Condom-use Intentions Research Articles

Let’s Talk About Condoms: Social Engagement in a Sexual Health Intervention Targeting Young Adults in Denmark

Objectives We tested whether social activities and interactions as part of a condom campaign strengthened young adults’ condom-use intentions and normative perceptions of condoms compared to simple exposure to campaign information. Method Data from 3,041 young adults collected after four annual condom campaigns were analyzed and combined into a meta-analysis. Results Interaction about the campaign and engagement in campaign-related activities was associated with higher condom use intention and more positive pro-condom norms. Conclusions The authors call for a greater emphasis on social influence in youth-aimed sexual health campaigns. Implications for the research are discussed.

Factors Influencing Intention on Condom Use During Sexual Intercourse With Regular Female Partners Among Men Who Have Sex With Men in Western China: A Structural Equation Modeling Analysis.

Given the rapid rise in HIV infection among men who have sex with men (MSM) in China, they may be a potential bridge for HIV transmission to the general female population, and increasing condom use is an important protective measure. This study aimed to explore factors that influence the intention of condom use during sexual intercourse with regular female partners among MSM in Western China, based on the Health Action Process Approach model. This study used a baseline sample from a cohort study of the National Science and Technology Major Project. A nonprobability sampling method was adopted to recruit MSM from western China. Information on sociodemographic characteristics, HIV-related characteristics, sexual behavior, and constructs of the Health Action Process Approach model was collected through structured questionnaires, and the data were analyzed using a structural equation model. Among 232 participants, 62.9% (146 of 232) intended to use condoms every time they had sex with their regular female partners during the following 3 months. The results of the structural equation model showed that self-efficacy had the greatest influence on behavioral intention (β = 0.398, P < 0.001), followed by negative outcome expectancy (β = -0.303, P < 0.05). In addition, risk perception (β = 0.206, P < 0.05) and positive outcome expectancy (β = 0.270, P < 0.01) had indirect effects on intention, whereas self-efficacy played a mediating role in these indirect influencing factors. Risk perception, outcome expectancy, and self-efficacy are predictors of condom use intention, with self-efficacy in particular serving as a significant medium for future interventions. These findings could provide a reference for future targeted interventions to reduce the likelihood of HIV transmission from MSM to the female population.

Full Longitudinal Mediation Modeling Analysis of HIV/AIDS Knowledge, Self-Efficacy, and Condom-Use Intention in Youth

Full Longitudinal Mediation Modeling Analysis of HIV/AIDS Knowledge, Self-Efficacy, and Condom-Use Intention in Youth

Perception of Peer Condom Use Buffers the Associations Between HIV Knowledge, Self-efficacy, and Condom-Use Intention Among Adolescents: a Moderated Mediation Model

A better understanding of the complex relationships between HIV knowledge, self-efficacy, perception of peer condom use, and condom-use intention is needed for improving HIV prevention among adolescents. The study analyzed survey data collected from high school students (N = 1970) in the Bahamas. Mediation and moderated mediation modeling analyses were used for data analysis. Results showed that self-efficacy mediated the association between HIV knowledge and condom-use intention. Perception of peer condom use moderated the mediation model by modifying the HIV knowledge-self-efficacy and self-efficacy-condom-use intention associations among males, but not for females. Findings of the study suggest the significant impact of perception of peer condom use in competition with HIV knowledge and self-efficacy in promoting condom use. Effective intervention program may consider targeting the modification of adolescents' perception of peer condom use to promote condom use among adolescents.

Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999–2020)

Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.

Cost analysis of a randomized trial of Getting to Outcomes implementation support for a teen pregnancy prevention program offered in Boys and Girls Clubs in Alabama and Georgia.

Implementation support can improve outcomes of evidence-based programs (EBP) for adolescents, but with a cost. To assist in determining whether this cost is worthwhile, this study estimated the cost of adding Getting To Outcomes© (GTO) implementation support to a teen pregnancy and sexually transmitted infection prevention EBP called Making Proud Choices (MPC) in 32 Boys and Girls Clubs (BGCs) in Alabama and Georgia. Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS) was a 2-year, cluster-randomized controlled trial comparing MPC with MPC + GTO. We used micro-costing to estimate costs and captured MPC and GTO time from activity logs completed by GTO staff. Key resource use and cost components were compared between the randomized groups, years, and states (to capture different community site circumstances) using 2-sample t tests. There were no significant differences between randomized groups in attendees per site, resource use, or costs for either year. However, there were significant differences between states. Adding GTO to MPC increased the societal costs per attendee from $67 to $144 (2015 US dollars) in Georgia and from $106 to $314 in Alabama. The higher Alabama cost was due to longer travel distances and to more BGC staff time spent on GTO in that state. GTO also improved adherence, classroom delivery, and condom-use intentions more in Alabama youth. Thus, Alabama's GTO-related BGC staff time costs may be better estimates of effective GTO. If teen childbearing costs taxpayers approximately $20,000 per teen birth, adding GTO to MPC would be worthwhile to society if it prevented one more teen birth per 140 attendees than MPC alone.Trial registration. ClinicalTrials.gov , NCT01818791. Registered March 26, 2013, https://clinicaltrials.gov/ct2/show/NCT01818791?term=NCT01818791&draw=2&rank=1.

