The Dynamics of Young Men's Condom Use During and Across Relationships. (Articles).

According to data from the 1991 National Survey of Adolescent Males, condom use is likely to be highest at the beginning of relationships and to decline as the relationship continues. The proportion of sexually active men aged 17-22 who used a condom with their most recent partner declined from 53% the first time they had intercourse with that partner to 44% at the most recent episode. Condom use also decreases with age; 59% of 17-18-year-aids used a condom the first time they had intercourse with their most recent partner, compared with 56% of 19-20-year-olds and 46% of 21-22-year-olds. However, the probability that the female partner used the pill the first time that the couple had sex increased with the man's age--from 21% among 17-18-year-olds to 35% among-21-22-year-olds. Young men were more likely to have used a condom if they thought their partner was sexually inexperienced, and less likely to have done so if they suspected their partner was at high risk for an STD.

(Family Planning Perspectives, 26:246-251, 1994)

One of the critical public health strategies in the prevention of the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) is promoting the use of condoms. Research has demonstrated that consistent and correct condom use is an effective means of protection against transmission of HIV and other STDs. (1) Condoms are also effective at pregnancy prevention, although less so than oral contraceptives. (2)

A number of recent studies have explored reasons for condom use and nonuse; these have examined demographic, attitudinal and educational characteristics that affect condom use. (3) Three disparate themes on condom use have surfaced. First, condoms are not usually used consistently, that is, at 100% of all acts of intercourse. Analyses of the 1988 National Survey of Adolescent Males (NSAM) found that only 35% of sexually active teenage men had always used a condom in the previous year, 43% had used them intermittently, and 22% had not used them at all. (4) Thus although condoms are widely used, they are generally not used consistently; other research has yielded similar findings. (5)

Second, the consistency with which condoms are used declines with age, even though sexual activity increases. The net result is that the proportion of sexual activity that is unprotected by a condom increases. Cross-sectional data indicate that older men use condoms less frequently than do younger men, (6) and longitudinal analyses show that condom use declines as adolescents grow older. (7) This decline over time in condom use extends beyond the years of adolescence and young adulthood; for example, findings from the 1991 National Survey of Men revealed that the proportion of men who used a condom in the previous four weeks declined for each successive five-year cohort of men aged 20 to 39. (8)

Third, condom use is affected by the female partners' characteristics. In some research, condoms were used more often with short-term (i.e., casual or secondary) partners than with long-term (i.e., steady or primary) partners. Two separate large-scale surveys found that adults with more than one partner in the last 12 months were 2-5 times more likely to report always using condoms with their secondary partners than with their primary partners. (9) However, a study of adolescent female family planning clinic users did not find consistent condom use to be related to the type of partner. (10)

The Sawtooth Hypothesis