Update on adolescent condom use

Arik V. Marcell, MD ; Arik V. Marcell, MD. Pamela J. Murray, MD ; Pamela J. Murray, MD. Pediatrics 5 : — Get Permissions. Cite Icon Cite. Use a new condom for each act of sexual intercourse. Unroll the condom all the way to the base of the erect penis. Throw away the used condom safely. Blythe, MD, Chairperson. Loretta E. Rachel J.

Jorge L. Karen S. Mark Del Monte, JD. Condom Distribution as a Structural Level Intervention. Available at: www. Accessed April 25, Births: final data Natl Vital Stat Rep. Estimated pregnancy rates and rates of pregnancy outcomes for the United States, — Teen fertility in transition: recent and historic trends in the United States.

Search ADS. Sexually transmitted diseases among American youth: incidence and prevalence estimates, Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States. HIV Surveillance Report, February Accessed June 15, Identification of HIV-infected to year-old men and women in 15 US cities through venue-based testing.

Teenagers in the United States: sexual activity, contraceptive use and childbearing, National Survey of Family Growth. National Center for Health Statistics. Condom use among high-risk adolescents: anticipation of partner disapproval and less pleasure associated with not using condoms.

A missing addend in the safer sex message. Does it fit okay? Problems with condom use as a function of self-reported poor fit. Social network influences on male and female condom use among women attending family planning clinics in the United States. The positive role of social networks and social networking technology in the condom-using behaviors of homeless young people.

Family and friend closeness to adolescent sexual partners in relationship to condom use. Condom use as a function of time in new and established adolescent sexual relationships. Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world. Condom availability programs in Massachusetts high schools: relationships with condom use and sexual behavior. Adolescent condom use and perceptions of risk for sexually transmitted diseases: a prospective study.

American Academy of Pediatrics. Policy statement—sexuality, contraception, and the media. Patterns of condom use among adolescents: the impact of mother-adolescent communication.

Parent-adolescent communication and sexual risk behaviors among African American adolescent females. The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study.

Parent-adolescent sexual communication: associations of condom use with condom discussions. Predictors of mother-adolescent discussions about condoms: implications for providers who serve youth. Evaluation of Talking Parents, Healthy Teens, a new worksite based parenting programme to promote parent-adolescent communication about sexual health: randomised controlled trial. BMJ ; Male condoms. Contraceptive Technology. Nonoxynol-9 spermicide for prevention of vaginally acquired HIV and other sexually transmitted infections: systematic review and meta-analysis of randomised controlled trials including more than women.

Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception and the percentage continuing use at the end of the first year. Cited by: 1 article PMID: J Adolesc Health , 52 4 suppl :S, 01 Apr Cited by: 16 articles PMID: Contact us. Europe PMC requires Javascript to function effectively.

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Abstract Purpose of review Pregnancy prevention efforts in the USA have largely focused on the use of hormonal contraceptive methods, relegating male condoms to discussions of 'dual-method' contraception or sexually transmitted infection prevention. With national attention and funding directed toward adolescent pregnancy prevention, a renewed focus on adolescent condom use, specifically addressing contraceptive benefits, is both timely and relevant.

Recent findings Two recent developments in condom use research are essential to increasing consistent condom use. First, there is a necessary shift toward understanding the relationship dynamics of condom use. As a coital event level contraceptive, condom use requires negotiation and participation from both participants. Second, there is increased attention to the condom itself as a determinant of use. Improvements in condom design, feel, and lubrication have reduced differences in sexual pleasure with condom use and nonuse.

Summary Promoting the initiation and maintenance of condom use across multiple partnered sexual encounters requires understanding of individual, dyadic, and condom attributes. Full text links Read article at publisher's site DOI : References Articles referenced by this article 44 Pharmacists' attitudes toward and practices with adolescents.

The results showed a global construct for attitude in the undergraduate sample and only the differentiated construct of affective attitude for cancer survivors. Also, a global construct for subjective norms was identified for both samples.

