Murphy J J, Boggess S
Population Studies Center, Urban Institute, Washington, DC.
Fam Plann Perspect. 1998 Nov-Dec;30(6):276-80, 303.
Understanding whether and to what degree changes in young men's attitudes explain increases in condom use over time can be useful in developing more effective disease prevention strategies.
Data from the 1988 and the 1995 National Survey of Adolescent Males are used to determine changes in attitudes toward condoms, pregnancy prevention and HIV and AIDS. Two-limit tobit models are employed to investigate the association between these attitudes and condom-use behavior and to examine how this relationship may have changed over time.
Between 1988 and 1995, young men's attitudes toward partner appreciation of condom use, condom-use embarrassment and pleasure reduction from condom use all changed in a direction suggestive of more consistent condom use. However, attitudes related to pregnancy prevention and AIDS avoidance changed in a direction suggestive of less-consistent condom use. Changes over time in the strength of the relationship between three attitude measures (masculinity, pleasure reduction and partner appreciation) and condom use also were predictive of lower levels of condom-use consistency. Only the strength of the relationship between condom-use embarrassment and consistent condom use changed in a direction corresponding to observed increases in rates of condom use among young men.
Many of the significant changes in young males' attitudes toward condoms do not explain the increase in consistent condom use among adolescent males that occurred between 1988 and 1995. However increasing male contraceptive responsibility and emphasizing the risks and consequences of contracting HIV appear to be viable routes for policymakers to explore. Efforts particularly need to be targeted toward Hispanics.
了解年轻男性态度的变化是否以及在多大程度上解释了随着时间推移避孕套使用的增加，对于制定更有效的疾病预防策略可能是有用的。
利用1988年和1995年全国青少年男性调查的数据来确定对避孕套、预防怀孕以及艾滋病毒和艾滋病态度的变化。采用双限托比特模型来研究这些态度与避孕套使用行为之间的关联，并考察这种关系可能如何随时间变化。
在1988年至1995年期间，年轻男性对伴侣对使用避孕套的认可、使用避孕套时的尴尬以及使用避孕套导致的快感降低等方面的态度都朝着更一致使用避孕套的方向转变。然而，与预防怀孕和避免感染艾滋病相关的态度却朝着不太一致使用避孕套的方向转变。三种态度指标（男子气概、快感降低和伴侣认可）与避孕套使用之间关系强度随时间的变化也预示着避孕套使用的一致性水平较低。只有使用避孕套时的尴尬与持续使用避孕套之间关系的强度朝着与年轻男性中观察到的避孕套使用率增加相一致的方向变化。
年轻男性对避孕套态度的许多显著变化并不能解释1988年至1995年间青少年男性持续使用避孕套的增加情况。然而，增加男性的避孕责任并强调感染艾滋病毒的风险和后果似乎是政策制定者可以探索的可行途径。尤其需要针对西班牙裔群体做出努力。
