Decision making over condom use during menses to avert sexually transmissible infections

Background The aim of this study was to test the hypothesis that receptive partners in penile–vaginal intercourse (PVI) who exercise independent decision making over condom use during menses do so to avert sexually transmissible infection (STI) transmission or acquisition. Methods: Data were collected through a partnership with Clue, the industry-leading female health app. A brief web-based questionnaire was developed, translated into 10 languages, and made accessible via a URL link sent to Clue users and posted on social media. Inclusion criteria were: age ≥14 years, not being currently pregnant and engaging in PVI and condom use during menses in the past 3 months. The analytical subsample comprised 12889 respondents residing in 146 countries. Results: Twenty per cent indicated independent decision making about condom use during menses. Independent decision making was associated with lower odds of reporting that condoms were used for contraception (adjusted odds ratio (aOR) 0.65; 99% confidence interval (CI) 0.57–0.73) and higher odds that they were used for the prevention of STIs (aOR 1.44; 99% CI 1.28–1.61). A third significant finding pertained to always using condoms during menses; this was less likely among those indicating independent (female only) decision making (aOR 0.69; 99% CI 0.62–0.78). Non-significant associations with another two outcomes were found: protecting the partner against menstrual blood and protecting themselves against semen. Conclusions: Findings from people in 146 countries strongly support the hypothesis that those exercising independent decision making over condom use during menses do so to avert STI transmission or acquisition. That only one-fifth of this global sample reported this type of independent decision making suggests that empowerment-oriented (structural-level) interventions may be advantageous for individuals who are the receptive partner in PVI that occurs during menses.

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Corrigendum to: Decision making over condom use during menses to avert sexually transmissible infections

Sexual Health ◽

10.1071/sh18136_co ◽

2019 ◽

Vol 16 (1) ◽

pp. 100

Author(s):

Richard A. Crosby ◽

Cynthia A. Graham ◽

Stephanie A. Sanders ◽

William L. Yarber ◽

Marija V. Wheeler ◽

...

Keyword(s):

Decision Making ◽

Condom Use ◽

Structural Level ◽

Significant Finding ◽

Web Based ◽

Sexually Transmissible Infections ◽

Independent Decision ◽

Sexually Transmissible Infection ◽

Transmissible Infection ◽

Do So

Background:The aim of this study was to test the hypothesis that receptive partners in penile–vaginal intercourse (PVI) who exercise independent decision making over condom use during menses do so to avert sexually transmissible infection (STI) transmission or acquisition. Methods: Data were collected through a partnership with Clue, the industry-leading female health app. A brief web-based questionnaire was developed, translated into 10 languages, and made accessible via a URL link sent to Clue users and posted on social media. Inclusion criteria were: age ≥14 years, not being currently pregnant and engaging in PVI and condom use during menses in the past 3 months. The analytical subsample comprised 12889 respondents residing in 146 countries. Results: Twenty per cent indicated independent decision making about condom use during menses. Independent decision making was associated with lower odds of reporting that condoms were used for contraception (adjusted odds ratio (aOR) 0.65; 99% confidence interval (CI) 0.57–0.73) and higher odds that they were used for the prevention of STIs (aOR 1.44; 99% CI 1.28–1.61). A third significant finding pertained to always using condoms during menses; this was less likely among those indicating independent (female only) decision making (aOR 0.69; 99% CI 0.62–0.78). Non-significant associations with another two outcomes were found: protecting the partner against menstrual blood and protecting themselves against semen. Conclusions: Findings from people in 146 countries strongly support the hypothesis that those exercising independent decision making over condom use during menses do so to avert STI transmission or acquisition. That only one-fifth of this global sample reported this type of independent decision making suggests that empowerment-oriented (structural-level) interventions may be advantageous for individuals who are the receptive partner in PVI that occurs during menses.

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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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Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

Sexual Health ◽

10.1071/sh14003 ◽

2014 ◽

Vol 11 (3) ◽

pp. 217 ◽

Cited By ~ 67

Author(s):

David J. Templeton ◽

Phillip Read ◽

Rajesh Varma ◽

Christopher Bourne

Keyword(s):

Nucleic Acid Amplification ◽

Effective Control ◽

Sexually Active ◽

Chlamydia Testing ◽

Sexually Transmissible Infections ◽

Sex With Men ◽

Time Required ◽

Sexually Transmissible Infection ◽

Transmissible Infection ◽

Asymptomatic Men

Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

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Are printed sexually transmissible infection materials for patients appropriate? A physician perspective

Sexual Health ◽

10.1071/sh08012 ◽

2008 ◽

Vol 5 (3) ◽

pp. 307 ◽

Cited By ~ 1

Author(s):

Asaduzzaman Khan ◽

David Plummer

Keyword(s):

General Practitioners ◽

New South ◽

New South Wales ◽

Postal Survey ◽

Physician Perspective ◽

South Wales ◽

Sexually Transmissible Infections ◽

Information Materials ◽

Sexually Transmissible Infection ◽

Transmissible Infection

The data from a postal survey of 409 general practitioners (GPs) practicing in New South Wales are analysed to explore GPs’ concerns, if any, about available printed information materials on sexually transmissible infections (STI) for patients. Just over half (55%) of GPs considered the materials for patients to be inadequate and/or inappropriate with 18% considering the materials as too technical for many patients and 13% considering the materials mostly out of date. Over a fifth reported that either STI materials were not available in their clinic or they did not know where to get those materials.

