Condom Use as a Function of Time in New and Established Adolescent Sexual Relationships

Fortenberry, J. Dennis; Tu, Wanzhu; Harezlak, Jaroslaw; Katz, Barry P.; Orr, Donald P.

doi:10.2105/ajph.92.2.211

Cited by 194 publications

(176 citation statements)

References 23 publications

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“…It has been suggested that concurrency may be socially acceptable and even normative in certain contexts, 28 29 particularly among younger people. It has been proposed that longer duration of condom use in adolescent relationships could make a significant important contribution to STI control, 30 and this is an approach which could also have wider applicability among other individuals who have high rates of partner change or concurrency.…”

Section: Tablementioning

confidence: 99%

Who uses condoms with whom? Evidence from national probability sample surveys

Cassell

Mercer

Imrie

et al. 2006

Sexually Transmitted Infections

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Objectives: To explore the changing pattern of condom use from 1990 to 2000; to identify sociodemographic and behavioural factors associated with condom use; and reasons for condom use in 2000. Methods: Large probability sample surveys administered among those resident in Britain aged 16-44 (n = 13 765 in 1990, n = 11 161 in 2000). Face to face interviews with self completion components collected sociodemographic, behavioural, and attitudinal data. Results: Condom use in the past year among sexually active 16-24 year old men increased from 61.0% in 1990 to 82.1% in 2000 (p,0.0001), and from 42.0% to 63.2% (p,0.0001) among women of the same age, with smaller increases among older age groups. Among individuals reporting at least two partners in the previous 4 week period, approximately two thirds reported inconsistent or no condom use (63.1% (95% CI 55.9% to 69.8%) of the men and 68.5% (95% CI 57.6% to 77.7%) of the women). Conclusions: Rates of condom use increased substantially between 1990 and 2000, particularly among young people. However, inconsistent condom use by individuals with high rates of partner acquisition may contribute significantly to the recent resurgence in STIs. This group is an important target for intensive and specific sexual health interventions.

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Section: Tablementioning

confidence: 99%

Who uses condoms with whom? Evidence from national probability sample surveys

Cassell

Mercer

Imrie

et al. 2006

Sexually Transmitted Infections

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“…3,4 Condoms may be perceived as a barrier to intimacy and trust, 4 and their use is often lower in established relationships. 5 As men often have the power to influence condom use for penetrative sex (because they wear condoms), efforts are needed to target the obstacles to condom use that men face. 3 Although there are a variety of health promotion interventions aimed at improving sexual health for men who have sex with men (MSM), there are fewer interventions specifically for adult men who have sex with women (MSW), 6,7 despite the fact that MSW report much less consistent condom use than MSM.…”

Section: Chapter 1 Introductionmentioning

confidence: 99%

The Men’s Safer Sex project: intervention development and feasibility randomised controlled trial of an interactive digital intervention to increase condom use in men

