BACKGROUND & AIMS: PURPOSE:The purpose of this study was to describe trends in vaginal intercourse (VI) and condom use during first VI from 2002 to 2017 among never-married 15- to 24-year-olds in the United States. METHODS:Data come from the National Survey of Family Growth. We used logistic regression and Stata's margins package to estimate the percentage reporting VI and condom use at first VI and to conduct statistical comparisons across time. RESULTS:VI was stable for 20- to 24-year-old men, but their condom use increased after 2002. For 15- to 19-year-old men, VI declined after 2011-2015 but condom use increased (83%). Among women, the overall percentage reporting VI and partner's condom use was stable, despite a significant increase in condom use among 15- to 19-year-olds between 2006-2010 and 2011-2015 (69%-75%). CONCLUSIONS:Condom use at first intercourse increased among young men, but a similar pattern was not observed for young women. Understanding why is crucial to the formulation of strategies to increase condom uptake.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:It is widely believed that marijuana use and alcohol use directly intercede on successful condom use. However, measurement differences and inconsistent findings in past research remain unclear whether marijuana and alcohol work directly to influence condom behavior, or spuriously function through other factors that actually reflect an increased likelihood of vaginal sex. The current study prospectively disentangles the association of marijuana and alcohol use on condom behavior among adolescent women. METHODS:Young women (N=387; 14-17 years) provided daily sexual diaries as part of a longitudinal cohort study (1999-2009) of sexual behavior and sexual relationships. To separate the effects of marijuana and alcohol use on vaginal sex from condom use (when vaginal sex occurs), we estimated a 3-category outcome variable (no vaginal sex, vaginal sex with a condom, vaginal sex without a condom), alternating no sex (Model 1) and sex without a condom (Model 2) as the referent categories. Generalized estimating equation multinomial logistic regression adjusted odds ratios for multiple sexual events from the same young woman over time. RESULTS:Subjects contributed 14,538 coital events; 30% of these events were condom-protected. Neither marijuana nor alcohol use was directly associated with lower condom use; the strongest effect of condom use (adjusted odds ratio) and nonuse was performance of these behaviors in the past week. CONCLUSIONS:This study finds no evidence of a relationship between marijuana or alcohol use and condom nonuse. Both condom use and nonuse were identified as consistent behavioral patterns, regardless of the effect of marijuana and alcohol use.

背景与目标：

BACKGROUND & AIMS: UNLABELLED:According to major theories of behavioral prediction, the most proximal psychological predictor of an individual's behavior is that individual's intention. With respect to interdependent behaviors such as condom use, however, relationship dynamics influence individuals' power to make decisions and to act. OBJECTIVE:The current study examines how relationship dynamics impact 3 condom use relevant outcomes: (a) the individual forming his or her own intention to use condoms, (b) the couple forming their joint intention to use condoms, and (c) actual condom use behavior. METHOD:We conducted a 2-wave longitudinal study of young heterosexual adult couples at high risk for HIV infection involving the collection of both individual- and couple-derived data. RESULTS:Results demonstrate the importance of both person (e.g., biological sex and dispositional dominance) and relational (e.g., relational power and amount of interest in the relationship, operationalized as commitment and perceived alternatives to the relationship) factors in predicting condom use intentions and behavior. Individuals who are lower in dispositional dominance are likely to incorporate their partner's intentions into their own individual intentions; the intentions of individuals who have less interest in the relationship are more highly predictive of the couple's joint intention; and the intentions of men and individuals higher in relationship power are more likely to exert a direct influence on condom use. CONCLUSIONS:These findings have implications for improving the health of high-risk individuals, including suggesting situations in which individuals are highly influenced by their partners' intentions.

背景与目标：

BACKGROUND & AIMS: :The primary purpose of this study was to determine factors that predict condom self-efficacy among a sample of soon-to-be-released adult male inmates with respect to self-reported HIV/AIDS risk behaviors. Approximately 230 inmates had agreed to enroll in the study. This analysis is based on completed baseline surveys from 187 inmates. Data were collected at baseline (prior to implementing the intervention) on self-reported condom self-efficacy HIV/AIDS risk behaviors. Findings support that, requesting that your partner uses condoms every time they had sex was the strongest indicator of self-reported condom self-efficacy by inmates in the sample (p<0.01). Findings also suggest that engaging in sexual activity after smoking marijuana, limiting the number of sex partners and asking partners' HIV status were significant predictors for the dependent variable of condom self-efficacy (p<.05); engaging in sexual activity after drinking was not (p<0.11). Findings suggest that it may be wise to take a best-practice approach using former inmates as peer educators if health-based interventions are to be delivered to soon-to-be-released adult male inmates.

