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Predictors of condom use in sexually active adolescents.

Unprotected sexual intercourse places a substantial number of adolescents at risk for sexually transmitted disease (STD) and human immunodeficiency virus (HIV) infection. While the most effective means of preventing STD/HIV infection among sexually active adolescents is consistent condom use, little is known about the factors that influence their consistent use among adolescents. This study of adolescents (n = 1049, mean age = 16.2 years) found that of the 266 teens who recently became sexually active, only 29% reported using condoms consistently. Consistent condom use was more frequent in males, those with little history of risk behavior and those with stronger intentions to use condoms in the future. Fear and anxiety of HIV, attitudes about risks other than HIV, and other safe behavior intentions were not significantly related to consistent condom use. Although intentions and recent behavior were significantly related, a different group of factors was found to predict intention to use condoms (e.g., perception of condom use by friends, general impulsive attitudes). Identifying and understanding the factors that influence adolescent sexual behavior and intentions is important for developing maximally effective HIV education/prevention programs.

Adolescent

Long-acting reversible contraception, condom use and sexually transmitted infections in developing countries: a multi-country serial cross-sectional analysis using demographic and health surveys.

INTRODUCTION: Unintended pregnancy and sexually transmitted infections (STIs) are major public health issues in developing countries. While long-acting reversible contraception (LARC) effectively prevents unintended pregnancy, there is limited evidence from large multinational studies on its association with condom use and STI-related outcomes. This study aimed to investigate the association between LARC use, condom use and STIs among women in developing countries. METHODS: This serial cross-sectional study extracted data from Demographic and Health Surveys (DHS), a series of nationally representative household surveys conducted in developing countries. The analysis included women aged 15 to 49 years, with data on contraceptive methods and demographics. Generalised linear mixed effect models (GLMMs) were used to estimate adjusted prevalence ratios (aPRs) for condom use and self-reported STI-related outcomes, comparing LARC users with both non-LARC users and oral contraceptive users. Subgroup analyses were conducted at the individual level and at the country level. RESULTS: Data from 2 171 884 women across 31 countries were analysed. Overall, the prevalence of self-reported STI-related outcomes was 7.4%, 3.9% of participants used LARC, and 7.5% of participants reported consistent condom use. LARC users were significantly less likely to use condoms compared with non-LARC users (aPR=0.40, 95% CI 0.30 to 0.53) and compared with oral contraceptive users (aPR=0.61, 95% CI 0.48 to 0.78). LARC use was associated with a higher prevalence of STI-related outcomes compared with non-LARC users (aPR=1.19, 95% CI 1.10 to 1.28) and compared with oral contraceptives users (aPR=1.14, 95% CI 1.05 to 1.24). Associations were stronger in low-Human Development Index (HDI) countries, especially among younger women (15-19 years), but were not significant in high-HDI countries. Country-level heterogeneity was observed. CONCLUSIONS: LARC use is associated with reduced condom use and higher self-reported STI prevalence, particularly among younger women and in lower HDI developing countries. These findings support integrating STI prevention into LARC services and promoting dual-method use to prevent both unintended pregnancies and STIs.

Humans

Allergy to rubber condom urinals and medical adhesives in male spinal injury patients.

In the National Spinal Injuries Unit at Stoke Mandeville Hospital, rubber condom urinals, kept on the penis with a medical adhesive, are used for incontinent male patients where possible. However, contact allergy to rubber condoms and/or the adhesives is a common problem and can cause considerable morbidity in paralysed patients. This paper investigates the rubber chemicals and adhesives most commonly implicated in causing contact allergy. The survey was divided into two parts: 1. Patch testing symptomatic inpatients 2. A questionnaire sent to new patients from January 1974 to ascertain the overall incidence of contact allergy. It was found that allergy to mercaptobenzthiazole (MBT)- and thiuram-containing condoms was relatively common and that latex/petroleum tube medical adhesives most commonly caused adhesive allergy. It is suggested that a condom made of the least allergenic rubber and an adhesive causing the least number of allergic reactions should be used from the outset for paralysed patients requiring a condom urinal.

Adhesives

[Factors associated with the failure to use condoms among a population of parenteral drug addicts].

