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Carmack C, Nganga S, Ahmed E, Coleman T. Concept Mapping STI/HIV Prevention and Condom Use among Young African American Adults. Behav Sci (Basel) 2024; 14:501. [PMID: 38920833 PMCID: PMC11201233 DOI: 10.3390/bs14060501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 06/27/2024] Open
Abstract
Theory-based HIV prevention programs have resulted in increased condom use, which remains the best method for the prevention of sexually transmitted infections (STIs) among sexually active heterosexual individuals. Particularly, the integrative model of behavior prediction theorizes that attitudes, norms, self-efficacy, and socioenvironmental factors influence intention and behavior and has been useful in understanding STI risk among adolescents. However, more research is needed regarding young African American adults. Given the increased freedom and decision-making independence afforded to young adults compared to adolescents, it is important to consider the STI/human immunodeficiency virus (HIV) prevention messages that would resonate with them, particularly regarding condom use. The present study sought to explore how attitudes, subjective norms, self-efficacies, and socioenvironmental factors may influence condom use and STI/HIV prevention, as conceptualized by the participants. We conducted a group-based concept map, a systems-thinking mixed methodology that resulted in a geospatial map reflecting the conceptualizations of the participants. Self-identified young heterosexual African American adults (N = 43) aged 20-26 engaged in an interactive concept mapping procedure in order to "map out" their overarching concepts about STI/HIV risk and condom use. Seven overall conceptual domains emerged: self-efficacy for partner communication, condom use self-efficacy, social media/sociocultural influences, condom use/STI knowledge, condom use cons, condom use pros, and subjective and social norms about condom use. We presented the concept map and discussed the conceptual interpretations and the relationships among the overarching concepts. We also discussed how the social environment, including the social media environment, was conceptualized regarding STI/HIV risk and prevention among young African American adults. Concept mapping can be viewed as a way to determine worthwhile messages for intervention development. The findings may provide information for prevention programs aimed at reducing the incidence of STIs among young adult heterosexual persons within African American communities.
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Affiliation(s)
- Chakema Carmack
- Psychological Health and Learning Sciences Department, University of Houston, Houston, TX 77204, USA; (E.A.); (T.C.)
- Health Research Institute—Research Center in Minority Institution (HRI-RCMI), University of Houston, Houston, TX 77204, USA
- Center for Health Equity and Evaluation Research (CHEER), Texas A&M University, College Station, TX 77843, USA
| | - Sarah Nganga
- Legacy Community Health, Houston, TX 77009, USA;
| | - Eisha Ahmed
- Psychological Health and Learning Sciences Department, University of Houston, Houston, TX 77204, USA; (E.A.); (T.C.)
| | - Taylor Coleman
- Psychological Health and Learning Sciences Department, University of Houston, Houston, TX 77204, USA; (E.A.); (T.C.)
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Wood SM, Bauermeister J, Fiks AG, Phillips AW, Richardson HM, Garcia SM, Maleki P, Beidas RS, Young JF, Gross R, Dowshen N. Adolescent Preferences for a Pediatric Primary Care-based Sexually Transmitted Infection and HIV Prevention Intervention. J Adolesc Health 2024; 74:1231-1238. [PMID: 38520429 PMCID: PMC11102325 DOI: 10.1016/j.jadohealth.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/16/2023] [Accepted: 01/22/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE We sought to elicit perspectives on HIV and sexually transmitted infection (STI) prevention among adolescents with recent STIs in primary care to optimize acceptability and effectiveness in designing a novel HIV/STI prevention intervention. METHODS We enrolled 13-19 year-olds with recent gonorrhea, chlamydia, trichomonas, and/or syphilis in a multimethods cross-sectional study at two primary care clinics. Participants completed surveys and interviews. We used an integrated analytic approach deductively coding data using the Integrated Behavioral Model, then inductively coding to identify themes not represented in the Integrated Behavioral Model. RESULTS Participants (n = 35) were 85% cisgender female, 14% cisgender male, 1% transgender female; 25% identified as lesbian, bisexual, or queer. Most (97%) identified as non-Latinx Black. None used condoms consistently, 26% were aware of pre-exposure prophylaxis (PrEP), and 31% were never HIV tested. Five key themes emerged. 1) Mental health was central to HIV prevention behavior uptake and coping with STI diagnosis. 2) Youth desired prevention counseling that allowed decisional autonomy and individualized goal setting. 3) Negative social norms around condoms and absent norms around HIV testing and PrEP limited method uptake. 4) Both confidence and concrete skills were needed to initiate prevention methods. 5) Youth desired education at the time of STI diagnosis to improve subsequent prevention decision making. DISCUSSION Key intervention design considerations included 1) integrating mental health assessment and referral to services, 2) promoting individualized goal setting, 4) building communication skills, 4) providing navigation and material support for PrEP uptake and HIV testing, and 5) augmenting comprehensive STI and HIV prevention education.
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Affiliation(s)
- Sarah M Wood
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - José Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Alexander G Fiks
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexis W Phillips
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Haley M Richardson
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephanie M Garcia
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Pegah Maleki
- Division of Hematology and Oncology, Department of Medicine, University Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Rinad S Beidas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Robert Gross
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nadia Dowshen
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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O'Leary A, Willis LA, Henny KD, Madden M, Koenig LJ. Development of a Video-Delivered Serial Drama Designed to Reduce Community Homophobia and HIV Stigma, Decrease Sexual Risk Behavior, and Increase HIV Testing Among Black Youth. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:439-451. [PMID: 38096457 PMCID: PMC10877481 DOI: 10.1521/aeap.2023.35.6.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior.
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Affiliation(s)
| | - Leigh A Willis
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kirk D Henny
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Neelan T, Knab J, Forrester EJ, Chesnut K, Kelly K, Zief S. The Impact of Brief Interventions With Condom Demonstrations on Youth: A Systematic Review. J Adolesc Health 2023; 73:801-812. [PMID: 37610388 DOI: 10.1016/j.jadohealth.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/23/2023] [Accepted: 06/21/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE This review examined whether there is evidence that brief interventions with condom demonstration lessons have impacts on behavioral and nonbehavioral outcomes for youth and young adults. METHODS We conducted a systematic review using a prespecified search strategy and processes consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified a pool of 11 eligible studies that tested the effectiveness of a single-session intervention that was no longer than 60 minutes and included a condom demonstration. We included all outcomes at all time points and organized them into eight domains. RESULTS Single-session interventions with condom demonstrations showed favorable short-term and long-term impacts for samples of largely sexually active youth. Studies found statistically significant impacts in 29%-50% of the tests for effects on attitudes toward condoms, knowledge of sexual health and condom use, perceptions of condom use and sexuality, and condoms use intentions. DISCUSSION Our review found evidence that brief interventions with condom demonstrations have potential effects on behavioral and nonbehavioral outcomes for vulnerable and transient sexually active youth warranting future studies to assess condom demonstrations in isolation.
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Affiliation(s)
- Theresa Neelan
- Mathematica Policy Research, Inc, Princeton, New Jersey.
| | - Jean Knab
- Mathematica Policy Research, Inc, Princeton, New Jersey
| | | | | | - Kevin Kelly
- Mathematica Policy Research, Inc, Princeton, New Jersey
| | - Susan Zief
- Mathematica Policy Research, Inc, Princeton, New Jersey
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Denney MR, Pichon LC, Brantley ML. Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee. Am J Mens Health 2023; 17:15579883231163727. [PMID: 36992529 PMCID: PMC10064477 DOI: 10.1177/15579883231163727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States. Understanding how these relationships interact is critical to designing effective HIV programs. We examined associations between MSM-related discrimination, MSM-related violence, and severe PD with HIV status among 2017 National HIV Behavioral Surveillance study participants in Memphis, Tennessee. Eligible participants were aged ≥18 years, born and identified as male, and reported having sex with another man in their lifetime. Participants completed a Centers for Disease Control and Prevention-designed anonymous survey and self-reported discrimination and violence across their lifetime, and PD symptoms within the past month, scored on the Kessler-6 Scale. Optional HIV rapid tests were performed on-site. Logistic regressions examined the associations between the exposure variables and HIV antibody-positive results. Among 356 respondents, 66.9% were aged <35 years and 79.5% identified as non-Hispanic Black; 13.2% reported experiencing violence, 47.8% reported discrimination, and 10.7% experienced PD. Of the 297 participants who tested, 33.33% were living with HIV. Discrimination, violence, and PD were significantly associated with each other (p < .0001). HIV antibody-positive test results were associated with violence (p < .01). Memphis-based MSM face a complex array of social experiences, which may increase vulnerability to HIV. On-site testing at community-based organizations and clinical settings among MSM may be an opportunity to screen for violence and incorporate strategies when designing HIV programs.
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Affiliation(s)
- Meredith R. Denney
- School of Medicine, Vanderbilt University, Nashville, TN, USA
- HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | | | - Meredith L. Brantley
- HIV/STI/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
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Onaisi R, Joseph JP, Castera P, Pontgratz C. Sexual risk behaviour reduction interventions in primary care in Organization of Economic Cooperation and Development countries. A systematic review. Fam Pract 2022; 39:762-770. [PMID: 34668006 DOI: 10.1093/fampra/cmab131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sexually transmitted infections are a major public health issue, both in France and worldwide. Primary healthcare professionals play a key role in sexual health and prevention, but few take on this subject. Prevention strategies are diverse, thus risk reduction strategies focussing on behavioural changes are still needed. PURPOSE We conducted a systematic review to analyse risk reduction interventions focussing on behavioural change in OECD countries in primary healthcare settings to help develop a prevention tool easy to apply in primary care. METHODS We searched for English- or French-language controlled trials in PubMed, Cochrane Library, Scopus, PsycINFO, PsycArticle, PBSC, SocINDEX, Google Scholar, and CAIRN, supplemented with the bibliographies of previous systematic reviews. Thirty controlled, randomized, or nonrandomized trials were included in the systematic review. We did not conduct any meta-analysis due to the diversity of populations, outcomes and study designs. RESULTS There are efficient interventions in primary healthcare settings for reducing sexual risk behaviours and/or incident STI. Their efficiency seems to grow with the length and intensity of the intervention. Most interventions target only young, high-risk patients, and their long-term impact is uncertain. Most included studies had an overall risk of bias estimated as high or with some concerns. CONCLUSIONS Some tools could be used in primary care, with possible efficiency though results are difficult to generalize, and value should be assessed in daily practice. Future research should also focus on older population given the epidemiological evolutions, but also lower-risk population to target all patients seen in primary care settings.
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Affiliation(s)
- Racha Onaisi
- Department of General Practice, University of Bordeaux, Bordeaux, France
| | - Jean-Philippe Joseph
- Department of General Practice, University of Bordeaux, Bordeaux, France.,CIC 1401-EC (Clinical Epidemiology), Bordeaux, France.,Inserm U1219, Univ. Bordeaux, Bordeaux, France
| | - Philippe Castera
- Department of General Practice, University of Bordeaux, Bordeaux, France
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Zaneva M, Philpott A, Singh A, Larsson G, Gonsalves L. What is the added value of incorporating pleasure in sexual health interventions? A systematic review and meta-analysis. PLoS One 2022; 17:e0261034. [PMID: 35148319 PMCID: PMC8836333 DOI: 10.1371/journal.pone.0261034] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/21/2021] [Indexed: 01/14/2023] Open
Abstract
Despite billions of dollars invested into Sexual and Reproductive Health and Rights (SRHR) efforts, the effect of incorporating sexual pleasure, a key driver of why people have sex, in sexual health interventions is currently unclear. We carried out a systematic review and meta-analysis following PRISMA guidelines across 7 databases for relevant articles published between 1 January 2005-1 June, 2020. We included 33 unique interventions in our systematic review. Eight interventions reporting condom use outcomes were meta-analyzed together with a method random effects model. Quality appraisal was carried out through the Cochrane Collaborations' RoB2 tool. This study was pre-registered on Prospero (ID: CRD42020201822). We identified 33 unique interventions (18886 participants at baseline) that incorporate pleasure. All included interventions targeted HIV/STI risk reduction, none occurred in the context of pregnancy prevention or family planning. We find that the majority of interventions targeted populations that authors classified as high-risk. We were able to meta-analyze 8 studies (6634 participants at baseline) reporting condom use as an outcome and found an overall moderate, positive, and significant effect of Cohen's d = 0·37 (95% CI 0·20-0·54, p < 0·001; I2 = 48%; τ2 = 0·043, p = 0·06). Incorporating sexual pleasure within SRHR interventions can improve sexual health outcomes. Our meta-analysis provides evidence about the positive impact of pleasure-incorporating interventions on condom use which has direct implications for reductions in HIV and STIs. Qualitatively, we find evidence that pleasure can have positive effects across different informational and knowledge-based attitudes as well. Future work is needed to further elucidate the impacts of pleasure within SRHR and across different outcomes and populations. Taking all the available evidence into account, we recommend that agencies responsible for sexual and reproductive health consider incorporating sexual pleasure considerations within their programming.
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Affiliation(s)
| | | | | | | | - Lianne Gonsalves
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Brown SA, Turner RE, Christensen C. Linking Families and Teens: Randomized Controlled Trial Study of a Family Communication and Sexual Health Education Program for Rural Youth and Their Parents. J Adolesc Health 2021; 69:398-405. [PMID: 34452729 DOI: 10.1016/j.jadohealth.2021.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study describes the results of an impact evaluation of the Linking Families and Teens (LiFT) program, a 5-hour program for families in rural communities. LiFT's goal is to reduce unplanned teen pregnancies by increasing family connectedness and youth's self-efficacy, knowledge, and sexual health skills. METHODS LiFT was externally evaluated using a cluster randomized controlled trial. Families, consisting of one or more dyads of high school aged youth and their parenting adults, were randomly assigned to a study condition. The program was implemented 57 times in rural communities in 9 states. The analytic sample includes 786 youth (407 program and 379 control) with baseline, 3-month, and 12-month data. The analysis used an intent-to-treat framework using ordinary least squares regression to measure effects on each outcome. RESULTS Fewer LiFT participants experienced a pregnancy than control youth, which was significant at 3 months (net of baseline, 0 program vs. 4 control) and marginally significant at 12 months (net of baseline, 6 program vs. 14 control.) At both follow-up periods, the program had statistically significant effects on youth's frequency of communication with their parenting adults about sexuality and pregnancy prevention and on their perceived competence to prevent pregnancy. CONCLUSIONS LiFT achieved lasting effects on increasing parent-child communication and youth self-efficacy to prevent unwanted pregnancies a full year following the brief, family-focused workshop. LiFT's impact on pregnancy was significant at 3 months and trended in the right direction at 12 months. A larger experimental study of this promising program is warranted to show the long-term effect on pregnancy.
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Nwaosu U, Raymond-Williams R, Meyrick J. Are psychosocial interventions effective at increasing condom use among Black men? A systematic review. Int J STD AIDS 2021; 32:1088-1105. [PMID: 34144658 PMCID: PMC8593286 DOI: 10.1177/09564624211024785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Black men experience a disproportionate burden of sexually transmitted infections (STIs) in the United Kingdom (UK). STIs can seriously affect the health and well-being of affected individuals. With condoms effective at preventing STI transmission, this review aims to explore the evidence of effectiveness of psychosocial interventions at increasing condom use among Black men to inform UK-based interventions for this at-risk but unheard population. Nine databases were searched for qualifying studies. Two reviewers independently assessed the quality of studies. A narrative synthesis read across the heterogeneous studies for evidence of effectiveness. A total of 17 studies met the inclusion criteria. This review identified scientifically weak evidence of effectiveness in multifaceted psychosocial interventions to increase condom use among Black men, particularly men who have sex with women and men who have sex with men mainly from United States settings. The multifaceted nature of interventions provides obscure evidence on successful elements of interventions with positive effects. Despite the disproportionate STI burden among this group, no UK-based studies were identified. Future research should aim to better understand condom use behavioural experiences and motivators of condom use among UK Black men to inform ethnically culturally relevant and tailored interventions.