背景与目标： : 这项研究的主要目的是确定预测即将释放的成年男性囚犯中有关自我报告的HIV/AIDS危险行为的避孕套自我效能的因素。大约230名囚犯同意参加这项研究。该分析基于187名囚犯完成的基线调查。在基线 (实施干预之前) 收集自我报告的避孕套自我效能HIV/AIDS风险行为的数据。调查结果支持，要求您的伴侣每次发生性行为时都使用避孕套是样本中囚犯自我报告避孕套自我效能的最强指标 (p<0.01)。研究结果还表明，吸食大麻后从事性活动，限制性伴侣的数量和询问伴侣的HIV状况是安全套自我效能因变量的重要预测因素 (p<.05); 饮酒后从事性活动不是 (p<0.11)。研究结果表明，如果要向即将释放的成年男性囚犯提供基于健康的干预措施，那么采取最佳实践方法可能是明智的，将前囚犯作为同伴教育者。

BACKGROUND & AIMS: :In a clinical study comparing the failure probabilities of two condom types, the sample of all reported acts of intercourse in which a study condom was used by a randomized participant is typically defined to be the primary analysis sample. However, it may also be desirable to make comparisons among only those acts in which the participants correctly followed all condom use instructions before, during, and after the act of intercourse (i.e., the "correct-use" subset). The timing associated with the definition of correct use creates a dilemma in that an act cannot be classified as a "correct-use act" until after the completion of both intercourse and withdrawal; if a condom fails (e.g., breaks or slips completely off of the penis) during intercourse then the couple has no chance at correct use during withdrawal. As a result of the implicitly conditional nature of this problem, it is not a simple matter to specify a correct-use subset of the primary analysis sample. With this in mind, we develop estimators for the correct-use failure probabilities, the corresponding standard errors, and test statistics for comparing the correct-use failure probabilities between condom groups. We demonstrate the utility of the proposed methods by applying them to data from a clinical study of condom contraceptive effectiveness, and we use simulated data to investigate the finite sample properties of the proposed methods. The simulation results indicate that one of our proposed estimators is at least approximately unbiased, even in small samples. Furthermore, one-sided noninferiority tests performed using this estimator tend to have sizes that are only marginally larger than the nominal test size in moderate to large samples.

背景与目标： : 在一项比较两种避孕套失败概率的临床研究中，随机参与者使用研究避孕套的所有报告的性交行为的样本通常被定义为主要分析样本。然而，也可能希望仅在参与者在性交行为之前、期间和之后正确遵循所有避孕套使用说明的那些行为 (即，“正确使用” 子集) 之间进行比较。与正确使用的定义相关的时机造成了一个两难境地，即在性交和戒断完成之前，一项行为不能被归类为 “正确使用行为”; 如果避孕套失效 (例如，在性交过程中，这对夫妇在退出过程中没有机会正确使用阴茎。由于此问题的隐含条件性质，指定主要分析样本的正确使用子集并不是一件简单的事情。考虑到这一点，我们开发了正确使用的故障概率，相应的标准误差的估计器，以及用于比较安全套组之间正确使用的故障概率的测试统计数据。我们通过将所提出的方法应用于避孕套避孕有效性的临床研究数据来证明它们的实用性，并且我们使用模拟数据来研究所提出方法的有限样本属性。仿真结果表明，即使在小样本中，我们提出的估计量之一也至少近似无偏。此外，使用该估计器进行的单侧非劣效性检验的大小往往仅略大于中等至较大样本中的标称检验大小。

BACKGROUND & AIMS: :The purpose of this descriptive correlational study using the transtheoretical model was to determine the relationship between stages of change and condom use among gay and bisexual men with primary (steady) and casual (occasional) partners. A convenience sample of 241 gay and bisexual men was recruited from the Internet. The majority of men (n = 198, 82%) never used condoms during anal, vaginal, or oral intercourse with primary partners, indicating they were in the first of five stages of change (precontemplation). Thirty percent (n = 71) of men reported using condoms every time during anal intercourse with casual partners and were in the last stage of change (maintenance). Multiple regression analysis revealed that older bisexual men who informed partners of their HIV status and who were confident and perceived more advantages in using condoms were in higher stages of change. By placing participants into various stages of change, stage specific interventions can be designed.

