Abstract
Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14–18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Bandura, A. (1994). Social cognitive theory and exercise of control over HIV infection. In R. J. DiClemente & J. L. Peterson (Eds.), Adolescents and AIDS: Preventing AIDS: Theories and Methods of Behavioral Intervention (pp. 25-60). New York: Plenum.
Berman, S. M., & Hein, K. (1999). Adolescents and STDs. In K. K. Holmes, P. F. Sparling, P. Mardh, S. M. Lemon, W. E. Stamm, P. Piot, & J. N. Wasserheit (Eds.), Sexually Transmitted Diseases (pp. 129-142). New York: McGraw-Hill.
Bolan, G., Ehrhardt, A. A., & Wasserheit, J. N. (1999). Gender perspectives and STDs. In K. K. Holmes, P. F. Sparling, P. Mardh, S. M. Lemon, W. E. Stamm, P. Piot, & J. N. Wasserheit (Eds.), Sexually Transmitted Diseases (pp. 117-128). New York: McGraw-Hill.
Bunnell, R. E., Dahlberg, L., Rolfs, R., Ransom, R., Gershman, K., Farshy, C., Newhall, W. J., Schmid, S., Stone, K., & St. Louis, M. (1999). High prevalence and incidence of sexually transmitted diseases in urban adolescent females despite moderate risk behaviors. Journal of Infectious Disease, 180, 1624-1631.
Centers for Disease Control and Prevention (1998a). Trends in sexual risk behaviors among high school students—United States, 1991-1997. Morbidity and Mortality Weekly Report, 47, 749-752.
Centers for Disease Control and Prevention (1998b). Youth risk behavior surveillance—United States, 1997. Morbidity and Mortality Weekly Report, 47, 1-92.
Centers for Disease Control and Prevention (1999a). HIV/AIDS surveillance report (Midyear ed.), 11(1):1-43.
Centers for Disease Control and Prevention (1999b). Sexually Transmitted Disease Surveillance, 1998. Atlanta, GA: Department of Health and Human Services.
Centers for Disease Control and Prevention (2000). Youth risk behavior surveillance—United States, 1999. Morbidity and Mortality Weekly Report, 49, 1-96.
Civic, D. (1999). The association between characteristics of dating relationships and condom use among heterosexual young adults. AIDS Education and Prevention, 11, 343-52.
Crosby, R. A. (1998). Condom use as a dependent variable: Measurement issues relevant to HIV prevention programs. AIDS Education and Prevention, 10, 448-457.
Crosby, R. A., DiClemente, R. J., Wingood, G. M., Sionean, C., Cobb, B., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (2002). Pregnant African American adolescent females are less likely to use condoms than their non-pregnant peers. Preventive Medicine, 34, 524-528.
Crosby, R. A., & Miller, K. S. (2002). The pivotal role of the family on adolescent females' sexual health. In G. M. Wingood & R. J. DiClemente (Eds.), Women's Sexual and Reproductive Health: Social, Psychological, and Public Health Perspectives (pp. 129-147). New York: Plenum.
DiClemente, R. J. (1991). Predictors of HIV-preventive sexual behavior in a high-risk adolescent population: The influence of perceived peer norms and sexual communication on incarcerated adolescents' consistent condom use. Journal of Adolescent Health, 12, 385-390.
Eng, T. R., Butler, W. T. (Eds.) (1997). The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: National Academy Press.
Fisher, W., Fisher, J. D., & Rye, B. (1995). Understanding and promoting AIDS preventive behavior: Insights from the theory of reasoned action. Health Psychology, 14, 255-264.
Jemmott, J. B., III, & Jemmott, L. S. (2000). HIV behavioral interventions for adolescents in community settings. In J. L. Peterson & R. J. DiClemente (Eds.), Handbook of HIV Prevention (pp. 103-128). New York: Plenum.
Kennedy, M. G., Mizuno, Y., Seals, B. F., Myllyluoma, J., & Weeks-Norton, K. (2000). Increasing condom use among adolescents with coalition-based social marketing. AIDS, 14, 1809-1818.
Kirby, D. (2000). School-based interventions to prevent unprotected sex and HIV among adolescents. In J. L. Peterson & R. J. DiClemente (Eds.), Handbook of HIV Prevention (pp. 83-102). New York: Plenum.
Misovich, S. J., Fisher, J. D., & Fisher, W. A. (1997). Close relationships and elevated HIV risk behavior: Evidence and possible underlying psychological processes. Review of General Psychology, 1, 72-107.
Moore, K. A., Miller, B. C., Glei, D., & Morrison, D. R. (1995). Adolescent sex, contraception, and childbearing: A review of recent research. Washington, DC: Child Trends Inc.
Pack, R., Crosby, R. A., & St. Lawrence, J. S. (2001). Association between adolescents' sexual risk behavior and scores on six psychometric scales: Impulsivity predicts risk. Journal of HIV/AIDS Prevention and Education for Adolescents and Children, 4(1), 33-47.
Rosenthal, D., Sheperd, H. (1993). A six-month follow-up of adolescents' sexual risk-taking, HIV/AIDS knowledge, and attitudes to condoms. Journal of Community and Applied Social Psychology, 3, 53-65.
Rotheram-Borus, M. J., Jemmott, L. S., & Jemmott, J. B. (1995). Preventing AIDS in female adolescents. In A. O. O'Leary & L. S. Jemmott (Eds.), Women at Risk: Issues in the Primary Prevention of AIDS (pp. 103-130). New York: Plenum.
Santelli, J. S., DiClemente, R. J., Miller, K. S., & Kirby, D. (1999). Sexually transmitted diseases, unintended pregnancy, and adolescent health promotion. Adolescent Medicine, 10, 87-108.
Sheeran, P., Abraham, C., & Orbell, S. (1999). Psychosocial correlates of heterosexual condom use: A meta-analysis. Psychological Bulletin, 125, 90-132.
St. Lawrence, J. S., Reitman, D., Jefferson, K. W., Alleyne, E. (1994). Factor structure and validation of an adolescent version of the condom attitude scale: An instrument for measuring adolescents' attitudes toward condoms. Psychological Assessment, 6, 352-359.
St. Lawrence, J. S., Chapdelanie, A. P., Devieux, J. G. (1999). Measuring perceived barriers to condom use: Psychometric evaluation of the Condom Barriers Scale. Assessment, 6, 391-404.
Stone, K. M., Timyan, J., & Thomas, E. L. (1999). Barrier methods for the prevention of sexually transmitted diseases. In K. K. Holmes, P. F. Sparling, P. Mardh, S. M. Lemon, W. E. Stamm, P. Piot, & J. N. Wasserheit (Eds.), Sexually Transmitted Diseases (pp. 1307-1322). New York: McGraw-Hill.
Wald, A., Langenberg, A. G., Link, K., Izu, A. E., Ashley, R., Warren, T., Tyring, S., Douglas, J. M. Jr. & Corey, L. (2001). Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women. Journal of the American Medical Association, 285, 3100-3106.
Wallace, R. A., & Wolf, A. (1986). Contemporary sociological theory: Continuing the classical tradition (2nd ed., pp. 232-260). Englewood Cliffs, NJ: Prentice-Hall.
Wingood, G. M., & DiClemente, R. J. (1998a). Gender-related correlates and predictors of consistent condom use among young adult African-American women: A prospective analysis. International Journal of STD and AIDS, 9, 139-45.
Wingood, G. M., & DiClemente, R. J. (1998b). Partner influences and gender-related factors associated with noncondom use among young adult African American women. American Journal of Community Psychology, 26, 29-51.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Crosby, R.A., DiClemente, R.J., Wingood, G.M. et al. Identification of Strategies for Promoting Condom Use: A Prospective Analysis of High-Risk African American Female Teens. Prev Sci 4, 263–270 (2003). https://doi.org/10.1023/A:1026020332309
Issue Date:
DOI: https://doi.org/10.1023/A:1026020332309