The 90's

Gender differences in AIDS-related heterosexual concerns and sexual behavior with new sexual partners, with an emphasis on condom use and subjective condom experiences, were assessed by a questionnaire survey of middleclass bar patrons, on location, in New York City. Patrons were asked about their number of sexual partners, the extent of their AIDS-related womes and behavioral responses to such concerns, as well as their use of condoms in different sexual situations and their subjective condom experiences. Most people report that AIDS-related concerns have affected their behavior in some way, primarily in the increased use of condoms. Condom use varies according to type of relationship and type of sexual act and results generally in more peace of mind, but less sexual enjoyment. Peace of mind strongly predicts condom use during casual sex for both genders. In terms of gender differences, women worry about AIDS with new sexual partners more than men do and they tend to limit their number of partners more. Women appreciate the use of condoms more than men do, most likely because erection and ejaculatory concerns are fundamental aspects of men's, but not women's, condom experiences. "Worrying about AIDS" predicts condom use during casual sex for men, but not women. More men than women had a condom with them when surveyed.     

“Jimmy Cap Before You Tap”: Developing Condom Use Messages for African American Women

This study examined which characteristics of persuasive communications are most effective in changing African American women’s condom use attitudes. Focus groups were convened with 40 African American women (M_age = 25.54, SD = 4.67) to assess their opinions on current effective strategies used to promote condom use among their peers. Participants discussed effective characteristics of messaging campaigns (i.e., source, message type, channel) and how these could be used in future prevention messages. Findings revealed that making messages that are fun, catchy, and informative, delivered frequently through social media, TV, or radio by a peer or celebrity would be perceived as most effective in changing young African American women’s attitudes. Other themes that emerged were that condom use is more strongly associated with pregnancy prevention than HIV prevention and that sexual partners were perceived to have negative condom use attitudes. Recommendations centered on increasing exposure of HIV prevention messages by placing messages on the Internet and including a funny phrase or jingle in the message so that it is easy to remember and could potentially serve as a conversation starter for discussing safe sex with partners.     

Testing a New Measure of Sexual Health Knowledge and Its Connections to Students' Sex Education,Communication, Confidence,and Condom Use

ABSTRACT

This study investigates the nature of college students' sexual health knowledge, prior sex education coverage, and sexual communication and confidence. We created a new, comprehensive sexual health knowledge measure to assess 347 undergraduates' knowledge of reproductive health, contraception, condom use, sexually transmitted diseases (STDs), and HIV/AIDS. Overall, students demonstrated a fairly poor understanding of sexual health issues. Women were more knowledgeable than men, specifically on the topics of contraception and STDs. Prior exposure to sex education covering mainstream reproductive health issues or newer contraception methods was correlated with greater knowledge across all domains, particularly for men. Greater knowledge was also correlated with greater sexual assertiveness and confidence with condoms among women.     

HIV Prevention and Social Desirability: Husband–Wife Discrepancies in Reports of Condom Use

Greater use of condoms within marriage would help limit the spread of HIV in sub‐Saharan Africa. Using data from the Malawi Diffusion and Ideational Change Project (MDICP), the authors examined the influence that the fidelity norm and the traditional association between marriage and reproduction have on condom use with a spouse. The sample included 749 married couples. The authors used latent class analysis to estimate a “true,” or latent measure of condom use by couples based on the individual reports of husbands and wives and to explore the reasons why individuals tend to misreport their use of condoms. They found that married couples with more children were more likely to use condoms and that having been informed by experts about AIDS prevention at home induced men and women to overreport condom use within marriage in a survey but may not necessarily increase the extent to which condoms are used.     

Gender, knowledge about AIDS, reported behavioral change, and the sexual behavior of college students

This article reports on an analysis of the relationships among knowledge about AIDS, self-reported changes in sexual behavior, and independent measures of those behaviors--condom use, coital frequency, and number of partners. The sample consisted of 195 sexually active, heterosexual college students attending a northeastern state university in spring 1988. With other relevant variables held constant, statistically significant associations in the predicted direction were found between knowledge and reported change and each of the dependent variables among the men, especially the men not involved in relationships. Among women, however, the only significant association was that between reporting the beginning of condom use and the frequency with which condoms were used in the past year. Possible reasons for these gender differences are discussed.     