背景与目标： : 使用跨理论模型进行的描述性相关研究的目的是确定具有主要 (稳定) 和休闲 (偶尔) 伴侣的同性恋和双性恋男性的变化阶段与避孕套使用之间的关系。从互联网上招募了241名同性恋和双性恋男性的便利样本。大多数男性 (n = 198，82%) 在与主要伴侣的肛门，阴道或口交期间从未使用过避孕套，这表明他们处于变化的五个阶段 (预想) 中的第一个阶段。30% (n = 71) 的男性报告说，每次与休闲伴侣进行肛门性交时都会使用避孕套，并且处于改变 (维持) 的最后阶段。多元回归分析显示，向伴侣告知其艾滋病毒状况并有信心并认为使用安全套有更多优势的老年双性恋男性处于较高的变化阶段。通过将参与者置于变化的各个阶段，可以设计针对特定阶段的干预措施。

BACKGROUND & AIMS: :Heterosexual transmission of HIV through contact with female sex workers (FSWs) is a growing concern for the HIV/AIDS epidemic in China. Using consecutive cross-sectional surveys, we examined the prevalence of HIV and sexually transmitted infections (STIs), risk behaviours, HIV knowledge and the utilization of intervention services among FSWs in Shandong Province. Of 3460 participants, half reported ever having STI-related symptoms, 57.8% had ≥7 clients in the last week, half reported inconsistent use of condoms with clients and 11.2% reported ever using illicit drugs. Consistent use of condoms with clients was associated with higher education, being 20-24 years of age, being recruited from hotels, having ever received free condoms and was inversely associated with STI-related symptoms. HIV-related knowledge was associated with higher education, ever testing for HIV and inversely associated with self-reported STI-related symptoms. The low rates of condom use, high number and frequent turnover of clients, high prevalence of self-reported STIs and drug use highlight the urgency for more effective intervention in these FSWs.

背景与目标： : 通过与女性性工作者 (fsw) 接触而传播艾滋病毒的异性是中国艾滋病毒/艾滋病流行的日益关注的问题。通过连续的横断面调查，我们检查了山东省fsw中HIV和性传播感染 (STIs) 的患病率，风险行为，HIV知识以及干预服务的利用情况。在3460名参与者中，一半报告曾患有性传播感染相关症状，57.8% 名在上周有 ≥ 7名客户，一半报告与客户使用避孕套不一致，11.2% 名报告曾使用非法药物。与客户一致使用避孕套与高等教育有关，年龄在20-24岁之间，是从酒店招募的，曾经接受过免费避孕套，并且与性传播感染相关症状呈负相关。与HIV相关的知识与高等教育，HIV检测有关，与自我报告的STI相关症状成反比。安全套使用率低，客户数量多且频繁流动，自我报告的性传播感染和药物使用率高，突显了对这些fsw进行更有效干预的紧迫性。

BACKGROUND & AIMS: INTRODUCTION:Freud opined that condom use during penile-vaginal intercourse (PVI), like sexual activities other than PVI, led to a detrimental effect on orgasm that fueled the neuroses. Although this hypothesis had not been empirically tested, Freud's hypothesis that inability to have a (PVI) vaginal orgasm is a sign of psychological immaturity has recently received empirical support. AIMS:The objective is to examine the hypotheses that use of immature psychological defense mechanisms correlates directly with frequency of condom use during PVI, but inversely with frequency of PVI without condoms. An additional aim is to examine the independent contributions of frequency of PVI with and without condoms, and different triggers of orgasm, in predicting the use of immature defense mechanisms. METHODS:Two hundred ten Portuguese participants (99 women) reported their frequency of PVI with and without condoms, and frequency of orgasms from different sexual activities during the preceding month, and also completed the Defense Style Questionnaire (DSQ-40). MAIN OUTCOME MEASURE:The association of DSQ-40 immature defenses (correlated with indices of psychopathology) with past month frequency of PVI with and without condoms, and orgasms from different sexual behaviors. RESULTS:Frequency of PVI with condoms correlated directly with use of immature defenses. Frequency of PVI without condoms correlated inversely with use of immature and neurotic defenses. Results were not confounded by relationship status, age, cohabitation, or social desirability responding. Regression analyses revealed that immature defenses were independently predicted by condom use for PVI and by masturbation orgasms (for both sexes). For women additional predictors were lack of vaginal orgasm, and orgasm from clitoral masturbation during PVI. CONCLUSIONS:The results are consistent with condom use during PVI being associated with psychological immaturity and predisposition to poorer mental health.

