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AJPH First Look, published online ahead of print Apr 16, 2009
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AJPH.2007.131870v1
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October 2009, Vol 99, No. S2 | American Journal of Public Health S417-S424
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.131870

RESEARCH AND PRACTICE

Multilevel Predictors of Inconsistent Condom Use Among Adolescent Mothers

Bethanie S. Van Horne, MPH, Constance M. Wiemann, PhD, Abbey B. Berenson, MD, Irwin B. Horwitz, PhD and Robert J. Volk, PhD

Bethanie S. Van Horne and Irwin B. Horwitz are with the University of Texas Health Science Center at Houston, Houston. Constance M. Wiemann and Robert J. Volk are with the Baylor College of Medicine, Houston, TX. Abbey B. Berenson is with the University of Texas Medical Branch, Galveston, TX.

Correspondence: Correspondence should be sent to Constance M. Wiemann, PhD, Department of Pediatrics, Section of Adolescent Medicine & Sports Medicine, Baylor College of Medicine, 6621 Fannin Street, Mail Station CC610.01, Houston, TX 77030-2399 (e-mail: cwiemann{at}bcm.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We used Bronfenbrenner's ecological systems theory to identify factors that predicted never or sometimes using condoms in a multiethnic cohort of adolescent mothers.

Methods. We interviewed adolescent mothers within 48 hours of delivery and surveyed them 6 and 12 months after delivery (n = 636). We used multinomial logistic regression to identify individual-, dyad-, family-, and peer and community-level factors associated with never or sometimes using versus always using condoms during intercourse at 12 months postpartum.

Results. Pregnancy status, partner refusal to use condoms, intimate partner violence, and race/ethnicity predicted both never and sometimes using condoms. Condom use 6 months earlier and church attendance also predicted never using condoms, whereas maternal monitoring was an additional predictor for sometimes using condoms.

Conclusions. Overlapping yet distinct risk profiles predicted never or sometimes using versus always using condoms. Factors from multiple levels of influence affected the condom use behaviors of adolescent mothers indicating that multilevel interventions are needed to promote safer sexual practices among these young women.






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