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McCool-Myers M, Myo A, Carter JA. Barriers to Purchasing Condoms in a High HIV/STI-Risk Urban Area. J Community Health 2020; 44:836-843. [PMID: 31055703 DOI: 10.1007/s10900-019-00670-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The Centers for Disease Control and Prevention (CDC) have identified Atlanta, Georgia as a high-risk environment for STI/HIV infection. Condoms are an inexpensive and effective method for preventing STI/HIV infection. The majority of individuals acquire their condoms through purchase, rather than through free condom distribution programs. However, individuals purchasing condoms in stores encounter numerous barriers. This study assessed the environmental and physical barriers surrounding condom purchases in stores in downtown Atlanta. The findings revealed a combination of high environmental and physical barriers, low visibility of condoms in stores and limited selection of safer sex supplies. In the most densely populated area of the city, stores which sold condoms were few (n = 25), equating to 1 store per ~ 7000 people. In 80% of stores, personnel were required in order to access the condoms. In 28% of stores, condoms were hidden underneath the counter. The majority of stores offered only one brand of male condoms with a limited selection of lubricants and no dental dams or internal condoms. Barriers and discomfort surrounding purchasing condoms can contribute to embarrassment, which has a negative impact on condom acquisition and ultimately on condom use. Efforts must be made to lower barriers in Atlanta and make condoms more readily available to high-risk populations. Community advocacy has been effective in removing barriers to condoms. Access can furthermore be improved by: installing condom vending machines in public locations, offering self-check-out in stores that do not have physical barriers and encouraging individuals to order condoms online.
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Affiliation(s)
- Megan McCool-Myers
- Emory University School of Medicine, Jane Fonda Center for Adolescent Reproductive Health, 46 Armstrong Street SE, Atlanta, GA, 30303, USA.
| | - Annabelle Myo
- Emory University School of Medicine, Jane Fonda Center for Adolescent Reproductive Health, 46 Armstrong Street SE, Atlanta, GA, 30303, USA
| | - Jacqueline Ann Carter
- Emory University School of Medicine, Jane Fonda Center for Adolescent Reproductive Health, 46 Armstrong Street SE, Atlanta, GA, 30303, USA
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Teen Perceptions of Sexual Activity: Influences, consequences, realities, and thoughts on safe sexual health practices. Dela J Public Health 2017; 3:66-76. [PMID: 34466900 PMCID: PMC8352461 DOI: 10.32481/djph.2017.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Teens’ engagement in sexual activity and safe sexual practices is an important public health issue in the US today. This descriptive survey study explored teens’ thoughts about the influences, consequences, and realities associated with teen sexual activity and pregnancy and their perceptions of access to sexual health education and contraception. Surveys were administered to 856 Delaware youth in 39 high school health classes from 16 schools. Of the 31 survey items, 25 offered significantly different responses; participants agreed with 16 and disagreed with 9 items (p < .005), revealing important findings concerning teen perceptions as the basis for meaningful interventions.
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Ubrihien A, Davies SC, Driscoll T. Is cost a structural barrier preventing men who have sex with men accessing condoms? A systematic review. AIDS Care 2016; 28:1473-80. [PMID: 27240970 DOI: 10.1080/09540121.2016.1189999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A systematic review was undertaken to determine whether cost is a structural barrier preventing men who have sex with men (MSM) accessing condoms. Studies were examined from a range of countries where condoms have been distributed free to particular populations and also those where condoms were available at a cost to the individual. The study inclusion criteria were: published between January 1990 and September 2014 inclusive; published in any language, discussed cost as a barrier to condom use, discussed cost barriers to MSM accessing condoms and included a measure of outcome. Articles were systematically extracted from MEDLINE, Embase, PyschINFO and Informat using the five search terms; Male Homosexuality, Access, Cost, Cost and Cost analysis, Condoms. Sixty-four articles were initially identified and 11 included in the final review. The included studies used cost-utility analysis, qualitative, cross-sectional, cohort or randomised control trial design. Large-scale free distribution programmes and smaller targeted programmes showed positive correlations in reducing the burden of disease from HIV and other sexually transmitted infections through eliminating the issue of cost. Decreasing the cost of condoms, and providing them for no cost, appears to increase their utilisation amongst MSM and possibly reduce the burden from HIV and other sexually transmitted infections. Inequality and stigma remain important barriers to MSM accessing and using condoms particularly in the developing world.