背景与目标：

BACKGROUND & AIMS: :Using data from the 2004 National Adolescent Surveys, this paper undertook a detail analysis of knowledge of correct condom use and consistency of use, as well as their covariates, among adolescents in Burkina Faso, Ghana, Malawi and Uganda. The strongest predictor of knowledge of correct condom use among both male and female adolescents is exposure to a condom use demonstration. In Burkina Faso, Ghana and Uganda, adolescents who have seen a condom demonstration are 2 to 5 times as likely as those who have not to have good knowledge of correct condom use. Age, ever received sex education in school, ever attended school and exposure to the radio are also significant predictors of knowledge of correct use, particularly among men. As indicated by behavior among young men, the extent to which adolescents use the condom consistently varies across countries. Yet, it is nowhere near the required 100% level. The proportion reporting consistent use of the method in the 3 months preceding the survey is 38% in Burkina Faso, 47% in Ghana, 20% in Malawi and 36% in Uganda. Age difference between partners is a major determinant of consistent use of condoms: young men whose partner is 0-4 years younger are about two and a half times more likely to use condoms consistently than those who whose partner is 5-9 years younger. Other important predictors of consistent condom use are residence, education, living arrangement and exposure to mass media, specifically the radio and newspaper. Findings from this study point to areas that policy and program can address to provide adolescents access to the kinds of information and service they need to achieve healthy sexual and reproductive lives.

背景与目标： : 本文利用2004次全国青少年调查的数据，对布基纳法索、加纳、马拉维和乌干达青少年正确使用避孕套和使用一致性的知识及其协变量进行了详细分析。在男性和女性青少年中，正确使用安全套知识的最强预测指标是暴露于安全套使用演示中。在布基纳法索，加纳和乌干达，看过避孕套示范的青少年是那些不了解正确使用避孕套的青少年的2至5倍。年龄，曾经在学校接受过性教育，曾经上学和接触广播也是正确使用知识的重要预测因素，尤其是在男性中。正如年轻人的行为所表明的那样，青少年使用避孕套的程度在不同国家之间一直存在差异。然而，它远没有达到所需的100% 水平。在调查前3个月报告一致使用该方法的比例38% 在布基纳法索，47% 在加纳，20% 在马拉维，36% 在乌干达。伴侣之间的年龄差异是持续使用安全套的主要决定因素: 伴侣年龄在0-4岁之间的年轻男性比伴侣年龄在5-9岁之间的年轻男性持续使用安全套的可能性高约2.5倍。持续使用安全套的其他重要预测因素是居住，教育，生活安排和接触大众媒体，特别是广播和报纸。这项研究的结果指出了政策和计划可以解决的领域，以使青少年获得实现健康的性生活和生殖生活所需的各种信息和服务。

BACKGROUND & AIMS: :To date, most condom research has focused on young or high-risk groups, with little evidence about influences on condom use amongst lower-risk community samples. These groups are not risk free and may still wish to negotiate safer sex; yet the considerations involved could be different from those in higher-risk groups. Our research addresses this gap: We report a cross-sectional questionnaire study enquiring about recent condom use and future use intentions in community settings. Our sample (n = 311) purposively included couples in established relationships, known to be condom users. Items included demographics, sexual history and social-cognitive variables taken from the theory of planned behaviour. The strongest association with condom use/use intentions amongst our respondents was sexual partner's perceived willingness to use them. This applied across both univariate and multivariate analyses. Whilst most social-cognitive variables (attitudes; self-efficacy and peer social norms) were significant in univariate analyses, this was not supported in multivariate regression. Of the social-cognitive variables, only "condom-related attitudes" were retained in the model explaining recent condom use, whilst none of them entered the model explaining future use intentions. Further analysis showed that attitudes concerning pleasure, identity stigma and condom effectiveness were most salient for this cohort. Our results suggest that, in community samples, the decision to use a condom involves different considerations from those highlighted in previous research. Explanatory models for established couples should embrace interpersonal perspectives, emphasising couple-factors rather than individual beliefs. Messages to this cohort could usefully focus on negotiation skills, condom advantages (other than disease prevention) and reducing the stigma associated with use.

