Self-efficacy For Condom Use Research Articles

Knowledge of Sexually Transmitted Infections and Its Association With Condom Use Self-Efficacy (CUSES) Among People Living With HIV (PLHIV) in Public Health Clinics in Selangor, Malaysia.

Background Condom use self-efficacy is critical in preventing the spread of HIV among people living with HIV (PLHIV). Knowledge of sexually transmitted infections (STIs) is a crucial factor in promoting safer sexual behaviors. However, there is scarce data on its association with condom use self-efficacy, particularly among PLHIV. Objectives This study aims to determine the association between knowledge of STIs and other demographic and behavioral factors with condom use self-efficacy among PLHIV in public health clinics at Hulu Langat, Selangor. Methods A cross-sectional study involved PLHIV attending public health clinics in Selangor, Malaysia. Participants were recruited using convenience sampling. Eligibility criteria included being 18 years or older, able to read and comprehend the Malay language, and having not been diagnosed with psychiatric illness or learning difficulties that may impede their ability to answer the questionnaire. Data were collected from December 2023 to March 2024 through self-administered questionnaires assessing demographic characteristics, sexual practice, clinical factors, knowledge of STIs, and condom use self-efficacy. Multiple linear regressions were performed to identify factors associated with condom use self-efficacy. Results The mean score for condom use self-efficacywas 77.72 ± 12.88, and the mean score for knowledge of STIs was 30.87 ± 5.50. The higher STI knowledge score was associated with higher condom use self-efficacy (B = 0.73, p < 0.001). Other significant factors were higher household income (B = 9.27, p < 0.001), recent sexual activity within the last three months (B = -4.34, p < 0.001), engaging in receptive anal sex (B = 7.06, p < 0.001), and not using a condom during the last sexual intercourse (B = -4.43, p < 0.001) wereassociated with condom use self-efficacy. Conclusion The study confirms that good STI knowledge increases condom use self-efficacy among PLHIV, therefore highlighting the need to educate those at risk with better knowledge of STIs. It also highlights the importance of conducting interventions for those at higher risk due to lower condom use self-efficacy and exploring their barriers towards the use of condoms.

Self-efficacy and consistent condom use by people living with HIV and seroconcordant and serodiscordant sexual partners in the Ceará, Brazil

ABSTRACT The objectives were to assess the self-efficacy and consistent condom use by people living with HIV (PLHIV). A cross-sectional, comparative study was carried out in outpatient clinics in Ceará State, Brazil, with a sample of 190 PLHIV, 95 serodiscordant and 95 seroconcordant. Interviews were conducted using the Socio-Demographic, Clinical, Epidemiological and Vulnerability Form and the Condom Use Self-Efficacy Scale. Descriptive analysis, associations between variables, odds ratio and 95% confidence interval were determined. P < 0.05 was considered statistically significant. Of the sample, 43.1% consistently used condoms (50.5% serodiscordant and 35.7% seroconcordant). Serodiscordant PLHIV without guidance on HIV prevention (P = 0.027) and without access to testing (P = 0.002) had lower self-efficacy and 11.5 times more chances for inconsistent condom use (P = 0.006), while those satisfied with follow-up in health were less likely to use condoms inconsistently (P = 0.011). We conclude that there is low consistent use of condoms among PLHIV, which increases the risk of HIV transmission and the acquisition of other sexually transmitted infections. Consistent condom use was greater among serodiscordant individuals, although there was no difference in self-efficacy in condom use between the groups.

Efficacy of health literacy interventions aimed to improve health gains of higher education students—a systematic review

