The Influence of Sexual Partner on Condom Use Among Urban Adolescents

Purpose: The influence of partner context (e. g., drinking alcohol in the 2 hours prior to sex, >= 3 years age discordant, met in public) on adolescent boys' and girls' condom use is unclear. Among an urban cohort of primarily (86%) minority 17-18-year-olds who reported having sex (n = 1,469), we assessed the association between condom use and partner characteristics for the most recent sexual experience. Methods: We used logistic regression to examine the odds of condom use by measured partner familiarity (casual or unexpected) and context characteristics. Analyses were stratified by gender. Results: Adolescent boys and girls were twice as likely to use condoms with partners they considered casual or unexpected. Adjusting for partner familiarity risk, adolescent boys' tended to decrease condom use with risky context partners. Adjusting for partner familiarity risk, adolescent girls were half as likely to use condoms with partners drinking alcohol 2 hours prior to sex [Odds Ratio (OR)= .6, 95% Confidence Interval (CI) = .4-.9]; >= 3 years age discordant (OR = .5, 95% CI = .3-.8); or met in public places (OR = .6, 95% CI = .4-.8). Conclusions: Regardless of partner familiarity risk, adolescent boys and girls faced barriers to condom use with risky context partners. Increased understanding of adolescents' perceptions of and control over partner risk and condom use with risky context partners is needed. Interventions aimed at decreasing adolescent sexually transmitted infections should include strategies for adolescents to choose less risky context partners and negotiate condoms with risky context partners. (C) 2013 Society for Adolescent Health and Medicine. All rights reserved.