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Health Psychology : Official Journal of... Jun 2018We tested an integrated social-cognitive model derived from multiple theories of the determinants of young people's condom use in Sub-Saharan Africa. The model comprised... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
We tested an integrated social-cognitive model derived from multiple theories of the determinants of young people's condom use in Sub-Saharan Africa. The model comprised seven social-cognitive antecedents of condom use: Attitudes, norms, control, risk perceptions, barriers, intentions, and previous condom use.
METHOD
We conducted a systematic search of studies including effects between at least one model construct and intended or actual condom use in young people from sub-Saharan African countries. Fifty-five studies comprising 72 independent data sets were included and subjected to random-effects meta-analysis. Demographic and methodological variables were coded as moderators. Hypotheses of the integrated model were tested using meta-analytic structural equation modeling.
RESULTS
The meta-analysis revealed significant nontrivial sample-weighted correlations among most model constructs. Moderator analyses revealed differences in six correlations for studies that included a formative research component relative to studies that did not. There was little evidence of systematic moderation of relations among model constructs by other candidate moderators. Meta-analytic structural equation models revealed significant direct effects of attitudes, norms, and control on condom use intentions, and of intention, control, and barriers on condom use. Including past condom use increased explained variance in condom use intentions and behavior but did not attenuate model effects. There were also significant indirect effects of attitudes, norms, and control on condom use through intentions.
CONCLUSIONS
Findings provide preliminary evidence to support the integrated condom use model in sub-Saharan African youth. The model provides guidance on potential targets for improving the effectiveness of condom promotion interventions. (PsycINFO Database Record
Topics: Adolescent; Adult; Africa South of the Sahara; Child; Condoms; Female; Humans; Male; Sexual Behavior; Young Adult
PubMed: 29708390
DOI: 10.1037/hea0000604 -
The Cochrane Database of Systematic... 2001The amount of protection that condoms provide for HIV and other sexually transmitted diseases is unknown. Cohort studies of sexually active HIV serodiscordant couples... (Review)
Review
BACKGROUND
The amount of protection that condoms provide for HIV and other sexually transmitted diseases is unknown. Cohort studies of sexually active HIV serodiscordant couples with follow-up of the seronegative partner, provide a situation in which a seronegative partner has known exposure to the disease and disease incidence can be estimated. When some individuals use condoms and some do not, namely some individuals use condoms 100% of the time and some never use (0%) condoms, condom effectiveness can be estimated by comparing the two incidence rates. Condom effectiveness is the proportionate reduction in disease due to the use of condoms.
OBJECTIVES
The objective of this review is to estimate condom effectiveness in reducing heterosexual transmission of HIV.
SEARCH STRATEGY
Studies were located using electronic databases (AIDSLINE, CINAHL, Embase, and MEDLINE) and handsearched reference lists.
SELECTION CRITERIA
For inclusion, studies had to have: (1) data concerning sexually active HIV serodiscordant heterosexual couples, (2) a longitudinal study design, (3) HIV status determined by serology, and (4) contain condom usage information on a cohort of always (100%) or never (0%) condom users.
DATA COLLECTION AND ANALYSIS
Studies identified through the above search strategy that met the inclusion criteria were reviewed for inclusion in the analysis. Sample sizes, number of seroconversions, and the person-years of disease-free exposure time were recorded for each cohort. If available, the direction of transmission in the cohort (male-to-female, female-to-male), date of study enrollment, source of infection in the index case, and the presence of STDs was recorded. Duplicate reports on the same cohort and studies with incomplete or nonsepecific information were excluded. HIV incidence was estimated from the cohorts of "always" users and for the cohorts of "never" users. Effectiveness was estimated from these two incidence estimates.
