RESUMO
According to the situation of 34 batches of natural rubber latex condoms tested by our center in 2018, the unqualified items in the product inspection items and the exploratory research results of D4 and D5 content in silicone oil lubricants are analyzed. We make recommendations on product technical requirements or standards to strengthen the quality supervision of products.
Assuntos
Preservativos/normas , Látex , Óleos de SiliconeRESUMO
Condoms are highly effective for HIV prevention, yet are not currently indicated by the US Food and Drug Administration (FDA) for anal sex. We surveyed a national sample of men who have sex with men to assess whether FDA label indication could affect anticipated condom use, and to determine levels of perceived condom failure for anal sex. We found that 69% of respondents anticipated that a label indication change would increase their likelihood of condom use. Median perceived failure was 15%. We anticipate that these results may aid the FDA in developing standards for a label indication for anal sex.
Assuntos
Preservativos/normas , Análise de Falha de Equipamento/estatística & dados numéricos , Guias como Assunto , Rotulagem de Produtos/normas , Comportamento Sexual , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , United States Food and Drug Administration , Adulto JovemRESUMO
Continuing high rates of sexually transmissible infections (STIs) in many countries highlight the need to identify effective behavioural interventions. Consistent and correct use of male condoms is a key strategy for the prevention of STIs. However, some men report problems with condom fit (e.g. the size and shape of the condom) and feel (e.g. tightness, irritation, sensitivity), which inhibits their use. We conducted a systematic review to identify existing interventions addressing condom use fit and feel problems. We searched electronic databases for peer-reviewed articles and searched reference lists of retrieved studies. Five studies met the inclusion criteria. These were generally small-scale pilot studies evaluating behavioural interventions to promote safer sex with men aged under 30 years, addressing, among other things, barriers to condom use relating to fit and feel. There were significant increases in the reported use of condoms, including condom use with no errors and problems. Improvements in some condom use mediators were reported, such as condom use self-efficacy, knowledge, intentions and condom use experience. There were mixed findings in terms of the ability of interventions to reduce STI acquisition. Behavioural interventions addressing condom fit and feel are promising in terms of effectiveness but require further evaluation.
Assuntos
Preservativos/estatística & dados numéricos , Promoção da Saúde/métodos , Sexo Seguro , Preservativos/normas , Humanos , Masculino , Sexo Seguro/psicologia , Sexo Seguro/estatística & dados numéricosRESUMO
BACKGROUND: Risky sexual behaviours are not uncommon among young adults particularly those in the higher levels of education. It is known that higher self-efficacy could contribute to better sexual and reproductive health outcomes including the use of condoms. However, there is limited research on the role of socio-demographic, behavioural and parental factors as predictors of condom-use self-efficacy. As a result, this exploratory study was designed to assess the predictors of self-efficacy for condom use among university students in Nigeria. METHODS: A cross-sectional survey was conducted with 755 university students in Nigeria from February to April 2018. Self-efficacy for condom use was assessed by combining responses to 11-items measures of condom self-efficacy drawn from the work of Barkley and colleagues. We fitted a structural equation model to identify the pathways through which socio-demographic, behavioural and parental factors predict two constructs of condom-use self-efficacy (self-efficacy for condom purchase and use and partner communication self-efficacy) in the sample. RESULTS: Demographic factors such as age (ß = -0.29, p<0.05) and sex (ß = 0.42, p<0.05), as well as ratings on religious importance (ß = -0.08, p<0.05) were directly associated with self-efficacy for condom purchase and use. These factors showed significantly mediated effects through sexual experience which also had a direct positive relationship (ß = 0.73, p<0.05) with self-efficacy for condom purchase and use. The receipt of parental support, on the other hand, was directly associated with higher partner communication efficacy for condom use (ß = 0.07, p<0.05). We found no evidence that the level of partner communication efficacy was directly associated with any of the behavioural, demographic or parental factors. CONCLUSION: The findings of this study affirm that sex, or age or having higher ratings on religious importance alone does not increases self-efficacy but also exposure to sexual activity through which these factors affect self-efficacy for condom purchase and use. These findings also highlight the need to address and strengthen condom use self-efficacy among young adults, particularly the sexually inexperienced, highly religious and young adults with limited support from their parent.