HIV/AIDS related perception and behavior: A comparative study among college students of different majors in China

ObjectiveIn order to carry out proper education and intervention of AIDS based on different features and demands of different majors, this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge, attitudes and behaviors. MethodsA questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China, who were recruited through stratified cluster sampling. AIDS-related knowledge, attitude, condom-use intention, self-efficacy and sexual behavior of these students were investigated. ResultsAIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use. Students of music or fine arts had the strongest intention to use condoms, while the students majoring in education had the weakest. The sexually active percentages of male students from different majors ranked as follows: music or fine arts (29.5%), minority nationality (12.2%), science & tech (10.9%), medicine (10.6%), education-major (10.0%), and liberal arts (8.2%). Among female students, the rank was music or fine arts (11.0%), science & tech (6.2%), education-major school (4.5%), minority nationality (4.5%), liberal arts (4.1%), and medicine (2.8%). ConclusionIt is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities, for example, to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.

Self-efficacy and response-efficacy: critical components of sexual and reproductive health interventions targeting condom use intention among American Indian adolescents

ABSTRACTThe Respecting the Circle of Life (RCL) intervention is a comprehensive, skills-based sexual/reproductive health program shown to be effective for reducing sexual risk among American Indian (AI) adolescents (13-19 years of age). This paper seeks to identify critical program components of the RCL intervention for replication of impacts on condom use intention (CUI) when scaling to additional communities. RCL was tested among AI adolescents through a cluster randomized controlled trial (N = 267) embedded in an 8-day basketball camp. Data were collected at baseline, immediately post-camp, at 6 and 12 months post-camp. Previously established predictors of CUI that were statistically significantly impacted by RCL at the post-camp time point were tested as mediators of RCL impact on CUI. Condom use self-efficacy and response efficacy fully mediated the effect of RCL on CUI. The indirect path through condom use self-efficacy had the greatest effect on CUI, explaining 79% of the direct effect. When stratified by gender, there was only evidence of mediation among girls. Results indicate condom use self-efficacy and response efficacy are critical components of the RCL intervention for AI girls, and sexual/reproductive health programs should include practical skills training to improve these constructs to maximize intervention impact on CUI.

A dyadic approach to understanding safer sex behavior in intimate heterosexual relationships.

This study applied a dyadic approach to condom-use research. Partners from 124 heterosexual couples independently completed a questionnaire assessing condom-related attitudes, subjective norms, perceived behavioral control, and intentions to use condoms. Results demonstrate the superiority of a dyadic approach to understanding couples' condom-use intentions and behavior over traditional, individual-level approaches. The addition of partner effects to the model, via the actor-partner interdependence model, resulted in an increase in the variance accounted for in condom-use intentions and this dyadic model showed better fit compared to the individual-level model. The results suggest that consideration of relationship partners plays an important role in the prediction of safer sex intentions.

Effectiveness of a Health Behavioural Intervention Aimed at Reduction of Risky Sexual Behaviours among Young Men in the KwaZulu-Natal Province, South Africa.

Two studies evaluating the same behavioural intervention were conducted in two areas in the KwaZulu-Natal province of South Africa using a randomized pre-test post-test control group design for study 1 (peri-urban) and a pre-test post-test design without a control group for study 2 (rural). The intervention included discussions and skills training on: (1) notions of masculinity, manhood, and responsibility, (2) personal and sexual relationships, (3) general communication skills, and (4) alcohol and other substance use. The intervention was aimed at men between 18 and 35 years of age. Measures of attitude, subjective norms, perceived behavioural control and intention for condom use, human immunodeficiency virus (HIV) testing, reduction of alcohol and drug use, avoiding sex while intoxicated, and avoiding sex with intoxicated people were assessed using a facilitator-administered questionnaire. The results for study 1 showed that 4 of the 19 variables scored significantly different at baseline and that all 19 variables showed no significant changes between pre-test and post-test. For study 2, one significant difference was found for attitude towards avoiding sex when one is intoxicated. Overall, the intervention had minimal success with just one area of positive effect. Further development and testing of this programme is recommended before it can be considered for broader scale implementation.

