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Lack of recent condom use among detained adolescent males: a multilevel investigation
  1. R Crosby1,
  2. L F Salazar2,
  3. R J DiClemente2,3
  1. 1College of Public Health, University of Kentucky, KY, USA
  2. 2Rollins School of Public Health, Emory University, GA, USA
  3. 3Emory Center for AIDS Research, Emory University School of Medicine, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Department of Pediatrics, GA, USA
  1. Correspondence to:
 Richard Crosby PhD
 College of Public Health, University of Kentucky, 121 Washington, Avenue, Room 111C, Lexington, KY 40506-0003, USA;


Objective: To investigate multiple levels of influence with respect to the lack of recent condom use among a high risk sample of adolescent males recruited from short term detention facilities.

Methods: A cross sectional survey of 231 adolescent males serving, predominantly, short term detention sentences. Assessments were conducted using audiocomputer assisted self interviewing. Condom use during the most recent sexual event was assessed as well as 20 potential correlates of not using condoms. Correlates were assessed within five levels of causation: personal, relational, peer affiliation, family, and societal.

Results: Nine correlates achieved bivariate significance (p<0.05). Of these, the personal level correlates were particularly important in a multivariate model. The motivation subscale from the Condom Barriers Scale was the strongest multivariate correlate of recent condom use. Adolescents scoring below the median were about 3.4 times more likely to report lack of recent condom use (p = 0.0006). Adolescents indicating they had ever caused a pregnancy were about 2.5 times more likely to report lack of condom use (p = 0.02). Finally, those reporting their peers did not use condoms were about twice as likely to report lack of use (p = 0.048).

Conclusion: Upon investigating multiple levels of potential influence on condom use, the multivariate findings suggest that personal level factors may be the most important determinant of non-use among adolescent males in short term detention facilities. Although structural changes may be needed to influence some forms of safer sex behaviour, direct intervention with adolescent males may be justified to favourably alter determinants of condom use.

  • A-CASI, audio computer assisted self interviewing
  • CBS, Condom Barriers Scale
  • STI, sexually transmitted infections
  • condom use
  • adolescents

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  • This research was supported in part by the Emory Center for AIDS Research (NIH/NIAID 2 P30 AI50409-04A1), the Rural Center for AIDS/STD Prevention at Indiana University, and a grant from the University Research Council at Emory University.

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