Assuntos
Comportamento , Preservativos/normas , Pais , Autoeficácia , Estudantes , Universidades , Adolescente , Feminino , Humanos , Masculino , Nigéria , Adulto JovemRESUMO
Male condoms are important to prevent transmission of HIV (and other STIs) and unwanted pregnancies. Research was conducted to evaluate the quality of male condoms available in the Dominican Republic market based on preliminary concerns of suspect product. Based on international testing standards (ISO 4074 and ASTM D 3492-08), condoms were sampled across ten prominent brands within the market and evaluated for airburst pressure / volume, freedom from holes, visual defects, package seal integrity, packaging and marking, lubricant quantity, and dimensions. Five of the brands were found to have extensive quality problems, where holes were found in 5.7% to 17.5% of the condoms (depending on the brand). Between 5.1% and 30.5% of these condoms failed to meet the requirements for airburst properties, and violations in regulatory labeling where observed. Three additional brands were compliant for the other tests, but were found to have the same challenges with labeling violations as the previous five brands. Two brands were found to be fully compliant with all aspects of the evaluation. The level of defects observed in these samples would greatly increase the risk of HIV transmission (and other STIs) and unwanted pregnancies. When projected on the annual market of male condoms sold in the Dominican Republic (~26 million), potentially over 1 million condoms could be estimated to adversely impact the health risk of the end-user. These results prompted action by the Dominican Republic regulatory authorities to investigate and remove poor quality product from the market. This research study emphasizes the need for continued vigilance towards increased regulatory and market surveillance efforts to better protect public health interests.
Assuntos
Preservativos/normas , Anticoncepção/instrumentação , Vigilância de Produtos Comercializados/normas , Controle de Qualidade , Infecções Sexualmente Transmissíveis/prevenção & controle , República Dominicana , Humanos , Cooperação Internacional , Látex , Masculino , Infecções Sexualmente Transmissíveis/transmissão , Estados Unidos , United States Agency for International DevelopmentRESUMO
CONTEXT: Urethritis prevalence in Europe changed in the last years due to both the increase of migratory streams from North Africa and the more frequent exposition of males to relevant risk factors. Owing to these reasons, urethritis treatment should be optimized by accurate microbiological investigations to avoid the risk of persistence, recurrence, or reinfection. OBJECTIVE: The aim of this systematic review is to optimize the treatments for urethritis and investigate the applicability of nucleic acid amplification test (NAAT) as the primary microbiological investigation. EVIDENCE ACQUISITION: A literature search in Medline, Cochrane, and Google Scholar databases was conducted up to June 2018. Subject headings were selected as follows: Urethritis OR gonococcal urethritis OR non-gonococcal urethritis AND Antibiotics OR Recurrence. A total of 528 abstracts were identified and selected. Finally, 12 full-text articles were selected for a qualitative synthesis. The Preferred Reported Items for Systematic Reviews and Meta-Analyses statement was used to perform an accurate research checklist and report. EVIDENCE SYNTHESIS: Empirical treatments are no more recommended, although a broad spectrum of antibiotic therapy may be initiated while awaiting the results from pathogens' microbiological characterization. First-line treatment for gonococcal urethritis consists of a single dose of ceftriaxone/azithromycin combined therapy. Specific therapies should be initiated for nongonococcal urethritis according to each single pathogen involved in the infection process. Owing to this reason, NAAT is mandatory in the clinical approach to the disease, although the Gram stain of urethral discharge or smear remains applicable for some less frequent nongonococcal urethritis. Moreover, the urethritis "modern view" also includes noninfectious etiologies that occurred after traumas or injection of irritating compounds. Sexual abstinence of at least 7 d should be observed from the start of treatment to avoid reinfection, while sexual partners should evenly be treated. CONCLUSIONS: The treatment of urethritis implies accurate determination of pathogens involved in the infection process by NAAT with subsequent appropriate antibiotic therapy, thus avoiding the risk of antibiotic resistance and overuse of antibiotics indicated for empirical treatments. The population exposed to relevant risk factors should be adequately informed about the increased risk of developing infections and motivated toward the intensive use of condoms during sexual intercourses. PATIENT SUMMARY: Urethritis is a sexually transmitted disease generally characterized by urethral discharge or other symptoms such as itching, tingling, and apparent difficulties in having a regular urinary flow. Microbiological investigations are mandatory to obtain satisfactory results from the treatment. Multiple antibiotic treatments are often necessary due to the high risk of multiple pathogens responsible for the disease. Similarly, sexual partners should be investigated and treated in the same way. Several risk factors such as immunodeficiency, multiple sexual partners, homo- and bisexuality, and alcohol abuse may be related to the disease. In these cases, the use of condom is strongly recommended.