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Affiliation(s)
- Ashley Ubrihien
- a Northern Sydney Sexual Health Service, Royal North Shore Hospital , St Leonards , NSW , Australia.,b School of Public Health, Sydney Medical School, University of Sydney , Sydney , NSW , Australia
| | - Stephen C Davies
- a Northern Sydney Sexual Health Service, Royal North Shore Hospital , St Leonards , NSW , Australia.,c Sydney Medical School, University of Sydney , Sydney , NSW , Australia
| | - Tim Driscoll
- b School of Public Health, Sydney Medical School, University of Sydney , Sydney , NSW , Australia
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Wilson AM, Ickes MJ. Purchasing condoms near a college campus: environmental barriers. Sex Health 2015; 12:67-70. [PMID: 25659603 DOI: 10.1071/sh14155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/07/2015] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background Given the propensity for college students to engage in sexual activity and the subsequent lack of consistent condom use, there is a need to determine environmental factors that may be motivating or deterring factors for college students to access condoms. This study aimed to determine the number of businesses available to purchase condoms from near a large, south-eastern college campus and investigate environmental differences between types of businesses. METHODS Environmental factors (e.g. distance from campus, barriers to purchasing, selection availability and price) were collected among businesses within a 2-mile radius of the campus. Both χ(2) and ANOVA determined significant differences between types of businesses (P≤0.05). RESULTS Forty-two businesses sold condoms, 66.7% of which were convenience-type stores. The average distance from the campus was 1.33 miles (s.d.=0.58). The average unit price of male condoms was significantly higher in drug store/pharmacies (M=1.68) compared with convenience-type stores (M=1.22) and grocery stores (M=0.97); P=0.005. Assistance was needed to purchase condoms in 25% of businesses. Barriers to purchasing condoms were significantly higher in convenience stores/gas stations (P<0.05). CONCLUSION Environmental barriers related to purchasing condoms exist and must be considered when targeting sexual health promotion on college campuses.
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Affiliation(s)
- Annie M Wilson
- Transylvania University, 300 North Broadway, Lexington, KY 40508, USA
| | - Melinda J Ickes
- Department of Kinesiology and Health Promotion, University of Kentucky, 111 Seaton Building, Lexington, KY 40506-0219, USA
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Gebhardt WA, van der Doef MP, Billingy N, Carstens M, Steenhuis I. Preferences for condom placement in stores among young Dutch men and women: relationships with embarrassment and motives for having sex. Sex Health 2012; 9:233-9. [PMID: 22697140 DOI: 10.1071/sh11050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Accepted: 07/19/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND Condom purchasing is an important preparation for condom use. The present study examined if products surrounding condoms in the store play a role in preferences for where to buy condoms among young people. METHODS Sixty-nine men and 111 women (<30 years) completed an online questionnaire on their preferences for condom placement, associated embarrassment with these placements, and motives for having sex. RESULTS Fifty percent of men and 70% of women indicated the counter as least preferred placement. Two-fifths of men and women preferred the sensual context, including among sex toys and lubricants; however, the remainder of participants, particularly women, preferred other less sexual contexts. Both the counter and sensual placement were strongly associated with embarrassment, and this, in turn, was predictive of placement preference. Finally, the motive for having sex to experience intimacy was negatively related to counter preference, and the motive for having sex to experience pleasure was negatively related to the neutral placement and the female personal care placement preferences. CONCLUSION The findings suggest that using multiple and alternative placements for condoms in stores may encourage condom purchasing behaviour among young people.
