Predictors of condom use in first sexual intercourse: a consideration of individual, situational, relational, and cohort effects

Context of First Same-Sex Condom Use and Nonuse in Young Black Gay and Bisexual Males

Despite high human immunodeficiency virus (HIV) rates among young Black men who have sex with men (YBMSM), there are limited data about condom use during first same-sex (FSS). This study sought to understand socio-contextual factors of 50 YBMSM aged 15-19 years that influenced condom use during FSS. Condom use was influenced by individual, partner, and community factors. Individual factors-recent illness or sexually transmitted infections (STI)-prompted condom use, while frequent HIV testing prompted nonuse. Partner factors-proactive encouragement from partners-prompted condom use, while trust and condom discomfort prompted nonuse. Larger community factors-such as presence of females-were key for use, while limited sexual health information combined with peers who discouraged condoms prompted nonuse. A multilevel approach may be useful in developing sexual health programming for these young men.

Black-White Differences in Sex and Contraceptive Use Among Young Women

This study examines black-white and other sociodemographic differences in young women's sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships. Black women were more likely to use less effective methods for pregnancy prevention (e.g., condoms) than white women, who tended to use more effective methods (e.g., oral contraceptives). And although the most effective method for pregnancy prevention-long-acting reversible contraception (LARC)-was used more often by black women than white women, LARC use was low in both groups. In addition, black women did not differ from white women in their number of discontinuations or different methods used and had fewer contraceptive method switches. Further, we find that net of race and adolescent experiences with sex and pregnancy, women from more-disadvantaged backgrounds had fewer and longer (and thus potentially more serious) relationships, used contraception less frequently (but not less consistently), and used less effective methods (condoms) than women from more-advantaged backgrounds.

Prevalence and predictors of condom use in a national sample of Canadian university students

Young adult Canadians of university age are highly sexually active compared to other age groups and are at relatively high risk for sexually transmitted infections (STI). It is therefore important to comprehensively assess condom use in this age group. In this study, the prevalence and individual predictors of condom use at last penile vaginal intercourse (PVI) were assessed in a national sample of 653 Canadian university students (252 male, 401 female). Overall, less than half of students (47.2%) reported condom use at last PVI. Condom use was higher among men (55.4%) than women (42.3%). For both men and women, the most frequently cited main reason for having used a condom was birth control. In multivariate analyses, the strongest predictor of condom use at last PVI was a preference for condoms as a contraceptive method; specifically, men and women who stated condoms were their preferred method were 9 and 23 times, respectively, more likely to use condoms at last PVI than those who selected another method. Female students who reported that their most recent sexual encounter occurred with a more committed partner (e.g., committed dating versus a hook-up) had slightly lower odds of reporting condom use at last PVI. The results indicated that rates of condom use are low among Canadian university students and that many students are likely at high risk for STI. Interventions to raise awareness of STIs are needed on Canadian university campuses and educational programs should emphasize improving attitudes towards condoms in addition to developing sexual health knowledge and condom use skills.