Does it fit okay? Problems with condom use as a function of self-reported poor fit

This is an open access article - Copyright © 2010 by the BMJ Publishing Group Ltd. All rights reservedOBJECTIVE: To identify associations between men's self-reports of ill-fitting condoms and selected condom use problems, using an event-specific analysis. METHODS: A convenience sample of men was recruited via advertisements in newspapers (two urban and one small town) and a blog on the website of a condom sales company. Men completed a questionnaire posted on the website of The Kinsey Institute for Research in Sex, Gender, and Reproduction. Inclusion criteria were: at least 18 years old, used condoms for penile–vaginal intercourse in the past 3 months and the ability to read English. RESULTS: In controlled, event-specific, analyses of 436 men, those reporting ill-fitting condoms (44.7%) were significantly more likely to report breakage (adjusted odds ratio (AOR 2.6), slippage (AOR 2.7), difficulty reaching orgasm, both for their female partners (AOR 1.9) and for themselves (AOR 2.3). In addition, they were more likely to report irritation of the penis (AOR 5.0) and reduced sexual pleasure, both for their female partner (AOR 1.6) and for themselves (AOR 2.4). Furthermore, they were more likely to report that condoms interfered with erection (AOR 2.0), caused erection loss (AOR 2.3), or became dry during sex (AOR 1.9). Finally, they were more likely to report removing condoms before penile–vaginal sex ended (AOR 2.0). CONCLUSIONS: Men and their female sex partners may benefit from public health efforts designed to promote the improved fit of condoms.Support for this project was provided, in part, by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, University of Colorado, and the University of Kentucky and by The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University

Turning on and turning off: A focus group study of the factors that affect women's sexual arousal

This is a post print version of the article. The official published version can be accessed from the link below.The aim of this study was to inform the development of a questionnaire to assess a woman's tendency to respond with sexual excitation/inhibition in different situations. Nine focus groups, involving 80 women (M age = 34.3 years; range, 18-84), were conducted. Women described a wide range of physical (genital and nongenital), cognitive/emotional, and behavioral cues to arousal. The relationship between sexual interest (desire) and sexual arousal was complex; sexual interest was reported as sometimes preceding arousal, but at other times following it. Many women did not clearly differentiate between arousal and interest. Qualitative data on the factors that women perceived as enhancers and inhibitors of sexual arousal are presented, with a focus on the following themes: feelings about one's body; concern about reputation; unwanted pregnancy/ contraception; feeling desired versus feeling used by a partner; feeling accepted by a partner; style of approach/initiation; and negative mood. The findings can help inform conceptualizations of sexual arousal in women.This research was funded (in part) by a grant from the Lilly Centre for Women‟s Health

Is phosphodiesterase type 5 inhibitor use associated with condom breakage?

This is an open access article - Copyright © 2009 by the BMJ Publishing Group Ltd. All rights reserved.We tested the hypothesis that phosphodiesterase type 5 inhibitor (PDE5i) use would be associated with increased likelihood of condom breakage using an event-specific analysis. A convenience sample of 440 men completed an internetbased questionnaire that assessed variables pertaining to the last time they used condoms for penile-vaginal intercourse (PVI). A bivariate (screening) analysis was performed to identify covariates for a multivariate analysis using logistic regression. Altogether, 5.9% of the men reported breakage and 9.5% reported PDE5i use during the last time a condom was used for PVI. Among men who had used PDE5i during the last condom-protected occasion of PVI, 11.9% reported breakage compared with 5.3% of those not reporting PDE5i use. Adjusting for men’s age, ethnic minority status, marital status, reported duration of PVI and alcohol use at last PVI, those using PDE5i were about four times more likely to also report condom breakage (AOR 4.02; 95% CI 1.20 to 13.48; p=0.04). Of note, duration of PVI was independently associated with breakage (AOR 1.36; CI 1.02 to 1.83; p=0.04). Findings suggest that PDE5i use may potentially be associated with increased odds of condom breakage among some men.Support for this project was provided, in part, by the Rural Center for AIDS/ STD Prevention, a joint project of Indiana University, University of Colorado and the University of Kentucky, and by The Kinsey Institute, Indiana University

