Feasibility study of the Home-based Exercises for Responsible Sex (HERS) intervention to promote correct and consistent condom use among young women

Abstract

Background: Male condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. KIHERS is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of the intervention with young women aged 16-25 in the UK (HERSUK). Methods: A repeated measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 & T3), conducted four weeks and eight weeks post intervention over a 3-month period. Ten process evaluation interviews were conducted post intervention. Results: Fifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for vaginal or anal intercourse in the past 4 weeks, increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for vaginal or anal intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach’s alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention. Conclusions: HERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided early indication of potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost effectiveness of this intervention, in a large scale controlled trial using a diverse sample and targeting young women most at risk of STIs.