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1

Haddad, Lisa B., Jennifer H. Tang, Jamie Krashin, Wingston Ng’ambi, Hannock Tweya, Bernadette Samala, Jane Chiwoko, et al. "Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study." BMJ Sexual & Reproductive Health 44, no. 1 (December 16, 2017): 1.2–12. http://dx.doi.org/10.1136/bmjsrh-2017-101825.

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BackgroundUnderstanding the influences on condom use among men and women living with HIV is critical to tailoring sexually transmitted infection/HIV prevention efforts.MethodsThis is a sub-analysis of a cross-sectional survey including 255 women and 220 men who were sexually active, HIV-positive, and attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (aPRs) to evaluate for factors associated with consistent condom use (always using condoms in the past month) and use at last coitus for men and women in separate models.ResultsAmong women: 38% and 55% reported consistent condom use and condom use at last coitus, respectively. For women, consistent use and use at last coitus were positively associated with the ability to refuse sex without condoms and shared decision-making compared with making the decision alone regarding condom use, and negatively associated with desire for children in the future. Consistent use also increased with longer antiretroviral therapy (ART) use (≥1 year compared with no ART use). Among men: 51% and 69% reported consistent condom use and condom use at last coitus, respectively. For men, the ability to refuse sex without condoms was associated with consistent use and use at last coitus, and believing that condoms should be used with other contraception was associated with consistent use.ConclusionsOur findings demonstrate ongoing low condom utilisation among HIV-positive individuals, and highlight that ART and contraceptive use do not deter condom use. Efforts to increase condom utilisation must recognise individual-level factors that influence use and should focus on relationship dynamics and promotion of empowerment and self-efficacy.
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Jadhav, Apoorva, Parinita Bhattacharjee, T. Raghavendra, James Blanchard, Stephen Moses, Shajy Isac, and Shiva S. Halli. "Risky Behaviors among HIV-Positive Female Sex Workers in Northern Karnataka, India." AIDS Research and Treatment 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/878151.

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Purpose. Little is known about the risky sexual behaviors of HIV-positive female sex workers (FSWs) in the developing world, which is critical for programmatic purposes. This study aims to shed light on their condom use with regular clients as well as husband/cohabiting partner, a first in India.Methods. Multivariate logistic regression analyses for consistent condom use with regular clients and husband/cohabiting partner are conducted for the sample of 606 HIV-positive FSWs.Results. Older FSWs are 90% less likely and nonmobile FSWs are 70% less likely to consistently use condoms. FSWs on ART are 3.84 times more likely to use condoms. Additionally, FSWs who changed their occupation after HIV diagnosis are 70% less likely to use condoms. FSWs who are currently cohabiting are more likely to consistently use condoms with repeat clients and are 3.22 times more likely to do so if they have felt stigma associated with being HIV-positive. FSWs who have multiple repeat clients, and who do not know the sexual behavior of these clients, are more likely to use condoms consistently.Conclusion. This study would help inform programs to target the following particularly vulnerable HIV-positive FSWs: those who are older, those who changed their occupation post-HIV diagnosis, and those who are nonmobile.
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Tsuyuki, Kiyomi, Regina María Barbosa, and Adriana de Araujo Pinho. "Dual Protection and Dual Methods in Women Living with HIV: The Brazilian Context." Journal of Sexually Transmitted Diseases 2013 (June 20, 2013): 1–8. http://dx.doi.org/10.1155/2013/540789.

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The cooccurrence of HIV and unintended pregnancy has prompted a body of work on dual protection, the simultaneous protection against HIV and unintended pregnancy. This study examines dual protection and dual methods as a risk-reduction strategy for women living with HIV. Data are from a cross-sectional sample of HIV-positive women attended in Specialized STI/AIDS Public Health Service Clinics in 13 municipalities from all five regions of Brazil 2003-2004 (N=834). Descriptive techniques and logistic regression were used to examine dual protection among women living with HIV. We expand the definition of dual protection to include consistent condom use and reversible/irreversible contraceptive methods, we test the dual methods hypothesis that women who use dual methods will use condoms less consistently than women who use only condoms, and we identify predictors of dual protection. Dual protection is common in our sample. Women who use dual methods have lower odds of consistent condom use than women who only use condoms. Among dual method users, we find that women who use an irreversible method use condoms more consistently than women who use a reversible method. Women on ART and with an HIV-serodiscordant partner have greater odds of consistent condom use than their counterparts.
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Akinyemi, Joshua O., Olutosin A. Awolude, Isaac F. Adewole, and Phyllis J. Kanki. "Condom use among antiretroviral therapy patients in Ibadan, Nigeria." Journal of Infection in Developing Countries 4, no. 08 (June 3, 2010): 495–502. http://dx.doi.org/10.3855/jidc.732.

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Background: While antiretroviral treatment (ART) has improved the health status of people living with HIV, new challenges to their sexual and reproductive health (SRH) needs and their ability to prevent secondary HIV infections have risen. This study aimed to determine the level and factors that affect condom use among ART-experienced patients at the premier teaching hospital in Nigeria. Methodology: This longitudinal study involved patients who initiated treatment at the University College Hospital, Ibadan, Nigeria, between January and December 2006. Sexually active patients who had received treatment for at least six months and had not defaulted on clinic follow-up schedules were studied. Data on socio-demographic characteristics and condom use were extracted from clinic records. Chi square test and logistic regression were employed to determine factors associated with condom use. Results: The study involved 866 patients, specifically, 306 (35.3%) men and 560 (64.7%) women aged 40.7 (SD 7.6) and 33.3 (SD 6.5) years respectively. Condoms usage before treatment and at last clinic visits was 14.0% and 43.3% respectively. Overall reports of condom use at specified periods were as follows: 1 - 6 months (33.0%); 7 - 12 months (37.3%) and above 12 months (53.8%). Patients in a marital union and those with higher education were more likely to use condoms. Conclusions: Condom use is significantly influenced by marital status and educational level. Although condom use increases together with follow-up time, the level can be improved. Primary and secondary prevention efforts targeting high-risk sexual behaviour among ART patients need to receive greater and continual attention.
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Adefala, Ngozi, Kolawole Sodeinde, Abiodun Osinaike, Fikayo Bamidele, and Adebola Omotosho. "Condom use and associated factors among HIV-positive patients accessing care at a private tertiary health institution in the southwest, Nigeria." Babcock University Medical Journal (BUMJ) 3, no. 1 (June 30, 2020): 49–58. http://dx.doi.org/10.38029/bumj.v3i1.26.

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Objective: This study aimed to assess the knowledge, attitude and practice towards condom utilization and other associated factors among people living with HIV/AIDS enrolled in the Virology clinic in Babcock University Teaching Hospital (BUTH) Ilishan, Ogun state, Nigeria. Methods: This cross-sectional study was conducted among 285 ART users selected using a systematic random sampling method. The minimum sample size was estimated using the formula z2pq/d2 and a 24% prevalence extracted from a previous similar study. Data were elicited using a structured interviewer-administered questionnaire, analyzed using SPSS version 20, and presented as tables. The Chi-square test was used to assess associations between categorical variables. The level of significance was set at the 95% confidence interval with a p-value of 0.05. Results: From the total respondents, 180(63.2%) were females, 93.7% had good knowledge, 141(49.5%) believed ARV prevents transmission of HIV and 144 (50.5%) strongly agreed that condom reduces sexual pleasure. Majority 254 (89.1%) were currently using condoms, 131 (46.0%) used a condom consistently, while 108 (37.9%) frequently use a condom during sexual intercourse. The Use of condoms had statistically significant associations with occupation (p<0.001), married at pre-diagnosis of HIV (p<0.001), married at post-diagnosis of HIV (p<0.001) and education (p= 0.015). Conclusion: The majority of the respondents had good knowledge and were using condoms. Discussions on safe sex and improved positive attitudes towards condom-use should, however, be encouraged further.
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Greenwood, Jeremy, Philipp Kircher, Cezar Santos, and Michèle Tertilt. "An Equilibrium Model of the African HIV/AIDS Epidemic." Econometrica 87, no. 4 (2019): 1081–113. http://dx.doi.org/10.3982/ecta11530.

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Twelve percent of the Malawian population is HIV infected. Eighteen percent of sexual encounters are casual. A condom is used a third of the time. To analyze the Malawian epidemic, a choice‐theoretic general equilibrium search model is constructed. In the developed framework, people select between different sexual practices while knowing the inherent risk. The calibrated model is used to study several policy interventions, namely, ART, circumcision, better condoms, and the treatment of other STDs. The efficacy of public policy depends upon the induced behavioral changes and equilibrium effects. The framework complements the insights from epidemiological studies and small‐scale field experiments.
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Dieckhaus, Kevin D., Toan H. Ha, Stephen L. Schensul, and Avina Sarna. "Modeling HIV Transmission from Sexually Active Alcohol-Consuming Men in ART Programs to Seronegative Wives." Journal of the International Association of Providers of AIDS Care (JIAPAC) 19 (January 1, 2020): 232595822095228. http://dx.doi.org/10.1177/2325958220952287.

