Latka M, Gollub E, French P, Stein Z
Columbia University School of Public Health, New York, New York, USA.
Sex Transm Dis. 2000 Sep;27(8):431-7. doi: 10.1097/00007435-200009000-00002.
A concern with hierarchy messages, which promote male condoms and female-controlled barrier methods along a prevention continuum, is that they may discourage condom use.
To measure male-condom and female-condom use among women who received hierarchy counseling and compare this with women counseled about condoms only.
Three observational cohorts that correspond to prevention message received were assembled, and consisted of female sexually transmitted disease clinic patients who were counseled about male condoms, female condoms, or a hierarchy message. The hierarchy message promoted male and female condoms, the diaphragm and cervical cap, spermicides, and withdrawal, in descending order of effectiveness against sexually transmitted diseases. After counseling, women were interviewed and returned for follow-up visits at 2 weeks, 4 months, and 6 months. The outcome was the mean proportion of male condom- or female condom-protected coital acts at each follow-up visit in the hierarchy cohort. The outcome was dichotomized as high (> or = 70% of coital acts protected) or low (< 70%), and generalized estimating equations were used to compare observed follow-up condom use with baseline within the hierarchy cohort and observed follow-up condom use between cohorts. It was assumed that condom use in persons not present at 6 months was equal to baseline levels, and condom use estimates were calculated for each full cohort that was initially enrolled.
一种担忧是，沿着预防连续统一体宣传男用避孕套和女性控制的屏障方法的分级信息可能会减少避孕套的使用。
测量接受分级咨询的女性中男用避孕套和女用避孕套的使用情况，并将其与仅接受避孕套咨询的女性进行比较。
根据收到的预防信息组建了三个观察队列，队列由接受男用避孕套、女用避孕套或分级信息咨询的女性性传播疾病门诊患者组成。分级信息按照预防性传播疾病的有效性从高到低的顺序，宣传了男用和女用避孕套、子宫托和宫颈帽、杀精剂以及体外排精。咨询后，对女性进行访谈，并在2周、4个月和6个月时回访。结果是分级队列中每次回访时男用避孕套或女用避孕套防护的性交行为的平均比例。结果被分为高（≥70%的性交行为得到防护）或低（<70%），并使用广义估计方程比较分级队列中观察到的随访避孕套使用情况与基线情况，以及各队列之间观察到的随访避孕套使用情况。假设6个月时未到场者的避孕套使用情况等于基线水平，并为最初入组的每个完整队列计算避孕套使用估计值。
