Self-efficacy to Negotiate Partner Condom Use Among High-risk Adolescent Girls

Abstract

Background Sexually active adolescent girls whose partners do not use condoms are at significant risk for sexually transmitted disease (SID). Low self-efficacy to negotiate partner condom use has been shown to be a major determinant of high-risk sexual behavior among adult women, but the factors that influence adolescent girls’ ability to engage in protected intercourse have not been fully explored. This study was undertaken to determine the association between self-efficacy to negotiate condom use and self-reported condom use. Methods 21 nonpregnant adolescent girls with cervicitis or pelvic inflammatory disease were enrolled over a 4-month period. Participants were interviewed to collect demographic infonnation, then completed a self-administered questionnaire, which included a 6-item condom use negotiation scale (Cronbach's alpha =.80), a 16-item SID prevention knowledge scale (Cronbach's alpha =.79), and questions on frequency of condom use, condom use at last sexual intercourse, and other sexual risk behaviors. Results Mean age was 17.3 years (range 14–22). 57% were black and 14% were Hispanic. Mean age at first sexual intercourse was 14.4 years; mean number of lifetime sexual partners was 6.2 (range 1–25) and 62% had I partner in the past 3 months. Over 80% reported high frequency partner condom use (“all of the time” or “most of the time”), but only 38% reported partner condom use at last intercourse. All participants whose partner used a condom at last intercourse also reported high frequency condom use. Mean knowledge score was 14.3 (± 2.4) (possible score 0–16). Knowledge score was not associated with condom use or negotiation score. Mean negotiation score was 26.1 (± 5.0) (possible score 6–30). Participants whose partner used a condom at last intercourse had higher negotiation scores than those whose partner did not (Wilcoxon Rank Sum test, p = 0.03). Participants who reported high frequency condom use had higher negotiation scores than those who reported low frequency condom use, but this difference was not significant. Conclusions High self-efficacy to negotiate condom use is associated with self-reported partner condom use at last sexual intercourse among high-risk adolescent girls. Further investigation into the influence of self-efficacy to negotiate condom use in adolescent girls is warranted and may have significant implications for development of STD risk reduction interventions.