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Background: The rollout of antiviral therapy in Low and Middle Income Countries (LMICs) has reduced HIV transmission rates at the potential risk of resistant HIV transmission. We sought to predict the risk of wild type and antiviral resistance transmissions in these settings. Methods: A predictive model utilizing viral load, ART adherence, genital ulcer disease, condom use, and sexual event histories was developed to predict risks of HIV transmission to wives of 233 HIV+ men in 4 antiretroviral treatment centers in Maharashtra, India. Results: ARV Therapy predicted a 5.71-fold reduction in transmissions compared to a model of using condoms alone, with 79.9%, of remaining transmissions resulting in primary ART-resistance. Conclusions: ART programs reduce transmission of HIV to susceptible partners at a substantial increased risk for transmission of resistant virus. Enhanced vigilance in monitoring adherence, use of barrier protections, and viral load may reduce risks of resistant HIV transmissions in LMIC settings.
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Ali, Mohammed Seid, Eleni Tesfaye Tegegne, Mekibib Kassa Tesemma, and Kaleab Tesfaye Tegegne. "Consistent Condom Use and Associated Factors among HIV-Positive Clients on Antiretroviral Therapy in North West Ethiopian Health Center, 2016 GC." AIDS Research and Treatment 2019 (March 17, 2019): 1–10. http://dx.doi.org/10.1155/2019/7134908.

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Background. The burden of Human Immune Deficiency Virus or Acquired Immune Deficiency Syndrome is high in sub-Saharan countries including Ethiopia which have over two-thirds of the global HIV burden. Many would argue that consistent condom use is not most effective method for HIV prevention. Condoms offer protection against unwanted pregnancy and some sexually transmitted infections including Human Immune Deficiency Virus, when used correctly and consistently. Inconsistent use of condom by People Living with Human Immune Deficiency Virus or Acquired Immune Deficiency Syndrome on Antiretroviral Therapy will lead to further worsening the Human Immune Deficiency Virus infection epidemic and reinfection with new drug resistant viral strains. Objective. To assess magnitude of consistent condom use and associated factors among HIV-positive clients on Antiretroviral Therapy in North West Ethiopian health center, 2016 GC. Method. An institutional based cross-sectional study was conducted, from April 15 to June 10, 2016. A total of 358 patients on ART in Koladiba Health Center had participated in this research. Koladiba Health Center is the first health center in Ethiopia that is found in Debbie district, which is located in north Gondar Zone. Study participants were selected by simple random sampling technique. Data were collected by using pretested structured questionnaires and analyzed using SPSS version 22. Descriptive statistics was computed and binary and multiple logistic regressions were also conducted to examine the effect of selected independent variables on consistent condom use. Result. A total of 358 ART clients participated in the study with response rate of 90%. Among study participants, 138 (38.5%) were in the age category of 35-44 years. About 216 (60.3%) of the participants were female and 325 (90.8%) were Orthodox followers. Consistent condom use was reported by 130 (55.8%) sexually active study subjects. Respondents in rural residence (AOR=0.326, 95% CI: 0.109, 0.973) and sexual partner initiated condom use (AOR=0.031, 95% CI: 0.005, 0.186) were found to be the independent predictors of consistent condom use. Conclusion and Recommendations. Consistent condom utilization among HIV clients on ART was low (55.8%). Place of residence and condom use initiation during sexual contact were significantly associated with consistent condom use. It is better to give more emphasis on health education and counseling service about consistent condom use for PLWHA who are on ART during follow-up especially for those who came from rural areas.
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Barnett, W., G. Patten, B. Kerschberger, K. Conradie, D. B. Garone, G. Van Cutsem, and C. KJ Colvin. "Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa." Southern African Journal of HIV Medicine 14, no. 4 (November 22, 2013): 166–69. http://dx.doi.org/10.4102/sajhivmed.v14i4.51.

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Background. The recent scale-up of antiretroviral therapy (ART) coverage in resource-limited settings has greatly improved access to treatment. However, increasing numbers of patients are failing first- and second-line ART.Objective. To examine factors affecting adherence to second-line ART from the perspective of clinic staff and patients, assessing both individual and structural perceived barriers.Methods. Research was conducted at a large primary care tuberculosis (TB)/HIV clinic in Khayelitsha, a peri-urban township in Cape Town, South Africa. Participants were drawn from a Médecins Sans Frontières-run programme to support patients failing second-line ART. A qualitative research approach was used, combining multiple methodologies including key informant interviews with staff (n=11), in-depth interviews with patients (n=10) and a Photovoice workshop (n=11). Responses and photographs were coded by content; data were transformed into variables and analysed accordingly.Results. Staff identified drinking, non-disclosure, not using condoms and pill fatigue as barriers to ART adherence, while patients identified side-effects, not using condoms and a lack of understanding concerning medication timing. With respect to service delivery, staff identified a need for continued counselling and educational support following ART initiation. Patients were concerned about missing medical records and poor staff attitudes in the clinic.Conclusion. These findings identify discrepancies between provider and patient perceptions of barriers to, and facilitators of adherence, as well as of service delivery solutions. This highlights the need for on-going counselling and education following ART initiation, improved quality of counselling, and improved methods to identify and address specific barriers concerning medication adherence.
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Kroiz, L. "Breeding Modern Art: Criticism, Caricature, and Condoms in New York's Avant-garde Melting Pot." Oxford Art Journal 33, no. 3 (October 1, 2010): 337–63. http://dx.doi.org/10.1093/oxartj/kcq032.

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11

Gorantla, Misha, and Nagaraj Kondagunta. "Clinico demographic profile of newly diagnosed HIV sero positive patients attending an ART centre: a cross sectional study." International Journal Of Community Medicine And Public Health 4, no. 8 (July 22, 2017): 2895. http://dx.doi.org/10.18203/2394-6040.ijcmph20173342.

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Background: India faces a high burden of HIV. An understanding of the determinants of this disease is of vital importance in curtailing this epidemic. The objective was to study the clinico-demographic profile of the study subject.Methods: This is a cross sectional study done on 142 patients which includes all newly diagnosed (diagnosed on or after 1st January 2012), sero positive, adult patients, enrolled at ART centre, Nalgonda and started on treatment during the months of December 2012, January 2013, February 2013. A pre designed, pre tested questionnaire was used. Data regarding their demographic characteristics and various clinical aspects was obtained. Results: Out of a total of 142 study subjects, majority (78.88%) belonged to economically productive age group (16-45 years). Married individuals constituted a majority (79.57%). A majority of the subjects were skilled laborers, belonged to lower middle class of BG Prasad classification, hailed from rural areas and belonged to nuclear families. Very few had high educational attainment. A majority (95.78%) reported not using condoms during their last sexual act and 9.16% subjects reported being previously diagnosed with an STD. Most common presenting complaint was fever and most common opportunistic infections were candidiasis and tuberculosis. Majority were found to belong to stage 1 HIV. Participants were mostly underweight and had severe anaemia. Majority had CD4 count between 201- 350 cells/mm3. Conclusions: Interventions targeting improvement in socio economic status, education levels, nutritional status as well as awareness about condom use must be built into the national HIV programme.
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Lucas, Kimberley D., Joseph Bick, and Janet C. Mohle-Boetani. "California’s Prisoner Protections for Family and Community Health Act." Public Health Reports 135, no. 1_suppl (July 2020): 50S—56S. http://dx.doi.org/10.1177/0033354920920629.

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In 2014, California passed Assembly Bill 966, which required condom access for persons incarcerated in all 35 California state prisons (33 men’s and 2 women’s prisons). The California Correctional Health Care Services and the Sexually Transmitted Disease Control Branch and the Office of AIDS of the California Department of Public Health collaborated in a prison administration–led multidisciplinary implementation workgroup. Our workgroup, representing public health, correctional health, legal and legislative affairs, labor relations, and prison staff members, participated in 4 planning meetings during May–September 2015. We surveyed prison staff members and incarcerated men to identify and address potential challenges; conceptualized a tamper-resistant condom dispenser; developed educational materials, frequently asked questions for staff members, and fact sheets for the public; and conducted forums for custody and medical staff members at each prison. Key lessons learned included the need for high-level custody support, engagement of labor unions early in the decision-making process, and flexibility within defined parameters for sites to determine best practices given their unique institutional population, culture, and physical layout. Condom access was initiated at 4 prisons in July 2015 and expanded incrementally to the remaining 29 men’s prisons through July 2016. A total of 243 563 condoms were accessed in the men’s prisons, for an average of 354 condoms per 1000 population per month. The start-up dispenser cost was $69 825 (735 dispensers at $95 each). We estimated an annual condom cost of $0.60 per person. Although staff members and incarcerated men expressed concern that this legislation would condone sex and provide repositories for contraband, no serious adverse incidents involving condoms were reported. California demonstrated that condom access is a safe, low-cost intervention with high uptake for a large correctional system and provided a replicable implementation model for other states. Prison condom programs have the potential to decrease transmission of sexually transmitted infections (STIs) among incarcerated persons and their communities, which are often disproportionately affected by STIs, HIV, and other chronic diseases.
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Wanyama, Jane N., Maria S. Nabaggala, Bonnie Wandera, Agnes N. Kiragga, Barbara Castelnuovo, Ivan K. Mambule, Josephine Nakajubi, et al. "Significant rates of risky sexual behaviours among HIV-infected patients failing first-line ART: A sub-study of the Europe–Africa Research Network for the Evaluation of Second-line Therapy trial." International Journal of STD & AIDS 29, no. 3 (August 17, 2017): 287–97. http://dx.doi.org/10.1177/0956462417724707.

