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de Vries A, den Daas C, Willemstein IJM, de Wit JBF, Heijne JCM. Interventions Promoting Condom Use Among Youth: A Systematic Review. J Adolesc Health 2024; 74:644-656. [PMID: 38085203 DOI: 10.1016/j.jadohealth.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 03/24/2024]
Abstract
In many European and other high-income, Western countries, condom use has been decreasing among youth. A variety of promotional strategies to increase condom use exists. Our systematic review aimed to identify effective elements in interventions aimed at increasing condom use in youth. We searched databases (2010-2021) for intervention studies promoting condom use among youth in Western, high-income countries. The primary outcome was condom use; the secondary outcome was sexually transmitted infection (STI) diagnoses. Effectiveness per intervention was defined based on the percentage of comparisons that showed significant increases in condom use and significant decreases in STIs. We compared the effectiveness of interventions for different participant-, intervention- and methodological characteristics. We included 74 papers describing 85 interventions in the review. Overall, the median intervention effectiveness was 33.3% (interquartile range = 0%-66.7%) for condom use and 0% (interquartile range = 0%-100%) for STI diagnoses. Intervention effectiveness for condom use was significantly higher in interventions tailored towards females and males specifically, compared with interventions applied to both sexes combined. Our findings show the difficulty in designing effective interventions to increase condom use among youth. Interventions aimed at either females or males were more effective in increasing condom use.
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Affiliation(s)
- Alcira de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Chantal den Daas
- Health Psychology Group and Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Inge J M Willemstein
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Janneke C M Heijne
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Rodrigues DL, de Visser RO, Lopes D, Prada M, Garrido MV, Balzarini RN. Prevent2Protect Project: Regulatory Focus Differences in Sexual Health Knowledge and Practices. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1701-1713. [PMID: 36702994 PMCID: PMC9879562 DOI: 10.1007/s10508-023-02536-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/05/2022] [Accepted: 01/07/2023] [Indexed: 06/18/2023]
Abstract
The way people perceive risks and make decisions about their health is regulated by two motivational systems-prevention of harm or promotion of pleasure. People more focused on prevention strive to avoid negative outcomes and enact more health-protective behaviors. In contrast, people more focused on promotion strive to attain positive outcomes and take more risks with their health. Building upon recent evidence extending this framework to sexual behaviors and health, we conducted a pre-registered online survey ( OSF ) with Portuguese and Spanish adults (N = 742; Mage = 31.42, SD = 9.16) to examine whether self-reported STI knowledge and sexual health practices differ based on predominant regulatory focus. This study was part of the Prevent2Protect project ( OSF ). Results showed that prevention-focused participants had heard about more STIs and retrieved more of their knowledge from scientific sources but had been tested for fewer STIs in the past. In contrast, promotion-focused participants indicated they had specific knowledge about more STIs, retrieved more of their knowledge from medical and peer sources, and had been tested for more STIs in the past. They also reported more frequent STI testing, using free testing facilities or asking their family practice doctor to get tested, more routine sexual health check-ups, and more use of other contraceptive methods, such as birth control pills. These results remained unchanged after controlling for demographic differences. Overall, our findings showed that different motives in sexuality shape sexual health knowledge and sexual health practices.
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Affiliation(s)
- David L Rodrigues
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal.
| | | | - Diniz Lopes
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Marília Prada
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Margarida V Garrido
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Rhonda N Balzarini
- Department of Psychology, Texas State University, San Marcos, TX, USA
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
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Jara H, Damena M, Urgessa K, Deressa A, Debella A, Mussa I, Mohammed A, Weldegebreal F. Consistent Condom Use and Associated Factors among sexually active Military Personnel in Eastern Ethiopia: Cross-Sectional Study Design. Risk Manag Healthc Policy 2022; 15:2057-2070. [PMID: 36386556 PMCID: PMC9642798 DOI: 10.2147/rmhp.s375340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
Background A condom is a latex-based device used to prevent pregnancy and sexually transmitted infections (STIs). Despite condom availability and promotion for use in STI prevention, consistent condom use remains too low in Ethiopia. A significant proportion of Ethiopian military personnel had multiple sexual partners, with lower rates of condom use with non-regular sexual partners. As a result, determining the pattern of condom use and the factors associated with it among military personnel is critical. Objective The purpose of this study was to evaluate consistent condom use and associated factors among sexually active military personnel in Eastern Ethiopia from February 1 to 28, 2020. Methods A cross-sectional study was conducted among 327 sexually active military personnel. To select the study participants, a systematic sampling technique was used. The data were entered into EpiData and exported to the Statistical Package for Social Sciences version 20 for analysis. To identify factors associated with condom use, bivariate and multivariable logistic regression analysis were used, and the strength of the association was measured using odds ratio and 95% confidence interval (CI), with P-values less than 0.05 considered statistically significant. Results The overall prevalence of consistent condom uses over one year by the respondents was 59.9% (95% CI: 54, 65). Study participants with an age of 30–35 years old (AOR = 3.12; 95% CI: 1.43, 11.38), above 35 years old (AOR = 2.42; 95% CI: 1.83, 9.30), college and above in educational status (AOR = 1.52; 95% CI: 1.20, 5.43), Officer in military rank (AOR = 3.12; 95% CI: 1.14, 10.15) and other military ranks (AOR = 3.08; 2.33, 8.52) were factors facilitate the use of condom consistently. Conclusion In this study, two in every five military personnel use condoms inconsistently. Designing appropriate intervention and behavioral change strategies, as well as increasing the accessibility and availability of condoms around military camps, will undoubtedly have a significant impact on consistent condom utilization.
