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  • Title: Factors associated with condom use in a high-risk heterosexual population.
    Author: Weinstock HS, Lindan C, Bolan G, Kegeles SM, Hearst N.
    Journal: Sex Transm Dis; 1993; 20(1):14-20. PubMed ID: 8430354.
    Abstract:
    The use of condoms has been advocated as a means of preventing the transmission of the human immunodeficiency virus and other sexually transmitted agents. To better understand factors that may influence condom use, 300 heterosexuals were enrolled in a cross-sectional study of patients attending San Francisco's only public sexually transmitted disease clinic. Interviewer-administered questionnaires were conducted. Condom use at last sexual intercourse was examined by logistic regression analysis. Men who used drugs or alcohol at last intercourse and whose partners did not want to use condoms were less likely to have used them; women who were black or Hispanic, who reported difficulty getting their partners to use condoms, or who reported that condoms decrease sexual pleasure also were less likely to have used them. Efforts to increase condom use in this population should target minorities, assist women to negotiate their use, emphasize the dangers of using alcohol and other drugs with sex, and address the perception that condoms interfere with sexual pleasure. Better information is needed to understand sexual behavior and other variables that may influence condom use in order to develop successful education campaigns promoting their use. To this end, this study examined the AIDS Risk Reduction Model among an equal number of men and women (300) attending the public sexually transmitted disease (STD) clinic in San Francisco in 1989. The population is indicative of the population diagnosed with syphilis and gonorrhea. Clinical data from medical charts were linked with questionnaire data. Variables that were identified as affecting condom use at last intercourse were perceived susceptibility to HIV infection, knowledge of HIV transmission, and perception of the seriousness of HIV infection. Also included were condom use factors such as ill fit of condoms or decreased sexual spontaneity, and sexual communication. Attitudes and beliefs were scaled items which had to have alpha coefficients greater than .60 in order to be included. Evaluation of significant factors was accomplished with the Mantel-Haenzel chi-square and student's t-test. Gender specific multivariate logistic regression was used to control for confounding factors such as age, stability of the relationship, and total number of sex partners in a year. Condom breakage was reported. The population was 57% (78) male and black or Hispanic and 51% (84) female and black or Hispanic. 46% (138) had incomes of $5000. 47% were newly diagnosed with an STD on the interview day. 64% had prior STDs. 2 reported having HIV infection and 2 reported having a sex partner with HIV infection. 51% stated that their steady partner had at least one STD during the prior sexual encounters. Sexual behavior was reported for partner's sexual involvement with others in the past 2 months, condom use among steady and casual partners, knowledge of HIV transmission, past condom usage, and use of condoms at last intercourse. In the multivariate analysis, black or Hispanic men who used drugs or alcohol at last sexual encounter and black or Hispanic men whose partners did not want to use condoms were less likely to use condoms at last intercourse. Less condom use for women was associated with blacks or Hispanics, the belief that condoms reduce sexual pleasure, the difficulty in exercising control over their use, and involvement with a steady partner.
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