Adolescent condom use, the health belief model, and the prevention of sexually transmitted disease
Hiltabiddle, S.J.
Journal of Obstetric Gynecologic and Neonatal Nursing Jognn 25(1): 61-66
1996
ISSN/ISBN: 0884-2175 PMID: 8627404 DOI: 10.1111/j.1552-6909.1996.tb02514.xDocument Number: 298692
A nurse practitioner at Women's and Children's Health Services in Philadelphia, Pennsylvania, has reviewed 26 documents on adolescent development, sexually transmitted disease (STDs), STD risk factors, and factors influencing condom use among heterosexual adolescents to develop recommendations for STD prevention programs. She uses the constructs of the Health Belief Model (HBM) to incorporate the findings of the literature review into the recommendations. Adolescents tend to use condoms infrequently and inconsistently. They also have a high rate of STDs. The perception that one can enjoy sex with condoms, condom use allows sex at the spur of the moment, condoms are clean and easy to use, condoms are popular with peers, and condoms require the male to be responsible has a positive association with intention to use condoms among adolescents. Among males, the perception of positive attitudes from their girlfriends toward condoms and an increased confidence in their ability to use condoms correctly is positively associated with condom use. Factors associated with nonuse include perceived barriers to condom use (inconvenience, reduced sexual pleasure, or embarrassing to use), increased use of nonbarrier contraceptives since they remove pregnancy prevention as a motivation for condom use, many lifetime partners, intercourse with strangers, multiple sex partners, and alcohol or illicit drug use. HBM focuses on the individual's perceptions, so health providers and educators should assess the individual's needs and how the adolescent's current behavior is meeting these needs. After identifying perceptions about condom use, the provider can intervene. Interventions include targeting misconceptions and perceptions of personal vulnerability and helping the adolescent do a more realistic risk assessment. Providers should focus on the social and physical benefits of condom use rather than just on the health benefits. They should also emphasize modes of STD transmission and effective means of protection, including a demonstration of condom use on a model.