Condom use among urban youth across the high school years: The role of neighborhood characteristics

Background:

Neighborhood characteristics have been linked to adolescent well-being, yet the association between neighborhood characteristics and HIV/AIDS risk behaviors has received limited attention. We address this gap by examining the association between neighborhood disadvantage and racial segregation, and consistent condom use using a longitudinal dataset of youth interviewed during the four years of high school (N = 850; 80% African American; 50% female). We obtained a 91% response rate over the four years. Neighborhood data was extracted from the US Census and linked to participants' data.

Methods:

We used a 3-level hierarchical model to examine the association between neighborhood characteristics, individual factors, and condom use over time. In our analyses, we accounted for individual-level factors (sex, race, GPA, SES, self-acceptance, depression and alcohol use) at Time 1 (age 14), as well as pregnancy concerns, sexual intercourse occasions, and number and age of partners over time.

Results:

Condom use in our sample decreased during adolescence. Youth reporting greater pregnancy concerns, sexual intercourse occasions, and number of partners were more likely to report condom use over time. We found no association between age of partner and condom use over time. Preliminary findings exploring the 3-level model suggest neighborhood disadvantage and racial segregation are only associated to youth's baseline condom use and self-acceptance, and are not related to trajectories of condom use.

Conclusions:

We will discuss the implications of our findings for HIV/AIDS prevention, including the notion that efforts to counteract or protect against the negative effects of neighborhood disadvantage may be beneficial.