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Condoms [MH] AND Meta-analysis [PT] and hasabstract
1: Sex Transm Dis 2002 Aug;29(8):476-82
Alcohol and condom use: a meta-analysis of event-level studies.
Alcohol and Drug Abuse Institute, University of Washington, Seattle, Washington
98105, USA. email@example.com
BACKGROUND: Although it is often assumed that drinking alcohol interferes with
condom use, studies on this topic have used several different methods and have
yielded inconsistent findings. By examining drinking and condom use in specific
sexual encounters, the role of alcohol in influencing unprotected intercourse is
targeted. GOAL: The goal of the study was to assess the relationship of alcohol
use and condom use in discrete sexual encounters using meta-analysis. STUDY
DESIGN: Studies in the literature were identified by computerized searches of
MEDLINE and PsycINFO and hand searches of reference lists. Summary odds ratios
were calculated for all analyses and for subgroups formed according to type of
sexual encounter (first, most recent, most recent with a new sexual partner).
RESULTS: The association of alcohol use and condom use varied by type of sexual
encounter: drinking at first intercourse was associated with decreased condom
use (odds ratio [OR], 0.54; 95% CI, 0.44-0.66), but drinking was unrelated to
condom use in recent sexual encounters (OR, 1.04; 95% CI, 0.89-1.21) and in
recent encounters with new partners (OR, 1.1; 95% CI, 0.92-1.32). CONCLUSION:
Drinking is not necessarily linked to unprotected intercourse; the relationship
between alcohol use and unprotected sex depends on context and sexual experience
of the partners.
PMID: 12172533 [PubMed - indexed for MEDLINE]
2: J Acquir Immune Defic Syndr 2002 Jul 1;30 Suppl 1:S73-93
A meta-analysis of the effect of HIV prevention interventions on the sex
behaviors of drug users in the United States.
Semaan S, Des Jarlais DC, Sogolow E, Johnson WD, Hedges LV, Ramirez G, Flores
SA, Norman L, Sweat MD, Needle R.
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
We examined the effectiveness of 33 U.S.-based HIV intervention studies in
reducing the sexual risk behaviors of drug users by reducing unprotected sex or
increasing the use of male condoms. The studies, identified as of June 1998,
through the HIV/AIDS Prevention Research Synthesis project, were published in
1988 or later, measured behavioral or biologic outcomes, used experimental
designs or certain quasi-experimental designs, and reported sufficient data for
calculating an effect size for sexual risk reduction. Of the 33 studies, 94%
recruited injection drug users; 21% recruited crack users. The mean age of
participants was 36 years. Almost all studies were randomized (94%), provided
another HIV intervention to the comparison groups (91%), and evaluated
behavioral interventions (91%). On average, interventions were conducted in 5
sessions (total, 10 hours) during 4.5 months. Interventions compared with no
interventions were strong and significant (k = 3; odds ratio [OR], 0.60; 95%
confidence interval [CI], 0.43-0.85). Interventions compared with other HIV
interventions showed a modest additional benefit (k = 30; OR, 0.91; 95% CI,
0.81-1.03). When we extrapolated our result (an OR of 0.60) to a population with
a 72% prevalence of risk behavior, the proportion of drug users who reduced
their risk behaviors was 12.6% greater in the intervention groups than in the
comparison groups. Our meta-analysis shows that interventions can lead to sexual
risk reduction among drug users and justifies providing interventions to drug
users. Developing interventions with stronger effects to further reduce sexual
risk behaviors among drug users must remain a high priority.
PMID: 12107362 [PubMed - indexed for MEDLINE]
3: Psychol Bull 2001 Jan;127(1):142-61
Theories of reasoned action and planned behavior as models of condom use: a
Albarracin D, Johnson BT, Fishbein M, Muellerleile PA.
Department of Psychology, University of Florida, Gainesville 32611, USA.
To examine how well the theories of reasoned action and planned behavior predict
condom use, the authors synthesized 96 data sets (N = 22,594) containing
associations between the models' key variables. Consistent with the theory of
reasoned action's predictions, (a) condom use was related to intentions
(weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and
subjective norms (r. = .39), and (c) attitudes were associated with behavioral
beliefs (r. = .56) and norms were associated with normative beliefs (r. = .46).
Consistent with the theory of planned behavior's predictions, perceived
behavioral control was related to condom use intentions (r. = .45) and condom
use (r. = .25), but in contrast to the theory, it did not contribute
significantly to condom use. The strength of these associations, however, was
influenced by the consideration of past behavior. Implications of these results
for HIV prevention efforts are discussed.
PMID: 11271752 [PubMed - indexed for MEDLINE]
4: Am J Public Health 1999 Sep;89(9):1397-405
Am J Public Health. 2000 Jul;90(7):1152-3.
Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic
review of published research, 1985-1997.
Weinhardt LS, Carey MP, Johnson BT, Bickham NL.