MAIN RESULTS
Of the 4709 references that were initially identified, 14 were included in the final analysis. There were 13 cohorts of "always" users that yielded an homogeneous HIV incidence estimate of 1.14 [95% C.I.:.56, 2.04] per 100 person-years. There were 10 cohorts of "never" users that appeared to be heterogeneous. The studies with the longest follow-up time, consisting mainly of studies of partners of hemophiliac and transfusion patients, yielded an HIV incidence estimate of 5.75 [95% C.I.: 3.16, 9.66] per 100 person-years. Overall effectiveness, the proportionate reduction in HIV seroconversion with condom use, is approximately 80%.
REVIEWER'S CONCLUSIONS
This review indicates that consistent use of condoms results in 80% reduction in HIV incidence. Consistent use is defined as using a condom for all acts of penetrative vaginal intercourse. Because the studies used in this review did not report on the "correctness" of use, namely whether condoms were used correctly and perfectly for each and every act of intercourse, effectiveness and not efficacy is estimated. Also, this estimate refers in general to the male condom and not specifically to the latex condom, since studies also tended not to specify the type of condom that was used. Thus, condom effectiveness is similar to, although lower than, that for contraception.
Topics: Cohort Studies; Condoms; HIV Infections; HIV Seronegativity; HIV Seropositivity; Heterosexuality; Humans
PubMed: 11687062
DOI: 10.1002/14651858.CD003255 -
Psychology & Health Feb 2018Negative feelings about condoms are a key barrier to their use. Using the behavioural affective associations model, we examined the joint effects of affective...
OBJECTIVE
Negative feelings about condoms are a key barrier to their use. Using the behavioural affective associations model, we examined the joint effects of affective associations and cognitive beliefs about condoms on condom use.
DESIGN
In Study 1 (N = 97), students completed measures of their affective associations and cognitive beliefs about sex and condoms, sexual activity and condom use. In Study 2 (N = 171), a measure of behavioural intentions and condom selection task were added.
MAIN OUTCOME MEASURES
Condom use measured in Study 1 as (1) current condom use, and (2) willingness to use condoms; in Study 2 as: (1) behavioural intentions, (2) number of condoms selected.
RESULTS
Affective associations with sex and condoms were behaviour-specific, were directly associated with the respective behaviour, and mediated the relations of cognitive beliefs to behaviour, ps < .05. In Study 2, affective associations were associated with behavioural intentions and the number of condoms selected, ps < .05; cognitive beliefs were indirectly associated with these outcomes through affective associations, indirect effects: ps < .05.
CONCLUSIONS
Affective associations are a behaviour-specific and proximal predictor of condom use, mediating the effect of cognitive beliefs, suggesting they may be a particularly viable intervention target.
Topics: Adolescent; Adult; Condoms; Emotions; Female; Health Knowledge, Attitudes, Practice; Humans; Intention; Male; Models, Psychological; Sexual Behavior; Students; Surveys and Questionnaires; Young Adult
PubMed: 28448163
DOI: 10.1080/08870446.2017.1320797 -
Reproductive Health Jan 2023Despite widespread messaging supporting male (external) condom use to prevent HIV in endemic settings, utilization of condoms is low across sub-Saharan Africa. A...
Despite widespread messaging supporting male (external) condom use to prevent HIV in endemic settings, utilization of condoms is low across sub-Saharan Africa. A thorough understanding of barriers to condom use as a form of HIV prevention is necessary to reduce HIV transmission. Here, we present qualitative data from rural eastern Africa to explain low utilization of condoms among heterosexual adults. Focus groups and interviews were conducted in Tanzania and Uganda between 2016 and 2019. A content analysis approach was used to identify attitudes about condoms and factors related to use/non-use. We found that strategies such as abstinence and being faithful to one's partner are perceived as ideal but rarely achievable methods of HIV prevention. Condoms are used in the setting of "failure" to abstain or be faithful and are therefore stigmatized as markers of infidelity. As such, use within cohabiting and long-term relationships is low. Our data suggest that negative perceptions of condoms may stem from persistent effects of the formerly applied "ABC" HIV prevention approach, a public health messaging strategy that described A-abstinence, B-be faithful, and C-use a condom as tiered prevention tools. Condom uptake could increase if HIV prevention messaging acknowledges existing stigma and reframes condom use for proactive health prevention. These studies were approved by Weill Cornell Medicine (Protocols 1803019105 and 1604017171), Mbarara University of Science and Technology (Protocol 16/0117), Uganda National Council of Science and Technology (Protocol SS-4338), and the Tanzania National Institute for Medical Research (Protocol NIMR/HQ/R.8c/Vol.I/1330).
