intercourse compared to other adolescents (Hingson et al., 1990). Embarrassment in obtaining and using condoms is also an important factor that may discourage their use (Hingson et al., 1990). In a sample of female adolescents who were pregnant or who already had a child, Koniak-Griffin and colleagues (1994) found that poor condom use was associated with greater embarrassment.

Age. Condom use among men declines with age. For example, data show that the rate of reported condom use at last intercourse steadily declined with increasing age from 39 percent of men 20-25 years old to 17 percent of men 35-39 years old in 1991 (Pleck et al., 1993). In 1992, 28 percent of adults 18-24 years of age surveyed reported using a condom at last intercourse compared to 19 percent of adults 30-34 years of age and 12 percent of adults 40-44 years of age (Laumann et al., 1994). These data may reflect the tendency to rely on contraceptive methods other than condoms as men grow older, establish long-term relationships, and depend more on female-controlled contraceptives such as oral contraceptives and sterilization (Landry and Camelo, 1994). Age also seems to be associated with the comfort level of persons in negotiating condom use with partners. For example, a national survey revealed that 69 percent of women 18-24 felt "very comfortable" in asking a new partner to use a condom compared to 55 percent of women 25-34 and 40 percent of women 35-44 years (EDK Associates, 1994).

Educational Level, Race, and Gender. Men with higher levels of education report higher rates of condom use compared to less educated men (Tanfer et al., 1993), but studies have failed to show that socioeconomic status is independently associated with condom use (Pleck et al., 1991; Ku et al., 1992). African American women are almost twice as likely to use condoms compared to women of other races (Anderson et al., 1996). In addition, African American men are more likely to have used condoms during their last episode of intercourse compared to either European American or Hispanic men (Laumann et al., 1994). The rate of condom use at first intercourse for African Americans, however, is lower than that for European American men independent of age at initial intercourse (Ku et al., 1993). Women generally report slightly lower rates of condom use at last intercourse compared to men. In 1992, 18 percent of men and 15 percent of women reported such use (Laumann et al., 1994).

Ability to Negotiate Use. Even if the individual has a condom, negotiating its use with one's partner may be difficult. Condom use may be particularly difficult in a romantic relationship. For a woman, asking a partner to use a condom (or for a man, using one himself) may convey a lack of trust in the partner. Women may fear that their partner will react angrily to the suggestion. Marin and colleagues (1993) found that Hispanic women's fear of an angry response by their partners to a request to use condoms predicted their reported use of condoms. In some cultures, suggestions about condom use may prompt male partners to view the

The National Academies of Sciences, Engineering, and Medicine
500 Fifth St. N.W. | Washington, D.C. 20001

Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement