Association Between Condom Use at Sexual Debut and Subsequent Sexual Trajectories: A Longitudinal Study Using Biomarkers

Taraneh Shafii, MD, MPH; Katherine Stovel, PhD; King Holmes, MD, PhD

Disclosures

Am J Public Health. 2007;97(6):1090-1095. 

In This Article

Results

Table 1 provides an overview of the study sample. More than half of the respondents were women (52%), and their average age at wave III was 22.2 years. Almost two thirds of the respondents identified themselves as White (64%), and slightly more than one fifth reported being married (22%). Average age at sexual debut was 15.2 years, and the median interval between sexual debut and most recent sexual intercourse was 6.8 years (range: 4.4–15.6 years). Sixty-two percent of the respondents reported having used a condom at their sexual debut, whereas 38% reported having used a condom during their most recent sexual intercourse. Median lifetime number of sexual partners was 5, and 6% of respondents had tested positive for either N gonorrhoeae or C trachomatis.

There were differences in the demographic and behavioral characteristics of adolescents who did and did not use a condom at their sexual debut ( Table 1 ). Condom users had somewhat more advantaged sociodemographic and educational profiles than did nonusers, and they engaged in fewer high-risk behaviors and more protective behaviors (including use of hormonal birth control at their sexual debut) than did nonusers. However, at wave III the 2 groups did not differ in terms of number of partners or frequency of sexual intercourse during the past year.

Table 2 presents estimated odds ratios (ORs) derived from simple and multiple logistic regressions of condom use during most recent sexual intercourse on condom use at debut. The odds ratios were not appreciably different in the 2 models, suggesting that control for relevant stable straits and time-varying factors did not account for the rate of subsequent condom use among early users. Seven years after their sexual debut, those who had used a condom at their debut were approximately 36% more likely than those who had not used a condom at their debut to have used a condom during their most recent sexual activity.

Table 3 presents estimates from simple and multiple linear regressions of the log of lifetime number of sexual partners on condom use at sexual debut. In both models, the coefficient associated with condom use at debut was statistically indistinguishable from zero, indicating that there was no difference between those who did and did not use a condom at their sexual debut in terms of subsequent number of sexual partners.

Table 4 reports ORs from simple and multiple logistic regressions of gonorrhea or chlamydia infection on condom use at debut and selected confounders. The adjusted model showed that respondents who reported using a condom at their sexual debut were half as likely as respondents who did not report using a condom at their debut to test positive for gonorrhea or chlamydial infection at wave III (adjusted OR = 0.50; 95% confidence interval [CI] = 0.26, 0.95), even though the 2 groups reported similar numbers of sexual partners (and similar frequencies of sexual activity).

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