Difference in Condom Use Among Sexually Active Males at Historically Black Colleges and Universities

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.     

The Trouble With Condoms: Norms and Meanings of Sexuality and Condom Use Among School-Going Youth in Kenya

ABSTRACT

Despite knowledge of the effectiveness of condoms in preventing HIV transmission, condoms continue to be reported in only a minority of sexual encounters even with nonpermanent partners. This study used focus-group discussions with youth and interviews with community leaders from 22 communities in the Nyanza and Rift Valley provinces, Kenya, to examine the sociocultural influences on condom use among school-going youth. Three overarching themes emerged from a thematic analysis of the data. Condoms did not fit with the purposes, meanings, and understandings of sexuality; in fact, condom use violated most of these. Condoms were also thought to be dangerous for girls and women, to contribute to the spread of HIV, and to be unnecessary for protection against HIV. Finally, given the hardships of life and multiple diseases and circumstances that threatened life, HIV was seen as just another trouble of living. Sex without a condom, within this context, was described as one of the pleasures of a short life. The complexities of sexuality evidenced in the discussions of these youth and adults challenge the viability of the ABC (abstain, be faithful, use a condom) message as a preventive measure against HIV transmission.     

A Survey of AIDS Knowledge and Attitudes Among Prostitutes in an International Border Community

Prostitutes are a high risk population engaged in high risk behavior for the transmission of HIV Disease (AIDS). This paper presents the results of a survey to evaluate the knowledge, attitudes and behaviors of prostitutes about HIV Disease (AIDS). This survey was conducted in an International Border Community. A total of sixty women participated in this survey. The sources of information on AIDS and its accuracy were explored. The impact of this knowledge on behavior was identified. The most important finding is that the prostitutes are not utilizing risk reduction behaviors while having sexual relationships with their clients. The survey found that fifty-four percent of the participants did not use condoms on a regular basis. And an alarming ten percent did not use condoms at all. The results of this survey have implications for social workers and public health workers who must develop strategies to work effectively with this high risk population.     

Getting your partner to use condoms: Interviews with men and women at risk of HIV/STDs

Data from individual semistructured interviews with 90 young heterosexual couples were analyzed to identify strategies that men and women at risk of HIV/STDs would use to influence their partners to use condoms for the purpose of disease prevention. In addition, we explored whether participants thought influencing strategies would differ for pregnancy prevention. Content analysis of the interview data indicated that participants would use the following verbal strategies: persuading/suggesting, commanding/asserting, and threatening to withhold sex. Several participants, particularly those who had recently used condoms with their partners, reported that they would also use non‐verbal strategies involving condoms themselves (e.g., putting a condom on, buying or getting condoms, or presenting a condom to their partner). Many participants believed that they would use a different strategy for pregnancy prevention because it would be easier to convince a partner to use condoms for that purpose.     

Determinants Influencing Male Condom use Among University Students in Portugal

ABSTRACT. A self-administered questionnaire was carried out among university students in Portugal, with the aim to examine determinants influencing male condom use, according to the information–motivation–behavioral skills model (J. Fisher & Fisher, 1992). Students’ levels of information, motivation, and behavioral skills regarding preventive sexual behavior (male condom use) were ascertained and were used to determine their association with condom use among 880 male and 1,807 female students aged 18 to 35 years old. Although 86.9% of respondents indicated that they used a condom during their first sexual intercourse, only 32.8% used a condom always during sexual intercourse in the last 12 months. Most young people, especially women, had a good level of information regarding HIV/AIDS transmission/prevention. They also showed reasonable positive attitudes and had positive subjective norms and intentions toward HIV/AIDS preventive behaviors. Men presented a higher perceived difficulty and a lower perceived effectiveness of HIV/AIDS preventive behavior, therefore reporting higher risk acceptance. A path analysis revealed that preventive sexual behavior did not depend directly on information level but on motivation and behavioral skills (especially among men). Information about HIV prevention/transmission was not significantly associated with condom use. The finding that motivation and behavioral skills were the strongest determinants of condom use suggested that these may be important factors in effective sexually transmitted infection-prevention programs.     

