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Huang JL, Xin X, Ma MJ, Ning Z, Xiao ST, Chen PP. A qualitative study on the clinical safety and user experiences of female condoms for anal intercourse among men who have sex with men in Shanghai, China. Front Public Health 2023; 11:1243891. [PMID: 38074717 PMCID: PMC10701689 DOI: 10.3389/fpubh.2023.1243891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objective This qualitative study aimed to understand the clinical safety, efficacy, and receptiveness of using the female condom (FC) during anal intercourse among men who have sex with men (MSM). Methods Subjects for this study were recruited from a two-group crossover trial among MSM in Shanghai. The trial consisted of two phases, each including the use of condoms (FC vs. male condom), questionnaires, and in-depth one-on-one interviews. The two phases were separated by a washout period of 4 weeks. The minimum sample size for this study was determined in accordance with the principle of "information saturation." The qualitative data were organized and analyzed using ATLAS.ti version 7. Results A total of 26 participants from the MSM population were recruited for this study, with 10 assuming the insertive role (i.e., "1"), 8 assuming the receptive role (i.e., "0"), and 8 being versatile (i.e., "0.5"). Each participant completed the crossover trial comprising two phases. The cumulative usage of FCs and male condoms (MCs) amounted to 115 and 127 times, respectively. During the reported sexual encounters, no participants reported incidents of condom rupture, slippage, or other malfunctions. A few participants reported experiencing slight chafing pain, primarily put forward by "0" participants. Apart from those reports, no instances of bleeding, swelling, or allergic reactions were reported. The efficiency of FC in disease prevention, the sexual partner's willingness to use FC, the freshness of FC, and positive sexual experiences were the main reasons for the consistent use of FC for anal sex. Discomfort and pain during sexual activity, the loose design and thick material of FCs, and difficulties in placing FCs were the major obstacles to FC use among MSM. The elements referring to the forehead exhibited varied in importance among "1,", "0," and "0.5" participants. Regarding the willingness to use the FC in the future anal intercourse, 61.54% of participants expressed a positive inclination, 23.08% were uncertain, and 15.38% stated that they would not. "A better sense of security during anal sex" was the main factor affecting willingness among "0" participants and "the sexual pleasure that the FC brought" among "1" participants. Improving the design and technology of FCs and increasing the frequency of use and practice might improve the use skills, which will favor the willingness to use FCs among the MSM population. Conclusion FCs received positive user feedback from study participants, but distinctions were found in individuals in different sexual roles. Large-scale quantitative studies are needed to evaluate the clinical safety of the FC and its effectiveness in preventing the transmission of STDs during anal intercourse.
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Affiliation(s)
- Jia-Lu Huang
- School of Public Health, Dali University, Dali, China
| | - Xin Xin
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Ming-Jun Ma
- School of Public Health, Dali University, Dali, China
| | - Zhen Ning
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shao-tan Xiao
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Pan-pan Chen
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
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Moazami S, Ashley M, Czechowski K, Courtice EL, Shaughnessy K. The Sexual Communication Scale (SeCS). JOURNAL OF SEX RESEARCH 2023; 60:71-90. [PMID: 36449265 DOI: 10.1080/00224499.2022.2129558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Many measures of comfort and frequency of sexual communication between partners are limited in gender/sex and sexual orientation inclusivity, how constructs are measured, and for whom. We conducted two studies to investigate a revised and extended version of the Female Partner's Communication During Sexual Activity Scale: the Sexual Communication Scale (SeCS). We revised the gender/sex language to improve inclusion and added items to assess frequency and comfort with sexual communication. In Study 1, an exploratory factor analysis (n = 578) supported a three-factor structure (Frequency of bidirectional communication, α = .96; Ease of own communication, α = .90; Ease of partner's communication, α = .83). In Study 2, a confirmatory factor analysis (n = 1479) further supported the three-factor structure. Specifically, the three-factor model provided a reasonably good fit (χ2 (44) = 511.35, p < .001, CFI = .97, GFI = .95, AGFI = .91, SRMR = .00, RMSEA = .08). In both studies, we found small or no differences in men and women's comfort and frequency of sexual communication. The results provide initial support that the SeCS is an internally consistent, multidimensional gender/sex inclusive tool for future research on sexual communication.