Department of Psychology, Syracuse University, NY 13244-2340, USA.
OBJECTIVES: This study examined whether HIV counseling and testing leads to
reductions in sexual risk behavior. METHODS: The meta-analysis included 27
published studies that provided sexual behavior outcome data, assessed behavior
before and after counseling and testing, and provided details sufficient for the
calculation of effect sizes. The studies involved 19,597 participants. RESULTS:
After counseling and testing, HIV-positive participants and HIV-serodiscordant
couples reduced unprotected intercourse and increased condom use more than
HIV-negative and untested participants. HIV-negative participants did not modify
their behavior more than untested participants. Participants' age, volition for
testing, and injection drug use treatment status, as well as the sample
seroprevalence and length of the follow-up, explained the variance in results.
CONCLUSIONS: HIV counseling and testing appears to provide an effective means of
secondary prevention for HIV-positive individuals but, as conducted in the
reviewed studies, is not an effective primary prevention strategy for uninfected
participants. Theory-driven research with attention given to the context of
testing is needed to further explicate the determinants of behavior change
resulting from HIV counseling and testing, and the effectiveness of specific
PMID: 10474559 [PubMed - indexed for MEDLINE]
5: Psychol Bull 1999 Jan;125(1):90-132
Psychosocial correlates of heterosexual condom use: a meta-analysis.
Sheeran P, Abraham C, Orbell S.
Department of Psychology, University of Sheffield, United Kingdom.
Despite increasing incidence of HIV/AIDS, there has been no systematic review of
correlates of condom use among heterosexual samples. To rectify this, the
present study used meta-analysis to quantify the relationship between
psychosocial variables and self-reported condom use. Six hundred sixty
correlations distributed across 44 variables were derived from 121 empirical
studies. Variables were organized in terms of the labeling, commitment, and
enactment stages of the AIDS Risk Reduction Model (Catania, Kegeles, & Coates,
1990). Findings showed that demographic, personality, and labeling stage
variables had small average correlations with condom use. Commitment and
enactment stage variables fared better, with attitudes toward condoms,
behavioral intentions, and communication about condoms being the most important
predictors. Overall, findings support a social psychological model of condom use
highlighting the importance of behavior-specific cognitions, social interaction,
and preparatory behaviors rather than knowledge and beliefs about the threat of
PMID: 9990846 [PubMed - indexed for MEDLINE]
6: Br J Soc Psychol 1998 Jun;37 ( Pt 2):231-50
Do intentions predict condom use? Meta-analysis and examination of six moderator
Sheeran P, Orbell S.
Department of Psychology, University of Sheffield, UK.
This study used meta-analysis to quantify the relationship between intentions
and behaviour in prospective studies of condom use. The effects of six moderator
variables were also examined: sexual orientation, gender, sample age, time
interval, intention versus expectation and condom use with 'steady' versus
'casual' partners. Literature searches revealed 28 hypotheses based on a total
sample of 2532 which could be included in the review. Overall, there was a
medium to strong sample-weighted average correlation between intentions and
condom use (r+ = .44), and this correlation was similar to the effect sizes
obtained in previous reviews. There were too few studies of gay men to permit
meaningful comparison of effect sizes between homosexual versus heterosexual
samples. Gender and measurement of intention did not moderate the
intention-behaviour relationship. However, shorter time intervals, older samples
and condom use with 'steady' rather than 'casual' partners were each associated
with stronger correlations between intentions and condom use. Factors which
might explain the significant effects of moderator variables are discussed and
implications of the study for future research on intention-behaviour consistency
PMID: 9639864 [PubMed - indexed for MEDLINE]
7: Soc Sci Med 1997 May;44(9):1303-12
Effectiveness of condoms in preventing HIV transmission.
Pinkerton SD, Abramson PR.
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee,
The consistent use of latex condoms continues to be advocated for primary
prevention of HIV infection despite limited quantitative evidence regarding the
effectiveness of condoms in blocking the sexual transmission of HIV. Although
recent meta-analyses of condom effectiveness suggest that condoms are 60 to 70%
effective when used for HIV prophylaxis, these studies do not isolate consistent
condom use, and therefore provide only a lower bound on the true effectiveness
of correct and consistent condom use. A reexamination of HIV seroconversion
studies suggests that condoms are 90 to 95% effective when used consistently,
i.e. consistent condom users are 10 to 20 times less likely to become infected
when exposed to the virus than are inconsistent or non-users. Similar results
are obtained utilizing model-based estimation techniques, which indicate that
condoms decrease the per-contact probability of male-to-female transmission of
HIV by about 95%. Though imperfect, condoms provide substantial protection
against HIV infection. Condom promotion therefore remains an important
international priority in the fight against AIDS.
