Condom use: A self-efficacy model.

A survey of heterosexually active college students gathered information about condom use, self-efficacy (SE), outcome expectancies, sexual attitudes, peer group influences, AIDS knowledge, and a perceived vulnerability to AIDS. On the basis of A. Bandura's (1986) social-cognitive theory, a structural model with SE as the central mediator was formulated and evaluated with LISREL. This model explained 46% of the variance in condom use from judgments of SE and effects attributable to peers and 53% of the variance in SE from outcome expectancies and peer group influences. Sexual attitudes, AIDS knowledge, and perceived vulnerability did not predict condom use. Most students were well-informed about HIV transmission but reported not feeling at risk, even though many engaged in risky sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Condom use in sexual exchange relationships among young single adults in Ghana

This article discusses some personal and situational factors which hinder the use of condoms among young single adults ages 18 to 25 years engaged in sexual exchange relationships in a Ghanaian town. Based on focus group discussions and in-depth interviews, this article highlights some key impediments often not adequately discussed in the discourse on condom use but considered vital in any attempt to increase condom use and ultimately reduce HIV transmission. The includes the dilemma facing women who want to use condoms for HIV prevention in premarital sexual exchange relationships (quite different from prostitution) contracted with material gain in mind. Women may face the risk of losing material benefits from sexual exchange relationships if the man is unwilling to use condoms. It is recommended that HIV health educators must increase the involvement of young single adults in exploring these and situational impediments and together design interventions to improve condom use.     

Condom use in unmarried Latino men: A test of cultural constructs.

The effects of cultural factors on condom use were assessed in a random digit-dialing household survey of 1,600 unmarried Latino adults in 10 states with large Latino populations. Measures of traditional gender-role beliefs, sexual coercion, sexual comfort, and self-efficacy in using condoms were developed specifically for this population. A multisample structural equation model analysis included 594 men who reported one or more heterosexual partners in the 12 months before interview. As predicted, men with more traditional gender-role beliefs reported more sexual coercion and less sexual comfort. Men reporting more sexual coercion and less sexual comfort had lower condom self-efficacy. Men with more condom self-efficacy and stronger condom social norms reported more condom use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping strategies that psychotherapists use in working with stressful clients.

Historically, research in the area of coping has been based on subjective data-gathering techniques and has dealt with specific life crises or the phenomenon of burnout. Many researchers concluded that client contact is the basis of burnout; however, little or no research has dealt solely with the client–therapist interaction. The purpose of this study was to address this interaction. The coping instrument used in this study consisted of selected coping scales of Folkman and Lazarus and of Prochaska and DiClemente, as well as those that we constructed. We identified six coping strategies that psychotherapists use to deal with the stress that they experience in working with difficult clients. Analyses also revealed that certain coping strategies were related to perceived success. By ascertaining coping strategies used by psychotherapists who perceive themselves as successful, both practitioner and researcher can gain a better understanding of how therapists cope with client-generated stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Condom use with a casual partner: What distinguishes college students' use when intoxicated?

Determining alcohol's precise role in sexual risk taking has proven to be an elusive goal. Past research has produced mixed results, depending on characteristics of individuals, their partners, and the situation, as well as how the link between alcohol consumption and sexual behavior was assessed. In this study, cross-sectional predictors of the frequency of condom use were examined for 298 heterosexual college students at a large urban university. In hierarchical multiple regression analyses that controlled for frequency of condom use when sober, alcohol expectancies regarding sexual risk taking and self-efficacy regarding condom use when intoxicated were significant predictors of frequency of condom use when intoxicated. These findings highlight the importance of targeting beliefs about alcohol's disinhibiting effects in STD- and HIV-prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facilitating condom use with clients during commercial sex in Nevada's legal brothels

OBJECTIVES: This study examined condom use in legal Nevada brothels. METHODS: Forty female prostitutes in two brothels were interviewed about client resistance to condoms and techniques for facilitating condom use. RESULTS: Of 3290 clients in the previous month, 2.7% (95% confidence interval [CI] = 2.2%,3.4%) were reluctant to use condoms. Of these individuals, 72% ultimately used condoms, while 12% chose nonpenetrative sex without condoms. The remaining 16% left the brothels without services. Condom use rates were markedly lower with nonpaying sex partners (lowers) than with clients. CONCLUSIONS: Brothel prostitutes may be at greater risk for acquiring HIV and other sexually transmitted diseases from lovers than from clients.     

Health risk profile of prostitutes in Dublin

A 50-year-old male presented with a very unusual case of a calcified anterior communicating artery (AComA) aneurysm associated with a tuberculum sellae meningioma. Until 10 years previously, the patient had been a professional soccer player for 15 years. He noticed a slight decrease in visual acuity in the right eye 7 years before. The patient was in the care of an oculist throughout this period. Two months before admission, a significant and rapid decrease of vision in the right eye occurred. Computed tomography and magnetic resonance imaging showed a round-shaped, partially calcified tumorous lesion. Four-vessel angiography revealed a large AComA aneurysm. During surgery, a tuberculum sellae. meningioma was found in combination with an AComA aneurysm with a completely calcified wall. The meningioma was resected totally. The AComA aneurysm with a calcified wall could not be clipped or resected and was left alone. His visual deficit improved postoperatively.     

