Decision making over condom use during menses to avert sexually transmissible infections

Abstract

Objective: 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 STI transmission/acquisition. Methods: Data were collected through a partnership with Clue, the industry-leading female healthapp. 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 or older, not being currently pregnant, and engaging in penile-vaginal intercourse (PVI) and condom use during menses in the past 3 months. The analytic sub-sample comprised 12,889 respondents residing in 146 countries. Results: Twenty percent 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 (AOR=.65; 99% CI=.57-.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=.69; 99% CI=.62-.78). Non-significant associations with two other outcomes occurred: protecting the partner against menstrual blood, and protecting themselves against semen. Conclusion: Findings from persons in 146 countries strongly support the hypothesis that those exercising independent decision-making over condom use during menses do so to avert STI transmission/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.