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管理式医疗中年轻女性对避孕套的低效使用。

Ineffective use of condoms among young women in managed care.

作者信息

Civic D, Scholes D, Ichikawa L, Grothaus L, McBride C M, Yarnall K S H, Fish L

机构信息

Clinical Improvement and Education Department, Group Health Cooperative, Seattle, WA 98112, USA.

出版信息

AIDS Care. 2002 Dec;14(6):779-88. doi: 10.1080/0954012021000031859.

Abstract

Condoms must be used effectively in order to prevent pregnancy and the spread of HIV/STD. This study investigated two types of ineffective condom use, delayed condom use (initiated after penetration has occurred) and condom slippage and/or breakage. We estimated prevalence and identified predictors of ineffective condom use among young women at risk of STDs. The study used baseline survey data from a randomized trial of women 18-24 years old at two managed care sites; 779 participants who were recent condom users were included in this analysis. Forty-four per cent of the sample reported delayed condom use in the past three months and 19% reported condom slippage and/or breakage. In multivariate logistic regression, younger age, primary partner, lack of partner support, multiple recent sexual partners and using condoms for contraception were positively associated with delayed condom use. Correlates of condom slippage and/or breakage were non-white race/ethnicity and history of any STD. Greater frequency of condom use independently predicted both outcomes. Ineffective condom use was common in this sample of experienced condom users and predictors were different for each outcome. HIV/STD prevention interventions must address more specific aspects of condom use than have previously been their focus, especially when condom use is already high.

摘要

为预防怀孕和艾滋病毒/性传播疾病的传播,必须有效使用避孕套。本研究调查了两种无效使用避孕套的情况,即延迟使用避孕套(在插入后才开始使用)以及避孕套滑落和/或破裂。我们估计了性传播疾病风险较高的年轻女性中无效使用避孕套的患病率,并确定了其预测因素。该研究使用了来自两个管理式医疗场所的18至24岁女性随机试验的基线调查数据;本分析纳入了779名近期使用过避孕套的参与者。44%的样本报告在过去三个月中延迟使用避孕套,19%报告避孕套滑落和/或破裂。在多变量逻辑回归中,年龄较小、主要伴侣、缺乏伴侣支持、近期有多个性伴侣以及使用避孕套进行避孕与延迟使用避孕套呈正相关。避孕套滑落和/或破裂的相关因素是非白人种族/族裔以及任何性传播疾病史。更频繁地使用避孕套可独立预测这两种结果。在这个有经验的避孕套使用者样本中,无效使用避孕套的情况很常见,而且每种结果的预测因素都不同。艾滋病毒/性传播疾病预防干预措施必须解决比以往更具体的避孕套使用方面的问题,特别是在避孕套使用率已经很高的时候。

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