Intragroup Differences among African Jamaican and African American Women: Empowerment, Male Condom-use Intentions and Negotiation

ABSTRACTAfrican American/Black women’s rate of HIV infection has been explored along several variables. Understanding how the epidemic affects different ethnic groups of women is crucial in developing effective prevention strategies. There remains a gap in knowledge around the effects of ethnicity on the rate of infection among the culturally diverse groups of women living in the U.S. subsumed under the label African American/Black. The purpose of the study is to explore whether cultural differences exist among African Jamaican and African American women that may affect their empowerment and condom-use intentions, placing them at a more heightened risk of contracting HIV. The results indicate that women’s sense of power, either in their relationships or within themselves, was not related to their condom-use self-efficacy or condom-use intentions. Although none of the five hypotheses was fully supported, related significant findings suggest that women’s level of acculturation was negatively related to their intentions to negotiate condom use. The longer women were in the United States, the lower their condom-use intentions.

Exploring the Role of Sex and Sexual Experience in Predicting American Indian Adolescent Condom Use Intention Using Protection Motivation Theory.

Introduction: American Indian (AI) youth experience poor sexual health outcomes. Research indicates the Protection Motivation Theory (PMT) is a robust model for understanding how sexual risk and protective behaviors are associated with condom use intention (CUI). Studies indicate the constructs of the PMT which influence CUI vary by sex and sexual experience. This analysis explores associations between PMT constructs and CUI by sex and sexual experience among AI youth who participated in the Respecting the Circle of Life (RCL) trial, a sexual and reproductive health intervention.Methods: We analyzed baseline data from the sample of 267 AIs, ages 13–19, who participated in the evaluation. We examined CUI and PMT construct scores by sex and sexual experience utilizing generalized estimated equations and multiple regression models to test which PMT constructs were associated with CUI across sex and sexual experience.Results: Twenty-two percentage of participants were sexually experienced; 56.8% reported CUI at baseline. We found several differences in scores in PMT constructs by sex and sexual experience including self-efficacy, response efficacy, vulnerability, severity, and extrinsic rewards. We also found constructs varied that were associated with CUI varied across sex and sexual experience. No PMT constructs were associated with CUI among sexually experienced youth.Conclusion: Results provide support for developing, selecting and delivering sexual health programs by sex and sexual experience in American Indian communities. Girls programs should focus on internal satisfaction and self-worth while boys should focus on negative impacts of not using condoms. Programs for youth who are not sexually active should focus on negative impacts of not using condoms. Programs for sexually inactive youth should work to change peer norms around condom use and improve knowledge about the efficacy of condom use.

HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review.