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Affiliation(s)
- Sara Moazami
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Marilyn Ashley
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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Stone N, Bedford R, Newby K, Brown K, Jackson L, Bremner S, Morrison L, McGrath N, Nadarzynski T, Bayley J, Perry N, Graham C. Reducing new chlamydia infection among young men by promoting correct and consistent condom use: Protocol for a randomised controlled trial. (Preprint). JMIR Res Protoc 2021; 11:e35729. [PMID: 35947422 PMCID: PMC9403823 DOI: 10.2196/35729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background The health, social, and economic costs of sexually transmitted infections (STIs) represent a major public health concern. Young people are considered one of the groups most at risk for acquiring and transmitting STIs. Correct and consistent condom use has been shown to be the most effective method for reducing STIs; however, condoms are often not used properly. Evidence shows that brief behavior change interventions that focus on skills, communication, and motivation to acquire safe sex practices should be adopted into routine care to reduce STIs. Funding for sexual health services in England has declined dramatically, so novel ways of reducing clinic attendance are being sought. The home-based intervention strategy (HIS-UK) to promote condom use among young men has shown promise in feasibility and pilot studies by demonstrating high acceptability of the intervention in participant and health professional feedback, including aiding men to find condoms they like and feel more confident when using condoms. Objective The aim of this study is to determine the effectiveness and cost-effectiveness of HIS-UK when compared to usual condom distribution care among young men. Methods The 3 trial arms consisting of “e-HIS” (HIS-UK delivered digitally), “ProHIS” (HIS-UK delivered face-to-face), and control condition (usual National Health Service [NHS] care) will be compared against the following 3 primary outcomes: the extent to which correct and consistent condom use is increased; improvement of condom use experiences (pleasure as well as fit and feel); and decrease in chlamydia test positivity. Eligibility criteria include men aged 16-25 years at risk of STIs through reporting of condom use errors (ie, breakage or slippage) or condomless penile-vaginal or penile-anal intercourse with casual or new sexual partners during the previous 3 months. Prospective participants will be recruited through targeted advertisements and an opportunistic direct approach at selected sexual health and genitourinary medicine services and university-associated health centers and general practitioner practices. Community and educational establishments will be used to further advertise the study and signpost men to recruitment sites. Participants will be randomly allocated to 1 of 3 trial arms. A repeated measures design will assess the parallel arms with baseline and 12 monthly follow-up questionnaires after intervention and 3 chlamydia screening points (baseline, 6, and 12 months). Results Recruitment commenced in March 2020. Due to the COVID-19 pandemic, the study was halted and has since reopened for recruitment in Summer 2021. A 30-month recruitment period is planned. Conclusions If effective and cost-effective, HIS-UK can be scaled up into routine NHS usual care to reduce both STI transmission in young people and pressure on NHS resources. This intervention may further encourage sexual health services to adopt digital technologies, allowing for them to become more widely available to young people while decreasing health inequalities and fear of stigmatization. Trial Registration ISRCTN Registry ISRCTN11400820; https://www.isrctn.com/ISRCTN11400820
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Affiliation(s)
- Nicole Stone
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Rowena Bedford
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Katie Newby
- Department of Psychology and Sports Science, Faculty of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Katherine Brown
- Department of Psychology and Sports Science, Faculty of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Louise Jackson
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Leanne Morrison
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nuala McGrath
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Department of Social Statistics and Demography, Faculty of Economic, Social and Political Sciences, University of Southampton, Southampton, United Kingdom
| | - Tom Nadarzynski
- School of Social Sciences, University of Westminster, London, United Kingdom
| | - Jake Bayley
- Barts Health NHS Trust, London, United Kingdom
| | - Nicky Perry
- University Hospitals Sussex NHS Trust, Brighton, United Kingdom
| | - Cynthia Graham
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
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Siegler AJ, Rosenthal EM, Sullivan PS, Ahlschlager L, Kelley CF, Mehta CC, Moore RH, Rosenberg ES, Cecil MP. Double-Blind, Single-Center, Randomized Three-Way Crossover Trial of Fitted, Thin, and Standard Condoms for Vaginal and Anal Sex: C-PLEASURE Study Protocol and Baseline Data. JMIR Res Protoc 2019; 8:e12205. [PMID: 31012862 PMCID: PMC6658242 DOI: 10.2196/12205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/04/2019] [Accepted: 02/14/2019] [Indexed: 11/21/2022] Open
Abstract
Background Male condoms are underused despite their ability to prevent transmission of HIV and other sexually transmitted infections. The perception of decreased sexual pleasure and poor condom fit are major contributors to condom nonuse. Objective The purpose of this study was to compare event-level performance and pleasure using fitted, thin, and standard condoms among men who have sex with men (MSM) and men who have sex with women (MSW). We also sought to assess condom type preference. We present the study design and enrollment data from the trial. Methods This study recruited sexually active men aged 18 to 54 years in Atlanta, Georgia, United States. We enrolled 252 MSM and 252 MSW in a double-blind, 3-way randomized crossover trial with conditions of fitted, thin, and standard condoms. A permuted block randomization scheme was used to assign each participant to the sequence in which they received each type of study condom. After a baseline screening and enrollment visit, randomized participants were followed for at least 6 and up to 12 weeks depending on their use of study condoms in each 2-week period between scheduled, in-person study visits. Participants were instructed to complete mobile-optimized coital logs as soon as possible after using condoms for anal or vaginal sex acts. The logs collected event-level pleasure and performance measures for the study condoms as well as other relevant data. A questionnaire was administered at the final study visit to assess overall study condom preference. Results The study