Condom application skills and self-efficacy in youth: A systematic review and meta-analysis

Abstract

Globally, and in the United States (U.S.) specifically, rates of reported sexually transmitted infections (STIs) have been steadily increasing and are especially high among youth aged 13–25 years. Using condoms correctly and consistently is an effective STI prevention measure for sexually active youth, yet public health endeavors tend to focus only on condom use consistency. Directly measuring condom application is challenging and expensive. Alternative tools evaluate this behaviour, but little evidence exists on the appropriateness of these instruments in measuring application skills. This systematic review and meta-analysis examined the association between condom application skills and self-efficacy. We conducted a search of several databases as well as unpublished works. Studies were included if they were in English, examined youth aged 13–25 years, and were available between 1992 and 2019. The authors screened 630 titles and abstracts for initial inclusion criteria. A full-text review of 30 studies was conducted. The authors included 19 studies in the systematic review and 5 studies were included in the meta-analysis. Both a fixed- and random-effects model (Q = .2321, I2 = 0%) yielded a medium-sized statistically non-significant association (r = 0.217) between skills and self-efficacy. Despite the small sample size, findings suggest that skills and self-efficacy may not be as interchangeable as previously assumed when assessing condom application. Implications for future research are discussed.

Global disease burden attributed to unsafe sex in 204 countries and territories from 1990 to 2019: results from the Global Burden of Disease Study 2019

“…The demarcation points in 2004 suggested that the burden of unsafe sex was under management and control in 2004. The underlying reason could be attributed to the popularity of condoms, the developments in medical technology, and increased awareness of reproductive health 32 , 33 .…”

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

“…We cannot possibly rule out the overestimation of condom use reported by participants themselves. However, the extent of condom protection was always difficult to quantify because of many methodological challenges inherent in studying privacy behavior that cannot be directly observed or measured ( 32 , 33 ). Finally, this study was based on the secondary database which did not collect HCV status of index cases and other risk factors like STIs or genital ulcers.…”

A meta-theoretical framework for organizing and integrating theory and research on motivation for health-related behavior

“…The differences in theoretical perspectives and labeling of motivation concepts make it difficult to organize, accumulate, and integrate research on motivation for health-related behavior, despite the fact that so much work has been done. Indeed, in contrast to other health psychology constructs, such as self-efficacy and outcome expectancies, for which researchers working within specific healthbehavior content areas have characterized and integrated findings across theoretical traditions (Ferrand et al, 2021;Newby et al, 2021;Bohlen et al, 2022;Pinquart and Borgolte, 2022), it is more difficult to characterize research on "motivation" in the broader field of health psychology or within specific content areas. 1 Thus, despite the fact that motivation is clearly important to predicting, understanding, and changing health-related behaviors, the heterogeneity in motivation labels and theoretical approaches is a major barrier to synthesizing research on motivation within health-related behavior domains.…”