title: Condom use among high-risk adolescents: anticipation of partner disapproval and less pleasure associated with not using condoms.
abstract: OBJECTIVE
  We determined the association of demographic, psychosocial, and contextual factors with condom use among a large community sample of at-risk adolescents recruited from four locations in the U.S.
  
  
  METHODS
  We enrolled 1,410 adolescents/young adults between the ages of 15 and 21 with a history of unprotected sex in the past 90 days at four study sites. Subjects completed an audio-assisted, computerized assessment that gathered information about sexual behavior and its contexts, substance use, and relevant risk and protective attitudes.
  
  
  RESULTS
  Nearly two-thirds of adolescents did not use condoms at the time of last intercourse and adolescents reported a mean of 15.5 (median = 5) unprotected intercourse occasions in the past 90 days. Controlling for relevant demographic variables, not using condoms was associated with the perception that condoms reduce sexual pleasure, the perception that partners will not approve of condom use, and less discussion with partners about condoms.
  
  
  CONCLUSIONS
  Even across racial/ethnic groups, gender, and geographic locations, several important correlates of adolescents' sexual risk reduction were identified. Many adolescents may feel that condoms reduce their sexual pleasure and fear partner reactions if they initiate condom use. These attitudes may be malleable through clinical and community-based interventions.
authors.affiliation: Rhode Island Hospital, Coro West, Ste. 204, 1 Hoppin St., Providence, RI 02903, USA. lkbrown@lifespan.org
authors.forename: Larry K
authors.initials: LK
authors.lastname: Brown
authors.forename: Ralph
authors.initials: R
authors.lastname: DiClemente
authors.forename: Richard
authors.initials: R
authors.lastname: Crosby
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fernandez
authors.forename: David
authors.initials: D
authors.lastname: Pugatch
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cohn
authors.forename: Celia
authors.initials: C
authors.lastname: Lescano
authors.forename: Scott
authors.initials: S
authors.lastname: Royal
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Murphy
authors.forename: Barbara
authors.initials: B
authors.lastname: Silver
authors.forename: William E
authors.initials: WE
authors.lastname: Schlenger
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000523:psychology*; D000328:Adult; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data*; D003710:Demography; D005260:Female; D005431:Florida; D005845:Georgia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010379:Peer Group; D012237:Rhode Island; D012309:Risk-Taking; D012494:Sampling Studies; D012747:Sexual Partners / Q000523:psychology*; D012925:Social Conformity; D047568:Unsafe Sex / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data*