Friday, January 20, 2006

Condom choice vs condom use

As we get closer to my favorite awareness week of the year (National Condom Week, of course), here's an interesting bit of research:

JAMAICA: "Does a Choice of Condoms Impact Sexually Transmitted Infection Incidence? A Randomized, Controlled Trial" Sexually Transmitted Diseases Vol. 33; No. 1: P. 31-35 (01.06.06):: Markus J. Steiner, PhD; Tina Hylton-Kong, MD; J. Peter Figueroa, MD; Marcia M. Hobbs, PhD; Freida Behets, PhD; Monica Smikle, PhD; Katie Tweedy, MPH; Sharon Powell; Linda McNeil, MPH; Alfred Brathwaite, MD

The authors investigated whether providing a choice of condoms would increase condom acceptability and self-reported use and decrease incident STD infection. The researchers randomized 414 men in Jamaica who presented with urethral discharge: Some men received the standard clinic condom, while others were given their choice of four different types of condoms. The men were presumptively treated at enrollment, and they were followed up at one, two, four, and six months.

Although participants in the choice group had a strong preference (P<0.01) for the most popular condom available in the nation, this did not equate to higher condom use (P=0.16). The six-month cumulative probability of first incidence of gonorrhea, chlamydia, or trichomoniasis was slightly greater in the choice group (21 percent; 95 percent confidence interval (CI), 15-28 percent) versus the control group (17 percent, 95 percent CI, 11-23 percent). The difference in survival curves was not significant.

The researchers concluded, "A choice of condoms may increase perceived acceptability but not lead to increased condom use and subsequently lower sexually transmitted infection rates." [emphasis added]

That implies, to me, that it takes a bit more than the mere availability of condoms to promote their acceptance and use. Active instruction on use and purpose is also needed with, perhaps, some new approaches to enhancing the understanding of condoms' importance to disease prevention.

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