Only the differentiated construct of self-efficacy for control was identified for both samples. It is important to note that, although Rhodes and Courneya preferred the causal-indicator model conceptualization of the TPB, they did not create an effect-indicator model to empirically test its model fit of the samples.

In contrast to the causal-indicator model, the effect-indicator model by Hagger and Chatzisarantis asserted that attitudes, subjective norms, and control exert direct influence upon their respective differentiated components See Fig. The effect-indicator model evaluates whether an observed construct e. Thus, changes in attitude, subjective norms, and control may lead to changes in the differentiated constructs independently. This leaves theoretical speculation for other possible differentiated constructs since differentiated constructs are unlikely to completely contribute to the total variance within the global construct.

It is important to note that although Hagger and Chatzisarantis preferred the effect-indicator model conceptualization of the TPB, they did not create a causal-indicator model to empirically test its model fit against a causal-indicator model of the TPB.

The present study expands health behavior literature by empirically testing whether the causal-indicator model or the effect-indicator model is the better conceptualization for modeling adolescent's intentions to use condoms.

There is a void in the health behavior literature regarding a comparison of these two models using the same sample and same behavior. Therefore, the present study will empirically analyze both models using the same sample and target intention: condom use. There are several reasons why the present application offers unique contributions beyond previous research and is needed.

First, previous research has supported both the causal-indicator model and effect-indicator model applied to the theory of planned behavior, but there has been no empirical study comparing the two conceptualizations using the same sample and same intention. In other words, support for either conceptualization effect-indicator TPB and causal-indicator TPB being superior over the other is truly unknown if both conceptualizations are not explored simultaneously.

For instance, research confirming that the causal-indicator model of TPB is a satisfactory model may have yielded better results if the model was constructed according to an effect-indicator model, and vice versa.

Second, because it is widely accepted that intentions are a strong predictor of various health behaviors Albarracin et al. Should interventionists focus on changing the general attitude, subjective norms, and perceived control within the adolescent, or should they strive to influence deeper, more specific constructs related to TPB when they endeavor to increase adolescent condom use?

Third, in the broader context of applying the theory of planned behavior to real data, researchers will benefit from such an investigation by creating accurate model parameters that better reflect these social cognitive antecedents of behavior.

A clear construction of how the theory operates is imperative in evaluating a theory-based intervention. The present study also contributes to the utility of attitude, subjective norms, and control theory of planned behavior in influencing condom use intention for African American adolescents; these components have been speculated to operate differently based on specific populations and behaviors Bollen and Lennox ; Jemmott et al. Because this theory can explain why people come to behave the way that they do with regard to health, it simultaneously gives researchers a basis for explaining behavior change and practitioners a basis for implementing behavior change through intervention.

Practitioners often struggle with which intervention components to target so that real behavior change will occur. Primary prevention is crucial for adolescent behavior, especially that of sexual risk and protection, given that it is most likely that one-third of U.

It would be most efficacious to target early adolescents before they become sexually active or before they decide to engage in unprotected intercourse. However, because early adolescence is a time where responsibilities and social patterns are being established, intervention strategies are worthwhile for influencing adolescents even if they have already begun these risky behaviors.

The present study aims to restore confidence in the TPB as a useful theory-based prevention ideology by using a sample of African American adolescents with a high percentage who intend to have sex within the next year. Thus, we are able to assess whether these adolescents intend to engage in protected intercourse i. This may have important implications in dealing with adolescent sexual behavior, such as increasing intentions to use condoms.

Using attitude toward condom use, subjective norms about condom use, and control over condom use to influence intention, we hypothesized that observed data would fit the effect-indicator model beyond that of the causal-indicator model. The causal-indicator model suggests that the differentiated constructs are uniquely contributing to the global constructs; however, the differentiated constructs are correlated.

Therefore, the global constructs do not reflect the true nature of the differentiated constructs and, in fact, represent an inflated contribution within the causal-indicator model.

The differentiated constructs will contribute uniquely to the global constructs if and only if the correlation between the differentiated constructs is low and not specified in the model; otherwise, the effects of one differentiated construct will be subsumed by the other.

