Prioritizing education about condom use among sexually active adolescent females

Many factors have been shown to influence condom use among adolescents, including negative experiences with prior use, risk-taking behaviors, perception of condom efficacy, and self-efficacy in obtaining and using condoms. In order to help prioritize topics for clinic-based education, this study attempted to determine which factors are most significantly associated with planned condom use. A 53-item questionnaire was administered to sexually active females presenting consecutively to an adolescent clinic. Two hundred ethnically and religiously diverse patients, with a median age of 17 years, participated. Median age at first sexual encounter was 15. Median number of lifetime partners was 2, with a median of 1 partner in the last year. Past condom use was reported by 88%, with 22% always, 38% usually, and 26% occasionally using condoms. Only 47% had used condoms during their most recent sexual encounter. Negative experiences with condom use were reported by 85%. Only 54% stated they would definitely use condoms during their next sexual encounter. Intent to use condoms in the future was significantly associated with both past use and fear of HIV infection. Intent was not significantly associated with most prior negative experiences, perception of condom efficacy in preventing STDs and pregnancy, or other perceived benefits of condom use. Thus, this novel approach to prioritizing topics revealed that health education among a clinic-based population should emphasize condom use from the onset of sexual activity, as well as its efficacy in preventing HIV infection.