A condom skill scale: assessing condom skills among female drug users

Use of latex condoms is a primary form of sexual risk reduction, and consequently many intervention programs have focused efforts on increasing condom use among high-risk populations. Use alone, however, will not fully protect the individual if condoms are not used correctly. The objective of this study was to describe the development and properties of a scale measuring demonstrated condom use skill using a sample of 261 drug-using women. Guttman's coefficient of reproducibility and Jackson's Plus Percentage Ratio (PPR) were used to determine the scalability of the Condom Skill Scale (CSS). Analysis of scale scores revealed high levels of condom skill among the population, although there was reduced performance for three items. Preliminary analysis suggests that the CSS is a potentially valid and reliable instrument, and may have application as a tool assessing condom skill level.     

Safer Sex and the Health Belief Model

Abstract

The goal of the present study was to build on the Health Belief Model (HBM) by adding predictors of late adolescent safer sex behavior: perceptions of peer norms for sexual behavior, and sexual attitudes that emerge from socialization. Sexually active, late adolescent college students (N = 154, 62.3% female; mean age 20.8 years, 76% European American) participated in the study. Predictors from the original HBM included perceived vulnerability, condom use self-efficacy, and attitudes about condoms. In addition, peer norms for condom use and sexual behavior, general sexual attitudes, and endorsement of the sexual double standard were included as predictors of safer sex behavior. Attitudes about condoms, perceived vulnerability, condom use self-efficacy, and the sexual double standard emerged as significant correlates of condom use. General sexual attitudes and the sexual double standard were significantly correlated with alcohol use before or during sex. With the addition of these variables, the regression models accounted for 28% of the variance in condom use, and 14% of the variance in alcohol use before or during sex.     

Encouraging Safer Sex: Mediating and Moderating Effects on Condom Use Among Italian Girls

ABSTRACT

Objectives: The present study investigated the effects of condom availability, peer norms, and negotiation self-efficacy on girls’ perception of male condom use. Methods: Participants were presented with a vignette in which condom availability, peer norms, and negotiation self-efficacy were manipulated. Results: Condom availability and peer norms interacted in determining condom use, such that protected sex was more likely when a condom was available and when peer norms approved, rather than disapproved, of condom use. The effect of peer norms on condom use was mediated by intentions to use a condom and communication between partners about condom use. Condom communication, identified as a direct antecedent of condom use, was influenced by negotiation self-efficacy. Conclusions: These results suggest that interventions aimed at reducing risky sexual behavior should not only make condoms available but also address key psychosocial variables, such as peer norms. Condom communication should be taken into account as well, considering that it can be affected directly by negotiation self-efficacy and can be affected indirectly by peer norms.     

Lights,camera, condoms! Assessing college men's attitudes toward condom use in pornography

ABSTRACT

Objective: Investigate male college students' attitudes toward actors' use of condoms in pornography. Participants: Two hundred thirteen undergraduate males attending a large, state-supported midwestern university in the fall semester, 2012. Methods: Using a Web-based procedure, participants completed questionnaires assessing their pornography use, sexual history characteristics, and their attitudes toward condom use by adult performers. Results: Factor analysis of the 11-item condom use attitudes questionnaire supported 2 distinct subscales: Condom Supportive Attitudes and Condom Critical Attitudes. Although participants typically agreed with statements supportive of condom use and generally disagreed with statements critical of condom use in pornography, gay men had significantly higher condom supportive subscale scores than did heterosexual men. Neither subscale was correlated with weekly viewing of pornography. Conclusions: Although some producers of adult films argue that actors wearing condoms will displease many viewers, current findings suggest that young men express support for use of condoms by pornographic film actors.     

The association of campus resources for gay,lesbian, and bisexual students with college students' condom use

The author and colleagues examined campus resources for gay, lesbian, and bisexual (GLB) students at 119 US colleges to determine how the presence of such resources affected sexually active students' condom use. A random sample of unmarried, sexually active college students surveyed in 1999 completed questionnaires. Condom use was compared across schools with different levels of GLB resources. Condom use rates, analyzed by sex and sex-partner groups, ranged from 32% to 52%. With additional college variables controlled for, GLB resources were positively associated with the proportion of sexually active students who used condoms (p < .001). This association existed primarily for students with only opposite-sex partners. The author's findings suggest that campus resources for GLB students may be associated with college students' condom use.     

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.     

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.     