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Affiliation(s)
- Uzochi Nwaosu
- Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Jane Meyrick
- Health and Applied Sciences, University of the West of England, Bristol, UK
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Henderson JT, Senger CA, Henninger M, Bean SI, Redmond N, O'Connor EA. Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2020; 324:682-699. [PMID: 32809007 DOI: 10.1001/jama.2020.10371] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Increasing rates of preventable sexually transmitted infections (STIs) in the US pose substantial burdens to health and well-being. OBJECTIVE To update evidence for the US Preventive Services Task Force (USPSTF) on effectiveness of behavioral counseling interventions for preventing STIs. DATA SOURCES Studies from the previous USPSTF review (2014); literature published January 2013 through May 31, 2019, in MEDLINE, PubMed (for publisher-supplied records only), PsycINFO, and Cochrane Central Register of Controlled Trials. Ongoing surveillance through May 22, 2020. STUDY SELECTION Good- and fair-quality randomized and nonrandomized controlled intervention studies of behavioral counseling interventions for adolescents and adults conducted in primary care settings were included. Studies with active comparators only or limited to individuals requiring specialist care for STI risk-related comorbidities were excluded. DATA EXTRACTION AND SYNTHESIS Dual risk of bias assessment, with inconsistent ratings adjudicated by a third team member. Study data were abstracted into prespecified forms. Pooled odds ratios (ORs) were estimated using the DerSimonian and Laird method or the restricted maximum likelihood method with Knapp-Hartung adjustment. MAIN OUTCOMES AND MEASURES Differences in STI diagnoses, self-reported condom use, and self-reported unprotected sex at 3 months or more after baseline. RESULTS The review included 37 randomized trials and 2 nonrandomized controlled intervention studies (N = 65 888; 13 good-quality, 26 fair-quality) recruited from primary care settings in the US. Study populations were composed predominantly of heterosexual adolescents and young adults (12 to 25 years), females, and racial and ethnic minorities at increased risk for STIs. Nineteen trials (n = 52 072) reported STI diagnoses as outcomes (3 to 17 months' follow-up); intervention was associated with reduced STI incidence (OR, 0.66 [95% CI, 0.54-0.81; I2 = 74%]). Absolute differences in STI acquisition between groups varied widely depending on baseline population STI risk and intervention effectiveness, ranging from 19% fewer to 4% more people acquiring STI. Thirty-four trials (n = 21 417) reported behavioral change outcomes. Interventions were associated with self-reported behavioral change (eg, increased condom use) that reduce STI risk (OR, 1.31 [95% CI, 1.10-1.56; I2 = 40%, n = 5253). There was limited evidence on persistence of intervention effects beyond 1 year. No harms were identified in 7 studies (n = 3458) reporting adverse outcomes. CONCLUSIONS AND RELEVANCE Behavioral counseling interventions for individuals seeking primary health care were associated with reduced incidence of STIs. Group or individual counseling sessions lasting more than 2 hours were associated with larger reductions in STI incidence, and interventions of shorter duration also were associated with STI prevention, although evidence was limited on whether the STI reductions associated with these interventions persisted beyond 1 year.
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Affiliation(s)
- Jillian T Henderson
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Caitlyn A Senger
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Michelle Henninger
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Sarah I Bean
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth A O'Connor
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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Jabr AM, Di Stefano M, Greco P, Santantonio T, Fiore JR. Errors in Condom Use in the Setting of HIV Transmission: A Systematic Review. Open AIDS J 2020. [DOI: 10.2174/1874613602014010016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The efficacy of condom use in declining HIV transmission may be compromised by their incorrect usage. Much focus has been paid on the regularity of condom usage but consumer mistakes and challenges must be considered. Breakage, slipping, leakage, incomplete use and other problems during the sexual event may compromise the protective role of the condom.
Objective:
To evaluate through a systematic review of published data, the type, and incidence of error and problems in condom use, and their possible role in reducing the preventive action of condoms.
Methods:
A systematic literature search for peer-reviewed articles published between January 2000 and January 2019, issued in English in peer-reviewed journals, and reporting the occurrence of condom errors/problems among HIV high-risk populations.
Results:
Twenty studies representing nine countries met the inclusion criteria. The most predominant mistakes associated with condom use included condom breakage, slippage, delayed condom application, early removal, issues related to erection loss and difficulties with fit and feel were reported, failure to squeeze out air, use of expired condoms, reuse of condom, and wearing the condom outside out were other issues noticed.