If the condom fits, wear it: a qualitative study of young African-American men

This is an open access article - Copyright @ 2004 BMJ Publishing GroupObjective: To extend the current knowledge base pertaining to condom failure among young African-American men by assessing their experiences with male condom use. Methods: Qualitative assessments were conducted with 19 African-American men (aged 18–29 years) who had just been diagnosed with an STI and reported using condoms in the previous 3 months. Results: Five categories were identified from the data. These categories pertained to: (1) the “fit and feel” of condoms; (2) condom brand and size; (3) application problems; (4) availability of condoms and lubricants; and (5) commitment to condom use. Common themes included reasons why men believed condoms would break or slip off during sex. Comfort problems, including tightly fitting condoms and condoms drying out during intercourse, were mentioned frequently. Condom associated erection problems were often described. Many men also noted that condom use reduced the level of sexual satisfaction for their female partners. Men noted that finding the right kind of condom was not always easy and it became apparent during the interviews that men typically did not acquire lubrication to add to condoms. Despite their expressed problems with using condoms, men were, none the less, typically emphatic that condom use is an important part of their protective behaviour against STIs. Conclusion: Men were highly motivated to use condoms; however, they experienced a broad range of problems with condom use. With the exception of losing the sensation of skin to skin contact, the vast majority of these problems may be amenable to behavioural interventions.This study was funded by a grant from the National Institutes of Mental Health (1 R21 MH066682-01A1)

Two heads are better than one: The association between condom decision-making and condom use errors and problems

This is an open access article - Copyright @ 2008 BMJ Publishing GroupObjectives: This exploratory study compared the frequency of condom use errors and problems between men reporting that condom use for penile–vaginal sex was a mutual decision compared with men making the decision unilaterally. Methods: Nearly 2000 people completed a web-based questionnaire. A sub-sample of 660 men reporting that they last used a condom for penile–vaginal sex (within the past three months) was analysed. Nine condom use errors/problems were assessed. Multivariate analyses controlled for men’s age, marital status, and level of experience using condoms. Results: Men’s unilateral decision-making was associated with increased odds of removing condoms before sex ended (adjusted odds ratio (AOR) 2.51, p=0.002), breakage (AOR 3.90, p=0.037), and slippage during withdrawal (AOR 2.04, p=0.019). Men’s self-reported level of experience using condoms was significantly associated with seven out of nine errors/problems, with those indicating less experience consistently reporting more errors/problems. Conclusions: Findings suggest that female involvement in the decision to use condoms for penile–vaginal sex may be partly protective against some condom errors/problems. Men’s self-reported level of experience using condoms may be a useful indicator of the need for education designed to promote the correct use of condoms. Education programmes may benefit men by urging them to involve their female partner in condom use decisions.Funding for this project was provided by the Canada Research Chair in Social Justice and Sexual Health at the University of Windsor, and the Rural Center for AIDS/STD Prevention and The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University

Men with broken condoms: Who and why?

This is an open access article - Copyright @ 2007 BMJ Publishing GroupObjectives: To identify (1) the prevalence of condom breakage, and demographic and sexuality-related differences among young men who have sex with women reporting and not reporting this event; (2) condom-specific behaviours associated with breakage. Methods: Young men (n=278) attending a clinic for treatment of sexually transmitted infections (STIs) responded to an anonymous questionnaire aided by a CD recording of the questions. The samples were screened to include only men who had used a condom during penile–vaginal sex at least three times in the past 3 months. Condom-specific behaviours (including breakage) were assessed using these last three acts of condom use as the recall period. Correlates achieving bivariate significance were subjected to multivariate analysis. Results: Nearly one third (31.3%) of the men reported recent breakage. The breakage rate was 15%. Three correlates significantly distinguished between men who did and did not report breakage. Men who had past STIs were more likely to report breakage (adjusted odds ratio (AOR) 2.08), as were men who also reported condom slippage (AOR 2.72). Less self-efficacy for correct condom use was also significantly associated with breakage (AOR 1.07). Further, three condom-specific behaviours were significantly associated with breakage: allowing condoms to contact sharp objects (AOR 2.6), experiencing problems with the “fit or feel” of condoms (AOR 2.3) and not squeezing air from the receptacle tip (AOR 2.0). Conclusions: Breakage may be common and may occur in a larger context of difficulties with condoms. STI clinics could potentially benefit some men by providing instructions on the correct use of condoms.Financial Support for this project was provided by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, University of Colorado and University of Kentucky, and the Office of the Associate Dean of Research, School of Health, Physical Education, and Recreation, Indiana University

Cosmology with redshift surveys of radio sources

We use the K-z relation for radio galaxies to illustrate why it has proved difficult to obtain definitive cosmological results from studies based entirely on catalogues of the brightest radio sources, e.g. 3C. To improve on this situation we have been undertaking redshift surveys of complete samples drawn from the fainter 6C and 7C radio catalogues. We describe these surveys, and illustrate the new studies they are allowing. We also discuss our `filtered' 6C redshift surveys: these have led to the discovery of a radio galaxy at z=4.4, and are sensitive to similar objects at higher redshift provided the space density of these objects is not declining too rapidly with z. There is currently no direct evidence for a sharp decline in the space density of radio galaxies for z > 4, a result only barely consistent with the observed decline of flat-spectrum radio quasars.Comment: 8 pages Latex, To appear in the "Cosmology with the New Radio Surveys" Conference - Tenerife 13-15 January 199

