Orr D P, Langefeld C D, Katz B P, Caine V A, Dias P, Blythe M, Jones R B
Department of Pediatrics, Indiana University School of Medicine, Indianapolis.
J Pediatr. 1992 Feb;120(2 Pt 1):311-7. doi: 10.1016/s0022-3476(05)80453-6.
A health belief model of condom use was used to identify factors associated with condom use in 390 sexually active female adolescents, aged 12 through 19 years, recruited at the time of a visit for reproductive health care. Fifty-six percent were white and the remainder black. Nineteen percent had genitourinary infections with Chlamydia trachomatis. Forty-six percent reported having had more than one sexual partner in the preceding year. Reported condom use for at least one specific reason (prevention of pregnancy, sexually transmitted disease, or acquired immunodeficiency syndrome) increased as behavioral, emotional, and sexually transmitted disease risk decreased, and as cognitive maturity and positive condom attitudes increased. Although uses of condoms to prevent pregnancy, sexually transmitted disease, and acquired immunodeficiency syndrome were positively intercorrelated, each made a contribution to explaining condom use at most recent coitus (odds ratios 2.95, 3.96, and 2.81, respectively). After statistical adjustment for the reported reasons for previous condom use, behavioral risk was the only additional factor associated with condom use at the most recent sexual encounter; women who participated in more risk behaviors (substance and alcohol use and minor delinquency) were less likely to have used a condom (odds ratio 0.61). Knowledge about sexually transmitted disease and acquired immunodeficiency syndrome, and concurrent use of contraceptive pills, were not related to condom practices. The data suggest that adolescents' perceptions about condoms, including the individual functions of condoms for contraception and for prevention of sexually transmitted disease, may be important in determining their use. Engaging in unprotected intercourse may be part of a larger behavioral domain that includes other unhealthy behaviors.
一项关于避孕套使用的健康信念模型被用于识别与390名年龄在12至19岁之间、有性活动的女性青少年避孕套使用相关的因素。这些青少年是在进行生殖健康护理就诊时招募的。其中56%是白人，其余为黑人。19%患有沙眼衣原体泌尿生殖系统感染。46%的人报告在前一年有不止一个性伴侣。报告因至少一个特定原因（预防怀孕、性传播疾病或获得性免疫缺陷综合征）而使用避孕套的情况，随着行为、情绪和性传播疾病风险的降低，以及认知成熟度和对避孕套的积极态度的增加而增加。尽管使用避孕套预防怀孕、性传播疾病和获得性免疫缺陷综合征之间呈正相关，但每一项在解释最近一次性交时的避孕套使用情况方面都有贡献（优势比分别为2.95、3.96和2.81）。在对报告的先前使用避孕套的原因进行统计调整后，行为风险是与最近一次性接触时使用避孕套相关的唯一额外因素；参与更多风险行为（使用毒品和酒精以及轻微违法犯罪行为）的女性使用避孕套的可能性较小（优势比为0.61）。关于性传播疾病和获得性免疫缺陷综合征的知识以及同时使用避孕药丸与避孕套使用行为无关。数据表明，青少年对避孕套的认知，包括避孕套在避孕和预防性传播疾病方面的个体功能，可能在决定他们是否使用避孕套方面很重要。进行无保护性交可能是包括其他不健康行为在内的更大行为领域的一部分。
