Social-cognitive predictors of consistent condom use among young people in Moscow.Russia is experiencing an explosive HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. epidemic and has one of the fastest growing incidence rates in the world. According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. the Russian Federal AIDS Center, the number of people infected in·fect
tr.v. in·fect·ed, in·fect·ing, in·fects
1. To contaminate with a pathogenic microorganism or agent.
2. To communicate a pathogen or disease to.
3. To invade and produce infection in. with HIV increased from 1,080 at the end of 1995 to 274,197 by March 2004. (1) Most experts estimate that the actual number of HIV cases is 5-10 times the officially registered number, and that more than one million people are living with HIV infection in Russia. Young people aged 15-29 are the most affected group. (2)
Until recently, nearly all new HIV infections were related to injection-drug use, but this situation has changed. Between 1998 and 2004, the proportion of new infections that were related to injection-drug use declined from 93% to 86%; the proportion attributable to heterosexual heterosexual /het·ero·sex·u·al/ (-sek´shoo-al)
1. pertaining to, characteristic of, or directed toward the opposite sex.
2. one who is sexually attracted to persons of the opposite sex. transmission rose from 5% to 23%. (3) The changing pattern of the epidemic is also evidenced by the growing numbers of HIV infections among pregnant women and children, as well as by the increasing prevalence of STDs that can facilitate heterosexual transmission of HIT The number of syphilis syphilis (sĭf`əlĭs), contagious sexually transmitted disease caused by the spirochete Treponema pallidum (described by Fritz Schaudinn and Erich Hoffmann in 1905). cases among females aged 10-14 in 1998 was 50 times that in 1990, (4) and in the Moscow region, the number of pregnant women with syphilis in 1997 was seven times that in 1993. (5) The number of children born to HIV-positive mothers is also increasing rapidly Only 20 children had been born with HIV in Russia before 1997, but by March 2004, the total was 7,918. (6)
Condom use is an effective strategy for the prevention of heterosexual transmission of STDs, including HIV. (7) Condoms, when used correctly and consistently, can reduce the rate of HIV transmission by 87%. (8) In Russia, however, fewer than half of sexually experienced people aged 15-25 ever use condoms; the proportion is only 29% among sexually experienced students and 6% among sexually experienced adults aged 15-55. (9) Use of contraceptive methods Noun 1. contraceptive method - birth control by the use of devices (diaphragm or intrauterine device or condom) or drugs or surgery
birth control, birth prevention, family planning - limiting the number of children born , including condoms, likewise is low, as the high rate of unintended pregnancies and accompanying high number of abortions among young women in Russia indicate. Almost three out of five pregnancies in Russia ended in abortion in 2002, and half of registered abortions were among women aged 20-30. (10) Overall, this suggests that unprotected sexual behavior sexual behavior A person's sexual practices–ie, whether he/she engages in heterosexual or homosexual activity. See Sex life, Sexual life. is common in the general population. This is worrisome in light of the growing HIV epidemic.
Understanding factors associated with safer sexual practices and condom use among young people is important in developing effective interventions. In this article, we assess the factors associated with consistent condom use among young men and women in Moscow. We included in our analysis variables that have been shown to be important in predicting sexual behavior and that could affect condom use in sexually active populations. (11)
Participants and Procedure
We used data from a September 2002 telephone survey conducted by the Validata research agency to obtain information about the coverage of a mass media campaign to promote safer sexual practices and to assess its impact on HIV knowledge, attitudes and practice among people aged 15-29. The media campaign lasted six consecutive months and included 30-second TV clips and outdoor advertising, including posters, leaflets and flyers about safer sexual behavior. The survey was sponsored by the nonprofit A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive.
Nonprofits are also called not-for-profit corporations. Nonprofit corporations are created according to state law. international organization Medecins sans Frontieres.
