Decreased Condom Use Research Articles

Transtheoretical model and condom use in HIV-positive youths.

The purpose of the study is to test constructs of the Transtheoretical Model for predicting unprotected intercourse in HIV-positive youths (ages 16-25 years). Questionnaires and interviews about sexual behavior, stage of change, self-efficacy, substance use, emotional distress, and social support were obtained from 60 HIV-positive youths. Path analysis, with standard errors determined by methods appropriate to small samples, suggested that self-efficacy completely mediated the relationship between stage of change and unprotected intercourse acts. Social support specific to reducing risk was associated with increased self-efficacy. Emotional distress and low general social support were not associated with decreased condom use. The path between substance use and decreased condom use approached significance. Results highlight the potential of prevention interventions that simultaneously boost self-efficacy and social support specific to practicing safer sex as well as those that reduce substance use.

Préservatif féminin ou masculin : proposez les deux !

As in the entire Ile-de-France, the Val-de-Marne is facing an increase in female contamination by HIV, a clear increase in STI and furthermore the number of legal abortions is still high. Various recent studies have emphasized the decrease in condom use since 1998. Can the possibility of proposing another condom, more specifically controlled by women, boost condom use? The conseil général (local government authority) thus initiated a study in the general population, from January 1st 2001 to December 31st 2001, in order to study the criteria of acceptability of the female condom (FC). Although the women coming to consultation had no specific requests a quarter finally tested the female condom during sexual intercourse. Among them 4 out of 10 are ready to use it again. Curiosity was the primary motivation of those who accepted to test the female condom (77 %). Women who were more at ease with their sexuality were twice more likely to test the female condom. Three main advantages were put forward by the women who tested the FC: the strength of the FC, the fact that insertion was possible prior to the sexual act and the possibility of postponing removal, the latter being considered a supplementary advantage. The disadvantages most frequently cited before use were its appearance and difficult insertion process. The frequency of utilisation of the FC was multiplied by three when women practised putting the condom in place in a non-sexual context. However, even when they recognized one or several disadvantages women accepted to test it. In addition, whenever a woman finds at least one advantage before use she is twice more likely to test it. This is where counselling by professionals in charge of presenting the FC becomes a deciding factor. The chance of using at least one sort of condom is increased when a choice of condoms is available. When both male and female condoms are available, the responsibility for prevention is better balanced within the couple: each partner can then be in charge of his or her own health. However the adoption of a barrier method such as the condom, means that the individual is conscious of such a need and finds that there are benefits mainly staying in good health. However the insufficient number of prevention and health promotion campaigns in France does not favour such an awareness. The availability of inexpensive female condoms in pharmacies, supermarkets as well as free distribution by certain institutions remains an unresolved question.

Effects of alcohol, expectancies, and partner type on condom use in college males: Event‐level analyses

Sexually active heterosexual college males (N = 93) provided data on over 1,500 sexual encounters. Alcohol consumption, expectancies about alcohol's impact on condom use, and partner type each contributed to use of a condom. Partner type covaried with alcohol consumption and condom use. The men consumed significantly more alcohol with new partners, followed by casual partners, and then by regular partners. In contrast, they were more likely to use condoms with new partners than with casual or regular partners. Drinking alcohol decreased condom use, but only with casual partners. Expectancies about alcohol's disinhibiting sexual effects decreased condom use as well. These data suggest that alcohol consumption does decrease condom use, particularly with casual partners and when drinkers believe alcohol alters sexual disinhibition. Improving knowledge about HIV and other STD transmission in casual partners and challenging expectancies about alcohol as a sexual disinhibitor could help decrease the spread of HIV and other STDs.

Intimate partner abuse and the reproductive health of sexually active female adolescents

Purpose The purpose of this study was to determine the associations between verbal and minor physical abuse by an intimate partner and reproductive health behavior. Methods Logistic regression analyses of 1996 cross-sectional data from 973 sexually active, dating female adolescents surveyed for wave II of the National Longitudinal Study of Adolescent Health Public Use Dataset examining the relationship between abuse by an intimate partner and reproductive health. We measured verbal (insulted in public, sworn at, or threatened with violence) and minor physical (threw something at them, pushed them, or shoved them) abuse by any intimate partner during the past 18 months and by any current intimate partner. Reproductive health variables included condom use with most recent intercourse, contraception use with most recent intercourse, history of sexually transmitted infection, and history of pregnancy. Results After adjusting for sociodemographic factors, number of intimate partners, and history of forced sexual intercourse, the current involvement in a verbally abusive relationship was associated with not using a condom during the most recent intercourse (odds ratio, 1.56; 95% confidence interval, 1.02–2.40), and both a history of involvement and current involvement in a physically abusive relationship were associated with a history of pregnancy (odds ratio, 2.50; 95% confidence interval, 1.47–4.17; and odds ratio, 3.57; 95% confidence interval, 1.85–6.67, respectively). Neither verbal nor physical abuse were associated with the other reproductive health outcomes. Conclusions Physical abuse by an intimate partner is associated with pregnancy and current involvement in a verbally abusive relationship is associated with decreased condom use among sexually experienced female adolescents. Health care providers should be attentive to the association between abuse and pregnancy among adolescents.