BackgroundHealth literacy (HL) among higher education students is low, making them vulnerable about their health. To reverse this trend, higher education institutions promote HL interventions with various topics and methods. A comprehensive understanding of HL interventions is essential to determine whether these interventions meet the health information needs to improve health outcomes (health gains). The aim of this review was to identify and synthesise evidence on the efficacy of HL interventions implemented in academic settings to improve health outcomes.MethodsA systematic review was performed followed the PRISMA guidelines, protocol was registered in PROSPERO (CRD42022369869). A search strategy was performed in the EBSCO Host Web platform, the time limit placed was: 01/01/2017 to 30/09/2022. Eligible studies were those published in peer-reviewed journals and involved higher education students over the age of 18 as the subject of the intervention. Eligible interventions included any interventions evaluated in a study with comparison group that included a pre-post measure of health outcomes, were conducted in an academic setting. To methodology quality of included studies, it was used the Joanna Briggs Institute critical appraisal tool. To synthesise results narrative and thematic synthesis was conducted.ResultsA total of 9 articles were included in this review, identified health literacy interventions with an impact on health outcomes. The total studies involved 2902 higher education students. All 9 studies were randomised controlled trials. The synthesised evidence supports the efficacy of interventions that contributed to positive changes in mental health, attitudes, norms, and self-efficacy of condom use, emotional, social, and psychological well being, subjective sleep quality, sleep latency, and habitual sleep efficiency, physical activity, and self-reported servings fried foods. HL interventions were educational or motivational and related to health promotion, disease prevention or healthcare.ConclusionsHL interventions in higher education students can significantly improve health outcomes protecting them from the negative effects of threats for their health. The interventions designed with different strategies are more effective. HL interventions are associated with health benefits on health promotion, disease prevention and healthcare. For the attendance of higher education to be a successful experience, continuity of HL interventions developed in academic settings is necessary.

Development of a risk estimation model for condomless sex among college students in Zhuhai, China: a cross-sectional study

BackgroundCondom use at last intercourse is an effective indicator for human immunodeficiency virus (HIV) prevention. To identify at-risk individuals and improve prevention strategies, this study explored factors associated with condomless sex at last intercourse in the last year and developed a risk estimation model to calculate the individual possibility of condomless sex among college students in Zhuhai, China.MethodsA cross-sectional study was conducted among 1430 college students who had sex in the last year from six universities in Zhuhai. The least absolute shrinkage and selection operator (LASSO) and logistic regression were performed to explore the predictors of condomless sex. The nomogram was constructed to calculate the individual possibility of condomless sex. Discrimination and calibration of the nomogram were evaluated using the area under the receiver-operator characteristic curve (AUROC) and the calibration curve.ResultsThe proportion of students who had condomless sex at last intercourse was 18.2% (260/1430). Students who had experienced more types of intimate partner violence (aOR, 1.58; 95% CI, 1.31 ~ 1.92) and had anal sex (aOR, 1.75; 95% CI, 1.06 ~ 2.84) were more likely to have condomless sex. Students who had heterosexual intercourse (aOR, 0.37; 95% CI, 0.21 ~ 0.70), used condoms at first sex (aOR, 0.20; 95% CI, 0.14 ~ 0.27), had high attitudes towards condom use (aOR, 0.87; 95% CI, 0.80 ~ 0.95) and self-efficacy for condom use (aOR, 0.84; 95% CI, 0.78 ~ 0.90) were less likely to have condomless sex. The nomogram had high accuracy with an AUROC of 0.83 and good discrimination.ConclusionsIntimate partner violence, anal sex, condom use at first sex, attitude towards condom use, and self-efficacy for condom use were associated with condomless sex among college students. The nomogram was an effective and convenient tool for calculating the individualized possibility of condomless sex among college students. It could help to identify individuals at risk and help universities and colleges to formulate appropriate individualized interventions and sexual health education programs.

Factors associated with casual sexual behavior among college students in Zhejiang Province, China: A cross-sectional survey.

This study aimed to analyze the characteristics and risk factors associated with casual sexual behavior among sexually active college students and to contribute to AIDS prevention and control efforts among this demographic. A cross-sectional survey was conducted using a stratified cluster sampling technique. Self-reported sexually active college students were selected as respondents from 11 cities in Zhejiang Province from October 8 to November 30, 2018. A questionnaire was used to collect variables such as demographic information, sexual attitudes, intervention acceptance, and self-efficacy of condom use. Univariate and multivariate analyses were performed. Among 3,771 college students who reported engaging in sexual activity, 675 (17.90%) reported engaging in casual sexual encounters. The multivariate analysis revealed multiple factors associated with casual sexual behavior among students: being male, originating from a city/town, having pursued HIV testing education in the last year, seeking HIV risk self-assessment within the last year, accepting to engage in one-night stand behavior, accepting to partake in commercial sexual activity, having conducted HIV antibody tests within the last year, homosexual partner or homosexual/heterosexual partner, demonstrating self-efficacy in condom usage, and monthly living expenses falling within the range of 1001-1500 yuan. Additionally, students with knowledge that appearance does not determine HIV infection, a proclivity for seeking HIV counseling and testing following high-risk sexual behavior and awareness that the centers for disease control provides HIV diagnosis were found to have significant associations with casual sexual activity. Casual sex is significantly prevalent among college students, with male, students from urban areas, those who accepted to engage in one-night stand behavior and partook in commercial sexual activity demonstrating a higher propensity for such behavior. This tendency can be attributed to several factors including a more liberal sexual attitude, a rudimentary understanding of HIV risk, and a low adoption rate of HIV testing. Therefore, it is imperative to enhance HIV prevention and education among college students.

Effectiveness of health literacy interventions on the health outcomes of higher education students

Abstract Background Health literacy is relevant to the empowerment process of higher education students. It reduces their vulnerability in health decision making. Higher education institutions are planning, implementing, and evaluating health literacy interventions on a variety of topics and using a variety of methodologies in order to achieve health benefits for their participants. Benefits in disease prevention, health promotion and health care have been associated with health literacy interventions. A review was conducted to identify and synthesise evidence on the effectiveness of health literacy interventions delivered in academic settings on the health outcomes of higher education students. Methods A systematic review of the literature was conducted with research on the EBSCO Host-Research Databases platform. The methodology followed the PRISMA guidelines, and the protocol was registered with PROSPERO. Methodological appraisal of the studies was carried out according to the Joanna Briggs Institute appraisal tool. A thematic and narrative synthesis was carried out for literature synthesis. Results This review included 9 articles out of 154 identified. The health gains of health literacy interventions in academic settings were positive changes in mental health; attitudes, norms, and self-efficacy for condom use; emotional, social, and psychological wellbeing; subjective sleep quality, sleep latency, and habitual sleep efficiency; physical activity; and self-reported servings of fried foods. The educational or motivational health literacy interventions contributed to health promotion, disease prevention or healthcare. Conclusions The variety of health literacy interventions that are delivered in an academic setting contributes to positive changes in the health outcomes of students in higher education. Investing in the design and delivery of health literacy interventions is one way to reduce their health vulnerability and protect them from the threats. Key messages • When planning health literacy interventions, it is important to know what health benefits they bring. • Health literacy interventions in an academic setting are important for health outcomes.

Cross-Cultural Adaptation and Psychometric Evaluation of Condom Uses Self-Efficacy Scale in Chilean College Students.

Background and Purpose: Limited culturally relevant condom self-efficacy measures have been adapted for use with Chilean college students. This study aims to culturally adapt and measure the psychometric properties of the Condom Use Self-Efficacy Scale (CUSES) by use in college students in Chile. Methods: This cross-sectional study was carried out in six stages: (a) authorization from original authors, (b) translation, (c) back translation, (d) analysis of equivalences, (e) content analysis, and (f) exploratory factor analysis and reliability assessment. Results: Of the 460 college students who completed the Chilean CUSES (Ch-CUSES), 73.9% were women, and 99% were single with a mean age of 20.5. Total scale Cronbach's alpha was 0.845, and factor analysis demonstrated six dimensions with 59.1% of the total variance. The factor loading scores of 21 items ranged between 0.515 and 0.921. Conclusions: Ch-CUSES shows good psychometric properties for assessing self-efficacy for condom use in Chilean college students.

