The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Thursday, May 11, 2006 - 9:45 AM
355

Who uses condoms after an STD clinic visit, and why?

Thomas A. Peterman, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-02, Atlanta, GA, USA, Linhui Tian, DSTDP, CDC, 1600 Cfilton RD, MS-E02, Atlanta, GA, USA, Lee Warner, NCCDPHP/DRH, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA, Carol A. Metcalf, Aurum Institute for Health Research, Johannesburg, South Africa, C. Kevin Malotte, Community Health and Social Epidemiology Program, California State University, Long Beach, CA, USA, Sindy M. Paul, New Jersey Department of Health and Senior Services, Trenton, NJ, and John M. Douglas, Director, Divsion of STD Prevention, CDC, Atlanta, GA, USA.


Background:
Despite many studies, little is known about why people use condoms some times and not others.

Objective:
Describe condom use over time in a large population and how methodology influences findings.

Method:
Secondary analysis of data from heterosexuals in a multicenter HIV prevention trial (RESPECT-2) with questionnaires every 3 months for a year. Condom use was defined as: consistent (100%), inconsistent, or none (0%). Cross-sectional analysis used all 3-month intervals to assess subject's condom use with: each partner individually, or with all partners combined. Cohort analysis assessed combined condom use for subjects who had all 4 follow-up visits. Case-crossover analysis included subjects whose use was consistent with one partner and none with another.

Result:
2132 subjects reported condom use with 7251 partners during 5409 3-month intervals. In cross-sectional analysis including all intervals: condom use with a partner was consistent (33%), inconsistent (26%), and none (40%); and subject's condom use with all partners was consistent (24%), inconsistent (39%), and none (37%). In the cohort of 647 subjects followed for all 4 visits: almost all were inconsistent condom users (77%); few reported consistent use (5%) or no use (18%). In cross-sectional analysis, inconsistent users reported not using a condom last time because: “the heat of the moment” (30%), “didn't think I would get STD/HIV” (25%), or “knew partner was HIV-negative” (22%), and rarely thought condom use suggested lack of trust (2%). In cross-sectional analysis, consistent use was reported most for partnerships with: non-main partners (55%), partners they had sex with 1-5 times (53%), partners thought very likely at risk for STD (45%), and new partners (44%). Case-crossover analysis findings were similar.

Conclusion:
Most subjects used condoms some times and not others, using them most with risky partners.

Implications:
Interventions in this population should not focus on trying condoms, but on continuing to use them during relationships.

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