About 15,000 telephone numbers were randomly selected from the telephone registry and given to the interviewers. At each residence, the person aged 15-29 whose birthday was closest to the day of the interview was asked to participate in the survey. Nine percent of potential participants completed interviews. Most of the rest did not agree to participate (38% overall) or were not available at the selected telephone number after at least three calls (42%); 11% refused to participate. Prior to the interview, the purpose of the study was explained to potential participants, and verbal informed consent was obtained. Overall, 1,203 interviews were conducted--609 with women and 594 with men. Interviews, which lasted 15-20 minutes, were conducted in Russian by 40 trained interviewers (mainly females) with at least one year of interviewing experience. After the interviews, the data were analyzed an·a·lyze
tr.v. an·a·lyzed, an·a·lyz·ing, an·a·lyz·es
1. To examine methodically by separating into parts and studying their interrelations.
2. Chemistry To make a chemical analysis of.
3. using SPSS A statistical package from SPSS, Inc., Chicago (www.spss.com) that runs on PCs, most mainframes and minis and is used extensively in marketing research. It provides over 50 statistical processes, including regression analysis, correlation and analysis of variance. 11.0.
The questionnaire was originally developed in 1997 by the AIDS Foundation East-West, and was used in 1998 and 2000 surveys to evaluate the influence of media campaigns on young Muscovites' knowledge, attitudes and practices regarding safer sex. Prior to our survey, the questionnaire was pilot-tested, and appropriate changes were made to improve its content and the wording of the questions. The interviews consisted of 92 questions on demographic characteristics; knowledge about the media campaign, HIV and AIDS, and condom use; sexual behavior; risk perceptions; and attitudes toward condoms. Questions related to knowledge about the media campaign were not used in the analyses because all participants likely had been exposed to the campaign.
Knowledge about HIV and AIDS was assessed through four questions: three about modes of HIV transmission (e.g., "What do you think, is it possible to get HIV from an infected person through needle sharing Needle sharing is the colloquialism for the reuse of syringes by multiple illegal drug users to administer intravenous drugs, and is a primary vector for diseases which can be transmitted through blood, including hepatitis and AIDS. ?"), and one about condoms as a preventive method against HIV ("Do you think using condoms during sexual intercourse sexual intercourse
or coitus or copulation
Act in which the male reproductive organ enters the female reproductive tract (see reproductive system). can prevent you from getting HIV?"). Each correct response was assigned one point, and a total score was computed for each participant. Respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. were considered to have high knowledge if their total score was four, moderate knowledge if it was three and low knowledge if it was less than three.
We also assessed levels of misconceptions Misconceptions is an American sitcom television series for The WB Network for the 2005-2006 season that never aired. It features Jane Leeves, formerly of Frasier, and French Stewart, formerly of 3rd Rock From the Sun. about the transmission of HIV Respondents were asked if the virus could be transmitted through a handshake handshake - handshaking , common dishes, a cough cough, sudden, forceful expiration of air from the lungs caused by an involuntary contraction of the muscles controlling the process of breathing. The cough is a response to some irritating condition such as inflammation or the presence of mucus (sputum) in the , sweat and toilet seats. Each incorrect response was assigned one point, and a total score was computed for each study participant. Respondents who gave no incorrect answers were regarded as having a low level of misconceptions, those who made up to three mistakes were regarded as having a moderate level of misconceptions and those who answered at least four questions incorrectly were regarded as having a high level of misconceptions.
To measure risk perceptions, we asked whether respondents think that they are at risk of getting STDs, getting HIV and being involved in an unwanted pregnancy unwanted pregnancy Obstetrics A pregnancy that is not desired by one or both biologic parents. See Teen pregnancy. if they have intercourse Verb 1. have intercourse - have sexual intercourse with; "This student sleeps with everyone in her dorm"; "Adam knew Eve"; "Were you ever intimate with this man?" . The section on sexual behavior and condom use included questions about whether the respondent In Equity practice, the party who answers a bill or other proceeding in equity. The party against whom an appeal or motion, an application for a court order, is instituted and who is required to answer in order to protect his or her interests. was sexually experienced and the age at which he or she had first had sexual intercourse, number of sexual partners during the last month, condom use during the last six months, reasons for using or not using condoms, and attitudes toward condoms. Response options for number of partners were "none," "one" or "more than one." For condom use during the last six months, respondents indicated whether they "always," "sometimes," "rarely" or "never" used condoms. For reasons for using or not using condoms, we asked respondents to indicate whether each item on a list of seven possible answers applied (e.g., "I have a permanent partner"; "I do not have money to buy condoms"). Attitudes toward condoms were measured by whether respondents agreed or disagreed with six statements about condom use, norms and effectiveness (e.g., "I think condoms are reliable protection against [sexually transmitted infections]"; "l think that a majority of people of my age use condoms"). The main outcome variable was consistent condom use during the last six months. Participants indicating that they had always used condoms during that period were identified as consistent users, and all others were categorized cat·e·go·rize
tr.v. cat·e·go·rized, cat·e·go·riz·ing, cat·e·go·riz·es
To put into a category or categories; classify.
