-
Journal of Acquired Immune Deficiency... Sep 2020The dapivirine vaginal ring reduced the risk of HIV infection by approximately 30% in Phase III trials. To ensure higher levels of protection against HIV and sexually... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The dapivirine vaginal ring reduced the risk of HIV infection by approximately 30% in Phase III trials. To ensure higher levels of protection against HIV and sexually transmitted infections, women should be counseled to use condoms when using the vaginal ring. This article evaluates the compatibility of male condoms with a placebo vaginal ring.
METHODS
This was a 2-period crossover, randomized, noninferiority trial. Couples in 2 sites in the United States were randomized to male condom use, with and without a placebo silicone vaginal ring, and asked to use 4 male condoms in each period. The primary noninferiority end points were total clinical failure and their component failure events (clinical breakage or slippage). Frequencies and percentages were calculated for each failure mode and differences in performance of the 2 periods using the male condom without the ring as reference. Noninferiority was defined using a 3% margin at the 5% significance level. Safety and acceptability were also assessed.
RESULTS
Seventy couples were enrolled, and 68 completed the trial with a total of 275 male condoms used in each period. Total condom clinical failure rates were 2.2% and 4.0% in the presence and absence of the vaginal ring, respectively, with a difference of -1.9% (95% confidence interval: -5.3% to 1.5%), thereby demonstrating noninferiority when used with the ring. There was no difference in safety between the 2 periods.
DISCUSSION
Concurrent use of the placebo silicone vaginal ring had no significant effect on male condom functionality or safety outcomes.
Topics: Adult; Condoms; Contraceptive Devices, Female; Cross-Over Studies; Female; Humans; Male; Silicones; Young Adult
PubMed: 32452969
DOI: 10.1097/QAI.0000000000002397 -
PloS One 2017When used correctly and consistently, the male condom offers triple protection from unintended pregnancy and the transmission of sexually transmitted infections (STIs)...
When used correctly and consistently, the male condom offers triple protection from unintended pregnancy and the transmission of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). However, with health funding levels stagnant or falling, it is important to understand the cost and health impact associated with prevention technologies. This study is one of the first to attempt to quantify the cost and combined health impact of condom use, as a means to prevent unwanted pregnancy and to prevent transmission of STIs including HIV. This paper describes the analysis to make the case for investment in the male condom, including the cost, impact and cost-effectiveness by three scenarios (low in which 2015 condom use levels are maintained; medium in which condom use trends are used to predict condom use from 2016-2030; and high in which condom use is scaled up, as part of a package of contraceptives, to meet all unmet need for family planning by 2030 and to 90% for HIV and STI prevention by 2016) for 81 countries from 2015-2030. An annual gap between current and desired use of 10.9 billion condoms was identified (4.6 billion for family planning and 6.3 billion for HIV and STIs). Under a high scenario that completely reduces that gap between current and desired use of 10.9 billion condoms, we found that by 2030 countries could avert 240 million DALYs. The additional cost in the 81 countries through 2030 under the medium scenario is $1.9 billion, and $27.5 billion under the high scenario. Through 2030, the cost-effectiveness ratios are $304 per DALY averted for the medium and $115 per DALY averted for the high scenario. Under the three scenarios described above, our analysis demonstrates the cost-effectiveness of the male condom in preventing unintended pregnancy and HIV and STI new infections. Policy makers should increase budgets for condom programming to increase the health return on investment of scarce resources.
Topics: Adolescent; Adult; Condoms; Cost-Benefit Analysis; Family Planning Services; Female; Global Health; HIV Infections; Humans; Male; Middle Aged; Pregnancy; Pregnancy, Unplanned; Sexually Transmitted Diseases; Young Adult
PubMed: 28510591
DOI: 10.1371/journal.pone.0177108 -
Australian and New Zealand Journal of... Jun 2018Individual and environmental resilience protective factors are suggested to be associated with adolescent condom use; however, previous studies have not comprehensively...
OBJECTIVE
Individual and environmental resilience protective factors are suggested to be associated with adolescent condom use; however, previous studies have not comprehensively examined such associations. This study aimed to determine the associations between condom use, and numerous individual and environmental resilience protective factors in sexually active Australian adolescents.
