Discontinuing condom use with main sex partners: Starting only to stop

BACKGROUND: Initiating condom use with sex partners and subsequently discontinuing use presents a risk for STD/HIV acquisition. Research has found an association between less favorable attitudes regarding condom effectiveness and discontinuing condom use, but beyond this little is known about why women discontinue condom use and the STD risk associated with this decision. The purpose of this study is to examine the STD risk associated with discontinuing condom use, as well as identify correlates of discontinuation. METHODS: Data were collected from 701 African American girls aged 14 to 20 years who enrolled in an HIV prevention intervention. In addition to laboratory-confirmed tests for trichomoniasis, chlamydia, and gonorrhea, psychosocial, sociodemographic data, as well as self-reported behavioral data related to condom use at first and last sex with main partner were collected using ACASI. Bivariate analyses were conducted to identify correlates of discontinuation and chi-squares examined whether STD rates differed significantly between discontinuers and those who never used condoms. RESULTS: Seventy-six percent (n=165) of participants were discontinuers. There was a significant relationship between discontinuing condom use and testing positive for gonorrhea (p=.03), but difference was detected for other STDs and pregnancy. Further, discontinuing condom use was associated with reported emotional abuse (p=.05), forced vaginal sex (p=.00), and lower condom use self efficacy (p=.03). CONCLUSIONS: Overall, discontinuers were not at equal risk for contracting STDs or getting pregnant compared to girls who do not use condoms. Future research should identify additional factors regarding why girls discontinue condom use with main sex partners.