Differences between men and women in condom use, attitudes, and skills in substance abuse treatment seekers

Risky Sexual Behaviors and Condom Use Barriers in Iranian Women with Substance Use Disorders

Background

Scant information exists on Iranian women's protective behaviors mainly constant condom use. Inconsistent condom use seems prevalent among women with substance use problems. We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian women with substance use disorders (SUDs).

Methods

In our cross-sectional study, we recruited 300 women who sought treatments for their SUDs from the active outpatient drug free (ODF) and Methadone Maintenance Therapy (MMT) centers in Tehran, Iran during 2017-2021. We used three batteries including demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ); and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis.

Results

The majority reported at least one lifetime experience of RSBs. Our results show that only 22% of the participants 'always' use condom in their sexual encounters. The lowest and highest subscale scores of the CBS were related to Sexual Experience (SE) (2.47 ± 0.86) and access/availability structure (3.52 ± 0.7), respectively. RSBs had negative significant association with Partner Barrier (PB) subscale scores (OR = 0.4; 95% CI: 0.22 to 0.73) and effect on SE subscale scores (OR= 0.54; 95% CI: 0.31 to 0.94).

Conclusion

RSBs was prevalent among our study population. RSBs and condom use barriers are significantly interwoven. The condom use barriers were highly associated with the types of sexual encounters such as group sex or casual sexual relations than specific mean of sexual performance (i.e. anal sex). Gender-specific RSBs, STIs/HIV/AIDS prevention program is recommended for women with SUDs.

The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries

BACKGROUND

Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries.

METHODS

We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively.

RESULTS

More than half [n = 4430, 53.8% (43.9-63.8)], two-fifth [n = 3242, 39.5% (33.2-45.9) and two-thirds of adolescents [n = 4838, 65.6% (57.5-73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR = 1.48;95%CI: 1.12-1.94], early sexual debut [AOR = 1.81(1.47-2.22)], having two or more sexual partners [AOR = 1.30(1.06-1.58)] and no/minimal parental support [AOR = 1.54(1.17-2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR = 1.37 (1.09-1.73)], early sexual debut [AOR = 1.83(1.48-2.27) and having no parental support [AOR = 1.64(1.34-2.00)].

CONCLUSION

Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.

A randomized clinical trial evaluating the impact of counselor training and patient feedback on substance use disorder patients' sexual risk behavior

INTRODUCTION

High risk sex-such as sex with multiple partners, condomless sex, or transactional or commercial sex-is a risk factor in individuals with substance use disorders (SUDs). SUD treatment can reduce sexual risk behavior, but interventions to reduce such behavior in this context have not been consistently effective. This study sought to determine if the impact of treatment on sexual risk behavior can be increased.

METHODS

In a nested 2 × 2 factorial repeated measures design, we examined outcomes of two interventions: training for counselors in talking to patients about sexual risk; and availability to both counselors and patients of a personalized feedback report based on patient self-report of sexual behavior. Counselors received either a brief, information-based, Basic Training, or a multi-session, skills-based Enhanced Training. Their patients completed an audio-assisted computerized assessment of sexual behavior and received either No Feedback or a Personalized Feedback Report (PFR). Four hundred seventy six patients participated. Patient follow-up occurred 3- and 6-months postbaseline. Primary patient outcome measures were Number of Unsafe Sex Occasions (USO) and whether patients reported talking about sex in counseling sessions (Discussed Sex), both in the past 90 days. Secondary outcomes included Number of Sexual Partners, Sex Under the Influence of Substances, and Perceived Condom Barriers.

RESULTS

Patients of Enhanced-condition counselors compared to those of Basic-condition counselors were more likely to report talking about sex with their counselor at 6-month follow-up. Personalized feedback also increased the likelihood of reporting counselor discussions at 6-month follow-up. Neither the training nor the feedback condition affected USO, Number of Partners, or Sex Under the Influence.

DISCUSSION

We discuss why these two interventions apparently altered counselor-patient communication about sexual risk behavior without affecting the behavior itself.