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Affiliation(s)
- Winifred A Gebhardt
- Clinical Health and Neuropsychology, Social and Behavioral Sciences, Leiden University, 2300 RB Leiden, Netherlands
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Bryant J, Ward J, Worth H, Hull P, Solar S, Bailey S. Safer sex and condom use: a convenience sample of Aboriginal young people in New South Wales. Sex Health 2011; 8:378-83. [PMID: 21851779 DOI: 10.1071/sh10138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 03/28/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND This paper examines condom use in a sample of Aboriginal young people in New South Wales (NSW) aged 16-30 years. METHODS Cross-sectional data were collected using hand-held computer devices from 293 Aboriginal people attending two Aboriginal events in NSW. RESULTS Almost two-thirds of respondents reported having had a casual sex partner in the previous 6 months. Of these, 39.2% reported always using a condom with casual partners. Having always used a condom with casual partners varied among respondents, and was more likely among younger respondents (adjusted odds ratio (AOR): 2.7, 95% confidence interval (CI): 1.2-6.1) and less likely among those who used illicit drugs (AOR: 0.2, 95% CI: 0.1-0.7). CONCLUSIONS In comparison to published studies of other Australians, casual sex appears to be more common among this sample of Aboriginal young people; however, the proportion who report having always used condoms with casual partners is very similar. This suggests that although casual sex is more common, Aboriginal young people do not engage in risky behaviour any more often than other young Australians. Further work should be conducted with those who do not always use condoms, such as those who are older and who use illicit drugs, particularly with regards to how abstinence from drug use supports protective behaviours such as condom use among this population of Aboriginal young people.
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Affiliation(s)
- Joanne Bryant
- National Centre in HIV Social Research, University of New South Wales, Sydney, NSW 2052, Australia.
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Chin KL. Sexual/reproductive health and the pharmacist: what is known and what is needed? JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2011. [DOI: 10.1111/j.1759-8893.2011.00050.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tobler AL, Komro KA. Contemporary options for longitudinal follow-up: lessons learned from a cohort of urban adolescents. EVALUATION AND PROGRAM PLANNING 2011; 34:87-96. [PMID: 21338843 PMCID: PMC3061838 DOI: 10.1016/j.evalprogplan.2010.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Revised: 12/16/2010] [Accepted: 12/25/2010] [Indexed: 05/16/2023]
Abstract
This study reports efforts to locate and survey participants in Project Northland Chicago (PNC), a longitudinal, group-randomized trial of an alcohol preventive intervention for racial/ethnic minority, urban, early-adolescents, 3-4 years following the end of the intervention. Data were collected annually among students from 6th-8th grade and then at age 17-18. Tracking procedures were used to maintain contact with participants and data collection consisted of three phases: (1) Internet- and mail-based surveys; (2) in-school survey administration; and (3) courier service delivery. Contact was lost with 11% of this urban cohort from the end of the PNC intervention activities through these longterm follow-up efforts, as indicated by returned locating postcards. Fifty-three percent of the cohort responded to the survey, the majority completing in Phase 1 of our data collection. Additional school-based and courier-delivery efforts increased our response rate by 11.5%. Costs per completed survey were $118 in Phase 1, $166 in Phase 2, and $440 in Phase 3. This study illustrates that it is possible to track and follow-up a high-risk cohort as they progress through adolescence, even with minimal efforts in intervening years. Lessons learned from this study may inform future efforts to track and collect longitudinal data among high-risk populations.
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Affiliation(s)
- Amy L. Tobler
- Corresponding Author: 1329 SW 16 Street, Rm 5130, P.O. Box 100177, Gainesville, FL 32610-0177, USA; Tel. (352) 265-0111 ext. 86268; Fax (352) 265-8047;
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Structural impediments to condom access in a High HIV/STI-risk area. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2010; 2010:630762. [PMID: 20886017 PMCID: PMC2945660 DOI: 10.1155/2010/630762] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/08/2010] [Accepted: 08/05/2010] [Indexed: 11/23/2022]
Abstract
As embarrassment is a known obstacle to condom acquisition, selling condoms from physically inaccessible places that require personnel assistance constitutes a barrier to access. This study investigates the extent of this barrier in the Bronx, a high HIV/STI prevalence county of New York. 75 of 320 listed Bronx pharmacies were sampled via computer randomization. Investigators coded condom placement and physical accessibility within these pharmacies and 140 surrounding stores. 91% of sites sold condoms. In 82%, condoms could not be accessed without assistance. Condoms were physically inaccessible in venues most encountered in the community: grocery stores versus pharmacies (OR=15; 95% CI, 5–48), independent versus chain pharmacies (OR=32; 95% CI, 6–235). They were physically inaccessible more in the lowest SES/highest HIV prevalence areas versus the highest SES/lowest HIV prevalence areas (OR = 4.3, 95% CI, 1.1–17). Findings can inform efforts to increase accessibility of condoms, distribute condoms in alternative settings, and prompt similar investigations in other high-risk communities.
