Correct Condom Use Research Articles

Toward Errorless Condom Use: A Comparison of Two Courses to Improve Condom Use Skills

Traditionally, researchers have focused HIV/AIDS prevention efforts on increasing condom use, yet few researchers have assessed condom use skills. Because incorrect condom use may lead to condom failure, promoting condom use without ensuring participants have the skills necessary for correct condom use may lead to increased risk of exposure. This study compared the effects of two condom use courses on condom use skills. These courses were administered as part of a HIV/AIDS educational program for college students. Participants in the treatment groups (n=179) attended either a limited, 1-Session, or extensive, 3-Session, condom use course, and an additional 108 participants served as a Control Group. Condom use skills increased among participants in both treatment groups; however, the greatest improvement was among those in the 3-Session Group. This finding supports use of the extensive, 3-Session course as a more effective means for improving condom use skills.

Public Opinion About Condoms for HIV and STD Prevention: A Midwestern State Telephone Survey

Public opinion is important in determining condom and condom education policies in public high schools.A random telephone survey of 517 Indiana residents was conducted from July through October 2003 to assess public opinion about education on correct condom use for HIV and STD prevention; condom availability in Indiana public high schools; and issues related to condom use, effectiveness and promotion. Data were analyzed using bivariate and linear regression techniques.A majority of respondents strongly or somewhat agreed that instruction on correct condom use for HIV and STD prevention should be provided in public high schools (77%), classroom instruction should include condoms (71%), only medically accurate information about condoms should being given (94%) and the federal government should promote condoms (70%). Fewer than half (48%) strongly or somewhat agreed that condoms should be made available to teenagers in public high schools without parental permission. Nearly all (92%) considered condoms at least somewhat effective in preventing HIV and other STDs. Non-Republican party affiliation, younger age and condom use within the previous five years were each significantly associated with having positive opinions on many of the condom-related statements.Public opinion appears to support the provision of correct condom use information in Indiana public schools. Schools should consider providing only medically accurate information about condoms and including condoms in instruction so students can see and touch them.

Condom Use Among Female Sex Workers in China: Role of Gatekeepers

The objective of this study was to assess the potential role of gatekeepers of establishments in promoting condom use among female sex workers (FSWs) in China. The goals of this study were to explore FSWs' perceptions of gatekeeper attitudes and support for condom use, and to assess their association with FSWs' practice, communication, intention, proper use, knowledge of correct use, and perceptions related to condom use. The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Perceived gatekeeper support for condom use was low among FSWs. Perceived support was positively associated with condom use communication with sexual partners, condom use frequency and intention, but not associated with proper condom use among FSWs. Perceived support was significantly associated with most condom use-related perceptions (e.g., self-efficacy of condom use, barriers to condom use, and perceived peer condom use) among FSWs. Healthcare professionals should work with gatekeepers to create a supportive local environment for condom use in sex work establishments. Gatekeepers need to clearly articulate their support for condom use to the FSWs. Training and skill acquisition regarding correct use of condoms among FSWs will be necessary.

The Effectiveness of Condoms for the Prevention of Sexually Transmitted Diseases

There is controversy about the protective effect of condoms in preventing sexually transmitted diseases (STDs). This paper summarizes recent studies that assess the association between condom use and the prevalence of various STDs. Because condom use is considered a marker for sexual partnerships with greater risk of STD transmission, limited evidence of protection has been found among those reporting condom use compared to non-users. Previously, methodological issues have impacted the performance of valid studies on condom effectiveness including inability to determine consistency and correctness of use or the infection status of partners. These assessments are critical to interpreting data from condom studies since they tend to confound effectiveness and underestimate the protective effect of condom use. Recent studies have assessed these issues and found that consistent condom use is associated with lower rates of gonorrhea, chlamydia, syphilis, trichomonas (women) and genital herpes than inconsistent use. Pelvic inflammatory disease may be decreased and HPV-associated lesions may regress faster. While consistent use has been found to reduce STD, incorrect use undermines this benefit, especially for heterosexual men. Thus, while non-use is a significant factor affecting condom use failure, consistent and correct use of condoms is an important strategy in reducing STD risk. Keywords: condoms, sexually transmitted diseases, and prevention

The effect of correct and consistent condom use on chlamydial and gonococcal infection among urban adolescents.