enrolled 252 MSM and 252 MSW, a total of 504 participants. MSM and MSW study arms were similar for a number of key traits including race and ethnicity, marital status, self-rated condom experience, and recent experience of condom failure. Men in the MSM arm were older, however, and fewer MSM were students. The majority of participants in both arms rated themselves as very experienced with using condoms, and the majority had used condoms recently. Over one-third of participants in each arm reported experiencing condom failure in the last 6 months. Conclusions This is the first condom trial to compare the performance of standard, thin, and fitted condoms and to use pleasure and preference as primary outcomes. Given the disparate impact of HIV on MSM, equal enrollment of MSM and MSW was a key feature of this study. Trial results may inform an FDA label indication for anal sex and provide new information regarding the relative performance of different types of condoms. Trial Registration ClinicalTrials.gov NCT02753842; https://clinicaltrials.gov/ct2/show/NCT02753842 (Archived by WebCite at http://www.webcitation.org/76RLTFyf0) International Registered Report Identifier (IRRID) DERR1-10.2196/12205
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Affiliation(s)
- Aaron J Siegler
- Rollins School of Public Health, Department of Behavioral Sciences and Health Educaiton, Emory University, Atlanta, GA, United States
| | - Elizabeth M Rosenthal
- University at Albany School of Public Health, Department of Epidemiology, State University of New York, Albany, NY, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Lauren Ahlschlager
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Colleen F Kelley
- School of Medicine, Emory University, Atlanta, GA, United States
| | - C Christina Mehta
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | - Reneé H Moore
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | - Eli S Rosenberg
- University at Albany School of Public Health, Department of Epidemiology, State University of New York, Albany, NY, United States
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Graham CA, Towler LB, Crosby RA. Assessing the perceived benefits of a new condom wrapper/integrated applicator: an exploratory study. Int J STD AIDS 2018; 30:329-335. [PMID: 30482100 DOI: 10.1177/0956462418803491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Errors and problems associated with male condom use are very prevalent and increase the likelihood of inconsistent and incomplete use, thereby compromising condom effectiveness. The aim of this study was to assess the perceived benefits of a new condom wrapper/integrated applicator designed to reduce barriers to condom use and lessen the likelihood of user errors and problems. After viewing videos depicting features of the wrapper/applicator, participants (N = 547; 62.9% male, M age = 29.2) completed online questionnaires. Most participants reported that the product would make condom application easier and quicker, make them more confident that condoms had been applied correctly and make sex more pleasurable and playful. The majority of participants who had recent experience of condom use errors/problems reported that the use of the product would likely prevent these issues from occurring. Reduced chance of condom damage, the design features of the wrapper and not having to touch the condom itself during application were perceived as particular benefits of the product. The findings suggest that the product might reduce the likelihood of a range of condom user errors and problems and enhance pleasure during condom-protected sex. Future larger-scale studies that involve participants physically testing the condom wrapper/applicator are warranted.
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Affiliation(s)
- Cynthia A Graham
- 1 Department of Psychology, University of Southampton, Southampton, UK
| | - Lauren B Towler
- 1 Department of Psychology, University of Southampton, Southampton, UK
| | - Richard A Crosby
- 2 Department of Health Behavior, University of Kentucky, Lexington, KY, USA
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Stone N, Graham C, Anstee S, Brown K, Newby K, Ingham R. Enhancing condom use experiences among young men to improve correct and consistent condom use: feasibility of a home-based intervention strategy (HIS-UK). Pilot Feasibility Stud 2018; 4:63. [PMID: 29541480 PMCID: PMC5842531 DOI: 10.1186/s40814-018-0257-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/22/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Condoms remain the main protection against sexually transmitted infections (STIs) when used correctly and consistently. Yet, there are many reported barriers to their use such as negative attitudes, reduced sexual pleasure, fit-and-feel problems and erection difficulties. The UK home-based intervention strategy (HIS-UK) is a behaviour change condom promotion intervention for use among young men (aged 16-25 years) designed to increase condom use by enhancing enjoyment of condom-protected intercourse. The objective of this feasibility study was to test HIS-UK for viability, operability and acceptability. Along with an assessment of the recruitment strategy and adherence to the intervention protocol, the study tested the reliability and suitability of a series of behavioural and condom use outcome measures to assess condom use attitudes, motivations, self-efficacy, use experience, errors and problems and fit and feel. METHODS The HIS-UK intervention and associated assessment instruments were tested for feasibility using a single-arm, repeated measures design with baseline measurement and two follow-up measurements over 3 months. A 3-month target of 50 young men completing the baseline questionnaire was set. Twenty process and acceptability evaluation interviews with participants and health promotion professionals were conducted post trial. RESULTS Of the 61 young men who registered for the study, 57 completed the baseline questionnaire and 33 met with the study researcher to receive the HIS-UK condom kit. Twenty-one young men remained for the duration of the study (64% retention). The Cronbach's alpha scores for the condom use outcome measures were 0.84 attitudes, 0.78 self-efficacy, 0.83 use experience, 0.69 errors and problems and 0.75 fit and feel. Participant and health professional feedback indicated strong acceptability of the intervention. CONCLUSIONS The feasibility study demonstrated that our recruitment strategy was appropriate and the target sample size was achieved. Adherence was favourable when compared to other similar studies. The condom use measures tested proved to be fit-for-purpose with good internal consistency. Some further development and subsequent piloting of HIS-UK is required prior to a full randomised controlled trial, including the feasibility of collecting STI biomarkers, and assessment of participant acceptance of randomisation. TRIAL REGISTRATION Research registry, RR2315, 27th March 2017 (retrospectively registered).
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Affiliation(s)
- Nicole Stone
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, UK
| | - Cynthia Graham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, UK
| | - Sydney Anstee
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, UK
| | - Katherine Brown
- Centre for Advances in Behavioural Science, Coventry University, Coventry, UK
| | - Katie Newby
- Centre for Advances in Behavioural Science, Coventry University, Coventry, UK
| | - Roger Ingham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, UK
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Glowacka M, Yardley L, Stone N, Graham CA. Feasibility and Preliminary Effectiveness of the Homework Intervention Strategy (eHIS) Program to Enhance Male Condom Use: Research Protocol. JMIR Res Protoc 2018; 7:e1. [PMID: 29295809 PMCID: PMC5770577 DOI: 10.2196/resprot.7937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although condoms are effective in reducing the risk of sexually transmitted infections (STIs) and unintended pregnancy, they are still often not used consistently and correctly. Negative impact on sensation and pleasure, ruining the mood, causing problems with maintaining erection, and condom slippage or breakage are some of the reasons given by men explaining why they do not want to use condoms. Although many interventions promoting condom use exist, some of them delivered online are complex and time- and resource-intensive. The Homework Intervention Strategy (eHIS) program, adapted from the existing face-to-face Kinsey Institute Homework Intervention Strategy (KIHIS) program, aims to address these issues by encouraging men to focus on sensation and pleasure when trying different types of condoms and lubricants in a low-pressure situation (on their own, without a partner present). OBJECTIVE The objectives of this study are to assess the feasibility, acceptability, and users' engagement with the eHIS program, its preliminary effectiveness in increasing condom use frequency and consistency, as well as the feasibility of the program's evaluation approach, including choice of measures and participant recruitment and retaining strategies (primary outcomes). Secondary outcomes include condom use experience, condom use attitudes, condom use self-efficacy, condom use errors and problems, and condom fit-and-feel. All of these will be analyzed in the context of participants' demographics, sexual history, and previous condom use. METHODS The study has a pre-post-test, within-subjects design. Men aged 18 to 69 and living in the United Kingdom are recruited through posters, leaflets, social media, and emails. Study participants are asked to complete T1 (baseline) measures before entering the eHIS website. After completing the T1 measures, they can order a free condoms and lubricants kit and have access to the eHIS website for 4 weeks. During that time they are asked to practice using different types of condoms and lubricants on their own in a no-pressure situation. Following T1, participants are asked to complete the T2 and T3 measures at 4 and 10 weeks, respectively. RESULTS Data collection for the study is completed. Data analysis is in progress and is expected to be completed by February 2018. CONCLUSIONS This brief, home-based, self-guided program may lead to increased consistent and correct condom use. Online delivery can make the program an easily accessible and low-cost health promotion intervention, which has the potential to reach a wide and diverse audience. If results of the current study show the program's feasibility and preliminary effectiveness in changing condom use related outcomes, a larger scale randomized controlled trial (RCT) will be conducted. TRIAL REGISTRATION Research Registry: researchregistry2325; http://www.researchregistry.com/browse-the-registry.html# home/registrationdetails/58da6cad1d7ab0314337d076/ (Archived by WebCite at http://www.webcitation.org/6vXs6S9XW).
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Affiliation(s)
- Marta Glowacka
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Nicole Stone
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Cynthia A Graham
- Department of Psychology, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, United Kingdom
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Graham CA, Crosby R, Sanders S, Milhausen R, Yarber WL. Condom-Associated Erection Problems: A Study of High-Risk Young Black Males Residing in the Southern United States. Am J Mens Health 2016; 10:141-5. [PMID: 25475105 DOI: 10.1177/1557988314561311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous research indicates that young men may experience condom-associated erection loss and that these problems may lead to inconsistent or incomplete condom use. The primary aim of this study was to assess, using a retrospective recall period of 2 months, correlates of condom-associated erection problems among young Black men attending sexually transmitted infection (STI) clinics. Data were collected in clinics treating patients with STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) condom use were eligible. A total of 494 men participated. Nineteen percent reported that condom-associated erection problems during condom application occurred at least once, and 17.8% indicated erection difficulties occurred during sexual intercourse at least once in the past 2 months. Multivariate analyses identified that condom-associated erection problems were associated with reports of sex with more than one partner during the recall period, reported problems with condom fit and feel, lower motivation to use condoms, and attempts at condom application before having a full erection. Findings suggest that clinic interventions should address possible condom-associated erection problems among young Black men who are at risk of STIs. Encouraging men who may be vulnerable to erection loss when condoms are used to allow sufficient time for sexual arousal to build may be an effective strategy.
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Affiliation(s)
- Cynthia A Graham
- University of Southampton, Southampton, England Indiana University, Bloomington, IN, USA
| | - Richard Crosby
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA University of Kentucky, Lexington, KY, USA
| | - Stephanie Sanders
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA Indiana University, Bloomington, IN, USA
| | - Robin Milhausen
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA University of Guelph, Guelph, Ontario, Canada
| | - William L Yarber
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA Indiana University, Bloomington, IN, USA
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9
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The Magnum Phenomenon and Its Challenges for HIV/Sexually Transmitted Disease Prevention. Sex Transm Dis 2016; 43:207. [PMID: 26859811 DOI: 10.1097/olq.0000000000000416] [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]
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Abstract
HIV infection rates remain steady in the USA despite the numerous prevention programs and tools available. Condoms play a central role in HIV prevention because they are highly effective, readily available, and affordable. Unfortunately, condom promotion efforts often incite fear as a motive force, while also taking the common "one-size-fits-all" approach. Reframing condom promotion through a sexual health framework, focusing on pleasure and highlighting condom fit issues, improves intervention efficacy. Condom distribution policies may further perpetuate condom users' difficulty, by withholding particular condom styles, brands, and information highlighting the nuances in shape, size, and material. Condom education and distribution practices focused on pleasure, proper fit, and condom access issues might increase condom utilization among high-risk populations.
