Freya L. Sonenstein

Sexual activity, condom use and AIDS awareness among adolescent males

New data from the 1988 National Survey of Adolescent Males indicate that 60 percent of never-married young men ages 15-19 are sexually active. Among 17-19-year-old males living in metropolitan areas, the rate of sexual activity reported in 1988 was 15 percent higher than that reported in 1979. This increase encompasses a rise of 23 percent among black males and 13 percent among nonblack males. Slightly more than half of the sexually active males in the 1988 survey reported that they had used a condom the last time they had had intercourse. Among both black and nonblack youths aged 17-19 living in metropolitan areas, rates of reported condom use at last intercourse more than doubled between 1979 and 1988. Conversely, reported reliance on ineffective methods of contraception or use of no method at last intercourse was 60 percent lower. When first intercourse occurred within two years of the 1988 survey, the odds of using a condom were increased by 110 percent over the odds when intercourse occurred between 1975 and 1982, after controlling for the effects of age at first intercourse, race and ethnicity. The young men in the sample were very knowledgeable about how the human immunodeficiency virus is transmitted, and over three-quarters of the sample did not dismiss the disease as uncommon, nor did they think that using condoms to prevent the spread of AIDS was too much trouble. The rates of condom use were significantly lower than average, however, among young men who had ever used drugs intravenously or whose partners had done so, young men who had ever had sex with a prostitute and those who had had five sexual partners or more in the past year.

The dynamics of young men's condom use during and across relationships

According to data from the 1991 National Survey of Adolescent Males, condom use is likely to be highest at the beginning of relationships and to decline as the relationship continues. The proportion of sexually active men aged 17-22 who used a condom with their most recent partner declined from 53% the first time they had intercourse with that partner to 44% at the most recent episode. Condom use also decreases with age; 59% of 17-18-year-olds used a condom the first time they had intercourse with their most recent partner, compared with 56% of 19-20-year-olds and 46% of 21-22-year-olds. However, the probability that the female partner used the pill the first time that the couple had sex increased with the mans age--from 21% among 17-18-year-olds to 35% among 21-22-year-olds. Young men were more likely to have used a condom if they thought their partner was sexually inexperienced, and less likely to have done so if they suspected their partner was at high risk for an STD.

Attitudes toward male roles among adolescent males: A discriminant validity analysis

This study investigates the discriminant validity of a measure of attitudes toward male roles, i.e., beliefs about the importance of men adhering to cultural defined standards for masculinity. Using data from the 1988 National Survey of Adolescent Males, the Male Role Attitude Scale (MRAS) is evaluated in terms of (1) its independence from measures of attitudes toward female roles, and of attitudes toward gender roles and relationships, and (2) its differential correlates with and incremental ability to explain variance in criterion variables compared to measures of these two other gender-related attitudes. As predicted, the MRAS is unrelated to attitudes toward the female role, but is significantly associated with attitudes toward gender roles and relationships. As further predicted, the MRAS, but not attitudes toward women or attitudes toward gender roles and relationships, is associated with homophobic attitudes toward male homosexuality and with traditional male procreative attitudes. In addition, the MRAS explains significant incremental variance in these criterion measures when attitude toward female roles and attitude toward gender roles and relationships are controlled for. These results support the theoretical argument that attitudes toward male roles are conceptually distinct from the other gender-related attitudes examined here.

Changes in sexual behavior and condom use among teenaged males: 1988 to 1995.

OBJECTIVES This study examines shifts in sexual experience and condom use among US teenaged males. METHODS Results from the 1988 and 1995 National Surveys of Adolescent Males were compared. RESULTS The proportion of never-married 15- to 19-year-old males who had had sex with a female declined from 60% to 55% (P = .06). The share of those sexually active using a condom at last intercourse rose from 57% to 67% (P < .01). Overall, the proportion of males who had sex without condoms last year declined from 37% to 27% (P < .001). CONCLUSIONS Although protective behaviors among teenagers have increased, significant proportions of teenagers--especially Black and Hispanic males--remain unprotected.

Levels of sexual activity among adolescent males in the United States

Although three-fifths of adolescent males aged 15-19 say they have had sexual intercourse, analyses of data from the 1988 National Survey of Adolescent Males indicate that their level of sexual activity is relatively moderate. The data show that among sexually experienced young men the mean number of partners in the last 12 months is 1.9, and the mean frequency of intercourse in the last four weeks is 2.7 times. Black males have had more partners than white or Hispanic males; however, after the number of years since first intercourse are controlled for, these differences disappear. On average, sexually experienced youth spent six out of the last 12 months with no sexual partner, and only 21 percent of sexually active males had more than one partner in any month in the last year. Comparisons with 1979 data suggest that proportionately more adolescents were sexually experienced in 1988, but fewer non-black males had first intercourse before their 15th birthday. The number of partners since first intercourse and in the past four weeks appears to have decreased, as has the frequency of intercourse in the last four weeks.

Age differences between minors who give birth and their adult partners.

The role of adult men in adolescent childbearing has received heightened attention in recent years, and a new policy efforts have focused on statutory rape laws as a way to reduce adolescent childbearing. Analyses of the 1988 National Maternal and Infant Health Survey indicate, however, that these policies would not apply to most teenage births. Among mothers aged 15-17 who had a child in 1988, 27% had a partner at least five years older than themselves. In addition, since 23% of minors with older partners were married at the time of the infants birth, 21% of babies born to unmarried minors were fathered by substantially older men. While births to young mothers and older men raise social concerns, these births make up a small share of all teenage childbearing: Only 8% of all births to 15-19-year-olds are to unmarried minors with a partner five or more years older.