Is There Risk Compensation among HIV Infected Youth and Adults 15 Years and Older on Antiretroviral Treatment in South Africa? Findings from the 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey

In this paper, risk compensation among individuals on antiretroviral therapy (ART), using the 2017 South African national survey on HIV, is explored. A multi-stage stratified cluster random sampling approach was used to realize 11,130 participants 15 years and older. Logistic regression analysis assessed the association between multiple sexual partners, condom use at last sexual encounter, consistency of condom usage and potential explanatory variables using HIV status and ART exposure as a mediator variable. HIV positive participants who were aware and on ART were less likely to have multiple sexual partners, and less likely not to use a condom at last sex compared to HIV positive participants who were aware but not on ART. The odds of reporting multiple sexual partners were significantly lower among older age groups, females, non-Black Africans, and rural settings, and higher among those with tertiary level education, and risky alcohol users. The odds of no condom use at last sexual encounter were more likely among older age groups, females, other race groups, and less likely among those with secondary level education. The odds of inconsistent condom use were more likely among older age groups, females, and other race groups, and less likely among those with tertiary level education, high risk and hazardous alcohol users. Risk compensation is not apparent among HIV infected adults who are on ART. Risk groups that should receive tailored interventions to reduced risky sexual behaviours were identified.

Increasing Condom Use and STI Testing: Creating a Behaviourally Informed Sexual Healthcare Campaign Using the COM-B Model of Behaviour Change

Sexually transmitted infections (STIs) are a major public health challenge. Although theoretically informed public health campaigns are more effective for changing behaviour, there is little evidence of their use when campaigns are commissioned to the commercial sector. This study describes the implementation of the COM-B model to a sexual health campaign that brought together expertise from academics, sexual healthcare, and marketing and creative professionals. Insights were gathered following a review of the relevant academic literature. Barriers and facilitators to condom use and STI testing were explored with the use of the COM-B model and the Behaviour Change Wheel in a workshop attended by academics, behavioural scientists, healthcare experts and creative designers. Feedback on the creative execution of the campaign was obtained from healthcare experts and via surveys. Barriers to psychological capability, automatic and reflective motivation, and social opportunity were identified as targets for the campaign, and creative solutions to these barriers were collaboratively devised. The final sexual health campaign was rated positively in its ability to change attitudes and intentions regarding the use of condoms and STI testing. This study describes the implementation of the COM-B model of behaviour change to a public sexual health campaign that brought together academics, public and commercial sector expertise. The barriers and facilitators identified in this collaborative process represent potential targets for future public health communication campaigns.

Do sexual expectancies and inhibitions predict high-risk sexual behaviours? Evidence from a cross-sectional survey among young psychoactive substance users in informal settlements in Kampala, Uganda

BACKGROUND

Psychoactive substance use is a public health challenge among young people in informal settlements. Though rarely examined, psychoactive substance use is linked to sexual expectancies and inhibitions, and consequently high-risk sexual behaviours. This study examined the association between sexual expectancies and inhibitions, and high-risk sexual behaviours among young psychoactive substance users (PSUs) in informal settlements in Kampala, Uganda.

METHODS

This cross-sectional study recruited 744 young PSUs from informal settlements in Kampala. Respondent driven sampling was used to recruit respondents. A 'modified' Poisson regression model was used for inferential statistics. Data were analysed using the Stata 14 software.

RESULTS

Of the 744 study participants, 45.6% believed that psychoactive substance use improves sexual performance; 43.3% believed that psychoactive substances make sex more pleasurable, and 53.3% believed that psychoactive substances give courage or confidence to approach a partner for sex. The belief that psychoactive substance use improves sexual performance (PR 1.14, 95% CI: 1.01-1.30), increases the likelihood of engaging in sex (PR 1.20, 95% CI: 1.04-1.40) or gives courage or confidence to approach a sexual partner (PR 1.21, 95% CI: 1.05-1.39) were associated with having sex while under the influence of psychoactive substances. The belief that a psychoactive substance user under the influence of psychoactive substances is more likely to engage in sex (PR 1.48, 95% CI: 1.15-1.90), and likely to find it difficult to refuse sex (PR 1.28, 95% CI: 1.06-1.55) were positively associated with engaging in multiple sexual partnerships. The belief that one easily forgets to use a condom when under the influence of psychoactive substances was positively associated with inconsistent condom use (PR 1.26, 95% CI: 1.09-1.45).

CONCLUSION

Psychoactive substance use expectancies associated with high-risk sexual behaviours included the belief that psychoactive substances improve sexual performance and improve confidence in approaching a sexual partner. Psychoactive substance use inhibitions associated with high-risk sexual behaviours included an increased likelihood of engaging in sexual intercourse, difficulties in refusing to engage in sexual intercourse, and forgetting to use condoms while intoxicated. Interventions targeting a reduction in high-risk sexual behaviour should integrate the impact of psychoactive substance use on sexual behaviour.