背景与目标： : 迄今为止，大多数避孕套研究都集中在年轻或高危人群上，几乎没有证据表明在低风险社区样本中影响避孕套使用。这些群体并非没有风险，可能仍希望谈判更安全的性行为; 然而，所涉及的考虑可能与高风险群体的考虑不同。我们的研究解决了这一差距: 我们报告了一项横断面问卷研究，询问社区环境中最近使用避孕套和未来使用意图。我们的样本 (n   =   311) 有目的地包括已建立关系的夫妇，已知是避孕套使用者。项目包括人口统计学，性史和来自计划行为理论的社会认知变量。在我们的受访者中，与避孕套的使用/使用意图最强烈的关联是性伴侣的使用意愿。这适用于单变量和多变量分析。尽管大多数社会认知变量 (态度，自我效能感和同伴社会规范) 在单变量分析中很重要，但多元回归不支持。在社会认知变量中，解释最近使用避孕套的模型中仅保留了 “与避孕套相关的态度”，而没有一个进入模型解释未来的使用意图。进一步的分析表明，有关愉悦，身份污名和避孕套有效性的态度对于该人群最为突出。我们的结果表明，在社区样本中，使用避孕套的决定涉及与先前研究中强调的不同的考虑因素。既定夫妻的解释模型应包含人际关系的观点，强调夫妻因素而不是个人信念。向该队列发送的消息可以有效地集中于谈判技巧，避孕套的优势 (疾病预防除外) 以及减少与使用相关的污名。

BACKGROUND & AIMS: OBJECTIVES:Condom use to prevent HIV in Africa has increased in nonmarital sexual encounters but remains low within marriage. Married women of reproductive age, however, are at high risk of HIV. GOAL:This study investigated factors associated with consistent condom use after a brief intervention. STUDY DESIGN:We conducted an HIV prevention condom intervention with a cohort of 394 married women, aged 17 to 47, recruited from clinics in Zimbabwe. Consistent condom users were ineligible. At enrollment, participants received education and were offered free male and female condoms and HIV testing. Women completed a follow-up questionnaire at 2-months. We used logistic regression analysis to measure the association of protected sex (i.e., 100% use of male or female condoms) at follow-up with condom attitudes, negotiation skills, HIV risk perception and testing. RESULTS:At follow-up, 179 (48.5%) women reported consistent condom use throughout the study, and 318 (87%) reported condom use at last sexual episode; 72 women tested HIV-positive, only 4 of whom reported at enrollment that it was likely that they were infected. Results showed that women who tested positive were more likely to report consistent condom use (OR 2.9, 95% CI 1.7-5.2). HIV risk perceptions and condom negotiation self-efficacy increased postintervention, and were significantly associated with consistent condom use. Hormonal contraception was negatively associated with consistent condom use (OR 0.3, 95% CI 0.19-0.65). CONCLUSIONS:Married women reported significant increases in consistent condom use in response to a brief intervention, especially if HIV-positive.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia. METHODS:A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use. RESULTS:The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67). CONCLUSIONS:Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.

