Towards condom skills: a cross-sectional study of the association between condom proficiency, condom problems and STI risk amongst MSM

BMC Public Health

Paul Flowers²  Daniel Clutterbuck¹  Lisa Goodall¹ 

[1] Chalmers Centre, 2A Chalmers Street, Edinburgh EH3 9ES, UK;School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK

关键词: Condom measures;    Condom proficiency;    Condom problems;    Sexually transmitted infections;    Men who have sex with men;    Condom skills;   

Others  :  1163144
DOI  :  10.1186/1471-2458-12-747

 received in 2012-05-09, accepted in 2012-08-30,  发布年份 2012

【 摘 要 】

Background

Condom use problems are common amongst Scotland’s men who have sex with men (MSM). To date condom errors have been associated with the likelihood of sexually transmitted infections in heterosexual sexually transmitted infection (STI) clinic attendees but not in MSM and direct evidence of a link between condom problems and STI acquisition in MSM have been lacking. This study investigated the possibility of an independent association between condom proficiency, condom problems and STI acquisition in MSM in Scotland.

Methods

An exploratory observational design employed cross-sectional surveys in both STI clinic and community settings. Respondents completed self-report measures of socio-demographic variables, scales of condom proficiency and condom problems and numbers of different partners with whom men have had unprotected anal intercourse (UAI partners) in the preceding year. Self-report data was corroborated with clinical STI diagnosis where possible. Analysis included chi-squared and Mann–Whitney tests and multiple logistic regression.

Results

792 respondents provided data with an overall response rate of 70% (n = 459 clinic sample, n = 333 community sample). Number of UAI partners was the strongest predictor of self-reported STI acquisition over the previous 12 months (p < 0.001 in both clinic and community samples). Demographic characteristics were not associated with self-reported STI diagnosis. However, condom proficiency score was associated with self-reported STI acquisition (p < 0.05 in both samples). Condom problem score was also associated with self-reported STI diagnosis in the clinic (p = 0.001) but not the community sample. Condom problem score remained associated with self-reported STI diagnosis in the clinic sample after adjusting for number of UAI partners with logistic regression.

Conclusions

This exploratory study highlights the potential importance of targeted condom use skills interventions amongst MSM. It demands further research examining the utility of condom problem measures in wider populations, across prospective and experimental research designs, and a programme of research exploring their feasibility as a tool determining candidacy for brief interventions.