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Affiliation(s)
- Hussen Jara
- Department of Public Health, Eastern Command, Harar, Ethiopia
| | - Melake Damena
- Department of Public Health and Health Policy, Haramaya University, Harar, Ethiopia
| | - Kedir Urgessa
- Department of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa
- Department of Public Health and Health Policy, Haramaya University, Harar, Ethiopia
- Correspondence: Alemayehu Deressa, Public Health and Health Policy Department, Haramaya University, P. O. Box: 235, Harar, Ethiopia, Tel +251 917841709, Fax +251 256668081, Email
| | - Adera Debella
- Department of Midwifery, Haramaya University, Harar, Ethiopia
| | - Ibsa Mussa
- Department of Public Health and Health Policy, Haramaya University, Harar, Ethiopia
| | - Ahmed Mohammed
- Department of Medicine, Haramaya University, Harar, Ethiopia
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
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Giménez-García C, Ballester-Arnal R, Ruiz-Palomino E, Nebot-García JE, Gil-Llario MD. Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999-2020). SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 31:100677. [PMID: 34775354 DOI: 10.1016/j.srhc.2021.100677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.
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Affiliation(s)
- Cristina Giménez-García
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain
| | - Rafael Ballester-Arnal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain.
| | - Estefanía Ruiz-Palomino
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain
| | | | - María Dolores Gil-Llario
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Valencia, Spain
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García-Vázquez J, Quintó L, Agulló-Tomás E. Impact of a sex education programme in terms of knowledge, attitudes and sexual behaviour among adolescents in Asturias (Spain). Glob Health Promot 2019; 27:122-130. [PMID: 31797718 DOI: 10.1177/1757975919873621] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sex education in schools is an adolescents' right, and can have health benefits, such as improved knowledge or increased condom use. In Asturias, a secondary school programme called Neither Ogres Nor Princesses educates pupils for four years with trained teaching staff and external workshops. This study examined whether this programme (a) improved adolescents' sexuality knowledge, attitudes and skills, and (b) increased condoms use. A quasi-experimental survey was conducted, with comparison arm, with a pre-test in the first year of secondary school (12- to 13-year-olds), and two post-tests: after the intervention (15- to 16-year-olds) and two years later (17- to 18-year-olds). A questionnaire with socio-demographic, knowledge, attitude, skill and sexual behaviour variables was used. The impact was evaluated with 'difference-indifferences' analyses. There was a greater increase of knowledge in the intervention arm in both post-tests, and an increase in skills in the first post-test. Girls in the intervention arm reported less practices with penetration and greater condom use the first time, this also among boys. However, the impact was limited in time. Interventions that aim to increase sex education in curricula with quality and fidelity are a priority to guarantee children's rights and their health.
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Affiliation(s)
| | - Llorenç Quintó
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic-Universitat de Barcelona. Barcelona. Spain
| | - Esteban Agulló-Tomás
- Social Psichology Area, School of Psichology, University of Oviedo, Asturias, Spain
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Gil-Llario MD, Morell-Mengual V, Ruiz-Palomino E, Ballester-Arnal R. Factorial Structure and Psychometric Properties of a Brief Scale of the Condom Use Self-Efficacy for Spanish-Speaking People. HEALTH EDUCATION & BEHAVIOR 2018; 46:295-303. [PMID: 30336694 DOI: 10.1177/1090198118806964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Studies have shown the role played by perceived self-efficacy in explaining condom negotiation and condom use. AIMS The factorial structure and the psychometric properties of the Brief Condom Use Self-Efficacy Scale are presented. METHOD The study included 368 men and 456 women aged 17 to 55 years ( Mage = 25.01, SD = 6.93). RESULTS Exploratory factor analysis yielded three factors: fear of rejection, impulse control, and condom acquisition and negotiation, which together accounted for 68% of the total variance. That structure was confirmed through confirmatory factor analysis. Cronbach's alpha for the Brief Condom Use Self-Efficacy Scale was .71. The scale provided adequate convergent validity, and positive correlations were observed between self-reported condom use and self-efficacy for use of other barrier methods. DISCUSSION This brief instrument could be a useful and appropriate measure to assess the types of condom use self-efficacy that occur at the different moments of a sexual relationship.
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Giménez-García C, Ballester-Arnal R, Gil-Llario MD, Salmerón-Sánchez P. Peer-Led or Expert-Led Intervention in HIV Prevention Efficacy? A Randomized Control Trial Among Spanish Young People to Evaluate Their Role. Health Promot Pract 2017; 19:277-286. [PMID: 28954546 DOI: 10.1177/1524839917733966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
HIV new infections still affect young people around the world. In this context, behavioral interventions seem to be effective in promoting safe sex although some conditions are still inconclusive in different regions. For example, there is insufficient evidence about who may be the best facilitator. For this reason, this study evaluates the effectiveness of peer and expert facilitators for HIV prevention aimed at Spanish young people. For this purpose 225 Spanish college students, aged between 18 and 25 (74.20% women and 25.80% men), were involved in an experimental design to evaluate the facilitators' effect in a brief intervention for HIV prevention. Participants' results were measured by three HIV preventive variables (knowledge, beliefs, and protective sex behavior in vaginal sex, anal sex, and sex after drugs consumption). Our findings reveal that both facilitators, experts and peers, have improved the HIV-associated factors and safe sex behaviors. Therefore, facilitators' status would not be so relevant for effectiveness in HIV prevention aimed at Spanish young people. To facilitate decision making in HIV prevention, we should study in depth what other variables make more effective facilitators.
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