Female condom skill and attitude: Results from a NIDA Clinical Trials Network gender-specific HIV risk reduction study.

The female condom is effective in reducing unprotected sexual acts; however it remains underutilized in the U.S. This study, part of the National Drug Abuse Treatment Clinical Trials Network protocol CTN-0019 (“Reducing HIV/STD Risk Behaviors: A Research Study for Women in Drug Abuse Treatment”), examined whether a 5-session HIV prevention intervention (Safer Sex Skills Building (SSB)), including presentation, discussion, and practice with female condoms, improved female condom skills and attitude among women in outpatient substance abuse treatment. Mixed-effects modeling was used to test the effect SSB on skills and attitude over 3- and 6-month post-treatment among 515 randomized women. SSB was significantly associated with increases in skills and attitude, and the female condom demonstration session was primarily responsible for skills improvement. Attitude was a partial mediator of the intervention effect in reducing unprotected sex.

Findings emphasize the utility of integrating female condom messages targeting proximal behavioral outcomes into HIV prevention. Female condoms should be visible and available in treatment programs and other places women frequent and discussion about female condoms should be integrated into group and individual counseling. This study supports the importance of brief, hands-on exercises for female condom skill instruction, as well as further research to enhance attitudinal change to reduce sexual risk.

Related protocols: CTN-0019