Knowledge,attitudes, and behavior related to condom use and STDs in a high risk population

Since the mid‐1980s, the incidence of sexually transmitted diseases (STDs) among Blacks has increased dramatically nationwide, particularly in Philadelphia and other major urban areas. One approach to this public health problem is to prevent the further transmission of disease through the use of condoms during sexual activity. To provide a basis for condom‐promotion programs within a high risk Black urban community, we explored condom use behavior and the relationship between condom use and variables related to demographic characteristics, knowledge, attitudes, perceived risk and concern about STDs, and STD history. A household survey was conducted of a stratified, quota sample of 925 male and female adolescent and adult residents in North and West Philadelphia. These areas have the highest rate of STDs in the city and among the highest rates in the country. The survey revealed a trichotomy among respondents with respect to condom use: approximately one‐third of the sample used condoms consistently; one‐third used them intermittently, and one‐third never used condoms. Consistent condom users tended to use condoms with both steady and casual partners; less frequent condom users tended to use condoms with partners who could be considered higher risk: new partners and casual partners. Although condom use rates did not vary as a function of age among males, women under age 20 were far more likely to use condoms than were other female age groups. Knowledge about STDs and prevention was not found to predict condom use. Negative attitudes toward condoms were related to non‐use, with the exception of women who used condoms in perceived high risk situations despite negative attitudes.     

Sexual Behavior Changes Among Heterosexual,Lesbian and Gay Bar Patrons as Assessed by Questionnaire Over an 18-Month Period

Both an original and a follow-up questionnaire study of bar patrons in Greenwich Village, New York, ascertained concern about acquiring AIDS and resultant sexual behavioral changes. In 1986 (shortly before the Koop report), almost all of the gay men sampled, a majority of the lesbian and heterosexual women, but less than a quarter of the heterosexual men reported that a concern about AIDS had affected their sexual behavior. By 1987/88, almost all of the gay men and about 80% of heterosexual men, women and lesbians reported a sexual behavior change. The greatest specific behavioral changes between the studies involved increasing reports of declining casual sex (for all groups except the gay men, more than half of whom had reported this by the first study), and a greatly increased use of condoms by heterosexuals (who had rarely used them earlier) and by gay men (who had begun using them by 1986). Variables which predict heterosexual condom use for each gender are reported.     

A Preliminary Study of Body Image and HIV Sexual Risk Behavior in Black Gay and Bisexual Men: Implications for HIV Prevention

Nearly three decades since the onset of the AIDS epidemic, Black gay and bisexual men (BGBM) experience increasingly disproportionate rates of HIV and AIDS in the United States. The aim of this exploratory research investigation was to examine the relationship between body image and HIV sexual risk behavior in a community-based sample of 481 BGBM in the New York metropolitan area. Multivariable analyses demonstrated that men with a negative body image were less likely to use condoms during anal intercourse with a male sexual partner as compared to those respondents with a positive body image. These findings pose considerable implications for the influence of body image on HIV sexual risk behavior in BGBM.     

Effects of a peer-led AIDS intervention with university students

Acquired immune deficiency syndrome (AIDS) has become a major health threat to university students. This study evaluated a peer-led AIDS intervention program with university students (1) increase knowledge of human immunodeficiency virus (HIV) transmission and infection; (2) change attitudes to reflect scientific information on AIDS-related facts; and (3) change behavioral intentions to correspond with safer sexual practices. Subjects were students (N = 142) from four undergraduate classes and were predominantly female (65%), white (82%), and sexually active (86%). A non-equivalent control group design was used, with two classes receiving the intervention and two classes receiving no information. For the intervention, peer educators presented AIDS-related information, modeled ways to use condoms safely and ways to discuss condom use with sexual partners, and led discussions on HIV infection and use with sexual partners, and led discussions on HIV infection and AIDS, relationships, sexuality, and condom use. A questionnaire was administered to assess differential changes in AIDS-related knowledge, attitudes, and behavioral intentions between the intervention and control groups. The results showed significant improvements among intervention subjects on the knowledge, attitudes, and behavioral intentions scales compared with the control group.     

