Orr D P, Langefeld C D
Department of Pediatrics, Indiana University School of Medicine, Indianapolis.
Pediatrics. 1993 May;91(5):873-9.
The purpose of this study was to identify the predictors of condom use in a population of male adolescents at risk for sexually transmitted diseases (STDs).
Cross-sectional cohort study.
Clinical sites (school-based, adolescent and STD clinics) providing reproductive health care to male adolescents in a midwestern city.
One hundred sixteen male adolescents 15 to 19 years of age were enrolled consecutively.
Subjects completed a multi-instrument questionnaire examining sexual behaviors, attitudes, and beliefs about STDs and condoms, cognitive maturity, and health risk behaviors; urethral specimens were cultured for Chlamydia trachomatis and Neisseria gonorrhoeae.
The median age was 17; 31% were white and 69% were African-American. Thirty-seven percent had urethral infections: 21% were infected with C trachomatis, 11% with N gonorrhoeae, and 5% with both organisms. More than 60% reported some experience with condoms and 23% reported condom use at last coitus. Consistent with the Health Belief Model, condom use for STD prevention was less likely among those reporting other health risk behaviors (odds ratio [OR] = 0.53; 95% confidence interval [CI] = 0.36 to 0.78; P < .001) and more STD risk behaviors (OR = 0.65; CI = 0.45 to 0.96; P = .03). Adolescents who were more highly motivated (OR = 1.58; CI = 1.09 to 2.30; P = .02) and who were more positive about condoms (OR = 1.83; CI = 1.25 to 2.68; P < .001) were more likely to report condom use for contraception. Adolescents using condoms for acquired immunodeficiency syndrome (AIDS) protection engaged in fewer behavioral (OR = .62; CI = 0.42 to 0.92; P = .02) and STD risks (OR = .67; CI = 0.45 to 0.99; P = .04). Three specific reasons for condom use were highly predictive of condom use at last intercourse: STD prevention (OR = 8.9; CI = 3.13 to 25.4; P < .001), birth control (OR = 2.1; CI = 1.05 to 4.25; P = .03), and AIDS prevention (OR = 2.4; CI = 1.05 to 5.42; P = .03).
Condom use among adolescent males is influenced by perceived benefit, namely prevention of pregnancy & avoidance of STDs including AIDS. Nonuse is associated with other risk-taking behavior.
本研究旨在确定在有性传播疾病（STD）风险的男性青少年人群中使用避孕套的预测因素。
横断面队列研究。
为中西部城市的男性青少年提供生殖健康护理的临床场所（校内、青少年及性病诊所）。
连续招募了116名年龄在15至19岁的男性青少年。
受试者完成了一份多项目问卷，调查性行为、对性病和避孕套的态度及信念、认知成熟度和健康风险行为；采集尿道标本检测沙眼衣原体和淋病奈瑟菌。
中位年龄为17岁；31%为白人，69%为非裔美国人。37%有尿道感染：21%感染沙眼衣原体，11%感染淋病奈瑟菌，5%同时感染两种病原体。超过60%报告有过使用避孕套的经历，23%报告在最近一次性交时使用了避孕套。与健康信念模型一致，在报告有其他健康风险行为的人群中，为预防性病而使用避孕套的可能性较小（优势比[OR]=0.53；95%置信区间[CI]=0.36至0.78；P<.001），且有更多性病风险行为的人群中也是如此（OR=0.65；CI=0.45至0.96；P=.03）。积极性较高的青少年（OR=1.58；CI=1.09至2.30；P=.02）以及对避孕套态度更积极的青少年（OR=1.83；CI=1.25至2.68；P<.001）更有可能报告为避孕而使用避孕套。为预防获得性免疫缺陷综合征（AIDS）而使用避孕套的青少年较少有行为风险（OR=.62；CI=0.42至0.92；P=.02）和性病风险（OR=.67；CI=0.45至0.99；P=.04）。在最近一次性交时使用避孕套的三个特定原因对使用避孕套具有高度预测性：预防性病（OR=8.9；CI=3.13至25.4；P<.001）、避孕（OR=2.1；CI=1.05至4.25；P=.03）和预防艾滋病（OR=2.4；CI=1.05至5.42；P=.03）。
青少年男性使用避孕套受到感知益处的影响，即预防怀孕和避免包括艾滋病在内的性病。不使用避孕套与其他冒险行为相关。