Vicarious Experience as a Predictor of Self-efficacy in Condom Use among Adolescents in Tanzania: Reflections from Media, Peers and Adults

Vicarious Experience as a Predictor of Self-efficacy in Condom Use among Adolescents in Tanzania: Reflections from Media, Peers and Adults

Web-Based Harm Reduction Intervention for Chemsex in Men Who Have Sex With Men: Randomized Controlled Trial

Men who have sex with men (MSM) who practice chemsex have a higher likelihood of engaging in risky sexual behaviors and higher rates of HIV infection and other sexually transmitted infections (STIs) than those who do not. This trial aimed to evaluate the effectiveness of a web-based intervention in reducing the sexual harms of chemsex among MSM. The study was a 2-arm, assessor-blinded, randomized, parallel-group trial with a 3-month follow-up period. The study was conducted in the year 2021 in Hong Kong. Underpinned by the theory of planned behaviors and a harm reduction approach, the intervention consisted of interactive components and knowledge-based information about chemsex. Participants in the control group received brief information and content about sexual violence. The primary outcome was self-efficacy in refusing risky sexual behaviors and chemsex, as measured by the Condom Self-Efficacy Scale (CSES), Self-Efficacy for Sexual Safety (SESS) instrument, and Drug Avoidance Self-Efficacy Scale (DASES). The secondary outcomes included intentions to have chemsex, actual engagement in chemsex, HIV and other STI testing, and condom use in the last 3 months. All outcomes were self-reported. An online structured questionnaire was used to collect data. In total, 316 MSM enrolled in the study. The intervention group demonstrated a significantly larger improvement in condom-use self-efficacy (as measured by CSES scores; time-by-group interaction: β=4.52, 95% CI 2.03-7.02; P<.001), self-efficacy for sexual safety (as measured by SESS scores; time-by-group interaction: β=2.11, 95% CI 0.66-3.56; P=.004), and drug avoidance self-efficacy (as measured by DASES scores; time-by-group interaction: β=6.98, 95% CI 1.75-12.22; P=.009). Regarding the secondary outcomes, participants in the intervention group demonstrated a significantly larger reduction in the likelihood of having engaged in chemsex in the last 3 months (time-by-group interaction: odds ratio [OR]=0.23, 95% CI 0.10-0.53; P=.001) and likelihood of having had the intention to engage in chemsex in the last 3 months (time-by-group interaction: OR=0.37, 95% CI 0.18-0.78; P=.009). Participants in the intervention group also showed a significantly larger increase in the likelihood of having undergone HIV testing in the last 3 months (time-by-group interaction: OR=3.08, 95% CI 1.72-5.54; P<.001). This study suggests that a web-based intervention with a harm reduction approach can enhance the self-efficacy of MSM in refusing risky sexual behaviors and chemsex and improve the uptake of HIV testing. We also provide initial evidence that such interventions can reduce both the intention of MSM to engage in chemsex and their actual engagement in chemsex. ISRCTN Registry ISRCTN20134522; https://www.isrctn.com/ISRCTN20134522. RR2-10.1186/s12889-021-10742-8.

The Relationship between Vicarious Experiences and Self-Efficacy in Condom use among Adolescents in Tanzania

Inadequate condom use among adolescents is a health and behavioural concern across countries. Adolescents are largely vulnerable to sexually transmitted diseases and early pregnancies. However, little attention has been paid to studying the factors that are associated with self-efficacy in condom use among adolescents. The study presents results on the relationship between vicarious experiences and self-efficacy in condom use among adolescents in Tanzania. The study applied a quantitative approach using a sample of 552 respondents from two districts of Mpanda and Njombe in Tanzania. The data were collected with questionnaires, and the analysis used independent t-test and Spearman's rank-order correlation coefficient. The results revealed a positive and statistically significant relationship between vicarious experiences and self-efficacy in condom use among adolescents (r=.462, p value=.001). It was also revealed that girls had higher condom use self-efficacy than boys (M=6.75, SD= 2.88), t=3.691, df=550, p value =.001). It is, thus, recommended that health behavioural change programmes such as condom use, targeting adolescents, should encourage the use of vicarious experiences such as peer educator programmes and TV/radio ads. That could help strengthening the use of condom, and it is practically effective in preventing HIV/AIDS and early pregnancies. It is further recommended that such programmes be packaged differently for boys and girls.

Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020

Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.

Factors Associated with Condom Use in Vaginal Intercourse Among Spanish Heterosexual and Bisexual Men

IntroductionIn Spain, the sexual route is the main route of transmission in new HIV diagnoses. Men who have heterosexual relations are the second group with the highest incidence of new HIV cases and have the highest rates of late diagnosis in Spain. Planning the response to the HIV epidemic requires specific and updated information on this group. This study aims to analyze sexual practices and frequency of condom use in heterosexual and bisexual men and identify variables that explain inconsistent condom use in vaginal intercourse.MethodsThe sample consists of 386 men between 18 and 57 years of age (M = 24.61; SD = 6.74).ResultsThe results indicate that the percentage of consistent condom use in vaginal intercourse is 64.9%. Not consuming drugs before sexual intercourse, perceiving a high self-efficacy for condom use, and good assertive communication skills are factors that positively influence condom use. In contrast, a high level of sexual compulsivity is a risk factor. The proposed model explains between 29.1% and 40% of the variance.Conclusionsand Policy Implications.Preventive actions implemented in this group should include work sessions that focus on developing assertive skills, reducing risks associated with drug use, and providing cognitive strategies to cope with compulsive sexual thoughts.

Effects of telehealth interventions for adolescent sexual health: A systematic review and meta-analysis of randomized controlled studies

Introduction Telehealth interventions to advance adolescent sexual health have evolved and are being used to promote adolescent sexual health knowledge and healthy sexual behaviors. However, as this area of intervention modality expands, there is a need to pause and examine the effects of telehealth interventions on adolescent sexual health outcomes. Addressing this knowledge gap will inform researchers and practitioners on the current state of evidence of telehealth interventions and inform further intervention development and testing. This study aimed to explore the meta-effects of telehealth interventions on self-efficacy of using condoms, condom use practices, and sexually transmitted infection testing behaviors among adolescents. Methods A systematic review and meta-analysis of randomized controlled trials were conducted. Seven databases (Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science) were searched for relevant full-text articles from the inception to May 2021. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random effects model to calculate the pooled effects of telehealth interventions for adolescents. Stata 16.0 was used for statistical analysis. Results A total of 15 studies (N = 5499) that used telehealth interventions with adolescents were included in the analysis. Telehealth interventions were found to increase self-efficacy for condom use (standardized mean difference: 0.22; 95% confidence interval: 0.08–0.36), practice for condom use (standardized mean difference: 0.35; 95% confidence interval: 0.23–0.47), and being screened/tested for sexual transmitted infections (standardized mean difference: 0.61; 95% confidence interval: 0.31–0.92). Discussion Telehealth interventions show promise as effective intervention delivery solutions for improving self-efficacy and certain sexual health behaviors among adolescents. These telehealth strategies could be important alternatives to in-person visits to accessing sexual health information or services near where they live. Future research should consider testing telehealth strategies where there is evidence of impact to move the field forward.

An Interactive Web-Based Sexual Health Literacy Program for Safe Sex Practice for Female Chinese University Students: Multicenter Randomized Controlled Trial.

BackgroundSexual health concerns among young adults worldwide help to motivate preventative practices against sexually transmitted infections. To foster better sexual health, sexual health literacy must be enhanced. Little research has been conducted on the impact of gender power dynamics on sexual health, such as sexual coercion, even though the prevalence of sexual coercion remains high in China.ObjectiveThis study describes the development and systematic evaluation of a web-based sexual health literacy intervention called “Smart Girlfriend” for female Chinese university students.MethodsA multicenter randomized controlled trial was conducted with 781 female university students at 5 universities with dormitories in Hong Kong. Inclusion criteria were used to select unmarried, female, Chinese university students who were ≥18 years old and had not received a sexual health intervention in the past 12 months. Participants were randomly assigned to 2 groups: one group received an interactive web-based sexual health literacy intervention and the other group received a single webpage of online information about condom use. The intervention content was based on the Health Belief Model and the Continuum of Conflict and Control theory. The primary outcome was self-reported consistency of condom use with every partner at 3-month and 6-month follow-up assessments, analyzed using zero/one inflated beta (ZOIB) regression. The secondary outcome was an appraisal of the knowledge, attitudes, norms, and self-efficacy of condom use using the 25-item Multidimensional Condom Attitudes Scale (MCAS). The intention to treat was applied in analyses.ResultsOf 1503 individuals that were screened, 781 (52%) were randomized into 2 groups. The retention rates at the 3-month and 6-month follow-ups were 92% and 91%, respectively. Most participants were born locally (536/746, 72%), and 18% (134/746) self-reported as a sexual minority. ZOIB results regarding the consistency of condom use were not significant [model 1: odds ratio (OR) 2.25 with a 95% credible interval (CrI) of 0.84-6.36; model 2: OR 8.03 (95% CrI 0.22-330.31); model 3: OR 1.21 (95% CrI 0.78-1.86)]. Consistency in the intervention group was 5% higher (95% CI −1.90 to 11.63) than the control group at the 3-month follow-up, and 1% higher (95% CI −5.81 to 8·02) at the 6-month follow-up. MCAS scores at the 3-month follow-up were significantly higher in the intervention group (mean 122.51, SD 15.97) than the control group (mean 119.86, SD 15.85; P=.02).ConclusionsAn interactive web-based sexual health literacy program did not significantly increase the consistency of condom use compared to a single webpage of condom use information; however, it did temporarily improve knowledge, attitudes, norms, and self-efficacy regarding condom use. Future revisions of this intervention should be personalized and delivered with a proactive approach.Trial RegistrationClinicalTrials.gov NCT03695679; https://clinicaltrials.gov/ct2/show/NCT03695679

