For the first time, sexual intercourse is the most common mode of transmission of HIV infection in women in the United States. Therefore, there is an imperative for a female-controlled barrier methods of protection. Although early reports indicated acceptability of the female condom (Reality), reports of its drawbacks have recently appeared in the lay press. In an effort to promote increased use of female condoms, the specific aims of this study will be to; 1) identify women's reactions, experiences and sensations to initial use of the female condom, and 2) test the usefulness of providing information to women about likely reactions, experiences and sensations and ways of dealing with these reactions as means of overcoming initial negative responses to the female condom. In the phase one, sixty women who will be recruited to use the female condom for the first time will be asked about their reactions, experiences, and sensations with its initial use. These will be used as the basis for an intervention designed to inform women about what reactions, experiences, and sensations they can expect when first using the female condom and that strategies might be useful in dealing with these experiences. In phase two, an experimental design will be used to compare the use of female condoms of 64 women who receive information about these expected reactions, experiences, and sensations and strategies to address these reactions to their use by 64 women who receive only factual, procedural information about insertion, removal and disposal of the condom. A sample of 160 subjects will initially be recruited to assure an adequate sample size. Women will be randomly assigned to either the control group or the experimental g roup. Information will be provided to the control and experimental groups by written materials and audiovisual tape. Thirty days after the educational program is presented, questionnaires will be sent ot he subjects. Descriptive and inferential statistical analyses will be used to examine the differences in the groups' reported use or non-use of female condoms, frequency of use, use or non-use of other barrier methods when female condoms are not used and their intentions to continue to use them. This study is expected to provide information about eh usefulness of strategies designed to minimize negative reactions to initial use of female condoms and promote their continued use. This study is part of a long-term research program that has the long term goal of reducing transmission of HIV/AIDS and other STDs to women by promoting the practice of safer sexual behaviors. The MBRS students participation in all phases of this study is expected to contribute to their motivation ot enter a career in biomedical research, on the basis that they will recognize the contribution of their research toward the saving of lives of women by preventing the spread of HIV/AIDS.
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