“It's a Different Condom,Let's See How It Works”: Young Men's Reactions to and Experiences of Female Condom Use During an Intervention Trial in South Africa

Although male partner cooperation is often essential for successful use of the female condom, only a few studies have directly assessed men's experiences of using the device. We examined barriers to and facilitators of female condom use via qualitative in-depth interviews with 38 young men (18 to 28 years) in South Africa whose partners, all university students, were enrolled in a female condom intervention trial. In all, 21 men used the female condom; the remaining 17 did not attempt use. The main facilitators to female condom use were convenience of use for men, curiosity to see how female condoms compared to male condoms, enhanced sexual sensation, and perceptions of better safety and comfort of the device compared to male condoms. The main barriers were men's limited familiarity with the device, insertion difficulties, and men's concerns about loss of control over sexual encounters. We recommend that human immunodeficiency virus (HIV) prevention and condom promotion programs around the world target men directly for education on female condoms and that they also work with couples jointly around issues of safer-sex communication and negotiation.     

Expectancies specific to condom use mediate the alcohol and sexual risk relationship

The present study tested the role of alcohol expectancies for condom use in mediating the alcohol and risky sex relationship. Expectancies for condom use are specific anticipations for alcohol's effect on one's ability to use a condom. College students (N = 563) reported on beliefs, intentions and actual sexual and drinking behavior. Among the sexually active, alcohol was directly related to future intention to use a condom in drinking situations for men, but not for women. In the men, alcohol expectancies for condom use mediated the relationship between drinking and condom intention. Beliefs that alcohol negatively impacts one's ability to use condoms were associated with more drinking and lower intentions to use a condom. These expectancies may help explain how alcohol affects risky sex in men. Gender differences and implications are discussed.     

Context of First Same‐Sex Condom Use and Nonuse in Young Black Gay and Bisexual Males

Despite high human immunodeficiency virus (HIV) rates among young Black men who have sex with men (YBMSM), there are limited data about condom use during first same‐sex (FSS). This study sought to understand socio‐contextual factors of 50 YBMSM aged 15–19 years that influenced condom use during FSS. Condom use was influenced by individual, partner, and community factors. Individual factors—recent illness or sexually transmitted infections (STI)—prompted condom use, while frequent HIV testing prompted nonuse. Partner factors—proactive encouragement from partners—prompted condom use, while trust and condom discomfort prompted nonuse. Larger community factors—such as presence of females—were key for use, while limited sexual health information combined with peers who discouraged condoms prompted nonuse. A multilevel approach may be useful in developing sexual health programming for these young men.     

Expectancies specific to condom use mediate the alcohol and sexual risk relationship

The present study tested the role of alcohol expectancies for condom use in mediating the alcohol and risky sex relationship. Expectancies for condom use are specific anticipations for alcohol's effect on one's ability to use a condom. College students (N = 563) reported on beliefs, intentions and actual sexual and drinking behavior. Among the sexually active, alcohol was directly related to future intention to use a condom in drinking situations for men, but not for women. In the men, alcohol expectancies for condom use mediated the relationship between drinking and condom intention. Beliefs that alcohol negatively impacts one's ability to use condoms were associated with more drinking and lower intentions to use a condom. These expectancies may help explain how alcohol affects risky sex in men. Gender differences and implications are discussed.     

Understanding heterosexual Chinese college students' intention to adopt safer sex behaviors

This study aimed to examine Chinese college students' safer sex behaviors and to explore whether or not the Theory of Reasoned Action would be useful in understanding AIDS/HIV‐prevention behaviors of Chinese students. A total of 455 Chinese college students (161 males and 267 females) in Hong Kong participated in the study. Results revealed that 24% of the students were sexually active during the surveyed year, with only 38.2% of them reporting regular condom use. About one third of the students intended to experiment with casual sex in the future, but only 64% would use condoms regularly if they were to have future casual sexual encounters. Results indicated that the Theory of Reasoned Action was most applicable in understanding Chinese college students’ intention to use condoms in future casual sexual encounters, rather than in current and future regular sexual activities. Specifically, students who intended‐to use condoms in future casual sex encounters tended to have accurate AIDS/HIV information, show little prejudice against people with AIDS/HIV, demonstrate greater concern about contracting AIDS/HIV, feel confident in condom use, and have positive attitudes toward safer sex behaviors. Gender disparity was also noted in the pattern of associations between safer sex behaviors and various psychological variables. Limitations of the present study and implications for future research were also discussed.