Assuntos
Azitromicina/uso terapêutico , Ceftriaxona/uso terapêutico , Técnicas de Amplificação de Ácido Nucleico/métodos , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Uretrite/tratamento farmacológico , África do Norte/epidemiologia , Antibacterianos/uso terapêutico , Azitromicina/administração & dosagem , Ceftriaxona/administração & dosagem , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/tratamento farmacológico , Chlamydia trachomatis/efeitos dos fármacos , Preservativos/normas , Quimioterapia Combinada/métodos , Europa (Continente)/epidemiologia , Feminino , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Humanos , Masculino , Neisseria gonorrhoeae/efeitos dos fármacos , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/microbiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Uretrite/diagnóstico , Uretrite/epidemiologia , Uretrite/microbiologiaRESUMO
BACKGROUND: The prevalence of HIV in Ghana is 1.3%, compared to 17% among men who have sex with men (MSM). There is limited empirical data on the current health care climate and its impact on HIV prevention services for Ghanaian MSM. The purposes of this study were to investigate (1) MSM's experiences using HIV prevention resources, (2) what factors, including health care climate factors, influenced MSM's use of prevention resources and (3) MSM self-identified strategies for improving HIV/sexually transmitted infection (STI) prevention among MSM in Ghanaian communities. METHODS: We conducted 22 focus groups (n = 137) with peer social networks of MSM drawn from three geographic communities in Ghana (Accra, Kumasi, Manya Krobo). The data were examined using qualitative content analysis. Interviews with individual health care providers were also conducted to supplement the analysis of focus group findings to provide more nuanced illuminations of the experiences reported by MSM. RESULTS: There were four major findings related to MSM experiences using HIV prevention resources: (1) condom quality is low, condom access is poor, and condom use is disruptive, (2) inaccurate information undermines HIV testing (3), stigma undermines HIV testing, and (4) positive attitudes towards HIV prevention exist among MSM. The main healthcare climate factors that affected prevention were that MSM were not free to be themselves, MSM were not understood by healthcare providers, and that MSM did not feel that healthcare providers cared about them. To improve HIV prevention MSM suggested increased education tailored to MSM should be provided to enable self-advocacy and that education and awareness are needed to protect human rights of MSM in Ghana. CONCLUSION: MSM in Ghana are exposed to negative health care climates. Health care spaces that are unsupportive of MSM's autonomy undermine the uptake of prevention measures such as condoms, HIV testing, and accurate sexual health education. These findings contribute to knowledge to inform development of HIV prevention interventions for MSM in Ghana, such as culturally appropriate sexual health education, and digital technology to connect individuals with resources supportive of MSM.
