M.D. Thesis Abstracts Yale University School of Medicine, 1998

The primary risk factor for HIV transmission in adolescents is their sexual behavior; therefore, if we are to decrease the transmission of HIV among adolescents we must address the factors associated with preventive and risky sexual behavior. The goal of this study was to collect information concerning the prevalence and correlates of condom usage in three cohorts of New Haven adolescents. Research was conducted at three public educational sites. Site 1 was a school for pregnant adolescents. Site 2 was a detention center with educational services for schoolaged children. Site 3 was a traditional public high school serving grades 9-12. Students at each site completed a questionnaire assessing sexual behavior, coping skills, self-esteem, substance use, sexual activity and a previous history of physical/sexual abuse. The data collection instrument incorporated three common theories in the field of adolescent sexual behavior: the Health Belief Model, the Self-Efficacy Theory and the Reference GroupBased Social Influence Theory. SAS was used for bivariate analysis. Site 1 had the lowest rate of condom use, with 29% reporting that they never use a condom. Site 2 reported the highest rate of condom use, with 47% of males and 63% of females reporting that they always used condoms during sexual intercourse. At this site consistent condom use was correlated with a positive attitude toward themselves (p = .001), a belief that they could avoid AIDS if they took precautionary steps (p = .003), and carrying a condom with them "just in case" (p = .001). At site 3, the majority of students used condoms consistently or abstained from sex. Those who did not use condoms consistently were more likely to drink alcohol (p = .042) and report higher levels of stress in their lives (p = .014). Each educational site had unique characteristics that influenced condom use behavior. These differences should be used to lead future research and the development of better interventions. If we are to stem the tide of adolescent transmission, AIDS education must be targeted, appropriate, and culturally sensitive.