Use of condom in sexual intercourse by intravenous drug users has been assessed among a clinical population (n = 139). The multiple logistic regression results show that being a female (OR = 5.1, 95% CI = 2.0-13.2), on drug dependence for a 5-year period or more (OR = 3.0; 95% CI = 1.3-6.9) correlates with non-condom use. Less than 25% of females use condom in their sexual contacts. On the contrary a higher educational level seems to protect subjects against non-condom use (R = 0.3; 95% CI = 0.1-0.8). The most parsimonious model fitting to data at hand includes such variables as sex, educational level, partnership and frequency of sexual intercourse, as well as years on addiction. Other set of variables such as living and working status, age, and previous sexually-transmitted diseases experience are not required for the final model. Emphasis is placed on the need for developing programs aimed at modifying the high risk behavior intravenous drug users resort to in their sexual intercourse, stressing that the main dissemination cause of the human immunodeficiency virus among such a population is due to their sharing drug injections equipment.

Adult

AIDS, sex and condoms: African healers and the reinvention of tradition in Zaire.

Condoms offer considerable protection against sexual transmission of AIDS. Yet many Africans who are at risk of infection reject condoms as "unnatural." Data from Zaire have been used to examine this culturally constructed category in relation to sexuality, procreation, gender roles, class formation and international health and development policy. Much more than a simple transfer of biomedical technology is involved. Condom use with regular partners raises issues of cultural politics at many levels. "Traditional" African healers represent important social networks with considerable authority in poor urban communities. They are able to reinterpret cultural categories and endow behavior with new meanings. Action-research in Kinshasa was used to explore roles that healers might play in promoting change to safer sex practices.

Acquired Immunodeficiency Syndrome

The condom and gonorrhoea.

The use of the condom by male patients attending a clinic specialising in sexually transmitted diseases has been assessed over a period of six months. Condom users were divided into those who used them properly and invariably, and those who did not. In the group studied, correct use of the condom was associated with a significantly lower probability of acquiring gonorrhoea (P less than 0-001) and a significantly higher chance of there being no sexually transmitted disease diagnosed (P less than 0-0005). The diagnosis-rate of non-specific urethritis, however, did not differ among the groups.

Contraceptive Devices, Male

Glans condom drainage system.

A form-fitting glans condom has been developed for use in small uncircumcised males with neurogenic bladders to avoid the problems inherent with diapers. The method to make the glans condom and early successful use in 19 of 33 patients are noted.

Adolescent

Experimental findings with spermantibodies: condom therapy (a case report).

A couple with no demonstrable cause for their infertility, except for a pronounced antisperm activity in the blood serum of the female partner, were instructed to use a condom while our laboratory monitored the wifes antibody titer. The antibody activity declined sufficiently and an artificial husband insemination were performed after seven months of therapy. A precise report of the spermantibody activity over an eleven month period are given by the authors.

Antibodies

The association of AIDS education and sex education with sexual behavior and condom use among teenage men.

According to a 1988 nationally representative survey, most 15-19--year-old men in the United States have received formal instruction about AIDS (73%), birth control (79%) and resisting sexual activity (58%). Results of multivariate analyses show the receipt of AIDS education and sex education to be associated with modest but significant decreases in the number of partners and the frequency of intercourse in the year prior to the survey. Having received instruction in these topics was also associated with more consistent condom use. Instruction in some topics was associated with increases in knowledge and attitudes about AIDS, but these increases were not always correlated with safer behavior.

Acquired Immunodeficiency Syndrome

Do condom catheter collecting systems cause urinary tract infection?

A study was undertaken to determine whether use of a condom catheter collection system (CCCS) is associated with urinary tract infection (UTI). No UTI developed in 79 episodes of CCCS use in patients who were cooperative or because of paralysis were unable to manipulate the collecting system (mean time per patient, 21.2 days; total number of patient days, 1,677). By contrast, in 15 patients who were identified prospectively as being uncooperative and who repeatedly manipulated the CCS, UTI developed in eight (53.3%) within a mean of 9.6 days. Urethral catheterization in cooperative patients during CCCS use was followed by development of UTI. Repeated interference with the proper use of CCCS and urethral catheterization during CCCS use are associated with an increased risk of UTI.

Humans

Condom urinals.

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Catheters, Indwelling