Errors in Condom Use in the Setting of HIV Transmission: A Systematic Review

Predictors of Condom Use among College Students

Consistent condom use is recognized as one of the most effective strategies to prevent unwanted pregnancies and sexually transmitted infections. Despite their effectiveness, condoms remain fairly well used among younger people. The conception of appropriate measures to change behaviors needs a deep understanding of the factors underlying poor adherence to condom use. This study aims to identify the predictors of condom use among college students. A cross-sectional, correlational, and predictive study was conducted involving a convenience sample of 1946 university students, with an average age of 21 years (20.74 ± 2.32). Pender's Health Promotion Model (HPM) was used as a conceptual and methodological framework to understand the relationship between the predictors of condom use. An explanatory theoretical model of condom use behavior was established using path analysis. Condom use among young people is infrequent, with only 39.4% of respondents reporting consistent use. Perceived benefits, positive feelings, and interpersonal influences emerged as variables with the most explicitly positive influence on the commitment to condom use, a trend confirmed for both sexes. Commitment was the strongest predictor of condom use behavior (β = 0.580; p < 0.001). Pender's HPM is effective in explaining the relationships between the predictors of condom use.

Association of HCV Prior Infection and Unprotected Sex on Subsequent HIV Acquisition Risk in the Era of Treatment as Prevention

Backgrounds

Little was known about the impact of HCV prior infection on HIV transmission and acquisition. We aimed to explore whether HCV prior infection and its interactions with unprotected sex affected HIV acquisition.

Methods

This study was conducted among HIV heterosexual serodiscordant couples whose index cases were receiving treatment during 2008–2014 in Zhumadian. At baseline, we collected information on demographics and medical history of ART use, CD4 count, and HIV viral load for index partners, and also HIV and HCV status for non-index partners. For each year's visit, we followed up on sexual behaviors among couples in the recent year and HIV seroconversion of non-index partners. Analyses of the Cox model and synergistic interaction were performed.

Results

We identified 81 HIV seroconversions over 18,370.39 person-years, with the overall HIV seroconversion rate of 0.44 per 100 person-years. Couples, whose index cases were aged 50 years and above, had a baseline viral load >400 copies per ml and no AIDS-defining illness, and newly-initiated ART in the study period had a higher risk of HIV seroconversion. Unprotected sex and HCV prior infection showed a synergistic association with HIV acquisition risk (RERI = 3.65, SI = 0.48, AP = 2.24).

Conclusion

Unprotected sex and HCV infection were independent risk factors associated with HIV acquisition. The coexistence of them might have a synergistic effect on the risk which needs further research.

Factors Associated With HIV Preventive Behavior Among Adults in Majang Zone of Gambella Region, Southwest Ethiopia

Background

HIV-positive people can spread the virus through unprotected sex; however, HIV can be avoided if populations are educated about the risks. In underdeveloped nations, evidence suggests that the ABC method for HIV prevention is quite effective. As a result, the goal of this study was to determine the magnitude of HIV prevention behavior among adults in the Majang zone of Southwest Ethiopia, as well as the factors that influence it.

Methods

A community-based cross-sectional study was carried out from March 1st to May 31st, 2019. The data were collected through a face-to-face interview using a modified validated questionnaire among systematically selected study participants. The collected data were coded and entered using Epidata manager version 4.0.2.101 and analyzed using SPSS version 21. A logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at a p-value less than 0.05.

Results

Of the 772 adults interviewed, the proportion of adults who had good HIV preventive behavior was 51.8%, 95% CI [48.3–55.3%]. Two hundred forty (31.9%) were used abstinence as a type of HIV preventive behavior followed by being faithful (16.1%) and consistent condom use (7.3%). The study also found that respondents with the age group ≥27 years old (AOR = 1.56, 95% CI [1.3–3.12]), marital status (being married (AOR = 6.30, 95% CI [4.48–11.4]), and divorced/widowed (AOR = 5.50, 95% CI [2.60–12.4]) and having good knowledge of HIV prevention methods (AOR = 2.18, 95% CI [1.71–4.00]) were the factors associated with good HIV preventive behavior.

Conclusion and Recommendation

In the study area, overall HIV prevention behavior was average. The characteristics linked with successful HIV prevention behavior among adults in the Majang community included increasing age, being married or divorced/widowed, and having a solid understanding of HIV prevention approaches. As a result, policy-level and multi-sectorial intervention approaches from all stakeholders are necessary to develop short- and long-term strategies to address the problem and improve the community’s quality of life.