cat as inconsistent users.
The analyses included all respondents who answered yes to the question "Have you ever had sexual intercourse?" The frequency distribution of potential predictors of condom use was examined, and appropriate categories were created. Most predictors were coded as dichotomous di·chot·o·mous
1. Divided or dividing into two parts or classifications.
2. Characterized by dichotomy.
di·chot variables. The prevalence of consistent condom use in each category of the predictor variables Noun 1. predictor variable - a variable that can be used to predict the value of another variable (as in statistical regression)
variable quantity, variable - a quantity that can assume any of a set of values was determined; univariate associations between condom use and predictor variables were summarized by using odds ratios and corresponding 95% confidence intervals confidence interval,
n a statistical device used to determine the range within which an acceptable datum would fall. Confidence intervals are usually expressed in percentages, typically 95% or 99%. .
To adjust for multiple predictors simultaneously, we performed multivariate The use of multiple variables in a forecasting model. analyses using logistic regression In statistics, logistic regression is a regression model for binomially distributed response/dependent variables. It is useful for modeling the probability of an event occurring as a function of other factors. models. Separate models were constructed for women and men. All variables that were significant in the univariate analyses and others that were thought to be important on the basis of previous reports were included in the logistic regression models. Stepwise stepwise
incremental; additional information is added at each step.
stepwise multiple regression
used when a large number of possible explanatory variables are available and there is difficulty interpreting the partial regression procedures, using both forward selection and backward elimination procedures, were used to determine the final model. After the final model was obtained, potential confounding confounding
when the effects of two, or more, processes on results cannot be separated, the results are said to be confounded, a cause of bias in disease studies.
confounding factor of variables that were not included was assessed by adding these variables to the model one at a time, and looking at the changes in estimates and standard errors of the other predictors. Changes of more than 10% in the estimated predictors indicated confounding. The fitness of the final model was assessed by using the Hosmer-Lemeshow test. (12)
Of the 1,203 young people who participated in the survey, 929 (77%) said they were sexually experienced and were included in the analysis. The sample included 455 women and 474 men. Respondents' mean age was 23.0 years (standard deviation In statistics, the average amount a number varies from the average number in a series of numbers.
(statistics) standard deviation - (SD) A measure of the range of values in a set of numbers. , 3.9). The majority (66%) of these young people were married or living with a partner. On average, they had had 13.2 years of formal education (standard deviation, 2.2). Age at first sexual intercourse averaged 17.7 years (standard deviation, 1.9); it ranged from 12.0 (among eight participants) to 28.0 (one participant). Seven percent of women and 20% of men reported having had more than one partner in the last month.
Fifty-five percent of women and 26% of men in the sample had a high level of HIV knowledge. Levels of misconceptions were generally moderate (42% among women, 40% among men) or low (46% and 51%, respectively). Only 22% of female participants and 27% of males perceived themselves to be at risk of getting HIV through sexual intercourse.
Overall, 44% of respondents said that they had always used condoms during intercourse INTERCOURSE. Communication; commerce; connexion by reciprocal dealings between persons or nations, as by interchange of commodities, treaties, contracts, or letters. in the last six months, while 57% reported that they had never used condoms or used them rarely Levels of consistent use were low both among married respondents (48% of women and 53% of men) and among their unmarried counterparts (29% and 27%, respectively). The proportion using condoms consistently was significantly higher among men than among women (48% vs. 39%; p<.05).
