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1996-03-04
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Document 0701
DOCN M9640701
TI Impact on sexually transmitted disease spread of increased condom use by
young females, 1987-1992.
DT 9604
AU Stigum H; Magnus P; Veierod M; Bakketeig LS; Department of Epidemiology,
National Institute of Public Health,; Oslo, Norway.
SO Int J Epidemiol. 1995 Aug;24(4):813-20. Unique Identifier : AIDSLINE
MED/96022687
AB BACKGROUND. Sexual behaviour data are crucial for understanding the
spread of sexually transmitted diseases (STD). Over a period (1987-1992)
in which the HIV epidemic increased public awareness of safe sexual
practices, we describe predictors of condom use, changes in condom use
over time, and the estimated effects of these changes on the spread of
STD. METHODS. Condom use reported by females aged 18-35 years with
non-cohabiting partners was analysed using data from two cross-sectional
postal surveys performed 5 years apart (1987 and 1992) on two separate
representative samples of 10,000 subjects aged 18-60 years living in
Norway. A simple mathematical model was used to assess the effects of
selection bias. A more complicated model was used to predict the effects
of condom use on the prevalence of STD in a population which includes a
core group of highly sexually active subjects. RESULTS. We found an
increase in the prevalence of condom use in the latest intercourse from
14% to 20% with non-foreign partners and from 10% to 38% with foreign
partners, from 1987 to 1992. In a logistic regression model, low
frequency of intercourse, high education, one lifetime partner, and late
sexual debut were predictors for condom use. Controlled for these
variables, the odds ratio (OR) for condom use in 1992 versus 1987 was
1.4 (95% confidence interval [CI]: 0.9-2.0) if the partner was
non-foreign, and 7.1 (95% CI: 2.5-20.5) if the partner was foreign. Not
using other contraceptive methods was a strong predictor for condom use;
OR = 17.4 (95% CI: 8.0-38.0). Condom use in the first intercourse with
the last partner was a strong predictor for condom use in the last
intercourse; OR = 19.2 (95% CI: 8.2-45.3). It appeared unlikely that the
increase in condom use could be explained by response bias. The
predicted reductions in STD prevalence due to the increase in condom use
ranged from zero to 30% depending on consistency of use, and on the
agent that is transmitted. CONCLUSIONS. Condom use among 18-35 year old
women has increased over the period, particularly with foreign partners.
Condoms are used primarily as contraception. The prevalences of STD with
high transmission rates are not reduced by inconsistent condom use,
while the prevalences of STD with low transmission rates are reduced by
both consistent and inconsistent condom use. Condom use in a core group
is more effective for reducing the STD prevalence than condom use in the
non-core group for gonorrhoea and HIV. For chlamydial infection, condom
use in the non-core group is more effective.
DE Adolescence Adult Coitus Condoms, Female/*UTILIZATION
Cross-Sectional Studies Data Collection Female Human HIV
Infections/EPIDEMIOLOGY/TRANSMISSION Logistic Models Mathematics
Middle Age Models, Biological Norway/EPIDEMIOLOGY Prevalence Sex
Behavior Sexual Partners Sexually Transmitted Diseases,
Viral/EPIDEMIOLOGY/*TRANSMISSION JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).