Background:
Condoms remain the only protection from STI transmission within non-mutually monogamous adolescent sexual relationships. To the extent that agreement between partners regarding condom use (or non-use) is a product of a shared decision, agreement on condom use may be something that changes within a relationship or is endogenous to a relationship.

Objective:
To determine whether agreement regarding condom use at first sex is correlated with agreement at last sex with a main sex partner.

Method:
Sexually active 15-19 year olds were recruited for a longitudinal study between August 2000 and June 2002 from two urban clinic populations. Trained interviewers conducted face-to-face structured interviews eliciting index participant and reported most recent main sex partner information. Participants were asked about their desire and perceived partner desire for condom use (first and last sex). We compared participants desire and perceived partner desire to determine agreement on use (or non-use) of condoms.

Result:
We enrolled 387 adolescents with a main sex partner. 76% of participants were female. Mean age was 17.8 years old. At first sex with most recent main sex partner, 79.3% (307/387) agreed with partner on use (or non-use) of condoms. Among those who agreed, 85.3% wanted to use condom. There were no differences on agreement if participants wanted or did not want to use condoms. At last sex, 77.0% (295/383) agreed on use or non-use of condoms. Among those who agreed, 42.7% wanted to use condom. Less reported agreeing if index wanted vs. did not want to use (64.0% vs. 90.9%; p<.0001; OR=0.18; 95% CI=0.1, 0.32).

Conclusion:
Adolescents usually report agreeing with their main sex partner about condom use. Disagreements most often occurred later in a relationship when the adolescents wanted to use condoms.

Implications:
Interventions which focus on condom negotiation must consider stage of relationship.