Between Embarrassment and Trust: Young Women and the Diversity of Condom Use

Keyword(s):  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicola Knights ◽  
Nicole Stone ◽  
Tom Nadarzynski ◽  
Katherine Brown ◽  
Katie Newby ◽  
...  

Abstract Background Male condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. The Kinsey Institute Home-Based Exercises for Responsible Sex (KIHERS) is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of an adapted version of the KIHERS intervention with young women aged 16–25 years in the United Kingdom (UK) (Home-Based Exercises for Responsible Sex-UK (HERS-UK). Methods A repeated-measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 and T3), conducted 4 weeks and 8 weeks post intervention over a 3-month period. Participants were provided a condom kit containing different condoms and lubricants and were asked to experiment with condoms alone using a dildo and/or with a sexual partner. Ten process evaluation interviews were conducted post intervention. Results Fifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for intercourse in the past 4 weeks increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach’s alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention. Conclusions HERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided an early indication of the potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost-effectiveness of this intervention, in a large-scale controlled trial using a diverse sample and targeting young women most at risk of STIs.


Contraception ◽  
2018 ◽  
Vol 97 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Brittney Bastow ◽  
Jeanelle Sheeder ◽  
Maryam Guiahi ◽  
Stephanie Teal

AIDS Care ◽  
2009 ◽  
Vol 21 (5) ◽  
pp. 561-566 ◽  
Author(s):  
Lisa M. Williamson ◽  
Katie Buston ◽  
Helen Sweeting

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024362 ◽  
Author(s):  
Gavin George ◽  
Brendan Maughan-Brown ◽  
Sean Beckett ◽  
Meredith Evans ◽  
Cherie Cawood ◽  
...  

ObjectiveThis study examines the role of age-disparate partnerships on young women’s HIV risk by investigating coital frequency and condom use within age-disparate partnerships involving women aged 15 to 24.DesignA community-based, cross-sectional study was conducted.SettingParticipants were randomly selected using a two-stage random sampling method in uMgungundlovu district, KwaZulu-Natal, South Africa, between June 2014 and June 2015.ParticipantsA total of 1306 15–24-year-old women in an ongoing heterosexual partnership were included in the analysis. Participants had to be a resident in the area for 12 months, and able to provide informed consent and speak one of the local languages (Zulu or English).Primary and secondary outcome measuresSexual frequency was assessed by asking participants how many times they had sex with each partner in the past 12 months. The degree of condomless sex within partnerships was assessed in the survey by asking participants how often they used a condom with their partners.ResultsAge-disparate partnerships were associated with a higher order category (once, 2–5, 6–10, 11–20, >20) of coital frequency (adjusted OR (aOR) 1.32, p<0.05, 95% CI 1.02 to 1.71) and with sex on more than 10 occasions (aOR 1.48, p<0.01, 95% CI 1.12 to 1.96) compared with age-similar partnerships. Age-disparate partnerships were also more likely to involve sex on more than 10 occasions with inconsistent condom use (aOR 1.43, p<0.05, 95% CI 1.04 to 1.96) in the previous 12 months.ConclusionThe finding that increased sexual activity is positively associated with age-disparate partnerships adds to the evidence that age-disparate partnerships pose greater HIV risk for young women. Our study results indicate that interventions to reduce risky sexual behaviour within age-disparate partnerships remain relevant to reducing the high HIV incidence rates among adolescent girls and young women.


AIDS ◽  
2003 ◽  
Vol 17 (10) ◽  
pp. 1547-1556 ◽  
Author(s):  
Delia Scholes ◽  
Colleen M McBride ◽  
Louis Grothaus ◽  
Diane Civic ◽  
Laura E Ichikawa ◽  
...  

2017 ◽  
Vol 55 (7) ◽  
pp. 817-823 ◽  
Author(s):  
Rhiana Wegner ◽  
Melissa A. Lewis ◽  
Kelly Cue Davis ◽  
Elizabeth C. Neilson ◽  
Jeanette Norris
Keyword(s):  

Sexual Health ◽  
2008 ◽  
Vol 5 (1) ◽  
pp. 41 ◽  
Author(s):  
Richard A. Crosby ◽  
Ralph J. DiClemente ◽  
Gina M. Wingood ◽  
Laura F. Salazar ◽  
Sara Head ◽  
...  

