Determinants of consistent condom use by adolescents: the impact of experience of sexual intercourse

The determinants of consistent condom use were investigated in a cross-sectional study of 1018 students 12-19 years of age from 18 Dutch secondary schools. The study was prompted by concern over the lack of acceptance of condoms on the part of young people in The Netherlands despite extensive acquired immunodeficiency syndrome (AIDS) prevention campaigns. Components of the variance in behavioral intention to use condoms included intuitive attitude regarding personal consequences 34%; self-efficacy (degree to which students considered themselves able to obtain and negotiate condom use) 12%; subjective social norms derived from parents peers and sexual partners 3%; perceived vulnerability to AIDS 2%; and perceived beliefs and behaviors of peer 2%. Adolescents with significant sexual experience (intercourse more than 5 times) were less likely than their inexperienced counterparts to respond positively to condom use as a means of avoiding transmission of AIDS. Students with extensive sexual experience were less likely to express discomfort with the idea of raising the subject of condom use with a new partner than their inexperienced peers but were likely to anticipate problems with consistent condom use with a well-known sexual partner. Those who reported consistent condom use also expressed confidence in their ability to use condoms even when drunk and to interrupt lovemaking to apply a condom. In addition consistent users were less likely to focus on the unpleasant aspects of condom use (decreased sexual stimulation messiness) and to perceive a positive social norm regarding this method of AIDS prevention. Given the finding that condoms decline in popularity as adolescents gain sexual experience behavioral skills programs that increase confidence in purchasing condoms and negotiating their use with sex partners should be implemented.