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Affiliation(s)
- Joshua D O'Neal
- Department of Sexuality Studies, San Francisco State University, HSS 370, 1600 Holloway Ave, San Francisco, CA, 94132, USA,
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The intimate link: a systematic review of highly effective reversible contraception and women's sexual experience. Clin Obstet Gynecol 2015; 57:777-89. [PMID: 25264699 DOI: 10.1097/grf.0000000000000058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Contraception is expressly designed for nonprocreative sexual activity, but we know little about how methods shape women's sexual experience. To systematically review the literature on highly effective reversible contraception (HERC) and sexual experiences. MEDLINE, SCOPUS, and Google Scholar were searched for relevant literature. Eleven studies met the inclusion criteria; all were conducted outside of the United States. All studies reviewed found either improvements or no change in sexual experience and function outcomes with HERC use. A need exists for more prospective studies with a wider range of measures to assess HERC methods' impact on women's sexual experiences.
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12
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Hernández-Romieu AC, Siegler A, Sullivan PS, Crosby R, Rosenberg ES. How often do condoms fail? A cross-sectional study exploring incomplete use of condoms, condom failures and other condom problems among black and white MSM in southern U.S.A. Sex Transm Infect 2014; 90:602-7. [PMID: 25080511 PMCID: PMC4408017 DOI: 10.1136/sextrans-2014-051581] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To compare the occurrence of risk-inducing condom events (condom failures and incomplete use) and the frequency of their antecedents (condom errors, fit/feel problems and erection problems) between black and white men who have sex with men (MSM), and determine the associations between risk-inducing condom events and their antecedents. METHODS We studied cross-sectional data of 475 MSM who indicated using a condom as an insertive partner in the previous 6 months enrolled in a cohort study in Atlanta, Georgia, USA. RESULTS Nearly 40% of black MSM reported breakage or incomplete use, and they were more likely to report breakage, early removal and delayed application of a condom than white MSM. Only 31% and 54% of MSM reported correct condom use and suboptimal fit/feel of a condom, respectively. The use of oil-based lubricants and suboptimal fit/feel were associated with higher odds of reporting breakage (p=0.009). Suboptimal fit/feel was also associated with higher odds of incomplete use of condoms (p<0.0001). CONCLUSIONS Incomplete use of condoms and condom failures were especially common among black MSM. Our findings indicate that condoms likely offered them less protection against HIV/sexually transmitted infection when compared with white MSM. More interventions are needed, particularly addressing the use of oil-based lubricants and suboptimal fit/feel of condoms.
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Affiliation(s)
| | - Aaron Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. USA
| | - Patrick S. Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. USA
| | - Richard Crosby
- Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY. USA
| | - Eli S. Rosenberg
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. USA
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Men who have sex with mens' exposure to, use of, and subjective experiences with the 'NYC Condom'. AIDS Behav 2014; 18:2172-7. [PMID: 24806454 DOI: 10.1007/s10461-014-0783-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In 2007, the New York City (NYC) Department of Health introduced the 'NYC Condom'--a Lifestyles® condom with a 'NYC' logo. Few studies have evaluated attitudes toward or distribution of the 'NYC Condom' among men who have sex with men (MSM)--a population at increased risk for HIV/STIs. 148 MSM completed a survey about their exposure to, use of, and experiences using the 'NYC Condom.' The majority (93.2 %) had seen the 'NYC Condom;' 82.4 % of said men had used it. Among MSM who used it, 82.1 % rated it average or above. Exposure did not statistically differ by race/ethnicity, HIV status, gay or barebacker identification, or sex role. Use was neither significantly associated with demographic characteristics nor recruitment source, suggesting distributional success in reaching various sub-populations of MSM. Among those who had not used the 'NYC Condom,' 22.2 % reported size or quality concerns, suggesting a demand for alternative prevention campaigns.
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Crosby RA, Charnigo RJ, Salazar LF, Pasternak R, Terrell IW, Ricks J, Smith RV, Taylor SN. Enhancing condom use among Black male youths: a randomized controlled trial. Am J Public Health 2014; 104:2219-25. [PMID: 25211749 DOI: 10.2105/ajph.2014.302131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We tested the efficacy of a brief intervention to promote correct and consistent use of condoms among Black male youths attending sexually transmitted infection (STI) clinics in 3 southern US cities. METHODS In 2010 to 2012, we screened (n = 1102) and enrolled (n = 702) youths aged 15 to 23 years who identified as Black and reported recent (past 2 months) sexual activity and randomized them to a private, brief, interactive intervention (n = 349) or an attention-equivalent control condition (n = 353). Assessments occurred at baseline and 2 and 6 months after the intervention. RESULTS At 6 months, with adjustment for age and pretest nonequivalence of the outcome variable, an estimated odds ratio (EOR) of 1.63 (95% confidence interval [CI] = 1.07, 2.49; P = .02) indicated efficacy for correct condom use. An adjusted generalized estimating equations model with both 2- and 6-month condom use variables produced an EOR of 1.49 (95% CI = 1.06, 2.08; P = .02). We did not observe significant effects on chlamydia and gonorrhea incidence. CONCLUSIONS This brief intervention, delivered as part of STI clinical care, could help alleviate the disproportionate STI-HIV burden among young Black men.
