An empirical study of ordinal condom use measures

Comparison of adolescents' reports of sexual behavior on a survey and sexual health history calendar

Assessing sexual risk is critical for human immunodeficiency virus (HIV) and sexually transmitted infection (STI) prevention with adolescents. This article compares sexual risk reports from two self-administered instruments, a standard survey and a sexual health history calendar (SHHC), among racially diverse youth (n = 232) ages 14 to 21 seeking services at a public health clinic. Agreement between methods was assessed using Lin's concordance correlation coefficients (CCC) and Bland-Altman plots. Lin's CCC showed poor to moderate agreement between instruments on reports of sexual partners in the past 3 (0.47), 6 (0.55), and 12 (0.49) months. While individual sexual partner questions were refused a total of 179 times on the survey, youth reported having sexual partners during the same time period on the SHHC in most (77.1%) of these instances. Poor agreement was also found for condom use frequency (CCC = 0.17), with youth's frequency of condom use on the SHHC differing from that reported on the survey for more than half (55.6%) of the months they were sexually active. While lack of objective sexual behavior measures limits conclusions about the accuracy of reports, the ways in which youth's responses varied across instruments may offer insight into the complexity of adolescent sexual risk taking as well as have important implications for development of HIV/STI preventive interventions.

Male human papillomavirus prevalence and association with condom use in Brazil, Mexico, and the United States

BACKGROUND

Reported associations of condom use and human papillomavirus (HPV) infection have been inconsistent. We investigated self-reported frequency of condom use and detection of genital HPV among men.

METHODS

A cross-sectional analysis was conducted in men aged 18-70 years from Brazil, Mexico, and the United States. Men completed questionnaires on sexual history, condom use, and sociodemographic characteristics. Among 2621 men reporting recent vaginal sex, prevalence of any HPV, any oncogenic type, and nononcogenic types only was estimated by frequency of condom use ("always" or "not always"). Multivariable models were used to estimate prevalence ratios (PRs) for HPV according to frequency of condom use.

RESULTS

The prevalence of any HPV was 70.5%; any oncogenic type, 34%, and nononcogenic types only, 22.2%. The adjusted PR for always vs not always using condoms was 0.87 (95% confidence interval [CI], .77-.97) for all countries combined. The association was stronger in the United States (PR, 0.70; CI, .55-.90) than in Brazil (PR, 0.84; CI, .71-1.01) or Mexico (PR, 1.05; CI, .89-1.25) (P for interaction = .025).

CONCLUSIONS

HPV prevalence was high even among those who reported always using condoms, and its associations with always using condoms varied among countries.

Attachment orientations and daily condom use in dating relationships

This daily experience study examined the roles of attachment orientations and daily relationship satisfaction in shaping daily condom use among college students in dating relationships. Seventy-five participants completed an initial measure of attachment orientation and then reported their relationship satisfaction and condom use each day for 14 consecutive days. The results showed that attachment anxiety was associated with less frequent use of condoms on a daily basis. Daily satisfaction was also associated with a decreased likelihood of using condoms, and this association was stronger for those high in attachment anxiety and mitigated for participants high in attachment avoidance. The associations between attachment orientations and daily condom use remained significant when controlling for important covariates including participant gender, use of another form of birth control, frequency of sex, and knowledge of a partner's sexual history. Implications for sexual risk-taking behaviors and future research using daily diary methods to study sexuality in intimate relationships are discussed.