Among inconsistent users, the most common reasons for not using condoms (Table 1) were having a permanent partner (37%), using other methods (30%) and feeling that condoms reduce pleasure during sex (28%). A substantial proportion of inconsistent users cited their partners' opposition to condom use (17%); only 1% reported that they did not have money to buy condoms. Significantly higher proportions of women than of men attributed their inconsistent use to having a permanent partner, using other contraceptive methods or having a partner who opposes condom use.
The most common reasons that consistent users gave for using condoms--cited by six in 10 overall--were to protect themselves against HIV, other STDs and unwanted pregnancy However, greater proportions of men than of women cited disease prevention, whereas a greater proportion of women than of men cited pregnancy prevention. Twenty-two percent of consistent users said they used the method because it prolonged pro·long
tr.v. pro·longed, pro·long·ing, pro·longs
1. To lengthen in duration; protract.
2. To lengthen in extent. sexual intercourse, and 15% said that their partners liked condoms; a higher proportion of men than of women reported this last reason.
Predictors of Consistent Condom Use
In the univariate analysis, consistent condom use decreased significantly with increasing age among both men and women (Table 2). Single respondents were more likely to use condoms consistently than were married respondents (odds ratio, 2.4 for women and 3.0 for men). Men with a low level of knowledge about HIV were more likely than those with a high level to use condoms consistently (1.7); level of knowledge was not significant for women, and misconceptions and risk perceptions were not associated with use among women or men. Participants who had had more than one partner in the past month were significantly more likely than those who had had only one to use condoms consistently (3.2 for women and 2.2 for men). Both women and men who believed that most of their peers use condoms had elevated odds of being consistent users (3.3 and 4.3, respectively). Other condom attitudes--believing that condoms protect against HIV, other STDs or pregnancy--were associated with consistent use among females or males, but not both.
Five variables were significantly associated with consistent condom use in the multivariate analysis multivariate analysis,
n a statistical approach used to evaluate multiple variables.
n a set of techniques used when variation in several variables has to be studied simultaneously. (Table 3). For both women and men, the likelihood of consistent use was elevated among respondents who were single (odds ratios, 1.8 and 2.6, respectively), those who believed that condoms offer reliable protection against unwanted pregnancy (2.4 and 1.6) and those who reported that most of their peers use condoms (2.9 and 4.6). Among women, consistent condom use decreased with increasing age, and having more than one sex partner in the last month was associated with an increased likelihood of consistent use.
Consistent condom use was relatively low among the sexually experienced young people in our study Among both women and men, only about half of surveyed unmarried respondents and fewer than a third of married respondents reported consistent use. We also observed significant differences in attitude toward condoms among women and men. A higher proportion of men than of women reported that they used condoms because their partners like to, while a significantly higher proportion of women than of men reported that they did not use condoms because their partners were against it. This suggests that educational programs aimed at developing negotiation skills among partners could increase condom use among young people in this population. A number of studies throughout the world have shown that improved partner communication skills are important in increasing condom use. (13) Moreover, a far higher proportion of women than of men reported using condoms to protect themselves from unwanted pregnancies, and a higher proportion of men than of women reported using condoms to protect themselves from HIV or STDs. These findings highlight the importance of developing gender-specific condom promotion messages.
Perceived condom effectiveness against unwanted pregnancy was associated with consistent condom use among men and women in the multivariate analysis. This could mean that if other contraceptive contraceptive /con·tra·cep·tive/ (-sep´tiv)
1. diminishing the likelihood of or preventing conception.
2. an agent that so acts. options become readily available, use of condoms is likely to decrease in this population. Hence, education and promotional campaigns should emphasize the effectiveness of condoms both in preventing the spread of HIV and other STDs and in protecting against unwanted pregnancy
Other predictors of consistent condom use in our study were marital status marital status,
n the legal standing of a person in regard to his or her marriage state. , age, number of partners (for women) and the belief that peers use condoms. These factors have been reported to influence sexual behaviors, including condom use, in many countries. (14) Married, older people are more likely to use other means of contraception contraception: see birth control.