HIV risk and condom use in the adult heterosexual population in France between 1992 and 2001: return to the starting point?

The aim of this paper is to measure changes in protection behaviours from 1992 to 2001, in assessing trends in condom use over time in the heterosexual adult population. These changes are measured through repeated AIDS KABP surveys comparing, over time, condom use during the 12 months prior to the surveys and condom use at first sexual intercourse before and after the beginning of the AIDS epidemic. National telephone surveys were conducted in 1992, 1994, 1998 and 2001. A total sample of 7026 heterosexual individuals, aged 18-54 years, was obtained. Two temporal phases are highlighted in condom use. The first shows an increase in both condom use at first sexual intercourse from 1985 to 1998, and in condom use during the 12 months prior to the surveys between 1992 and 1998, suggesting that sexual health promotion messages may have increased HIV/AIDS preventive behaviours. The second phase shows a decrease in condom use. Compared with 1998, condom use at first sexual intercourse in the 2001 survey still remains high; however, condom use in the 12 months prior to the survey is clearly decreasing, particularly among those with multiple sexual partners during the past 12 months. Reasons for this relapse in condom use in the general population include changes in social and individual representation due to the introduction of highly active antiretroviral therapy, the difficulties in sustaining long-term preventive behaviours, and a high level of awareness in the population and/or the decrease of large HIV prevention campaigns.

Acceptability of emergency contraception in Brazil, Chile, and Mexico: 1 - Perceptions of emergency oral contraceptives.

This article presents the results of a study on the acceptability of emergency contraception (EC) in Brazil, Chile, and Mexico. Opinions of potential users and possible providers were obtained through discussion groups and those of authorities and policy-makers through semi-structured interviews. Most participants had a positive opinion of EC, based on the view that it can help reduce unplanned pregnancy, adolescent pregnancy, and unsafe abortion. Several interviewees felt that all women should be informed about EC, while others viewed it as a method for special situations such as rape and unprotected first sexual intercourse. Concern was expressed that its introduction might be associated with a decrease in condom use, increase in sexually transmitted diseases, and irresponsible or promiscuous sexual behavior among adolescents. The need for EC was clearly perceived by most participants, leading to the conclusion that health authorities have the responsibility of implementing programs for its introduction. Training of health care personnel should include the discussion of reproductive health problems that could be prevented by EC.

Condom use and sexual behaviors among individuals procuring free male condoms in South Africa: a prospective study.

Although the South African government has increased the number of male condoms distributed free to the public, there is no understanding of whether these are being used effectively to prevent the spread of sexually transmitted diseases, including HIV infection. The study goal was to determine sexual behaviors and barriers to condom use among individuals procuring condoms distributed free to the public sector. In a prospective study, individuals who procured condoms from 12 public health facilities across South Africa were recruited and observed for the next 5 weeks. The 384 successfully observed subjects reported 3262 sexual contacts, of which 2637 (81%) involved protection with a condom. In multivariate analysis, alcohol consumption and use of other contraceptives were associated with unprotected sexual intercourse. The levels of condom use are relatively high in this population, but these data highlight several important barriers to condom use that may be targeted by future interventions.

Protease Inhibitor Combination Therapy and Decreased Condom Use Among Gay Men

Protease Inhibitor Combination Therapy and Decreased Condom Use Among Gay Men

Protease Inhibitor Combination Therapy and Decreased Condom Use Among Gay Men

The objective of the study was to determine whether treatment with protease inhibitors is associated with unprotected sexual behavior. A total of 592 HIV-infected persons recruited from statewide public clinics in nonurban Alabama communities completed an assessment that, among other variables, elicited information on demographics, current sexual practices, health status, and medication use. Associations of treatment with protease inhibitors and high-risk sexual behavior were estimated, adjusting for potential confounders. Treatment with protease inhibitors was not associated with whether a person was sexually active or with high-risk practices among sexually active heterosexual men and women. Among men who had sex with men, however, treatment with protease inhibitors was associated with never using condoms and with inconsistent use of condoms. Clinicians treating patients with protease inhibitors should consider providing risk-reduction counseling.

Highlights of the sexual activity of the heterosexual population in the province of Quebec.

OBJECTIVES: To describe and quantify the level of sexual activity of the heterosexually active population of Quebec. METHODS: The data analysed included 2889 heterosexually active individuals aged 15-60 (agemed =...

