216788 Condoms and sugar daddies: Sexual bargaining about condom use among low SES women

Wednesday, November 10, 2010 : 8:50 AM - 9:10 AM

Janet E. Rosenbaum, PhD, AM , Maryland Population Research Center, University of Maryland, College Park, MD
Ralph DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory University, Atlanta, GA
Eve Rose, MSPH , Rollins School of Public Health Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
Gina M. Wingood, ScD, MPH , Rollins School of Public Health Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
Jonathan Zenilman, MD , Infectious Diseases Division, Johns Hopkins Bayview Medical Center, Baltimore, MD
While some policymakers assume that safe sex merely requires information or personal confidence, behavioral models suggest that social context may determine females' bargaining power to insist on safe sex. This study uses data from a 3 wave, 12 month study of 715 low-SES African-American adolescent women. Six propensity-weighted logistic regressions predicted never using condoms in the past 14 and 60 days at waves 2 and 3. 24.0% of respondents reported receiving most of their spending money from their boyfriend, which is not predicted by public assistance program participation, neighborhood context, or family background, but is predicted by educational achievement and expectations, abuse history, sexual risk-taking, and sexually transmitted disease status. After weighting by estimated propensity scores, no differences remain between women who receive spending money and those who do not in the 39 evaluated covariates. Women who receive spending money were twice as likely to never use condoms as women who do not, adjusting for earlier condom use, relationship length, use of oral contraceptives, partner concurrency, and intervention status, in all six regressions (p-values from 0.002 to 0.05). Women who discontinue receiving spending money from boyfriends are 2.3 (p=0.04) and 2.9 (p=0.008) times as likely to start using condoms as women who continue. These findings may have policy implications for adolescents' jobs programs or programs that pay women not to become pregnant, which may promote self-reliance and increase safe sex among disadvantaged adolescent women.

Learning Areas:
Biostatistics, economics
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Audience members will be able to identify some economic factors that predict lower condom use, and explain potential policy solutions to these factors.

Keywords: Reproductive Planning, Condom Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I planned the analysis and analyzed the data that resulted in this paper, consulting with co-authors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5073.0: Sexual risk in adolescents