Condom use among criminally-involved adolescents

Abstract

Condom use was studied for 421 sexually active, minority male adolescents who were currently in jail in New York City. Over three-quarters of the youths were users of alcohol and marijuana and about one-quarter were users of cocaine or crack, but drug injectors were rare. In the six months before arrest they had multiple sexual partners and about one-third had engaged in anal intercourse. Inconsistent condom use was the norm, with 17% reporting that they never used condoms and only 15% reporting that they used condoms every time for insertive sex. In multivariate analysis, more frequent condom use was independently predicted by gay/bisexual preference, greater acceptability and accessibility of condoms, partners' receptivity to use, self-initiation of use, and self-efficacy of avoiding AIDS. Condoms were used less frequently with steady than with causual partners, and rarely for anal or oral sex. AIDS prevention curricula addressing these factors should be delivered to high risk adolescents while they are temporarily accessible in jail.

PIP: Studies have found criminally-involved male adolescents to be highly sexually active, involved in unprotected sexual activities with multiple partners, and heavy consumers of alcohol and drugs extensively, behaviors which are conducive to HIV exposure and transmission. This paper reports findings on the sex behavior and condom use of 421 sexually active, minority male adolescents incarcerated at the Adolescent Reception Center on Rikers Island during February 1991-February 1992. The volunteers were aged 16-19 years (median age, 17.8 years), 98.8% were Black or Hispanic, 95.2% were heterosexual, 3.3% were bisexual, and 1.4% were gay. Each young man was compensated with $10 credited to his commissary accounts for participation in a 90-minute personal interview. 38.0% had been arrested for robbery, 27.3% for drug offenses, 16.9% for property crimes, and 13.5% for weapons offenses. 9.0% were in for murder. 74.8% were detained, while the remained had been sentenced. During the month before arrest, 81.0% consumed alcohol, 76.0% smoked marijuana, and approximately 25% used cocaine or crack cocaine, but IV drug use was rare. Only 1% of the sample reported ever using IV drugs. They had an average of three partners each during the 6 months before arrest, although few had identifiable high-risk partners. 17% reported never using condoms and 15% reported using condoms every time for insertive sex. Inconsistent condom use was therefore the norm. 15.9% had ever had a STD. Multivariate analysis found more frequent condom use to be independently predicted by gay/bisexual preference, greater acceptability and accessibility of condoms, partners' receptivity to use, self-initiation of use, and self-efficacy of avoiding AIDS. Condoms were used less frequently with steady than with casual partners, and rarely for anal or oral sex. 30% of heterosexual and 60% of gay/bisexual youths reported engaging in anal intercourse. 83% of the sample believed that it is hard to get HIV from sex. Most believed that they had already changed their behavior to reduce their risk, such as reducing the number of sex partners, being more selective of sex partners, and/or increasing condom use. AIDS prevention messages should be conveyed to these adolescents while they are a captive audience.