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González-Hernández AM, Escobar-Estupinan JL, Vallejo-Medina P. Condom Use Errors and Problems in a Sample of Young Colombian Adults. JOURNAL OF SEX RESEARCH 2020; 57:1217-1224. [PMID: 32077316 DOI: 10.1080/00224499.2020.1728207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Condom effectiveness can be reduced by a number of problems and errors that take place during use. The purpose of the present study was to translate and adapt the Condom Use Errors and Problems Survey (CUES) into Spanish and to use it for testing the prevalence of these issues in a sample of young Colombian adults. A total of 775 people (414 women and 361 men) between 18 and 26 years of age participated in the study. Participants completed the following questionnaires online: Condom Use Errors and Problems Survey, Sexual Opinion Survey, Sexual Assertiveness Scale, Multidimensional Condom Attitudes Scale, a sociodemographic and sexual history questionnaire, plus two questions concerning condom-associated erectile problems. Results showed significant differences in the prevalence of condom use errors/problems associated with gender, sexual orientation, and whether the participant had a stable sexual partner. The occurrence of problems/errors ranged from 9.4% to 69.5%. Except for certain specific practices, observations were similar to those of studies performed in North America. Results indicate that the present linguistic adaptation of the CUES for its use in Colombian Spanish-speaking populations is an effective instrument to assess problems and errors associated with the use of male condoms.
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Estimating the Prevalence and Predictors of Incorrect Condom Use Among Sexually Active Adults in Kenya: Results From a Nationally Representative Survey. Sex Transm Dis 2016; 43:87-93. [PMID: 26766524 DOI: 10.1097/olq.0000000000000393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Condom use continues to be an important primary prevention tool to reduce the acquisition and transmission of HIV and other sexually transmitted infections. However, incorrect use of condoms can reduce their effectiveness. METHODS Using data from a 2012 nationally representative cross-sectional household survey conducted in Kenya, we analyzed a subpopulation of sexually active adults and estimated the percent that used condoms incorrectly during sex, and the type of condom errors. We used multivariable logistic regression to determine variables to be independently associated with incorrect condom use. RESULTS Among 13,720 adolescents and adults, 8014 were sexually active in the previous 3 months (60.3%; 95% confidence interval [CI], 59.0-61.7). Among those who used a condom with a sex partner, 20% (95% CI, 17.4-22.6) experienced at least one instance of incorrect condom use in the previous 3 months. Of incorrect condom users, condom breakage or leakage was the most common error (52%; 95% CI, 44.5-59.6). Factors found to be associated with incorrect condom use were multiple sexual partnerships in the past 12 months (2 partners: adjusted odds ratio [aOR], 1.5; 95% CI, 1.0-2.0; P = 0.03; ≥3: aOR, 2.3; 95% CI, 1.5-3.5; P < 0.01) and reporting symptoms of a sexually transmitted infection (aOR, 2.8; 95% CI, 1.8-4.3; P < 0.01). CONCLUSIONS Incorrect condom use is frequent among sexually active Kenyans and this may translate into substantial HIV transmission. Further understanding of the dynamics of condom use and misuse, in the broader context of other prevention strategies, will aid program planners in the delivery of appropriate interventions aimed at limiting such errors.