Birth control by prevention of conception or impregnation. The most common method is sterilization. The most effective temporary methods are nearly 99% effective if used consistently and correctly. and tend to have trusting relationships with their spouses. These factors may reduce the perceived need for condoms as a means of disease prevention. On the other hand, young people, who may have relatively unstable unstable,
adj 1. not firm or fixed in one place; likely to move.
2. capable of undergoing spontaneous change. A nuclide in an unstable state is called
radioactive. An atom in an unstable state is called
excited. sexual relationships, may be more likely to use condoms consistently Although monogamy monogamy: see marriage. and abstinence abstinence: see fasting; temperance movements. are important HIV prevention strategies, condom use remains an important approach for prevention of HIV and unwanted pregnancies among married couples and others in long-term partnerships. Thus, promotion of condoms as contraceptive methods or as dual protection against unwanted pregnancies and STDs may be an appropriate strategy among married people. (15)
The association between consistent condom use and belief that condoms are used by peers suggests that increasing the proportion of young people using condoms is likely to lead to higher condom use in this population. Promotional campaigns in the general population can increase overall condom use by making condoms more socially acceptable in the community Another approach for promoting condoms, especially among young people, can be peer-based education. As indicated in many studies, peers play a very important role in behavioral change. (16)
In our study, the level of HIV knowledge, level of misconceptions about HIV and perceived risk of getting HIV through sexual intercourse were not significantly associated with consistent condom use in multivariate analysis. These findings are consistent with results from other studies. (17) Nevertheless, we cannot underestimate the importance of HIV education, which is essential for effecting behavioral change, reducing stigma stigma: see pistil.
mark of Cain
God’s mark on Cain, a sign of his shame for fratricide. [O. T.: Genesis 4:15]
scarlet letter regarding HIV and thus preventing new cases of infection.
When interpreting the results presented here, we have to take into account factors that might have influenced our findings. Because of the cross-sectional design of our study, the observed associations may not be causal causal /cau·sal/ (kaw´z'l) pertaining to, involving, or indicating a cause.
relating to or emanating from cause. . Additionally, our findings are subject to potential selection bias: Women and men who refused to participate in the survey may have differed from respondents with respect to sexual behaviors, background characteristics and level of HIV knowledge. Furthermore, selection bias may be a potential problem because some households in Moscow do not have a telephone.
Information bias also may affect our results. Participants could have given socially acceptable answers in response to sensitive questions. The result could be, for example, an underestimation of the proportion who had had more than one partner. Similarly, to "satisfy" interviewers, respondents may have overreported consistent condom use.
Finally, our questionnaire may have omitted predictors of consistent condom use. For example, behavioral beliefs may influence sexual behavior and condom use among young people. (18) Studies need to be done to test these associations in the Russian context.
Our findings have several implications for condom promotion programs in Moscow. First, it will be important to increase awareness about the effectiveness of condoms against both unwanted pregnancies and STDs, including HIV, in ongoing condom promotion activities. Second, gender-specific peer-based education and training in negotiation skills can be used to promote condoms among youth. It is also important to target young single men as the at-risk population group by emphasizing condom effectiveness against STDs, and by promoting a general healthy lifestyle. Third, condoms should be recommended for married couples and people with one permanent partner as a contraceptive option as well as for STD (Subscriber Trunk Dialing) Long distance dialing outside of the U.S. that does not require operator intervention. STD prefix codes are required and billing is based on call units, which are a fixed amount of money in the currency of that country. prevention. Policies need to be adjusted to implement this approach in local family planning clinics family planning clinic n → clínica de planificación familiar
family planning clinic n → centre m de planning familial
This research was supported by the Harvard School of Public Health The Harvard School of Public Health is (colloquially, HSPH) is one of the professional graduate schools of Harvard University. Located in Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, next to Harvard Medical School and Cambridge, Massachusetts, , Boston. The authors thank Validata research agency and Murdo Bijl at AIDS Foundation East-West for donating the data set used in the statistical analysis.
