Condom Use in Commercial Sex Workers and Clients Among Incarcerated Sexworkers and STD Clinic Attendees in Jinan, Shandong Province

Background: Commercial sex workers and clientsare important core populations in the transmission ofsexually transmitted diseases (STDs) and human im-munodeficiency virus (HIV) infection. Research on thefrequency and determinants of condom use in com-mercial sex workers and their clients is important inincreasing condom use and reduction of the STD/HIV.Burden. Objectives: To establish the frequency of and fac-tors related to intention to use condoms and actualcondom use in commercial sex contacts and to deter-mine the differences in condom use between sex work-ers and clients.Methods: Incarcerated commercial sex workers(ICSW) and male STD clinic attendees were recruitedinto a cross-sectional study to obtain data on the fre-quency and factors associated with intention to usecondoms and condom use in commercial sexual con-tacts with an interviewer-administered questionnaire.Consistent condom use in ICSWs and never usingcondoms in male STD clinic attendees were analyzedusing univariate and multivariate logistic regressionmodels. Results: The frequency of reported consistent in-tention to use condoms and reported actual condomuse was 62% and 50.6%, respectively among 158ICSWs. For male STD clinic attendees, the propor-tion of reported consistent intention to use condomsand reported actual condom use was 10% and 20.7%,respectively. The factors positively influencing theconsistent intention to use condoms were pregnancypreventing measures and the belief of condom efficacyin the prevention of STD/HIV, whereas the factor as-sociated with actually consistent condom use was preg-nancy-preventing measure in ICSWs. Factors associ-ated with no intention to use condoms were low income,low STD/HIV knowledge level and the frequency ofvisiting CSW. The latter factor was also associatedwith never using condoms in male STD clinicattendees. Conclusions: Consistent condom use during com-mercial sex contacts was low, especially in clients.Greater effort is needed in condom promotion programin order to raise the level of condom use in commer-cial sex contacts.

AIDS-related Knowledge,Condom Usage Among Medical Postgraduates

Objective To investigate the knowledge about safety/unsafty of sexual acts relating to HIV transmission, levels of embarrassment related to condom and condom usage among medical postgraduates. Methods From August to December, 1998, a self-administered anonymous questionnaire was given to 271 new medical postgraduates from two medical colleges of Beijing and Hebei Province. Results There was a hazy understanding of the protective function of condom from AIDS among medical postgraduates. Only 14.4% medical postgraduates persisted in using condom, and 27.94% had never or almost never used it. The levels of embarrassment about condom were high. The median score was 3.55+0.98. Whether to use condom was related with the attitudes to condom, but not to AIDS. Conclusion There was some misunderstanding about condom and inconsistent condom usage in medical postgraduates. So it is essential to strengthen the sexual health education among them.

Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students

Objective To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model （EPPM）-based integrated model. Methods A total of 3,082 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Results Among the participants, 2,387 （46.7%） were male, 2,586 （53.3%） were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect （r = 0.23）, perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education （r = 0.40） and intention to engage in premarital sex （r = -0.16）, respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex （intent-to-premarital-sex） had a poor indirect impact on condom-use self-efficacy （total effect was -0.06）. Furthermore, attitude toward HIV health education （r = 0.49） and intent-to-premarital-sex （r = -0.32） had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. Conclusion The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.

Condom-Assisted Transurethral Resection: A New Surgical Technique for Urethral Tumor

Backgrounds: It is difficult to develop clear endoscopic field during transurethral resection (TUR) of urethral tumors, because irrigation water easily spills out from the meatus. We have devised a surgical technique to facilitate TUR of urothelial tumors. Methods: A 79-year old man developed urethral tumors in the anterior urethra and fossa navicularis 6 months after TUR of bladder tumor. We covered his penis and the resectoscope with a tip-cut condom. The tip-end of condom and the resectoscope sheath was tightly sealed and irrigation water was filled inside the condom. Results: The urethral tumors were successfully resected under a clear vision by filling irrigation water inside a tip-cut condom that covered over the resectoscope and the penis. Conclusion: This technique may be useful for TUR of anterior urethral tumors, especially tumors at fossa navicularis, which is often associated with difficulty in obtaining clear surgical vision.

Power Relation and Condom Use in Commercial Sex Behaviors

To explore whether condom use is influenced by power relation in commercial sex behaviors. Methods Variables were designed to measure the power relation in commercial sex behaviors based on the theory of gender and power relation and data were collected from male sexually transmitted diseases （STD） patients and female commercial sex workers （FSWs） working at recreation centers or being detained in a women education center to identify the relationship between condom use and power relation in male and female respondents using bivariate and multiple regression analysis. Results A significant relationship was identified between power relation and female condom use, the higher the score of power relations, the higher frequency the condom use, but no similar result was found in males. Females got a higher score of power relation than males. Conclusions Power relation is one of the factors that influence condom use, which should be considered when relevant theories are used to study the rate of condom use. It is worthwhile exploring the relationship between safe sex and power relation in spouses and regular sex partners when interventions are adopted to prevent HIV/AIDS spreading from high risk groups to the general population.

Study on Perception of Potential Condom Use among Unmarried Migrants

Objective To understand the perception of potential condom use and its influencing factors so as to promote condom use among unmarried migrantsMethod A survey, using self-administered structured anonymous questionnaire, was conducted among 1 092 unmarried migrants aged 15～24 years old in urban area of Shanghai. Results The unmarried migrants had some knowledge of condom. However, their knowledge level and their attitude towards condom use were not so optimistic. Subjects' knowledge of contraceptives and STD/AIDS had a positive influence on their attitude toward condom use. Subjects with positive attitude to condom use were more likely to use condom in sexual activity (OR=1.61). Conclusion Unmarried migrants have lower rate of condom use if they have insufficient knowledge of condom. Therefore, it is essential to strengthen the sexual health education among unmarried sex-active migrants in order to encourage contraceptive use, especially condom use.

Evaluation of Condom Use among University Undergraduates in Port Harcourt, Nigeria

Background: Barrier contraception has the beauty of dual protection—against pregnancy and sexually transmitted infections. Following the persisting burden of unsafe abortion and human immunodeficiency virus (HIV), much sensitization/campaign has been ongoing in the past few decades by government and non-governmental organisations (NGOs) in Nigeria against unprotected sexual intercourse. The youth are generally assumed to have high risk sexual behaviour, hence this study on Port Harcourt university undergraduates. Objectives: To determine the awareness and use of condom among University undergraduates in Port Harcourt. Methods: The study was a prospective descriptive cross-sectional study of 636 undergraduate students of the University of Port Harcourt and Rivers state University, South-south Nigeria. The multistage sampling technique was used to randomly select participants and data collected using a pretested structured self administered questionnaire. Data was analyzed using version 23.0 SPSS and reported in means, frequencies and percentages. Probability value was set at 5% (p χ2 = 200.602). Only 5.5% of the respondents in this study were willing to know their HIV status. Conclusion: There is a high level of condom awareness among Port Harcourt University undergraduates. Surprisingly, their practice of unprotected sexual intercourse is still high.

Cross-sectional study on AIDS knowledge and condom use in rural areas

Objective:To understand AIDS knowledge and condom use in rural areas,and to analyze theinfluencing factors of condom use.Methods:This is a cross-sectional study using the cluster-sampling method.4,800 subjects,randomly selected from six counties in China,were questioned using an anonymous survey.Results:36% of the subjects knew that tooth extraction could transmit AIDS.38.4% of thesubjects knew that the use of public razors could transmit AIDS.27.1% of the subjects had useda condom in the last year.The influencing factors of condom use were:sex(OR=1.325),age(OR=1.419),AIDS counseling(OR=2.181),educational level(OR=0.622),location of regis-tered permanent residence(OR=0.732),AIDS knowledge score(OR=0.736),and resident ofhigh AIDS prevalent province(OR=0.354).Conclusion:AIDS knowledge in rural areas is still lacking.The rate of condom use was verylow.The main influencing factors of low condom use were being female,elderly,and no AIDScounseling.Higher educational level,registered permanent resident in town,high AIDS knowl-edge score,and resident of high AIDS prevalent provinces were the propitious factors for condomuse.

Latent Profiles of Social Media Users, STI Knowledge, and Condom Use among African American Young Adults

The abundance of social networking platforms has increased the frequency and the availability for which individuals communicate with one another. The feasibility and accessibility to go online to find sexual partners pose opportunity for contracting sexually transmitted infections (STI) in the absence of safe sexual practices. Low condom use has been reported among young adults who seek sexual partners online. African American young adults have some of the highest rates of infection for certain STIs. In order to mitigate the incidence and prevalence of STIs in at-risk populations, sexually active young adults must use condoms consistently and correctly during sexual activities. The present study sought to uncover the heterogeneity within African American young adults regarding their online networking utilization, STI knowledge, and sexual risk behavior. African American young adults (N = 236), ages 18 - 23, completed private online survey administration. Using latent class analysis, three classes were identified: Social Network Communicators (43%;N = 101), Social Networking Daters (36%;N = 83), and Media Sharers (21%;N = 52). Social Networking Daters exhibited the highest probability of using online dating sites daily, low STI knowledge, and a zero probability of consistent condom use. All three groups exhibited relatively low STI knowledge. Furthermore, having a history of STI increased the likelihood of being classified into the Social Networking Daters class relative to the other classes. Findings highlight the need to capitalize upon online platforms for African American young adults who utilize online dating sites and other online environments.

Risk Factors Affecting Condom Use among Royal Thai Army Conscripts in Thailand

The study was conducted to explore factors associated with condom use of young Thai men conscripts. Methods: A cross-sectional study was conducted. Participants were 159 conscripts in second year who served in the Royal Thai Army by lottery method. Demographic data, sexual history including condom use, HIV and STDs and knowledge were collected using a self-administered questionnaire. Logistic regression was used to analyze the data. Results: Condom use at the last sex was 41.18% of the conscripts aged 20 - 27 years and secondary school education completed of 74.2%. 25.78% had experience with drugs used but injection was rare (6.9%). Age at the first sex was reported lowest at 11 years, 9.4% reported first sex with men and 21.38% were married. The participants have sexual history (last six months) with female only of 83.2%, male only of 4.1% and both of 14.6%. Among these only 12.6% reported every time of condom use and 19.5% never used condom. Older age, higher education, drinking alcohol, drugs use and higher knowledge were associated with condom use with statistical significance. Conclusions: Condom use among male Thai conscripts was low. Education and a condom use program are urgently needed to prevent future spread of HIV and STDs.

An IEC Programme on the Promotion of Condom Use To Prevent AIDS

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Disclosure, Multiple Sex Partners, and Consistent Condom Use among HIV Positive Adults on Antiretroviral Therapy in Johannesburg, South Africa

Inconsistent condom use among persons on antiretroviral treatment (ART) is a major public health concern because of the risk of HIV transmission. This study examined the association between socio-demographic variables and knowing partners’ HIV status, multiple sex partners, and consistent condom use among 400 HIV-infected adults who had received ART for at least six months in Johannesburg, South Africa. The study used a cross-sectional survey and a structured interviewer administered questionnaire. Over half (n = 225, 56.3%) of participants were on ART for more than two years. Two thirds (n = 234, 63.2%) were aware of partner’s HIV status. Over a third (n = 136, 34.0%) reported having more than one sex partners. Three quarters (n = 279, 75.8%) reported consistent condom use with regular partner. Discussing HIV testing (aOR = 2.28, CI: 1.31 -3.95), awareness of partner’s HIV status (aOR = 2.59, CI: 1.50 -4.46), level of education (aOR = 0.64, CI: 0.42 -0.98), and duration on ART (aOR = 0.71, CI: 1.31 -3.95) were predictors for consistent condom use. Awareness of partner’s HIV status was associated with multiple partnership (aOR = 0.38, CI: 0.21 -0.66), living with partner (aOR = 4.75, CI: 2.86 -7.91), discussing HIV testing (aOR = 2.43, CI: 1.48 -3.99), and duration on ART (aOR = 2.04, CI: 1.43 -2.92). While gender (aOR = 5.68, CI: 3.46 -9.34), marital status (aOR = 0.44, CI: 0.25 -0.77), and awareness of partner’s HIV status (aOR = 0.52, CI: 0.30 -0.89) were associated with multiple partnerships. Risky sexual behaviours occurred in all types of partners and knowing partner’s HIV status was a predictor for consistent condom use with all types of partners. It is essential that HIV prevention strategies create an enabling environment for disclosure and reductions of risky sexual behaviours by HIV-infected persons on ART.

Consistent Condom Use among HIV Positive Women Attending Comprehensive Care Centre of Thika Level 5 Hospital, Kenya