Assuntos
Atitude Frente a Saúde , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Relações Médico-Paciente , Adolescente , Adulto , Preservativos/normas , Preservativos/estatística & dados numéricos , Preservativos/provisão & distribuição , Atenção à Saúde , Grupos Focais , Gana , Infecções por HIV/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pesquisa Qualitativa , Estigma Social , Adulto JovemRESUMO
BACKGROUND: Reliable and valid scale measures of barriers to condom use are not available for young black men who have sex with men (YBMSM). The purpose of this study was to evaluate the Condom Barriers Scales for application with YBMSM. METHODS: A clinic-based sample of 600 YBMSM completed a computer-assisted self-interview. The primary measure was a 14-item abbreviated version of the Condom Barriers Scale. Reliability and criterion validity were assessed. RESULTS: All 3 subscales were reliable: partner-related barriers (Cronbach α=0.73), sensation-related barriers (α=0.70), and motivation-related barriers (α =0.81). A complete absence of barriers was common: 47.0% (partner-related), 30.7% (sensation-related), and 46.5% (motivation-related). Dichotomized subscales were significantly associated with reporting any condomless insertive anal sex (all Ps < 0.001) and any condomless receptive anal sex (all Ps < 0.001). The subscales were significantly associated with these measures of condomless sex preserved at a continuous level (all Ps <0.001, except for sensation barriers associated with condomless receptive anal sex = 0.03). Further, the subscales were significantly associated with reporting any condom use problems (all Ps <0.001) and a measure of condomless oral sex (all Ps <0.001, except for partner-related barriers=0.31). Finally, the sensation-related barriers subscale was significantly associated with testing positive for Chlamydia and/or gonorrhea (P=0.049). CONCLUSIONS: The 3 identified subscales yielded adequate reliability and strong evidence of validity, thereby suggesting the utility of these brief measures for use in observational and experimental research with YBMSM.
Assuntos
Infecções por Chlamydia/prevenção & controle , Preservativos/normas , Gonorreia/prevenção & controle , Infecções Sexualmente Transmissíveis/prevenção & controle , Negro ou Afro-Americano , Homossexualidade Masculina , Humanos , Masculino , Sexo Seguro , Comportamento Sexual , Parceiros Sexuais , Minorias Sexuais e de Gênero , Adulto JovemRESUMO
BACKGROUND: The increased incidence of sexually transmitted infections (STIs) in Brazil represents a significant public health issue. This issue has raised awareness among health authorities regarding the quality of condoms. In Brazil, male condoms need to be certified. The certification process evaluates in detail the manufacturing and quality of the final product; however, post-market surveillance is not part of the normal certification practice. METHODS: From 2009 to 2011, we evaluated 20 male condoms brands per lot of 8 manufactures-both domestic and imported-marketed in Rio de Janeiro, Brazil. Sampling was performed per ISO 2859-1, and the condoms were evaluated on length, width, thickness, holes, integrity of primary packaging, bursting volume, bursting pressure, label and secondary packaging, following the criteria established in the Brazilian National Health Oversight Agency Resolution no. RDC 62/2008. RESULTS: Of the 20 evaluated brands, 17 brands were found to be noncompliant with the guidelines of the Brazilian National Health Oversight Agency Resolution no. RDC 62/2008 in at least one of the analyses performed. CONCLUSIONS: Any nonconforming unit has serious public health implications.
