Increased Condom Use Among Teenage Males, 1988-1995: The Role of Attitudes.

Context: 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.

Methods: 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 to bit 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.

Results: 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.

Conclusions: 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.

Family Planning Perspectives, 1998, 30(6):276-280 & 303

Unprotected sexual intercourse among American teenagers has many serious public health and societal consequences, particularly the transmission of HIV and other sexually transmitted diseases (STDs). Among the 40,000-80,000 Americans who become infected with HIV each year, one in four are teenagers. (1) In addition, adolescents account for one-third of all chlamydia and gonorrhea cases and one-10th of all syphilis cases in the United States. (2)

The risk of STD transmission among youths may be reduced by encouraging safer sexual behaviors, such as the use of condoms. Next to abstinence, consistent and correct condom use is the most effective way to prevent the transmission of HIV. (3) Indeed, as part of the U.S. government's Healthy People 2000 initiative, the surgeon general's office has set a goal of increasing teenagers' use of condoms at last intercourse to 75%. (4)