Decision making over condom use during menses to avert sexually transmissible infections
Richard A. Crosby A B C J K , Cynthia A. Graham A B D , Stephanie A. Sanders A B E , William L. Yarber A B E F , Marija V. Wheeler G , Robin R. Milhausen A B H and Virginia J. Vitzhum A G IA The Kinsey Institute, Indiana University, Bloomington, IN 47408, USA.
B Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN 47408, USA.
C Department of Health Behavior, University of Kentucky, Lexington, KY 40506, USA.
D Department of Psychology, University of Southampton, University Road, Southampton SO17 IBJ, UK.
E Department of Gender Studies, Indiana University, Bloomington, IN 47405, USA.
F School of Public Health, Indiana University, Bloomington, IN 47405, USA.
G Clue by BioWink GmbH, Adalbertstraße 8, D-10999, Berlin, Germany.
H Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, ON N16 2WI, Canada.
I Department of Anthropology, Indiana University, Bloomington, IN 47405, USA.
J Present address: College of Public Health, 111 Washington Avenue, Lexington, KY 40506, USA.
K Corresponding author. Email: crosbyr3@gmail.com
Sexual Health 16(1) 90-93 https://doi.org/10.1071/SH18136
Submitted: 27 July 2018 Accepted: 21 September 2018 Published: 11 January 2019
Abstract
Background: The aim of this study was to test the hypothesis that receptive partners in penile–vaginal intercourse (PVI) who exercise independent decision making over condom use during menses do so to avert sexually transmissible infection (STI) transmission or acquisition. Methods: Data were collected through a partnership with Clue, the industry-leading female health app. A brief web-based questionnaire was developed, translated into 10 languages, and made accessible via a URL link sent to Clue users and posted on social media. Inclusion criteria were: age ≥14 years, not being currently pregnant and engaging in PVI and condom use during menses in the past 3 months. The analytical subsample comprised 12 889 respondents residing in 146 countries. Results: Twenty per cent indicated independent decision making about condom use during menses. Independent decision making was associated with lower odds of reporting that condoms were used for contraception (adjusted odds ratio (aOR) 0.65; 99% confidence interval (CI) 0.57–0.73) and higher odds that they were used for the prevention of STIs (aOR 1.44; 99% CI 1.28–1.61). A third significant finding pertained to always using condoms during menses; this was less likely among those indicating independent (female only) decision making (aOR 0.69; 99% CI 0.62–0.78). Non-significant associations with another two outcomes were found: protecting the partner against menstrual blood and protecting themselves against semen. Conclusions: Findings from people in 146 countries strongly support the hypothesis that those exercising independent decision making over condom use during menses do so to avert STI transmission or acquisition. That only one-fifth of this global sample reported this type of independent decision making suggests that empowerment-oriented (structural-level) interventions may be advantageous for individuals who are the receptive partner in PVI that occurs during menses.
Additional keywords: condoms, global, menstruation, sexually transmitted infections, women.
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