Men’s Condom Use at Coitarche: An Analysis of National Survey of Family Growth Data (2006-2013) [28I

Abstract

INTRODUCTION: Interventions to prevent unplanned pregnancy cannot overlook the role of young men. Using National Survey of Family Growth data from 2006 to 2013, we characterized men reporting having not used a condom at their first intercourse (coitarche) with a non-steady partner, as well as associated factors. METHODS: Survey respondents who reported ever having intercourse were asked about contraception used at coitarche, inclusive of male and female methods. Analysis was restricted to respondents whose first sexual partner was an unsteady partner, thereby comprising a population for whom condoms are recommended for preventing both pregnancy and sexually transmitted infections. Demographic and behavioral factors were examined against condom use, with significant associations included in multivariable logistic regression. Bivariate associations of condom use with receipt of specific sex education topics are described. RESULTS: The odds of unprotected coitarche decreased by nearly 25% between 2006 and 2010 and 2011 and 2013. Older respondents had 2.0-4.0 (95% CI 1.6-5.3; P<.01) times the odds of unprotected coitarche compared to those below age 19. Other independently associated factors included coitarche before age 15 (OR 3.0; 95% CI 2.6-3.6; P<.01) and with an older-aged partner (OR 1.7; 95% CI 1.4-2.0; P<.01). Among respondents who received sex education prior to coitarche, discussion of STIs and contraception were associated with condom use at coitarche; abstinence-only education was not associated. CONCLUSION: Nearly 1 in 5 young men reported not using a condom at coitarche with an unsteady partner. Prevention efforts should continue to evaluate psychosocial and structural reasons why young men do not use condoms.