Identifying Predictors of Condom Use

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Project Summary Black adolescents are disproportionately at risk of negative sexual health outcomes, such as HIV and other sexually transmitted infections (STIs), compared to their peers. Condoms are an effective preventative measure for adolescents, as they are more accessible than other forms of HIV prevention (e.g., pre-exposure prophylaxis) in addition to being the only form of contraceptive that reduces the risk of both STIs and unintended pregnancy. However, condom use among Black adolescents is particularly low, with Black adolescents reporting lower condom use at last intercourse than White and Hispanic adolescents. Black individuals face interpersonal experiences (e.g., racial discrimination) and structural inequities (e.g., healthcare and condom access) influential to their condom use decisions. Adolescent condom use decisions may also be influenced by the rapid biological changes taking place during this developmental period and the navigation of romantic and sexual relationships for the first time. Prior literature has mostly focused on individual-level (i.e., individual attributes) predictors of condom use, finding somewhat conflicting results and neglecting the structural, environmental, and contextual predictors influential to condom use for this age group. Thus, the purpose of this study is two-fold: (1) to use meta-analytic methods to systematically review and statistically synthesize the literature surrounding individual-level predictors of condom use for Black adolescents (Aim 1) and (2) to use in-depth individual interviews to address the gaps in prior literature surrounding the role of structural, contextual, and environmental factors in condom use among Black adolescents (Aim 2). The proposed study will utilize the Multiple Domain Model of Condom Use, a model outlining both the cognitive decision-making around condom use, as well as the socio-structural, environmental, and contextual factors influential to condom use, as a framework to address multilevel predictors of condom use decisions amongst this population. Through conducting this F31 study in coordination with the proposed training activities, the F31 PI will meet the following training goals: 1) gain proficiency in meta-analytic techniques; 2) gain proficiency in qualitative research methods; 3) gain theoretical and empirical knowledge of the health disparities experiences by Black adolescents; 4) develop expertise in adolescent sexual health and behaviors; and 5) build publication record, presentation skills, and professional network through professional development training, all of which will aid in their goal of becoming an independent researcher.