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There are limited data on the prevalence of risky sexual behaviours in individuals failing first-line antiretroviral therapy (ART) and changes in sexual behaviour after switch to second-line ART. We undertook a sexual behaviour sub-study of Ugandan adults enrolled in the Europe–Africa Research Network for the Evaluation of Second-line Therapy trial. A standardized questionnaire was used to collect sexual behaviour data and, in particular, risky sexual behaviours (defined as additional sexual partners to main sexual partner, inconsistent use of condoms, non-disclosure to sexual partners, and exchange of money for sex). Of the 79 participants enrolled in the sub-study, 62% were female, median age (IQR) was 37 (32–42) years, median CD4 cell count (IQR) was 79 (50–153) cells/µl, and median HIV viral load log was 4.9 copies/ml (IQR: 4.5–5.3) at enrolment. The majority were in long-term stable relationships; 69.6% had a main sexual partner and 87.3% of these had been sexually active in the preceding six months. At enrolment, around 20% reported other sexual partners, but this was higher among men than women (36% versus 6.7 %, p < 0.001). In 50% there was inconsistent condom use with their main sexual partner and a similar proportion with other sexual partners, both at baseline and follow-up. Forty-three per cent of participants had not disclosed their HIV status to their main sexual partner (73% with other sexual partners) at enrolment, which was similar in men and women. Overall, there was no significant change in these sexual behaviours over the 96 weeks following switch to second-line ART, but rate of non-disclosure of HIV status declined significantly (43.6% versus 19.6%, p <0.05). Among persons failing first-line ART, risky sexual behaviours were prevalent, which has implications for potential onward transmission of drug-resistant virus. There is need to intensify sexual risk reduction counselling and promotion of partner testing and disclosure, especially at diagnosis of treatment failure and following switch to second- or third-line ART.
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Granich, Reuben, Nicolas Muraguri, Alexandre Doyen, Navneet Garg, and Brian G. Williams. "Achieving Universal Access for Human Immunodeficiency Virus and Tuberculosis: Potential Prevention Impact of an Integrated Multi-Disease Prevention Campaign in Kenya." AIDS Research and Treatment 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/412643.

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In 2009, Government of Kenya with key stakeholders implemented an integrated multi-disease prevention campaign for water-borne diseases, malaria and HIV in Kisii District, Nyanza Province. The three day campaign, targeting 5000 people, included testing and counseling (HTC), condoms, long-lasting insecticide-treated bednets, and water filters. People with HIV were offered on-site CD4 cell counts, condoms, co-trimoxazole, and HIV clinic referral. We analysed the CD4 distributions from a district hospital cohort, campaign participants and from the 2007 Kenya Aids Indicator Survey (KAIS). Of the 5198 individuals participating in the campaign, all received HTC, 329 (6.3%) tested positive, and 255 (5%) were newly diagnosed (median CD4 cell count 536 cells/μL). The hospital cohort and KAIS results included 1,284 initial CD4 counts (median 348/L) and 306 initial CD4 counts (median 550/μL), respectively (campaign and KAIS CD4 distributionsP=0.346; hospital cohort distribution was lowerP<0.001andP<0.001). A Nyanza Province campaign strategy including ART <350 CD4 cell count could avert approximately 35,000 HIV infections and 1,240 TB cases annually. Community-based integrated public health campaigns could be a potential solution to reach universal access and Millennium Development Goals.
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Campbell, Susan Miller, Letitia Anne Peplau, and Sherrine Chapman DeBro. "Women, Men, and Condoms." Psychology of Women Quarterly 16, no. 3 (September 1992): 273–88. http://dx.doi.org/10.1111/j.1471-6402.1992.tb00255.x.

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Little is known concerning gender and ethnic differences in attitudes about condoms or about the impact of attitudes on condom use. College students ( N = 393) rated many features of condoms. Overall, students were mildly positive about condoms, believing they offer effective protection but detract from sexual sensation. Both past condom use and future intentions to use condoms were higher among students with more favorable global attitudes toward condoms and more favorable specific beliefs about the interpersonal dynamics of condom use. Future intentions to use condoms were also associated with greater worry about sexually transmitted diseases and fewer previous sexual partners. Women were more favorable toward condoms than men. Gender differences also emerged in the predictors of condom use. Implications for assessing condom attitudes and for increasing condom use among young heterosexuals are discussed.
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Menteng, Febri Destrianti. "Analysis Use Of Condom In Jondul Pekanbaru City 2018." Photon: Jurnal Sain dan Kesehatan 9, no. 2 (July 20, 2019): 123–31. http://dx.doi.org/10.37859/jp.v9i2.875.

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Sexually transmitted diseases are one of the reproductive tract infections (ISR) whose main mode of transmission is through sexual intercourse. The number of STD cases in Riau Province has increased during 2013-2017. Condoms act as protective devices for PMS. The purpose of this study is to analyze condom use in the area of ​​Jondul City Pekanbaru. This study used a qualitative method that was carried out in August-September 2018. Data analysis carried out was prior analysis in the field, analysis during the field and analysis after in the field. The informants in this study were 9 people taken from the principle of adequacy. From the results of this study obtained that the CSWs already know about condoms and the benefits of using condoms, however, they rarely know the terms STIs or STDs. CSWs do not agree to contact if customers do not want to use condoms. The motivation for using condoms is for fear of contracting the disease. Condoms have been provided by the local health center and distributed to brothel owners at the Jondul location and then distributed to the prostitutes. However, the CSWs do not use condoms that have been given and prefer to use condoms that they buy themselves at the pharmacy. The type of condom used in the Jondul location is a male condom. It is suggested to health workers to prioritize health promotion efforts on the use of condoms to sex workers to reduce PMS numbers. Keywords : Behavior, Knowledge, Attitude, Negosiation, Motivation, Availibility of Condom, Type of Condom
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Diekman, Amanda B., Wendi L. Gardner, and Mary McDonald. "LOVE MEANS NEVER HAVING TO BE CAREFUL: The Relationship Between Reading Romance Novels and Safe Sex Behavior." Psychology of Women Quarterly 24, no. 2 (June 2000): 179–88. http://dx.doi.org/10.1111/j.1471-6402.2000.tb00199.x.

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According to the sexual script portrayed in romance novels, true love is demonstrated by being “swept away” in passion. To the extent that this traditional romance script influences romance readers' own sexual scripts, readers may express greater reluctance to engage in precautionary sexual health behaviors, such as using condoms. We explored the relationship between women's reading of romance novels and their attitudes toward condom use, reports of past condom use, and intention to use condoms in the future. A systematic content analysis of modern romance novels documented the extremely low incidence of portrayals of condom use in initial sexual encounters. Study 1 demonstrated that high levels of romance reading were associated with negative attitudes toward condoms and reduced intent to use condoms in the future; Study 2 showed experimentally that including safe sex elements in romance stories increased positive attitudes toward condoms and marginally increased intent to use condoms in the future.
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Korobchuk, Anna, Hayk Davtyan, Olga Denisiuk, Rony Zachariah, Georgios K. Nikolopoulos, Dimitrios Paraskevis, Britt Skaathun, et al. "People with high HIV viral load within risk networks: who are these people and who refers them best?" Journal of Infection in Developing Countries 13, no. 07.1 (July 31, 2019): 103S—110S. http://dx.doi.org/10.3855/jidc.11273.

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Introduction: Viral load is one of the most important determinants for HIV transmission. Identification of people with high viral load (PHVL) can be effective in limiting onward HIV transmission. In order to improve the identification of these individuals within risk networks, we determined a) the number of PHVL recruited through risk networks b) their socio-demographic, behavioural and clinical characteristics and c) the characteristics of individuals who referred these PHVL to the study. Methodology: From November 2013 to March 2016, in Odessa, Ukraine, Transmission Reduction Intervention Project (TRIP) was implemented to identify people recently infected with HIV within the risk networks of “seeds” and “venues” where they engaged in risk behaviour. Results: TRIP identified 53 PHVL, of whom 32 (60%) injected drugs; 42 (79%) were unaware of their HIV status; 25 (47%) had more than one sex partner, and only 14 (26%) were using condoms. There were 164 people who referred individuals into the study; 33 of them (20%) referred PHVL. In terms of referrers, those with lower than secondary level of education, not living with a sex partner, and reporting regular condom use were significantly more likely (p < 0.05) to refer PHVL. Most PHVL (38, 72%) and their referrers (27, 82%) were found through venues. Conclusions: In Odessa city, PHVL are at high risk of transmitting HIV as the majority inject drugs, do not know their HIV status, and have unprotected sex and/or multiple partners. Targeting these individuals for HIV prevention, harm reduction and initiation of antiretroviral treatment (ART) is urgent.
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Smith, Anthony M. A., Damien Jolley, Jane Hocking, Kim Benton, and John Gerofi. "Does additional lubrication affect condom slippage and breakage?" International Journal of STD & AIDS 9, no. 6 (June 1, 1998): 330–35. http://dx.doi.org/10.1258/0956462981922359.