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Pending research issues in male condom use promotion

Sexual Health ◽

10.1071/sh08080 ◽

2008 ◽

Vol 5 (4) ◽

pp. 317 ◽

Cited By ~ 7

Author(s):

Richard Crosby ◽

Lee Warner

Keyword(s):

Condom Use ◽

Effective Means ◽

Sufficient Evidence ◽

Human Papillomavirus Vaccination ◽

Vaginal Microbicides ◽

Research Issues ◽

Protective Behaviour ◽

Mass Marketing ◽

Sexually Transmissible Infection ◽

Transmissible Infection

Sufficient evidence has accumulated to warrant the expansion of condom use research in several additional directions. Possible risk compensation pertaining to human papillomavirus vaccination and vaginal microbicides is one example. A second area of needed research involves the question of when couples can be advised to safely discontinue condom use given that ‘lifelong’ condom use is not a realistic goal for most people. A third example is intensified research designed to identify more effective means of mass marketing condoms and their use as a health-protective behaviour. As the AIDS and sexually transmissible infection pandemics persist, intensified condom promotion research is an ethical imperative.

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Progress and challenges to male and female condom use in South Africa

Sexual Health ◽

10.1071/sh11011 ◽

2012 ◽

Vol 9 (1) ◽

pp. 51 ◽

Cited By ~ 50

Author(s):

Mags E. Beksinska ◽

Jennifer A. Smit ◽

Joanne E. Mantell

Keyword(s):

South Africa ◽

Public Sector ◽

Condom Use ◽

National Level ◽

Female Condom ◽

Rapid Expansion ◽

Male And Female ◽

The Public ◽

Sexually Transmissible Infections ◽

Sexually Transmissible Infection

South Africa has responded to the sexually transmissible infection and HIV epidemic with a rapid expansion of its national-level public sector condom program. Male condoms are available widely at no cost in the public sector, with expanded access via social marketing and the private sector. The female condom program is one of the largest and best established globally. National surveys show progressive increases in rates of condom use at last sex. However, inconsistent and incorrect condom use and the likelihood that condoms are discontinued in longer-term partnerships are some of the challenges impeding the condom program’s successes in the fight against sexually transmissible infections and HIV. This article reviews the current condom program, related guidelines and policies, and the existing data on male and female condom use, including distribution and uptake. We discuss the main challenges to condom use, including both user and service-related issues and finally how these challenges could be addressed.

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Assortative sexual mixing patterns in male–female and male–male partnerships in Melbourne, Australia: implications for HIV and sexually transmissible infection transmission

Sexual Health ◽

10.1071/sh16055 ◽

2016 ◽

Vol 13 (5) ◽

pp. 451 ◽

Cited By ~ 6

Author(s):

Eric P. F. Chow ◽

Tim R. H. Read ◽

Matthew G. Law ◽

Marcus Y. Chen ◽

Catriona S. Bradshaw ◽

...

Keyword(s):

Condom Use ◽

Health Centre ◽

Rank Correlation ◽

Risk Groups ◽

Strong Positive Correlation ◽

Limited Data ◽

Spearman’S Rank Correlation ◽

Mixing Patterns ◽

Sexually Transmissible Infection ◽

Transmissible Infection

Background: Assortative mixing patterns have become a new and important focus in HIV/sexually transmissible infection (STI) research in recent years. There are very limited data on sexual mixing patterns, particularly in an Australian population. Methods: Male–female and male–male partnerships attending the Melbourne Sexual Health Centre (MSHC) between 2011 and 2014 were included. Correlation of age between two individuals within a partnership was examined by using Spearman’s rank correlation. The Newman’s assortativity coefficient was used as an aggregate quantitative measurement of sexual mixing for number of partners and condom use. Results: 1165 male–female and 610 male–male partnerships were included in the analysis. There was a strong positive correlation of age in both male–female (rho = 0.709; P < 0.001) and male–male partnerships (rho = 0.553; P < 0.001). The assortative mixing pattern for number of partners was similar in male–female (r = 0.255; 95% CI: 0.221–0.289) and male–male partnerships (r = 0.264; 95% CI: 0.218–0.309). There was a stronger assortative mixing pattern for condom use in male–male (r = 0.517, 95% CI: 0.465–0.569) compared with male–female (r = 0.382; 95% CI: 0.353–0.412) partnerships. Conclusion: Male–female and male–male partnerships have a high assortativity mixing pattern for age, number of partners and condom use. The sexual mixing pattern is not purely assortative, and hence it may lead to increased HIV and STI transmission in certain risk groups.