To evaluate the relationship between self-reported correct and consistent condom use and chlamydial and gonococcal infection. Cross-sectional study. An urban adolescent health care clinic. Patients A total of 509 adolescent girls tested for Chlamydia trachomatis and Neisseria gonorrhoeae infection by urine nucleic acid amplification tests. Main Outcome Measure Effect of condom use on infection rates of chlamydia and gonorrhea. Consistent condom use was defined as using condoms for every act of vaginal sex and correct use as consistent use without any of the following: beginning sex without a condom, taking it off before finishing sex, flipping it over, condom breakage, or condom slippage. A total of 95% of the participants were African American, with a mean age of 16.6 years. Chlamydia prevalence was 21% (105/509) and gonorrhea prevalence was 7% (36/509). Condom errors were reported by 316 (71%) of 442 participants who had reported using a condom at least once in the previous 3 months. Consistent use was reported by 176 patients (35%); however, both correct and consistent use was reported by only 80 patients (16%). After adjusting for confounders, correct and consistent use was protective for chlamydia (odds ratio, 0.4; 95% confidence interval, 0.2-1.0) and highly protective for gonorrhea (odds ratio, 0.1; 95% confidence interval, 0-0.7). Our findings indicate that assessing both correctness and consistency of use is important for evaluation of condom effectiveness.

Screening, diagnosis and management of early syphilis in genitourinary medicine clinics in the UK

Our objective was to assess if female sex workers (FSWs) and their potential male clients in Cotonou, Benin, know how to use male condoms correctly. From April to June 2000, 314 FSWs and 208 men were interviewed, and asked to demonstrate on a wooden penis how they usually use male condoms. In all, 27.6% of both women and men tore the condom envelope on the notch; 89.3% of the women versus 75.4% of the men easily found the correct side; 17.3% of the women versus 28.3% of the men held the top of the condom to avoid air entering; 91.4% of the women versus 75.6% of the men correctly unrolled the condom. Taking all the four criteria together, only approximately 11% of participants performed a correct condom use demonstration. FSWs frequently reported condom breakage, which was significantly associated with incorrect condom demonstration (P = 0.04). Correct condom use is suboptimal in these heavy consumers of male condoms in Benin. Condom breakage is frequent and is associated with incorrect use.

Interactive behavioural video intervention effectively lowers incidence of STDs and encourages correct condom use in adolescent girls

QuestionDoes an interactive behavioural intervention encourage behaviour change and reduce risk of sexually transmitted diseases (STDs) in adolescent girls?Study DesignRandomised controlled trial.Main resultsInteractive video intervention reduced the self-reported incidence of all STDs and chlamydial infection compared with educational information delivered in a book or in commercially available leaflets up to 6 months (all STDs: OR 0.36, p=0.05; chlamydial infection: OR 0.13, p=0.05). Objective measures of incidence showed a similar trend, although results were not statistically significant. The interactive intervention increased rates of abstinence from sex in the first 3 months (OR 2.50, p=0.027), but not between 3 and 6 months (OR 1.45, p=0.34). Condom use was similar in all groups at 3 and 6 months.Authors’ conclusionsAn interactive video intervention for adolescent girls can reduce new infections of STDs, and encourage short term abstinence.

HIV-infected Population National Data

The correct and consistent use of condoms is the most effective way for HIV-positive individuals who are sexually active to prevent the transmission of HIV infection to HIV-negative sexual partners. The use of contraceptive methods in HIV-infected populations has been little studied.

Condom Use Assessment of Persons in Drug Abuse Treatment

The purpose of this study was to objectively and quantitatively assess individual skill level of male condom use. This study developed a reliable and face valid assessment of correct male condom use based on Centers for Disease Control and Prevention criteria. Participants (N= 163) were recruited from persons in treatment for cocaine addiction. Condom use was assessed on the basis of correct completion of eight discrete steps. An overall score of 40% correct condom use indicated the need for training in this sample. Assessment showed training needs especially related to steps involving reduction of ejaculate leakage and steps related to potential hazards of nonoxynol-9 use. Frequency of condom use was also assessed; there was no correlation between frequency of condom use and condom use skill. Drug addiction treatment programs are encouraged to incorporate HIV risk reduction programs that teach condom use skills and use the CUDOS as an empirical measure of condom skill acquisition.

