| |
HIV Prevention and Health Behavior Resource Library
Research and Technical Resources
Condom Effectiveness
| |
|
| Title |
Increasing condom use without reducing HIV risk: results of a controlled community trial in Uganda (click here for paid access at www.jaids.com) |
| Author |
Phoebe Kajubi, Moses R. Kamya, Sarah Kamya, Sanny Chen, Willi McFarland, and Norman Hearst |
| Publisher |
Journal of Acquired Immune Deficiciency Syndrome, vol. 40, pp. 77–82 |
| Publication Date |
2005 |
| Abstract |
Background: Although consistent condom use is effective in reducing individual risk for HIV infection, the public health impact of condom promotion in a generalized epidemic is less clear. We assess the change in condom uptake and number of sex partners after a
condom promotion trial in Kampala, Uganda.
Methods: Two similar poor urban communities near Kampala were randomized. One received a condom promotion program that taught condom technical use skills in workshops for men aged 18 to 30 years (n = 297) and encouraged condom use. Men in the control community (n = 201) received a brief informational presentation about
AIDS. Participants received coupons redeemable for free condoms from distributors in both communities and completed questionnaires at baseline and 6 months later.
Results: Six-month follow-up was completed for 213 men (71.7%) in the intervention group and for 165 (82.1%) men in the control group. Men in the intervention group redeemed significantly more condom coupons than men in the control group (on average, 110 vs. 13 each; P = 0.002). Men in the intervention group increased their number of sex partners by 0.31 compared with a decrease of 0.17 partners in the control group (P = 0.004). Other measures did not support a net reduction in sexual risk in the intervention community compared with the control community and, in fact, showed trends in the opposite direction.
Conclusions: In this study, gains in condom use seem to have been offset by increases in the number of sex partners. Prevention interventions in generalized epidemics need to promote all aspects of sexual risk reduction to slow HIV transmission. |
| Keywords |
HIV, AIDS, condoms, prevention, sexual behavior, Uganda, Africa |
| |
|
| Title |
Contraceptive Prevalence and Adult HIV Prevalence (PPT, 140 KB) |
| Author |
Edward C. Green and Allison Herling |
| Publisher |
n/a |
| Publication Date |
2005 |
| Abstract |
A PowerPoint slide showing maps of Africa shaded according to modern contraceptive prevalence and adult HIV prevalence. |
| Keywords |
|
| |
|
| Title |
Condom Promotion for AIDS Prevention in the Developing World: Is It Working? (click here for paid access) |
| Author |
Norman Hearst and Sanny Chen |
| Publisher |
Studies in Family Planning, vol. 35, issue 1, pp. 39-42 |
| Publication Date |
2004 |
| Abstract |
Two decades of experience and research provide new insights into the role of condoms for AIDS prevention in the developing world. This literature review and synthesis is based on computerized searches of the scientific literature and review of conference presentations, publications of national and international organizations, and popular media. Condoms are about 90 percent effective for preventing HIV transmission, and their use has grown rapidly in many countries. Condoms have produced substantial benefit in countries like Thailand, where both transmission and condom promotion are concentrated in the area of commercial sex. The public health benefit of condom promotion in settings with widespread heterosexual transmission, however, remains unestablished. In countries like Uganda that have curbed generalized epidemics, reducing the number of individuals’ sex partners appears to have been more important than promoting the use of condoms. Other countries continue to have high rates of HIV transmission despite high reported rates of condom use among the sexually active. The impact of condoms may be limited by inconsistent use, low use among those at highest risk, and negative interactions with other strategies. Recommendations include increased condom promotion for groups at high risk, more rigorous measurement of the impact of condom promotion, and more research on how best to integrate condom promotion with other prevention strategies. |
| Keywords |
|
| |
|
| Title |
HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda (click here for free access at www.aidsonline.com) |
| Author |
Saifuddin Ahmed, Tom Lutalo, Maria Wawer, David Serwadda, Nelson K. Sewankambo, Fred Nalugodaa, Fred Makumbia, Fred Wabwire-Mangen, Noah Kiwanuka, Godfrey Kigozia, Mohamed Kiddugavu and Ron Gray |
| Publisher |
AIDS, vol 15, pp. 2171-2179 |
| Publication Date |
2001 |
| Abstract |
Objective: Evidence of condom effectiveness for HIV and sexually transmitted disease (STD) prevention is based primarily on high-risk populations. We examined condom effectiveness in a general population with high HIV prevalence in rural Africa.
Methods: Data were from a randomized community trial in Rakai, Uganda. Condom usage information was obtained prospectively from 17 264 sexually active individuals aged 15-59 years over a period of 30 months. HIV incidence and STD prevalence was determined for consistent and irregular condom users, compared to non-users. Adjusted rate ratios (RR) of HIV acquisition were estimated by Poisson multivariate regression, and odds ratios of STDs estimated by logistic regression.
Results: Only 4.4% reported consistent condom use and 16.5% reported inconsistent use during the prior year. Condom use was higher among males, and younger, unmarried and better educated individuals, and those reporting multiple sex partners or extramarital relationships. Consistent condom use significantly reduced HIV incidence
[RR, 0.37; 95% con®dence interval (CI), 0.15-0.88], syphilis [odds ratio
(OR), 0.71; 95% CI, 0.53-0.94] and gonorrhea/Chlamydia (OR, 0.50; 95% CI, 0.25-0.97) after adjustment for socio-demographic and behavioral characteristics. Irregular condom use was not protective against HIV or STD and was associated with increased gonorrhea/Chlamydia risk (OR, 1.44; 95% CI, 1.06-1.99). The population attributable fraction of consistent use for prevention of HIV was -4.5% (95% CI, -8.3 to 0.0), due
to the low prevalence of consistent use in the population.
Conclusions: Consistent condom use provides protection from HIV and STDs, whereas inconsistent use is not protective. Programs must emphasize consistent condom use for HIV and STD prevention. |
| Keywords |
Africa, condom, effectiveness, HIV, prevention, sexually transmitted
disease |
| |
|
|
|