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Geneva (jənē`və), Fr. Genève, canton (1990 pop. 373,019), 109 sq mi (282 sq km), SW Switzerland, surrounding the southwest tip of the Lake of Geneva. : UNAIDS, 2003.
(3.) Russian Federal AIDS Center, 2004, op. cit. (see reference 1).
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The Weavers are small passerine birds related to the finches.
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American microbiologist. He shared a 1954 Nobel Prize for work on the cultivation of the polio virus. and Davis K, Condom effectiveness in reducing heterosexual HIV transmission, Cochrane Database of Systematic Reviews, 2002, 1: CD003255.
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The countries of eastern Europe, especially those that were allied with the USSR in the Warsaw Pact, which was established in 1955 and dissolved in 1991. and Central Asia, Infektsii Peredaiushchiesia Polovym Putem, 2002, No. 5, pp. 48-54 (in Russian).
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Of, relating to, or undergoing adolescence.
A young person who has undergone puberty but who has not reached full maturity; a teenager. Thai vocational students , Journal of Nursing Scholarship, 2003, 35(2): 157-163.
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The science of statistics applied to the analysis of biological or medical data. , second ed., Belmont, CA: Wadsworth, 2000.
(13.) Greig FE and Koopman C, Multilevel mul·ti·lev·el
Having several levels: a multilevel parking garage.
Adj. 1. multilevel - of a building having more than one level analysis of women's empowerment em·pow·er
tr.v. em·pow·ered, em·pow·er·ing, em·pow·ers
1. To invest with power, especially legal power or official authority. See Synonyms at authorize.
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MSE Materials Science & Engineering
MSE Mean Squared Error
MSE Mean Square Error
MSE Master of Science in Engineering
MSE Manufacturing Systems Engineering
MSE Mechanically Stabilized Earth British Medical Journal The British Medical Journal, or BMJ, is one of the most popular and widely-read peer-reviewed general medical journals in the world. It is published by the BMJ Publishing Group Ltd (owned by the British Medical Association), whose other , 1998, 316 (7125): 138-139; Eramova I and Toskin IA, 2002, op. cir. (see reference 9); Shorokhov SS, Poletaeva TA and Makarova LN, The forms and analysis of the results of work in preventing HIV infection among youth, Zhurnal Mikrobiologii, Epidemiologii I Immunobiologii, 1999, No. 1, pp. 89-91 (in Russian); and Gyarmathy VA, Thomas RP and Mikl J, Sexual activity and condom use among eastern European adolescents--the Study of Hungarian Adolescent Risk Behaviours, International Journal of STD and AIDS, 2002, 13(6):399-405.
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Natalia Bobrova is research officer, Department of Primary Care and Social Medicine, Imperial College, London.
Oleg Sergeev is director, Chapaevsk Medical Association, Chapaevsh, Russia.
Tatyana Grechukhina is senior program advisor, AIDS Foundation East-West, Moscow.
Saidi Kapiga is associate professor of reproductive health Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene , Department of Population and International Health at Harvard School of Public Health, Boston.
