Reduction of condom use errors from a brief, clinic-based intervention: a secondary analysis of data from a randomised, controlled trial of young black males

A home-practice intervention for increasing condom use among university undergraduates

The consistently high rate of sexually transmitted infections among people 18-24 years old warrants novel strategies promoting condom use among large segments of this population. Ample opportunity exits to employ such strategies in university settings. This study evaluated a sex-positive, home-practice intervention designed to promote condom use among university undergraduates engaging in penile-vaginal intercourse (PVI). A sample of 29 opposite-sex undergraduate couples, engaging in PVI, was recruited from a large university. After teaching couples about condom use, a health educator helped couples select condoms/lubricants from options comprising various sizes, fits, shapes, textures, and other features. A 30-day 'homework assignment' was made to use these products while reducing condom use errors/problems and enhancing sexual pleasure. A repeated measures design, with a six-month observation period, was used to evaluate the program. Over the six-month period, the mean frequency of condomless PVI decreased from 26.4 to 3.9 times (P < .001). Significant and favorable changes were also found relative to attitudes toward condom use (P = .027) and in condom use self-efficacy (P < .001). Most students completing the follow-up assessment indicated the intervention would favorably impact their future condom use. Findings suggest this intervention program may be important to promoting condom use among university couples engaging in PVI.

"The use of educational strategies for promotion of knowledge, attitudes and contraceptive practices among teenagers - A randomized clinical trial"

OBJECTIVE

To evaluate two educational interventions and identify differences between them in what concerns the promotion of knowledge, attitudes and practices in relation to the pill and male condom.

METHODS

A randomized controlled clinical trial was conducted with teenagers, in which two different educational interventions were used, one based on the methodology of problematization (PG) and another on the pedagogy of transmission (TG). Knowledge, attitudes and practices were verified through a questionnaire applied before, one month and three months after the intervention.

RESULTS

The two educational interventions promoted positive changes in the answers to questions on the knowledge, attitudes and practices of adolescents, from both groups. In what concerns knowledge, performance when answering the questionnaire was better after the intervention for both. However, only the PG showed improvements in performance over time. The TG showed a higher chance of displaying certain positive attitudes and more chances of correct answers about some practices.

CONCLUSION

The two educational interventions, despite having used different methodologies, have generally been proved to be effective for teaching about the pill and condom use, with positive impacts on knowledge, attitudes and practices, but with the methodology of problematization, the maintenance of knowledge in the time period studied was obtained.

Brief condom interventions targeting males in clinical settings: a meta-analysis

OBJECTIVE

The objective of this study is to assess the effectiveness of brief clinic-based condom skills interventions that target males.

STUDY DESIGN

We searched PubMed, Cumulative Index of Nursing and Allied Health Literature and PsychInfo for studies published from January 1980 through September 2014, using relevant search terms. We included studies if interventions taught about condoms lasting 60 min or shorter, used randomized or quasi-experimental design, were conducted in a clinical setting and targeted males. Two investigators sequentially reviewed abstracts. We abstracted and reviewed data from 16 studies that met the selection criteria. Where outcomes were poolable, we conducted meta-analyses using a random-effects model and I(2) index to assess heterogeneity. Outcome measures included condom knowledge, attitudes, behaviors, sexually transmitted infections (STIs)/human immunodeficiency virus and unintended pregnancy.

RESULTS

Across studies, teaching about condoms was nested within sexual risk reduction curricula. Most interventions were one on one and conducted in STI clinics. Pooled analyses indicated that intervention receipt was associated with increases in percent of sex acts with condoms (standardized mean difference=0.29 [0.18, 0.41]; 0.19 [0.06, 0.33]) and reductions in STIs at 12-month follow-up or longer {odds ratio (OR)=0.82 [95% confidence interval: 0.67, 0.99]}. One study assessed unintended pregnancy and did not find an intervention effect.

CONCLUSIONS

Study findings hold promise for considering brief condom skills interventions in clinical settings that can result in improvements in males' condom behaviors and possibly biological outcomes.