PMID: 9141163 [PubMed - indexed for MEDLINE]
8: Sante 1997 Mar-Apr;7(2):127-34
[10 years' research in the social sciences on AIDS in Burkina Faso. Elements for
[Article in French]
Societes d'Afrique et sida, Universite de Bordeaux II, France.
The first cases of AIDS in Burkina Faso were reported in 1986. During the past
ten years, there have been several types of research conducted in Burkina Faso
in the field of social sciences, including KABP, focus groups, and ethnographic
studies. This article reviews approximately 100 publications and presents the
results most relevant to prevention. Although general knowledge of the disease,
its transmission and means of protection has improved, part of the population
remains poorly informed; erroneous ideas remain prevalent and certain concepts,
for example asymptomatic infection, are ignored. Young women in rural areas have
the poorest knowledge. Understanding the information is conditioned by
underlying perceptions of blood and physiology, the "components of the person",
pre-existent and sexually transmitted diseases, and modes of transmission.
Research on sexuality has elucidated the age at which individuals become
sexually active, and paramatrimonial practices. The prevalence of STD is high.
STD are mostly treated by traditional practitioners or by automedication. Family
planning is insufficiently developed. AIDS prevention should be integrated into
wider considerations of reproductive health. The popular perception that
"Others" are responsible for bringing AIDS into the country has often been
reinforced by health messages. Consequently, people do not sufficiently consider
themselves vulnerable to HIV infection. The populations that are most
vulnerable, for various reasons that have been analysed, include young girls and
women, married women, prostitutes, truck drivers, and young men from rural
areas. The message "Fidelity or condom" has been widely used. However, it has
hindered the generalisation of the use of condoms, because asking for a condom
consequently implies distrust of the partner. The interpretation of fidelity is
diverse, and many people who choose this means of prevention believe erroneously
that they are protected. Studies of the social impact of AIDS reveal
fragmentation of society, reactions causing social exclusion and discriminative
practices, and no social visibility of HIV infected persons. After ten years of
preventive actions, the prevalence of HIV is still increasing, evidence of the
failure of the preventive strategies. It is no longer sufficient to see
prevention as the transfer of knowledge from professionals to the population.
Preventive strategies such as voluntary testing and the participation of HIV+
persons in informative actions need to be developed. Prevention should be
understood on new bases. The concept of "vulnerability" might help the
definition of in-depth actions and also focus interventions. The idea of
developing social cohesion to confront the epidemic may help avoid some of the
adverse consequences of previous actions. Do these concepts conform to current
AIDS prevention attitudes? To answer this question, social scientists should
study the ideologies, knowledge, beliefs, and practices of institutions and
professionals working in the field of AIDS prevention.
PMID: 9273119 [PubMed - indexed for MEDLINE]
9: Soc Sci Med 1993 Jun;36(12):1635-44
Soc Sci Med. 1994 Apr;38(8):1169-70.
A meta-analysis of condom effectiveness in reducing sexually transmitted HIV.
Department of Preventive Medicine and Community Health, University of Texas
Medical Branch, Galveston 77555-1053.
Before condoms can be considered as a prophylaxis for sexually transmitted human
immunodeficiency virus (HIV), their efficacy must be considered. This paper
reviews evidence on condom effectiveness in reducing the risk of heterosexually
transmitted human HIV. A meta-analysis conducted on data from in vivo studies of
HIV discordant sexual partners is used to estimate the protective effect of
condoms. Although contraceptive research indicates that condoms are 87%
effective in preventing pregnancy, results of HIV transmission studies indicate
that condoms may reduce risk of HIV infection by approximately 69%. Thus,
efficacy may be much lower than commonly assumed, although results should be
viewed tentatively due to design limitations in the original studies.
PMID: 8327927 [PubMed - indexed for MEDLINE]
10: Sex Transm Dis 1993 Mar-Apr;20(2):70-6
The effect of video interventions on improving knowledge and treatment
compliance in the sexually transmitted disease clinic setting. Lesson for HIV
Healton CG, Messeri P.
Division of Socio-Medical Sciences, Columbia University, School of Public
Health, New York, NY 10032.
Eight intervention studies investigating patient education and treatment
adherence in the sexually transmitted disease (STD) clinic setting are reviewed.
Across the eight studies selected for analysis, meta-analytic procedures were
applied to compare the impact of educational and prevention approaches. The
effect of video was compared with that of other modes of health education on: 1)
knowledge and attitudes about STDs and condoms and 2) treatment compliance, as
measured by return for test of cure, drug compliance, premature resumption of
sexual activity, and condom coupon redemption rates. The largest effects were
those for video on knowledge and attitudes about STDs and condoms, followed by
the effects of other non-video interventions on STD knowledge. Lower effects
were found among video and non-video interventions targeting treatment
compliance outcomes. These results are consistent with prior prevention studies
that have demonstrated difficulty in achieving behavior change.
PMID: 8503062 [PubMed - indexed for MEDLINE]