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Affiliation(s)
- Richard A Crosby
- Richard A. Crosby, Richard J. Charnigo, and Rachel V. Smith are with the College of Public Health, University of Kentucky, Lexington. Laura F. Salazar is with the Institute of Public Health, Georgia State University, Atlanta. Ryan Pasternak and Ivy Terrell are with the Health Sciences Center, and Stephanie N. Taylor is with the Delgado Personal Health Center STD Clinic, Louisiana State University, New Orleans. JaNelle Ricks is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
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Crosby RA, Milhausen RR, Mark KP, Yarber WL, Sanders SA, Graham CA. Understanding problems with condom fit and feel: an important opportunity for improving clinic-based safer sex programs. J Prim Prev 2014; 34:109-15. [PMID: 23355256 DOI: 10.1007/s10935-013-0294-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to investigate gender differences and other demographic correlates of condom fit and feel problems among a diverse sample of adult condom users and to examine men's and women's perceptions and experiences with condom fit and feel problems. Participants were recruited from an electronic mailing list. The analytic sample (N = 949) included self-identified heterosexual men (n = 771) and women (n = 178) who reported using condoms for penile-vaginal or penile-anal intercourse in the past 3 months. Both quantitative and qualitative methods were applied. Of the sample, 38.3% reported experiencing at least one condom fit or feel problem. Problems with condom fit during sex did not differ significantly by gender (p = .73). Perceptions of specific condom use problems were organized into five themes: (1) decreased sensation, (2) lack of naturalness, (3) condom size complaints, (4) decreased pleasure, and (5) pain and discomfort. In this diverse sample, there was a high prevalence of condom fit and feel issues among women as well as men. These issues, mostly focused on loss of pleasure, represent a substantial public health problem and thus warrant attention in safer sex programs.
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Affiliation(s)
- Richard A Crosby
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.
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Grov C, Wells BE, Parsons JT. Self-reported penis size and experiences with condoms among gay and bisexual men. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:313-22. [PMID: 22552706 PMCID: PMC5826649 DOI: 10.1007/s10508-012-9952-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 09/23/2011] [Accepted: 01/14/2012] [Indexed: 05/31/2023]
Abstract
As researchers and community-based providers continue to encourage latex condom use as a chief strategy to prevent HIV transmission among men who have sex with men, research is needed to better explore the intersecting associations among penis size (length and circumference), condom feel, ease of finding condoms, recent experience of condom failure (breakage and slippage), and unprotected anal sex. Data were taken from a 2010 community-based survey of self-identified gay and bisexual men in New York City (n = 463). More than half (51.4 %) reported penile length as 6-8 in. long (15-20 cm) and 31.5 % reported penile circumference as 4-6 in. around (10-15 cm). Variation in self-reported penile dimensions was significantly associated with men's attitudes toward the typical/average condom, difficulty finding condoms that fit, and the experience of condom breakage. Men who had engaged in recent unprotected insertive anal intercourse reported significantly higher values for both penile length and circumference, and these men were significantly more likely to report that the average/typical condom was "too tight." Most men had measured their length (86.2 %) and/or circumference (68.9 %), suggesting that penile measurement might be a common and acceptable practice among gay and bisexual men. As HIV and STI prevention providers continue to serve as leading distributers of free condoms, these findings further highlight the need for condom availability to be in a variety of sizes. Improving condom fit and attitudes toward condoms may also improve condom use and minimize condom slippage and breakage.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, USA
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17
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Cecil M, Warner L, Siegler AJ. Online purchases of an expanded range of condom sizes in comparison to current dimensional requirements allowable by US national standards. Sex Health 2013; 10:408-13. [DOI: 10.1071/sh13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 05/25/2013] [Indexed: 11/23/2022]
Abstract
Background Across studies, 35–50% of men describe condoms as fitting poorly. Rates of condom use may be inhibited in part due to the inaccessibility of appropriately sized condoms. As regulated medical devices, condom sizes conform to national standards such as those developed by the American Society for Testing and Materials (ASTM) or international standards such as those developed by the International Organisation for Standardisation (ISO). We describe the initial online sales experience of an expanded range of condom sizes and assess uptake in relation to the current required standard dimensions of condoms. Methods: Data regarding the initial 1000 sales of an expanded range of condom sizes in the United Kingdom were collected from late 2011 through to early 2012. Ninety-five condom sizes, comprising 14 lengths (83–238 mm) and 12 widths (41–69 mm), were available. Results: For the first 1000 condom six-pack units that were sold, a total of 83 of the 95 unique sizes were purchased, including all 14 lengths and 12 widths, and both the smallest and largest condoms. Initial condom purchases were made by 572 individuals from 26 countries. Only 13.4% of consumer sales were in the ASTM’s allowable range of sizes. Conclusions: These initial sales data suggest consumer interest in an expanded choice of condom sizes that fall outside the range currently allowable by national and international standards organisations.
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Calabrese SK, Reisen CA, Zea MC, Poppen PJ, Bianchi FT. The pleasure principle: the effect of perceived pleasure loss associated with condoms on unprotected anal intercourse among immigrant Latino men who have sex with men. AIDS Patient Care STDS 2012; 26:430-5. [PMID: 22663165 DOI: 10.1089/apc.2011.0428] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sexual pleasure has been identified as an important consideration in decision-making surrounding condom use. We examined the impact of perceived pleasure loss associated with condom use on recent history of insertive and receptive unprotected anal intercourse (UAI) among Latino men who have sex with men (MSM) living in the United States. A total of 482 Dominican, Colombian, and Brazilian immigrant MSM were surveyed regarding sexual attitudes and practices via computer-assisted self-interviewing technology with audio enhancement (ACASI). Participants rated the pleasure they derived from protected and unprotected anal intercourse in each position (insertive and receptive) and also reported their HIV status, relationship status, and recent sexual history. Men who had engaged in both positions, with and without condoms (n=268), perceived a greater pleasure loss associated with condoms during anal intercourse in the insertive versus receptive position. Logistic regression analyses controlling for HIV status, relationship status, and age revealed that men who perceived greater pleasure loss from condoms were more likely to have engaged in UAI over the past 3 months (n[insertive]=297; n[receptive]=284). Findings indicate that the pleasure loss associated with condoms may be a key deterrent for their use in either sex position among Latino MSM. Therefore, pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use.
