Patterns of condom use and sexual behavior among never-married women

Abstract

Background and objectives: Use of condoms is one of the main methods sexually active persons may choose to prevent infection with sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). Little is known about patterns of condom use among women in the United States. We provide a conceptualization of patterns of condom use and factors associated with these patterns.

Goal of this study: To examine patterns of condom use and associated characteristics among sexually active, never-married women in the United States.

Study design: Analysis of data from the 1988 National Survey of Family Growth, which is a nationally representative sample of women in their childbearing years.

Results: Only a minority of sexually active, never-married women report using condoms, and even fewer report using them consistently. Women with characteristics traditionally associated with increased risk of infection with STD and HIV appear to be less likely to report using condoms and to report using them consistently. Women who report use of condoms to prevent STDs are more likely to report consistent condom use; less likely to cease using condoms; and more likely to initiate consistent condom use.

Conclusion: Findings suggest the need for innovative programming targeted for specific sexually active populations to promote both initiation and maintenance of use of condoms.

PIP: The US Centers for Disease Control's Division of STD/HIV Prevention analyzed 1988 data on 1887 sexually active, never-married women living throughout the US to learn their condom use patterns and associated characteristics of these patterns. More than 75% of these women had had more than 2 lifetime sexual partners, but only 41.2% (777) of all women reported having used condoms within at least 1 month during the previous 4 years and just 31.6% (245) of these women used them consistently (i.e., 13% of all women). 44.5% of women who used condoms at some time during the previous 4 years had stopped using them. 26.2% of women who did not use condoms at the beginning of the 4-year reference period began to use them consistently at another point of the period. The data did not allow the researchers to determine whether the women used the condoms correctly or whether they used them consistently during the course of each month, however. Black and Hispanic women, with lower levels of education and higher numbers of lifetime sexual partners, were most likely not to use condoms. Yet, these women were those at the highest risk of acquiring sexually transmitted disease (STDs) or HIV infection. The most consistent users were women at low risk of acquiring these disease: older White women with few lifetime sexual partners who used condoms to prevent STDs and considered themselves at low risk of acquiring AIDS. Women who used condoms to prevents STDs were more likely to use condoms in the previous 4 years, use them consistently, and initiate consistent condom use; they were also less likely to cease using condoms. These findings stress the need for STD/HIV prevention efforts (raising awareness and effective ways to reduce the risk) to target young, minority women with many lifetime sexual partners, women who have not used condoms to prevent STDs, and women who consider themselves to be at risk for HIV infection.