A Comparison of Condom Use Desires in Adolescent Couples

Background:
The adoption of protective behaviors for STDs in couples is a decision often made by two individuals. Previous investigations of condom use tend to focus on the motivations of only one partner. Individuals in couples may have different motivations for or against performing a behavior. The focus on one partner may not provide a sufficient picture of the factors influencing behavior.

Objective:
Our objectives were to 1) examine the agreement of condom use desires within adolescent couples and 2) identify factors associated with agreement.

Method:
Adolescents, ages 14-19, and their sex partners were recruited for a longitudinal study from public STD clinics in Baltimore City. Participants were interviewed on partner-specific motivations for recent sexual behavior. Condom use desire was determined by the participant's response of wanting to use condoms at last sex. We used kappa to assess agreement between partners, and multiple logistic regression to identify associations. Our analysis was limited to main partnerships (N=88 couples).

Result:
Overall agreement of condom use desire between partners was low, k=0.12 (CI: -0.09, 0.33). The condom use desire of males was negatively associated with agreement in the couple, OR=0.32 (CI: 0.12-0.84). Additionally, having an age difference of 2 or more years and having previously discussed using condoms within partnerships was associated with agreement of condom desires, OR=1.23 (CI: 1.01-1.51) and OR=3.80 (CI: 1.54, 9.37), respectively.

Conclusion:
The condom use desires of adolescent partners often disagreed. Those who disagreed were less likely to discuss condom use.

Implications:
It is important to consider the motivations of both partners when examining behavior requiring concerted action. Additionally, future research is needed to investigate power dynamics within couples to assess whose desires are translated into actual behavior. Finally, there is a need for improving communication of condom use desires in adolescent couples