Predictors of condom use among adolescents in Peru

BACKGROUND:

The Latin American/Caribbean region constitutes >10% of new cases of STIs globally, with adolescents at particular risk. There is currently limited knowledge of sexual behaviors among Latin American adolescents

OBJECTIVE:

To evaluate sexual conducts, knowledge and demographic characteristics associated with condom use among adolescents in Peru.

METHODS:

A nationally-representative, cross-sectional study was performed in 2004 using a household-based survey and multistage cluster sampling. Unmarried male and female residents of selected cities between 15-19 years of age were selected for participation. Consenting participants answered a face-to-face questionnaire for demographic data, and a self-administered questionnaire exploring sexual behaviors.

RESULTS:

The resulting sample included 995 men and 1180 women (overall participation: 96%). Overall, 23% of females and 45% of males were sexually active (p<0.001). Mean age was similar in males (16.8y) and females (16.9y). Condom use at last intercourse was lower in females (27%) than in males (52%). Multiple logistic regression showed that receiving sexual education from school, health-workers, sexual partner, friends and the media were significantly associated with condom use at last sex for females (OR:[95% CI]: 53.6[8.2-350.6]), OR:[95% CI]:33.4[2.6-436.0], OR:[95% CI]:23.4[2.8-194.9], OR:[95% CI]:22.9[2.4-216.7], OR:[95% CI]:19.1[1.5-243.6], respectively) as compared to receiving education from family. For males, significant associations existed between condom use at last sex and both condom use at first sex and knowledge of where to obtain condoms (OR:[95% CI]:18.2[2.3-142.5]), (OR:[95% CI]:10.0[4.2-23.4]).

CONCLUSIONS:

Effective promotion of condom use will depend on improvements in access to condoms for all adolescents accompanied by strengthened condom negotiation skills and empowerment, particularly for females.