Increasing Condom Use Without Reducing HIV Risk: Results of a Controlled Community Trial in Uganda
Abstract
BACKGROUND: Although consistent condom use is effective in reducing individual risk for HIV infection, the public health impact of condom promotion in a generalized epidemic is less clear. We assess the change in condom uptake and number of sex partners after a condom promotion trial in Kampala, Uganda. METHODS: Two similar poor urban communities near Kampala were randomized. One received a condom promotion program that taught condom technical use skills in workshops for men aged 18 to 30 years (n = 297) and encouraged condom use. Men in the control community (n = 201) received a brief informational presentation about AIDS. Participants received coupons redeemable for free condoms from distributors in both communities and completed questionnaires at baseline and 6 months later. RESULTS: Six-month follow-up was completed for 213 men (71.7%) in the intervention group and for 165 (82.1%) men in the control group. Men in the intervention group redeemed significantly more condom coupons than men in the control group (on average, 110 vs. 13 each; P = 0.002). Men in the intervention group increased their number of sex partners by 0.31 compared with a decrease of 0.17 partners in the control group (P = 0.004). Other measures did not support a net reduction in sexual risk in the intervention community compared with the control community and, in fact, showed trends in the opposite direction. CONCLUSIONS: In this study, gains in condom use seem to have been offset by increases in the number of sex partners. Prevention interventions in generalized epidemics need to promote all aspects of sexual risk reduction to slow HIV transmission.
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As suggested by a recent community trial in Uganda, the overall effect of some interventions could be offset by riskier behaviors at the population level and thus hinder the targeted decrease of HIV incidence.
“As suggested by a recent community trial in Uganda, the overall effect of some interventions could be offset by riskier behaviors at the population level and thus hinder the targeted decrease of HIV incidence [70].”
From Relationships, love and sexuality: what the Filipino teens think and feel (2009) · cites this paper as [70]
Our results are consistent with the cited paradoxical effect since the teens that falsely perceived condoms as being 100% effective were indeed more frequently sexually experienced.
“Our results are consistent with this cited paradoxical effect since the teens that falsely perceived condoms as being 100% effective were indeed more frequently sexually experienced.”
From Relationships, love and sexuality: what the Filipino teens think and feel (2009) · cites this paper as [70]
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- Authors
- Kajubi, P., Kamya, M. R., Kamya, S., Chen, S., McFarland, W., & Hearst, N.
- Affiliations
- Makerere University (UG)
- San Francisco Department of Public Health (US)
- University of California, San Francisco (US)
- Corresponding author
- Kajubi, Phoebe
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2005-09-01
- Volume
- 40
- Issue
- 1
- Pages
- 77-82
- ISSN
- 1525-4135 (ISSN-L)
- OpenAlex
- W1999420671
- Cited by
- 67
- References
- 19
- Citations by year
- 2026: 1 · 2023: 2 · 2020: 3 · 2019: 2 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 6 · 2013: 4 · 2012: 2
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- condom use, HIV prevention, condom promotion, number of sexual partners, sexual risk reduction, generalized HIV epidemic, sexual behavior, Kampala
- MeSH terms
- Adolescent, Adult, Follow-Up Studies, Humans, Male, Surveys and Questionnaires, Sexual Behavior, Sexual Partners, Uganda, Urban Population, HIV Infections, Condoms
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