Skip to main content

Advertisement

SpringerLink
Log in

Promoting Female Condom Use Among Female University Students in KwaZulu-Natal, South Africa: Results of a Randomized Behavioral Trial

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

An Erratum to this article was published on 21 July 2015

Abstract

Relatively few interventions have tested the efficacy of female condom promotion either alone or in combination with other barrier methods. We evaluated the efficacy of a two-session (enhanced) cognitive-behavioral intervention (EI) (n = 147) against a one-session control (minimal) educational intervention (MI) (n = 149) to promote female condom (FC) use among female students aged 18–28 at a South African university. We assessed change from baseline to 2.5 and 5 months in number of vaginal intercourse occasions unprotected by male or female condoms in EI versus MI using generalized linear models with a log link function and GEE. Both groups reported significant reductions in number of unprotected vaginal intercourse occasions from baseline to each follow-up, with no significant difference between the two-session and single-session intervention. Introduction of a brief group-based MI FC promotion intervention with FC access holds promise for delivery in clinics and other community venues.

Resumen

Hay relativamente pocos las intervenciones que han puesto a prueba la eficacia de la promoción del condón femenino, ya sea solo o en combinación con otros métodos de barrera. Se evaluó la eficacia de una intervención cognitivo conductual de dos sesiones (aumentado) (IA) (n = 147) comparado a un control de una sesión (mínima) de intervención educativa (IM) (n = 149) para promover el uso del condón femenino (CF) entre los estudiantes femeninas con 18-28 años de edad en una universidad sudafricana. Se evaluó el cambio desde el inicio hasta 2.5 y 5 meses en número de ocasiones de coito vaginal sin protección con condones masculinos o femeninos en IA contra IM utilizando modelos lineales generalizados con una función de enlace de logaritmo y GEE. Ambos grupos reportaron reducciones significativas en el número de ocasiones con coito vaginal sin protección desde el inicio hasta cada ocasión de seguimiento, sin diferencias significativas entre la intervención de dos sesiones y de una sola sesión. La introducción de una breve IM para promover el CF basado en el grupo con acceso al CF se vea prometedora para entrega en las clínicas y otros lugares de la comunidad.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Reproductive Health Supplies Coalition. Caucus on new and underused reproductive health technologies. Product brief: female condom. Reproductive Health Supplies Coalition; 2012.

  2. Ahmed K, Deperthes B, Frederick B, Ehlers S, Kapp N, Paladines C, et al. UN Commission on Life-Saving Commodities for Women and Children. Contraceptive commodities for women’s health working paper. New York,: UN Commission on Life-Saving Commodities for Women’s and Children’s Health; 2012 March.

  3. World Health Organization. Global HIV/AIDS response: epidemic update and health sector progress towards universal access: progress report 2011. Geneva: World Health Organization; 2011.

    Google Scholar 

  4. Fontanet AL, Saba J, Chandelying V, Sakondhavat C, Bhiraleus P, Rugpao S, et al. Protection against sexually transmitted diseases by granting sex workers in Thailand the choice of using the male or female condom: results from a randomized controlled trial. AIDS. 1998;12:1851–9.

    Article  CAS  PubMed  Google Scholar 

  5. French PP, Latka M, Gollub EL, Rogers C, Hoover DR, Stein ZA. Use-effectiveness of the female versus male condom in preventing sexually transmitted disease in women. Sex Transm Dis. 2003;30:433–9.

    Article  CAS  PubMed  Google Scholar 

  6. Hoke T, Feldblum P, Van Damme K, Nasution M, Grey T, Wong E, et al. Temporal trends in sexually transmitted infection prevalence and condom use following introduction of the female condom to Madagascar sex workers. Int J STD AIDS. 2007;18:461–6.

    Article  CAS  PubMed  Google Scholar 

  7. Artz L, Maculuso MM, Brill I, Kelaghan J, Austin H, Fleenor M, et al. Effectiveness of an intervention promoting the female condom to patients at sexually transmitted disease clinics. Am J Public Health. 2000;90:237–44.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Vijayakumar G, Mabude Z, Smit J, Beksinska M, Lurie M. A review of female-condom effectiveness: patterns of use and impact on protected sex acts and STI incidence. Int J STD AIDS. 2006;17:652–9.

    Article  PubMed  Google Scholar 

  9. Gollub EL. The female condom: tool for women’s empowerment. Am J Public Health. 2000;90:1377–81.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Peters A, Jansen W, Van Driel F. The female condom: the international denial of a strong potential. Reprod Health Matters. 2010;18:119–28.

    Article  PubMed  Google Scholar 

  11. Hoffman S, Mantell J, Exner T, Stein Z. The future of the female condom. Perspect Sex Reprod Health. 2004;36:120–6.

    Article  PubMed  Google Scholar 

  12. United Nations Population Fund. HIV prevention gains momentum. 978-0-89714-933-4. New York: UNFPA; 2011.

  13. Husken S, Terlikowski J. Join the global movement for female condoms. In: Impatient Optimists. 2013. http://www.impatientoptimists.org/Posts/2013/09/Join-the-Global-Movement-for-Female-Condoms. Accessed 19 Sept 2013.

