Condom Presence, Condom Use, and Men's Sexual Decision Making

BACKGROUND Adolescents and young adults (AYA) less than 25 years of age have the highest rates of sexually transmitted infections (STI) in the United States. Current STI prevention strategies for AYA rely primarily on individual approaches, leaving sexual partners with significant unmet sexual and reproductive healthcare and health education needs. Dyadic interventions may hold promise for harnessing the power of communal coping within relationship dynamics to enhance sexual decision-making, communication, and behavior changes that reduce the future risk of STIs. OBJECTIVE This paper describes the protocol and research methods of a dyad-based behavioral intervention that augments individual evidence-based interventions with joint health education counseling for heterosexual AYA dyads within a primary care setting. The trial aims to improve partner communication and collaborative sexual decision making, and to promote the adoption of sexual behaviors such as consistent condom use. The primary objective of this study is to assess the feasibility, acceptability and effectiveness of a dyadic intervention targeted at preventing STIs in heterosexual couples in an urban setting. METHODS One hundred AYA (50 dyads) aged 16-25 years, engaged in heterosexual intercourse, who reside in the city, and are willing to recruit their main sexual partner for the study will be recruited and randomized into two groups; an intervention arm and a control arm. Participants will be recruited from an AYA Medicine Clinic and using social media (Facebook and Instagram). The index participant and partner will complete a single individual session separately (Sister to Sister / Focus on the Future) with a gender-matched health educator. Dyads will then be randomized to receive an additional joint debriefing session together to discuss relationship dynamics, condom negotiation etc. Participants will separately complete a telephone interview 6 weeks post intervention to determine the feasibility, acceptability and impact of the intervention on mutual sexual negotiation, consistency of condom use, communal coping skills, etc. RESULTS So far, 44 (25%) of 173 eligible participants have been enrolled and randomized. Participants are mostly females (90.9%), with at least a high school diploma (87%), and 9.0 average lifetime sexual partners. Acceptability is high, with 97.5% of participants expressing satisfaction with their study experience. 100% of dyads recruited were still together at 6-week follow-up. CONCLUSIONS Findings from this study will add to the current literature on the approaches to STI prevention and its success will inform its application in risk reduction counselling for youth who are most at risk. CLINICALTRIAL Clinical Trials.gov identifier (NCT number): NCT03275168

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Corrigendum to “Sex, sexual arousal, and sexual decision making: An evolutionary perspective” [Personal. Individ. Differ., 177 (2021): 110826 Pages 1–5]

Personality and Individual Differences ◽

10.1016/j.paid.2021.110908 ◽

2021 ◽

Vol 178 ◽

pp. 110908

Author(s):

Courtney L. Crosby ◽

David M. Buss ◽

Lawrence K. Cormack ◽

Cindy M. Meston

Keyword(s):

Decision Making ◽

Sexual Arousal ◽

Evolutionary Perspective ◽

Sexual Decision Making

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Condom Decision Making Among Latino and Black Adolescent Males: Social Neurobiological and Paternal Influences

Research on Social Work Practice ◽

10.1177/10497315211022802 ◽

2021 ◽

pp. 104973152110228

Author(s):

Vincent Guilamo-Ramos ◽

Adam Benzekri ◽

Marco Thimm-Kaiser ◽

Margarita Rivera ◽

Taleria R. Fuller ◽

...

Keyword(s):

Decision Making ◽

Condom Use ◽

Ordinary Least Squares ◽

Unprotected Sex ◽

Adolescent Males ◽

Adolescent Male ◽

Condomless Sex ◽

Black Adolescent ◽

Black Adolescent Males ◽

Paternal Influence

Purpose: We explored mechanisms of paternal influence associated with adolescent male condom decision making and behavior within an integrated framework of social neurobiological and behavioral theories of condom use. Method: Self-administered surveys from Latino and Black adolescent males aged 15–19 years ( n = 191) and their fathers were obtained. Dyads were recruited using area sampling methodology. Analyses included multivariable logistic and ordinary least squares regression examining direct and indirect associations of adolescent decision-analytic and paternal influence factors with adolescent condomless sex in the past 3 months. Results: Notions of masculinity, low-risk perception, partner approval of, and self-efficacy for condomless sex were associated with engaging in unprotected sex. Adolescent males reported reduced odds of engaging in condomless sex when indicating greater levels of father–son communication, relationship satisfaction, and paternal monitoring. Conclusion: Father-based interventions grounded in integrated theoretical frameworks of behavioral decision making and neuroscience have the potential to promote condom use among adolescent males.

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Adolescent condom use in Southern Africa: narrative systematic review and conceptual model of multilevel barriers and facilitators

BMC Public Health ◽

10.1186/s12889-021-11306-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Áine Aventin ◽

Sarah Gordon ◽

Christina Laurenzi ◽

Stephan Rabie ◽

Mark Tomlinson ◽

...

Keyword(s):

Decision Making ◽

Condom Use ◽

Conceptual Model ◽

Sex Education ◽

Southern Africa ◽

A Priori ◽

Barriers And Facilitators ◽

Policy Support ◽

Structural Level ◽

Interpersonal Barriers

Abstract Background Adolescent HIV and pregnancy rates in Southern Africa are amongst the highest in the world. Despite decades of sexual and reproductive health (SRH) programming targeting adolescents, recent trends suggest there is a continued need for interventions targeting condom use for this age group. Methods This review synthesises evidence from qualitative studies that describe the determinants of condom use among adolescents in Southern Africa. We conducted systematic searches in four databases. Data were extracted, appraised for quality and analysed using a ‘best-fit’ framework synthesis approach. Results We coded deductively findings from 23 original studies using an a priori framework and subsequently conducted thematic analysis. Synthesised findings produced six key themes relating to: 1) pervasive unequal gender norms and restrictive masculinities favouring male sexual decision-making and stigmatising condom use in committed relationships; 2) other social norms reflecting negative constructions of adolescent sexuality and non-traditional family planning; 3) economic and political barriers including poverty and a lack of policy support for condom use; 4) service-level barriers including a lack of youth-friendly SRH services and comprehensive sex education in schools; 5) interpersonal barriers and facilitators including unequal power dynamics in sexual partnerships, peer influences and encouraging condoning condom use, and inadequate communication about SRH from parents/caregivers; and 6) negative attitudes and beliefs about condoms and condom use among adolescents. A conceptual model was generated to describe determinants of condom use, illustrating individual-, interpersonal- and structural-level barriers and facilitating factors. Conclusion SRH programming targeting barriers and facilitators of condom use at multiple levels is recommended in Southern Africa. We present a multilevel integrated model of barriers and facilitators to guide adolescent SRH decision-making, programme planning and evaluation. Given the existence of multilevel barriers and facilitators, interventions should, likewise, take a multilevel approach that incorporates locally relevant understanding of the individual-, interpersonal- and structural-level barriers and facilitators to condom use among adolescents in the region.

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