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Tsuyuki K, Gipson JD, Urada L, Barbosa RM, Morisky DE. Dual protection to address the global syndemic of HIV and unintended pregnancy in Brazil. JOURNAL OF FAMILY PLANNING AND REPRODUCTIVE HEALTH CARE 2016; 42:271-279. [PMID: 26880759 PMCID: PMC5384873 DOI: 10.1136/jfprhc-2015-101175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/29/2015] [Accepted: 11/23/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Syndemic HIV and unintended pregnancy is prevalent in Brazil, where 79% of female HIV cases occur in women of reproductive age and 55% of all pregnancies are unintended. Although increasing condom use to prevent HIV may decrease non-barrier contraception and increase unintended pregnancy, few studies focus on dual protection or dual methods (condoms with another modern contraceptive). AIM To describe the correlates of dual method use and consistent condom use in women of reproductive age in Brazil. METHOD Data are from the 2006 Pesquisa Nacional de Demografia e Saúde da Mulher e da Criança, a decennial nationally representative household survey of women of reproductive age in Brazil. Multivariate logistic regression models identify the socio-demographic, sexual debut, fertility and relationship factors associated with dual method use and consistent condom use. RESULTS Two-thirds of contracepting women in Brazil used dual protection (40% exclusive condoms, 27% dual methods). Consistent condom use in the past year occurred among 61% of exclusive condom users and 27% of dual method users. Dual methods (vs exclusive condoms) was associated with some high school education [relative risk ratio (RRR)=1.69, p<0.05], living in the Southern region (RRR=1.59, p<0.01), and number of children (RRR=1.22, p<0.01), net of other factors. Consistent condom use was associated with condom use at sexual debut [adjusted odds ratio (AOR)=1.84, p<0.001], wants no (more) children (AOR=1.86, p<0.001), single/separated relationship status (AOR=2.77/2.45, p<0.001) and using exclusive condoms (vs dual methods: AOR=0.19, p<0.001). CONCLUSIONS Findings highlight that targeting and delivering integrated HIV and family planning services should focus on completed/large families. single/separated individuals, and promoting dual protection at sexual debut.
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Affiliation(s)
- Kiyomi Tsuyuki
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
| | - Jessica D. Gipson
- Department of Community Health Sciences, University of California, Los Angeles
| | - Lianne Urada
- Division of Global Public Health, School of Medicine, University of California, San Diego (UCSD)
| | - Regina M. Barbosa
- Population Studies Center (NEPO), University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Donald E. Morisky
- Department of Community Health Sciences, University of California, Los Angeles
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Cousins G, Layte R, Ingham R, McGee H. Sexual risk-taking at home and on holidays: the importance of context for the late application of condoms. Sex Health 2013; 10:414-8. [PMID: 23838080 DOI: 10.1071/sh13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 05/29/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Several studies have examined condom use during 'holiday' sex but have not considered condom errors in this context. This study aims to identify factors associated with late application of condoms during participants' most recent vaginal intercourse at home and away from home (holidays or short breaks). METHOD Participants aged 19-30 years from a national Irish survey were recontacted (n=388; 51% men; mean age: 23.9 years). Telephone interviews regarding participants' most recent sex at home (n=362) and away from home (n=178) were conducted. RESULTS A higher proportion reported condom use away from home (79% v. 62%), with a lower prevalence of late application (14% v. 24%). Pregnancy prevention as the primary motive for condom use increased the odds of late application at home (adjusted odds ratio (AOR): 4.56, 95% confidence interval (CI): 2.10-9.90) and away (AOR: 3.97, 95% CI: 1.36-11.59). A weak desire to use a condom also increased the likelihood of late application at home (AOR: 2.40, 95% CI: 1.03-5.62) and away (AOR: 11.18, 95% CI: 2.84-43.98). Subgroup analysis of those reporting both sexual events suggests that young adults take greater sexual risks with casual partners at home compared to away. CONCLUSIONS The findings suggest that young adults take greater sexual risks at home than when away. Regardless of location, young adults are most likely to report late application when they have a weak desire to use a condom and when they use condoms primarily to prevent pregnancy.
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Affiliation(s)
- Gráinne Cousins
- School of Pharmacy, Royal College of Surgeons in Ireland, 123 Stephen's Green, Dublin 2, Ireland
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Brown JL, Sales JM, DiClemente RJ, Salazar LF, Vanable PA, Carey MP, Brown LK, Romer D, Valois RF, Stanton B. Predicting discordance between self-reports of sexual behavior and incident sexually transmitted infections with African American female adolescents: results from a 4-city study. AIDS Behav 2012; 16:1491-500. [PMID: 22323006 DOI: 10.1007/s10461-012-0163-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This study examined correlates of the discordance between sexual behavior self-reports and Incident Sexually Transmitted Infections. African American adolescent females (N = 964) from four U.S. cities were recruited for an HIV/STI prevention trial. Self-reported sexual behaviors, demographics, and hypothesized psychosocial antecedents of sexual risk behavior were collected at baseline, 6-, 12-, and 18-month follow-up assessments. Urine specimens were collected and tested for three prevalent STIs (chlamydia, gonorrhea, trichomonas) at each assessment. Seventeen percent of participants with a laboratory-confirmed STI reported either lifetime abstinence or recent abstinence from vaginal sex (discordant self-report). Lower STI knowledge, belief that fewer peers were engaging in sex, and belief that more peers will wait until marriage to have sex were associated with discordant reports. Discordance between self-reported abstinence and incident STIs was marked among African American female adolescents. Lack of STI knowledge and sexual behavior peer norms may result in underreporting of sexual behaviors.