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Summary: The risk of condom slippage (1.94%) and breakage (0.89%) among 3607 condoms was analysed with respect to the use of additional lubricant. Whether or not lubricant was used, the site at which it was applied and the type of lubricant used were all found to vary significantly with the type of sexual act(s) for which the condoms were used. Little evidence was found for differing effects of type of additional lubricant (water-based, saliva or other) or site of lubricant use (on penis/ inside condom, on condom, in vagina/anus). The use of lubricant more than doubles the risk of slippage for vaginal sex. While anal sex is associated with much higher risks of slippage the use of lubricant for this practice actually reduces the risk of slippage to that similar for vaginal sex where lubricant is used. No significant effect of additional lubricant on condom breakage was observed. It is recommended that education messages concerning the use of additional lubricant may need to change to take into account the varied nature of lubricant use practices and the differential effects of lubricant with respect to sexual practices. Specifically, if the use of additional lubricant has little or no impact on condom breakage but increases condom slippage then encouraging its use may be counterproductive if condom users consider slippage to be a reason not to use condoms.
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Liu, Hongjie, May Kennedy, Hui Liu, Fuchang Hong, Toan Ha, and Zheng Ning. "Mediation effect of perceived behavioural control on intended condom use: applicability of the theory of planned behaviour to money boys in China." Sexual Health 10, no. 6 (2013): 487. http://dx.doi.org/10.1071/sh13028.

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BackgroundMoney boys (MBs) are male sex workers who sell sex to men who have sex with men. The objectives of this study were to assess (a) the sexual HIV risk of MBs; (b) the ability of the theory of planned behaviour (TPB) to predict MBs’ intentions to use condoms; and (c) the manner in which TPB constructs (attitudes towards condom use, subjective norms and perceived behavioural control) combine to influence condom use intentions. Methods: Participants came from 10 MB-frequented clubs in two cities in China. Multiple regression and path analytic models were used to test inter-relationships among the TPB constructs. Results: Seventy-eight percent of the 122 MB participants reported having used condoms for every anal sex act. About one-third reported having had female sexual partners in the past 2 months; of these MBs, half (53%) used condoms for every sex act. A revised model using TPB constructs accounted for 52% of the variance of condom use intentions and revealed that perceived behavioural control was a mediator in pathways beginning with attitudes and ending with condom use intentions, and beginning with subjective norms and ending with intentions. Conclusions: The findings suggest that a revised model of TPB applies to condom use intentions among Chinese MBs. It may be appropriate to adapt HIV interventions that are grounded in TPB and that have been shown to be effective elsewhere for use with Chinese MBs. HIV interventions for this population should give perceived behavioural control and its predictors special consideration.
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Whiting, Willandra, Jennifer R. Pharr, Mark P. Buttner, and Nancy L. Lough. "Behavioral Interventions to Increase Condom Use Among College Students in the United States: A Systematic Review." Health Education & Behavior 46, no. 5 (June 5, 2019): 877–88. http://dx.doi.org/10.1177/1090198119853008.

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Background. Traditional undergraduate college students in the United States are in the age range that experiences the highest rate of sexually transmitted infections (STIs) and are vulnerable to contracting STIs. Increasing condom use among college students is a prevention strategy to reduce the spread of STIs. Aim. The purpose of this systematic review of the literature was to identify behavioral interventions that increased condom use behaviors and/or intentions among college students. Method. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed in systematically searching, extracting, appraising, and synthesizing the evidence. A quality assessment was also conducted with the tool provided by the Effective Public Health Practice Project. Results. The initial search yielded 715 records. After critical appraisal, seven articles remained for review. Discussion. Four of the interventions were developed using the three constructs of the information, motivation, and behavioral skills model, and all four found significant increases in condom use or condom use intentions. Additionally, interventions that included modules to increase self-efficacy for condom use, taught participants where to get condoms and how to negotiate condom use with partners, or elicited positive associations (feels) toward condoms saw increased condom use or intention to use condoms.
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Kheiri, Hossein, and Mohsen Jafari. "Optimal control of a fractional-order model for the HIV/AIDS epidemic." International Journal of Biomathematics 11, no. 07 (October 2018): 1850086. http://dx.doi.org/10.1142/s1793524518500869.

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In this paper, we present a general formulation for a fractional optimal control problem (FOCP), in which the state and co-state equations are given in terms of the left fractional derivatives. We develop the forward–backward sweep method (FBSM) using the Adams-type predictor–corrector method to solve the FOCP. We present a fractional model for transmission dynamics of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) with treatment and incorporate three control efforts (effective use of condoms, ART treatment and behavioral change control) into the model aimed at controlling the spread of HIV/AIDS epidemic. The necessary conditions for fractional optimal control of the disease are derived and analyzed. The numerical results show that implementing all the control efforts increases the life time and the quality of life those living with HIV and decreases significantly the number of HIV-infected and AIDS people. Also, the maximum levels of the controls and the value of objective functional decrease when the derivative order [Formula: see text] limits to 1 ([Formula: see text]). In addition, the effect of the fractional derivative order [Formula: see text] ([Formula: see text]) on the spread of HIV/AIDS epidemic and the treatment of HIV-infected population is investigated. The results show that the derivative order [Formula: see text] can play the role of using ART treatment in the model.
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Marsh, Kerry L., Blair T. Johnson, and Lori A. J. Scott-Sheldon. "Heart Versus Reason in Condom Use: Implicit Versus Explicit Attitudinal Predictors of Sexual Behavior." Experimental Psychology 48, no. 2 (April 2001): 161–75. http://dx.doi.org/10.1026//0949-3946.48.2.161.

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Abstract. We test the hypothesis that explicit and implicit measures of attitudes would differentially predict deliberate versus spontaneous behavior in the domain of condom use. Students completed explicit attitudinal and thought-listing measures about using condoms and implicit measures using attitude priming and Implicit Association Test (IAT) procedures. An attitude IAT measured the association between condom images and affective images; a self-identity IAT measured association of condoms with the self. We predicted and found that condom use with main partners was predicted by explicit measures but not implicit measures; the opposite was true for condom use with casual partners. Although the attitude priming measure was not positively correlated with casual condom use, the IATs were. The patterns of relations, however, were unexpectedly complex, due to a strong decrease in IAT effects over time, and different IATs assessing unique attitudinal dimensions.
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Junior, Mauricio da Silva Oliveira, Mirian N. Tavares, Juciano de Sousa Lacerda, and Glícia M. Azevedo de M. Tinoco. "Looks on Faces." International Journal of Creative Interfaces and Computer Graphics 11, no. 1 (January 2020): 18–35. http://dx.doi.org/10.4018/ijcicg.2020010102.

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The case here presented brings a work created to raise awareness about sexually transmitted infections and how they can be close to our reality. Advertising campaigns to combat sexual infections converge in prevention before any path to cure or treatment. One of the most efficient and inexpensive methods for such protection is the use of condoms, and in studies of advertising campaigns carried out around the world, it is noticed that there is an incentive to use this prevention method, but there is no supply of the item. This is an issue the work presented intended to solve. The work used augmented reality resources on a printed panel with historical and artistic content, a time-based code management system and an automated device to complete the interaction with the viewer, all managed by the artifact itself, without the need for human support. This work was initially part of the 7th Doctoral Retreat in Digital Media-Art at Universidade Aberta de Portugal (UAb-PT) and Universidade do Algarve (Ualg) and is part of the doctoral thesis of the researcher and author of this study.
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Morisky, Donald E., Melanie Peña, Teodora V. Tiglao, and Kenn Y. Liu. "The Impact of the Work Environment on Condom Use among Female Bar Workers in the Philippines." Health Education & Behavior 29, no. 4 (August 2002): 461–72. http://dx.doi.org/10.1177/109019810202900406.

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The purpose of this research is to examine how condom use is affected by specific aspects of the work environment: (1) social-structural and environmental influences and constraints, (2) mandatory condom use policy, and (3) the level of social influence and reinforcement between manager and employee. A total of 1,340 bar workers and 308 nonestablishment freelanceworkers comprise the study group. In establishments where a condom use policy exists, female barworkerswere 2.6 times more likely to consistently use condoms during sexual intercourse comparedwith establishments that do not have such a policy in place. The results suggest a need for the development of comprehensive educational policies in all entertainment establishments, including regular meetings with employees, reinforcing attendance at the Social Hygiene Clinic, promoting AIDS awareness, making condoms available in theworkplace, and mandating 100% condom use behavior among all employees.
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De Bro, Sherrine Chapman, Susan Miller Campbell, and Letitia Anne Peplau. "Influencing A Partner to Use a Condom." Psychology of Women Quarterly 18, no. 2 (June 1994): 165–82. http://dx.doi.org/10.1111/j.1471-6402.1994.tb00449.x.