Topics: Adult; Male; Humans; Condoms; HIV Infections; Sexual Behavior; Tanzania; Uganda; Health Knowledge, Attitudes, Practice; Acquired Immunodeficiency Syndrome
PubMed: 36631809
DOI: 10.1186/s12978-023-01563-6 -
Investigacion Y Educacion En Enfermeria Jun 2016Evaluate the knowledge about male and female condoms among women living in subnormal agglomerate and identify sources of information and appropriate care to use.
OBJECTIVE
Evaluate the knowledge about male and female condoms among women living in subnormal agglomerate and identify sources of information and appropriate care to use.
METHODS
Household survey, descriptive, transversal and quantitative study with 300 women over 18 of João Pessoa, Paraíba, Brasil, who began their sexual life. The systematic sampling plan for data collection was used. The interview form included sociodemographic questions and gazed relevant aspects of the use of condoms as a preventive measure of sexually transmitted infections and AIDS.
RESULTS
TV and healthcare professionals were the main sources of information. The participants knew more often the male condom features compared to women. The care most often mentioned by women as the use of male and female condoms were related to the validity, form of openness and conditions of packaging and storage of condoms. The largest number of care focused on measures taken in the pre-sexual moment. Moreover, care was nonspecific on the female condom.
CONCLUSION
The participating women have inadequate knowledge on female and male condoms. It is necessary that the nursing seek health education strategies for improving knowledge about relevant information about male and female condoms.
Topics: Adolescent; Adult; Brazil; Condoms; Condoms, Female; Cross-Sectional Studies; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Interviews as Topic; Male; Sexually Transmitted Diseases; Young Adult
PubMed: 28569930
DOI: 10.17533/udea.iee.v34n2a06 -
PloS One 2019Zimbabwe faces an uncertain future for condom funding and potential condom insecurity as international donors prioritize creating more self-sustaining markets and the...
BACKGROUND
Zimbabwe faces an uncertain future for condom funding and potential condom insecurity as international donors prioritize creating more self-sustaining markets and the government identifies how to best ensure access and uptake. We tested the impact of an intensive intervention on demand and supply after a price increase to the social marketed condom, Protector Plus. The study occurred during a deteriorating economy and pressure to reach sustainability quickly. We highlight where strategic donor investments can impact condom programming and markets.
METHODS
We randomized ten purposively selected districts in Zimbabwe and assigned them to two study groups to test the impact of an intensive social marketing intervention. To the best of our knowledge, this is the first experimental study conducted within a larger market strengthening context. We tracked sales of Protector Plus and distribution of the public sector condom monthly. We conducted baseline and follow-up surveys among consumers and traders, and used the difference-in-difference method to test the intervention's impact on condom preferences and brand equity.
RESULTS
Protector Plus sales rebounded to previous levels after the price increase. We detected no significant difference in sales between the experimental and control districts. Among traders, there were no significant differences in brand preference for Protector Plus attributed to the intervention. Among consumers, there was a significant increase in emotional attachment and beliefs about condom efficacy in the experimental districts.
DISCUSSION
Study findings demonstrate where international donor and government investments can impact condom programming and condom markets. Broader findings from the intervention highlight where investments can improve condom coverage, cost recovery, and collaboration between the public, social marketing, and commercial sectors. Strategic investments for strengthening condom markets include: consumer research to segment markets, willingness to pay studies to set price points, distribution system improvements to increase efficiency, intensive demand generation to increase demand and use, market facilitation across sectors, and market intelligence to inform decision making. When a disciplined social marketing approach is used, the market benefits: subsidies can be better targeted, branded products can appeal to the right audiences, and room can be made for the commercial sector to enter the market.
Topics: Adolescent; Adult; Commerce; Condoms; Female; HIV Infections; Humans; Investments; Male; Marketing; Middle Aged; Young Adult; Zimbabwe
PubMed: 31490964
DOI: 10.1371/journal.pone.0221581 -
The Pan African Medical Journal 2018The cornerstone of HIV prevention among female adolescent prostitutes is awareness promotion complemented with advocacy on consistent and correct use of condom. The...
INTRODUCTION
The cornerstone of HIV prevention among female adolescent prostitutes is awareness promotion complemented with advocacy on consistent and correct use of condom. The study aimed at reviewing HIV awareness and condom use among female adolescent prostitutes in Lagos communities, Nigeria.
METHODS
It was a mixed-method study realized through a questionnaire-based survey and in-depth interviews of adolescent sex workers in Oyingbo and Yaba communities of Lagos State, Nigeria; conducted between 1 of April, 2014 and 30 of September, 2014. SPSS version 17.0 and content analysis were used in analyzing quantitative and qualitative data respectively.
RESULTS
97.3% had heard about HIV/AIDS; with 86.9% being tested for HIV in the preceding 6 months. While there was consistent use of male condom in 99.7% of the respondents, 90% had experience with the use of female condom, however, 95.5% would allow non- use of condom for higher financial reward.
CONCLUSION
Although the level of awareness of HIV/AIDS was high among the respondents, there is need to improve on the level of awareness and preventive strategies for HIV/AIDS, with more emphasis laid on the consistent and correct use of condom in this highly vulnerable class of people.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Child; Condoms; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Nigeria; Sex Workers; Surveys and Questionnaires; Young Adult
PubMed: 31086630
DOI: 10.11604/pamj.2018.31.178.17034 -
BMJ Open Nov 2014Self-reported anal intercourse by female sex workers (FSWs) documented in recent studies from India range between 11.9% and 22%. However, comparable data on anal...
OBJECTIVES
Self-reported anal intercourse by female sex workers (FSWs) documented in recent studies from India range between 11.9% and 22%. However, comparable data on anal intercourse and condom use from male clients of FSWs is lacking. Using data from a bio-behavioural survey (2009-2010), we examined prevalence of anal intercourse, male clients' self-reported inconsistent condom use during anal intercourse with FSWs, and correlates of this behaviour in India's high HIV prevalence southern states (Andhra Pradesh, Maharashtra and Tamil Nadu combined).
METHODS
Using two-stage time location cluster sampling, we recruited 4803 clients of FSWs, ages 18-60 years, who had purchased sex from an FSW in the past month. After obtaining informed consent, respondents were interviewed and tested for HIV and sexually transmitted infections (syphilis, gonorrhoea and chlamydia). Logistic regression analysis was used to identify the factors associated with inconsistent condom use during anal intercourse (in the past 6 months) with FSWs.
RESULTS
Overall, 12.3% clients reported anal intercourse in the past 6 months, of whom 48.4% used condoms inconsistently. Clients of FSWs who were ages 26 years or older (AOR 2.68, p=0.032); employed as manual labourers (AOR 2.43, p=0.013); consumed alcohol (AOR 2.63, p=0.001); reported five or more sex acts with FSWs in the past month (AOR 2.53, p=0.031); and perceived themselves to be at higher risk for HIV (AOR 4.82, p=0.001) were more likely to inconsistently use condoms during anal intercourse.
CONCLUSIONS
The results suggest that sex workers and their clients commonly practice anal intercourse, but a relatively high proportion of clients do not consistently use condoms, leading to a greater risk of acquiring HIV and its further transmission to other male and female sexual partners. Given the multidirectional risk, safer sex communication on heterosexual anal intercourse must be incorporated into HIV prevention programmes.