Uptake and User Characteristics for Pharmacy-Based Contraception and Chlamydia Treatment: A Quantitative Retrospective Study from the UK

The health provider Umbrella delivers several SRHS through more than 120 pharmacies in Birmingham (England). Umbrella pharmacy data collected between August 2015 and August 2018 were used to descriptively analyse the uptake and user characteristics for emergency contraception, short-acting oral contraception, condoms and chlamydia treatment. In total, 54,309 pharmacy visits were analysed. A total of 30,473 females presented for emergency contraception. Most were supplied with an emergency contraceptive pill (98.6%, 30,052 out of 30,473), which was levonorgestrel in 57.4% of cases (17,255 out of 30,052). Of those females who attended for short-acting oral contraception, 54.3% (1764 out of 3247) were provided with the progesterone-only pill. Of those who were given chlamydia treatment, the majority received doxycycline (76.8%, 454 out of 591). A total of 74% (14,888 out of 19,998) of those who requested condoms were not provided with specific instructions on their use. Pharmacies have the potential to make a substantial contribution to the delivery of an integrated sexual health service including rapid access to emergency contraception, convenient delivery of short-acting hormonal contraception and treatment of chlamydia. Appropriate education, support and audit is required to ensure the delivery of high-quality care.

Intimate Partner Violence and Coerced Unprotected Sex Among Young Women Attending Community College

The present study examined the mediating role of sexual assertiveness in the relationship between psychological, physical, and sexual intimate partner violence (IPV) victimization and unprotected sex as a result of condom use resistance among sexually active young women attending community college. Women reported engagement in unprotected sex as a result of a partner's use of one of 32 forms of condom use resistance (e.g., physical force, deception, or other forms of coercion to avoid using a condom during intercourse). Women ages 18-24 years (N = 212) attending community college were recruited through paper advertisements to complete assessments of social and dating behavior in the campus computer laboratory. Only the women with a history of sexual intercourse (N = 178; 84% of the sample) were included in analyses. More frequent engagement in unprotected sex as a result of a partner's condom use resistance was associated with physical, psychological, and sexual IPV victimization. Sexual assertiveness mediated the relationship between physical IPV victimization and the frequency of unprotected sex as a result of condom use resistance. Efforts to prevent dating violence and enhance the sexual health of community college women may benefit from focusing on targeting sexual assertiveness as a protective factor.

Women at Greater Sexual Risk for STIs/HIV Have a Lower Mesolimbic and Affective Bias Response to Sexual Stimuli

Young adult women in the United States have high rates of sexually transmitted infections, increasing the risk of human immunodeficiency virus (HIV). The underlying neurobiology of behaviors that increase the probability of contracting sexually-transmitted diseases (STIs) and HIV is just beginning to be explored. The current study assessed the link between sexual risk and the brain and behavioral response to sexual cues in emerging adult women. Our hypothesis was that women with more activity in reward/motivational circuitry would report higher sexual risk behaviors and would evidence higher positive affective bias to visual sexual stimuli. Women (n = 52; age = 18–24 years) who had protected sex 100% of the time (n = 17) vs. those who did not (n = 35), in the past 3 months, were compared on their brain response to 500 ms evocative (sex, aversive, food) vs. neutral cues in a blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) fast event-related design. Based on existing literature, an a priori anatomical “cue-reactive” mask was used to constrain the analyses. Self-reported sexual activity and the affective bias scores to sexual cues were examined as correlates with the brain response to cues. In contrast to our initial hypothesis, the higher sexual risk (Unprotected) group had significantly less activation in mesolimbic brain regions and lower (less positive) affective bias scores to sexual cues compared to the lower risk (Protected) group. As predicted, the brain response was positively correlated with sexual bias. Follow-up analyses showed an effect of partner “risk” (e.g., more vs. less knowledge of partner’s STIs/HIV status). This evidence suggests that women who have protected sex may view sexual-related stimuli more positively, reflected by a neural response in reward/motivational regions and more positive sexual bias scores. In contrast, young women at increased risk for STIs/HIV may feel more negatively about sexual-related stimuli, evidenced by a lower mesolimbic response and a less positive affective bias to sexual cues. These data may help identify young women who are at greatest risk for acquiring STIs and/or HIV, which carries added importance with the availability of new medications that can prevent HIV.

African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study

PURPOSE

To better understand sexual health disparities among African-American sexual minority adolescents.

METHODS

African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history.

RESULTS

Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV.

CONCLUSIONS

African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.

