Safer sex in context: Condom and contraceptive use among adolescent women.

Abstract

This dissertation strives to deepen and diversify our understanding of adolescent female sexuality, particularly the issues and conditions that shape and constrain safer sex. Using the Theory of Planned Behavior as a theoretical springboard, the links between safer sex practices and four domains (religiosity, mental health, sex-positive attitudes, and gendered power) are explored among a racially diverse sample of adolescent women. For this dissertation, data from 2,193 adolescent women between the ages of 15 and 20 were drawn from the National Longitudinal Study of Adolescent Health (Udry, 1998). Survey measures included those assessing sexual attitudes, subjective norms regarding sex, contraceptive self-efficacy, sexual behavior and relationship histories, religiosity, depressive symptomatology, and self-esteem. SUDAAN was used to perform multinomial logistic and linear regression analyses of three dependent variables: consistency of condom use; consistency of contraceptive use; and contraceptive effectiveness. Results supported the viability of sociocognitive variables (e.g., attitudes, subjective norms, and self-efficacy) in predicting more consistent and effective safer sex. In addition, different constellations of demographic characteristics were predictive of each of the dependent variables. Latinas were significantly less consistent and less effective practitioners of safer sex than their peers. Religious participation decreased the odds of consistent contraceptive use and a significant negative interaction effect between participation and identifying as Latina was found for contraceptive effectiveness. Asian Pacific Islander American respondents affiliated with Born-Again, Catholic, or other denominations engaged in safer sexual practices than White and/or non-religious respondents. Depressive symptomatology reduced the likelihood of consistent condom use among the general sample, but was found to be less detrimental to safer sex practices among Latinas. Conversely, self-esteem among Latinas was more predictive of safer sex practices than among White respondents. Holding sex-positive attitudes had no impact on safer sex behavior. Finally, with regard to gendered power, physical abuse decreased the odds of consistent condom use and several significant interactions provided evidence of moderator effects of gendered power on contraceptive self-efficacy. Not only do these findings carry implications for future research and practice, but their complexity also aptly reflects the complexity of the sexual lives of adolescent women.