Adolescent Males' Condom Use: Relationships between Perceived Cost-Benefits and Consistency

Abstract

The relationship between males perceived cost benefits and consistency of condom use in 4 areas preventing pregnancy avoiding AIDS partner expectations and embarrassment and reduction of pleasure--is examined. The stratified nationally representative sample of 1880 never-married males 15-19 years provided the data (the National Survey of Adolescent Males). There was overrepresentation of black and Hispanic men. Measures utilized and defined are as follows: consistency of condom use subjective expected utility of condom use the personal cost benefits of preventing pregnancy the normative belief in preventing pregnancy avoiding AIDS partner expectations embarrassment and reduction of pleasure and control variables (e.g. current age race family income living in a female-headed family at age 14 educational goals age at 1st intercourse region metropolitan residence importance of religion being born again locus of control and self-esteem). Although 1 limitation is the accuracy of teen reports of condom use which may be overreported the results indicate the consistency of adolescent males condom use is high. Males use of condoms is motivated both by perceptions of personal cost benefits to themselves and by cost benefits related to normative expectations. Consistency is significantly associated with males degree of belief in normative male contraceptive responsibility and perceived decreased pill use by partner. The utility for pregnancy prevention in contrast to prior research was not associated with condom use in either bivariate or multivariate analysis. This could be accounted for by the specification of the measure or that normative belief motivates condom use to a greater degree than perceived personal benefit. Worry about AIDS covaries with condom use but perceived risk is not related. Partner expectation is strongly related to condom use. Condom use is associated with the males degree of belief in a normative male responsibility to prevent pregnancy rather than as a personal benefit and the utility of the partner appreciating condom use. The findings for condom consistency and condom use at least intercourse follow a similar pattern except for utility (partner appreciates) and disutility (embarrassment). Consistency is not associated with current age and is positively associated with age at 1st intercourse. Those with >2 partners in the last year are more inconsistent users. The highest consistency is among black adolescent males. The implication for sex education is that emphasis should be on the benefit of consistent condom use in preventing AIDS and pregnancy encouragement of women to insist on condom use male responsibility in contraception and general social norms supporting condom use.