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Burke HM, Ridgeway K, Murray K, Mickler A, Thomas R, Williams K. Reproductive empowerment and contraceptive self-care: a systematic review. Sex Reprod Health Matters 2022; 29:2090057. [PMID: 35892261 PMCID: PMC9336472 DOI: 10.1080/26410397.2022.2090057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Holly M. Burke
- Scientist, FHI 360, Reproductive, Maternal, Newborn, and Child Health division, Durham, NC, USA. Correspondence:
| | - Kathleen Ridgeway
- Research Associate, FHI 360, Health Services Research division, Durham, NC, USA
| | - Kate Murray
- Research Associate, FHI 360, Reproductive, Maternal, Newborn, and Child Health division, Durham, NC, USA
| | - Alexandria Mickler
- Program Analyst, USAID/Public Health Institute, Office of Population and Reproductive Health, Washington, DC, USA
| | - Reana Thomas
- Technical Officer, FHI 360, Research Utilization division, Durham, NC, USA
| | - Katie Williams
- MPH Candidate, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Fellow, FHI 360, Durham, NC, USA
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Algren MH, Deen L, Tolstrup JS, Thygesen LC. Associations between health-risk behaviours and non-condom use among 28,620 Danish students: a cross-sectional study. EUR J CONTRACEP REPR 2021; 27:45-52. [PMID: 34907840 DOI: 10.1080/13625187.2021.2005018] [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: 10/19/2022]
Abstract
PURPOSE Investigations into the associations between health-risk behaviours and non-condom use are important for planning effective preventive interventions targeted sexually transmitted infections. To date, there are no such studies on the Danish general population. The aim of this study was to examine associations between health-risk behaviours (including daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) and non-condom use among Danish students. MATERIAL AND METHOD Cross-sectional data from 28,620 sexually active students aged 15-25 years from the Danish National Youth Study 2014 were analysed using multilevel logistic regression. RESULTS Health-risk behaviours (daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) were significantly associated with higher odds for non-condom use among Danish students, even after adjustment for age, gender, education, religion, and geographical region. The associations remained significant after adjusting for the remaining health-risk behaviours. CONCLUSION Overall, the study showed a clear association between health-risk behaviours and non-condom use among Danish students. The findings of this study have important implications for future planning of more targeted health promotion intervention programmes aimed to increase condom use among young people as a means to reduce sexually transmitted infections.
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Affiliation(s)
- Maria Holst Algren
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Laura Deen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Condoms, Trust and Stealthing: The Meanings Attributed to Unprotected Hetero-Sex. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084257. [PMID: 33923821 PMCID: PMC8074011 DOI: 10.3390/ijerph18084257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/16/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
University students tend to have greater sexual health knowledge than the general public, yet condom use among this group continues to be a public health concern because effective condom use could reduce sexually transmitted infections and, for heterosexual women, unwanted pregnancies. We report findings from a small, qualitative study of condom use among sexually active heterosexual university students in the UK. In interviews, students shared their views about condom use and sometimes their personal experiences too. This paper identifies some of the meanings attributed to condom use in the accounts of nine heterosexually active 20-25 year-olds. Participants explained that when they felt comfortable communicating with their partners, they were more likely to use condoms, and those with negative sexual experiences or under social or psychological pressure were less likely to use them. The findings highlight issues of trust and power between men and women in heterosexual relationships, and describe contexts for dishonest sexual practice, including the traditional notions of femininity that were linked to condom use by this group. The issue of stealthing arose in one woman's account of her experience and in several others' reports of what occurs commonly. Stealthing, the secretive removal of a condom by a (usually male) partner during sexual intercourse without a partner's knowledge or permission, produces non-consensual unprotected sex. We present stealthing as a product of the sexual double-standards described and as a form of interpersonal violence (IPV) and, among these heterosexual partners, as a form of gender-based violence. This study provides a glimpse into university students' decision-making regarding condom use and highlights how gendered inequalities shape heterosex, in particular, communication about safer sex, that in some cases, compromise women's decisions about (safer) sex.