Background: Condoms offer protection against human immunodeficiency virus (HIV) transmission when used correctly and consistently. Many HIV infected people do not use condom regularly, thus leading to new HIV infections and reinfections. In Kenya, condom use is considered to be low and HIV prevalence is high among women aged 15 - 49 years where utilization of condoms among HIV positive women has not been studied. Objectives: The study aimed at determining the prevalence of consistent condom use among HIV positive women aged 18 - 49 years and to investigate the variables associated with it. Methods: A mixed method of study design (qualitative and quantitative approaches) was employed. A total of 422 participants were selected randomly and interviewed using a pretested structured questionnaire. Three (3) focus group discussions with 8 participants in each group were conducted. Chi-square test (p < 0.05) and odds ratio with corresponding 95% confidence interval were computed to establish the association between consistent condom use and independent variables. Binary logistic regression model was used to identify variables independently associated with consistent condom use. Qualitative data were transcribed and coded and then analysed thematically. Results: Consistent condom use among sexually active HIV positive women was found to be 57.4% (95%CI: 52.7% - 62.1%). The stepwise logistic regression revealed that attending tertiary education [aOR = 2.54;95%CI = 1.30 - 4.95;P = 0.006], disclosing HIV status [aOR = 2.27;95%CI = 1.27 - 4.06;P = 0.005], having an HIV negative partner [aOR = 4.23;95%CI = 1.99 - 8.98;P < 0.001], not taking alcohol [aOR = 1.72;95%CI = 1.10 - 2.69;P = 0.017], never encountered resistance to use condom by partners [aOR = 1.87;95%CI = 1.15 - 3.03;P = 0.011] and perceived risk of contracting STIs [aOR = 2.11;95%CI = 1.12 - 3.97;P = 0.021] as factors independently associated with consistent condom use. Conclusion: This study shows that there is still low prevalence of consistent condom use among HIV positive women. More education, campaigning and sensitization should be tailored among HIV positive women during counseling so as to avoid re-infection and transmission of infections.

I Just Trust Him: The Notion of Consideration as a Barrier to Condom Use amongst Women Who Inject Drugs in Central Java

The HIV epidemic in Indonesia has risen sharply since 2004, from 2682 cases in 2004 to 19,973 in 2009. The main transmission route of HIV in Indonesia is injecting drug use. There is little research on women who inject drugs in Indonesia. In-depth interviews were carried out with 19 women who injected drugs in three small cities in central Java. The interviews explored the living conditions of the women and the context of HIV risk. The transcripts were coded and the data were thematically analyzed. In this paper we report on condom use with regular partners. Condom use was very low with their regular partners, even though both they and their partners were injecting drug users. The reasons women gave were that they trusted their partners (although they realised this trust was shaky). The women used traditional Javanese cultural concepts of consideration to explain why they did not use condoms. This was heightened by other cultural norms of women’s place in Javanese society. Although the women in the study were marginalized because of their drug use, they still hold to many Indonesian cultural precepts—of consideration and care for the other above oneself in their relationships with their regular partners which impede condom use. While notions of consideration and harmony were used to explain non-condom use, the same notions could also be used in couple-counseling to assist.

HIV Status Disclosure and Uptake of Female Condom among Women Accessing Antiretroviral Therapy Services at a Military Hospital in Lagos, Nigeria

Background: Female condom (FC) has efficiently challenged the increased risk for sexually transmitted infections (STI)/HIV, unwanted pregnancy and promoted self-protection and autonomy among females. However, despite being provided free of charge, the researchers have not observed satisfactory level of demand for FC by the HIV-positive clients at our facility. This study sought to establish the determinants or deterrent factors to the uptake and the use of FC among HIV-infected female clients in an Army hospital, Lagos. Method: A cross-sectional descriptive design was used and 340 interviewees were selected for the survey. Analyses were completed using Epi InfoTM version 7.2.1.0. Association between variables of interests was established using Chi-square. Result: Mean age of the participants was 37.91 ± 8.33 years while the median age was 37. Greater proportion was married (50.5%), business women (55.5%), had at least school certificate (90.1%), and had regular sexual partner (84.4%). Only 69.8% disclosed their status to their sexual partners, while 79.5% in turn were informed of their partners’ HIV status. Being in marital union, younger age and being aware of partner’s HIV status were significantly associated with HIV disclosure (p < 0.001). Contraceptive uptake was 59.8%, while FC use was 5.4%. Most reported limiting factors to FC utilization were non-availability (22.5%) and use of male condom by the partner (13.8%). Conclusion: Suboptimal HIV status disclosure, contraceptive use and very low FC uptake among participants need urgent attention to limit further spread of the virus, STI and prevent unwanted pregnancies.