Because Black men who have sex with men (BMSM) experience high rates of both HIV and incarceration relative to other groups, the various stages of criminal justice involvement may serve as important intervention points for addressing HIV and related conditions in this group. Although systematic reviews of HIV interventions targeting MSM in general and BMSM in particular exist, no review has explored the range and impact of HIV, sexually transmitted infection (STI), and substance use prevention and care continuum interventions focused on criminal justice-involved (CJI) populations. To describe the range and impact of published HIV, STI, and related substance use interventions for US-based CJI populations and to understand their relevance for BMSM. We conducted systematic searches in the following databases: PubMed, MEDLINE, Cochrane, CINAHL, and PsycINFO, covering the period preceding December 1, 2016. We selected articles in scientific publications involving quantitative findings for studies of US-based interventions that focused on CJI individuals, with outcomes related to sexual or substance use risk behaviors, HIV, or STIs. We excluded studies if they provided no demographic information, had minimal representation of the population of interest (< 30 African American or Black male or transgender participants), had study populations limited to those aged younger than 18 years, or were limited to evaluations of preexisting programs. We abstracted data from these articles on study design; years covered; study location; participant number, demographics, and sexual orientation (if available); criminal justice setting or type; health condition; targeted outcomes; and key findings. We scored studies by using the Downs and Black quality and bias assessment. We conducted linear regression to examine changes in study quality by publication year. Fifty-eight articles met inclusion criteria, including 8 (13.8%) modeling or cost-effectiveness studies and 13 (22.4%) randomized controlled trials. Just 3 studies (5.2%) focused on sexual or gender minorities, with only 1 focused on BMSM. In most studies (n = 36; 62.1%), however, more than 50% of participants were Black. The most common intervention addressed screening, including 20 empirical studies and 7 modeling studies. Education-focused interventions were also common (n = 15) and usually employed didactic rather than skill-building approaches. They were more likely to demonstrate increases in HIV testing, knowledge, and condom-use intentions than reductions in sex- and drug-risk behaviors. Screening programs consistently indicated cost-effectiveness, including with BMSM. Care continuum interventions for people living with HIV showed mixed results; just 3 involved randomized controlled trials, and these interventions did not show significant differences compared with control conditions. A minority of programs targeted non-custody-based CJI populations, despite their constituting a majority of the CJI population at any given time. Screening CJI populations for HIV and other STIs is effective and cost-efficient and holds promise for reducing HIV in BMSM. Education-based and care provision interventions also hold promise for addressing HIV, STIs, mental health, and substance use in CJI populations. Additional empirical and modeling studies and results specific to sexual minorities are needed; their paucity represents a disparity in how HIV is addressed. Public Health Implications. HIV and STI screening programs focused on CJI populations should be a priority for reducing HIV risk and numbers of undiagnosed infections among BMSM. Funding agencies and public health leaders should prioritize research to improve the knowledge base regarding which care continuum intervention approaches are most effective for BMSM with criminal justice involvement. Developments in modeling approaches could allow researchers to simulate the impacts and costs of criminal justice involvement-related interventions that might otherwise be cost, time, or ethically prohibitive to study empirically.

Quantum changes in self-efficacy and condom-use intention among youth: A chained cusp catastrophe model

IntroductionThe complex relationships among HIV knowledge, condom-use skills, self-efficacy, peer influence and intention to use condoms have been rigorously investigated. However, studies guided by a linear behavior change model often explain only a limited amount of variances. This study aims to advance our understanding of the relationships through a nonlinear quantum change paradigm. MethodsData (n = 1970, 40.61% male, mean age 16.94 ± 0.74) from a behavioral intervention program among high school students in the Bahamas were analyzed with a chained cusp catastrophe model in two steps. In the first step, self-efficacy was analyzed as the outcome with HIV knowledge/condom-use skills as asymmetry variables and peer influence as bifurcation variable. In the second step, condom-use intention was analyzed as the outcome while self-efficacy (outcome in the first step) was used as bifurcation variable allowing peer influence as bifurcation, and HIV knowledge/condom-use skills were included as asymmetry. Cusp modeling analysis was conducted along with equivalent linear models. ResultsThe cusp model performed better than the linear and logistic models. Cusp modeling analyses revealed that peer influence significantly bifurcated the relationships between HIV knowledge/condom-use skills and self-efficacy; while both self-efficacy and peer influence significantly bifurcated the relationship between HIV knowledge/condom-use skills and condom-use intention. ConclusionOur findings support the central role of self-efficacy and peer influence as two chains in bridging the complex quantum relationships between HIV knowledge/condom-use skills and condom-use intention among adolescents. The nonlinear cusp catastrophe modeling provided a new method to advance HIV behavioral research.

Quantum changes in self-efficacy and condom-use intention among youth: A chained cusp catastrophe model

Quantum changes in self-efficacy and condom-use intention among youth: A chained cusp catastrophe model

Acculturative stress, poor mental health and condom-use intention among international students in China

Objectives:Engaging in sexual risk behaviour can be a maladaptive strategy for international students to deal with stress. This study examined the role of poor mental health in mediating the relati...

Entertainment-Education Using Traditional Folk Song among Female Factory Workers in Lao PDR

Background: Socio-economic development has led to rapid changes in young people's lifestyle and sexual behaviour in Lao PDR. HIV/AIDS education provided at school is not sufficient; therefore, developing effective educational methods is necessary. The purpose of this study was to develop an Entertainment-Education Music Video using 'Lam', Lao traditional folk song (EEMVL) and evaluate its effectiveness. Methods: Experimental study was conducted at a factory in southern part of Laos. Factory workers received HIV/ AIDS education by watching EEMVL. Fifty one female factory workers were completed semi structured questionnaires at pre and post intervention, and at a two-week follow-up. The questionnaire was included items about knowledge and awareness of HIV/AIDS, self-efficacy of condom use, intention of condom use, positive and negative attitude to people living with HIV/AIDS. Results: The results showed increased self-efficacy of condom use (p<0.001), reduced negative attitude towards people living with HIV/AIDS (p=0.003) and improved communication on HIV/AIDS information among factory workers (p<0.001) from pre intervention to two-week follow-up. Intention of condom use was increased from pre to post (p=0.017), however, decreased at the two-week follow-up (p=0.02). This decreased intention was due to the participant's understanding of the importance of gaining the skills to protect oneself from HIV infection, and realizing that condoms cannot give 100% protection against HIV infection. Moreover, the participants expressed their desire to preserve Lao culture against HIV/AIDS and to fulfill their responsibility as Lao nationals. Conclusion: These results suggested that the social modeling behaviour demonstrated in the EEMVL led the audience to improve their health literacy on HIV/AIDS prevention and stimulated interpersonal communication among the participants.