Conclusions:
Condom use problems and mistakes are prevalent across the globe. Educational efforts are needed to empower HIV the at-risk population with confidence and knowledge to improve correct condom use and increase preventive activity
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Stagg DL, McCarthy J. Service learning: A method of instruction for community health content in nursing curriculums. TEACHING AND LEARNING IN NURSING 2020. [DOI: 10.1016/j.teln.2019.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lachowsky NJ, Fulcher K, Lal A, Crosby R. Adaptation, feasibility and performance of a brief clinic-based intervention to improve prevention practices among sexual minority men. CANADIAN JOURNAL OF HUMAN SEXUALITY 2019. [DOI: 10.3138/cjhs.2018-0043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Nathan J. Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, BC
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Karyn Fulcher
- School of Public Health and Social Policy, University of Victoria, Victoria, BC
| | - Allan Lal
- School of Public Health and Social Policy, University of Victoria, Victoria, BC
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
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Anstee S, Shepherd J, Graham CA, Stone N, Brown K, Newby K, Ingham R. Evidence for behavioural interventions addressing condom use fit and feel issues to improve condom use: a systematic review. Sex Health 2019; 16:539-547. [PMID: 31665616 DOI: 10.1071/sh19001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022]
Abstract
Continuing high rates of sexually transmissible infections (STIs) in many countries highlight the need to identify effective behavioural interventions. Consistent and correct use of male condoms is a key strategy for the prevention of STIs. However, some men report problems with condom fit (e.g. the size and shape of the condom) and feel (e.g. tightness, irritation, sensitivity), which inhibits their use. We conducted a systematic review to identify existing interventions addressing condom use fit and feel problems. We searched electronic databases for peer-reviewed articles and searched reference lists of retrieved studies. Five studies met the inclusion criteria. These were generally small-scale pilot studies evaluating behavioural interventions to promote safer sex with men aged under 30 years, addressing, among other things, barriers to condom use relating to fit and feel. There were significant increases in the reported use of condoms, including condom use with no errors and problems. Improvements in some condom use mediators were reported, such as condom use self-efficacy, knowledge, intentions and condom use experience. There were mixed findings in terms of the ability of interventions to reduce STI acquisition. Behavioural interventions addressing condom fit and feel are promising in terms of effectiveness but require further evaluation.
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Affiliation(s)
- Sydney Anstee
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Alpha House, Wessex Institute, Enterprise Road, University of Southampton Science Park, Southampton, Hampshire SO16 7NS, UK
| | - Cynthia A Graham
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK; and Corresponding author.
| | - Nicole Stone
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK
| | - Katherine Brown
- Centre for Advances in Behavioural Science, Faculty of Health and Life Sciences, Richard Crossman Building (4th Floor), Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Katie Newby
- Centre for Advances in Behavioural Science, Faculty of Health and Life Sciences, Richard Crossman Building (4th Floor), Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Roger Ingham
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK
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Crosby RA. Dealing with pre-exposure prophylaxis-associated condom migration: changing the paradigm for men who have sex with men. Sex Health 2019; 14:106-110. [PMID: 27585107 DOI: 10.1071/sh16128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 07/29/2016] [Indexed: 11/23/2022]
Abstract
The behavioural aspects of pre-exposure prophylaxis (PrEP) are challenging, particularly the issue of condom migration. Three vital questions are: (1) at the population-level, will condom migration lead to increases in non-viral sexually transmissible infections?; (2) how can clinic-based counselling best promote the dual use of condoms and PrEP?; and (3) in future PrEP trials, what are the 'best practices' that should be used to avoid type 1 and type 2 errors that arise without accounting for condom use behaviours? This communication piece addresses each question and suggests the risk of a 'PrEP only' focus to widening health disparities.
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Affiliation(s)
- Richard A Crosby
- College of Public Health at the University of Kentucky, 151 Washington Avenue, Lexington, KY 40506-0003, USA
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Efficacy of a Clinic-Based Safer Sex Program for Human Immunodeficiency Virus-Uninfected and Human Immunodeficiency Virus-Infected Young Black Men Who Have Sex With Men: A Randomized Controlled Trial. Sex Transm Dis 2019; 45:169-176. [PMID: 29419709 DOI: 10.1097/olq.0000000000000721] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM). METHODS Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data. RESULTS Compared with the reference group, human immunodeficiency virus (HIV)-infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23-2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74-2.63, P < 0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed. CONCLUSIONS A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.
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Thato R, Daengsaard E, Sukrak N. The Effect of a Brief HIV Prevention Program on Risk Reduction Behaviors Among Thai Men Diagnosed With Sexually Transmitted Infections. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 12:265-272. [PMID: 30342223 DOI: 10.1016/j.anr.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Men diagnosed with sexually transmitted infections (STIs) are at greater risk for Human Immunodeficiency Virus (HIV) infection and STIs reinfection. This study aimed to test the effectiveness of a brief human immunodeficiency virus (B-HIV) prevention program on HIV and sexually transmitted infection (STI) knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors, and reinfection rate among Thai men with STIs. METHODS A quasi-experimental design was conducted. Participants were selected from men with STI symptoms. They were randomly assigned to a B-HIV prevention program or usual care, 100 each. The program consisted of 3 modules. Key messages for HIV prevention were sent weekly through Line. Outcomes were HIV and STI knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors (condom use, the number of sexual partners, and condomless sex), and STI reinfection rate. Independent t-test and binary logistic regression were performed. RESULTS The B-HIV prevention program significantly increased HIV and STI knowledge and resulted in perception of greater benefits from condoms and greater risk reduction self-efficacy. Program participants used condoms more frequently with many types of partners, especially with casual partners and sex workers. The intervention group practiced condomless sex less frequently than the control group. The program did not improve participants' condom use with lovers/steady partners and did not decrease the number of sexual partners and STI reinfection rate at 3-month follow-up. CONCLUSIONS A B-HIV prevention program could reduce the risk of HIV infection among male clients with current STIs by enhancing their condom use with casual partners and sex workers. Strategies to improve condom use with lovers/steady partners among this high-risk population is needed.