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Little is known about the influence strategies that young heterosexual adults use to persuade a new sexual partner to use or avoid the use of condoms. College students' ( N = 393) opinions about and experiences with six condom power strategies were examined. Overall, students gender-typed the strategies as “feminine” when the goal was to persuade a partner to use condoms and as “masculine” when trying to avoid condom use. Effectiveness and comfort ratings of the strategies varied both by students' gender and the particular tactic being evaluated. Gender differences also emerged in students' actual experiences with the strategies. When trying to encourage condom use, men utilized seduction most often; whereas, withholding sex was the most popular tactic used by women. For avoiding condom use, men were more likely than women to employ seduction, reward, and information. Implications for understanding the impact of gender and social influence in the domain of condom use are discussed.
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Figueroa, J. Peter, Jacqueline P. Duncan, Althea Bailey, and Nicola Skyers. "The HIV epidemic in Jamaica: a need to strengthen the National HIV Program." Revista Panamericana de Salud Pública 44 (November 20, 2020): 1. http://dx.doi.org/10.26633/rpsp.2020.157.

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Objectives. To assess the status of the HIV epidemic and programmatic implementation in Jamaica while identifying strategies for achieving effective HIV control. Methods. The assessment included a review of the core indicators of the UNAIDS Global Monitoring Framework, a desk review of program reports, and unstructured interviews of stakeholders. Results. HIV prevalence among adults in Jamaica was 1.5% in 2018 with an estimated 32 617 persons living with HIV (PLHIV) and 27 324 persons (83.8%) diagnosed with HIV; 12 711 (39.0% of all PLHIV or 46.5% aware of their status) were on anti-retroviral therapy (ART) in the public health sector and 61.8% PLHIV on ART were virally suppressed. HIV prevalence among men who have sex with men remains high (31.4% in 2011, 29.6% in 2017) but has declined among female sex workers (12% in 1990, 2% in 2017). HIV prevalence among public sexually transmitted infection clinic attendees, prison inmates and the homeless has increased in recent years. During 2018 approximately 200 000 persons (14% of the population 15-49 years) were tested with 1 165 newly diagnosed PLHIV, indicating that many of the estimated 1 600 newly infected persons in 2018 were unaware of their status. Conclusions. Critical policy initiatives are needed to reduce barriers to HIV services, ensure young persons have access to condoms and contraceptives, affirm the rights of the marginalized, reduce stigma and discrimination, and introduce pre-exposure prophylaxis. While HIV spread in Jamaica has slowed, the UNAIDS Fast Track goals are lagging. The HIV program must be strengthened to effectively control the epidemic.
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Napier, Stephen. "The Missing Premise in the HIV-Condom Debate." Linacre Quarterly 78, no. 4 (November 2011): 401–14. http://dx.doi.org/10.1080/002436311803888195.

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In a recent article in this journal, “Condoms and HIV: The State of the Debate,” William Newton argues that there are basically two issues around which parties dispute. The first is whether the use of a condom by a discordant couple amounts to performing a contraceptive act. At issue here is whether a couple's use of a condom to prevent disease transmission renders the act a contraceptive act. The second issue pertains to whether the use of a condom, apart from whatever the intentions of the agents are, is itself a failure to consummate a marital act. It is the second issue that I wish to address in this paper. I aim to argue that the Canon-Law argument, as I will call it, wishes to argue that because condomistic sex fails to consummate a marriage, the sexual act performed is immoral. I argue against this inference on two grounds: the first is that the conclusion succumbs to counterexamples, and second, the inference must rely on a premise that I show is false.
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Mbalinda, Scovia N., Dan K. Kaye, Mathew Nyashanu, Noah Kiwanuka, and Robert Gaspar. "Using Andersen’s Behavioral Model of Health Care Utilization to Assess Contraceptive Use among Sexually Active Perinatally HIV-Infected Adolescents in Uganda." International Journal of Reproductive Medicine 2020 (September 28, 2020): 1–9. http://dx.doi.org/10.1155/2020/8016483.

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Background. Contraceptive practices of perinatally HIV-infected adolescents (PHIAs) have implications related to pregnancy prevention, risks of HIV heterosexual transmission, reinfection, and vertical transmission. The study assessed contraceptive use among sexually active PHIAs in Uganda. Methods. Mixed methods consisting of a survey and in-depth interviews were employed among 213 sexually active PHIAs who were attending antiretroviral therapy (ART) clinics. The study was guided by Andersen’s Behavioral Model of Health Service Use as a theoretical framework to identify factors that influence contraceptive use. These factors include health care factors, personal characteristics, enabling factors, and needs. The outcome was contraceptive use. Multivariable logistic regression was used to establish determinants of contraceptive use. Qualitative data were analyzed by thematic analysis. Results. Most PHIAs were female (67.6%); the mean (SD) and median (IQR) age was 17.5 (±1.4) and 18 (17-19) years. The mean age of sexual debut and at marriage were 15 (±1.7) and 17 (±1.1), respectively. Condoms were the most known method of family planning (indicated by 55.4%). Only 16.9% of the participants knew about dual protection (condom use for FP as well as HIV/STI prevention). Of the PHIAs, 43.6% had ever used modern contraception and 56.9% of the females had ever been pregnant. The odds of contraceptive ever-use were significantly higher among adolescents aged 17-19 years (OR 5.1, 95% CI: 2.1-13.3) compared to those aged 10-16 years, those in school (OR 1.8, 95% CI: 1.07-3.2) compared to those out of school, and those with perceived need to use FP (OR 2.0, 95% CI: 1.1-3.9) compared to their counterparts. The odds of contraceptive used were lower among females (OR 0.13, 95% CI: 0.06-0.28) compared to males. From the in-depth interviews, the attitude of health workers, availability of health workers, having a friend using family planning, and waiting time were viewed to affect contraceptive use. Conclusion. Contraceptive use among sexually active perinatally HIV-infected adolescents was (43.6%). However, out of those who used family planning majority were using short-term methods. The unmet need for family planning was high (47%) with high reports of pregnancy (56.9%). The factors associated with contraceptive use included education, age, sex (predisposing factors), and perceived need of family planning (need factors). Other factors that could affect contraceptive use from qualitative analysis included attitude of health workers, availability of health workers, having a friend using family planning (predisposing factors), and waiting time (health system factors). HIV care for adolescents should be promoted using SRH approach. There is a need to provide training for all providers to cater for SRH services. We should continue to provide youth-responsive adolescent sexual and reproductive health services across all ART facilities and build a supportive environment and continue to integrate SRH services into HIV care.
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Tolosa-Kline, Ayla, Elad Yom-Tov, Caitlin Hoffman, Cherie Walker-Baban, and Felicia M. T. Lewis. "Trojan Horse: An Analysis of Targeted Advertising to Reduce Sexually Transmitted Diseases Among YMSM." Health Education & Behavior 48, no. 5 (April 3, 2021): 637–50. http://dx.doi.org/10.1177/10901981211000312.

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Background Men who have sex with men (MSM) increasingly use internet-based websites and geospatial apps to seek sex. Though these platforms may be useful for public health intervention, evaluations of such interventions are rare. We sought to evaluate the online behavior of young MSM of color in Philadelphia and the effectiveness of using ads to link them to DoYouPhilly.org, where users can order free condoms, lubricant, and sexually transmitted infection test kits delivered via the U.S. postal service. Method Data collection and analyses were conducted in two phases. First, we performed keyword research and analyzed web browser logs using a proprietary data set owned by Microsoft. Subsequently, we ran a Google Ads campaign using the keywords identified in the preliminary phase, and directed targeted users to the DoYouPhilly.org condom or test kit ordering pages. Results were analyzed using MATLAB 2018. Results Test kit advertisements received 5,628 impressions, 157 clicks, and 18 unique conversions. The condom advertisements received 128,007 impressions, 2,583 clicks, and 303 unique conversions. Correlation between the click-through rate and the conversion rate per keyword was ρ = −.35 ( P = .0096) and per advertisement was ρ = .40 ( P = .14). Keywords that directly related to condoms were most effective for condom ordering (42% conversion rate vs. ≤2% for other classes), while keywords emphasizing the adverse effects of unprotected sex were most effective in test kit ordering (91% conversion rate vs. 13% and 12% for other classes). Conclusions Online advertisements seemed to affect real-world sexual health behavior, as measured by orders of condoms and test kits, among a group of young MSM living in the same community.
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Parmley, Lauren E., Kieran Hartsough, Oliver Eleeza, Akopon Bertin, Bockarie Sesay, Amon Njenga, Mame Toure, et al. "COVID-19 preparedness at health facilities and community service points serving people living with HIV in Sierra Leone." PLOS ONE 16, no. 4 (April 15, 2021): e0250236. http://dx.doi.org/10.1371/journal.pone.0250236.

