Sexual Partner Characteristics Influence Condom Use Among Minority Adolescents

Background: Adolescents are more likely to use condoms with casual rather than steady partners. Yet, it is unclear if adolescent condom use is influenced by partner context (e.g., drinking alcohol in the 2 hours prior to sex, meeting in public or on the street, and ≥ 3 years age discordance).

Objectives: Among a Chicago urban cohort of 1535 primarily (83%) minority 17-18 year olds who reported having vaginal or anal sex, we assessed associations between partnership context and relationship characteristics (unexpected vs. expected and casual vs. main) on condom use at the last time they had sex.

Methods: We used logistic regression to examine the odds of condom use by each partner risk characteristic within gender strata.

Results: Adolescents were twice as likely to use condoms with partners they did not expect that day or considered a casual partner. Women were less likely to use condoms with partners who were drinking alcohol in the two hours prior to sex (OR=0.6, 95% CI =0.4-0.8), met on the street or in public (OR=0.5, 95% CI =0.4-0.8), ≥ 3 years years age discordant (OR=0.4, 95% CI =0.3-0.7). Men had similar condom use regardless of partner context risk. The associations between condom use and partner context were similar when adjusting for race/ethnicity and partner relationship characteristics.

Conclusions: Adolescent women were more likely to use condoms with partners they did not know well, but were less likely to use condoms when encountering risky partner context situations. Adolescents may be unaware of partner context risks, or may have impaired negotiating power and judgment in these situations.

Implications for Programs, Policy, and Research: The reasons behind young women being less likely to use condoms when faced with risky partner contexts should be explored and incorporated into HIV and STI preventive interventions.