Factors Associated with Condom Use Self-Efficacy Among Preparatory School Students in Sodo Town, Southern Ethiopia 2020: A Cross-Sectional Study.

BackgroundCondoms are playing a central role in the prevention of sexually transmitted infections, human immune virus, and unintended pregnancy particularly among young peoples. Therefore, this study aimed to assess factors associated with condom use self-efficacy among preparatory school youths in Sodo town, Ethiopia.MethodsThis institution-based cross-sectional study was conducted among 424 study participants from January 25 to February 20, 2020. Data were collected using a validated pretested structured questionnaire. Descriptive analysis was done and results were presented in texts and tables. Those variables at bivariate analysis with p-value <0.2 at 95% confidence level were moved to a multivariate logistic regression model to control potential confounding variables. Odds ratio with 95% confidence interval was computed to ascertain association during multivariate analysis model. Statistical tests at P-value <0.05 were considered as cutoff point to determine statistical significance.ResultsOut of a total of 424 youths, only 416 had participated in the study yielding a response rate of 98.1%. The prevalence of higher self-efficacy among respondents was 70%. Factors that were independently associated with condom use self-efficacy in multivariate analysis were having sexual experience (AOR=2.047,95% CI:1.141–3.675), having life goals (AOR=1.736, 95% CI: 1.021–2.951), having social support (AOR=2.395,95% CI:1.501–5.458), and having good knowledge about condoms (AOR=2.535,95% CI:1.499–4.282).ConclusionThe finding of this study showed that participants who had sexual experience, social support, knowledge of the human immune virus, and having life goals were found to be significantly associated with condom use self-efficacy. These results suggest ways to increase self-efficacy for condom use among youth that can increase the effectiveness of future interventions for youth.

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.

Piloting an evidence-based intervention for HIV prevention among street youth in Eldoret, Kenya

ObjectivesThis study presents findings from piloting an adapted evidence-based intervention, Stepping Stones and Creating Futures, to change street-connected young people’s HIV knowledge, condom-use self-efficacy, and sexual practices.MethodsEighty street-connected young people participated in a pre- and post-test mixed methods design in Eldoret, Kenya. The primary outcome of interest was HIV knowledge. Secondary outcomes included condom-use self-efficacy and sexual practices. Multiple linear regression models for change scores with adjustment for socio-demographic variables were fitted. Qualitative and quantitative findings are presented together, where integration confirms, expands on, or uncovers discordant findings.ResultsParticipants had a significant increase in HIV knowledge from pre- to post-intervention. The median HIV knowledge score pre-intervention was 11 (IQR 8–13) and post-intervention 14 (IQR 12–16). Attendance was significantly associated with HIV knowledge change scores. Qualitatively participants reported increased HIV and condom-use knowledge and improved condom-use self-efficacy and health-seeking practices.ConclusionsOur findings support the potential for further testing with a rigorous study design to investigate how best to tailor the intervention, particularly by gender, and increase the overall effectiveness of the program.