Evaluation of Condom Use and Associated Factors among Adult HIV Clients in Maiduguri, North Eastern Nigeria: A Comparative Cross Sectional Study

Objective: To assess the pattern of condom use among HAART naive and experienced patients in north eastern Nigeria. Methods: An interviewer-administered questionnaire was used to assess the pattern of condom use among 201 HIV clients. Participants included for this comparative cross sectional study were divided into two group: HAART experienced participants that had been on therapy for at least 12 months and HAART naive participants that had been registered at least 3 months before the beginning of the study. Results: Almost half of the HAART naive and substantial proportion of HAART experienced couples never used condom. Few (13.4%) HAART experienced and 16.5% naive participants always used condom. Inconsistent condom use among HAART naive and experienced partners was 38.8% and 41.8% respectively. Spouse notification of HIV was significantly associated with the use of condoms (p = 0.02;OR 1.32, 95% CI: 1.06 - 1.64). The stepwise logistic regression indicated that female (OR 2.40;CI: 1.09 - 3.82), partner notification of HIV sero-positive status (OR 1.32;CI: 1.06 - 1.64, yes versus none), occupation as a civil servant (OR 1.40;CI: 0.15 - 1.05), are factors independently associated with condom use in our studied participants. Conclusion: We report that condom use is uncommon among HIV clients in our environment. Condom is significantly influenced by partner notification of HIV seropositive status, occupation as a civil servant and female gender. This study supports an absence of association between condom uptake and HAART use. Intensive and regular condom counselling for every HIV-positive outpatient who attends the clinic in our environment is expedient. We recommend interventions directed at increasing condom use among HIV clients in our environment.

Demographic, Socio-Economic and Psychosocial Determinants of Current and Consistent Condom Use among Adolescents in Botswana

Background: To facilitate effective program designs aimed at assisting youth avoid unnecessary negative reproductive health outcomes, there is need to understand determinants of condom use among adolescents. Objectives: To determine demographic, socioeconomic and psychosocial factors associated with adolescent condom use in Botswana. Methods: Logistic regression models were employed to analyse a weighted sample of 221 adolescents aged 15 to 19 years from the 2012 Botswana AIDS Impact Survey who had a sexual relationship during the 12 months preceding the survey. Results: A majority of adolescents were current and consistent condom users (81% and 72% respectively). Both current and consistent condom use were positively associated with secondary or higher education, unemployed, high perception of severity of HIV to health and high self-efficacy perception. However, being female, non-Christian, having medium or comprehensive HIV/AIDS related knowledge and high perceived personal risk to HIV infection were negatively associated with both outcomes. Although being 18 to 19 years, having multiple sexual partners and high perception of condom attributes were positively associated with current condom use, they were negatively associated with consistent use. Conclusions: The study showed that in addition to demographic and socioeconomic factors, psychosocial factors are important predictors for condom use among adolescents.

The differenced of characteristics of contraceptive method of condom and vasectomy: A cross-sectional study among married of male in Indonesia

Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesia.Methods:A cross-sectional study was conducted among 168 of married male(84 of condom method and 84 of vasectomy method)from April to August 2019 in Jember regency of East Java,Indonesia using purposive sampling method.A self-administered questionnaire was used to measure sociodemographic and contraceptive method of participants.Chi square test was performed to analyze the differences of characteristic of contraceptive method of condom and vasectomy among married male(P<0.05).Results:There were a significant differenced ethnic(χ^2=7.664,P-value=0.006)and access of information(χ^2=8.111,P-value=0.044)between condom and vasectomy method among married male.Conclusion:Characteristics of ethnic and access information are related with contraceptive method choosing for using condom and vasectomy among married male in Indonesia.Therefore,accessibility of contraceptive method through health education should be implemented for married male in Indonesia setting regarding their social and cultural context.

Risk Factors of Condom Use among Clients of Commercial Sex Workers in Saunas and Beauty Parlors in China

Objectives: To describe and analyze risk factors associatedwith disuse of condoms during commercial sexual intercourseamong clients attending sauna and massage centers. Methods: Selected female sex workers from saunas andbeauty parlors were trained as interviewers. They surveyedclients during provision of sexual services. Informationcollected included customers' demographics, knowledge ofSTDs, rationale for and history of condom use. Risk factorsfor condom usage were assessed though logistical modeling.Results: A total of 50 clients were interviewed. The rates ofcondom usage for last sexual intercourse with commercial andnon-commercial partners were 57% and 53% for clients ofsauna centers and 30% and 40% for clients of beauty parlors,respectively. The choice to use a condom was influenced byclients 60.8% of the time, sex workers 30.4%, and otherfactors 8.8%. The choice against using a condom was decidedupon by clients 69.7% of the time, sex workers 9.1%, andother factors 21.2%. Multivariate analysis showed thateducational level and perception of risk of infection werefactors for condom use. Clients with a high school educationhad a higher condom use rate than those with a middle schooleducation or less. Furthermore, clients who perceived risk ofdisease used condoms more frequently than those who did not.Conclusions: Clients played a significant role in decidingwhether or not to use a condom during commercial sex. Lackof perception of risk is a major factor for not using condoms.A program for promotion of prophylactics targeting bothcommercial sex workers and their clients is recommended.