Feasibility study of the Kinsey Institute Homework Intervention (KIHISUK) to promote correct and consistent condom use

有什么问题吗？在过去的10年里，英格兰的性传播感染(STI)率增加了约50%，每年新增约50万例。性传播感染的健康、社会和经济代价是巨大的。例如，未经治疗的衣原体感染可能会导致盆腔炎和不孕。目前，NHS的治疗费用估计为每年6.2亿GB。卫生署已将降低性传播感染比率列为改善性健康的优先事项，并已确认年轻的异性恋人士为“高危”组别。我们为何需要采取行动？尽管正确和持续地使用避孕套可以防止性传播感染，但使用避孕套存在许多障碍，如消极态度、减少性快感、“合身和感觉”问题以及勃起困难。避孕套的有效性也因避孕套的不完全使用而降低(即从头到尾都不使用避孕套)，这是在使用避孕套时遇到问题的男性更常见的报告。许多健康促进干预措施试图提高知识和技能，以增加避孕套的使用；然而，结果好坏参半。尽管有一些证据表明这些干预措施是有效的，但实际上，健康促进工作人员可能没有时间或金钱来使用这些干预措施。因此，迫切需要开发快速而有效的干预措施，以改善避孕套的使用体验，增加持续和正确的避孕套使用，并降低年轻人的性风险。我们该怎么办？我们希望调整一项在美国开发和测试的避孕套推广计划，以便在英国的年轻男性中使用。美国的这项计划发放了“避孕套工具包”(包含不同的避孕套和润滑剂)，要求男性在家中通过完成各种作业练习来自己试用避孕套。当他们测试每个避孕套时，他们被要求考虑自己的快乐，以及他们最喜欢哪些避孕套。然后，男性会对他们使用的避孕套进行评分。该计划的目的是让男性通过以下方式提高他们的避孕套技能：1)找到“正确/最佳”类型的避孕套和润滑剂，2)测试使用技术，3)在没有压力的情况下练习(他们自己)。在这项研究中，我们想看看这一想法是否适用于英国男性，以提高他们使用避孕套的技能和他们使用避孕套的快感。为此，我们将与青年男子和健康促进专业人员交谈，以了解他们的意见，并帮助我们修改和发展新方案的组成部分。然后，我们将邀请汉普郡和西米德兰兹郡社区和教育机构的年轻人信息和建议服务参与，并帮助招募50名16至25岁的年轻人来测试该计划。我们要衡量的是：我们想知道年轻人是否喜欢这个项目的不同元素，以及是否有可能在不同的环境中进行我们的研究。我们还在测试是否有可能进行一项更大规模的试验，看看该计划是否可以改变男性对避孕套的看法和使用，并估计执行这一计划所需的成本、时间、资源、样本量和结果衡量标准等。在节目结束时，我们将询问参与者对这项研究的看法以及我们要求他们做的事情。这项工作将增加开发有效的安全套推广干预措施的可能性，并评估更大规模的试验是否合理和适当。

What is the problem? Rates of sexually transmitted infections (STIs) in England have increased by around 50% over the last 10 years, with about half a million new cases occurring every year. The health, social, and economic costs of STIs are huge. Untreated chlamydia, for example, can lead to pelvic inflammatory disease and infertility. The current estimated cost of treatment to the NHS is £620 million per year. The Department of Health has identified the need to reduce STI rates as a priority for improving sexual health and have recognised young heterosexuals as target 'at-risk' groups.Why do we need to do something? Although condoms can be protective against STIs when used correctly and consistently, there are many barriers to their use such as negative attitudes, reduced sexual pleasure, "fit-and-feel " problems, and erection difficulties. The effectiveness of condoms is also reduced by incomplete use of condoms (i.e. not using condoms from start to the finish of sex), which is more commonly reported by men who experience problems whilst using condoms. Many health promotion interventions try to improve knowledge and skills to increase condom use; results, however, have been mixed. Although there is some evidence that these interventions can be effective, in practice health promotion staff may not have the time or the money to use these. There is therefore an urgent need to develop quick but effective interventions to improve condom use experiences, increase consistent and correct condom use, and reduce sexual risk among young people.What are we going to do? We want to adapt a condom promotion programme which has been developed and tested in the US for use among young men in the UK. The US programme gives out "condom kits" (containing different condoms and lubricants) asks men to try out the condoms at home by themselves by completing various homework exercises. As they test each condom they are asked to think about their own pleasure and which condoms they like best. Men then score/rate the condoms they use. The aim of the programme is for men to improve their condom skills by 1) finding the "right/best" types of condoms and lubricants, 2) testing techniques of applying them, and 3) by practicing with them in no pressure situations (on their own). In this study we want to see if the idea can be adapted for use with men in the UK to improve their skills in applying condoms and their pleasure in using them. To do this we will be speaking to young men and health promotion professionals to find out their views and help us modify and develop the components of the new programme. We will then invite young people's information and advice services in community and educational establishments in Hampshire and the West Midlands to take part and help recruit 50 young men aged 16-25 to test out the programme. What we will measure: We want to know if young men like the different elements of the programme and if it is possible to run our study in the different settings. We are also testing whether it is possible to do a larger trial to see if the programme can change men's views and use of condoms, and to estimate the costs, time, resources, sample sizes, outcome measures etc. needed to carry this out. At the end of the programme we will ask participants for their views about the study and what we asked them to do. This work will increase the likelihood of developing an effective condom promotion intervention, and to assess whether a larger trial is justified and appropriate.