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After a decade of civil war and the 2014–2016 West African Ebola outbreak, Sierra Leone now faces the COVID-19 pandemic with a fragile health system. As was demonstrated during Ebola, preparedness is key to limiting a health crisis’ spread and impact on health systems and ensuring continued care for vulnerable populations including people living with HIV (PLHIV). To assess COVID-19 preparedness and inform interventions to ensure continuity of HIV services at health facilities (HFs) and community service points (CSPs), we conducted site readiness assessments in Freetown, the epicenter of COVID-19 in Sierra Leone. Data were collected at nine high-volume HIV HFs and seven CSPs in April 2020, a month after COVID-19 was declared a pandemic. CSPs comprised three community drop-in centers providing HIV counseling and testing services as well as HIV prevention services (e.g., condoms and lubricants) for key and priority populations and four community-based support groups serving PLHIV. At the time of assessment, CSPs did not provide antiretroviral therapy (ART) but were considered potential sites for expansion of differentiated service delivery (DSD)—a client-centered approach to HIV care—in the context of COVID-19. Overall, 5/9 HFs had trained staff on use of personal protective equipment (PPE) and prevention of COVID-19 transmission. Most had access to masks (5/9) and gloves (7/9) for management of suspected/confirmed COVID-19 cases, and 4/9 HFs had triage procedures for isolation of suspected cases. Conversely, few CSPs had access to masks (2/7) or gloves (2/7) and no staff were trained on PPE use or COVID-19 transmission. 7/9 HFs had adequate ART stock for multi-month dispensing though few had procedures for (3/9) or had trained staff in providing DSD (2/9). Among CSPs where measures were applicable, 2/4 had procedures for DSD, 1/3 had staff trained on DSD and none had adequate ART stock. Identification of gaps in COVID-19 preparedness is a critical step in providing support for infection control and modified service delivery. Findings from this assessment highlight gaps in COVID-19 preparedness measures at sites supporting PLHIV in Sierra Leone and indicate CSPs may require intensive supervision and training to ensure HIV services are uninterrupted while minimizing COVID-19 risk, especially if used as sites to scale up DSD.
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Kharsany, Ayesha B. M., and Quarraisha A. Karim. "HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities." Open AIDS Journal 10, no. 1 (April 8, 2016): 34–48. http://dx.doi.org/10.2174/1874613601610010034.

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Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included.
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Dube, Nkosiyazi, Thobeka S. Nkomo, and Priscalia Khosa. "Condom Usage Negotiation Among Customarily Married Women in Katlehong, Johannesburg." SAGE Open 7, no. 1 (January 2017): 215824401668734. http://dx.doi.org/10.1177/2158244016687345.

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South Africa has the highest number of HIV-infected people in the Southern African Region, and of great concern is the fact that cases of new infections among young people, especially young women and girls, are on the increase. The prevalence of HIV and deaths caused by AIDS are still on the increase, whereas condom use, particularly in rural areas, remains low. Consistent condom use is central to the prevention of unwanted pregnancies, HIV, and other sexually transmitted infections (STIs); yet, young men and women alike are hesitant to use condoms because of threats to their relationships, cultural roles, and, at times, economic survival. This study explored the views of customarily married housewives regarding condom use negotiation with their husbands. The findings point toward the need to empower women while they are still young so that they can be assertive, financially independent, and able to make their own decisions with regard to their sexuality.
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Salazar, Laura F., Richard A. Crosby, Ralph J. DiClemente, Gina M. Wingood, Celia M. Lescano, Larry K. Brown, Kathy Harrington, and Susan Davies. "Self-Esteem and Theoretical Mediators of Safer Sex Among African American Female Adolescents: Implications for Sexual Risk Reduction Interventions." Health Education & Behavior 32, no. 3 (June 2005): 413–27. http://dx.doi.org/10.1177/1090198104272335.

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Theories of health behavior posit that change is accomplished by modifying factors deemed as mediators. A set of mediators from several theoretical models used in sexual risk reduction programs was assessed among a sample of 522 African American female adolescents. The goal was to determine whether self-esteem was associated with sexually transmitted disease (STD), pregnancy, and the set of theoretical mediators controlling for covariates. Bivariate analyses showed no relationship between self-esteem and STD or pregnancy; multivariate regression analysis revealed a significant relation between self-esteem and the set of mediators. Girls higher in self-esteem were more likely to hold positive condom attitudes, felt more efficacious in negotiating condom use, had more frequent communication with sex partners and parents, perceived fewer barriers to using condoms, and were less fearful of negotiating condom use. Self-esteem should be considered when designing and evaluating sexual risk reduction programs for this population.
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Bhattacharya, Gauri. "Sociocultural and Behavioral Contexts of Condom Use in Heterosexual Married Couples in India: Challenges to the HIV Prevention Program." Health Education & Behavior 31, no. 1 (February 2004): 101–17. http://dx.doi.org/10.1177/1090198103259204.

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This article examines sociocultural expectations of sexual behavior and the reasons why not using condoms may be logical to married heterosexual couples in India. Married women who report monogamous sexual relationships with their husbands are a high-risk group for HIV infection in India. Based on the public health model and a population-based perspective on HIV infection prevention, this article illustrates the underlying mechanisms that link the role of women in society, holistic health beliefs, and cultural beliefs about the transmission of HIV with the precursors to nonuse of condoms. The author concludes that promoting condom use requires an emphasis on family health, not only as contraceptives. Challenges for reducing the social stigma and developing a comprehensive policy on HIV prevention and AIDS treatment and care are discussed.
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Crosby, Richard A., Ralph J. DiClemente, Gina M. Wingood, Brenda K. Cobb, Kathy Harrington, Susan L. Davies, Edward W. Hook, and M. Kim Oh. "Condom Use and Correlates of African American Adolescent Females’ Infrequent Communication with Sex Partners about Preventing Sexually Transmitted Diseases and Pregnancy." Health Education & Behavior 29, no. 2 (April 2002): 219–31. http://dx.doi.org/10.1177/109019810202900207.

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This study of 522 African American female adolescents, ages 14 to 18, investigated associations between condom use and infrequently communicating with sex partners about sexually transmitted diseases (STDs) and pregnancy prevention. Correlates of infrequent communication were identified. Sexually active adolescents were recruited from schools and adolescent medicine clinics in low-income neighborhoods of Birmingham, Alabama. Adolescents completed a self-administered survey and face-to-face interview. Communication frequency was assessed using a five-item scale. Infrequent communication was significantly associated with lower odds of condom use. Multivariate correlates of infrequent communication were less frequent communication with parents about STD/pregnancy prevention, recent sex with a nonsteady partner, low perceived ability to negotiate condom use and fear of this negotiation, and low motivation to use condoms. Given the importance of partner communication in promoting safer sex behaviors, STD and pregnancy prevention programs may benefit adolescents by addressing the identified psychosocial correlates of infrequent communication with their partners.
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Morisky, Donald E., Chrystene Nguyen, Alfonso Ang, and Teodora V. Tiglao. "HIV/AIDS Prevention Among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines." Health Education & Behavior 32, no. 1 (February 2005): 57–68. http://dx.doi.org/10.1177/1090198104266899.

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This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the repeated measures analysis of variance (ANOVA) indicate a significant change on knowledge about HIV/AIDS from baseline to posttest and from posttest to follow-up ( F= 449.27, df= 2, p< .001). There was also a significant change on attitudes about condom use from baseline to posttest and from posttest to follow-up ( F= 425.19, df= 2, p= 0.001), and a significant effect on condom use behavior with commercial sex workers from baseline to posttest and follow-up ( F= 428.31, df= 2, p= .001). The peer-mediated intervention was found to be an effective means of HIV/AIDS prevention among taxi and tricycle drivers in the Philippines.
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Quaife, Matthew, Aurélia Lépine, Kathleen Deering, Fern Terris-Prestholt, Tara Beattie, Shajy Isac, R. S. Paranjape, and Peter Vickerman. "The cost of safe sex: estimating the price premium for unprotected sex during the Avahan HIV prevention programme in India." Health Policy and Planning 34, no. 10 (October 11, 2019): 784–91. http://dx.doi.org/10.1093/heapol/czz100.

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Abstract There is some evidence that female sex workers (FSWs) receive greater earnings for providing unprotected sex. In 2003, the landscape of the fight against HIV/AIDS dramatically changed in India with the introduction of Avahan, the largest HIV prevention programme implemented globally. Using a unique, cross-sectional bio-behavioural dataset from 3591 FSWs located in the four Indian states where Avahan was implemented, we estimate the economic loss faced by FSWs who always use condoms. We estimate the causal effect of condom use on the price charged during the last paid sexual intercourse using the random targeting of Avahan as an instrumental variable. Results indicate that FSWs who always use condoms face an income loss of 65% (INR125, US$2.60) per sex act compared to peers providing unprotected sex, consistent with our expectations. The main finding confirms that clients have a preference for unprotected sex and that policies aiming at changing clients’ preferences and at improving the bargaining power of FSWs are required to limit the spread of HIV.
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Randolph, Mary E., Steven D. Pinkerton, Anton M. Somlai, Jeffrey A. Kelly, Timothy L. McAuliffe, Richard H. Gibson, and Kristin Hackl. "Seriously Mentally Ill Women’s Safer Sex Behaviors and the Theory of Reasoned Action." Health Education & Behavior 36, no. 5 (May 20, 2009): 948–58. http://dx.doi.org/10.1177/1090198108324597.