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Agents of change: Comparing HIV-related risk behavior of people attending ART clinics in Dar es Salaam with members of their social networks. PLoS One 2020; 15:e0238240. [PMID: 32886666 PMCID: PMC7473570 DOI: 10.1371/journal.pone.0238240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 08/12/2020] [Indexed: 12/30/2022] Open
Abstract
The aim of the study is to compare sociodemographic characteristics, psychosocial factors, HIV knowledge and risk behaviors of people living with HIV (PLH) and their social network members (NMs) to inform HIV prevention programs that engage PLH as prevention educators in their communities. We compared baseline characteristics of PLH enrolled in an intervention to become HIV prevention Change Agents (CAs) (n = 458) and 602 NMs they recruited. CAs and NMs responded to questionnaires through a computer-driven interface with Audio Computer-Assisted Self Interview (ACASI) software. Although NMs scored higher on socio-economic status, self-esteem and general self-efficacy, they had lower HIV knowledge (AOR 1.5; 95% CI: 1.1–2.1), greater inconsistent condom use (AOR 3.2; 95% CI: 2.4–4.9), and recent experience as perpetrators of physical (AOR 2.5; 95% CI: 1.2–5.1) or sexual (AOR 4.1; 95% CI: 1.4–12.7) intimate partner violence; and as victims of physical (AOR 1.5; 95% CI: 1.0–2.3) or sexual (AOR 2.2; 95% CI: 1.3–3.8) forms of violence than CAs. Higher HIV knowledge and lower sexual risk behaviors among CAs suggest PLH’s potential as communicators of HIV prevention information to NMs. CAs’ training should also focus on improving self-esteem, general self-efficacy and social support to increase their potential effectiveness as HIV prevention educators and enhance their own overall health and well-being.
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Li H, Tucker JD, Ma W, Kim ES, Marley G, Kang D, Liao M, Tang W, Jiang B. Growth Trajectories of Peer Norms, Self-efficacy and Condom Use Behavior Among Sexually Active Chinese Men Who Have Sex with Men: Latent Class Analysis and Growth Mixture Modeling. AIDS Behav 2020; 24:854-865. [PMID: 31016503 DOI: 10.1007/s10461-019-02515-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Data from a randomized controlled trial in 2015 were used to estimate the growth trajectories of peer norms, self-efficacy, and condom use behavior, and to identify associated sociodemographic and behavioral factors among a sample of 804 Chinese men who have sex with men (MSM). Latent class analysis and growth mixture modeling were conducted using Mplus. Two growth trajectories were estimated for each outcome variable with good model fit. The growth trajectories of peer norms were related to age (β = - 0.066, p < 0.05). The growth trajectories of self-efficacy were related to age (β = 0.057, p < 0.01) and using a condom during first sexual encounter with another man (β = 0.777, p < 0.001). The growth trajectories of condom use behavior were related to income (β = 0.366, p < 0.01) and having casual male partners (β = - 1.016, p < 0.001). Predictors for the growth factors within each latent class were also estimated. For subsets of MSM who are older, richer, used a condom during their first sexual encounter with another man, and do not have a casual male partner, condom videos may not have sufficient efficacy and other interventions may be necessary.
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Li H, Xue L, Tucker JD, Wei C, Durvasula M, Hu W, Kang D, Liao M, Tang W, Ma W. Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men. BMC Public Health 2017; 17:641. [PMID: 28784172 PMCID: PMC5545844 DOI: 10.1186/s12889-017-4662-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 08/01/2017] [Indexed: 12/26/2022] Open
Abstract
Background Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM), a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association. Methods A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services), condom use peer norms, condom use self-efficacy, and frequency of condom use. Results The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036). HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy. Conclusion The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4662-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haochu Li
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China. .,UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,SESH Global, Guangzhou, China.
| | - Li Xue
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China
| | - Joseph D Tucker
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,SESH Global, Guangzhou, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Maya Durvasula
- Department of Economics, Duke University, Durham, NC, USA
| | - Wenqi Hu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China
| | - Dianming Kang
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Meizhen Liao
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Weiming Tang
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,SESH Global, Guangzhou, China.,Guangdong Provincial Center for Skin Diseases and STI Control, Guangzhou, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China.
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Wang YC. Individual, interpersonal, and community predictors of consistent condom use among Taiwanese university students. AIDS Care 2015; 28:354-8. [PMID: 26477524 DOI: 10.1080/09540121.2015.1096892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examines the predictive value of individual, interpersonal, and community factors for consistent condom use among university students in Taiwan. The analytic sample for this cross-sectional study comprised 105 sexually active students, a subgroup of the respondents in a survey on university students in mid-Taiwan, with a mean age of 21, and 51.4% being female. The outcome variable was assessed as the proportion of times a condom was used in sex with steady sex partners. Risky sex appeared less related to having multiple sex partners (8.57%) than with inconsistent condom use (71.4%). Hierarchical regression analysis showed that 47.4% of variance in the outcome variable could be explained by AIDS knowledge, class adjustment, perception of good friends' condom use, and discussion of condom use with good friends. This study found that predictors across different levels may work in combination to influence students' condom use. Enhancing HIV/AIDS knowledge, improving class adjustment, facilitating peer norm of condom use may work in combination to increase students' condom use.
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Affiliation(s)
- Ya-Chien Wang
- a Department of Medical Sociology and Social Work , Chung Shan Medical University , Taichung City , Taiwan, R.O.C
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Xiao Z, Li X, Lin D, Tam CC. Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1095-1106. [PMID: 25950448 PMCID: PMC6277979 DOI: 10.1080/10810730.2015.1018575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.