The Role of Attitude Functions,Efficacy, Anticipated Emotions,and Relationship Status on College Students' Condom Use Intentions

Conducted from the reasoned action perspective, previous research related to condom use generally included a limited number of variables and treated attitudes and self-efficacy as unidimensional constructs. Informed by attitude functions theory and health literature on condom use and anticipated emotions, this project aims to provide a more detailed understanding of college students' intentions to use condoms during sexual intercourse. Results show that relationship status moderated the relationships between several psychological variables and condom use intentions. For female college students negative anticipated emotions were a stronger predictor of condom use intentions for those in monogamous relationships for three months or longer than for those in other relationships or not in a relationship. On the other hand, subjective norms were a stronger predictor of intentions for those in other types of relationship or not in a relationship than for those in a monogamous relationship for three months or longer. For male participants, sexual sensation was a more important, negative predictor of condom use intentions among those in monogamous relationships for three months or longer (versus other relationship status or not in a relationship). Both theoretical and practical implications are discussed.     

The Association of Campus Resources for Gay,Lesbian, and Bisexual Students With College Students' Condom Use

Abstract

The author and colleagues examined campus resources for gay, lesbian, and bisexual (GLB) students at 119 US colleges to determine how the presence of such resources affected sexually active students' condom use. A random sample of unmarried, sexually active college students surveyed in 1999 completed questionnaires. Condom use was compared across schools with different levels of GLB resources. Condom use rates, analyzed by sex and sex-partner groups, ranged from 32% to 52%. With additional college variables controlled for, GLB resources were positively associated with the proportion of sexually active students who used condoms (p < .001). This association existed primarily for students with only opposite-sex partners. The author's findings suggest that campus resources for GLB students may be associated with college students' condom use.     

Adaptive training for existing male transsexual gender role: A case history

The development of AIDS interventions for adolescents is hindered by the lack of data on the conditions that influence high‐risk sexual behavior. We examined psychosocial correlates of condom use and multiple partner sex for a sample of sexually‐active heterosexual adolescent women. Respondents reported higher levels of vaginal intercourse than the “average” adolescent. A minority were engaging in anal intercourse. Condom use was associated with perceived enjoyment of condoms and communication skills. Number of sexual partners was associated with susceptibility beliefs, social norms, and sexual communication skills. The findings support the general observation that AIDS interventions with adolescents should build sexual communication skills, address motivational issues, and teach people how to enjoy safe‐sex activities.     

How Condom Discontinuation Occurs: Interviews With Emerging Adult Women

We have almost no data on how and when couples stop using condoms. This qualitative study investigated the process of condom discontinuation. From November 2013 to April 2014, a total of 25 women living in a college town in the Midwest, ages 18 to 25, participated in semistructured interviews centered around three domains: partner interactions, contraceptive use, and sexually transmitted infection (STI) prevention. Analysis followed a critical qualitative research orientation. Participants described actively seeking the best options to prevent pregnancy, perceiving condom discontinuation in favor of hormonal methods as a smart decision, and reported wanting to discontinue using condoms due to physical discomfort. Oftentimes, nonverbal communication around contextual instances of condom unavailability paved the way for discontinuation. Participants indicated the decision to stop using condoms was neither deliberate nor planned. Condom discontinuation rarely occurred at one point in time; instead, it was preceded by a period of occasional use. Even after participants described themselves as not using condoms, sporadic condom use was normal (typically related to fertility cycles). This study provides a more detailed understanding of how and why emerging adults negotiate condom discontinuation, thereby enhancing our ability to design effective condom continuation messages. Attention should be paid to helping emerging adults think more concretely about condom discontinuation.     

Do Associations Between Pleasure Ratings and Condom Use During Penile–Vaginal Intercourse Vary by Relationship Type?: A Study of Canadian University Students

Research suggests the relationship between pleasure and condom use during penile–vaginal intercourse (PVI) is associated with relationship status. This online study examined pleasure ratings and condom use at last PVI, stratifying by partner type, among a national sample of Canadian university students. Participants were 715 undergraduates (60.7% women, 39.3% men) who reported on their most recent sexual experience. Condom use decreased with level of relationship commitment, whereas ratings of pleasure increased. Overall, participants were more likely to rate their most recent PVI as Very pleasurable when condoms were not used compared to when condoms were used. However, when stratified by partner type, these differences largely disappeared. For women, with one exception, there were no differences in pleasure between PVI with and without condoms across most partner-type categories. Women in committed dating relationships were more likely to report their last PVI as very pleasurable if condoms were not used than women in these same relationships who had used condoms. Across relationship categories, men who did and did not use condoms did not differ in terms of their pleasure ratings. The results of this study suggest relationship context should be taken into account when assessing condom use experiences.     

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.     

