       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).