Condom use by Dutch men with commercial heterosexual contacts: determinants and considerations

We report responses from 559 clients of female prostitutes, with a view to determining to what extent previously identified factors play a part in condom use. To increase the response rate to advertisements in daily and weekly newspapers, interviews were held by phone. This procedure had the advantage of ensuring the anonymity many clients demanded. Of those clients having vaginal or anal contact (91%), 14% had not always used condoms in the previous year. Compared with consistent condom users, these men were less highly educated, had twice as many commercial contacts, and had more contacts with "steady" prostitutes. They were either more emotionally motivated to visit prostitutes than were consistent condom users or exhibited a stronger need for sexual variation. They showed a more compulsive attitude toward visiting prostitutes, had a more negative attitude toward prostitution in general, evaluated condoms more negatively, had a higher personal efficacy to achieve unsafe contacts, and had a higher general risk assessment, commensurate with their behavior. Men with only safe contacts had either an intrinsic or an extrinsic motivation for condom use. Among extrinsically motivated men, their behavior change was more recent and had not yet taken root: They still envisioned unsafe commercial sex to be possible in the future. Education aimed at the small group of men practicing unsafe contacts will not easily and directly lead to behavior change. But these educational activities may support prostitutes to persist in (consistent) condom use, regardless of clients' pressure to do otherwise.     

Condom use among young women: Modeling the theory of gender and power.

Objective: This study sought to articulate pathways between constructs from the theory of gender and power and their associations with sexual behavior. Design: The data were collected preintervention during a randomized controlled HIV prevention trial. Participants were 701 sexually active, unmarried African American females, aged 14–20, who were not pregnant, and were recruited from three health clinics in a southeastern US city. Structural equation modeling was used for the analyses. Main Outcome Measure: Self-reported condom use. Results: Theoretical associations yielded a well-fitting structural model across initial and cross-validation samples. A significant amount of variance was explained for the variables of condom use (R2 = .31, .18), partner communication (R2 = .30, .26), substance use during sex (R2 = .32, .51), and negative personal affect (R2 = .36, .48). Partner communication (.35, .38) was the strongest predictor of condom use, negative personal affect (?.41, ?.37) was the strongest predictor of partner communication, and physical risk (.54, .54) was the strongest predictor of negative personal affect. Conclusion: This model provides evidence to support both direct and indirect associations between social and behavioral risk factors and condom use. Associations between theory of gender and power constructs and condom use can facilitate future development and analyses of interventions based on this theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Condom use as a dependent variable: measurement issues relevant to HIV prevention programs

The value of condoms in efforts to slow the spread of HIV infection has been well established in the literature. Behavioral science faces the challenge of promoting condom use through intervention programs. As these programs are evaluated, multiple issues should be considered in relation to measuring participant use of condoms for the purposes of preventing HIV infection. Lack of attention to these issues is likely to create a large number of Type I and Type II errors. Ten common sources of error are described and corresponding recommendations for eliminating these errors are offered. A review of published studies shows that there is little consistency relevant to controlling for these sources of error. Incorporation of standardized methodology will allow for more accurate program evaluation and benefit researchers by facilitating comparisons across studies.     

The UCLA Multidimensional Condom Attitudes Scale: Documenting the complex determinants of condom use in college students.

Describes the development and validation of the UCLA Multidimensional Condom Attitudes Scale (MCAS). The relationships between the MCAS and gender, sexual experience, intentions to use a condom, and past condom use were assessed. The MCAS has 5 distinct factors: (1) Reliability and Effectiveness of condoms, (2) the sexual Pleasure associated with condom use, (3) the stigma attached to persons who use condoms (Identity Stigma), (4) the Embarrassment About Negotiation and Use of condoms, and (5) the Embarrassment About the Purchase of condoms. Results strongly suggest that condom attitudes are multidimensional and thus cannot meaningfully be summed to a single global score. Results further indicate that men and women hold very different attitudes toward condoms. Implications of scale multidimensionality and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human immunodeficiency virus infection among high-risk seronegative prostitutes in Nairobi

To determine the frequency and duration of antibody-negative human immunodeficiency virus (HIV) infection among heterosexually exposed African women, 56 HIV-seronegative female prostitutes in Nairobi were studied. Polymerase chain reaction (PCR) was used to detect HIV DNA in peripheral blood at enrollment, and women were followed prospectively with serologic testing to determine HIV seroincidence. Six women (11%) were infected with HIV by PCR criteria at enrollment. Seroconversion occurred in 5 of these subjects within 1-12 months, while the sixth remained seronegative when last evaluated at 5 months. The cumulative annual seroconversion rate in the entire cohort was 38%. Using maximum likelihood analysis, the mean interval between HIV infection and seroconversion was estimated to be between 3 and 4 months, similar to that described for homosexual men and blood product recipients in the United States. Prolonged HIV infection in the absence of antibodies appears to be uncommon in this setting.     