Assuntos
Preservativos , Saúde da População Urbana , Brasil , Fenômenos Químicos , Preservativos/economia , Preservativos/normas , Qualidade de Produtos para o Consumidor , Guias como Assunto , Humanos , Masculino , Teste de Materiais , Fenômenos Físicos , Porosidade , Rotulagem de Produtos , Vigilância de Produtos Comercializados , Controle de Qualidade , Infecções Sexualmente Transmissíveis/prevenção & controle , Saúde da População Urbana/etnologiaRESUMO
RESUMO Objetivou-se identificar o conhecimento e as situações de vulnerabilidade de homens jovens usuários de crack perante o HIV. Trata-se de pesquisa exploratória, descritiva e qualitativa, realizada em uma comunidade terapêutica do município de Fortaleza-CE, entre janeiro e março de 2012. Participaram do estudo 10 jovens, com idades entre 18 e 24 anos. As informações foram coletadas por meio de anotações em diário de campo e de entrevista semiestruturada, e os dados obtidos foram analisados pela técnica de análise de conteúdo. Os resultados indicaram quatro categorias temáticas: quem são os usuários de crack?; o conhecimento acerca do HIV; prevenção; e situações de vulnerabilidade ao HIV. Os jovens demonstraram pouco conhecimento sobre a AIDS, com predominância de mitos, e se consideravam vulneráveis ao HIV, visto que o compartilhamento de cachimbos para o uso do crack e a perda da consciência favoreciam o não uso do preservativo durante as relações sexuais e a multiplicidade de parceiros. A pesquisa traz subsídios para que o profissional de saúde se aproprie das necessidades relatadas pelos jovens e planeje estratégias educativas que possam permitir uma reflexão sobre a temática das drogas e sua relação complexa com os vários fatores que cercam essa questão, inclusive o HIV.
RESUMEN El objetivo fue identificar el conocimiento y las situaciones de vulnerabilidad de hombres jóvenes usuarios de crack ante el VIH. Se trata una investigación exploratoria-descriptiva, cualitativa, realizada en una comunidad terapéutica del municipio de Fortaleza-CE, entre enero y marzo de 2012. Participaron del estudio 10 jóvenes, con edades entre 18 y 24 años. Las informaciones fueron recolectadas por medio de apuntes en diario de campo y de entrevista semi estructurada, y los datos obtenidos fueron analizados por la técnica de análisis de contenido. Los resultados indicaron cuatro categorías temáticas: ¿quiénes son los usuarios de crack?; el conocimiento acerca del VIH; prevención; y situaciones de vulnerabilidad al VIH. Los jóvenes demostraron poco conocimiento sobre el SIDA, con predominancia de mitos, y se consideraban vulnerables al VIH, visto que el intercambio de pipas para el uso del crack yla pérdida de la conciencia favorecíanal no uso del preservativo durante las relaciones sexuales y la multiplicidad de compañeros. La investigación trae contribuciones para que el profesional de salud se apropie de las necesidades relatadas por los jóvenes y planee estrategias educativas que puedan permitir una reflexión sobre la temática de las drogas y su relación compleja con los varios factores que cercan esta cuestión, incluso, el VIH.
ABSTRACT This study aimed to identify the knowledge that young people who are crack users have on HIV and their situations of vulnerability. This is an exploratory, descriptive and qualitative research conducted in a therapeutic community in the city of Fortaleza, between January and March 2012. The study included 10 young men aged between 18 and 24 years. Information was collected through notes in a field diary and semi-structured interviews and data were analyzed using content analysis. The results indicated four thematic categories: who are the users of crack?; knowledge about HIV; prevention; and situations of vulnerability to HIV. The young men showed to have little knowledge about AIDS, especially believing in myths, and they are considered vulnerable to HIV, since they share pipes for the use of crack and lose consciousness favoring the practice of sex with multiple partners and without condoms. The research brings important information for the use healthcare professionals regarding the needs reported by young men and for them to plan educational strategies that might allow a reflection on the theme of drugs and its complex relationship with the various factors surrounding this issue, including HIV.
