HIV Prevention: Gender differences in condom skills among Severely Mentally Ill (SMI) Adults Who Abuse Alcohol and Other Drugs (AOD)

Abstract: This study analyzed gender differences in condom skills among a cohort of severely mentally ill (SMI) adults. SMI adults engage in high-risk sex activities that increase their vulnerability to HIV/AIDS. Although condom use has been a key element of risk reduction among SMI much is still unknown about gender-related differences in condom skills for this population. Gender based differences make women more susceptible to infection. Purpose of this study is to show whether gender should be taken into account in program design.

Methods: Baseline data examined for 126 male and 159 female, inner city, culturally diverse (17.2% Hispanic, 55.4% African-American, 23.5% Caucasian, 2.1% Other) alcohol and drug abusing SMI adults in an ongoing NIH-funded HIV prevention program (n=285). A direct measure of condom use skills was adapted from Exner et al., 1993. Frequencies, cross-tabs, T-tests, and chi square comparisons were used to explore gender differences in condom skills.

Results: Significant associations between gender and condom skills (F = 20.70, df = 1, p = .012). Specifically, women significantly more likely to be skilled than men in: rolling condom onto the penis, removing air from condom and leaving space at tip of condom for ejaculation (all p < .05).

Conclusion: Knowledge and skills combined have higher impact in effectuating behavioral change. Consistent and correct use of condoms is a proven method of reducing sexually transmitted infections. This study showed significant gender differences on condom skills. Future designs of programs for SMI should take gender into account in program design.