College of Public Health, University of Kentucky, Lexington, Kentucky; Rural Center for AIDS/STD Prevention, The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, Indiana.
College of Public Health, University of Kentucky, Lexington, Kentucky.
Am J Prev Med. 2014 Jul;47(1):70-2. doi: 10.1016/j.amepre.2014.01.026. Epub 2014 Apr 18.
Identifying malleable predictors of condom use in a clinic-based population may benefit efforts to prevent sexually transmitted infections (STIs).
To prospectively test associations between three measures (relational-trust factors, fit and feel, and dislike of condom use) and perfect condom use in patients attending clinics diagnosing STIs.
A convenience sample was recruited from five clinics in three U.S. cities. Data were collected from December 2007 through April 2011. Daily electronic diaries were completed for up to 180 days. Occasions of penile-vaginal intercourse (PVI) involving condom use without any of four errors/problems were classified as "perfect use." Three subscales (relational-trust factors, fit and feel, and dislike of condom use) were developed from baseline data. Generalized estimating equations were used to account for non-independence of PVI events.
Among 17,156 reported occasions of PVI, condoms were either not used or used with errors/problems in 8,857 (51.6%) instances. The remaining 8,829 occasions (48.4%) involved perfect use. Relational-trust (p=0.054) and fit and feel (p=0.13) issues were not significantly associated with perfect use. Dislike of condom use (p=0.005) was significantly associated with perfect use (estimated OR=0.93, 95% CI=0.89, 0.98). Significant interactions with race, age, or gender were not observed.
Clinic attendees may be more likely to use condoms perfectly if three perceptions are reduced in magnitude: I won't use condoms, condoms spoil the mood, and I get turned off when my partner suggests we use condoms. Findings support a paradigm shift in the way clinics promote condom use to patients.
在诊所人群中识别可改变的 condom 使用预测因素可能有助于预防性传播感染（STIs）。
前瞻性测试三种措施（关系信任因素、合身和感觉、不喜欢 condom 使用）与在诊断 STIs 的诊所就诊的患者完美 condom 使用之间的关联。
从美国三个城市的五个诊所招募了一个方便样本。数据收集时间为 2007 年 12 月至 2011 年 4 月。最多完成 180 天的每日电子日记。没有出现四种错误/问题的阴茎阴道交（PVI）情况下，将 condom 使用归类为“完美使用”。从基线数据中开发了三个子量表（关系信任因素、合身和感觉、不喜欢 condom 使用）。使用广义估计方程来解释 PVI 事件的非独立性。
在报告的 17156 次 PVI 中，有 8857 次（51.6%） condom 未使用或使用时有错误/问题。其余 8829 次（48.4%）涉及完美使用。关系信任（p=0.054）和合身感觉（p=0.13）问题与完美使用无显著关联。不喜欢 condom 使用（p=0.005）与完美使用显著相关（估计 OR=0.93，95% CI=0.89，0.98）。未观察到与种族、年龄或性别有显著相互作用。
如果减少三种感知的程度，诊所就诊者可能更有可能完美地使用 condom：我不会使用 condom， condom 会破坏情绪，当我的伴侣建议我们使用 condom 时，我会感到厌烦。研究结果支持在向患者推广 condom 使用方面改变诊所的范式。
