Condom Availability in High School Does Not Increase Teenage Sexual Activity but Does Increase Condom Use

Abstract

A 1994 study of 7119 students from 12 randomly selected high schools in New York New York and 5738 students from 10 high schools in Chicago Illinois explored the impact of condom availability on the premarital sexual activity of teenagers. New York was selected for this study because its Board of Education implemented one of the first school-based condom distribution programs in the US in 1991. Chicago provides students with AIDS education but not condoms. In both cities 47% of students who had attended the high school for less than a year (proxy measure for program exposure) and 60% of longer-term students were sexually active with increases in this rate with age. Approximately 25% of sexually active new students and 20% of continuing students reported having 3 or more partners in the previous 6 months. However sexually active continuing New York teens reported a significantly higher rate of condom use (61%) in their last sexual encounter than their counterparts in Chicago (56%). New students in New York and Chicago were about equally likely to report such use (58% and 60% respectively). Logistic regression analysis controlled for a range of possible confounding factors indicated that continuing students in New York were 1.4 times more likely than their Chicago counterparts to have used a condom at last intercourse. High-risk students (those reporting 3 or more sexual partners in the previous 6 months) from New York were 1.9 times more likely than were Chicago teens to report such use and a significantly greater proportion of the high-risk compared with low-risk New York students had taken condoms from the school program. These findings indicate that a school-based condom distribution program can decrease urban teens risk of contracting HIV and other sexually transmitted diseases without the feared increases in rates of adolescent sexual activity.