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Affiliation(s)
- Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand.
| | - Ekkachai Daengsaard
- General Male Clinic, Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Bangkok, Thailand
| | - Nutthavit Sukrak
- General Male Clinic, Bangrak STIs Cluster, Bureau of AIDS, TB, and STIs, Ministry of Public Health, Bangkok, Thailand
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De Vasconcelos S, Toskin I, Cooper B, Chollier M, Stephenson R, Blondeel K, Troussier T, Kiarie J. Behaviour change techniques in brief interventions to prevent HIV, STI and unintended pregnancies: A systematic review. PLoS One 2018; 13:e0204088. [PMID: 30260991 PMCID: PMC6159869 DOI: 10.1371/journal.pone.0204088] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 09/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Behaviour-change interventions have been consistently considered an essential part of comprehensive HIV, STI and unintended pregnancy prevention. In 2015, the World Health Organization reviewed and assessed existing evidence on brief behavioural interventions, leading to the publication of Brief sexuality-related communication: recommendations for a public health approach. This guideline recommends the use of brief behaviour intervention and communication programmes to promote sexual health and to prevent HIV, STIs, and unintended pregnancies in primary health services, particularly sexual and reproductive health services. OBJECTIVE With the purpose of informing the development of a brief behaviour intervention in sexual and reproductive health, we conducted a systematic review of brief intervention to prevent HIV, STI and unintended pregnancies, to identify behaviour change techniques (BCTs) used in health care settings. METHODS Participants from all ages and genders were included. Brief interventions delivered in ≤ 60 minutes were included. Data was extracted, and interventions were coded following the Behaviour Change Techniques Taxonomy (BCTTv1) guidelines. RESULTS Of the 6.687 articles identified, 355 were reviewed and 37 studies were included. In effective interventions, we identified 48 behaviour change techniques (BCTs). A core set of 8 frequently used behaviour change techniques was identified: "Problem solving", "Feedback on behaviour", "Social support (unspecified)", "Instructions on how to perform the behaviour", "Information about health consequences", "Information about social and environmental consequences", "Demonstration of the behaviour" and "Credible source". CONCLUSIONS The technical content of brief behaviour interventions was identified in a reliable and standardized way providing preliminary indications on potentially effective techniques to achieve behaviour change.
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Affiliation(s)
- Sofia De Vasconcelos
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Igor Toskin
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Bergen Cooper
- Center for Health and Gender Equity (CHANGE), Washington, D.C., United States of America
| | - Marie Chollier
- UNESCO Chair for Sexual Health and Human Rights (UCSHHR), Paris, France
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Rob Stephenson
- School of Nursing and the Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Karel Blondeel
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Thierry Troussier
- UNESCO Chair for Sexual Health and Human Rights (UCSHHR), Paris, France
| | - James Kiarie
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Crosby RA, Mena L, Smith RV. Promoting positive condom use experiences among young black MSM: a randomized controlled trial of a brief, clinic-based intervention. HEALTH EDUCATION RESEARCH 2018; 33:197-204. [PMID: 29534210 PMCID: PMC5961371 DOI: 10.1093/her/cyy010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/22/2018] [Indexed: 06/14/2023]
Abstract
The aim of this study is to determine, among young Black men who have sex with men (YBMSM), the 12-month efficacy of a single-session, clinic-based intervention promoting condom use to enhance sexual pleasure (purpose 1) and the use of condoms from the start-to-finish of anal sex (purpose 2). A pre-test, post-test randomized controlled trial was conducted, using a 12-month period of follow-up observation, in STI clinics. Data from 394 YBMSM completing baseline and 12-month follow-up assessments were analyzed. The experimental condition comprised a one-to-one, interactive program (Focus on the Future) designed for tailored delivery. Regarding study purpose 1, in an age-adjusted linear regression model for 277 HIV-uninfected men, there was a significant effect of the intervention (Beta=0.13, P =0.036) relative to more favorable sexual experiences when using condoms. Regarding study purpose 2, in an adjusted logistic regression model, for HIV-uninfected men, there was a significant effect of the intervention (AOR=0.54, P =0.048) relative to using condoms from start-to-finish of anal sex. Significant effects for HIV-infected men were not observed. A small, but non-significant, effect was observed relative to men's self-report of always using condoms. This single-session program may be a valuable counseling tool for use in conjunction with pre-exposure prophylaxis-related care for HIV-uninfected YBMSM.
