(P31) Interventions promoting condom use among young heterosexual people: a systematic review

Background: In many European and other high-income, Western countries, condom use has been decreasing among youth; a group that is often disproportionally affected by sexually transmitted infections (STIs). A variety of promotional strategies to increase condom use exists. Our systematic review aimed to identify effective elements in interventions aimed at increasing condom use in heterosexual youth.

Methods: We searched databases (2010-2021) for intervention studies that promote condom use among young (16-29), heterosexual people in Western, high-income countries. The primary outcome was condom use, the secondary outcome was STI diagnoses. For each intervention, we extracted data on each comparison of the intervention for different periods of follow-up time and different outcome measures. Effectiveness per intervention was defined based on the percentage of comparisons that showed a significant increase (p-value < 0.05) in condom use and, if applicable, a significant decrease in STIs. We compared the (median values of) effectiveness of interventions targeted at different populations (e.g., age of the participants), that had different intervention characteristics (e.g., mode of delivery) and different methodological characteristics (e.g., study design).

Results: We included 74 papers describing 85 interventions in the review. Overall, the median intervention effectiveness was 33.3% (IQR = 0% - 66.7%) for condom use and 0% (IQR = 0% - 100%) for STI diagnoses. We found no significant differences in intervention effectiveness for the analyzed characteristics, besides for the targeted sex of the intervention. Intervention effectiveness for condom use was significantly higher in interventions tailored towards females and males specifically, compared with interventions applied to both sexes combined.



Conclusions: Our findings show the difficulty in designing effective interventions to increase condom use among young people. Interventions aimed at either females or males were more effective in increasing condom use, suggesting that future interventions aiming to increase condom use should take sex- and gender differences into account.