  14. UNAIDS. Country progress report on the declaration of commitment on HIV/AIDS. Final Report, Republic of South Africa. New York: UNAIDS; 2010.

  15. Beksinska M, Smit J, Joanis C, Potter W. New female condoms in the pipeline. Reprod Health Matters. 2013;20:188–96.

    Article  Google Scholar 

  16. Beksinska M, Smit J, Joanis C, Usher-Patel M, Potter W. Female condom technology: new products and regulatory issues. Contraception. 2011;83:316–21.

    Article  PubMed  Google Scholar 

  17. Beksinska M, Smit JA, Mantell JE. Progress and challenges to male and female condom use in South Africa. Sex Health. 2012;9:51–8.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Peterson K, Herman L, Marseille E, Kahn JG. In: Smarter programming of the female condom: increasing its impact on HIV prevention in the developing world. www.fsg-impact.org/app/content/ideas/item/Female_Condom_Impact.html. FSG Social Impact Advisors; 2008.

  19. Center for Health and Gender Equity (CHANGE). Female condoms and U.S. foreign assistance: an unfinished imperative for women’s health. Washington: Center for Gender Equity and Health; 2011.

  20. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African National HIV prevalence, incidence and behaviour survey. South Africa: HSRC Press; 2014.

    Google Scholar 

  21. Pettifor A, Rees H, Steffenson A, Hlongwa-Madikizela L, MacPhail C, Vermaak K, et al. HIV and sexual behaviour among young South Africans: National survey of 15-24 year olds. Johannesburg: Reproductive Health Research Unit, University of the Witwatersrand; 2004.

    Google Scholar 

  22. Department of Health, Medical Research Council, OrcMacro. South African Demographic and Household Survey 2003. Pretoria: Department of Health; 2007.

  23. Department of Health. Republic of South Africa. National contraception and fertility planning policy and service delivery guidelines. Pretoria: Department of Health; 2012.

    Google Scholar 

  24. MatCH (Maternal, Adolescent and Child Health Research). Developing a strategy for female condom parallel programming: Proceedings of an expert meeting, MatCH, Durban, 23–24 November 2011.

  25. Guerra FM, Simbayi LC. Prevalence of knowledge and use of the female condom in South Africa. AIDS Behav. 2014;18:146–58.

    Article  PubMed  Google Scholar 

  26. Higher Education HIV/AIDS Programme (HEAIDS). HIV prevalence and related factors: higher education sector study, South Africa, 2008–2009. Pretoria: Higher Education South Africa; 2010.

    Google Scholar 

  27. Ray S, van de Wijgert J, Mason P, Ndowa F, Maposhere C. Constraints faced by sex workers in use of female and male condoms for safer sex in urban Zimbabwe. J Urban Health. 2001;78:581–92.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. van Devanter N, Gonzales V, Merzel C, Parikh NS, Celantano D, Greenberg J. Effect of an STD/HIV behavioral intervention on women’s use of the female condom. Am J Public Health. 2002;92:109–15.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Witte SS, El-Bassel N, Gilbert L, Wu E, Chang M, Hill J. Promoting female condom use to heterosexual couples: findings from a randomized clinical trial. Perspect Sex Reprod Health. 2006;38:148–54.

    Article  PubMed  Google Scholar 

  30. Kalichman SC, Williams E, Nachimson D. Brief behavioural skills building intervention for female controlled methods of STD-HIV prevention: outcomes of a randomized clinical field trial. Int J STD AIDS. 1999;10:174–81.

    Article  CAS  PubMed  Google Scholar 

  31. Feldblum PJ, Kuyoh MA, Bwayo JJ, Omari M, Wong EL, Tweedy KG, et al. Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya. AIDS. 2001;15:1037–44.

    Article  CAS  PubMed  Google Scholar 

  32. Choi KH, Hoff C, Gregorich SE, Grinstead O, Gomez C, Hussey W. The efficacy of female condom skills training in HIV risk reduction among women: a randomized controlled trial. Am J Pub Health. 2008;98:1841–8.

    Article  Google Scholar 

  33. Exner TM, Tesoriero JM, Battles HB, Hoffman S, Mantell JE, Correale J, et al. A randomized controlled trial to evaluate a structural intervention to promote the female condom in New York state. AIDS Behav. 2012;16:1121–32.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Feldblum PJ, Bwayo JJ, Kuyoh MA, Welsh MJ, Ryan KA, Chen-Mok M. The female condom and STDs: design of a community intervention trial. Ann Epidemiol. 2000;10:339–46.

    Article  CAS  PubMed  Google Scholar 

  35. Malow R, Ziskind D, Jones DL. Use of female controlled microbicidal products for HIV risk reduction. AIDS Care. 2000;12:581–8.

    Article  CAS  PubMed  Google Scholar 

  36. Hoffman S, Exner TM, Leu CS, Ehrhardt AA, Stein ZA. Female condom use in a gender-specific family planning clinic trial. Am J Public Health. 2003;93:1897–903.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Gollub EL, Cyrus-Cameron E, Armstrong K, Boney T, Chhatre S. Basic body knowledge in street-recruited, active drug-using women enrolled in a “body empowerment” intervention trial. AIDS Care. 2013;25:732–7.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Bandura A. A social cognitive approach to the exercise of control over AIDS infection. Beverly Hills: Sage; 1992.