Adolescent Males' Condom Use: Relationships between Perceived Cost-Benefits and Consistency.

The relationship between males perceived cost benefits and consistency of condom use in 4 areas preventing pregnancy avoiding AIDS partner expectations and embarrassment and reduction of pleasure--is examined. The stratified nationally representative sample of 1880 never-married males 15-19 years provided the data (the National Survey of Adolescent Males). There was overrepresentation of black and Hispanic men. Measures utilized and defined are as follows: consistency of condom use subjective expected utility of condom use the personal cost benefits of preventing pregnancy the normative belief in preventing pregnancy avoiding AIDS partner expectations embarrassment and reduction of pleasure and control variables (e.g. current age race family income living in a female-headed family at age 14 educational goals age at 1st intercourse region metropolitan residence importance of religion being born again locus of control and self-esteem). Although 1 limitation is the accuracy of teen reports of condom use which may be overreported the results indicate the consistency of adolescent males condom use is high. Males use of condoms is motivated both by perceptions of personal cost benefits to themselves and by cost benefits related to normative expectations. Consistency is significantly associated with males degree of belief in normative male contraceptive responsibility and perceived decreased pill use by partner. The utility for pregnancy prevention in contrast to prior research was not associated with condom use in either bivariate or multivariate analysis. This could be accounted for by the specification of the measure or that normative belief motivates condom use to a greater degree than perceived personal benefit. Worry about AIDS covaries with condom use but perceived risk is not related. Partner expectation is strongly related to condom use. Condom use is associated with the males degree of belief in a normative male responsibility to prevent pregnancy rather than as a personal benefit and the utility of the partner appreciating condom use. The findings for condom consistency and condom use at least intercourse follow a similar pattern except for utility (partner appreciates) and disutility (embarrassment). Consistency is not associated with current age and is positively associated with age at 1st intercourse. Those with >2 partners in the last year are more inconsistent users. The highest consistency is among black adolescent males. The implication for sex education is that emphasis should be on the benefit of consistent condom use in preventing AIDS and pregnancy encouragement of women to insist on condom use male responsibility in contraception and general social norms supporting condom use.

The association of AIDS education and sex education with sexual behavior and condom use among teenage men.

According to a 1988 nationally representative survey, most 15-19--year-old men in the United States have received formal instruction about AIDS (73%), birth control (79%) and resisting sexual activity (58%). Results of multivariate analyses show the receipt of AIDS education and sex education to be associated with modest but significant decreases in the number of partners and the frequency of intercourse in the year prior to the survey. Having received instruction in these topics was also associated with more consistent condom use. Instruction in some topics was associated with increases in knowledge and attitudes about AIDS, but these increases were not always correlated with safer behavior.

Understanding changes in sexual activity among young metropolitan men: 1979-1995.

CONTEXT Changes in the sexual behavior of teenagers can have a significant impact on levels of adolescent pregnancy and transmission of sexually transmitted diseases (STDs). Understanding the role played by attitudes and educational efforts will provide critical prevention information. METHODS Data on the sexual behavior, sexual attitudes, educational experiences and demographics of 2,087 never-married metropolitan males aged 17-19 from the 1979 National Survey of Young Men and the 1988 and 1995 waves of the National Survey of Adolescent Males were analyzed through multivariate methods to examine factors that predict sexual behavior as well as those that predict sexual attitudes. RESULTS The percentage of males aged 17-19 who had ever had sex increased from 66% in 1979 to 76% in 1988 and then decreased to 68% in 1995. The frequency of sexual intercourse in the year prior to the survey increased significantly over time, although the lifetime number of sexual partners did not. Acceptance of premarital sex increased significantly from 1979 to 1988, then decreased significantly from 1988 to 1995. Over time, young men were increasingly likely to prefer having and supporting a baby to marriage, abortion or adoption as the resolution to a nonmarital pregnancy. Trends in attitudes were strongly associated with sexual behaviors, with more conservative attitudes predicting less sexual activity. AIDS education, which was nearly universal in 1995, was associated with decreased sexual activity, although not among black youths. CONCLUSIONS More conservative sexual attitudes and increased exposure to AIDS education are key predictors of decreased sexual activity among adolescent males. However, broader societal factors, such as fear of AIDS and increased awareness of problems associated with teenage pregnancy and STDs, may underlie both attitudinal and behavioral changes.

Contraceptive Attitudes and Intention to Use Condoms in Sexually Experienced and Inexperienced Adolescent Males

In the 1988 National Survey of Adolescent Males, about three fifths of sexually experienced and inexperienced adolescent males intending to have sex in the next year reported there is an “almost certain chance” they will use a condom with a hypothetical future partner. Sexually experienced males report lower perceived costs for condom use related to embarrassment (assessed in a subjective expected utility format) than do inexperienced males. However, experienced males perceive condoms as being more costly in terms of reduction of pleasure. The perceived benefits of using condoms in terms of preventing pregnancy and gaining appreciation from the partner, and attitudinal endorsement of male responsibility in contraception more generally, are similar for the two groups. Among both the sexually experienced and inexperienced, believing that males are responsible for contraception and, to a lesser extent, perceiving that condoms have low costs in terms of reduction of pleasure and high benefits in gaining the partners appreciation influence intent to use a condom. Attitudes discounting the risk of AIDS reduce intended condom use in both groups. For the sexually inexperienced, other factors associated with intention to use a condom include metropolitan residence, high educational aspirations, and self-esteem. For the experienced, not being Hispanic, holding religion to be important, liberal attitudes about the male sex role, worry about AIDS, and condom use at last intercourse also predict intended condom use.