Knights Nicola, Stone Nicole, Nadarzynski Tom, Brown Katherine, Newby Katie, Graham Cynthia A
Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, UK.
School of Social Sciences, University of Westminster, London, UK.
Pilot Feasibility Stud. 2021 Jul 27;7(1):145. doi: 10.1186/s40814-021-00885-1.
Male condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. The Kinsey Institute Home-Based Exercises for Responsible Sex (KIHERS) is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of an adapted version of the KIHERS intervention with young women aged 16-25 years in the United Kingdom (UK) (Home-Based Exercises for Responsible Sex-UK (HERS-UK).
A repeated-measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 and T3), conducted 4 weeks and 8 weeks post intervention over a 3-month period. Participants were provided a condom kit containing different condoms and lubricants and were asked to experiment with condoms alone using a dildo and/or with a sexual partner. Ten process evaluation interviews were conducted post intervention.
Fifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for intercourse in the past 4 weeks increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach's alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention.
HERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided an early indication of the potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost-effectiveness of this intervention, in a large-scale controlled trial using a diverse sample and targeting young women most at risk of STIs.
如果正确且持续使用，男用避孕套在预防常见性传播感染（STIs）和意外怀孕方面是有效的。然而，避孕套使用错误和问题很常见，并且年轻人报告了一些负面体验，比如快感降低。金赛研究所居家责任性锻炼（KIHERS）是一项针对年轻女性的新型避孕套推广干预措施，旨在减少避孕套使用错误和问题，提高自我效能，并使用以快感为重点的方法改善对避孕套的态度。该研究的目的是在英国对16至25岁的年轻女性测试KIHERS干预措施改编版（英国居家责任性锻炼（HERS-UK））的可操作性、可行性和可接受性。
采用重复测量单臂设计，在3个月期间进行基线评估（T1）以及干预后4周和8周的两次随访评估（T2和T3）。为参与者提供一个包含不同避孕套和润滑剂的避孕套套装，并要求她们单独使用假阴茎和/或与性伴侣一起试用避孕套。干预后进行了10次过程评估访谈。
55名年轻女性接受了干预；36名（65%）完成了T2评估，33名（60%）完成了T3评估。避孕套使用错误和问题减少，自我效能提高，对避孕套的态度显著改善。在过去4周内报告在性交时使用避孕套的参与者比例从T1（20人；47%）增至T2（27人；87%）和T3（23人；77%），并且在性交时使用润滑剂与避孕套的比例从T1（6人；30%）增至T2（13人；48%）和T3（16人；70%）。然而，使用避孕套的动机没有改变。克朗巴哈系数得分表明所使用测量方法具有良好的内部一致性。定性数据为该干预措施的可接受性提供了有力证据。
HERS-UK按计划实施，招募策略在学院/大学环境中取得成功。这项可行性研究为该干预措施的潜在有效性和可接受性以及对年轻女性采用以快感为重点的方法的益处提供了早期迹象。所使用的测量方法捕捉到了结果变量的变化，并被认为符合目的。未来的研究应在一项使用多样化样本并针对最易感染性传播感染的年轻女性的大规模对照试验中探索该干预措施的成本效益。
