Condom Use during Most Recent Anal Intercourse Event among a US Sample of Men Who Have Sex with Men
ABSTRACT Recent nationally representative data documenting event-level condom use have included samples that are predominantly heterosexual, resulting in limited information on rates of condom use for penile-anal intercourse (PAI) among men who have sex with men (MSM).
This study sought to document the demographic and event-specific situational factors associated with condom use during most recent PAI among MSM.
Data were collected via an Internet survey from 14,750 MSM (ages 18-87 years) from 50 U.S. states and the District of Columbia.
Measures included items related to sociodemographics, recent sexual behavior history, event characteristics, condom use, and items associated with ejaculation during the event.
Participants' median age was 39.0 years; race/ethnicities included white (83.2%), Latino (7.2%), and African American (3.9%), and most men (85.3%) identified as homosexual. Age (P ≤ 0.001), race/ethnicity (P ≤ 0.001), partner status (P ≤ 0.001), and location of sexual event (P ≤ 0.001) were all significantly related to the likelihood of condom use during men's most recent PAI with another man. In total, only 2.5% of the entire sample reported that ejaculation occurred in their own or their sexual partner's anus without a condom during most recent PAI.
This study provides a large-scale assessment of condom use during the most recent PAI among MSM in the United States. Findings from this study highlight diversity in condom use behaviors and demonstrate varying degrees of potential risk for human immunodeficiency virus and other sexually transmitted infections. Future prevention efforts should consider contextual components of condom use, including partner type, location of the sexual event, and semen exposure, to more accurately develop individualized risk reduction strategies.
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ABSTRACT: Objective Research assessing contraceptive use often focuses on most effective method used and suggests that very few women rely on withdrawal. We adopted a new measurement strategy in an attempt to measure contraceptive practices, and withdrawal in particular. Study Design We collected data from a national sample of 4,634 U.S. women aged 18-39; the survey was administered online in November and December 2012. We obtained information about recent use of hormonal methods and coital methods using two separate items, and we placed withdrawal first on the list of coital methods. The analysis examines several measures of withdrawal use in the last 30 days: most effective method used, any use, use with other methods and withdrawal “method mix.” Results Among women at risk of unintended pregnancy, 13% reported that withdrawal was the most effective method used in the last 30 days, but 33% had used withdrawal at least once. Most women who used withdrawal had also used a hormonal or long-acting method (13% of the sample) or condoms (11%) in the last 30 days, and a minority reported using only withdrawal (12%). Younger women, women in dating relationships and women strongly motivated to avoid pregnancy had some of the highest levels of “dual” use of withdrawal with condoms or highly effective methods. Conclusion Many women and couples in our sample used withdrawal in combination, or rotation, with condoms and highly effective methods. Findings suggest that some people who use withdrawal may be more versus less vigilant about pregnancy prevention. Implications Health care providers who discuss contraception should include withdrawal in these conversations. A substantial minority of individuals has used it recently, and many appear to be using it as a backup or secondary method. If dual use were more widespread, it could help reduce the incidence of unintended pregnancy.Contraception 10/2014; 90(4). DOI:10.1016/j.contraception.2014.04.016 · 3.09 Impact Factor
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ABSTRACT: Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. Methods: A representative sample of 20094 men and women aged 16-69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Results: Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001-02 and 2012-13. Conclusion: Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.Sexual Health 11/2014; 11(5):495-504. DOI:10.1071/SH14102 · 1.58 Impact Factor
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ABSTRACT: IntroductionThe relationship between depressive symptomatology and risky sexual behaviors has been controversial in literature.AimThe current study aims to reexamine the relationship between depression and sexual behaviors among men who have sex with men (MSM) using different sets of analytical assumption.Methods Six hundred twenty MSM were recruited in a lesbian, gay, bisexual, and transgender community center in Taiwan to participate in a cross-sectional survey. An additional variable of squared depressive symptomatology was used to detect nonlinearity between depressive symptomatology and logit-transformed unprotected anal intercourse (UAI) and unprotected oral sex (UOS). Multivariable logistic regression was applied to further estimate the relationship among the three variables.Main Outcome MeasuresDepressive symptomatology was measured by the Beck Depression Inventory (BDI), UAI, and UOS.ResultsDepressive symptomatology had a nonlinear relationship with unprotected anal and oral sex. While linear BDI scores of MSM were not associated with unprotected sexual behaviors in the logistic model, their scores were significantly associated with unprotected sexual behaviors in the model that included both the linear (UAI, odds ratio [OR] = 1.087; P < 0.01; UOS, OR = 1.099, P < 0.01) and quadratic BDI scores (UAI, OR = 0.998, P < 0.01; UOS, OR = 0.997, P < 0.01). The relationship between BDI scores and the probability of unprotected sexual behaviors corresponded to an inverted U-shaped curve, as opposed to a straight line.Conclusions Our findings suggest that depressive symptomatology has a significant curvilinear relationship with unprotected sexual behaviors. MSM with moderate levels of depression may be at elevated risk of engaging in unprotected sexual behaviors in comparison to their peers who exhibit either significantly higher or lower depression scores. Shiu CS, Chen YC, Tseng PC, Chung AC, Wu MT, Hsu ST, and Ko NY. Curvilinear relationship between depression and unprotected sexual behaviors among men who have sex with men. J Sex Med **;**:**–**.Journal of Sexual Medicine 09/2014; 11(10). DOI:10.1111/jsm.12638 · 3.15 Impact Factor