A Novel, Self-guided, Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Emetu, Roberta E.; Marshall, Alexandra; Sanders, Stephanie A.; Yarber, William L.; Milhausen, Robin R.; Crosby, Richard A.; Graham, Cynthia A.

doi:10.1080/07448481.2013.856914

Cited by 28 publications

(43 citation statements)

References 16 publications

(13 reference statements)

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“…[26] Interventions and health promotion programs that improve condom-use must focus on appropriate and consistent use. [27] Fortunately, we found that men who reported intentional consistent condom-use as a prevention strategy had four times greater odds of condom-use at the event-level. Condoms provide prevention for many STIs, but the TasP- and HAART-related attitudes and seroadaptive practices of men with lower odds of condom-use in our study reflect intentional consideration to reduce their possibility of acquiring HIV, potentially without (equal) concern for other STIs.…”

Section: Discussionmentioning

confidence: 81%

An Event-Level Analysis of Condom Use During Anal Intercourse Among Self-Reported Human Immunodeficiency Virus–Negative Gay and Bisexual Men in a Treatment as Prevention Environment

Lachowsky¹,

Tanner²,

Cui³

et al. 2016

Sexual Trans Dis

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Background We sought to identify factors associated with condom-use during anal intercourse among self-identified HIV-negative gay, bisexual, and other men who have sex with men (GBM) in Vancouver, Canada following “treatment as prevention” (TasP) scale-up in 2010. Methods Sexually-active GBM were recruited using respondent-driven sampling (RDS) from 2012–2014. We analyzed participants’ most recent sexual encounter with up to their last five sexual partners within the past six months. In addition to individual- and event-level explanatory factors, we assessed potential associations with TasP awareness, TasP-related prevention practice (viral load sorting), and TasP-related attitudes (HIV treatment optimism). Accounting for clustering at the RDS chain- and participant-level, factors associated with event-level condom-use versus non-use were determined using a multivariable generalised linear mixed model built using backward selection and AIC minimization. Results Of 513 participants, 436 GBM (85%) reported a total of 1196 anal sex events with 56% condom-use. The proportion of condom-protected sexual events decreased monthly over the study period (OR=0.95 per month, 95%CI:0.92–0.98). TasP practices and attitudes were significantly associated with lower odds of condom-use at the univariate level, but were no longer significant at multivariate level. In the multivariable model, event-level partner methamphetamine use (aOR=0.18, 95%CI:0.06–0.58), frequency of recent anal intercourse with that partner (aOR=0.97 per act, 95%CI:0.95–0.98) and time since first sex with that partner (aOR=0.97 per 6 months, 95%CI:0.95–0.99) were associated with lower odds of condom-use while event-level participant alcohol use (aOR=1.41, 95%CI:1.01–1.98) and no planned future sex with that partner (aOR=1.56, 95%CI:1.08–2.27) were associated with greater odds of condom-use. Event-level receptive-only (aOR=2.10, 95%CI:1.38–3.20) or insertive-only (aOR=2.53, 95%CI:1.64–3.90) sexual positions were associated with greater odds of condom-use compared with reporting both positions. Conclusions TasP-related factors were not the most salient predictors of GBM’s condom-use. Health promotion must consider associations between condomless anal sex and substance use and relational factors.

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Section: Discussionmentioning

confidence: 81%

An Event-Level Analysis of Condom Use During Anal Intercourse Among Self-Reported Human Immunodeficiency Virus–Negative Gay and Bisexual Men in a Treatment as Prevention Environment

Lachowsky¹,

Tanner²,

Cui³

et al. 2016

Sexual Trans Dis

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“…water-based lubricants, silicon-based lubricants). Thus, condom interventions such as the Kinsey Institute Homework Intervention Strategy (KIHIS) 17,18 may benefit men experiencing CAEP as it attends to some of the most commonly cited CAEP attributions: sensation loss, application distraction, condom fit and feel and condom application skills. KIHIS is a self-guided home-based intervention, which encourages men to practice applying, using and removing a variety of condoms and condom-safe lubricants alone in a ‘low-pressure’ sexual situation.…”

Section: Discussionmentioning

confidence: 99%

Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men

et al. 2015

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Background Previous studies have associated men who experience condom-associated erection problems (CAEP) with incomplete condom use and/or foregoing using condoms altogether. However, how men respond to CAEP and what they attribute CAEP to, remains unclear. Understanding young men's CAEP responses and attributions could help improve sexually transmissible infections (STI)/HIV prevention programs and interventions. Methods Behavioural responses to, and attributions for, CAEP during application (CAEP-Application) and/or during penile-vaginal intercourse (CAEP-PVI) were reported using an online questionnaire by 295 young, heterosexual men (aged 18–24 years) who were recruited via social media websites and university Listservs across major cities in the Midwestern USA. Results Behavioural responses to CAEP-Application included receiving oral or manual stimulation, stimulating a partner, self-stimulation, foregoing condom use and applying the condom after starting intercourse. Attributions for CAEP-Application included: distraction, fit and feel problems, application taking too long and having consumed too much alcohol. Behavioural responses to CAEP-PVI included increasing the intensity of intercourse, removing the condom to receive oral or manual stimulation and removing condom and continuing intercourse. Attributions for CAEP-PVI included: lack of sensation, taking too long to orgasm, not being ‘turned on’ enough, fit and feel problems and partner-related factors. Conclusions Men who report CAEP respond with both STI/HIV risk-reducing and potentially risk-increasing behaviours (e.g. forgoing condom use). Men attribute their experiences to a wide range of individual- and partner-level factors. Addressing men's CAEP behavioural responses and attributions may increase the efficacious value of condom programs and STI/HIV prevention interventions – particularly among men who experience CAEP.

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“…Following completion of screening (Stage 2), five studies met all the inclusion criteria: studies that tested and reported outcome measures representing aspects of condom use fit and feel. [15][16][17][18][19] Characteristics of included studies…”

Section: Resultsmentioning

confidence: 99%

Evidence for behavioural interventions addressing condom use fit and feel issues to improve condom use: a systematic review

et al. 2019

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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.

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A Novel, Self-guided, Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Abstract: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).

Cited by 28 publications

References 16 publications

An Event-Level Analysis of Condom Use During Anal Intercourse Among Self-Reported Human Immunodeficiency Virus–Negative Gay and Bisexual Men in a Treatment as Prevention Environment

An Event-Level Analysis of Condom Use During Anal Intercourse Among Self-Reported Human Immunodeficiency Virus–Negative Gay and Bisexual Men in a Treatment as Prevention Environment

Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men

Evidence for behavioural interventions addressing condom use fit and feel issues to improve condom use: a systematic review

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