METHODS
Participants were Grade 10 students attending 28 Australian government high schools (n=1,688). An online survey (2011) collected data regarding: sexual intercourse (past year), condom use and 14 individual and environmental resilience protective factors. Multivariable backward stepwise logistic regression models examined associations between student condom use and protective factors (total, subscale).
RESULTS
Only total environmental protective factors remained in the final total score model; students with higher total environmental protective factors scores were 2.59 times more likely to always use a condom(95%CI:1.80-3.74). Only three of 14 protective factor subscales were associated with a higher likelihood of always using a condom in the final subscale model (individual: goals/aspirations; environmental: community participation, pro-social peers).
CONCLUSIONS
Total environmental and three protective factor subscales demonstrated prominent associations with consistent use of condoms in sexually active adolescents. Implications for public health: Consideration of particular resilience protective factors in adolescent sexual risk behaviour prevention, such as condom use, is warranted.
Topics: Adolescent; Australia; Condoms; Environment; Female; Humans; Individuality; Logistic Models; Male; Protective Factors; Risk-Taking; Sexual Behavior; Students; Surveys and Questionnaires
PubMed: 29528537
DOI: 10.1111/1753-6405.12744 -
AIDS and Behavior Feb 2018We examined why male condoms broke or slipped off during commercial sex and the actions taken in response among 75 female and male sex workers and male clients recruited...
We examined why male condoms broke or slipped off during commercial sex and the actions taken in response among 75 female and male sex workers and male clients recruited from 18 bars/nightclubs in Mombasa, Kenya. Most participants (61/75, 81%) had experienced at least one breakage or slippage during commercial sex. Many breakages were attributed to the direct actions of clients. Breakages and slippages fell into two main groups: those that were intentionally caused by clients and unintentional ones caused by inebriation, forceful thrusting during sex and incorrect or non-lubricant use. Participant responses included: stopping sex and replacing the damaged condoms, doing nothing, getting tested for HIV, using post-exposure prophylaxis and washing. Some sex workers also employed strategies to prevent the occurrence of condom breakages. Innovative client-oriented HIV prevention and risk-reduction interventions are therefore urgently needed. Additionally, sex workers should be equipped with skills to recognize and manage breakages.
Topics: Adolescent; Adult; Coitus; Condoms; Female; HIV Infections; Humans; Interviews as Topic; Kenya; Male; Qualitative Research; Risk Reduction Behavior; Sex Work; Sex Workers; Sexual Partners; Sexually Transmitted Diseases; Unsafe Sex
PubMed: 28975484
DOI: 10.1007/s10461-017-1922-3 -
The Cochrane Database of Systematic... Jan 2006The male condom, which consists of a thin sheath placed over the glans and shaft of the penis, is designed to prevent pregnancy by providing a physical barrier against... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The male condom, which consists of a thin sheath placed over the glans and shaft of the penis, is designed to prevent pregnancy by providing a physical barrier against the deposition of semen into the vagina during intercourse. Beginning in the 1990s, nonlatex male condoms made of polyurethane film or synthetic elastomers were developed as alternative male barrier methods for individuals with allergies, sensitivities or preferences that prevented the consistent use of condoms made of latex.
OBJECTIVES
The review sought to evaluate nonlatex male condoms in comparison with latex condoms in terms of contraceptive efficacy, breakage and slippage, safety, and user preferences.
SEARCH STRATEGY
We searched computerized databases for randomized controlled trials of nonlatex condoms. We also wrote to the manufacturers of nonlatex condoms and known investigators in an attempt to locate any other trials not identified in our search.
SELECTION CRITERIA
The review included all randomized controlled trials identified in the literature search that evaluated a male nonlatex condom made of polyurethane film or synthetic elastomers in comparison with a latex condom.
DATA COLLECTION AND ANALYSIS
We evaluated all titles and abstracts located in the literature searches for inclusion. Two authors independently extracted data from the identified studies. We analyzed data with RevMan. The Peto odds ratio (Peto OR) with 95% confidence interval (CI) was calculated for each outcome of contraceptive efficacy, condom breakage and slippage, discontinuation of use, safety, and user preference. Contraceptive efficacy, early discontinuation, and safety outcomes were also measured with survival analysis techniques.
