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Objectives. We examined correlates of condom use among a national random probability sample of sexually experienced young adults aged 15 to 24 years (n = 7686) in South Africa.
Methods. Using data from the Reproductive Health and HIV Research Unit National Youth Survey, we conducted gender-stratified bivariate and multivariate logistic regression analyses to determine predictors of whether respondents had used a condom during their most recent sexual intercourse.
Results. Condom use at sexual debut and talking with one's first sexual partner about condoms were the most significant predictors of condom use at most recent intercourse. Other significant predictors included high condom use self-efficacy, optimism about the future, and reported behavior change attributable to HIV/AIDS. Young adults who were married or had been involved in a relationship for 6 months or more were significantly less likely to have used a condom during their most recent sexual intercourse.
Conclusions. Our findings point to the importance of exposing youths to sexuality education before their sexual debut as well as voluntary counseling and testing and programming that supports young adults, particularly young women, in making informed decisions about sexual intercourse and condoms. (Am J Public Health. 2007;97:1241-1248. doi:10.2105/AJPH.2006.086009)
Young adults represent one of the groups at highest risk for HIV infection.1 Indeed, the results of a nationally representative household survey conducted in South Africa in 2003 revealed that more than 15% of young women and almost 5% of young men aged 15 to 24 years were infected with HIV.2
Condoms remain the most effective protection against HIV and other sexually transmitted infections (STIs) for sexually active young adults. Most South African youths know that condoms prevent HIV, STIs, and unwanted pregnancies and that it is important to use a condom every time they have sexual intercourse.3 In addition, in South Africa, condoms are provided free of charge by the government and are available to young adults through a number of venues, including public-sector clinics and youth centers; indeed, 87% of South African youths report that it would be "very easy" to obtain condoms if the need arose.2
According to 2 recent surveys, however, including the survey on which the current study was based, only about 57% to 59% of young men and 48% of young women report having...