Assuntos
Humanos , Masculino , Adulto Jovem , Síndrome da Imunodeficiência Adquirida/prevenção & controle , HIV/imunologia , Cocaína Crack/efeitos adversos , Análise de Vulnerabilidade/análise , Necessidades e Demandas de Serviços de Saúde/normas , Parceiros Sexuais/classificação , Preparações Farmacêuticas/análise , Preservativos/normas , Vulnerabilidade a Desastres/prevenção & controleRESUMO
BACKGROUND: Despite preventive efforts, HIV incidence remains high among men who have sex with men (MSM) in industrialized countries. Condoms are an important element in prevention but, given the high frequency of condom use and their imperfect effectiveness, a substantial number and proportion of HIV transmissions may occur despite condoms. We developed a model to examine this hypothesis. METHODS: We used estimates of annual prevalent and incident HIV infections for MSM in Ontario. For HIV-negative men, we applied frequencies of sexual episodes and per-contact HIV transmission risks of receptive and insertive anal sex with and without a condom and oral sex without a condom. We factored in the proportion of HIV-infected partners receiving antiretroviral therapy and its impact in reducing transmissibility. We used Monte-Carlo simulation to determine the plausible range for the proportion of HIV transmissions for each sexual practice. RESULTS: Among Ontario MSM in 2009, an estimated 92,963 HIV-negative men had 1,184,343 episodes of anal sex with a condom and 117,133 anal sex acts without a condom with an HIV-positive partner. Of the 693 new HIV infections, 51% were through anal sex with a condom, 33% anal sex without a condom and 16% oral sex. For anal sex with a condom, the 95% confidence limits were 17% and 77%. CONCLUSIONS: The proportion of HIV infections related to condom failure appears substantial and higher than previously thought. That 51% of transmissions occur despite condom use may be conservative (i.e. low) since we used a relatively high estimate (87.1%) for condom effectiveness. If condom effectiveness were closer to 70%, a value estimated from a recent CDC study, the number and proportion of HIV transmissions occurring despite condom use would be much higher. Therefore, while condom use should continue to be promoted and enhanced, this alone is unlikely to stem the tide of HIV infection among MSM.
Assuntos
Preservativos/normas , Infecções por HIV/transmissão , Falha de Equipamento , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Ontário/epidemiologia , Prevalência , Fatores de Risco , Sexo Seguro , Comportamento SexualRESUMO
In 2007, the New York City (NYC) Department of Health introduced the 'NYC Condom'--a Lifestyles® condom with a 'NYC' logo. Few studies have evaluated attitudes toward or distribution of the 'NYC Condom' among men who have sex with men (MSM)--a population at increased risk for HIV/STIs. 148 MSM completed a survey about their exposure to, use of, and experiences using the 'NYC Condom.' The majority (93.2 %) had seen the 'NYC Condom;' 82.4 % of said men had used it. Among MSM who used it, 82.1 % rated it average or above. Exposure did not statistically differ by race/ethnicity, HIV status, gay or barebacker identification, or sex role. Use was neither significantly associated with demographic characteristics nor recruitment source, suggesting distributional success in reaching various sub-populations of MSM. Among those who had not used the 'NYC Condom,' 22.2 % reported size or quality concerns, suggesting a demand for alternative prevention campaigns.
Assuntos
Preservativos/normas , Homossexualidade Masculina/psicologia , Adulto , Atitude Frente a Saúde , Preservativos/estatística & dados numéricos , Coleta de Dados , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Rotulagem de Produtos , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricosRESUMO
A qualitative study was conducted to obtain a detailed understanding of two key determinants of condom breakage - 'rough sex' and poor condom fit - identified in a recent telephone survey of female sex workers, in Bangalore, India. Transcripts from six focus-group discussions involving 35 female sex workers who reported condom breakage during the telephone survey were analysed. Rough sex in different forms, from over-exuberance to violence, was often described by sex workers as a result of clients' inebriation and use of sexual stimulants, which, they report, cause tumescence, excessive thrusting and sex that lasts longer than usual, thereby increasing the risk of condom breakage. Condom breakage in this setting is the result of a complex set of social situations involving client behaviours and power dynamics that has the potential to put the health and personal lives of sex workers at risk. These findings and their implications for programme development are discussed.