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Affiliation(s)
| | - Carol A. Reisen
- The George Washington University, Washington, District of Columbia
| | | | - Paul J. Poppen
- The George Washington University, Washington, District of Columbia
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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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Topping AA, Milhausen RR, Graham CA, Sanders SA, Yarber WL, Crosby RA. A comparison of condom use errors and problems for heterosexual anal and vaginal intercourse. Int J STD AIDS 2011; 22:204-8. [PMID: 21515752 DOI: 10.1258/ijsa.2011.010259] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Condom use errors and problems were compared for anal and vaginal intercourse among a convenience sample of heterosexual men aged 18-66 years (n = 757). Men completed an online questionnaire for the last male condom use event for penile-anal (10.4%) or penile-vaginal (89.6%) intercourse. The prevalence of condom use errors and problems was similar regardless of intercourse type with a few exceptions; those reporting anal intercourse were significantly more likely to report using water-based (P < 0.001) and oil-based (P = 0.037) lubricant and to remove condoms before sex was finished (P < 0.001). The large majority of the sample (93.8%) reported at least one of the nine errors assessed and almost half (46.2%) reported at least one of the seven problems, indicating that many adults may need assistance with these issues. Condom use promotion programmes designed for heterosexual adults are needed that address condom use errors and problems for penile-anal as well as penile-vaginal intercourse.
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Affiliation(s)
- A A Topping
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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Gassman RA, Agley J, Johnston JD, Middlestadt SE, van Puymbroeck M, YoussefAgha AH. Catalyzing Transdisciplinary Studies in Public Health. Health Promot Pract 2010; 13:90-7. [DOI: 10.1177/1524839910370425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Researchers, educators, and service providers recognize that health behaviors and conditions are interdependent, yet they are too often addressed compartmentally. This “silo” approach is unfortunate because it leads to inefficiencies and less effective approaches to prevention. This article describes a process designed to promote better understanding of the interrelatedness of health behaviors and outcomes through a multidimensional Internet-based health survey aimed at undergraduate college students. In addition, we describe a data-sharing platform whereby faculty and students from across disciplines may access the raw data for a variety of uses. An analysis is performed illustrating a syndemic between binge drinking, sexually transmitted diseases, and using alcohol or drugs prior to sexual intercourse. Potential applications of the multidomain survey are discussed, as well as lessons learned and limitations of this approach.
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Affiliation(s)
- Ruth A. Gassman
- Indiana Prevention Resource Center in the Department of Applied Health Science at Indiana University, Bloomington, Indiana
| | - Jon Agley
- Department of Applied Health Science at Indiana University, Bloomington, and the Indiana Prevention Resource Center, Indiana
| | | | - Susan E. Middlestadt
- Department of Applied Health Science at Indiana University, Bloomington, Indiana
| | - Marieke van Puymbroeck
- Department of Recreation, Park, and Tourism Studies at Indiana University, Bloomington, Indiana
| | - Ahmed H. YoussefAgha
- Department of Applied Health Science at Indiana University, Bloomington, Indiana
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Dodge B, Reece M, Herbenick D, Schick V. Experiences of Condom Fit and Feel Among Men in Five European Nations. ACTA ACUST UNITED AC 2010. [DOI: 10.3149/jmh.0903.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Reece M, Mark K, Schick V, Herbenick D, Dodge B. Patterns of condom acquisition by condom-using men in the United States. AIDS Patient Care STDS 2010; 24:429-33. [PMID: 20586647 DOI: 10.1089/apc.2010.0011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Condom-distribution programs have striven to make condoms more accessible to sexually active individuals, particularly adolescents and populations disproportionately affected by HIV and other STIs. Despite such programs, little is known about where condom-using men in the United States acquire their condoms. The purpose of this study was to document condom-access trends among a large sample of sexually active condom-using men in the United States. Data were collected from 1,832 men from all 50 U.S. states and the District of Columbia by using an Internet-based survey in which men provided details regarding the source of condoms that they had used within the past 30 days. Men reported acquiring their condoms from a variety of sources, including free condom-distribution programs (56.7%) and from venues where they had purchased condoms for themselves (75.7%). Bivariate analyses indicated that participants who reported using free condoms tended to be younger, self-identified as not heterosexual, or not currently in a monogamous relationship. Further, results indicated that those participants who accessed only free condoms did not differ from those who used only purchased condoms, indicating that perhaps efforts to make condoms more accessible through public health distribution campaigns are reaching a more general population of condom-using men than expected. Findings illustrate the importance of continuing free condom-distribution efforts but also suggest benefits of facilitating linkages between public health and a community's retail venues to increase access to the growing diversity of condoms in the marketplace.