Planning and Finance How CERs give project developers a competitive advantage under the REIPPP

The South African government has pledged to reduce its total annual GHG emissions by 34% below its business-as-usual trajectory by 2020. One of the incentive instruments the government has put in place to realise this objective is the REIPPP, a competitive bidding process whereby the lowest bidders are awarded long term power purchase agreements at the offered price in R/MWh. One way of improving a project's competitive edge is via the cross subsidising of its REIPPP bidding price with the revenue stream from the sale of CERs it can generate under the CDM. Now that the third bidding round under the REIPPP is in full swing and rounds 4, 5 and 6 have been announced, project developers are investigating all possible avenues to find a competitive edge. Cross subsidising will allow a project to bid at a price that is between 9% and 27% lower than it would be able to do without the CER revenue stream. Registering a REIPPP project under the CDM therefore becomes a must if a project wants to stand any chance in the competitive bidding process

Acoustic sources and far-field noise of chevron and round jets

This paper investigates numerically the acoustic sources and far-field noise of chevron and round jets. The acoustic sources are described by the fourth-order space–time velocity cross correlations, which are calculated based on a large-eddy simulation flowfield. Gaussian functions are found to fit the axial, radial, and azimuthal cross correlations reasonably well. The axial length scales are three to four times the radial and azimuthal length scales. For the chevron jet, the cross-correlation scales vary with azimuthal angle up to six jet diameters downstream; beyond that, they become axisymmetric like those for a round jet. The fourth-order space–time cross correlation of the axial velocity R_1111 is the dominant source component, and there are considerable contributions from other source components such as R_2222, R_3333, R_1212, R_1313, and R_2323 cross correlations where 1, 2, and 3 represent axial, radial, and azimuthal directions, respectively. For the chevron jet, these cross correlations decay rapidly with axial distance whereas for the round jet, they remain roughly constant over the first 10 jet diameters. The chevron jet intensifies both the R_2222 and R_3333 cross correlations within two jet diameters of the jet exit. The amplitude, length, and time scales of the cross-correlations of a large-eddy simulation velocity field are investigated as functions of position and are found to be proportional to the turbulence amplitude, length, and time scales that are determined from a Reynolds-averaged Navier–Stokes calculation. The constants of proportionality are found to be independent of position within the jet, and they are quite close for chevron and round jets. The scales derived from Reynolds-averaged Navier–Stokes are used for source description, and an acoustic analogy is used for sound propagation. There is an excellent agreement between the far-field noise predictions and measurements. At low frequencies, the chevron nozzle significantly reduces the far-field noise by 5–6 dB at 30 deg and 2–3 dB at 90 deg to the jet axis. However, the chevron nozzle slightly increases high-frequency noise. It was found that R_1212 and R_1313 cross correlations have the largest contribution to the jet noise at 30 deg to the jet axis, whereas the R_2323 cross correlation has the largest contribution to the jet noise at 90 deg to the jet axis. The Reynolds-averaged Navier–Stokes calculations are repeated with different turbulence models, and the noise prediction is found to be almost insensitive to the turbulence model. The results indicate that the modeling approach is capable of assessing advanced noise-reduction concepts.Depuru Mohan expresses his sincere gratitude to St John’s College, University of Cambridge, for the award of a Manmohan Singh Scholarship; as well as Cambridge Commonwealth, European, and International Trust for the award of an Honorary Cambridge International Scholarship. S. A. Karabasov wishes to thank the Royal Society of London for the award of a University Research Fellowship. H. Xia acknowledges the computational time on the European High Performance Computing systems, Partnership for Advanced Computing in Europe, under project 2010PA0649. The authors are grateful to J. Bridges, C. Brown, N. Georgiadis, and J. DeBonis of the NASA John H. Glenn Research Center for providing the experimental data

Potent single-domain antibodies that arrest respiratory syncytial virus fusion protein in its prefusion state

Human respiratory syncytial virus (RSV) is the main cause of lower respiratory tract infections in young children. The RSV fusion protein (F) is highly conserved and is the only viral membrane protein that is essential for infection. The prefusion conformation of RSV F is considered the most relevant target for antiviral strategies because it is the fusion-competent form of the protein and the primary target of neutralizing activity present in human serum. Here, we describe two llama-derived single-domain antibodies (VHHs) that have potent RSV-neutralizing activity and bind selectively to prefusion RSV F with picomolar affinity. Crystal structures of these VHHs in complex with prefusion F show that they recognize a conserved cavity formed by two F protomers. In addition, the VHHs prevent RSV replication and lung infiltration of inflammatory monocytes and T cells in RSV-challenged mice. These prefusion F-specific VHHs represent promising antiviral agents against RSV