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Coyle KK, Franks HM, Glassman JR, Stanoff NM. Condom use: slippage, breakage, and steps for proper use among adolescents in alternative school settings. THE JOURNAL OF SCHOOL HEALTH 2012; 82:345-352. [PMID: 22712671 DOI: 10.1111/j.1746-1561.2012.00708.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND School-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI), and pregnancy prevention programs often focus on consistent and correct condom use. Research on adolescents' experience using condoms, including condom slippage/breakage, is limited. This exploratory study examines proper condom use and the occurrence of condom slippage/breakage among alternative school youth. METHODS Data are from an HIV/STI prevention trial for youth in continuation school settings (N = 776). Analyses included separate hierarchical logistic regression analyses to explore the relationship between potential correlates and each outcome variable. RESULTS Students' use of steps for proper condom use varied-73.8% put on the condom before sexual contact, 71.1% squeezed air from the tip, and 92.0% unrolled the condom fully. Notably, 28.5% reported condom slippage/breakage. Results from the regression analyses showed that 4 sets of variables (demographic, substance use, sexual risk behaviors, and condom psychosocial factors) were associated with putting on a condom before sexual contact; none of the variable sets were associated with the other 2 condom steps measured. For slippage/breakage, the demographic and sexual risk behaviors were significant correlates; steps for proper condom use approached statistical significance (p = .058). CONCLUSIONS This study extends the limited research on how adolescents use condoms, and highlights important targets for prevention interventions.
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Affiliation(s)
- Karin K Coyle
- Research Department, ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA.
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Wu JQ, Li YY, Ren JC, Li N, Zhou Y, Zhao R, Zhang YF. Male condom use and condom problems among women in Shanghai. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2012. [DOI: 10.1016/s2305-0500(13)60047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sanders SA, Yarber WL, Kaufman EL, Crosby RA, Graham CA, Milhausen RR. Condom use errors and problems: a global view. Sex Health 2012; 9:81-95. [PMID: 22348636 DOI: 10.1071/sh11095] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Accepted: 11/24/2011] [Indexed: 11/23/2022]
Abstract
Background
Significantly more research attention has been devoted to the consistency of condom use, with far fewer studies investigating condom use errors and problems. The purpose of this review was to present the frequency of various condom use errors and problems reported worldwide. Methods: A systematic literature search was conducted for peer-reviewed articles, published in English-language journals between 1995 and 2011. Results: Fifty articles representing 14 countries met criteria for inclusion. The most common errors included not using condoms throughout sex, not leaving space at the tip, not squeezing air from the tip, putting the condom on upside down, not using water-based lubricants and incorrect withdrawal. Frequent problems included breakage, slippage, leakage, condom-associated erection problems, and difficulties with fit and feel. Prevalence estimates showed great variation across studies. Prevalence varied as a function of the population studied and the period assessed. Conclusion: Condom use errors and problems are common worldwide, occurring across a wide spectrum of populations. Although breakage and slippage were most commonly investigated, the prevalence of other condom use errors and problems found in this review were substantially higher. As a framework for understanding the role of condom errors and problems in inadequate protection, we put forward a new model: the Condom Use Experience model. This model can be used to generate testable hypotheses for future research. Addressing condom use errors and problems in research and interventions is crucial to closing the gap between the perfect use and typical use of condoms.