Partner condom use among adolescent girls with sexually transmitted diseases

Purpose: To explore associations of self-reported condom use with sexual risk knowledge and behaviors, perceptions of peer condom use, and communication with sexual partners about condom use among adolescent girls with sexually transmitted diseases (STDs). Methods: Adolescent girls with cervicitis or pelvic inflammatory disease (PID) completed a 62-item self-administered questionnaire on sexual risk knowledge and behaviors, condom use, perceptions of peer condom use, and condom use negotiation with partners. Associations with frequency of condom use and condom use at last sexual intercourse were analyzed. Results: A total of 24 girls were enrolled: 13 with cervicitis and 11 with PID; 22 had complete data for analysis. Compared with girls who reported low frequency of condom use, girls who reported condom use all or most of the time were younger (16.7 vs. 19.5 years; p = .008), were less likely to have a prior history of STD (67% vs. 0%; p = .03), and were more likely to think that all or most of their friends use condoms (72% vs. 0%; p = .02). Compared with girls who had not used a condom with last sexual intercourse, girls who had used a condom were younger (16.2 vs. 17.9 years; p = .04), had fewer lifetime partners (2.7 vs. 8.4; p = .03) and had higher mean scores in condom use negotiation (29.1 vs. 24.4; p = .02), and were more likely to think that all or most of their friends used condoms (100% vs. 31%; p = .001). Knowledge about condoms and STD prevention was high (mean 14.3 ± 2.3 of 16) but was not associated with condom use. Conclusions: STD interventions for partner condom use among high-risk adolescent girls must recognize the decrease in condom use with increasing age and focus on maintaining safer sex behaviors, building condom use negotiation skills, and promoting the perception of condom use by friends.

Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception

Objectives: The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. Study Design: To investigate ongoing condom behavior in teens using levonorgestrel (Norplant) contraceptive implants, oral contraceptives, and condoms alone, we examined data from a 2-year prospective cohort study of 399 urban teens. The study consisted of 3 clinic-based cohorts of adolescent female contraceptive users: Norplant contraceptive implants (n = 200), oral contraceptives (n = 100), and condoms alone (n = 99). Data were collected at an admission interview and at 1- and 2-year follow-up from method continuers. Results: Norplant contraceptive implant users were less likely than oral contraceptive or condom users to report condom use at last sex or consistent condom use at 1- and 2-year follow-up. The implant group showed a significant decrease in condom use from admission to 2 years after method initiation. The proportion of implant users self-reporting new sexually transmitted infections at 2-year follow-up, however, was not significantly greater than that of oral contraceptive or condom users. Conclusions: Our findings indicate that teen users of Norplant contraceptive implants are less likely to use condoms than teens who choose oral contraceptives but, probably because of differences in sexual behavior, are no more likely to self-report sexually transmitted infections. Our findings also indicate that teens who choose oral contraceptives and condoms do not use them consistently enough to avoid pregnancies or sexually transmitted infections. (Am J Obstet Gynecol 1999;180:929-37.)

Obstacles to Condom Use: The Combination of Other Forms of Birth Control and Short-Term Monogamy

Two hundred thirty-seven college students involved in heterosexual relationships were surveyed to determine the effects of relationship type and use of forms of contraception other than condoms on condom use. Findings indicated that in the context of a short-term, monogamous relationship, the use of another form of birth control was associated with decreased condom use. In addition, 20% of the participants reported that they had wanted to use a condom for disease prevention on at least one occasion but had decided not to do so because they were using another form of contraception. Implications for preventive health are discussed.

Why Common Sense Goes Out the Window: Effects of Alcohol on Intentions to Use Condoms

Four studies tested the hypothesis that alcohol decreases the likelihood of condom use during casual sex. First, in a correlational study, it was found that among men who reported that they usually use condoms, those who were intoxicated when they last had intercourse were less likely than sober men to have used one. Further, in two laboratory experiments and one field experiment, intoxicated people reported more positive intentions to have unprotected sex than sober people. These results are consistent with alcohol myopia as introduced by Steele and associates the notion that alcohol decreases cognitive capacity, such that intoxicated people are more likely to attend to the most salient cues in a situation. Intoxicated people may focus on the perceived benefits of having intercourse rather than on the negative consequences of not using condoms. These studies provide strong evidence that alcohol causes a decrease in condom use and suggest a mechanism for that relationship.

High Risk Sexually Transmitted Disease Behaviour in Canada

High risk sexually transmitted disease (STD)/human immunodeficiency virus (HfV) transmission behaviour appears to be the norm, not the exception, for most adolescents. The perception of STD/HIV risk and actual risk do not always match. The major motivating factor for condom use evident in adolescents was fear of pregnancy, not fear of the acquired immune deficiency syndrome or STDs. Other factors influencing decreased condom use included: embarrassment about buying condoms: difficulty discussing condoms with a prospective partner; use of oral contraceptives; belief that condoms interfere with sexual pleasure; low HIV knowledge; and, for women, a large number of sexual partners. Overall. females reported having had more STDs than males. Prostitutes, both male and female, reported the highest rates (45% and 68%, respectively). Of the street youths studied, 16% reported having at least one prior STD diagnosis, compared to 9% of school dropouts and 5% of first year college students. The number of sexual partners and participation in anal intercourse strongly inlluenced the reported STD rate for street youths. STD/HIV risk reduction educational programs must be targeted and adapted to the cultural and social needs and resources of the different adolescent groups, particularly street youth, who are clearly a ′core′ group for adolescent STD.