REGIONAL DIFFERENCES IN POSITIVE SEXUAL BEHAVIOUR AMONG YOUTH IN SUB-SAHARAN AFRICA

The question of youth sexual behaviour has been widely debated, with researchers such as Berhan and Berhan (2015) arguing that young adults aged 15-24 are more likely to engage in risky behaviours. However, research has not adequately addressed the issue of positive sexual behaviours, in particular among young people in sub-Saharan Africa. Adapting the compensatory model of risk and resiliency theory, this study examined the determinants of positive sexual behaviours among youth in sub-Saharan Africa. Using recent data from Demographic and Health Surveys of sixteen countries representative of each African region (East, West, Southern and Central), it was hypothesized that positive sexual behaviours of youth (condom use at last sex and single sexual partnership) would be most strengthened by protective factors at the individual and family levels, and that these behaviours would differ by region due to regional variation in socio-cultural practices. Delayed age at sexual debut (first sex after the age of 15) was found to be the strongest protective factor for positive sexual behaviours among males and females in sub-Saharan Africa. Certain socioeconomic variables were found to be positively associated with positive sexual behaviours and the associations differed by gender.

A Brief Assessment for HIV Risk: The TCU HVHP Form

Targeted HIV screens may help identify some risk-related concerns of drug-using offenders. The present study describes the Texas Christian University HIV/Hepatitis Risk Assessment (TCU HVHP) form, a 19-item self-report instrument measuring HIV and hepatitis risks based on a sample (N = 1,056) of offenders in eight prisons. Principal components analysis indicated four scales (Injection Risk, Condom Attitudes, Sex Risk, and AIDS Concern) with reliable psychometric properties with coefficient α reliabilities ranging from .72 to .88. Concurrent validities indicated the four scales were related to motivation for treatment, level of drug use, psychosocial functioning, and criminal thinking, although the patterns varied by gender. The TCU HVHP Form should be attractive to programs needing a brief assessment measuring HIV risk behaviors, attitudes toward condom use, and concerns about acquiring and transmitting HIV.

Modeling Beliefs, Attitudes, and Intentions of Condom Use Among Secondary School Students in Kenya

As in other parts of sub-Saharan Africa, youth in Kenya report low rates of condom use. Although several studies have explored reasons for the low condom use among Kenyan youth, not many have established linkages between lack of use and normative beliefs and attitudes around condoms. Using the Theory of Planned Behavior (TPB), this article examined whether beliefs and attitudes around condoms influenced intentions and actual condom use. Data for the study were restricted to 1453 sexually active youth during the last school break. Path analysis was used to examine the relationship between the TPB constructs and condom use among Kenyan youth. Results indicated a direct relationship between attitudes and condom use for male respondents and an indirect relationship between these two variables for females. Both males and females who expressed greater intentions to use condoms were significantly more likely to report they used condoms consistently. Also, male and female youth with higher perceived behavioral control were significantly more likely to have used condoms consistently. Males with friends who used condoms were significantly more likely to use condoms consistently. The findings suggest the importance of examining young people's attitudes toward condoms-in particular, those deeply rooted in misconceptions that serve to discourage safer sexual behaviors.

Condom use negotiation among high school adolescents in Ghana: the role of gender

Gender has a profound effect on the sexual risk preventive intentions and behaviour of young people. However, little is known about the role of gender on condom use negotiation among adolescents in Ghana. This study explored gender differences in condom use negotiation among school-going adolescents in Ghana. Participants ( n = 684) completed self-report measures based on attitudes towards condom use, subjective norms regarding condom use, perceived behavioural control over condom use, intentions to use condoms, and on actual condom use behaviour. Results revealed statistically significant differences in condom use by gender. Specifically, attitudes towards condom use were more favourable among male students than they were among female students. Male students perceived slightly greater control over condom use than did female students. Moreover, male students reported slightly more condom-protected sexual behaviour than did female students. These results highlight the usefulness of designing gender-specific sexual risk reduction programmes among high school adolescents in Ghana.