MAIN RESULTS
While the eZ.on condom did not protect against pregnancy as well as its latex comparison condom, no differences were found in the typical-use efficacy between the Avanti and the Standard Tactylon and their latex counterparts. The nonlatex condoms had significantly higher rates of clinical breakage than their latex comparison condoms: the Peto OR for clinical breakage ranged from 2.6 (95% CI 1.6 to 4.3) to 5.0 (95% CI 3.6 to 6.8). Few adverse events were reported. Substantial proportions of participants preferred the nonlatex condom or reported that they would recommend its use to others.
AUTHORS' CONCLUSIONS
Although the nonlatex condoms were associated with higher rates of clinical breakage than their latex comparison condoms, the new condoms still provide an acceptable alternative for those with allergies, sensitivities, or preferences that might prevent the consistent use of latex condoms. The contraceptive efficacy of the nonlatex condoms requires more research.
Topics: Condoms; Contraception; Humans; Latex; Male; Polystyrenes; Polyurethanes; Randomized Controlled Trials as Topic
PubMed: 16437459
DOI: 10.1002/14651858.CD003550.pub2 -
BioMed Research International 2020Unsafe sexual behavior among adolescents still represents a public health challenge. To have safe sex, effective condom utilization is needed. Condom use remains...
BACKGROUND
Unsafe sexual behavior among adolescents still represents a public health challenge. To have safe sex, effective condom utilization is needed. Condom use remains relatively low among adolescents in sub-Saharan Africa. Even though adolescents have good knowledge about condom use, they are still engaged in risky sexual behavior.
OBJECTIVE
To assess condom use and attitude toward condom use among college students in southwest Ethiopia.
METHODS
A cross-sectional study was conducted among 453 students at Mizan-Aman Polytechnic College in southwest Ethiopia. Data were collected using a structured self-administered questionnaire. The collected data were entered using EpiData version 4.2.0.0 and analyzed using SPSS version 20 statistical software. Binary logistic regression was computed. Independent variables with a value of less than 0.05 in the multivariable logistic regression model were considered significant.
RESULTS
Of the 453, 180 were sexually active. Among those sexually active, 119 (66.1%) used condoms in their last sexual intercourse. The proportion of positive attitude toward condom use was 53.4%, and the mean attitude score for condom use was 28.6 (±9.99 SD) ranging from 10 to 50. The study also found that being male (AOR = 1.77, 95% CI [1.19-2.65]), rural resident (AOR = 2.20, 95% CI [1.47-3.30]), ever had sex (AOR = 1.87, 95% CI [1.23-2.85]), and knowledge of STIs (AOR = 1.66, 95% CI [1.10-2.51]) were factors associated with a positive attitude toward condom use.
CONCLUSION
The proportion of positive attitude toward condom use among college students in Ethiopia was low. The study also found that being male, rural resident, ever had sex, and knowledge of STIs were factors associated with a positive attitude toward condom use. Therefore, strengthening information, education, and communication (IEC) on condom self-efficacy; providing condoms on campuses; and imparting education about sexually transmitted infections for young adults are central for improving condom use and attitudes toward condom use. Besides, inculcating sexual and reproductive health in the educational curriculum plays paramount importance.
Topics: Adolescent; Adult; Condoms; Cross-Sectional Studies; Ethiopia; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Male; Safe Sex; Students; Universities; Young Adult
PubMed: 33029533
DOI: 10.1155/2020/9582139 -
American Journal of Public Health Oct 2009
Topics: Condoms; Erotica; Homosexuality, Male; Humans; Male; Occupational Health; Risk-Taking; United States; Workplace
PubMed: 19696372
DOI: 10.2105/AJPH.2009.169912 -
The Pan African Medical Journal 2021despite the wide availability of free male condoms in South Africa, high rates of new HIV transmissions are reported to occur among married couples. The aim of this...
INTRODUCTION
despite the wide availability of free male condoms in South Africa, high rates of new HIV transmissions are reported to occur among married couples. The aim of this study was to determine the level of condom use among the married people and to assess the factors associated with condom use in the Tshwane district of the Gauteng province.
