title: Correlates of incorrect condom use among depressed young women: an event-level analysis.
abstract: OBJECTIVE
  Depressed young women are at particularly high risk of sexually transmitted infections (STIs), yet little is known about their condom use practices. This study sought (1) to describe condom use errors among depressed adolescent and young adult women and (2) to identify event- and individual-level correlates of incorrect use.
  
  
  METHODS
  Depressed, sexually active outpatients ages 15-22 responded to a computer-based questionnaire, then reported on penile-vaginal sex events on a handheld computer several times a day for two weeks. For each sex event with a condom, incorrect condom use was defined as a response indicating incorrect use on at least one of five questions. Event- and individual-level correlates of incorrect use were analyzed using logistic regression adjusted for age and within-individual clustering.
  
  
  METHODS
  Participants were recruited from two adolescent clinics, a psychiatric clinic, and a young parents' program of an urban children's hospital and collected data in the settings of their everyday lives.
  
  
  METHODS
  Thirty-one young women contributed 143 condom use events to these analyses.
  
  
  METHODS
  None.
  
  
  METHODS
  Incorrect condom use.
  
  
  RESULTS
  Incorrect condom use was reported for 51% of condom use events. The most common error was not holding the condom on withdrawal (31%). Having sex to change mood, to relax, or for physical pleasure increased the odds of incorrect condom use, but was no longer significant when individual-level variables were included in the model. In the multiple logistic regression model, impulsiveness increased and stronger belief that mood affects sexual behaviors decreased the odds of incorrect condom use (adjusted OR 1.3 and 0.81, respectively).
  
  
  CONCLUSIONS
  Even if they use condoms, depressed adolescent and young adult women are at increased risk of STIs because they frequently use condoms incorrectly. Psychological factors may help identify depressed young women who are at particularly high risk of incorrect condom use.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts 02115, USA. lydia.shrier@childrens.harvard.edu
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Shrier
authors.forename: Courtney
authors.initials: C
authors.lastname: Walls
authors.forename: Christopher
authors.initials: C
authors.lastname: Lops
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
mesh_terms: D000293:Adolescent; D003075:Coitus / Q000523:psychology; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D012725:Sexual Behavior / Q000523:psychology*; D055815:Young Adult