【 授权许可】

   
2012 Goodall et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Sullivan PS, Hamouda O, Delpech V, Geduld JE, Prejean J, Semaille C, van Sighem A, Fenton KA: Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005. Ann Epidemiol 2009, 19:423-431.
• [2]Hart GJ, Williamson LM: Increase in HIV sexual risk behavior in homosexual men in Scotland, 1996–2002: prevention failure? Sex Transm Infect 2005, 81:367-372.
• [3]Knussen C, Flowers P, McDaid LM, Hart GJ: HIV-related sexual risk behavior between 1996 and 2008, according to age, among men who have sex with men (Scotland). Sex Transm Infect 2011, 87:257-259.
• [4]McDaid LM, Hart GJ: Sexual risk behavior for transmission of HIV in men who have sex with men: recent findings and potential interventions. Curr Opin HIV AIDS 2010, 5:311-315.
• [5]Howe BE, Clutterbuck D: Targeting of HIV pretest discussion and risk-reduction interventions in a low-prevalence setting. Int J STD AIDS 2009, 20:470-472.
• [6]Johnson WD, Diaz RM, Flanders WD, Goodman M, Hill AN, Holtgrave D, Malow R, McClellan WM: havioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev 2008, 3:CD001230.
• [7]Crosby RA, Yarber WL, Sanders SA, Graham CA, McBride K, Milhausen RR, Arno JN: Men with broken condoms: who and why? Sex Transm Infect 2007, 83:71-75.
• [8]Hensel DJ, Stupiansky NW, Herbenick D, Dodge B, Reece M: When condom use is not condom use: an event-level analysis of condom use behaviors during vaginal intercourse. J Sex Med 2011, 8:28-34.
• [9]Topping AA, Milhausen RR, Graham CA, Sanders SA, Yarber WL, Crosby RA: A comparison of condom use errors and problems for heterosexual anal and vaginal intercourse. Int J STD AIDS 2011, 22:204-208.
• [10]Du Bois SN, Emerson E, Mustanski B: Condom-related problems among a racially diverse sample of young men who have sex with men. AIDS Behav 2011, 15:1342-1346.
• [11]Knussen C, Flowers P: The condom study: An investigation into condom use, availability, knowledge, norms and breakage amongst men who have sex with men in Scotland. In GayCon 08. Glasgow; 2008.
• [12]Warner L, Stone KM, Macaluso M, Buehler JW, Austin HD: Condom use and risk of gonorrhea and Chlamydia: a systematic review of design and measurement factors assessed in epidemiologic studies. Sex Transm Dis 2006, 33:36-51.
• [13]Shlay JC, McClung MW, Patnaik JL, Douglas JM: Comparison of sexually transmitted disease prevalence by reported condom use: errors among consistent condom users seen at an urban sexually transmitted disease clinic. Sex Transm Dis 2004, 31:526-532.
• [14]Williamson LM, Dodds JP, Mercey DE, Hart GJ, Johnson AM: Sexual risk behavior and knowledge of HIV status among community samples of gay men in the UK. AIDS 2008, 22:1063-1070.
• [15]Bland JM: Statistics notes: Cronbach's alpha. BMJ 1997, 314:572.
• [16]Fitch JT, Stine C, Hager WD, Mann J, Adam MB, McIlhaney J: Condom effectiveness: factors that influence risk reduction. Sex Transm Dis 2002, 29:811-817.
• [17]Yarber WL, Graham CA, Sanders SA, Crosby RA: Correlates of condom breakage and slippage among university undergraduates. Int J STD AIDS 2004, 15:467-472.
• [18]Warner L, Newman DR, Kamb ML, Fishbein M, Douglas JM, Zenilman J, D'Anna L, Bolan G, Rogers J, Peterman T: Problems with condom use among patients attending sexually transmitted disease clinics: prevalence, predictors, and relation to incident gonorrhea and chlamydia. Am J Epidemiol 2008, 167:341-349.
• [19]Jakopanec I, Schimmer B, Grjibovski AM, Klouman E, Aavitsland P: Self-reported sexually transmitted infections and their correlates among men who have sex with men in Norway: an Internet-based cross-sectional survey. BMC Infect Dis 2011, 10:261.
• [20]Mayer KH, O'Cleirigh C, Skeer M, Covahey C, Leidolf E, Vanderwarker R, Safren SA: Which HIV-infected men who have sex with men in care are engaging in risky sex and acquiring sexually transmitted infections: findings from a Boston community health centre. Sex Transm Infect 2010, 86:66-70.
• [21]McDaid LM, Hart GJ: Contact with HIV prevention services highest in gay and bisexual men at greatest risk: cross-sectional survey in Scotland. BMC Public Health 2010, 10:798. BioMed Central Full Text
• [22]Hart GJ, Elford J: Sexual risk behavior of men who have sex with men: emerging patterns and new challenges. Curr Opin Infect Dis 2010, 23:39-44.
• [23]Golombok S, Harding R, Sheldon J: An evaluation of a thicker versus a standard condom with gay men. AIDS 2001, 15:245-250.
• [24]Kamb ML, Fishbein M, Douglas JM, Rhodes F, Rogers J, Bolan G, Zenilman J, Hoxworth T, Malotte CK, Latesta M, Kent C, Lentz A, Graziano S, Byres RH, Peterman TA: Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. Project RESPECT Study Group. JAMA 1998, 280:1161-1167.
• [25]Crosby R, DiClemente RJ, Charnigo R, Snow G, Troutman A: A brief, clinic-based, safer sex intervention for heterosexual African American men newly diagnosed with an STD: a randomized controlled trial. Am J Public Health 2009, 99:S96-S103.
• [26]Milhausen RR WJ, Sanders SA, Crosby RA, Yarber WL, Graham CA: A novel, self-guided, home-based intervention to promote condom use among young men: a pilot study. Journal of Men's Health 2011, 8:274-281.
• [27]Koblin B, Chesney M, Coates T: Effects of a behavioral intervention to reduce acquisition of HIV infection among men who have sex with men: the EXPLORE randomised controlled study. Lancet 2004, 364:41-50.
• [28]Dodds JP, Johnson AM, Parry JV, Mercey DE: A tale of three cities: persisting high HIV prevalence, risk behavior and undiagnosed infection in community samples of men who have sex with men. Sex Transm Infect 2007, 83:392-396.
• [29]SIGMA Research: VITAL STATISTICS 2010: The UK Gay Men's Sex Survey Data Report All England. 2012. http://www.sigmaresearch.org.uk/gmss/year/yr2010 webcite