Condom Use Among Sexually Active Rural High School Adolescents Personal, Environmental, and Behavioral Predictors

Abstract

Adolescents who engage in unprotected intercourse are at risk of pregnancy and sexually transmitted infection (STI). Although adolescents in rural areas participate in levels of sexual risk taking similar to that of nonrural youth, few data are available identifying factors that influence condom use among rural adolescents. The purpose of this study is to determine the predictive value of selected personal, environmental, and behavioral factors for condom use among rural adolescents in grades 9-12. A cross-sectional survey was conducted among sexually active youth (N = 613), ages 14-19, in three rural school districts in the Northeast. Using logistic regression, identified predictors for condom use include personal standards (odds ratio [OR] = 2.45; confidence interval [CI]: [2.39, 6.47]), condom use goals (OR = 1.32; CI [1.21, 1.45]), condom use at first intercourse (OR = 3.93; CI [2.39, 6.47]) and male gender. School nurses are encouraged to incorporate identified predictors of condom use when considering interventions promoting safer sexual behaviors among rural youth.

Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior

“…37,41 The same procedure was used to handle the three studies that reported both general contraceptive use and condom use. 17,43,44 Specifically, we averaged the effect of communication on these sexual health outcomes for primary analyses, but we used a random number generator to select one outcome variable from each study when we examined the type of outcome (contraceptive use vs. condom use) as a moderator. 37,41 …”

“…3,9–12 While several studies have found moderate, positive associations between parent communication and youth contraceptive or condom use, 13–16 other studies have found non-significant or even negative effects. 17–19 Further, while it is possible that parental communication about sex can be protective for youth, open sexual communication often does not take place. Instead, embarrassment, inaccurate knowledge, or low self-efficacy may prevent some parents from engaging their children in honest and supportive conversations about sex.…”

Intrapersonal and Interpersonal Correlates of Condom Use among Young Adults from Continuation High Schools

“…Findings vary when self-efficacy includes or is solely defined by condom mechanics. Among rural White adolescents, self-efficacy that includes both negotiation and mechanics is correlated with but is not predictive of condom use (Haley et al, 2012). Sexual risk-reduction interventions that have targeted increasing condom mechanics self-efficacy in CHS youth are limited and have shown either short-term marginal significance (Coyle et al, 2013) or significance for the control group only (Coyle et al, 2006).…”

“…It includes negotiating condom use with a sexual partner and the mechanics of placing a condom (Brafford & Beck, 1991). Persons with greater self-efficacy for condom use (Haley et al, 2012;Shneyderman & Schwartz, 2012) or condom negotiation (Crosby et al, 2013) are more likely to report condom use. For Latinos, embracing Latino cultural values (a distal construct of acculturation) is associated with greater condom use-self-efficacy whereas identifying more with American cultural values is related to less condom use (Ma et al, 2014).…”

“…By communicating on sex and sex-related topics with adolescents, parents convey the importance of engaging in open conversations on sexuality while relaying sexual health information (Widman, Choukas-Bradley, Noar, Nesi, & Garrett, 2016). Parent-adolescent communication is significantly associated with condom use in some adolescent samples (Aspy et al, 2007;Hadley et al, 2009;Widman et al, 2016) but not in other samples (Haley et al, 2012;Somers & Ali, 2009). Discrepant findings may be due to methodological approaches that vary by sexual communication content, which parent delivers the information, and gender of the adolescent (Guilamo-Ramos, Lee, & Jaccard, 2016).…”