HIV Risk, Substance Use, and Personality Characteristics among Adults with History of Serious Mental Illness

The present study examined the relationship between characteristics associated with personality disorders, substance use, and HIV risk among adults with a history of serious mental illness. Participants included 103 adults with antisocial or borderline personality disorder, serious mental illness, and recent HIV risk behavior. The sample was predominately male (64%), diverse (42% African American and 13% Hispanic), and homeless/marginally housed (76%). In order to examine the relationship between personality characteristics and risk we constructed a risk index comprising key symptoms of antisocial and borderline personality disorders, namely; impulsivity, affective instability, and disregard for safety of self/others. Contrary to our primary hypotheses, risk index scores did not predict HIV risk behavior and substance abuse did not mediate this risk. Exploratory analyses did reveal that women engaged in significantly more risk behaviors than their male counterparts and that risk scores were a significant predictor of total sex acts for women but not men. In addition, increased emotional dysregulation was a significant predictor of condomless sex acts for women but not men. Finally, recent alcohol use and increased impulsivity was associated with more condomless oral sex for men and women. These results suggest the relationship among serious mental illness, personality disorder, substance abuse, and gender is complex and merits further study.

Sexual Risk Behaviors and Condom Use Barriers in Iranian Men with Substance Use Disorders

BACKGROUND

We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian men with substance use disorders (SUDs).

METHODS

Of the total 1800 outpatient drug free (ODF) and methadone maintenance treatment program (MMTP) active centers in Tehran, Iran, six were selected to participate in the current study. Data were collected (n = 300 men) using three questionnaires including a demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ), and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis.

FINDINGS

The majority, (n = 194, 64.7%) reported at least one lifetime episode of RSBs. Compared to married participants (23.1%), 88.5% of single and 87.0% of divorced men had a history of RSB. Generally, the lowest and highest subscale scores of the CBS were related to sexual experience (2.60 ± 0.71) and access/availability structure (3.77 ± 0.54), respectively. The results of MANOVA analysis showed that there was a statistically significant difference between the CSB subscales based on the participants' education and marital status (P < 0.001). Only the partner barrier subscale had a significant negative relationship (P = 0.003) with RSB.

CONCLUSION

Sexual dynamic of Iranian men with SUDs is different. Barriers to condom use seem to be socio-culturally determined. Culturally acceptable strategies need to be utilized in Iranian clinical settings reaching beyond simply condom accessibility for this at risk population.

[Adherence to condom use: the real behavior in the Northeast of Brazil]

OBJECTIVE

To investigate the socioeconomic, demographic and cultural elements that interfere in the adherence to the use of condoms in an open population.

METHODOLOGY

A cross-sectional study with a quantitative approach was conducted through an explanatory household survey, in the municipality of Caraúbas, West Potiguar mesoregion, with 3 482 individuals older than 18. A Likert questionnaire was administered by community health agents in a household setting. Descriptive statistics were performed, followed by univariate and bivariate analyzes, using the Chi-square test.

RESULTS

The most receptive groups to condom use are the earliest age groups, male subjects, participants who do not have a stable relationship, and those with a higher education level. The association between condom and condom use showed that the more affluent strata represented less condom adoption. The reasons for condom abandonment were the preference for another contraceptive method and the confidence in the partner, and the main reason for its use was prevention against sexually transmitted diseases.

DISCUSSION

Adherence to condom use is scarce in all the groups considered. The popularization of the method must be fostered by individual and collective measures directed to consider the use of condoms for a dual purpose, by expanding information through sex education campaigns and overcoming gender conflicts.

Sex Partner Type, Drug Use and Condom Use Self-Efficacy Among African Americans from Disadvantaged Neighborhoods: Are Associations with Consistent Condom Use Moderated by Gender?

Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type (steady versus casual), drug use, and condom use self-efficacy regarding consistent condom use (CCU) among a community-based sample of adults. The sample included 1,357 African American men and women (M age 37.0, SD 13.1 years; 44% women, 66% men) from 61 disadvantaged census block groups in Atlanta, GA as part of a study of individual and neighborhood characteristics and HIV risk-taking. Having a steady partner decreased the odds of CCU, while higher condom use self-efficacy increased the odds of CCU. Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only. Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners.

Barriers to Condom Use: Results for Men and Women Enrolled in HIV Risk Reduction Trials in Outpatient Drug Treatment

HIV transmission often occurs through heterosexual high-risk sex. Even in the era of HIV combination prevention, promoting condom use, and understanding condom barriers, remain priorities, especially among substance-dependent individuals. Men and women (N=729) in outpatient drug treatment participated in a five-session gender-specific risk reduction group or one-session HIV Education group. Condom barriers (Motivation, Partner-related, Access/Availability, Sexual experience) were assessed at baseline and 6-month follow-up. Completing either intervention was associated with fewer motivation and partner-related barriers. Among women, reductions in motivation and sexual experience barriers were associated with less sexual risk with primary partners. Condom barriers are important to gender-specific HIV prevention; given limited resources, brief interventions maximizing active components are needed.