    Google Scholar 

  39. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.

    Google Scholar 

  40. Ehrhardt AA, Exner TM, Hoffman S, Silberman I, Leu CS, Miller S, et al. A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial. AIDS Care. 2002;14:147–61.

    Article  CAS  PubMed  Google Scholar 

  41. Exner TM, Meyer-Bahlburg HFL, Yingling SL, Hoffman S, Ortiz-Torres B. Psychosexual and psychosocial interviews for Project FIO (the future is ours). Unpublished. New York: Columbia University, Department of Psychiatry; 1994.

  42. Harrison A, O’Sullivan LF, Hoffman S, Dolezal C, Morrell R. Gender role and relationship norms among young adults in South Africa: measuring the context of masculinity and HIV risk. J Urban Health. 2006;83:709–22.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Rubin DB. Inference and missing data. Biometrics. 1976;63:581–92.

    Article  Google Scholar 

  44. Kamb ML, Fishbein M, Douglas JM Jr, Rhodes F, Rogers J, Bolan G, et al. Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. Project RESPECT study group. JAMA. 1998;280:1161–7.

    Article  CAS  PubMed  Google Scholar 

  45. Mantell JE, Smit JA. Female condom use among South African students. National Institute of Child Health and Human Development. R01-HD046351. 2004-2010, unpublished data.

  46. Mantell JE, Smit JA. HIV prevention efficacy beliefs about male circumcision in South Africa American Foundation for AIDS Research (amfAR). 107200-44-RGRL; 2008-2010, unpublished data.

  47. Mantell JE, Dworkin S, Exner TM, Hoffman S, Smit JA, Susser I. The promises and limitations of female-initiated methods of HIV/STI protection. Soc Sci Med. 2006;63:1998–2009.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Mantell JE, Stein ZA, Susser I. Women in the time of AIDS: barriers, bargains, and benefits. AIDS Educ Prev. 2008;20:91–106.

    Article  PubMed  Google Scholar 

  49. Dowdy DW, Sweat MD, Holtgrave DR. Country-wide distribution of the nitrile female condom (FC2) in Brazil and South Africa: a cost-effectiveness analysis. AIDS. 2006;20:2091–8.

    Article  PubMed  Google Scholar 

  50. Beksinska M, Smit JA, Mabude Z, Mantell JE. Evaluation of the national South African female condom program: investigating factors associated with uptake and sustained use. USAID-PEPFAR cooperative agreement AID-OAA-A-13-00069, 2013.

Download references

Acknowledgments

This research was supported by a grant from NICHD (NICHD; R01-HD046351; Joanne E. Mantell, M.S., MS.P.H, Ph.D., Principal Investigator; Jennifer A. Smit, Ph.D., South Africa Site Principal Investigator). The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University is supported by a center grant from the National Institute of Mental Health (P30-MH43520; Principal Investigator: Robert H. Remien, Ph.D.). We are grateful to the students who participated in this study and the valuable contributions of the study’s Community Advisory Board. We also acknowledge the contributions of the officials at the higher education institution study site, who supported the study. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Child Health and Human Development, the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, MatCH Research (Maternal and Adolescent Child Health Research), and the University of the Witwatersrand, Faculty of Health Sciences, Department of Obstetrics & Gynaecology.

Conflicts of interest

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA

    Joanne E. Mantell, Theresa M. Exner, Susie Hoffman, Elizabeth A. Kelvin, Cheng-Shiun Leu & Zena A. Stein

  2. Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Maternal, Adolescent and Child Health Research (MatCH Research), University of the Witwatersrand, Durban, 3629, South Africa

    Jennifer A. Smit, Zonke Mabude, Mags Beksinska & Claudia Ngoloyi

  3. School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, 3627, South Africa

    Jennifer A. Smit

  4. Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, NY, 10032, USA

    Susie Hoffman

  5. City University of New York School of Public Health, Hunter College, Epidemiology and Biostatistics Program, New York, NY, 10035, USA

    Elizabeth A. Kelvin

  6. Department of Biostatistics, Mailman School of Public Health at Columbia University, New York, NY, 10032, USA

    Cheng-Shiun Leu

  7. GH Sergievsky Center, Joseph Mailman School of Public Health Columbia University, New York, NY, 10032, USA

    Zena A. Stein

Authors
  1. Joanne E. Mantell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer A. Smit
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Theresa M. Exner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zonke Mabude
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susie Hoffman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mags Beksinska
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elizabeth A. Kelvin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Claudia Ngoloyi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cheng-Shiun Leu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Zena A. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joanne E. Mantell.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mantell, J.E., Smit, J.A., Exner, T.M. et al. Promoting Female Condom Use Among Female University Students in KwaZulu-Natal, South Africa: Results of a Randomized Behavioral Trial. AIDS Behav 19, 1129–1140 (2015). https://doi.org/10.1007/s10461-014-0860-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-014-0860-6

Keywords

Palabras claves

Search

Navigation