Topics: Adolescent; Adult; Cluster Analysis; Condoms; Cross-Sectional Studies; Health Behavior; Humans; India; Male; Middle Aged; Prevalence; Sex Work; Sex Workers; Sexual Behavior; Young Adult
PubMed: 25410604
DOI: 10.1136/bmjopen-2014-005166 -
Revista Espanola de Salud Publica Jun 2023The HIV increase cases raises concern worldwide. This phenomenon is related, among other things, to sexual practices where condom use is limited. To achieve the...
OBJECTIVE
The HIV increase cases raises concern worldwide. This phenomenon is related, among other things, to sexual practices where condom use is limited. To achieve the eradication of AIDS, international organizations have been interested in analyzing and understanding the sexual practices of certain population groups, within these men who have sex with other men. In this sense, the objective of this study was to analyze the discourses on the use and non-use of condoms held by a group of gay, bisexual and other men who have sex with men (GBHSH) men from two cities in Colombia.
METHODS
A qualitative study was carried out with data analysis through the iterative process, from the interpretation of the Information, Motivation and Behavioral Skills (IMB) model. The collection of information was carried out between 2020 and 2021 through in-depth interviews, virtually and in person, with a sample of 20 GBHSH from Colombia from the cities of Cali and Medellín.
RESULTS
In the Information component, it was identified that traditional sexual education had a negative impact and was very focused on a cisheterosexual and reproductive perspective. Regarding Motivational, it was highlighted that the majority were oriented towards not using condoms and that perceiving a low risk of contracting an STI was the main motivation for not using condoms. Regarding Behavioral Skills, it was analyzed that distrust towards the sexual partner promoted its use, but the intensification of pleasure, added to the consumption of alcohol and drugs, caused its use to decrease. It was also evidenced that the use of drugs such as PreP or PEP discouraged condom use in relationships.
CONCLUSIONS
The information on condom use revolves around cisheteronormative practices, leaving aside the care related to STIs. The motivation for not using condoms revolves around misinformation, pleasure and trust in the couple, while the motivation for condom use revolves around health care. The behavior regarding the non-use of condoms is related to the previous points, while misinformation and pleasure in non-use predominate.
Topics: Male; Humans; Condoms; Sexual and Gender Minorities; Colombia; Cities; Homosexuality, Male; Spain
PubMed: 37387243
DOI: No ID Found -
International Journal of STD & AIDS Nov 2013Preventing HIV infection is a priority for militaries. HIV prevention research is needed to monitor existing programme, identify areas for modification, and develop new...
Preventing HIV infection is a priority for militaries. HIV prevention research is needed to monitor existing programme, identify areas for modification, and develop new interventions. Correct and consistent condom use is highly effective against HIV. However, use among soldiers is lower than ideal. This study describes condom use behaviours and examines correlates of use in the Botswana Defence Force (BDF). Analyses were based on 211 male BDF personnel, aged 18-30, who completed a cross-sectional survey that collected baseline data for an intervention study. Results showed that 51% of participants reported always using condoms, 35% used condoms most times, and 14% used condoms occasionally/never. Condom use varied by partner type and was typically higher with casual partners in comparison to regular partners. After adjustment for age and marital status, factors associated with lower condom use included excessive alcohol use, perception that using condoms reduce sexual pleasure, and having a trusted partner. However, higher levels of HIV knowledge and reports of being circumcised were protective against lower condom use. HIV interventions aimed at increasing condom use in the BDF should address condom perceptions, alcohol abuse, and issues of trust. Innovative ways to increase condom use in this population should also be explored.
Topics: Adult; Botswana; Condoms; Cross-Sectional Studies; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Humans; Logistic Models; Male; Military Personnel; Risk Factors; Sexual Behavior; Sexual Partners; Young Adult
PubMed: 23970609
DOI: 10.1177/0956462413486889