Assessment of condom use in men and women
Oxford Doctoral Course in Clinical Psychology, Isis Education Centre, Warneford Hospital, Headington, Oxfordshire, UK. Annual review of sex research
Self-reported condom use is a key variable in surveys of sexual behavior and in studies evaluating interventions to reduce the risk of sexually transmitted infections. This article provides a review of how male condom use has been assessed in research. We critically review a number of methodological issues, including the length of the recall period, terminology, specification of partner variables, validity and reliability of condom use, and use of newer data collection methods such as daily diaries and computer-assisted and online technologies. Assessment of condom use errors and problems, and the role of women in condom use are discussed. Finally, we offer recommendations for improving assessment of condom use in future research.
Available from: Sarah A Stoddard
- "With increasing recognition that consistency of condom use varies between partners, measuring condom use specific to each sex partner is becoming more common (e.g., condom use in reference to casual versus steady partners) (Graham et al., 2005). In a recent review, Noar et al. (2006) concluded that condom use measurement has improved in a number of ways, including better measurement types and recall periods, greater specificity to sexual acts, and increased assessment of test-retest reliability, social desirability, and condom use skills. "
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ABSTRACT: The conundrum of measuring condom use consistency, particularly with adolescents, has left researchers with a cacophony of strategies, thereby limiting comparability and interpretation.
The aim of this analysis was to compare and contrast two measures of condom use consistency, global versus partner specific, and their relationships with key covariates, using trajectory groups differentiated by stability of condom use consistency over three time points.
Using self-report data from sexually active girls (aged 13-17 years) in a clinic-based intervention study aimed at lowering risk for early pregnancy, this analysis compared two measures of self-reported condom use consistency: (a) a global measure: overall condom use consistency in the past 6 months and (b) a partner-specific measure: condom use consistency with the most recent sex partner in the last 6 months. Using a subjective rule-based approach, the adolescent girls in the study (n = 151) were classified into trajectory groups representing their condom use consistency at three time points (baseline and 6 and 12 months). Then, using bivariate methods, trajectory groups were compared on four baseline covariates (age, treatment condition, hormonal use in the last 6 months, and number of sex partners in the last 6 months) and three time-varying covariates measured at baseline and at 6 and 12 months (hormonal use stability, stability of primary sex partner, and stability of number of sex partners).
For the trajectory groups formed using the global measure of condom use consistency, stability of the primary sex partner differed significantly between trajectory groups. For the partner-specific trajectory groups, two baseline and one time-varying covariate relationships were significant: hormonal use in the 6 months prior to baseline, number of sex partners in the past 6 months (baseline), and stability of the primary sex partner (time varying), with hormonal use stability (time varying) trending toward significance.
The larger number of significant covariate relationships with the partner-specific trajectory groups suggests greater utility in assessing partner-linked behavior rather than a global measure. Despite limitations of the analytic strategy, this study sheds light on a measurement conundrum that has been an obstacle to comparing and contrasting indicators of condom use consistency during adolescence.
Available from: Merrill Charles Singer
- "SEPs routinely distribute health promotion brochures, and customers may become inured or confused by the plethora of information. Communication problems continue to plague HIV risk reduction efforts: condom misuse persists despite package inserts and condom use campaigns [5,6]. Our findings are consistent with reports of unintended consequences of SEP-based HIV prevention activities  and suggest that, along with continued distribution of risk reduction materials, risk reduction staff should be encouraged to instruct their clients - briefly and often - about the proper use of these materials. "
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ABSTRACT: To redress gaps in injection drug users' (IDUs) knowledge about hepatitis risk and prevention, we developed a brief intervention to be delivered to IDUs at syringe exchange programs (SEPs) in three US cities. Following a month-long campaign in which intervention packets containing novel injection hygiene supplies and written materials were distributed to every client at each visit, intervention effectiveness was evaluated by comparing exposed and unexposed participants' self-reported injection practices. Over one-quarter of the exposed group began using the novel hygiene supplies which included an absorbent pad ("Safety Square") to stanch blood flow post-injection. Compared to those unexposed to the intervention, a smaller but still substantial number of exposed participants continued to inappropriately use alcohol pads post-injection despite exposure to written messages to the contrary (22.8% vs. 30.0%). It should also be noted that for those exposed to the intervention, 8% may have misused Safety Squares as part of pre-injection preparation of their injection site; attention should be paid to providing explicit and accurate instruction on the use of any health promotion materials being distributed. While this study indicates that passive introduction of risk reduction materials in injection drug users through syringe exchange programs can be an economical and relatively simple method of changing behaviors, discussions with SEP clients regarding explicit instructions about injection hygiene and appropriate use of novel risk reduction materials is also needed in order to optimize the potential for adoption of health promotion behaviors. The study results suggest that SEP staff should provide their clients with brief, frequent verbal reminders about the appropriate use when distributing risk reduction materials. Issues related to format and language of written materials are discussed.
Available from: Peter A Vanable
- "Recent studies have linked the likelihood of condom failure to a number of user errors, such as using an oil-based lubricant (e.g., Vaseline®) and completely unrolling the condom before application (Crosby, DiClemente, Yarber, Snow, & Troutman, 2008). Furthermore, researchers have linked condom failure to characteristics of condom users, including inexperience with condoms and younger age (Crosby, Graham, Yarber, & Sanders, 2004; Crosby, Sanders, Yarber, & Graham, 2003; Crosby, Yarber, Sanders, & Graham, 2005). Overall, adolescents are more likely than adults to have a condom break or slip off during sexual intercourse (for a comprehensive review, see Graham, Crosby, Sanders, & Yarber, 2005). "
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ABSTRACT: The purpose of this study was to explore the meaning and context of self-reported "condom failure" among sexually active African American adolescents. Semistructured interviews regarding methods of protection from pregnancy and sexually transmitted disease (STD) with 124 youth (ages 14-19 years) were content analyzed. The findings suggested three meanings of condom failure. First, condom failure represents a legitimate and important risk related to sexual activity. Second, it can serve as an excuse repertoire for adolescents who engaged in unprotected sex and later experienced either pregnancy or a STD. Third, it may serve as an explanation for males who deceive their partners into having unprotected sex. The findings are discussed with regard to their implications for HIV or STD prevention and research.
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