Mechanisms of Action for Empirically Supported Interventions to Reduce Adolescent Sexual Risk Behavior: A Randomized Controlled Trial

PurposeAdolescents are at high risk for sexually transmitted infections, including HIV. Interventions to reduce adolescent sexual risk often have modest outcomes. Understanding of the mechanisms of program effectiveness is needed to develop stronger interventions. We used a randomized controlled trial to examine mechanisms of response to two empirically supported interventions: motivational interviewing versus behavioral skills training. MethodsA total of 262 adolescents (mean age = 15.89 years, standard deviation = 1.24; 34% female and 61% Latinx) were recruited from juvenile justice programs in the U.S.; all youth were randomized to motivational interviewing or behavioral skills training. Primary outcomes included (1) theory-based mechanisms (condom use attitudes, norms, self-efficacy, and intentions measured before and immediately after the interventions); and (2) risky sexual behavior (frequency of unprotected sex) and condom use measured 3 months postintervention. ResultsBoth interventions significantly increased positive attitudes toward condom use, self-efficacy for condom use, and intentions to use condoms post-test, with no differences by condition. Neither intervention impacted norms for condom use. Both interventions significantly decreased risky sexual behavior and increased condom use at the 3-month follow-up. The pattern of associations of Theory of Planned Behavior constructs to behavior were of similar magnitude in the two groups. ConclusionsThe results indicate common mechanisms of action for these two interventions and support the use of transdiagnostic mechanisms of treatment impact for sexual risk reduction.

Community Perspectives on Zika Virus Disease Prevention in Guatemala: A Qualitative Study.

.Zika virus, which is transmitted by Aedes aegypti mosquitoes and through sexual transmission, disproportionally affects the human fetus. Guatemala experienced a surge of Zika cases beginning in 2016. We conducted a qualitative study of community perceptions of the seriousness of Zika, as well as the effectiveness, feasibility, and collective efficacy of Zika prevention actions. Free listing elicited the preventive actions salient for 68 participants comprising pregnant women, men with a pregnant partner, and women likely to become pregnant; 12 focus group discussions in a highland and a lowland town explored other concepts through rank orderings of prevention practices depicted on cards. Participants’ initial concern about Zika, based on recent experience with chikungunya and high media coverage, diminished because of its mild symptoms and reduced media coverage. Participants identified more than 32 salient preventive actions, many of which are considered effective by programs. Participants ranked water storage container cleaning and regular unspecified cleaning of the house and its surroundings as highly effective, feasible, and of high collective efficacy; however, the actions lacked the specificity needed to effectively destroy mosquito eggs. Community-level removal of tires and discarded containers had lower collective efficacy than household-level implementation because of the municipal and community cooperation needed. Condom use, although salient for Zika prevention, was hindered by gender roles. The findings indicate space for increasing self-efficacy for condom use among fathers-to-be, abandoning nonspecific terms such as “cleaning” and “standing water,” increasing people’s skills in using bleach as an ovicide, and promoting antenatal care and family planning counseling.

Testing the Efficacy of an HIV Prevention Intervention Among Latina Immigrants Living in Farmworker Communities in South Florida.

Latina immigrants living in farmworker communities are a population in need of HIV risk reduction interventions due to their high risk for HIV and their limited access to health care and prevention services. The present study is the first to evaluate the efficacy of SEPA intervention on a cohort of 234 pre-established Latina immigrants living in farmworker communities in South Florida. SEPA is a CDC evidenced-based and Latinx culturally tailored HIV risk reduction intervention. Data were collected through structured interviews at baseline and 6-months post intervention and were analyzed using generalized linear mixed modeling. Results showed that SEPA was effective on increasing condom use during vaginal and anal sex with male partners, self-efficacy for condom use, intentions to negotiate safe sex and HIV-related knowledge from baseline to 6-months post intervention. These findings contribute to the evidence supporting the efficacy of SEPA by confirming previous results and demonstrating the efficacy of this intervention for Latinas of diverse backgrounds.