背景与目标：

BACKGROUND & AIMS: AIMS AND OBJECTIVES:To examine intentions to engage in condom use and potential partner-related barriers to condom use, including intimate partner violence (IPV), low levels of sexual relationship power and perceptions of monogamy, among women at risk for HIV. BACKGROUND:In the United States, women account for approximately one in four new HIV infections. Despite the effectiveness of consistent condom use, women often confront biological, cultural and psychosocial barriers that limit their ability to engage in condom-use. DESIGN:Cross-sectional, quantitative study. METHODS:Participants (N = 90) were recruited from a domestic violence shelter, a domestic violence support organisation and an obstetrics/gynaecology clinic in Philadelphia, PA. Data were collected by questionnaires to assess women's condom-use intentions, actual condom-use behaviour, sexual partner risk factors, experience of IPV, level of sexual relationship power and perceptions of monogamy. RESULTS:Fifty-eight per cent of participants (n = 52) indicated a difference between their preference and intentions to use condoms vs. their actual use, with 62% (n = 32) using condoms less frequently than they would like. Significant differences in condom use emerged for women with low vs. high sexual relationship power and women who reported being in a monogamous relationship vs. those who did not. Of particular concern, a majority of these relationships were with high-risk partners, further increasing women's already elevated risk of acquiring HIV. CONCLUSIONS:Condom use is a multifaceted issue, particularly in sexual relationships involving power differentials and perceived monogamy. Condom use was complicated by women's own preferences, sexual relationship power differentials and by the perceived exclusivity of the relationship with their sexual partners. RELEVANCE TO CLINICAL PRACTICE:These findings have important implications for nurses as they are uniquely positioned to facilitate HIV risk reduction among their patients through the discussion of sexual health issues and barriers to negotiating condom use that women may confront.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Adolescent girls and young women (AGYW), including those who sell sex in sub-Saharan Africa, are especially vulnerable to HIV. Reaching them with effective prevention is a programmatic priority. The HIV prevention cascade can be used to track intervention coverage, and identify gaps and opportunities for programme strengthening. The aim of this study was to characterise gaps in condom use and identify reasons underlying these gaps among young women who sell sex (YWSS) in Zimbabwe using data from enrolment into an impact evaluation of the DREAMS programme. DREAMS provided a package of biomedical, social and economic interventions to AGYW aged 10 to 24 with the aim of reducing HIV incidence. METHODS:In 2017, we recruited YWSS aged 18 to 24 using respondent-driven sampling in six sites across Zimbabwe. We measured knowledge about efficacy of, access to, and effective (consistent) use of condoms with the most recent three sexual partners, separately by whether YWSS self-identified as female sex workers (FSW) or not. Among YWSS without knowledge about efficacy of, not having access to, and not effectively using condoms, we described the potential reasons underlying the gaps in the condom cascade. To identify socio-demographic characteristics associated with effective condom use, we used logistic regression modelling. All analyses were RDS-II weighted and restricted to YWSS testing HIV-negative at enrolment. RESULTS:We enrolled 2431 YWSS. Among 1842 (76%) YWSS testing HIV-negative, 66% (n = 1221) self-identified as FSW. 89% of HIV-negative YWSS demonstrated knowledge about efficacy of condoms, 80% reported access to condoms and 58% reported using condoms consistently with the three most recent sexual partners. Knowledge about efficacy of and effective use of condoms was similar regardless of whether or not YWSS self-identified as FSW, but YWSS self-identifying as FSW reported better access to condoms compared to those who did not (87% vs 68%; age- and site-adjusted (adjOR) = 2.69; 95% CI: 2.01 to 3.60; p < 0.001). Women who reported experiencing sexual violence in the past year and common mental disorder in the past week were less likely to use condoms consistently (43% vs. 60%; adjOR = 0.49; 95% CI: 0.35 to 0.68; p < 0.001) and (51% vs. 61%; adjOR = 0.76; 95% CI: 0.60 to 0.97; p = 0.029), respectively. CONCLUSIONS:Despite high knowledge about efficacy of and access to condoms, there remain large gaps in self-reported consistent condom use among YWSS. Addressing the structural determinants of YWSS' inconsistent condom use, including violence, could reduce this gap. YWSS who do not self-identify as FSW have less access to condoms and may require additional programmatic intervention.

背景与目标：

BACKGROUND & AIMS: :Health care providers can play a key role in influencing clients to initiate and maintain use of the female condom, an underused method for HIV/STI and pregnancy prevention. In 2001-2002, based on semistructured interviews with 78 health care providers from four types of settings in New York City, we found that most providers had seen the female condom, but they had not used it and did not propose the method to clients. They lacked details about the method-when to insert it, where it can be obtained, and its cost. Gender of provider, provider level of training, and setting appeared to influence their attitudes. Unless and until provider training on the female condom is greatly improved, broader acceptance of this significant public health contribution to preventing HIV/AIDS and unwanted pregnancy will not be achieved.

背景与目标： : 卫生保健提供者可以在影响客户发起和维持使用女用避孕套方面发挥关键作用，这是一种未充分使用的艾滋病毒/性传播感染和预防怀孕的方法。2001-2002年，根据对来自纽约市四种类型的78名医疗保健提供者的半结构化访谈，我们发现大多数提供者都看过女用避孕套，但他们没有使用过，也没有向客户提出该方法。他们缺乏有关该方法的详细信息-何时插入，可以在何处获得以及成本。提供者的性别，提供者的培训水平和环境似乎会影响他们的态度。除非并且直到提供者对女用避孕套的培训得到极大改善，否则将无法广泛接受对预防艾滋病毒/艾滋病和意外怀孕的重大公共卫生贡献。