Factors influencing selected heterosexual male college students' condom use

This study assessed selected heterosexual male college students' use of condoms, their reasons for using condoms, and their attitudes toward sexuality and condoms. Three hundred five male subjects completed a questionnaire that assessed class standing, marital status, reasons for using condoms, number of recent sexual partners, intention to use condoms, and attitudes toward sexuality and condoms. Although no relationship between attitudes toward sexuality and attitudes toward condoms was noted, a negative correlation (-.42) was found between attitude toward condoms and intention to use condoms within the next month if the subject were to have intercourse during that time. Recommendations for increasing condom use are presented.     

The Condom Fairy program: A novel mail-order service for condoms and sexual health supplies

Abstract

Objective: In recent years college health professionals have used a variety of innovative strategies to increase availability and accessibility of condoms and safer sex products. The purpose of this study is to evaluate the efficacy and efficiency of a mail-order delivery program titled the Condom Fairy. Participants: Seven hundred thirty-three students (63.4% women, 86.1% heterosexual, and 59.2% Caucasian) completed a questionnaire assessing their overall experience with the program. Methods: Participants completed a 60 item questionnaire 30?days after receiving condoms and safer sex products. Results: Overall, 46,980 condoms were distributed over a six semester period. Almost all of the participants (97.4%) reported they ordered male condoms while 58.0% ordered sexual lubricant, 11.1% female condoms, and 10.2% latex dams. Nearly than three-quarters (73.9%) of participants reported they used the condoms provided. Conclusions: Findings support the implementation of innovative mail-in condom and safer sex product programs on college campuses.     

Condom Negotiation Strategies as a Mediator of the Relationship between Self-Efficacy and Condom Use

College students are a group at high risk of sexually transmitted infections due to inconsistent condom use and engaging in other risky sexual behaviors. This study examined whether condom use self-efficacy predicted the use of condom negotiation strategies (i.e., condom influence strategies) and whether condom influence strategies mediated the relationship between condom use self-efficacy and condom use within this population, as well as whether gender moderated the mediation model. Results showed a strong relationship between condom use self-efficacy and condom influence strategies. Additionally, condom influence strategies completely mediated the relationship between condom use self-efficacy and condom use. Although condom use self-efficacy was related to condom use, the ability to use condom negotiation strategies was the most important factor predicting condom use. The mediation model held across genders, except for the condom influence strategy withholding sex, where it was not significant for men. For women, condom use self-efficacy promoted the use of a very assertive negotiation strategy, withholding sex, and was consequently related to increased condom use. Overall, using assertive condom negotiation strategies (e.g., withholding sex and direct request) were found to be the most important aspects of increasing condom use for both women and men. Implications and suggestions for prevention programming are discussed.     

The moderating effect of alcohol use on protective and risky sex behaviors among college students in the Southeast United States

ABSTRACT

Objective: College students are a high-risk population for new human immunodeficiency viruses (HIV) diagnoses. Although condom use self-efficacy and HIV knowledge can protect against risky sexual behavior (RSB), these same protective factors have been shown to exacerbate RSB. The influence of alcohol use can further complicate these protective factors to influence RSB. Participants: 689 African American/Black and non-Hispanic White college students attending a public university in the Southeast United States. Method: This study sought to examine the relations between condom use self-efficacy and HIV knowledge with RSB and the moderating effect of alcohol use. Results: Findings showed positive associations between RSB and HIV knowledge and alcohol use. Unexpectedly, low frequency drinkers with high condom use self-efficacy were at increased risk for RSB compared to high frequency drinking counterparts. Conclusions: Findings point to the need to target prevention services for low-risk drinkers in college settings.     

Predictors of safer sex on the college campus: a social cognitive theory analysis.

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N = 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjunction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.     

Sexual Coercion,Verbal Aggression,and Condom Use Consistency Among College Students

Abstract

Objective: The relationship between condom use and 2 less visible categories of intimate partner violence (IPV), sexual coercion and verbal aggression, was examined among college students. Methods: In March 2007 a random cross-sectional sample of undergraduates from the southeast region of the United States was taken to collect information about sexual coercion and verbal aggression, in addition to condom use consistency. Alcohol use was also assessed. Results: Of the 142 participants, 31.7% reported being victims of sexual coercion, and 78% reported having verbally aggressive partners. Participants who reported experiencing sexual coercion in their relationship were significantly less likely to consistently use condoms. Additionally, alcohol use before or during episodes of verbal aggression was negatively associated with condom use. Alcohol use was also significantly associated with heightened incidents of coercion and aggression. Conclusions: Results indicate that among college students, the presence of sexual coercion adversely affects condom use, as does alcohol use.