An event-specific analysis of condom breakage among African American men at risk of HIV acquisition
An event-specific analysis of condom breakage among African American men at risk of HIV acquisition
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DOI：
10.1097/olq.0b013e3181585bf5
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发表时间：
2008-02-01
影响因子：
3.1
通讯作者：
Troutman, Adewale
中科院分区：
文献类型：
--
作者：
Crosby, Richard;Diclemente, Ralph J.;Troutman, Adewale
背景：非裔美国男性是人类免疫缺陷病毒感染的高危人群。避孕套破损是他们性保护行为的一个未充分研究的方面。本研究确定了用户的错误，导致安全套破损，使用特定事件的分析，在新诊断出的性传播疾病（STD）的年轻非洲裔美国人。方法：招聘发生在一个公共资助的性病诊所位于美国南部的一个大都市地区。在296名被筛选为合格的非洲裔美国男性中，271名（91.5%）同意参加。男性完成了一份自填问卷。报告与男性一起使用避孕套的男性被排除在分析之外，留下264名男性的分析样本。召回期为男性最后一次使用避孕套进行阴茎-阴道性交（在过去3个月内）。结果：超过五分之一（21.2%）的报告避孕套破损。年龄每增加一年，断裂的几率降低10% [调整后的比值比（AOR）= 0.90，95%置信区间（CI）= 0.81-0.99，P = 0.028]。使用油性润滑剂的男性报告断裂的可能性是其他男性的3倍多（AOR = 3.21，95%CI = 1.48-7.00，P = 0.003），在戴上避孕套之前完全展开避孕套的人报告破裂的可能性也高出约3倍（AOR = 3.34，95%CI = 1.76-6.50，P = 0.0001）。男性的破损率表明两种错误，即，使用油基润滑剂并在使用前展开避孕套的比例为54.5%，而在这两种错误中，分别有33.3%和12.8%。结论：在HIV感染高危人群中，安全套破损是常见的。这个问题可以通过咨询男性避免使用油基润滑剂和教授他们基本的避孕套使用技巧来缓解。
Background: African American men are at high risk of human immunodeficiency virus acquisition. Condom breakage is an understudied aspect of their sexual protective behavior. This study identified user errors leading to condom breakage using an event-specific analysis among young African American men newly diagnosed with a sexually transmitted disease (STD).Methods: Recruitment occurred in a publicly funded STD clinic located in a metropolitan area of the Southern United States. Of 296 African American men screened as eligible, 271 (91.5%) agreed to participate. Men completed a self-administered questionnaire. Men reporting condom use with men were excluded from the analysis, leaving an analytic sample of 264 men. The recall period was for the last time men used condoms for penile-vaginal sex (within the past 3 months).Results: More than one-fifth (21.2%) reported condom breakage. Each year of advancing age decreased the odds of breakage by 10% [adjusted odds ratio (AOR) = 0.90, 95% confidence interval (CI) = 0.81-0.99, P = 0.028]. Men who had used an oil-based lubricant were more than 3 times as likely to report breakage (AOR = 3.21, 95% CI = 1.48-7.00, P = 0.003) and those who completely unrolled the condom before putting it on were also about 3 times more likely to report breakage (AOR = 3.34, 95% CI = 1.76-6.50, P = 0.0001). The breakage rate for men indicating both errors, i.e., use of an oil-based lubricant and unrolling the condom before application, was 54.5% compared with 33.3% among those indicated either error, and 12.8% among those indicating neither error. Attributable risk for the 2 errors combined was 39%.Conclusions: Condom breakage among this sample of men at high risk for human immunodeficiency virus infection was common. This problem could be mitigated by counseling men to avoid the use of oil-based lubricants and by teaching them basic condom application skills.