METHODS
a cross-sectional study was conducted among 325 clients accessing health care services at the Steve Biko Academic Hospital. A self- administered questionnaire was used to collect data, which were entered onto an Excel spreadsheet and imported into Epi info version 7 for analysis. A logistic regression model was used to investigate the association between condom use and the explanatory variables. The odds ratio was used to measure the strength of the associations. The 95% CI and a cut-off point of 0.05 for the p-value were used to indicate statistical significance.
RESULTS
the mean age of the participants was 41.6 years (SD=7.7). Two hundred and seventy-six (276; 85%) of the 325 participants reported not using condoms. Trust, doing regular HIV testing, and refusal by the husband were among the reasons given for not using condoms. In this study it was found that, the level of education, age and employment status were the determinants of condom use.
CONCLUSION
the level of condom use was low and sero-discordance was found to be the primary motivator for condom use. This study recommends the strengthening of and the widespread implementation of the CVCT service.
Topics: Adult; Age Factors; Condoms; Cross-Sectional Studies; Educational Status; Employment; Female; HIV Infections; Humans; Male; Middle Aged; Sexual Behavior; South Africa; Spouses; Surveys and Questionnaires; Trust
PubMed: 34733379
DOI: 10.11604/pamj.2021.40.11.26681 -
American Journal of Public Health Nov 2018We describe the implementation of a youth-focused condom distribution initiative in Omaha, Nebraska, developed by the Women's Fund of Omaha. During a 2.5-year period,...
We describe the implementation of a youth-focused condom distribution initiative in Omaha, Nebraska, developed by the Women's Fund of Omaha. During a 2.5-year period, initiative partners distributed nearly 1.4 million free condoms to community members via outreach events and 197 condom distribution boxes. The Women's Fund of Omaha also implemented seven media campaigns encouraging condom use. The number of condoms distributed per month increased from 9840 in September 2015 to 71 220 in February 2018. Condom distribution initiatives can play an important role in increasing condom access.
Topics: Adolescent; Condoms; Female; Health Promotion; Health Services Accessibility; Humans; Male; Mass Media; Nebraska; Safe Sex; Sexually Transmitted Diseases; Young Adult
PubMed: 30252514
DOI: 10.2105/AJPH.2018.304679 -
Public Health Reports (Washington, D.C.... 2013Despite large public investments in condom distribution programs for HIV prevention among men who have sex with men (MSM), few evaluations have documented the reach of...
OBJECTIVES
Despite large public investments in condom distribution programs for HIV prevention among men who have sex with men (MSM), few evaluations have documented the reach of condom distribution programs or whether free condoms distributed to MSM are actually used. Among MSM recruited from social networking and dating websites, we examined the proportion who reported acquiring and using free condoms, and associations between select characteristics and reported acquisition and use of free condoms.
METHODS
We used baseline data from a prospective, online cohort of U.S. MSM. Participants reported acquiring free condoms in the 12 months before interview and, for those who acquired condoms and had anal intercourse, use of the free condoms they acquired. We used multivariable log binomial regression models to describe factors associated with self-reported acquisition and use of condoms.
RESULTS
Of the 2,893 men in the analytic sample, 1,701 (59%) reported acquiring free condoms in the past year. Acquisition of free condoms was higher for men who were younger, more educated, recently tested for HIV, and had higher numbers of sex partners. Seventy-three percent of men who acquired free condoms reported using them; use was higher for men who were black, had been recently tested for HIV, and reported greater numbers of sex partners.
CONCLUSIONS
Most MSM in our online sample reported receiving free condoms, and most who acquired free condoms reported using them. These data suggest that condom distribution programs have reasonable reach and utility as part of a comprehensive package of HIV prevention interventions for U.S. MSM.
Topics: Adolescent; Adult; Age Factors; Condoms; HIV Infections; Homosexuality, Male; Humans; Male; Middle Aged; Sexual Behavior; Socioeconomic Factors; United States; Young Adult
PubMed: 23997285
DOI: 10.1177/003335491312800509