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Seriously mentally ill women at risk for HIV infection ( n = 96) participated in structured interviews assessing sexual and substance-use behavior over a 3-month period. The majority of the women (63.5%) did not use condoms. Consistent with the theory of reasoned action, attitudes toward condom use and perceived social norms about safer sex were associated with safer sex intentions. Supplementing variables from the theory of reasoned action with safer sex self-efficacy explained additional variance in safer sex intentions. Greater safer sex intentions were related to both greater condom use and less frequent unprotected intercourse. In addition, less frequent sex after drug use and a less fatalistic outlook were associated with less frequent unprotected intercourse. Life circumstances specific to this population are particularly important to examine to improve the effectiveness of risk reduction interventions for seriously mentally ill women.
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Haignere, Clara S., Rachel Gold, and Heather J. McDanel. "Adolescent Abstinence and Condom Use: Are We Sure We Are Really Teaching What is Safe?" Health Education & Behavior 26, no. 1 (February 1999): 43–54. http://dx.doi.org/10.1177/109019819902600105.

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This article reviews existing research on condom and abstinence method and user-failure rates, and the use of this research in determining sexuality education curricula. Latex condoms effectively prevent pregnancies and most sexually transmitted diseases or infections (STIs), with method-failure rates between 0.5% and 7%, but with user-failure rates between 12% and 70%. Total abstinence presumably has a method-failure rate of zero, but research on periodic abstinence indicates user-failure rates between 26% and 86%. No researchers have attempted to establish total abstinence user-failure rates. Abstinence-only curricula evaluations have demonstrated changes in adolescents’attitudes but little change in sexual behaviors. Comprehensive sexuality education curricula have demonstrated attitudinal changes and delays in adolescents’sexual activity. Since inconsistent use of either condoms or abstinence threatens adolescents’ health, this article urges more scientific research on total abstinence user-failure rates, better and clearer dissemination of research findings, and encourages funders to require educators to show thorough knowledge of research findings.
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Crosby, Richard, Shayna Skakoon-Sparling, Robin R. Milhausen, Stephanie Sanders, Cynthia A. Graham, and William L. Yarber. "The Protective Value of Discussing Condom Use: A Study of Young Black Men Attending STI Clinics in the Southern United States." Health Education & Behavior 45, no. 5 (June 1, 2018): 706–13. http://dx.doi.org/10.1177/1090198118775496.

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Young Black men (YBM) experience disparities in both HIV incidence and incidence of bacterial sexually transmitted infections (STIs); thus, developing efficacious behavioral interventions is an especially critical goal. One potential avenue for intervention involves improving sexual health communications among YBM and their partners, before sex occurs. Such discussions may serve several purposes, including improving condom use and facilitating the negotiation of correct and consistent condom use. The aim of the current study was to determine the STI-protective effects of discussing condom use with sex partners, among medically underserved YBM. A total of 702 YBM were recruited from three STI clinics in the Southern United States. YBM completed a self-interview at baseline and again 6 months later. At 12 months postenrollment, a chart review determined incidents of STIs. The majority of YBM participants (61.1%) had recently discussed condom use with partners before sex. Of the 12 assessed outcomes, 7 were significantly associated with this measure. In each case, a protective effect was observed. In controlled analyses, the 12-month incidence of STIs was significantly ( p = .05) greater among YBM not discussing condoms with sex partners. The results of the current study suggest that, among YBM attending clinics, discussing condom use with sex partners may promote safer sex practices. This behavior was also predictive of lower STI incidence in the ensuing 12 months, suggesting that it may be an ideal intervention target for programs designed to protect YBM against STI acquisition, including HIV.
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42

Eversole, Jillian S., Nancy F. Berglas, Julianna Deardorff, and Norman A. Constantine. "Source of Sex Information and Condom Use Intention Among Latino Adolescents." Health Education & Behavior 44, no. 3 (November 30, 2016): 439–47. http://dx.doi.org/10.1177/1090198116671704.

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Adolescence is a common time for sexual initiation and information seeking about sexual health, yet little is known about how adolescents’ sources of information about sex influence their sexual beliefs and behaviors. This is particularly true for Latino adolescents, whose sources of sex information and sexual behaviors are vastly understudied. A survey of ninth-grade Latino adolescents ( N = 1,186) was employed to examine the relationship between adolescents’ primary source of sex information and their intention to use condoms. The study also examined the potential influences of demographics (age, gender), sociodemographics (socioeconomic status, parent education, and linguistic acculturation), and sexual experience on condom use intention. Among Latino youth, the most commonly reported source of sex information was parents (37.8%), followed by another relative (17.1%), school (13.4%), and friends (11.4%). Hierarchical regression analyses showed that after controlling for other factors, primary source of sex information was significantly associated with condom use intention ( p = .042). Hierarchical regression results stratified by gender showed that this relationship remained significant for males ( p = .004) but not for females ( p = .242). Males who reported friends (odds ratio [ OR] = 0.44, p = .003) or the media/Internet ( OR = 0.44, p = .008) as their primary sources of sex information, as compared to parents as their primary source, reported significantly lower intention to use condoms. These findings suggest it may be important for Latino adolescents, particularly males, to have additional or other sources for sex information in order to promote healthy sexual behaviors. Alternatively, interventions targeting parents or other family members to improve sexual health communication with adolescent boys may prove essential.
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43

Cina, Stephen J., Kim A. Collins, Matthew Fitts, and Mark J. Pettenati. "Isolation and Identification of Male and Female DNA on a Postcoital Condom." Archives of Pathology & Laboratory Medicine 124, no. 7 (June 1, 2000): 1083–86. http://dx.doi.org/10.5858/2000-124-1083-iaioma.

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Abstract Background.—Identification of male perpetrators of sexual assault may be made from cells and fluids recovered from postcoital condoms. To date, the focus has been on identifying the person who had worn the condom. Objective.—To describe a method for scientifically identifying both the male and female participants in a sex act by employing polymerase chain reaction–based technology on swabs taken from the internal and external surfaces of a condom. Fluorescence in situ hybridization may be used to screen for the presence of female cells on a condom. Methods.—Swabs were taken from the internal and external surfaces of a condom 8 hours postcoitus. DNA was isolated from each swab through standard organic extraction. Extracted DNA was amplified for 8 different genetic loci using the Promega PowerPlex kit and the sex identification amelogenin marker. Amplified samples were electrophoresed on precast sequencing gels and analyzed fluorescently using a Hitachi FMBIO 2 fluorescent scanner and software. Each DNA sample obtained from the condom was compared with male and female buccal controls. At the time of collection, air-dried slides were prepared from the swabs for subsequent multicolor fluorescence in situ hybridization using dual X- and Y-chromosome probes with 4′-6-diamidino-2-phenylindole (DAPI) counterstaining. Results.—A pure sample of female DNA was isolated from the external surface of the condom as determined by exclusive amplification of the X-chromosome–specific 212-base pair amelogenin marker. Swabs taken from the internal surface yielded DNA originating from the male participant. Identification was conclusive at 8 of 8 genetic loci. Fluorescence in situ hybridization identified pure populations of male epithelial cells from the internal surface of the condom and female cells from the external surface. Conclusions.—Cells shed from a female during sexual intercourse can be retrieved from the external surface of a condom following sexual intercourse. Fluorescence in situ hybridization can be used to screen for the presence of female cells, and positive identification of the female sexual partner can then be made using polymerase chain reaction–based methods. We suggest that swabs taken from both surfaces of a condom used during sexual assault may be used to provide information that will definitively link the victim to the suspect.
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44

Burns, Jade C., Shawtaabdee Chakraborty, and Denise Saint Arnault. "Social Media Preference and Condom Use Behaviors: An Analysis of Digital Spaces With Young African American Males." Health Education & Behavior 48, no. 2 (March 11, 2021): 190–98. http://dx.doi.org/10.1177/1090198121993043.

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Background. African American adolescents and young adults have an increased likelihood of engaging in risky sexual behaviors. With rising rates of sexually transmitted infections among this population, deeper consideration is now being focused on using social media to engage, educate, and improve sexual behavior in this group. Purpose. To determine why social media is useful and how it may affect the attitude, norms, and perceived behavioral control on condom use among young African American males (YAAMs) ages 18 to 21. Method. Group-depth interviews ( n = 41, mean age = 19, SD = 1.2) were conducted in metro Detroit to understand and describe the who, what, where, why, and how regarding social media use and preference among YAAMs) ages 18 to 21, and their condom use behaviors. Results. The most popular reasons for using social media were for educational purposes, entertainment, browsing the site, self-expression, seeking out or maintaining relationships with friends and family, and social justice. YouTube was stated as the easiest site to promote condom use education. YAAMs would seek out condom use education on social media sites if someone respected in the community or someone famous promoted condom use messages on the sites or if it was used to show where condoms were available for free or for purchase. Conclusion. Understanding how YAAMs use social media may help researchers design better questions to address disparities within this population. More important, it can help health care providers, families, and the community promote healthy behaviors and lifestyle changes among YAAMs.
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45

Roye, Carol, Paula Perlmutter Silverman, and Beatrice Krauss. "A Brief, Low-Cost, Theory-Based Intervention to Promote Dual Method Use by Black and Latina Female Adolescents: A Randomized Clinical Trial." Health Education & Behavior 34, no. 4 (May 31, 2006): 608–21. http://dx.doi.org/10.1177/1090198105284840.

