Condoms for Men, Not Women

Three different brief intervention programs to promote condom use were tested among patients in inner-city sexually transmitted disease (STD) clinics. The first, "Condom Skills," focused on teaching mechanical aspects of how to use a condom. The second, "Social Influences," emphasized how to negotiate condom use with one's sexual partner. The third, "Distribution," provided patients with an unlimited number of free condoms, retrievable at local community businesses. Of the 903 subjects whose medical records were reviewed after exposure to the intervention programs, evidence of continued unsafe sexual behavior, documented by subsequent treatment for a new STD, was found for 12.6% of the women and 19.9% of the men. When compared with male control subjects, male study patients had fewer documented subsequent STD reinfections. The relative risk (RR) and 95% confidence interval (CI) values were 0.48 and 0.28, 0.81 for the condom skills group; 0.65 and 0.40, 1.04 for the social influences group; and 0.85 and 0.56, 1.29 for the distribution group. There was no decrease in the incidence of STDs among female patients compared with control subjects; indeed, there was a trend toward increased risk of STDs among women exposed to the Social Influences intervention program. This study demonstrates that brief condom promotion programs can be effective for male STD patients, and that caution must be exercised in promoting condoms to women with a high risk of acquiring STDs. Further research on programs promoting safer sex among these women is needed.