and syphilis, respectively, in 2016 [1]. The U.S has a high rate of STI occurrence. STIs occurred at a higher rate in the year 2017 than they did at any point in the past two decades, with reported rates of 9.5, 528.8, and 171.9 per 100,000 people of all ages for syphilis (primary and secondary), chlamydia, and gonorrhoea, respectively [2]. Surveillance data indicate that the rate of occurrence of chlamydia and gonorrhea are highest for those aged 20–. Rates of human immunodeficiency virus (HIV) are highest among individuals aged 20–29 years Trend data from 2017 paint a bleak portrait of STI occurrences in the U.S, with a 67% and a 76% increase in gonorrhea and syphilis diagnoses, respectively, since 2013 [2]
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