title: Initial and sustained female condom use among low-income urban U.S. women.
abstract: OBJECTIVE
  The female condom (FC), an effective barrier method for HIV/sexually transmitted infection (STI) prevention, continues to be absent from most community settings, including reproductive health and treatment clinics. Reducing or eliminating basic barriers, including lack of awareness, knowledge of proper use, and access to free samples, may significantly increase use among those who want or need them.
  
  
  METHODS
  A prospective cohort of 461 women in Hartford, Connecticut (2005-2008), was interviewed at baseline, 1 month, and 10 months about FC use and other personal, partner, peer, and community factors. All participants received brief demonstration of FC use and four free FC1 at baseline. Pairwise longitudinal tests and structural equation modeling were used to test predictors of initial (1 month) and sustained (10 month) FC use.
  
  
  RESULTS
  Although only 29% of the sample reported ever having used FC at baseline, 73% of never users (51% of the returned 1-month sample) had initiated FC use by 1 month after receiving the brief intervention. Additionally, 24% of the returned 10-month sample (30% of 10-month FC users) reported sustained use, measured as having used FC at baseline or 1 month and also in the prior 30 days. General latent variable modeling indicated that FC knowledge and attitudes predicted initiating FC use; male condom use, FC knowledge and attitudes, and network exposure to FC information predicted sustained use.
  
  
  CONCLUSIONS
  Findings indicated that many women will potentially initiate and continue using FC when basic barriers are removed. Brief FC education with free trial samples should be built into standard clinical practice and public health programs.
authors.affiliation: Institute for Community Research, Hartford, Connecticut, USA. mweeks@icrweb.org
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Weeks
authors.forename: Emil
authors.initials: E
authors.lastname: Coman
authors.forename: Helena
authors.initials: H
authors.lastname: Hilario
authors.forename: Jianghong
authors.initials: J
authors.lastname: Li
authors.forename: Maryann
authors.initials: M
authors.lastname: Abbott
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D019111:Single-Use Internal Condom / Q000706:statistics & numerical data*; D003237:Connecticut; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D011203:Poverty; D011446:Prospective Studies; D021841:Safe Sex; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control* / Q000635:transmission; D013997:Time Factors; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult