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Correct condom application among African-American adolescent females:
the relationship to perceived self-efficacy and the association to confirmed
STDs.
Journal of Adolescent Health 2001;29(3):194-199
Crosby RA,
DiClemente RJ, Wingood GM, Sionean C, Cobb BK, Harrington K, Davies SL, Hook
EW,
Oh MK.
Abstract
PURPOSE: To assess condom application ability and the relationship between
perceived ability and demonstrated ability. Also, to examine the association
between high-demonstrated condom application ability and recent sexual risk
behaviors and laboratory-diagnosed sexually transmitted diseases (STDs) among
African-American adolescent females. METHODS: A purposeful sample of sexually
active African-American females (n = 522) completed a structured interview
and provided vaginal swab specimens for STD testing. Subsequent to the interview,
adolescents demonstrated their condom application skills using a penile model.
A 9-item scale assessed adolescents' perceived self-efficacy to apply condoms.
Sexual risk behaviors assessed by interview were noncondom use at last intercourse
and the last five intercourse occasions for steady and casual sex partners
as well as any unprotected vaginal sex in the past 30 days and the past 6
months. RESULTS: Approximately 28% of the sample tested positive for at least
one STD and nearly 26% self-reported a history of STDs. Controlled analyses
indicated that adolescents' self-efficacy for correct use was not related
to demonstrated skill. Adolescents' demonstrated ability was not related
to any of the sexual risk behaviors. Likewise, recent experience applying
condoms to a partner's penis and demonstrated ability were not related to
laboratory-diagnosed STDs or self-reported STD history. CONCLUSIONS: Adolescents
may unknowingly be at risk for human immunodeficiency virus and STD infection
owing to incorrect condom application. Further, high-demonstrated ability
to apply condoms was not related to safer sex or STDs. Reducing sexual risk
behaviors may require more than enhancing adolescent females' condom application
skills and may require addressing other relational skills.