Bailey

Webster

Hunter

et al. 2016

Health Technol Assess

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BackgroundThis report details the development of the Men’s Safer Sex website and the results of a feasibility randomised controlled trial (RCT), health economic assessment and qualitative evaluation.Objectives(1) Develop the Men’s Safer Sex website to address barriers to condom use; (2) determine the best design for an online RCT; (3) inform the methods for collecting and analysing health economic data; (4) assess the Sexual Quality of Life (SQoL) questionnaire and European Quality of Life-5 Dimensions, three-level version (EQ-5D-3L) to calculate quality-adjusted life-years (QALYs); and (5) explore clinic staff and men’s views of online research methodology.Methods(1) Website development: we combined evidence from research literature and the views of experts (n = 18) and male clinic users (n = 43); (2) feasibility RCT: 159 heterosexually active men were recruited from three sexual health clinics and were randomised by computer to the Men’s Safer Sex website plus usual care (n = 84) or usual clinic care only (n = 75). Men were invited to complete online questionnaires at 3, 6, 9 and 12 months, and sexually transmitted infection (STI) diagnoses were recorded from clinic notes at 12 months; (3) health economic evaluation: we investigated the impact of using different questionnaires to calculate utilities and QALYs (the EQ-5D-3L and SQoL questionnaire), and compared different methods to collect resource use; and (4) qualitative evaluation: thematic analysis of interviews with 11 male trial participants and nine clinic staff, as well as free-text comments from online outcome questionnaires.Results(1) Software errors and clinic Wi-Fi access presented significant challenges. Response rates for online questionnaires were poor but improved with larger vouchers (from 36% with £10 to 50% with £30). Clinical records were located for 94% of participants for STI diagnoses. There were no group differences in condomless sex with female partners [incidence rate ratio (IRR) 1.01, 95% confidence interval (CI) 0.52 to 1.96]. New STI diagnoses were recorded for 8.8% (7/80) of the intervention group and 13.0% (9/69) of the control group (IRR 0.75, 95% CI 0.29 to 1.89). (2) Health-care resource data were more complete using patient files than questionnaires. The probability that the intervention is cost-effective is sensitive to the source of data used and whether or not data on intended pregnancies are included. (3) The pilot RCT fitted well around clinical activities but 37% of the intervention group did not see the Men’s Safer Sex website and technical problems were frustrating. Men’s views of the Men’s Safer Sex website and research procedures were largely positive.ConclusionsIt would be feasible to conduct a large-scale RCT using clinic STI diagnoses as a primary outcome; however, technical errors and a poor response rate limited the collection of online self-reported outcomes. The next steps are (1) to optimise software for online trials, (2) to find the best ways to integrate digital health promotion with clinical services, (3) to develop more precise methods for collecting resource use data and (4) to work out how to overcome barriers to digital intervention testing and implementation in the NHS.Trial registrationCurrent Controlled Trials ISRCTN18649610.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 91. See the NIHR Journals Library website for further project information.

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“…3 Many women become infected through their main partner due to low rates of consistent condom use in primary relationships. 5,6 Because male condom use is not directly under a woman's control, gender inequalities may be particularly important in shaping this sexual risk behavior.…”

Section: Introductionmentioning

confidence: 99%

Economic Dependence and Unprotected Sex: The Role of Sexual Assertiveness among Young Urban Mothers

et al. 2010

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In the USA, sexual intercourse is the leading route of human immunodeficiency virus transmission among women, primarily through their main partner. Because male condom use is not directly under a woman's control, gender inequalities may help shape this sexual risk behavior. To examine this association, data came from follow-up interviews of young, primarily minority, pregnant women enrolled in a prospective, randomized controlled trial. Specifically, we aimed to determine the relationship between economic dependence on a male partner and condom use, and to establish whether this relationship was mediated by sexual assertiveness. Overall, 28% of women reported being economically dependent on a male partner. Young women dependent on a male partner were 1.6 times more likely to report not using a condom at last sex than women not dependent on their partner (95% confidence interval=1.11-2.32; p=0.01). Sexual assertiveness mediated the relationship between economic dependence and condom use (Sobel=2.05, p=0.04). Coupled with past research, this study supports the premise that sexual behaviors may be rooted in a complex web of social determinants. Addressing gender inequalities in contextual factors may promote healthier decisions within sexual relationships.

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Condom Use as a Function of Time in New and Established Adolescent Sexual Relationships

Abstract: Prolongation of condom use in ongoing relationships may be a useful intervention to prevent sexually transmitted diseases.

Cited by 194 publications

References 23 publications

Who uses condoms with whom? Evidence from national probability sample surveys

Who uses condoms with whom? Evidence from national probability sample surveys

The Men’s Safer Sex project: intervention development and feasibility randomised controlled trial of an interactive digital intervention to increase condom use in men

Economic Dependence and Unprotected Sex: The Role of Sexual Assertiveness among Young Urban Mothers

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