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Aboriginal women's stories of sexually transmissible infection transmission and condom use in remote central Australia

Sexual Health ◽

10.1071/sh07009 ◽

2007 ◽

Vol 4 (4) ◽

pp. 237 ◽

Cited By ~ 16

Author(s):

Astrid M. Stark ◽

Alex Hope

Keyword(s):

Qualitative Research ◽

Sexual Assault ◽

Sexual Health ◽

Condom Use ◽

Aboriginal People ◽

Sociocultural Context ◽

Perception Of Risk ◽

Central Australia ◽

Sexually Transmissible Infection ◽

Transmissible Infection

Background: Sexually transmissible infection (STI) rates are persistently high in central Australia, creating conditions for a potential HIV pandemic in the area. There is a shortage of qualitative research examining the underlying factors affecting STI transmission in this region. The present study investigates Aboriginal women’s current levels of knowledge regarding STI and their transmission, perception of risk for STI, patterns of condom use, access to condoms and experiences of condom negotiation with their partners. It also explores the sociocultural context of their sexual health. Methods: The present study used qualitative methods with a semistructured questionnaire. Twenty-four women aged 18–35 years from one remote central-Australian Aboriginal community were recruited. Results: The results revealed poor understandings of STI transmission, limited access to condoms and low levels of condom use despite a high perception of risk to STI. They also identified specific issues facing these women regarding the sociocultural context of their condom use, their access to condoms and the transmission of STI. The perceived effects of alcohol abuse, infidelity, sexual assault and shame on the acquisition of STI were significant issues for the women. Conclusion: This research has identified an urgent need for further qualitative research into the sociocultural factors that facilitate the spread of STI among Aboriginal people of remote central Australia. Implications include the need to increase their knowledge regarding STI and STI transmission, to increase women’s access to condoms and to incorporate the teaching of skills to deal with sexual assault and violence into sexual-health education.

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An Integrated Model of Discrete Choice and Response Time

Journal of Marketing Research ◽

10.1509/jmkr.45.5.593 ◽

2008 ◽

Vol 45 (5) ◽

pp. 593-607 ◽

Cited By ~ 32

Author(s):

Thomas Otter ◽

Greg M. Allenby ◽

Trish Van Zandt

Keyword(s):

Decision Making ◽

Response Time ◽

Discrete Choice ◽

Response Times ◽

Marketing Research ◽

Race Model ◽

Exogenous Variables ◽

Web Based ◽

Dependent Variables ◽

Do So

Computer and Web-based interviewing tools have made response times ubiquitous in marketing research. Practitioners use these data as an indicator of data quality, and academics use them as an indicator of latent processes related to memory, attributes, and decision making. The authors investigate a Poisson race model with choice and response times as dependent variables. The model facilitates inference about respondents' preferences for choice alternatives, their diligence in providing responses, and the accessibility of attitudes and the speed of thinking. Thus, the model distinguishes between respondents who are quick to think and those who are quick to react but do so without much thought. Empirically, the authors find support for the endogenous nature of response times and demonstrate that models that treat response times as exogenous variables may result in misleading inferences.

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Oral Transmission of Sexually Transmissable Infections: A Narrative Review

Acta Médica Portuguesa ◽

10.20344/amp.12191 ◽

2019 ◽

Vol 32 (12) ◽

pp. 776

Author(s):

Catarina Queirós ◽

João Borges da Costa

Keyword(s):

Oral Cavity ◽

Bacterial Infections ◽

Sexual Practices ◽

Oral Sex ◽

Oral Transmission ◽

Papillomavirus Infection ◽

Sexually Transmissible Infections ◽

Basic Functions ◽

Sexually Transmissible Infection ◽

Transmissible Infection

Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissible infections increasingly recognized. Patients harboring a sexually transmissible infection may first present lesions on the oral cavity, as these may be visible and interfere with basic functions such as speech or swallowing. Moreover, the oral cavity may function as a reservoir for future spread of these infections. In order to successfully control this problem, a greater focus on oral sex should be persued, along with promotion of the use of condom and education on safe oral sex practices. Furthermore, examination of the oral cavity should is essential when evaluating any patient suspected of harboring a sexually transmissible infection. In this article, oral transmission of several viral and bacterial infections is reviewed, including human papillomavirus infection, genital herpes, syphilis and gonorrhea, among others.

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