A Review of Indian Perceptions on Condom Use

In the late 1960s, India's National Family Planning Programme introduced condoms as one of the family planning methods. Since its inception, the condom has been promoted as a method of family planning through social marketing. With the rising prevalence and incidence of sexually transmitted infections (STIs), such as HIV/AIDS, the condom has been promoted as a dual method of protection against both unintended pregnancies and sexually transmitted infections. Despite different initiatives at various levels, overall condom use among Indian couples remains low. In this paper, we examine the research on condom perception among Indian couples. The report specifically evaluates research and strategies designed to enhance condom usage among couples; predictors of condom use; reasons for not using a condom; and perception versus the experience of condom failure. Non-acceptance by partners, perceived ineffectiveness, reduced comfort, lack of sexual satisfaction, husband's alcohol usage, depression, and anxiety, and not being accessible at the time were among the reported condom-related issues. The importance of the media in promoting condom use was mentioned as a significant strategy to raise awareness and use. Acceptance of male condoms would be aided in a variety of ways.

Sexual Practices and Misconceptions Regarding Condom Usage and Status of Voluntary HIV Testing among Truck Drivers Employed in Transport Sector of Haryana- A Cross-sectional Study

Introduction: Truck drivers serve as a bridge population between high risk group and general population. Their nature of job demands travelling for days which compromises their lifestyle and health needs. Aim: To describe the sexual practices and misconceptions regarding condom usage and the status of voluntary Human Immunodeficiency Virus (HIV) testing among truck drivers and helpers. Materials and Methods: This was a cross-sectional study conducted during a health screening camp, conducted by team from a tertiary care centre of district Faridabad among truck drivers employed in a transport company. All the participants were interviewed by a trained counsellor using a structured, closed ended questionnaire. Data was analysed by using SPSS version 21. Fischer’s-exact and Chi-square tests were applied to test differences in proportions. Student t-test was applied to test the differences in mean between two groups. A p-value <0.05 was considered statistically significant. Results: Total 117 male truck drivers and helpers participated in the study, of which 87.2% were sexually active with condom usage rate of 41.2%. Majority of the sexually active participants (92.8%) had more than one sexual partner in the last year. Condom usage was significantly higher among those having multiple partners than single partner (p<0.001). Having sex with wife (36.4%) and preferred sex without condom (21.1%) were two major reasons elicited for non-usage of condoms. Almost half (46.2%) preferred to buy condoms from chemist shop. Only 14.7% of all the sexually active participants were ever tested for HIV. Conclusion: Truck drivers with multiple sexual partners were prevalent; however, usage of condoms was high among them.

Modelling the impact of a sex work crackdown on syphilis transmission among female sex workers and their clients in South China

ObjectiveTo estimate the potential effects of an intense sex work crackdown on syphilis transmission in Guangdong Province, China.MethodsWe developed a deterministic compartmental model of syphilis transmission among female sex workers (FSW) and their male clients in Guangdong Province, China. We based model assumptions on census data and scientific literature, and we fitted the model to sentinel surveillance estimates of syphilis prevalence (positive results in both treponemal and non-treponemal tests) among FSW between 2009 and 2013. We estimated the impact of an intense sex work crackdown in 2014 by comparing the number of new syphilis infections between 2014 and 2020 in crackdown versus basecase (no crackdown) scenarios. In modelling scenarios, we examined main crackdown mechanisms of impact, including changed number of FSW engaging in sex work, reduction of weekly transactions, condom usage rate and syphilis diagnosis rate.ResultsIn the basecase, predicted syphilis prevalence in FSW decreased from 2% in 2014 to 0.4% in 2020. In crackdown scenarios, syphilis incidence was predicted to transiently decrease and then to rebound relative to basecase levels a few years later. Shorter crackdowns led to higher, faster rebounds.ConclusionsShort-term intense crackdowns may exacerbate syphilis transmission among FSW and further marginalise an already vulnerable group. This study provides a quantitative, infection-related basis for changing sex work policies to reduce harms.