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HIV/AIDS disproportionately affects young women of color. Young women who use hormonal contraception are less likely to use condoms. Brief, inexpensive HIV-prevention interventions are needed for high-volume clinics. This study was a randomized clinical trial of two interventions: (a) a video made for this study and (b) an adaptation of Project RESPECT counseling. Four hundred Black and Latina teenage women completed a questionnaire about their sexual behaviors and were randomly assigned to (a) see the video, (b) get counseling, (c) see the video and get counseling, or (d) receive usual care. At 3-month follow-up, those who saw the video and received counseling were 2.5 times more likely to have used a condom at last intercourse with their main partner than teens in the usual care group. These differences did not persist at 12-month follow-up. This suggests that a brief intervention can positively affect condom use in the short term.
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46

Wilkerson, J. Michael, Jayson Michael Rhoton, Dennis Li, Shruta Amit Rawat, Pallav Patankar, B. R. Simon Rosser, and Maria Ekstrand. "Information, Motivation, and Self-Efficacy Among Men Who Have Sex With Men and Transgender Women in the State of Maharashtra, India." Health Education & Behavior 46, no. 2 (September 11, 2018): 304–11. http://dx.doi.org/10.1177/1090198118796880.

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Background. India’s National AIDS Control Programme calls for, among other things, targeted behavioral interventions that address determinants contributing to new infections among men who have sex with men (MSM) and hijras (transgender women). Aim. To determine if the information–motivation–behavioral skills model was transferable to an Indian context. Methods. We recruited 442 MSM and 7 hijras into an online cross-sectional study that asked questions about condom use knowledge, motivation, self-efficacy, and sexual behavior. Structural equation modeling was used to test the overall information–motivation–behavioral skills structure. Results. Condom use and HIV risk knowledge did not significantly predict condom use self-efficacy or having condomless anal sex with more than one male partner in the past 3 months, and knowledge was not significantly correlated with attitudes toward barebacking. Despite this, the final structural model explained 14.4% of the variance in condom use self-efficacy and 20.0% of the variance in risky sexual behavior. Overall fit of the model was good: χ2(201, N = 447) = 445.002, p < .0001, root mean square error of approximation = .052, 90% CI [.046, .059], comparative fit index = .989, Tucker–Lewis Index = .987. Conclusion. The public health response to India’s HIV epidemic is currently different than in the West due to differences in medication access and public health infrastructure. As Indian MSM and hijras learn more about the effectiveness of viral suppression and hopefully have greater access to preexposure prophylaxis, researchers should monitor for changing attitudes toward condoms and be prepared to collaborate with the public health infrastructure in order to develop interventions that reinforce positive attitudes toward condom use.
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47

Dalessandro, Cristen, Laurie James-Hawkins, and Christie Sennott. "Strategic Silence: College Men and Hegemonic Masculinity in Contraceptive Decision Making." Gender & Society 33, no. 5 (May 29, 2019): 772–94. http://dx.doi.org/10.1177/0891243219850061.

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Condom use among college men in the United States is notoriously erratic, yet we know little about these men’s approaches to other contraceptives. In this paper, accounts from 44 men attending a university in the western United States reveal men’s reliance on culturally situated ideas about gender, social class, race, and age in assessing the risk of pregnancy and STI acquisition in sexual encounters with women. Men reason that race- and class-privileged college women are STI-free, responsible for contraception, and will pursue abortion services if necessary. Since men expect women will take responsibility, they often stay silent about condoms and other contraceptives in sexual encounters—a process we term “strategic silence.” Men’s strategic silence helps uphold local constructions of hegemonic masculinity that prioritize men’s sexual desires and protects these constructions by subtly shifting contraceptive and sexual health responsibility onto women. Our analysis demonstrates the importance of men’s expectations of women for upholding constructions of hegemonic masculinity, which legitimate gender inequality in intimacy and are related to men’s underestimation of the risks associated with condom-free sex.
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48

Bhattacharjee, Parinita, Linda Campbell, Raghavendra Thalinja, Sapna Nair, Mahesh Doddamane, Satyanarayana Ramanaik, Shajy Isac, and Tara S. Beattie. "Understanding the Relationship Between Female Sex Workers and Their Intimate Partners: Lessons and Initial Findings From Participatory Research in North Karnataka, South India." Health Education & Behavior 45, no. 5 (April 4, 2018): 824–35. http://dx.doi.org/10.1177/1090198118763934.

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While traditional HIV prevention programs with female sex workers (FSWs) in Karnataka, India, have focused on reducing HIV transmission between FSWs and clients through increased condom use, these programs have not fully addressed the transmission risk between FSWs and their nonpaying intimate partners (IPs). Condom use is infrequent and violence is recurrent in these relationships: Furthermore, there is little evidence on the precise nature of FSW–IP relationships. Our study addresses this knowledge gap to inform HIV programs targeted at FSWs. A series of workshops, using participatory tools, was held to explore FSW-IP relationships; 31 FSWs and 37 IPs participated. Three aspects of FSW–IP relationships were examined: how FSWs and IPs understand and interpret their relationships, factors influencing condom use, and the role of violence and its consequences. FSWs wish to be perceived as their IPs’ wives, while IPs expect their FSW partners to accept their dominance in the relationship. Nonuse of condoms signals fidelity and elevates the status of the relationship almost to that of marriage, which helps FSWs enter the category of “good” (married) women. Tolerating and accepting violence in these relationships is normative, as in other marital relationships; IPs justify violence as necessary to establish and maintain their power within the relationship. Both FSWs and IPs value their relationships despite the high degree of risk posed by low condom use and high levels of violence. Implications for program design include addressing current norms around masculinity and gender roles, and improving communication within relationships.
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49

Brunk, Timothy. "Consumerism and the Liturgical Act of Worship." Horizons 38, no. 1 (2011): 54–74. http://dx.doi.org/10.1017/s0360966900007696.

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ABSTRACTThis paper selects three aspects of consumerism (individualism, the chronically reinvented self, and viewing nearly everything as a product or commodity) and assesses how they pose a challenge to liturgical worship, which is properly grounded in a Christian indentity that is fundamentally communal. When consumerism takes the form of shopping for a parish, it threatens to undermine this communal identity. At the same time, parish-shopping may well be an expression of a sincere search for a vital Christian community. This paper thus neither condemns nor condones parish shopping but stresses rather that there is work to be done to build up the sense of community in Roman Catholic parishes. Liturgical worship is an essential element in that process, but liturgy by itself cannot build or sustain community.
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50

Liang, Xia, Jun Yang, Abu S. Abdullah, Zhikui He, and Li Yang. "The Evaluation of the Effect of ICT in HIV Prevention in the General Population in China Based on an Information-Motivation-Behavioral Skill Model." BioMed Research International 2020 (October 29, 2020): 1–8. http://dx.doi.org/10.1155/2020/8786467.

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Objectives. With an increase in human immunodeficiency virus (HIV) infection, the application of information and communication technology (ICT) is considered as a helpful solution. The aim of this study is to evaluate the effect of ICT in HIV prevention in the general population based on an information-motivation-behavioral skill (IMB) model. Methods. A national follow-up study on the evaluation of ICT on HIV health education effects before and after large sample intervention was conducted in 16 provinces of China. ICT was used to carry out a six-month educational program on the prevention of HIV for participants using the WeChat platform. The research group conducted a second questionnaire for participants to collect data and built the IMB model using Mplus 7.0 analysis software. Results. A total of 997 questionnaires were sent, and 957 effective questionnaires were recovered, a recovery rate of 96.0%. Before the ICT intervention, the scores of information was 15.68 ± 3.28 , of motivation was 14.47 ± 4.26 , of behavior skills was 2.26 ± 1.08 , and of condom use was 2.19 ± 1.15 . After the ICT intervention, the scores for information ( 18.54 ± 2.48 ), motivation ( 16.06 ± 4.11 ), behavior skills ( 4.74 ± 1.04 ), and condom use ( 2.64 ± 1.15 ) improved significantly. ICT use had a significant regression effect on motivation ( β = 0.237 , P < 0.001 ), behavior skills ( β = 0.997 , P < 0.001 ), and information ( β = 0.441 , P < 0.001 ), while motivation ( β = 0.196 , P < 0.001 ), behavior skills ( β = 0.207 , P < 0.001 ), and information ( β = 0.092 , P < 0.001 ) had a significant regression effect on condom use. Conclusions. The ICT intervention can not only improve information about HIV prevention, motivation, and behavior skills but also promote the use of condoms, so as to achieve the result of promoting behaviors that act to prevent AIDS within the general population.
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