Background: The influence that female partners exert regarding condom use is not well known. In the present study, the relative roles of personal sexual agency and relational factors in determining whether young African American women engaged in unprotected vaginal sex (UVS) were studied. Methods: A cross sectional study of 713 young, African American women (aged 15–21 years) was conducted. Data were collected using an audio-computer assisted self-interview. Three measures of sexual agency were assessed and three relational factors were assessed. To help assure validity in the outcome measure, condom use was assessed in five different ways. Multivariate analyses were used to determine whether variables independently predicted UVS. Results: Two of the six predictor variables achieved multivariate significance with all five measures of condom use: (1) fear of negotiating condom use with male partners, and (2) indicating that stopping to use condoms takes the fun out of sex. A relational factor (male-dominated power imbalances) achieved multivariate significance for four of the five measures of UVS. A sexual agency factor (whether young women greatly enjoyed sex) achieved multivariate significance for three of the five measures. Conclusion: The results suggest that young African American women at high-risk of sexually transmissible infections (STI)/HIV acquisition may experience male-dominated power imbalances and also fear the process of negotiating condom use with their male partners. Although these factors were independently associated with UVS, two factors pertaining to sexual agency of these young women were also important predictors of UVS. Intervention efforts designed to avert STI/HIV acquisition among young African American women should therefore include programs to address both sexual agency and relational factors.


Sexual Health ◽  
2015 ◽  
Vol 12 (3) ◽  
pp. 194 ◽  
Author(s):  
Robert Scott ◽  
Regina Foster ◽  
Lisa N. Oliver ◽  
Anna Olsen ◽  
Julie Mooney-Somers ◽  
...  

Background Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander people have higher rates of sexually transmissible infections (STI). The identification of the sexual risk and healthcare seeking behaviours of young Aboriginal and Torres Strait Islander people in a regional Australian setting was sought. Methods: A cross-sectional survey of 155 young Aboriginal and Torres Strait Islander people (16–24 years) in Townsville was conducted. Results: Most participants (83%) reported ever having had sex, with a median age of 15 years at first sex and a range from 9 to 22 years. While young men reported more sexual partners in the last 12 months than young women, they were also more likely to report condom use at the last casual sex encounter (92% vs 68%, P = 0.006). Young women were significantly more likely than young men to report never carrying condoms (35% vs 16%); however, they were more likely to have had STI testing (53% vs 28%, P = 0.004). Of those reporting previous STI testing, 29% reported ever being diagnosed with an STI. Conclusions: The sample of young Aboriginal and Torres Strait Islander people reported an early age at first sex, variable condom use and low uptake of STI testing. The high prevalence of self-reported STI diagnoses indicate a need for opportunistic sexual health education and efforts designed to promote the uptake of STI screening in this group.


2021 ◽  
pp. 1-17
Author(s):  
Ucheoma Nwaozuru ◽  
Thembekile Shato ◽  
Chisom Obiezu-Umeh ◽  
Florida Uzoaru ◽  
Stacey Mason ◽  
...  

Abstract Despite the high prevalence of HIV among adolescent girls and young women (AGYW) aged 15–24 years in Ghana, HIV testing remains low among this population. The objective of this study was to examine the relationship between ethnicity and HIV testing among AGYW in Ghana. The 2014 Ghana Demographic and Health Survey data were used and analyses were restricted to 3325 female participants aged 15–24 years. Chi-squared tests and a logistic regression model were used to assess the association between ethnicity and HIV testing. Furthermore, the PEN-3 cultural model informed the conceptual framework that explained the relationship between ethnicity and HIV testing behaviour. Results from the bivariate analysis showed an association between ethnicity and HIV testing among AGYW (p<0.05). However, when controlling for other behavioural and socioeconomic determinants of HIV testing in the logistic regression, there was no association between ethnicity and HIV testing. The significant predictors of HIV testing were marital status, having multiple sexual partners, and condom use. The AGYW who were married (adjusted odds ratio [aOR] = 4.56, CI: 3.46–6.08) or previously married (aOR = 4.30, CI: 2.00–9.23) were more likely to test for HIV compared with those who were never married. Having multiple sexual partners (aOR = 0.41, CI: 0.20–0.85) and condom use (aOR = 0.56, CI: 0.38–0.84) were associated with lower odds of HIV testing. The results provide evidence that ethnicity is not associated with HIV testing among AGYW in Ghana, as the bivariate association was attenuated when other behavioural and socioeconomic determinants of HIV testing were accounted for. These findings highlight the importance of considering individual-level factors, community-level factors, and other socio-cultural factors as they really matter in the development of HIV prevention programmes for adolescent girls and young women in Ghana.


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