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Condom use among young adults in the United States: The importance of relationship characteristics

Yasamin Kusunoki, MPH, School of Public Health/Department of Community Health Sciences, University of California, Los Angeles, 650 Charles E. Young Drive South, Box 951772, Los Angeles, CA 90095-1772, 310-794-9391, ykusunok@ucla.edu and Dawn M. Upchurch, PhD, School of Public Health/ Department of Community Health Sciences, University of California, Los Angeles, 650 Charles E. Young Drive South, Box 951772, Los Angeles, CA 90095-1772.

Use of condoms is a key protective behavior in the prevention of unintended pregnancy and STDs/HIV during adolescence and young adulthood. Although contraceptive use among youth is improving in the United States, a substantial proportion of youth continue to engage in unprotected sex, the majority of youth who do use contraception do not do so consistently, and there are persisting differences in use by gender, race/ethnicity, and age. An emerging body of literature suggests that contraceptive behavior may vary by the characteristics of individuals' sexual relationships. While this research has improved our understanding of the role of relationships, it has often been restricted to high risk groups and limited by simple measures of the relational context and insufficient data on individuals' relationship experiences. We address these limitations by utilizing the retrospective sexual relationship histories of over 15,000 young adults available in the most recent wave (2001-2002) of the National Longitudinal Study of Adolescent Health (Add Health) to explore relationship-specific condom use. We first provide a detailed description of young adults' sexual relationships and examine the extent to which the characteristics of these relationships vary depending on key individual characteristics such as age, gender, and race/ethnicity. Through the use of multilevel logistic regression techniques, we then examine the contributions of relationship-specific factors on the likelihood of using a condom. Findings indicate that several relationship characteristics are significantly associated with condom use even when controlling for individual characteristics. Furthermore, the effects of relationship characteristics differ depending on individual characteristics.

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