Author contact: firstname.lastname@example.org
TABLE 1. Percentage of 15-29-year-olds reporting selected reasons for inconsistent condom use and for consistent condom use, by gender, Moscow, 2002 Reason Total Women Men Inconsistentuse (N=451) (N=239) (N=212) I have a permanent partner *** 36.7 45.9 27.8 I use other methods to prevent unwanted pregnancy *** 30.4 38.0 23.0 Condoms are uncomfortable and reduce pleasure 27.6 27.9 27.2 My partner is against using condoms *** 16.7 22.4 11.2 I do not have moneyto buy condoms 0.8 0.7 0.8 Consistent use (N=404) (N=179) (N=225) I want to protect myself from sexually transmitted infections *** 59.7 52.1 67.1 I want to protect myself from unwanted pregnancy *** 58.6 63.5 53.8 I want to protect myself from HIV/AIDS *** 58.0 50.1 65.6 Condoms prolong sexual intercourse 21.9 19.1 24.5 My partner likes them *** 14.6 7.5 21.5 *** Gender differences significant at p<.001. TABLE 2. Percentage of 15-29-year-olds reporting consistent condom use, by selected characteristics, and odds ratios (and 95% confidence intervals) from univariate analysis assessing characteristics associated with consistent use, by gender Characteristic Women Men % Odds ratio % Odds ratio Age *** 15-20 55.6 2.4 (1.4-4.1) 61.2 2.5 (1.5-4.2) 21-23 35.2 1.0 (0.6-1.9) 41.1 1.1 (0.7-1.9) 24-26 30.9 0.9 (0.5-1.5) 43.4 1.2 (0.7-2.1) 27-29 (ref) 34.3 1.0 38.5 1.0 Marital status Single 48.4 2.4 (1.6-3.5) 53.3 3.0 (1.9-4.9) Married (ref) 28.5 1.0 27.4 1.0 Level of HIV knowledge High (ref) 40.6 1.0 39.2 1.0 Moderate 39.0 0.9 (0.6-1.4) 52.0 1.3 (0.7-2.2) Low 35.0 0.8 (0.4-1.4) 45.0 1.7 (1.1-2.6) Level of HIV misconceptions High (ref) 40.0 1.0 54.3 1.0 Moderate 40.6 1.0 (0.6-1.9) 49.7 0.7 (0.4-1.3) Low 38.0 0.9 (0.5-1.7) 44.4 0.8 (0.4-1.6) Risk perceptions At risk for STDs 42.1 1.2 (0.8-1.8) 50.3 1.2 (0.8-1.7) At riskfor HIV 44.1 1.3 (0.8-2.0) 50.0 1.2 (0.8-1.7) At riskfor unwanted pregnancy 37.2 0.8 (0.6-1.2) 51.2 1.3 (0.9-1.8) No answer 30.2 0.7 (0.4-1.4) 41.5 1.3 (0.8-2.1) No. of sexual partners in past month 0 45.0 1.4 (0.7-2.7) 63.6 0.9 (0.5-1.4) 1 (ref) 37.4 1.0 44.8 1.0 >1 65.6 3.2 (1.5-6.9) 52.1 2.2 (1.1-4.2) Attitudes toward condoms Condoms are reliable protection against HIV 41.3 1.3 (0.9-1.9) 51.4 1.7 (1.1-2.5) Condoms are reliable protection against STDs 43.6 1.8 (1.2-2.7) 49.9 1.4 (0.9-2.1) Condoms are reliable protection against unwanted pregnancy 48.0 2.4 (1.6-3.5) 52.2 1.5 (1.0-2.2) Most of my peers use condoms 45.6 3.3 (2.0-5.4) 53.4 4.3 (2.5-7.5) *** p<.001 for linear trend. Notes: ref=reference category. Characteristics which no reference category is indicated were measured dichotomously. TABLE 3. Odds ratios (and 95% confidence intervals) from logistic regression analysis assessing characteristics associated with consistent condom use, by gender Characteristic Women Men Age *** 15-20 1.7 (0.9-3.3) 1.6 (0.9-2.8) 21-23 0.9 (0.5-1.8) 0.7 (0.4-1.3) 24-26 0.8 (0.5-1.5) 1.1 (0.6-2.0) 27-29 1.0 1.0 Marital status Single 1.8 (1.1-2.9) 2.6 (1.5-4.5) Married (ref) 1.0 1.0 Believe that condoms are reliable protection against unwanted pregnancy Yes 2.4 (1.6-3.8) 1.6 (1.1-2.4) No (ref) 1.0 1.0 Think that most peers use condoms Yes 2.9 (1.7-4.9) 4.6 (2.6-8.2) No (ref) 1.0 1.0 No. of sexual partners during last month No answer 0.8 (0.4-1.6) 0.8 (0.5-1.3) 0 1.3 (0.7-2.8) 1.5 (0.7-3.0) 1 (ref) 1.0 1.0 >1 2.3 (1.0-5.3) 1.3 (0.8-2.1) *** p<.001 for linear trend for women. Note: ref=reference category.