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Rowe CL, Wang W, Greenbaum P, Liddle HA. Predicting HIV/STD Risk Level and Substance Use Disorders Among Incarcerated Adolescentst. J Psychoactive Drugs 2011; 40:503-12. [DOI: 10.1080/02791072.2008.10400656] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Cynthia L. Rowe
- a Center for Treatment Research on Adolescent Drug Abuse, University of Miami Miller School of Medicine, Department of Epidemiology and Public Health , Miami, FL
| | - Wei Wang
- b College of Public Health, University of South Florida , Tampa, FL
| | - Paul Greenbaum
- c Department of Child and Family Studies , Florida Mental Health Institute, University of South Florida , Tampa, FL
| | - Howard A. Liddle
- a Center for Treatment Research on Adolescent Drug Abuse, University of Miami Miller School of Medicine, Department of Epidemiology and Public Health , Miami, FL
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Correlates of incorrect condom use among depressed young women: an event-level analysis. J Pediatr Adolesc Gynecol 2011; 24:10-4. [PMID: 20493734 PMCID: PMC2946981 DOI: 10.1016/j.jpag.2010.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 03/30/2010] [Accepted: 04/02/2010] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE Depressed young women are at particularly high risk of sexually transmitted infections (STIs), yet little is known about their condom use practices. This study sought (1) to describe condom use errors among depressed adolescent and young adult women and (2) to identify event- and individual-level correlates of incorrect use. DESIGN Depressed, sexually active outpatients ages 15-22 responded to a computer-based questionnaire, then reported on penile-vaginal sex events on a handheld computer several times a day for two weeks. For each sex event with a condom, incorrect condom use was defined as a response indicating incorrect use on at least one of five questions. Event- and individual-level correlates of incorrect use were analyzed using logistic regression adjusted for age and within-individual clustering. SETTING Participants were recruited from two adolescent clinics, a psychiatric clinic, and a young parents' program of an urban children's hospital and collected data in the settings of their everyday lives. PARTICIPANTS Thirty-one young women contributed 143 condom use events to these analyses. INTERVENTIONS None. MAIN OUTCOME MEASURE Incorrect condom use. RESULTS Incorrect condom use was reported for 51% of condom use events. The most common error was not holding the condom on withdrawal (31%). Having sex to change mood, to relax, or for physical pleasure increased the odds of incorrect condom use, but was no longer significant when individual-level variables were included in the model. In the multiple logistic regression model, impulsiveness increased and stronger belief that mood affects sexual behaviors decreased the odds of incorrect condom use (adjusted OR 1.3 and 0.81, respectively). CONCLUSIONS Even if they use condoms, depressed adolescent and young adult women are at increased risk of STIs because they frequently use condoms incorrectly. Psychological factors may help identify depressed young women who are at particularly high risk of incorrect condom use.
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Gálvez-Buccollini JA, DeLea S, Herrera PM, Gilman RH, Paz-Soldan V. Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru. BMC Public Health 2009; 9:23. [PMID: 19152702 PMCID: PMC2644290 DOI: 10.1186/1471-2458-9-23] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Accepted: 01/19/2009] [Indexed: 11/23/2022] Open
Abstract
Background Risky sexual behaviors of young adults have received increasing attention during the last decades. However, few studies have focused on the sexual behavior of young adults in shantytowns of Latin America. Specifically, studies on the association between sexual behaviors and other risk factors for sexually transmitted infections (STI) and HIV/AIDS transmission, such as the consumption of illicit drugs or alcohol are scarce in this specific context. Methods The study participants were 393 men and 400 women between 18 and 30 years of age, from a shantytown in Lima, Peru. Data were obtained via survey: one section applied by a trained research assistant, and a self-reporting section. Logistic regression was used to estimate associations between use of any illicit drug, high-risk sexual behaviors and reported STI symptoms, adjusting for alcohol consumption level and various socio-demographic characteristics. Results Among men, age of sexual debut was lower, number of lifetime sexual partners was higher, and there were higher risk types of sexual partners, compared to women. Though consistent condom use with casual partners was low in both groups, reported condom use at last intercourse was higher among men than women. Also, a lifetime history of illicit drug consumption decreased the probability of condom use at last sexual intercourse by half. Among men, the use of illicit drugs doubled the probability of intercourse with a casual partner during the last year and tripled the probability of reported STI symptoms. Conclusion Drug consumption is associated with high-risk sexual behaviors and reported STI symptoms in a Lima shantytown after controlling for alcohol consumption level. Development of prevention programs for risky sexual behaviors, considering gender differences, is discussed.
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