Journal of Community Health

, Volume 19, Issue 6, pp 395–407 | Cite as

Condom use relative to knowledge of sexually transmitted disease prevention, method of birth control, and past or present infection

  • Jay M. Fleisher
  • Ruby T. Senie
  • Howard Minkoff
  • James Jaccard


The purpose of this study was to assess knowledge regarding STD spread and prevention, and to assess motivational and behavioral factors that influence the use of condoms to prevent STD acquisition among inner-city women at high risk for STD infection. In addition, the effect of past and/or current STD infection on a woman's knowledge of the mechanism of STD acquisition and subsequent use of a condom to prevent STD infection was explored. We utilized three inner-city clinics offering family planning or gynecologic care located in Brooklyn, New York. Our study linked clinical findings regarding current infection with chlamydia orTrichomonas vaginalis. One thousand four hundred and four sexually active black and Hispanic women participated in the study. A past history of STD (37%) or current infection (29%) was recorded for 54% of the study population (12% were positive for both past and current infection). On average, only 60% of women who reported prior treatment for STD infection reported receiving any information regarding prevention of re-infection during the course of treatment. Depending on the specific STD, from 6.8% to 42.9% of women reporting prior treatment for an STD did not know the disease they were being treated for was sexually transmitted. Condom use for disease prevention was more frequently reported by women who had previously been treated for an STD (OR=1.62, 95% CI 1.23-2.13). However, condom use for contraception was a stronger predictor of use for STD prevention. Women who relied on condoms for contraception were almost 10 times more likely to also report condom use for STD prevention relative to women who did not use condoms for contraceptive purposes (OR=9.71, 95% CI 7.0-13.5). In addition, condom use was associated with the perceived attitude of their sexual partner toward such use. Condom use to prevent STD acquisition was more than twice as frequently reported when a favorable attitude was perceived by a male sexual partner (OR=2.30, 95% CI 1.54−3.43). Our findings suggest that prevention of unplanned pregnancy was a stronger motivator for condom use than disease prevention among the women comprising our study group. The findings also indicate the need for more extensive information regarding STD prevention among women at high risk for STD acquisition. Health care providers must insure that the information they give is clear and easily understood by the patient population they serve. Health care providers must also emphasize the importance of developing behaviors that protect against both unwanted pregnancies and STD infection, and that this responsibility should be shared by both sexual partners.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Stone KM, Grimes DA, Magder LS: Primary prevention of sexually transmitted diseases.JAMA 255:1763–1766, 1986.CrossRefPubMedGoogle Scholar
  2. 2.
    Condoms for prevention of sexually transmitted diseases.MMWR, 1988 andJAMA 259: 1925–1927, 1988.Google Scholar
  3. 3.
    Trussell J, Hatcher RA, Cates W, Stewart FH, Kost K: Contraceptive failure in the United States: an update.Stud Fam Plann 21:51–54, 1990.PubMedGoogle Scholar
  4. 4.
    Mosher WD: Contraceptive practice in the United States, 1982–1988.Fam Plann Perspect 22: 198–205, 1990.PubMedGoogle Scholar
  5. 5.
    Mishell DR, Contraception.N Engl J Med 320:777–787, 1989.PubMedGoogle Scholar
  6. 6.
    Cates W: Sexually transmitted diseases and family planning: strange or natural bedfellows?J Reprod Med 29:317–322, 1984.PubMedGoogle Scholar
  7. 7.
    Hearst N, Hulley SB: Preventing the heterosexual spread of AIDS.JAMA 259:2428–2432, 1988.CrossRefPubMedGoogle Scholar
  8. 8.
    Soskolne V, Aral SO, Magder LS, Reed DS, Bowen GS: Condom use with regular and casual partners among women attending family planning clinics.Fam Plann Perspect 23:222–225, 1991.PubMedGoogle Scholar
  9. 9.
    Jaccard J, Wilson T, Endias R, Minkoff H: Use of multiple contraceptive methods and increased risk for sexually transmitted disease. Submitted for publication.Fam Plann Perspect, 1992.Google Scholar
  10. 10.
    Upchurch DM, Farmer MY, Glasser D, Hook EW: Contraceptive needs and practices among women attending an inner-city STD clinic.Am Public Health Assoc 77:1427–1430, 1987.Google Scholar
  11. 11.
    Vessey MP, Villard-Mackintosh L., McPherson K, Yeates D: Factors influencing use-effectiveness of the condom.Br J Fam Plann 14:40–43, 1988.Google Scholar
  12. 12.
    Wasser SC, Aral SO, Reed DS, Bowen GS: Assessing behavioral risk for HIV infection in family planning and STD clinics: similarities and differences.Sex Transm Dis 16:178–183, 1989.PubMedGoogle Scholar
  13. 13.
    Roter DL, Knowles N, Somerfield M, Baldwin J: Routine communication in sexually transmitted disease clinics: An observational study.Am J Public Health 80:605–606, 1990.PubMedGoogle Scholar
  14. 14.
    1989 Sexually Transmitted Diseases Treatment Guidelines.MMWR 38:Suppl S-8, September 1, 1989.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1994

Authors and Affiliations

  • Jay M. Fleisher
    • 2
  • Ruby T. Senie
  • Howard Minkoff
    • 2
  • James Jaccard
    • 1
  1. 1.University at AlbanyState University of New YorkAlbanyUSA
  2. 2.Department of Preventive Medicine & Community HealthSUNY Health Science Center at BrooklynBrooklyn

Personalised recommendations