Assuntos
Preservativos/estatística & dados numéricos , Preservativos/normas , Comportamento Contraceptivo/estatística & dados numéricos , Falha de Equipamento/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adulto , Análise de Falha de Equipamento/estatística & dados numéricos , Estudos de Avaliação como Assunto , Feminino , Humanos , Índia , Entrevistas como Assunto , Vigilância da População , Medição de Risco , Populações Vulneráveis/estatística & dados numéricos , Saúde da Mulher , Adulto JovemAssuntos
Coito/psicologia , Preservativos/normas , Prazer , Parceiros Sexuais/psicologia , Desenho de Equipamento , Feminino , HumanosRESUMO
BACKGROUND: Across studies, 35-50% of men describe condoms as fitting poorly. Rates of condom use may be inhibited in part due to the inaccessibility of appropriately sized condoms. As regulated medical devices, condom sizes conform to national standards such as those developed by the American Society for Testing and Materials (ASTM) or international standards such as those developed by the International Organisation for Standardisation (ISO). We describe the initial online sales experience of an expanded range of condom sizes and assess uptake in relation to the current required standard dimensions of condoms. METHODS: Data regarding the initial 1000 sales of an expanded range of condom sizes in the United Kingdom were collected from late 2011 through to early 2012. Ninety-five condom sizes, comprising 14 lengths (83-238mm) and 12 widths (41-69mm), were available. RESULTS: For the first 1000 condom six-pack units that were sold, a total of 83 of the 95 unique sizes were purchased, including all 14 lengths and 12 widths, and both the smallest and largest condoms. Initial condom purchases were made by 572 individuals from 26 countries. Only 13.4% of consumer sales were in the ASTM's allowable range of sizes. CONCLUSIONS: These initial sales data suggest consumer interest in an expanded choice of condom sizes that fall outside the range currently allowable by national and international standards organisations.
Assuntos
Comércio/estatística & dados numéricos , Preservativos/classificação , Preservativos/normas , Pênis/anatomia & histologia , Disponibilidade de Medicamentos Via Internet/estatística & dados numéricos , Humanos , Masculino , Tamanho do Órgão , Reino UnidoRESUMO
Abstinence-until-marriage (AUM) - strongly supported by religious conservatives in the USA - became a key element of initial human immunodeficiency virus (HIV) prevention efforts under the President's Emergency Plan for AIDS Relief (PEPFAR). AUM programmes have demonstrated limited efficacy in changing behaviours, promoted medically inaccurate information and withheld life-saving information about risk reduction. A focus on AUM also undermined national efforts in Africa to create integrated youth HIV prevention programmes. PEPFAR prevention efforts after 2008 shifted to science-based programming, however, vestiges of AUM remain. Primary prevention programmes within PEPFAR are essential and nations must be able to design HIV prevention based on local needs and prevention science.
Assuntos
Comportamento do Adolescente , Infecções por HIV/prevenção & controle , Religião e Sexo , Educação Sexual/normas , Abstinência Sexual , Adolescente , África/epidemiologia , Orçamentos , Preservativos/normas , Preservativos/tendências , Estudos de Avaliação como Assunto , Feminino , Infecções por HIV/economia , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Cooperação Internacional , Masculino , Educação Sexual/métodos , Educação Sexual/tendências , Estados Unidos , Adulto JovemRESUMO
We examined condom breakage rates and predictors of breakage in a prospective telephone-based study of female sex workers (FSWs) in Bangalore, India. We obtained data on 3,257 condom-use sex acts, and breakage occurred in 2.1 % of these. Situational factors, especially those associated with male clients' behaviors, were the most important predictors of breakage, including sexual inexperience, roughness and violence. Breakage was also associated with having vaginal and anal sex at the same encounter and with poor-fitting condoms. Despite lower than expected breakage rates, the high client volume of FSWs means that there are many unprotected sex acts caused by breakage. Discussions should be held around new education messages, and how programs can respond quickly when sex workers encounter clients who are inebriated, violent or unusually sexually charged. More work is urgently needed with police, and on FSW empowerment, the use of help lines, and counseling for the most vulnerable women.
