What are we preventing: Condom use during pregnancy among young expectant couples

Background: Condom use among young couples is often to prevent pregnancy and/or STDs. Pregnancy removes pregnancy prevention from sexual decision-making and can help us understand why couples use condoms for disease prevention. Methods: Preliminary analyses were conducted on 200 dyads from an ongoing study of expectant couples. The average age of women and men was 18.7 and 21.3, respectively, and 77% of participants were Black or Hispanic. Couples in their 3rd trimester reported condom use over the past 6 months. We assessed risk factors (e.g., number of partners, STD history, cheating, HIV testing), relationship factors (e.g., length, satisfaction, power, attachment, communication), and psychosocial predictors (e.g., condom attitudes, efficacy) for both male and female partners. Results: 68% of couples reported never using condoms in the past 6 months, 18% reported inconsistent condom use, and only14% used condoms consistently. Both men's and women's past and current risk behavior did not relate to condom use during pregnancy (all p>.05). Predictors of any condom use included women's increased avoidance attachment (OR=1.86, p<.05), women's increase relationship power (OR=4.10, p<.01), and using a condom the first time the couple had sex (OR=2.85, p<.01). Predictors of consistent condom use included men's increased avoidance attachment (OR=1.96, p<.05), and men's increased sexual communication (OR=1.52, p<.05). Conclusion: Most couples do not use condoms during pregnancy. Past and current risk among either member of the couple does not influence condom use. However, relationship power and sexual communication may be protective and could be targeted in interventions among pregnant couples.