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Affiliation(s)
- Richard A Crosby
- Department of Health Behavior, College of Public Health, University of Kentucky, 111 Washington Ave., Lexington, KY 40506-0003, USA
- Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN 47405, USA
- Division of Infectious Disease, University of Mississippi Medical Center, Jackson, MS, USA
| | - Leandro Mena
- Division of Infectious Disease, University of Mississippi Medical Center, Jackson, MS, USA
| | - Rachel Vickers Smith
- Department of Health Behavior, College of Public Health, University of Kentucky, 111 Washington Ave., Lexington, KY 40506-0003, USA
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Ng JYS, Chan RKW, Chio MTW, Lim RBT, Koh D, Wong ML. An Abstinence and Safer Sex Intervention for Adolescents Attending the Public Sexually Transmitted Infection Clinic in Singapore. J Adolesc Health 2018; 62:737-746. [PMID: 29661642 DOI: 10.1016/j.jadohealth.2017.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/20/2017] [Accepted: 12/27/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE The objective of this study was to evaluate the efficacy of a behavioral intervention in increasing secondary abstinence and safer sex among heterosexually active adolescents aged 16-19 years. METHODS This was a randomized controlled trial conducted at the only national sexually transmitted infection clinic in Singapore. The intervention focused on information giving, motivation, and skills building to abstain or practice safer sex. The outcome measures were self-reported secondary abstinence, consistent condom use, and keeping to one partner in the past 6 months over a 12-month period. We recruited 688 adolescents, with 337 participants receiving intervention and 351 receiving standard care (control). RESULTS At the 12-month follow-up, 187 (56%) intervention participants and 189 (54%) control participants were retained. Over the 12-month period, the intervention had a significant effect on secondary abstinence in adolescent boys (42% vs. 27%, adjusted risk ratio [aRR] 1.80, 95% confidence interval [CI] 1.29-2.34) but not in adolescent girls (21% vs. 24%, aRR 1.10, 95% CI .68-1.66). Consistent condom use was higher among intervention adolescent girls than control adolescent girls (40% vs. 20%, aRR 2.01, 95% CI 1.32-2.82), but this effect was not evident in adolescent boys (51% vs. 43%, aRR 1.27, 95% CI .78-1.88). Intervention effect on keeping to one partner was evident in both adolescent boys (76% vs. 45%, aRR 1.35, 95% CI 1.06-1.50) and adolescent girls (79% vs. 65%, aRR 1.20, 95% CI 1.02-1.23). CONCLUSIONS An intervention targeting adolescents in a clinical care setting did achieve an increase in secondary abstinence in adolescent boys, consistent condom use in adolescent girls, and keeping to one partner in both genders at 1-year assessment.
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Affiliation(s)
- Junice Yi Siu Ng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Roy Kum Wah Chan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Department of STI Control, National Skin Centre, Ministry of Health, Singapore
| | - Martin Tze-Wei Chio
- Department of STI Control, National Skin Centre, Ministry of Health, Singapore
| | - Raymond Boon Tar Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - David Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; PAPRSB Institute of Health Sciences, University Brunei Darussalam, Brunei
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Boman J, Lindqvist H, Forsberg L, Janlert U, Granåsen G, Nylander E. Brief manual-based single-session Motivational Interviewing for reducing high-risk sexual behaviour in women - an evaluation. Int J STD AIDS 2017; 29:396-403. [PMID: 28920542 DOI: 10.1177/0956462417729308] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to develop and evaluate brief Motivational Interviewing (MI) to facilitate behaviour change in women at high risk of contracting sexually transmitted infections (STIs). One hundred and seventy-three women (mean age 24.7) at high risk of contracting STIs were randomized to a brief risk-reducing MI counselling intervention (n = 74) or assigned to the control group (n = 99). MI skill was assessed using the Motivational Interviewing Treatment Integrity (MITI) Coding System. Seventeen of 74 (23%) women tested for Chlamydia trachomatis (CT) in the MI intervention group and 22 of 99 (22%) in the control group had a genital CT infection 0-24 months before baseline. All additional CT testing was monitored up to 24 months for all 173 women in the study. None of the 49 CT-retested women in the MI group was CT infected, as compared to 3 of 72 (4%) women in the control group. A generalized estimating equations model with sexual high-risk behaviour measured at baseline and at six-month follow-up produced an adjusted estimated odds ratio of 0.38 (95% confidence interval = 0.158, 0.909), indicating efficacy. Brief manual-based single-session MI counselling seems to be effective in reducing high-risk sexual behaviour in women at high risk of acquiring STIs.
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Affiliation(s)
- Jens Boman
- 1 Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Helena Lindqvist
- 2 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Urban Janlert
- 4 Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Gabriel Granåsen
- 4 Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- 1 Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
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Correlates of Enhanced Sexual Pleasure from Condom Use: A Study of Young Black Men Who Have Sex with Men in the United States. AIDS Behav 2017; 21:1491-1496. [PMID: 27683086 DOI: 10.1007/s10461-016-1564-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study of young Black MSM (YBMSM) explored the correlates and outcomes of enhanced sexual pleasure from condom-protected sex. Six-hundred YBMSM were enrolled from an sexually transmitted infection clinic in the southern United States. Men completed a computer-assisted self-interview. A 3-item scale assessed perceptions related to condoms enhancing sexual pleasure. Nine of 14 correlates met the screening level of significance and were tested in a regression model. Three obtained multivariable significance: (1) Men discussing condom use with sex partners had greater odds (AOR = 1.67, 95 % CI 1.20-2.34) of experiencing enhanced pleasure; (2) Insertive-partners had lower odds (AOR = 0.63, 95 % CI 0.44-0.91) of experiencing enhanced pleasure; and (3) men scoring higher in internalized homophobia had lower odds (AOR = 0.66, 95 % CI 0.47-0.93) of experiencing enhanced pleasure. Also, men experiencing enhanced pleasure were less likely to report any condomless anal sex. The experience of enhanced sexual pleasure during condom-protected sex may be an important "target" of behavioral intervention efforts.
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Jones J, Salazar LF, Crosby R. Contextual Factors and Sexual Risk Behaviors Among Young, Black Men. Am J Mens Health 2017; 11:508-517. [PMID: 26614447 PMCID: PMC5675245 DOI: 10.1177/1557988315617525] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial ( N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes ( p < .05). Parental monitoring was an effect modifier for the perceived peer norms and lifetime sexual partners association ( p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.
