Identification of strategies for promoting condom use: a prospective analysis of high-risk African American female teens.
Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, Georgia 30322, USA. rcrosby@sph.emory.edu
Richard A
RA
Crosby
Ralph J
RJ
DiClemente
Gina M
GM
Wingood
Laura F
LF
Salazar
Kathy
K
Harrington
Susan L
SL
Davies
M Kim
MK
Oh
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D011446:Prospective Studies; D012725:Sexual Behavior / Q000208:ethnology*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control