Sexual Behavior Patterns and Condom Use in Newly Sexually Active Female University Students

Our objective was to describe sexual behavior patterns and condom use in newly sexually active female university students. We conducted a 4-year retrospective cohort study (2000-2007) of university women enrolled close to sexual debut (N = 250). Participants reported daily information on intercourse, condom use, and partner/partnership characteristics into Web-based biweekly sexual behavior diaries. We calculated intercourse frequency, proportion of condom-protected events, and incidence of new partner acquisition. We used logistic regression to examine factors associated with condom use at sexual debut; Kaplan-Meier methods to describe cumulative incidence of condom non-use after use at debut; and Cox proportional hazards ratios to examine factors associated with condom non-use. A total of 188 women had at least one male sex partner prior to enrollment or during follow-up. One-third (34.1%) of 27,736 intercourse events were condom-protected. Older age (20+ vs. < 20 years) and use of hormonal birth control were associated with lower likelihood of condom use at sexual debut (adjusted odds ratio [aOR] 0.41, 95% CI 0.17-0.97 and aOR 0.32, 95% CI 0.10-1.03, respectively). Women who reported partners with previous sex partners were less likely to discontinue using condoms after debut (hazard ratio = 0.35, 0.16-0.77) than those reporting partners without previous partners. In college-aged women, older age and hormonal contraceptive use were each inversely associated with condom use at first intercourse. Women with sexually experienced partners were more likely to continue using condoms. Continued efforts are necessary to promote condom use among college-aged women.