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24
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Condom Breakage Among Young Black Men Who Have Sex With Men: An In-Depth Investigation Including Men Living With HIV/AIDS. Sex Transm Dis 2016; 43:84-6. [PMID: 26760179 DOI: 10.1097/olq.0000000000000401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Correlates of condom breakage (reported by 19% of 398 young black who have sex with men) for anal insertive sex included the following: condoms drying out (P = 0.018), erection loss during application (P = 0.03), and using erection-enhancing drugs (P = 0.003). Breakage was 2.7 times greater for HIV-positive men (P = 0.001). Breakage was associated with testing positive for urethral infections (P = 0.012).
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25
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Measures of Attitudes Toward and Communication about Condom Use: Their Relationships With Sexual Risk Behavior Among Young Black Men Who Have Sex With Men. Sex Transm Dis 2016; 43:94-8. [PMID: 26766525 DOI: 10.1097/olq.0000000000000392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to construct and test measures of psychosocial mediators that could be used in intervention studies seeking to promote safer sex behavior among young black men who have sex with men (YBMSM). METHODS A total of 400 YBMSM, ages 18 to 29 years, were recruited from a clinic for sexually transmitted infection in the southern United States. All men had engaged in penile-anal sex with a man as a "top" in the past 6 months. The men completed an audio-computer-assisted self-interview and provided specimens used for nucleic acid amplification testing to detect Chlamydia and gonorrhea. Four measures were constructed and tested for criterion validity (Safer Sex Communication, Condom Turn-Offs, Condom Pleasure Scale, and a single item assessing frequency of condom use discussions before sexual arousal). RESULTS With the exception of Safer Sex Communication, all of the measures showed criterion validity for both unprotected anal insertive and unprotected anal receptive sex. With the exception of the Condom Turn-Offs, the 3 other measures were supported by criterion validity for oral sex. Both the Condom Turn-Offs and Condom Pleasure Scale were significantly related to whether or not the men reported multiple partners as a top, but only the Condom Pleasure Scale was associated with reports of multiple partners as a "bottom." Only the Condom Turn-Offs Scale was positively associated with having been diagnosed with either Chlamydia or gonorrhea. CONCLUSION Findings provide 3 brief scales and a single item that can be used in intervention studies targeting YBMSM. Perceptions about condoms being a turnoff and about condoms enhancing pleasure showed strong association with sexual risk behaviors.
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Long L, Abraham C, Paquette R, Shahmanesh M, Llewellyn C, Townsend A, Gilson R. Brief interventions to prevent sexually transmitted infections suitable for in-service use: A systematic review. Prev Med 2016; 91:364-382. [PMID: 27373209 DOI: 10.1016/j.ypmed.2016.06.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 05/26/2016] [Accepted: 06/27/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are more common in young people and men who have sex with men (MSM) and effective in-service interventions are needed. METHODS A systematic review of randomized controlled trials (RCTs) of waiting-room-delivered, self-delivered and brief healthcare-provider-delivered interventions designed to reduce STIs, increase use of home-based STI testing, or reduce STI-risk behavior was conducted. Six databases were searched between January 2000 and October 2014. RESULTS 17,916 articles were screened. 23 RCTs of interventions for young people met our inclusion criteria. Significant STI reductions were found in four RCTs of interventions using brief one-to-one counselling (2 RCTs), video (1 RCT) and a STI home-testing kit (1 RCT). Increase in STI test uptake was found in five studies using video (1 RCT), one-to-one counselling (1 RCT), home test kit (2 RCTs) and a web-based intervention (1 RCT). Reduction in STI-risk behavior was found in seven RCTs of interventions using digital online (web-based) and offline (computer software) (3 RCTs), printed materials (1 RCT) and video (3 RCTs). Ten RCTs of interventions for MSM met our inclusion criteria. Three tested for STI reductions but none found significant differences between intervention and control groups. Increased STI test uptake was found in two studies using brief one-to-one counselling (1 RCT) and an online web-based intervention (1 RCT). Reduction in STI-risk behavior was found in six studies using digital online (web-based) interventions (4 RCTs) and brief one-to-one counselling (2 RCTs). CONCLUSION A small number of interventions which could be used, or adapted for use, in sexual health clinics were found to be effective in reducing STIs among young people and in promoting self-reported STI-risk behavior change in MSM.
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Affiliation(s)
- L Long
- Psychology Applied to Health Group, University of Exeter Medical School, University of Exeter, UK
| | - C Abraham
- Psychology Applied to Health Group, University of Exeter Medical School, University of Exeter, UK.
| | - R Paquette
- Research Department of Infection and Population Health, University College London, UK
| | - M Shahmanesh
- Research Department of Infection and Population Health, University College London, UK
| | - C Llewellyn
- Division of Public Health and Primary Care, Brighton and Sussex Medical School, UK
| | - A Townsend
- Psychology Applied to Health Group, University of Exeter Medical School, University of Exeter, UK
| | - R Gilson
- Research Department of Infection and Population Health, University College London, UK
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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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Marcell AV, Gibbs S, Lehmann HP. Brief condom interventions targeting males in clinical settings: a meta-analysis. Contraception 2015; 93:153-63. [PMID: 26410175 DOI: 10.1016/j.contraception.2015.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/30/2015] [Accepted: 09/20/2015] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Arik V Marcell
- Johns Hopkins School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA; Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Susannah Gibbs
- Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Harold P Lehmann
- Johns Hopkins School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA.
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