Test–retest reliability of self-reported sexual health measures among US Hispanic adolescents

Objective: Although Hispanic adolescents in the USA are often the focus of sexual health interventions, their response to survey measures has rarely been assessed within evaluation studies. This study documents the test–retest reliability of a wide range of self-reported sexual health values, attitudes, knowledge and behaviours among Hispanic adolescents from low-income, urban communities. Method: Intraclass correlation coefficients were calculated for sexual health scales (knowledge, values about condom use, parent communication, protection self-efficacy and condom-use intentions) in a 2-week sample ( N = 86). Cohen’s kappa and the intraclass correlation coefficients were calculated for behaviours (romantic and sexual behaviours, and sexual health services history) in two separate 2-week samples ( N = 86, N = 202). Selected behaviours were also examined for retractions in both 2-week samples and in a 1-year sample ( N = 291). Results: Among sexual health scales, test–retest reliability ranged from .37 for condom-use intentions to .93 for parent communication. Among behaviours, reliability ranged from 0.27 for use of sexual health services to 1.00 for use of birth control at first sex. Retractions ranged from below 10% for ever having had a steady partner to 50% or more for sexual health services and testing. Conclusion: Test–retest reliability differed greatly across self-reported sexual health values, attitudes, knowledge and behaviours for the three samples of Hispanic adolescents. Overall, however, most items and scales showed good to excellent reliability (i.e. a coefficient greater than .60), suggesting that Hispanic adolescents are moderately to highly stable reporters in response to sexual health measures.

Attitudes Towards PrEP and Anticipated Condom Use Among Concordant HIV-Negative and HIV-Discordant Male Couples

Since the July 2012 approval by the FDA of emtricitabine/ tenofovir disoproxil fumarate (Truvada) for use as pre-exposure prophylaxis (PrEP) against HIV, its feasibility and acceptability has been under study. HIV-discordant couples are likely targets for PrEP but little is known about how this new prevention tool impacts relationships. We examined, among gay male couples, the acceptability of individual and partner use of PrEP and intentions to use condoms with primary and outside partners in the context of PrEP use. Data are from two independent samples of couples recruited in the San Francisco bay area and New York City-a qualitative one (N=48 couples) between March and November, 2011, and a quantitative one (N=171 couples) between June, 2012 and May, 2013. Data were categorized by couple HIV status and general linear models; chi-square tests of independence were used to examine condom-use intentions with primary and outside partners, by sexual risk profile, and race. Almost half of the HIV-negative couples felt PrEP was a good HIV prevention strategy for themselves and their partner. Over half reported that they would not change their current condom use if they or their partner were taking PrEP. However, approximately 30% of HIV-negative couples reported that they would stop using condoms or use them less with primary and outside partners if they were on PrEP or if their partner was on PrEP. A large percentage of couples view PrEP positively. However, to ensure safety for both partners, future programing must consider those who intend not to use condoms while on PrEP.

Unintentional Exposure to Online Sexual Content and Sexual Behavior Intentions Among College Students in China.

This study examined the relations of unintentional exposure to Internet sexual content to intentions for sex and condom use and potential mediators of these relations, including attitudes, norms, and self-efficacy, among college students in China. A sample of 524 Chinese college students completed an online questionnaire. Mediation path analyses were conducted to test the theory of planned behavior as a model of the relations between unintentional exposure and intentions to have sex and use condoms. On average, students reported being unintentionally exposed to Internet sexual content about 3 to 4 times during the past month. Unintentional exposure was indirectly associated with intention to have sex, mediated through descriptive and injunctive norms. Descriptive norm was a stronger mediator for females than males. In contrast, unintentional exposure was unrelated to condom-use intention and mediators. The theory of planned behavior provides a model for the development of Internet-based interventions with these students.