Therefore, statistically, the effect-indicator model is preferred because the differentiated constructs are not orthogonal, are positively correlated, and thus may be subsumed by global constructs, given that the within-construct correlation exceed the between-construct correlation. On the other hand, if the differentiated constructs cannot act as indicators of the global constructs, then that particular set of differentiated constructs may be independent of its global constructs and independently influencing the global construct, thus favoring the causal-indicator model.

The study sample consisted of African American adolescents ages 12—17 who were recruited from a Midwestern U. No socio-demographic variables were collected from the youth; however, the area in which they were recruited primarily was a low income African American community. These adolescents participated in the Youth Empowerment Project YEP , which was a series of risk reduction, skill building classes.

The present analysis uses initial baseline data from the YEP project. The YEP survey used in this study was created with specific recommendations for utilizing the theory of planned behavior Jemmott et al. The YEP survey, administered at the start of the program session, included questions. The present analysis used the condom use variables in the sexual cognitions subscale of the survey.

This subscale consisted of 71 items. The first part of the sexual cognitions subscale asked questions about how adolescents perceive approval from others on the issue of sex. The second part of the sexual cognitions subscale made statements about attitudes toward sex to which the adolescents were asked to agree or disagree. A final section of the subscale asked about how easy or accessible it is for them to have sex or obtain resources for sexual relations e.

Although the survey contained various types of sexual behavior items, only questions pertaining to condom use were utilized for the present study. Specific attention was given to the condom use variables so that the implied association to the adolescent's intent to use condoms could be evaluated. Various aspects of condom use e. An alpha coefficient of. Adolescents were targeted using radio and newspaper ads within the surrounding African American community. Upon recruitment, adolescents as well as their parents were given an informed consent and notified that all information would be kept confidential and used only as group or aggregate data.

They were told about the YEP project and its goals. They also were informed that they could discontinue participation for any reason at any time. This was done as a special measure to help reduce social desirability.

The behavioral contract encouraged the adolescents to respond honestly to the survey's very personal questions and reiterated that their responses would be kept confidential and away from parents. The present analysis was designed to test the two augmentations of the theory of planned behavior as it applies to the intent to use condoms among African American adolescents. First, principle components analysis was used in order to reduce the condom use variables into the six proposed constructs components.

Manifest variables that would indicate attitude affective attitude and instrumental attitude , subjective norms injunctive norms and descriptive norms , and control controllability and self-efficacy were examined; two manifest variables were used to indicate intentions to use condoms. Results of the principle components analysis and, subsequently, the condom use items chosen for inclusion in the structural equation model SEM are presented in Table 2.

Second, items congruent with theory and with factor loadings of. This ensured the adequacy of a measurement model. Data were also evaluated according to various statistical considerations for structural equation models SEM , such as sample size requirements, identification of the model, and low measurement error.

A structural model of the theory of planned behavior was then constructed using intention to use condoms as the endogenous latent outcome.

Next, observed data were imposed onto the model for fit. Last, both models were compared using appropriate fit indices. Items with an adequate structure loading and that were congruent with the theory were selected for consideration in the measurement model. Cronbach's alpha statistic was used to calculate the internal consistency of the factor items. All factor items exhibited adequate reliability, as reported in Table 3.

Two structural models were constructed: the causal-indicator model and the effect-indicator model. Structure for the causal-indicator model indicated that paths from the first-order differentiated constructs flow directly into the higher-order global constructs. This imposed a conceptualization that global constructs were indicators of the differentiated constructs.

Residual variances among the global constructs were correlated. In accordance with Rhodes and Courneya's commonality model for a general factor, all global constructs were modeled to directly influence intention, the endogenous latent construct under investigation.

In contrast, structure for the effect-indicator model indicated that paths from the higher-order global constructs flow directly into the first-order differentiated constructs.

This conceptualization questions the notion that the global constructs are linear combinations of the differentiated constructs and allows for shared variance in the differentiated constructs. Like the causal-indicator model, all global constructs were modeled to directly influence intention; the global constructs were correlated amongst one another.

Abstract Contraception remains an important part of national efforts to reduce adolescent pregnancy in the United States. Publication types Review.