Assuntos
Preservativos/estatística & dados numéricos , Falha de Equipamento/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Delitos Sexuais/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Saúde da Mulher/normas , Adolescente , Adulto , Preservativos/normas , Estudos Transversais , Escolaridade , Feminino , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia/epidemiologia , Poder Psicológico , Estudos Prospectivos , Telefone , Populações VulneráveisRESUMO
Condom use remains as the frontline defense against the HIV/AIDS pandemic. Fortunately, an ever-expanding body of empirical literature is currently guiding improvements in use of this prevention strategy. Recent advances include improved measurement of condom use behaviors, advances in condom effectiveness research, innovations in the design of condoms, and greater intervention efficiency for high-risk populations. After reviewing each of these four areas of research, this article will offer speculation about the future of condom use for HIV prevention.
Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Preservativos/normas , Desenho de Equipamento , Prática Clínica Baseada em Evidências , Previsões , Humanos , Pesquisa , Comportamento SexualRESUMO
BACKGROUND: This study prospectively assessed and compared the incidence of condom use errors/problems among clinic patients testing positive for one or more of 3 sexually transmitted diseases (STDs) and those testing negative. The study also identified event-level condom use errors associated with condom breakage and slippage during sex. METHODS: Enrolled clinic patients (N = 928) were tested for 3 STDs, then patients electronically recorded sexual intercourse and condom use behaviors daily for up to 6 months. Data were available on condom use errors and problems for the >10,000 sex events involving condoms. Assessed errors/problems were as follows: (1) not using a new condom, (2) allowing condoms to contact sharp objects, (3) not using condoms from start to finish of sex, (4) condoms drying out, (5) erection loss during condom use, (6) breakage, (7) slippage during sex, and (8) slippage after sex. Because the event-level measures were correlated within individual, generalized estimation equation models were used for analyses. RESULTS: All 8 forms of errors/problems with condom use occurred, with varying levels of frequency, without significant differences by baseline STD status for either men or women. Condom breakage was associated with contact with sharp objects (P < 0.0001) and drying out (P < 0.0001). Slippage during sex was associated with erection loss (P < 0.0001) and drying out (P < 0.0001). CONCLUSION: Subsequent to STD evaluation, much of the sex occurring with the use of a condom may not confer adequate protection. Problems found to be associated with condom breakage and slippage are potentially amenable to counseling interventions.
Assuntos
Preservativos/estatística & dados numéricos , Falha de Equipamento/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/prevenção & controle , Coito , Preservativos/efeitos adversos , Preservativos/normas , Aconselhamento , Feminino , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Humanos , Incidência , Masculino , Prontuários Médicos , Ereção Peniana , Estudos Prospectivos , Tricomoníase/epidemiologia , Tricomoníase/prevenção & controle , Estados Unidos/epidemiologia , Saúde da População Urbana , Adulto JovemRESUMO
BACKGROUND: School-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI), and pregnancy prevention programs often focus on consistent and correct condom use. Research on adolescents' experience using condoms, including condom slippage/breakage, is limited. This exploratory study examines proper condom use and the occurrence of condom slippage/breakage among alternative school youth. METHODS: Data are from an HIV/STI prevention trial for youth in continuation school settings (N = 776). Analyses included separate hierarchical logistic regression analyses to explore the relationship between potential correlates and each outcome variable. RESULTS: Students' use of steps for proper condom use varied-73.8% put on the condom before sexual contact, 71.1% squeezed air from the tip, and 92.0% unrolled the condom fully. Notably, 28.5% reported condom slippage/breakage. Results from the regression analyses showed that 4 sets of variables (demographic, substance use, sexual risk behaviors, and condom psychosocial factors) were associated with putting on a condom before sexual contact; none of the variable sets were associated with the other 2 condom steps measured. For slippage/breakage, the demographic and sexual risk behaviors were significant correlates; steps for proper condom use approached statistical significance (p = .058). CONCLUSIONS: This study extends the limited research on how adolescents use condoms, and highlights important targets for prevention interventions.