Errors in Condom Use in the Setting of HIV Transmission: A Systematic Review

Background: The efficacy of condom use in declining HIV transmission may be compromised by their incorrect usage. Much focus has been paid on the regularity of condom usage but consumer mistakes and challenges must be considered. Breakage, slipping, leakage, incomplete use and other problems during the sexual event may compromise the protective role of the condom. Objective: To evaluate through a systematic review of published data, the type, and incidence of error and problems in condom use, and their possible role in reducing the preventive action of condoms. Methods: A systematic literature search for peer-reviewed articles published between January 2000 and January 2019, issued in English in peer-reviewed journals, and reporting the occurrence of condom errors/problems among HIV high-risk populations. Results: Twenty studies representing nine countries met the inclusion criteria. The most predominant mistakes associated with condom use included condom breakage, slippage, delayed condom application, early removal, issues related to erection loss and difficulties with fit and feel were reported, failure to squeeze out air, use of expired condoms, reuse of condom, and wearing the condom outside out were other issues noticed. Conclusions: Condom use problems and mistakes are prevalent across the globe. Educational efforts are needed to empower HIV the at-risk population with confidence and knowledge to improve correct condom use and increase preventive activity

Sexual risk behaviour and sexually transmitted infections in men who have sex with men

<p class="abstract"><strong>Background:</strong> In India the estimated men who have sex with men (MSM) population is around 352, 000, among that 4.3% are living with HIV. The incidence of sexually transmitted infections (STIs) in MSM is greater than that reported in women and men who have sex with women only. The aim of the study is to determine the trends of sexual behaviour and the pattern of sexually transmitted infections in men who have sex with men.</p><p class="abstract"><strong>Methods:</strong> A retrospective study of the data collected from the clinical records of all MSM, who had attended the STI clinic of Kilpauk Medical College, Chennai, Tamil Nadu, during the three-year study period, from July 2016 to June 2019. Demographic data, sexual risk behaviour, condom usage and STIs, among the MSM, were computed and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the study period 489 MSM attended the STI clinic, 51.9% were bisexual and 48.1 % were homosexual. Among them, exclusive penetrative sex in 50.7%, exclusive receptive sex in 15.7% and both in 33.6% were reported. Condom usage was consistent in 18.8%, inconsistent in 28.8% and 52.9% never used condom. Unprotected sex is more common in oral sex than with anal sex. STIs were seen in 20.9% and HIV in 1.4% of MSM. Syphilis was the most common STI seen.</p><p class="abstract"><strong>Conclusions:</strong> Our study elucidated the high prevalence of STIs among MSM and increasing trends of sexual risk behaviour. Health service providers must take necessary steps to improve the provision of biological and medical measures to screen, treat and prevent infections.</p><p class="abstract"> </p>

The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus on Gonorrhea Prevalence

Pre-exposure prophylaxis (PrEP) has been shown to be highly effective in reducing the risk of HIV infection in gay and bisexual men who have sex with men (GbMSM). However, PrEP does not protect against other sexually transmitted infections (STIs). In some populations, PrEP has also led to riskier behaviour such as reduced condom usage, with the result that the prevalence of bacterial STIs like gonorrhea has increased. Here we develop a compartmental model of the transmission of HIV and gonorrhea, and the impacts of PrEP, condom usage, STI testing frequency and potential changes in sexual risk behaviour stemming from the introduction of PrEP in a population of GbMSM. We find that introducing PrEP causes an increase in gonorrhea prevalence for a wide range of parameter values, including at the current recommended frequency of STI testing once every 3 months for individuals on PrEP. Moreover, the model predicts that a higher STI testing frequency alone is not enough to prevent a rise in gonorrhea prevalence, unless the testing frequency is increased to impractical levels. However, testing every 2 months in combination with sufficiently high condom usage by individuals on PrEP would be successful in maintaining gonorrhea prevalence at pre-PrEP levels. The results emphasize that programs making PrEP more available should be accompanied by efforts to support condom usage and frequent STI testing, in order to avoid an increase in the prevalence of gonorrhea and other bacterial STIs.