Training clients to help themselves: Outcome effects of training college student clients in facilitative self-responding.

Used training in facilitative self-responding to help clients alter what they say to themselves. The training was compared to empathy-based individual counseling for personal-social problems. 20 undergraduates served as Ss. Treatment consisted of 6 1-hr weekly sessions. Ss were compared on posttests of empathy, regard, genuineness, and concreteness of their self-help responses and self-ratings and observer ratings of interpersonal functioning and improvement on specific counseling goal behaviors. Significant treatment and Treatment * Measures interaction effects were observed, indicating significant differences in favor of the trained group for 6 of the 8 variables. Group differences on the 2 self-rating measures were not significant. The fact that minimally facilitative levels of self-responding and positive change as rated by observers was attained only by the trained group indicated the usefulness of the technique for self-help training. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring quality of life in cardiac rehabilitation clients

OBJECTIVE: To clarify the origin of defective mismatch repair (MMR) in sporadic endometrial cancers with microsatellite instability (MSI), a thorough mutation analysis was performed on the human mismatch repair gene MSH3. METHODS: Twenty-eight MSI-positive endometrial cancers were investigated for mutations in the human mismatch repair gene MSH3 using single-strand conformation variant (SSCV) analysis of all 24 exons. All variants were sequenced. Loss of heterozygosity was investigated at all MSH3 polymorphisms discovered. A subset of tumors were investigated for methylation of the 5' promoter region of MSH3 using Southern blot hybridization. RESULTS: An identical single-base deletion (delta A) predicted to result in a truncated proteins was discovered in six tumors (21.4%). This deletion occurs in a string of eight consecutive adenosine residues (A8). Because simple repeat sequences are unstable in cells with defective MMR, the observed mutation may be an effect, rather than a cause, of MSI. Evidence of inactivation of the second MSH3 allele in tumors with the delta A mutation would strongly support a causal role for these MSH3 mutations. However, there was no evidence of a second mutation, loss of sequences, or methylation of the promoter region in any of the tumors with the delta A mutation. CONCLUSION: Although the delta A mutation is a frequent event in sporadic MSI-positive endometrial cancers, it may not be causally associated with defective DNA MMR.     

Issues in psychotherapy with EAP clients.

Suggests that employee assistance programs (EAPs) are growing at a rapid rate, partly in response to the success of psychotherapy. This emerging service delivery pattern remains unregulated, and the consumer is potentially easily abused. Several cases highlight the unique blend of business, clinical, ethical, legal, and moral concerns arising in the relationship between the provider, EAP counselor, and consumer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contraception in Spain

This report analyzes various aspects of contraception in Spain. One notable finding is the wide socioeconomic, cultural and health variation among regions. Since 1975 a significant drop in the birth rate has been observed overall. Twenty per cent of the women studied at risk of pregnancy are using oral contraceptives. The most widespread contraceptive method is still coitus interruptus, followed by oral contraception and the condom, as well as the rhythm method. The highest use of oral contraceptive and IUDs is seen in Catalonia (20% and 26% respectively) followed by Andalusia, Madrid and Valencia. Although contraception has only recently become legal in Spain, it is widely available either without charge or very inexpensively; all methods including abortion are available. At present, priority is given to special interest groups such as women in special circumstances, teenagers, etc. and to special programs like "Integrated Care for Women" which includes contraception, STD, pregnancy monitoring, early diagnosis of gynaecologic cancer and menopause.     

Experience-seeking characteristics of methadone clients.

The following scales were administered to 32 clients (mean age 34.09 yrs) of a methadone program and a demographically matched normal control group of 32 Ss (mean age 32.16 yrs): modified version of Pearson's Novelty-Experiencing Scale, her Desire-for-Novelty Scale, and Vando's Reducer-Augmenter Scale. Methadone Ss scored higher than controls on measures reflecting boredom, desire for change, and attraction to physically thrilling activities. Correlations of these measures with length of most recent dependency before treatment, time on program, and time since initial dependency suggest that the demonstrated peculiarities of the methadone clients probably antedated their involvement with opiate drugs. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current procedures for diagnosing dysphagia in elderly clients

Intubation no longer remains the only solution to feeding problems of the elderly patient with dysphagia. Dysphagic disorders result from neurogenic, myogenic, psychogenic, or mechanical causes. Thus numerous hospitalized or institutionalized elderly patients may have dysphagic symptoms. The consequences of this disorder are significant, and aspiration pneumonia is often the outcome. Current diagnostic procedures available to identify dysphagia are discussed.