Developmental changes in condom use among urban adolescent females: influence of partner context.

PURPOSE

National surveys have found that the percentage of female adolescents who report condom use at last sex differs by age group. Using longitudinal data, the authors examined whether there are longitudinal changes in condom use and whether these changes are due in part to developmental changes in the types of sexual relationships in which young women are involved.

METHOD

A clinic sample of 298 African American female adolescents aged 14-19 years at enrollment were interviewed every 6 months for a period of 36 months. At each interview, participants were asked to name all their recent sex partners, to classify each partner as main or casual, and to report whether a condom was used at last sex with each of these partners. Hierarchical generalized linear modeling was used to analyze repeated measures within individuals.

RESULTS

On average, there was no statistically significant change in condom use over time. The odds of having a single main partner increased by 4% for each 6 months spent in the study (odds ratio: 1.04%, 95% confidence interval: 1.02-1.05). Stratifying females by longitudinal relationship patterns resulted in three distinct condom use trajectories.

CONCLUSION

Data suggest that longitudinal changes in condom use are a function of developmental changes in relationships, whereby young women trend toward monogamous relationships. As condoms are abandoned within these monogamous relationships, lowering infection rates in sex partners through broader sexually transmitted infections screening or through community-level interventions aimed at sex networks might prove to be a more effective approach to reduce sexually transmitted infections risk in young women.