A study on awareness of sexually-transmitted disease/acquired immunodeficiency syndrome and related factors among migrant workers in Hangzhou City, Zhejiang Province of China

To understand awareness on transmission routes of sexually transmitted diseases and acquired immunodeficiency syndrome (STD/AIDS) among migrant workers in Hangzhou City, Zhejiang Province. A cross-sectional study was conducted in migrant workers in Hangzhou with self-administered anonymous questionnaire to collect their demographic information and awareness on STD/AIDS. All the data were analyzed by SPSS 11.0 software. A total of 3 001 subjects were interviewed. Most of them have already had some knowledge about STD/AIDS, but not complete. There were 556 (18.8%) migrant workers did not understand that condom could prevent from STD, and 759 did not know if it could do. There were 357 (11.9%) workers did not know AIDS could be prevented, and 746 (24.9%) thought that AIDS could be cured. There were 637 workers did not know that correct use of condom could reduce occurrence of AIDS, and 725 of them thought AIDS could be infected by hands-shaking and hugging with patients of AIDS. There existed statistically significant difference in awareness on STD/AIDS between men and women, workers with varied marital status and education levels. Awareness on STD/AIDS in migrant workers was smattering, allowing of not optimistic. Community-based health education on knowledge about STD/AIDS should be strengthened among high-risk migrant workers with varied channels to improve their awareness.

Correlates of condom breakage and slippage among university undergraduates

An anonymous questionnaire was used to explore relationships between condom breakage, slippage and possible correlates in a sample of 428 single, never married college men and women. Specific condom use errors and problems that could lead to breakage and slippage were also examined. A three-month recall period was used. Breakage/slippage was found to be associated with never receiving instruction on correct condom use (P = 0.001), more than one sex partner (P = 0.001), more frequent use of condoms (P = 0.001), and partner(s) being less than highly motivated to use condoms (P = 0.02). Those reporting that condoms had contacted a sharp object were three times as likely to report breakage (P = 0.001). Those using condoms without proper lubrication (P = 0.006) and those experiencing loss of erection during sex (P = 0.001) were more likely to report slippage. Further research should investigate the efficacy of instruction addressing specific factors that may reduce the incidence of breakage/slippage, thereby enhancing condom effectiveness.

Factors Affecting Behaviours that address HIV Risk among Nigerian University Students

Objective: The aim of this study was to identify factors affecting HIV risk reduction among University students in Nigeria. Design: Cross-sectional survey. Setting: 450 first year University students at Obafemi Awolowo University, Ile-Ife, Nigeria. Participants: The sample consisted of 220 (48.9%) males and 230 (51.1%) females in the age range of 16 to 30 years (M age 21.6 yr., SD=2.9) chosen at convenience from a first year orientation class. Main outcome measures: Sexual behavior and condom use, knowledge about correct condom use, intention of condom use, behavioural norms, attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS vulnerability (likelihood to get it), severity, prevention benefits and prevention barriers, and condom use self-efficacy. Results: Bivariate analysis found that HIV/AIDS perceived prevention barriers, HIV/AIDS perceived severity, and male gender were associated, and age at first vaginal intercourse was inversely associated with HIV risk behavior. Regression analysis indicated that perceived prevention barriers and male gender were predictive and age at first vaginal intercourse was inversely predictive for HIV/AIDS risk behavior. Conclusion: HIV prevention intervention programmes should include addressing the perceived prevention barriers particularly with condom use, students engaging early in their life in sexual intercourse and male students. IFE Psychologia (2003) 11(2), 1-8

When ideal and real culture clash--trust, infidelity and condom use.

With high rates of HIV transmission in South Africa, the correct and consistent use of condoms has become critically important. The findings reported in this article form part of a larger study that investigated the vulnerability of women to HIV infection. This article concentrates on one dimension of the study: how a clash between real and ideal culture negatively impacts upon condom use. This study, conducted in Bloemfontein, revealed that an ideal culture of trust, resulted in non condom use. On the other hand, this study also revealed that despite the emphasis on an ideal culture of trust, a real culture of infidelity exists. This places individuals at risk of contracting HIV, as condom use is guided by ideal rather than real culture.

The effects of a skill-based intervention promoting consistent and correct use of the male condom among high-risk women

The effects of a skill-based intervention promoting consistent and correct use of the male condom among high-risk women

Knowledge and practice of condom use among black and white South Africans

The aim of the study was to investigate knowledge and sexual practices with reference to correct use of condoms among 108 Black and 114 White adult South Africans chosen by systematic random sampling. Results indicated that about 25% of the sexually active sample (28,6% Blacks and 18,9% Whites) reported never having used condoms. About 55% of the sample reported never using condoms, 20% always, 12% regularly and 13% irregularly in the preceding three months. The overall knowledge mean score about correct usage was 7,7% (Whites 8,3 and Blacks 7,1) (range 0-10). The most common mistakes with the respect to condom use knowledge were ignorance before putting on a condom just before ejaculation (44%), when to take off a condom (41%), unrolling a condom before putting it on the penis (33%), and the use of oil-based lubricant with a condom (31%). Predictors for programmes consider cultural diversity.

Chronic disease risk factors among healthy adolescents attending public schools in the state of Morelos, Mexico

Background. Little research (and fewer interventions) has been done on longitudinal exposure to risk factors for chronic diseases in young people in Latin America, including Mexico, although chronic diseases constitute the first cause of death in Mexico. Our objective was to document the prevalence of chronic disease risk factors among adolescents as a baseline measurement for a cohort study and to develop educational interventions. Methods. Questionnaires, blood samples, and anthropometric measurements were collected from 13,293 public school students of both sexes, ages 11–24 years in Morelos, Mexico. This constitutes the baseline measurement for a cohort study. Twenty focus groups and 10 in-depth interviews were done with girls aged 12–17 years. Two educational interventions promoting physical activity and sexual health were designed. Results. Prevalence of obesity was 21.2%. On average, participants spent 0.5 h/day on vigorous physical activity and 3.7 h/day watching television. Sexual initiation was reported by 14.5% (girls = 9.1%, boys = 21.5%); 52.3% of whom reported using condoms. Young women demonstrated correct condom use and perceived themselves at risk for HIV/AIDS but did not have condom negotiation skills. Prevalence of experimenting with tobacco was 15.1% (girls = 10.4%, boys = 21.1%); current smoking was 14.4% (girls = 10.6%) and boys = 19.2%), while 6.3% of participants reported monthly intoxication with alcohol, and 4.5% reported past and 2.1% reported current illegal drug use. Conclusions. Results indicate substantial exposure to risk factors for chronic diseases and reproductive health problems in this population. The study will generate interventions and constitutes initiation of a longitudinal study able to explore causal associations between risk factors and chronic diseases in this population.

A Guttman scale for assessing condom use skills among college students.

HIV risk-reduction interventions frequently teach correct condom use skills, yet few researchers actually measure those skills. Without measuring condom use skills, it is not possible to evaluate the effectiveness of condom use interventions, or determine what variables may be related to those skills. The Measure of Observed Condom Use Skills (MOCUS) was developed using standard Guttman scaling procedures, and administered to 106 female and 71 male undergraduates. The MOCUS was administered by the primary investigator to each participant individually. Guttman scale analyses demonstrated the MOCUS has acceptable reproducibility. These findings support future use of the MOCUS to assess condom use skills.

Measurement of Condom Use as a Risk Factor for HIV Infection

Correct and consistent condom use can prevent susceptible people from acquiring HIV infection. However, in many countries repeated cross-sectional studies reveal a trend of increasing prevalence of HIV infection alongside an increase in reported condom use. Changes in sexual behaviour that reduce the number of new HIV infections will not become apparent through changes in HIV prevalence until some time after the behaviour change takes place. Limitations in the data used to assess condom use may also explain the concurrent increases in condom use and HIV prevalence. One common indicator of condom use, the UNGASS indicator (condom use at last higher risk sex of those aged 15–24), has been chosen to illustrate how changes in the proportion of people who report using condoms do not always explain changes in the size of the group who had high risk behaviour. Indicators based on the proportion of the whole population who have sex without using a condom would be better measures of the size of the group at highest risk of HIV infection.

Factors affecting behaviours that address HIV risk among black and white South Africans.

The aim of this study was to identify factors affecting HIV risk reduction among 150 Black and 150 White South Africans chosen by systematic random sampling. Main outcome measures included sexual behavior and condom use, knowledge about correct condom use, intention of condom use, behavioural norms, attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS health beliefs, and HIV risk behaviour. Bivariate analysis gave positive significant relations among being single, age, HIV/AIDS perceived severity, HIV/AIDS prevention barriers and HIV risk behaviour. Further, bivariate analysis gave negative significant relations among age at onset of puberty, age at first vaginal intercourse, correct condom use knowledge, subjective norms, intention to use condoms and HIV risk behaviour. Regression analysis indicated that for subjective norm to use condoms, less intention for condom use, less condom use knowledge and younger age of first vaginal intercourse were predictive for HIV/AIDS risk behaviour. HIV prevention intervention programmes should include the identified factors and cultural diversity.

Incorrect condom programming in the primary health care setting: “A prescription for a disaster”?

In the effort to stem the HIV pandemic, the promotion of the correct and consistent use of condoms has to be a priority in the primary health care sector. This study, concentrating on the southern Free State, sought to identify obstacles to condom usage and to develop strategies to encourage condom usage. Both primary health care workers and their clients served as respondents in the study.