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Affiliation(s)
- Michael Reece
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Kristen Mark
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Vanessa Schick
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Debra Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Brian Dodge
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
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Reece M, Briggs L, Dodge B, Herbenick D, Glover R. Perceptions of condom fit and feel among men living with HIV. AIDS Patient Care STDS 2010; 24:435-40. [PMID: 20578905 DOI: 10.1089/apc.2010.0021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Promoting consistent and correct condom use remains a priority public health activity, although some HIV- and STI-related providers remain challenged by some men's resistance to condoms, which some claim do not fit properly or do not feel comfortable. Although these perceptions have been examined across multiple populations, they have not been documented among men living with HIV. During spring 2008, data were collected from 215 men living with HIV at HIV service organizations in the Midwestern and Southeastern United States. Participants completed the Condom Fit and Feel Scale and measures related to demographics and condom use during sexual interactions within the past 90 days. Men were primarily homosexual, African American, with a high school degree or higher, and unemployed. More than half of participants had used condoms for sexual intercourse within the previous 90 days. The majority of the men reported few problems with the fit and feel of condoms, with 63.1% reporting that condoms "fit my penis just fine," and 80.9% reported being able consistently to find condoms that they perceived to be "sized appropriately for my penis." Some men did report specific characteristics of condoms that challenged fit and feel, including 20.6% endorsing (always or often) that condoms feel too tight, 15.9% that condoms are too short, 17.8% or that condoms would not roll down far enough to cover their penis completely (15.6%). These data provide insights into mechanisms through which providers can help to increase men's access to the diverse range of condoms in the marketplace.
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Affiliation(s)
- Michael Reece
- Center for Sexual Health Promotion, Indiana University, Bloomington, 47405, USA.
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Grov C, Parsons JT, Bimbi DS. The association between penis size and sexual health among men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2010; 39:788-97. [PMID: 19139986 PMCID: PMC2874247 DOI: 10.1007/s10508-008-9439-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 10/09/2008] [Accepted: 10/11/2008] [Indexed: 05/11/2023]
Abstract
Larger penis size has been equated with a symbol of power, stamina, masculinity, and social status. Yet, there has been little research among men who have sex with men assessing the association between penis size and social-sexual health. Survey data from a diverse sample of 1,065 men who have sex with men were used to explore the association between perceived penis size and a variety of psychosocial outcomes. Seven percent of men felt their penis was "below average," 53.9% "average," and 35.5% "above average." Penis size was positively related to satisfaction with size and inversely related to lying about penis size (all ps < .01). Size was unrelated to condom use, frequency of sex partners, HIV status, or recent diagnoses of HBV, HCV, gonorrhea/Chlamydia/urinary tract infections, and syphilis. Men with above average penises were more likely to report HPV and HSV-2 (Fisher's exact p <or= .05). Men with below average penises were significantly more likely to identify as "bottoms" (anal receptive) and men with above average penises were significantly more likely to identify as "tops" (anal insertive). Finally, men with below average penises fared significantly worse than other men on three measures of psychosocial adjustment. Though most men felt their penis size was average, many fell outside this "norm." The disproportionate number of viral skin-to-skin STIs (HSV-2 and HPV) suggest size may play a role in condom slippage/breakage. Further, size played a significant role in sexual positioning and psychosocial adjustment. These data highlight the need to better understand the real individual-level consequences of living in a penis-centered society.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York (CUNY)
- Center for HIV/AIDS Educational Studies and Training (CHEST)
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Department of Social & Personality Psychology, The Graduate Center of CUNY
- To whom correspondence should be addressed at Department of Psychology, Hunter College, CUNY, 695 Park Avenue, New York, NY. 10065. . 212-206-7919x226; 212-206-7994 (Fax)
| | - David S. Bimbi
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Department of Natural and Applied Sciences, LaGuardia Community College, CUNY
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Satinsky S, Fisher C, Stupiansky N, Dodge B, Alexander A, Herbenick D, Reece M. Sexual compulsivity among men in a decentralized MSM community of the Midwestern United States. AIDS Patient Care STDS 2008; 22:553-60. [PMID: 18479226 DOI: 10.1089/apc.2007.0255] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Among men who have sex with men (MSM), sexual compulsivity has been associated with higher frequencies of sexual behaviors that may increase risk for transmission of HIV and other sexually transmitted infections (STI). In a Midwestern region where social and community resources for MSM are relatively diffuse, the patterns of partner-seeking and sexual behavior, and their relations to sexual compulsivity, may be different than findings from most other assessments of men in large urban areas. Using a community-based participatory approach (CBPR) and a cross-sectional survey, quantitative data were collected between November 2006 and January 2007 from 504 men related to sexual compulsivity, sexual partner-seeking, and sexual behavior. We sought to explore sexual behaviors in venues where men reported meeting sexual partners, based on their level of compulsivity. Venues that could be characterized as "sexualized" were better predictors of higher sexual compulsivity scores among men than those that are "social" in nature. Men who were higher in compulsivity reported patterns of saturating sexualized venues in order to find sexual partners. Given the unique patterns of sexual partner-seeking in this area, interventions to decrease sexual risk-taking should take into account that men who have a higher propensity for sexual compulsivity are visiting multiple venues, and prevention messages need to be tailored to be consistent across these contexts. In addition, these may need to be differentially designed based on the specific environment in which they are to be delivered.
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Affiliation(s)
- Sonya Satinsky
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Christopher Fisher
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Nathan Stupiansky
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Brian Dodge
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Andreia Alexander
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Debby Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - Michael Reece
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
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