Grasso Michael A, Schwarcz Sandra, Galbraith Jennifer S, Musyoki Helgar, Kambona Caroline, Kellogg Timothy A
From the *Global Health Sciences, University of California, San Francisco, San Francisco, CA; †Prevention Branch, DGHA, CDC-Kenya, Nairobi, Kenya; ‡National AIDS and STI Control Program, Nairobi, Kenya; and §Kenya Medical Research Institution, Nairobi, Kenya.
Sex Transm Dis. 2016 Feb;43(2):87-93. doi: 10.1097/OLQ.0000000000000393.
Condom use continues to be an important primary prevention tool to reduce the acquisition and transmission of HIV and other sexually transmitted infections. However, incorrect use of condoms can reduce their effectiveness.
Using data from a 2012 nationally representative cross-sectional household survey conducted in Kenya, we analyzed a subpopulation of sexually active adults and estimated the percent that used condoms incorrectly during sex, and the type of condom errors. We used multivariable logistic regression to determine variables to be independently associated with incorrect condom use.
Among 13,720 adolescents and adults, 8014 were sexually active in the previous 3 months (60.3%; 95% confidence interval [CI], 59.0-61.7). Among those who used a condom with a sex partner, 20% (95% CI, 17.4-22.6) experienced at least one instance of incorrect condom use in the previous 3 months. Of incorrect condom users, condom breakage or leakage was the most common error (52%; 95% CI, 44.5-59.6). Factors found to be associated with incorrect condom use were multiple sexual partnerships in the past 12 months (2 partners: adjusted odds ratio [aOR], 1.5; 95% CI, 1.0-2.0; P = 0.03; ≥3: aOR, 2.3; 95% CI, 1.5-3.5; P < 0.01) and reporting symptoms of a sexually transmitted infection (aOR, 2.8; 95% CI, 1.8-4.3; P < 0.01).
Incorrect condom use is frequent among sexually active Kenyans and this may translate into substantial HIV transmission. Further understanding of the dynamics of condom use and misuse, in the broader context of other prevention strategies, will aid program planners in the delivery of appropriate interventions aimed at limiting such errors.
使用避孕套仍然是减少艾滋病毒及其他性传播感染的获得与传播的一项重要一级预防工具。然而，不正确使用避孕套会降低其有效性。
利用2012年在肯尼亚进行的一项具有全国代表性的横断面家庭调查数据，我们分析了性活跃成年人亚群，并估计了在性行为期间不正确使用避孕套的比例以及避孕套错误的类型。我们使用多变量逻辑回归来确定与不正确使用避孕套独立相关的变量。
在13720名青少年和成年人中，8014人在过去3个月内有性行为（60.3%；95%置信区间[CI]，59.0 - 61.7）。在那些与性伴侣使用避孕套的人中，20%（95%CI，17.4 - 22.6）在过去3个月内至少有一次不正确使用避孕套的情况。在不正确使用避孕套的人群中，避孕套破裂或渗漏是最常见的错误（52%；95%CI，44.5 - 59.6）。发现与不正确使用避孕套相关的因素包括在过去12个月内有多个性伴侣（2个伴侣：调整后的优势比[aOR]，1.5；95%CI，1.0 - 2.0；P = 0.03；≥3个：aOR，2.3；95%CI，1.5 - 3.5；P < 0.01）以及报告有性传播感染症状（aOR，2.8；95%CI，1.8 - 4.3；P < 0.01）。
在性活跃的肯尼亚人中，不正确使用避孕套的情况很常见，这可能会导致大量艾滋病毒传播。在更广泛的其他预防策略背景下，进一步了解避孕套使用和误用的动态情况，将有助于项目规划者提供旨在限制此类错误的适当干预措施。