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Affiliation(s)
- Zhiwen Xiao
- a Valenti School of Communication , University of Houston , Houston , Texas , USA
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A randomized controlled trial evaluating the efficacy of a theory-based intervention promoting condom use among Chinese monogamous female sexually transmitted infection patients. Int J Behav Med 2014; 21:719-29. [PMID: 24493478 DOI: 10.1007/s12529-014-9388-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Chinese monogamous women may contract sexually transmitted diseases (STD) from their sole male sex partner, but these women do not have high self-efficacy in negotiating about condom use with their regular sex partners. PURPOSE We aim to investigate the relative efficacy of a theory-based and clinic-based cognitive behavioral intervention versus a control intervention in increasing prevalence of condom use with their male sex partner among Chinese monogamous female sexually transmitted disease patients. METHODS A randomized controlled trial (RCT) was conducted. Participants were randomly allocated into the intervention group (n = 88) or the control group (n = 88). All participants were phone interviewed at baseline and at 2 and 3 months after completion of the baseline survey. The three-session group intervention was based on the information-motivation-behavioral skills (IMB) model. Participants of the control group were provided with educational pamphlets. The primary outcome was consistent condom use in the last month. Relative risks were calculated, and multiple logistic regression models were fit. RESULTS As compared to the control group, the intervention group reported higher prevalence of consistent condom use with the sole male sex partner in the last month at month 2 (75.3 versus 59.8%, RR = 1.26, 95% CI = 1.01, 1.57) and month 3 (77.8 versus 54.6%, RR = 1.42, 95% CI = 1.13, 1.80), whilst the baseline between-group difference was statistically non-significant. Some other secondary outcomes such as "intention to request condom use in the next month even if the sexual partner dislikes using condoms" were also statistically significant. Furthermore, the majority (94%) of the intervention group members were satisfied with the intervention. CONCLUSIONS The theory-based intervention is potentially efficacious, but the follow-up period was relatively short. Large-scale randomized clinical trials and subsequent translational research are greatly warranted in the future.
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Xiao Z, Li X, Lin D, Jiang S, Liu Y, Li S. Sexual communication, safer sex self-efficacy, and condom use among young Chinese migrants in Beijing, China. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2013; 25:480-494. [PMID: 24245595 DOI: 10.1521/aeap.2013.25.6.480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Mediation effect of sexual communication on the relationship between safer sex self-efficacy and condom use was tested among 307 homosexually active migrant men, 376 heterosexually active migrant men, and 265 heterosexually active migrant women. The study found certain aspects of sexual communication mediated the effect of self-efficacy on condom use among the three samples. The findings underscored the importance of including components that promote safer sex self-efficacy and sexual communication in HIV prevention interventions for Chinese migrants.
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Tung WC, Hu J, Efird J, Su W, Yu L. HIV knowledge and condom intention among sexually abstinent Chinese students. Int Nurs Rev 2013; 60:366-73. [DOI: 10.1111/inr.12039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- W.-C. Tung
- Orvis School of Nursing; University of Nevada-Reno; Reno; NV; USA
| | - J. Hu
- School of Nursing; University of North Carolina at Greensboro; Greensboro; NC; USA
| | - J.T. Efird
- Biostatistics Unit; Center for Health Disparities Research; East Carolina University; Greenville; NC; USA
| | - W. Su
- School of Information Science and Engineering; Lanzhou University; Lanzhou; Gansu; China
| | - L. Yu
- HOPE School of Nursing; Wuhan University; Wuchang; Hubei; China
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Tung WC, Cook DM, Lu M, Yang W. HIV knowledge and behavior among Chinese college students in China and the United States. West J Nurs Res 2013; 35:1171-83. [PMID: 23618822 DOI: 10.1177/0193945913486201] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Disease prevention can be improved with a better understanding of student-environment interactions. The purposes of the study were (a) to compare HIV/AIDS-related knowledge, attitudes, sexual behaviors, and sources of HIV/STI information and (b) to investigate the association between sources of HIV/STI information and HIV/AIDS-related knowledge, attitudes, and sexual behaviors among Chinese college students in China and the United States. Comparative, correlational analysis of survey data from 608 students in two countries was conducted. Chinese students in the United States scored higher on knowledge questions. More students in the United States received HIV/STI information from the Internet and family members than did students in China. Traditional media and schoolteachers had a stronger association with participants' HIV-related knowledge, age at first intercourse, and number of sexual partners in both samples than did other sources. The survey revealed incomplete knowledge within both groups. Prevention programs should focus on risky misconceptions and should teach about strategic utilization of media.
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