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Systematic Assessment of Condom Use Measurement in Evaluation of HIV Prevention Interventions: Need for Standardization of Measures

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Abstract

When evaluating HIV prevention interventions, condom use is a common outcome measure used to assess changes in HIV-related behaviors; however, no widely accepted standards exist for its measurement. Using systematic review data on HIV prevention interventions conducted in low- and middle-income countries, we examined trends in condom use measurement since 1990. We abstracted data from standardized forms on six dimensions of condom use: partner type, temporal period, measurement scale, consistency, controlling for abstinence, and type of sex. Of 215 studies reviewed, 109 studies (51 %) measured condom use as a primary outcome. Outcomes were stratified by partner type in 47 studies (43 %). Assessing condom use at last sex was the most common measurement. Consistency of condom use was assessed in 47 studies (43 %). Developing and utilizing standards for condom use measurement would increase comparability of findings across studies and benefit HIV prevention research. Recommendations include measuring condom use at last sex, frequency of condom use, and number of protected sex acts in studies evaluating the efficacy of behavioral interventions on sexual risk behavior.

Resumen

A evaluar intervenciones preventivas de VIH, el uso del condón es una medida de resultado común usada para evaluar cambios en comportamientos relacionados con el VIH; sin embargo, normas bien aceptadas no existen para medir el uso del condón. Usar datos de revistas sistemáticas sobre evaluaciones de intervenciones preventivas de VIH hechas en países de bajo- y medio-ingreso, examinamos tendencias en las medidas del uso del condón desde 1990. Abstraemos datos de formas estandarizadas en seis medidas del uso del condón: tipo de pareja, período temporal, escala de medición, consistencia, controlar por abstinencia, y tipo de sexo. De 215 estudios revistos de intervención, 109 estudios (51 %) midieron el uso de condón como resultado primario. Resultados fueron estratificados por tipo de pareja en 47 estudios (43 %). Evaluar el uso de condón al último acto de sexo fue la medida más común. Consistencia del uso de condón fue evaluado en 47 estudios (43 %). Desarrollar y utilizar normas para medición del uso de condón ampliaría comparabilidad de resultados a través de estudios y beneficiaría investigación de la prevención de VIH. Recomendaciones incluyen medir el uso del condón al último acto de sexo, frecuencia del uso de condón, y el número de actos de sexo protegidos en estudios que evalúan la eficacia de intervenciones de comportamiento del riesgo sexual.

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Acknowledgments

This research was supported by the US National Institute of Mental Health, Grant R01 MH090173. The authors thank all previous Evidence Project coders and Dashia Pennington, Samantha Herrera, Jewel Gausman, Jeremy Lapedis, Erica Koegler, and Jenny Tighe for their help abstracting data for this review. The authors also thank Jenny Tighe for translating the abstract into Spanish and Sarah Robbins for reviewing the manuscript.

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Authors and Affiliations

  1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E5037, Baltimore, MD, 21205, USA

    Virginia A. Fonner & Caitlin E. Kennedy

  2. Department of HIV/AIDS, World Health Organization, Geneva, Switzerland

    Kevin R. O’Reilly

  3. Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, SC, USA

    Michael D. Sweat

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  1. Virginia A. Fonner
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  2. Caitlin E. Kennedy
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Correspondence to Virginia A. Fonner.

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Fonner, V.A., Kennedy, C.E., O’Reilly, K.R. et al. Systematic Assessment of Condom Use Measurement in Evaluation of HIV Prevention Interventions: Need for Standardization of Measures. AIDS Behav 18, 2374–2386 (2014). https://doi.org/10.1007/s10461-013-0655-1

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