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Sixsmith J, Griffiths J, Hughes J, Wren J, Penfold S, Natusch H. Accessibility of condoms to young people in Manchester, UK. JOURNAL OF FAMILY PLANNING AND REPRODUCTIVE HEALTH CARE 2006; 32:219-25. [PMID: 17032508 DOI: 10.1783/147118906778586534] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND METHODOLOGY Issues relevant to the accessibility of male condoms for young people in the Greater Manchester area (UK) were investigated, using semi-structured, in-depth interviews and a questionnaire survey. RESULTS Family planning clinics and condom vending machines (CVMs) were the most cited sources for condom acquisition. Young people's knowledge of where and when they could access condoms varied by age and gender. Suitable positioning of CVMs would need to take such variations into account when targeting potential customers. Levels of embarrassment about acquiring condoms also varied according to gender. The lifestyles of young people indicated the sorts of places in which CVMs might offer increased accessibility. For younger men and women this tended to involve low-cost, semi-private places such as local parks, school toilets and shopping malls/streets. Older men with higher spending power and increased confidence could access condoms through pub and club toilets and chemist shops. CONCLUSIONS Accessible positioning of CVMs was related to the age, gender and lifestyle of the participants, and programmes to enhance accessibility should reflect this. Increased accessibility for younger groups, and especially women, needs to take into account issues of cost, confidence and embarrassment. For older groups, lifestyle choices indicated pubs and clubs as key locations for both men and women.
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Affiliation(s)
- Judith Sixsmith
- Division of Psychology and Social Change, Manchester Metropolitan University, Manchester, UK.
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Marcell AV, Plowden K, Bowman SM. Exploring older adolescents' and young adults' attitudes regarding male hormonal contraception: applications for clinical practice. Hum Reprod 2005; 20:3078-84. [PMID: 16006471 PMCID: PMC1282454 DOI: 10.1093/humrep/dei168] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Male hormonal contraceptive methods (HCM) are in Phase I clinical trials in the USA. International studies report that adults have positive attitudes regarding male HCM, but little is known about US minority young peoples' attitudes--a population that experiences high unintended pregnancy rates. METHODS Thirty urban African American young persons [50% males; mean age = 18.8 (SD = 2.5)] participated in semi-structured interviews to explore attitudes regarding male HCM. Data were independently analysed by two researchers according to qualitative research methodology, including transcript coding for content, categorization of codes, performance of content analysis for theme development, and corroboration of findings by a third researcher. RESULTS The data revealed five major themes that can facilitate and/or hinder male HCM adoption: (1) impact of reversing roles in HCM use; (2) men's lack of involvement in health care; (3) men's reliability to use HCM effectively; (4) perceived responsibility of men who use HCM; and (5) men's apprehension to use new medicines. Overall, participants had positive impressions about male HCM (67% male; 67% female) and female partner trust of males' use was high (85%), as were males' intentions (60%). CONCLUSIONS Findings provide a foundation for clinical interventions including: (1) increasing males' involvement in reproductive health; (2) helping males to overcome apprehensions about male HCM safety; and (3) standardizing male HCM education in the clinical setting. Future research efforts should examine whether study findings hold for other populations.
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Affiliation(s)
- Arik V Marcell
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD 21201, USA.
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Blake SM, Ledsky R, Goodenow C, Sawyer R, Lohrmann D, Windsor R. Condom availability programs in Massachusetts high schools: relationships with condom use and sexual behavior. Am J Public Health 2003; 93:955-62. [PMID: 12773362 PMCID: PMC1447877 DOI: 10.2105/ajph.93.6.955] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study assessed relationships between condom availability programs accompanied by community discussion and involvement and adolescent sexual practices. METHODS Sexual practice and condom use differences were assessed in a representative sample of 4166 adolescents enrolled in high schools with and without condom availability programs. RESULTS Adolescents in schools where condoms were available were more likely to receive condom use instruction and less likely to report lifetime or recent sexual intercourse. Sexually active adolescents in those schools were twice as likely to use condoms, but less likely to use other contraceptive methods, during their most recent sexual encounter. CONCLUSIONS The strategy of making condoms available, an indication of socioenvironmental support for condom use, may improve HIV prevention practices.
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Affiliation(s)
- Susan M Blake
- Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC 20037, USA.
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