Department of Health Outcomes and Policy, College of Medicine, and the Institute for Child Health Policy, University of Florida, Gainesville, Florida.
J Adolesc Health. 2013 Dec;53(6):742-8. doi: 10.1016/j.jadohealth.2013.06.020. Epub 2013 Aug 8.
The influence of partner context (e.g., drinking alcohol in the 2 hours prior to sex, ≥3 years age discordant, met in public) on adolescent boys' and girls' condom use is unclear. Among an urban cohort of primarily (86%) minority 17-18-year-olds who reported having sex (n = 1,469), we assessed the association between condom use and partner characteristics for the most recent sexual experience.
We used logistic regression to examine the odds of condom use by measured partner familiarity (casual or unexpected) and context characteristics. Analyses were stratified by gender.
Adolescent boys and girls were twice as likely to use condoms with partners they considered casual or unexpected. Adjusting for partner familiarity risk, adolescent boys' tended to decrease condom use with risky context partners. Adjusting for partner familiarity risk, adolescent girls were half as likely to use condoms with partners drinking alcohol 2 hours prior to sex [Odds Ratio (OR) = .6, 95% Confidence Interval (CI) = .4-.9]; ≥3 years age discordant (OR = .5, 95% CI = .3-.8); or met in public places (OR = .6, 95% CI = .4-.8).
Regardless of partner familiarity risk, adolescent boys and girls faced barriers to condom use with risky context partners. Increased understanding of adolescents' perceptions of and control over partner risk and condom use with risky context partners is needed. Interventions aimed at decreasing adolescent sexually transmitted infections should include strategies for adolescents to choose less risky context partners and negotiate condoms with risky context partners.
伴侣背景（例如，在性行为前 2 小时内饮酒、年龄相差 ≥3 岁、在公共场所相识）对青少年男孩和女孩使用避孕套的影响尚不清楚。在一个主要由（86%）少数族裔 17-18 岁青少年组成的城市队列中，他们报告有过性行为（n=1469），我们评估了最近一次性经历中避孕套使用与伴侣特征之间的关联。
我们使用逻辑回归检查了与衡量的伴侣熟悉度（偶然或意外）和背景特征相关的避孕套使用几率。分析按性别分层。
与他们认为偶然或意外的伴侣发生性行为时，青少年男孩和女孩使用避孕套的可能性是两倍。在调整了伴侣熟悉度风险后，青少年男孩与有风险的伴侣发生性行为时使用避孕套的可能性降低。在调整了伴侣熟悉度风险后，与饮酒 2 小时前发生性行为的伴侣（OR=0.6，95%置信区间（CI）=0.4-0.9）、年龄相差 ≥3 岁的伴侣（OR=0.5，95%CI=0.3-0.8）或在公共场所相识的伴侣（OR=0.6，95%CI=0.4-0.8）相比，青少年女孩使用避孕套的可能性降低了一半。
无论伴侣熟悉度风险如何，青少年男孩和女孩在与有风险背景的伴侣发生性行为时都面临着使用避孕套的障碍。需要进一步了解青少年对伴侣风险的看法以及对有风险的背景伴侣使用避孕套的控制。旨在减少青少年性传播感染的干预措施应包括减少青少年选择风险较高的伴侣并与有风险的伴侣协商使用避孕套的策略。
