DIFFERENCES IN ADOLESCENT CONDOM USE TRENDS BY GLOBAL REGION

• Published in: Journal of adolescent health Vol. 66; no. 2S; p. S36
• Main Authors: Koumans, Emily H, Welch, Rachel, Warner, D Lee
• Format: Journal Article
• Language: English
• Published: New York Elsevier BV 01-02-2020
• Subjects: Acquired immune deficiency syndrome; Adolescents; African Americans; Age of onset; AIDS; Birth control; Cohabitation; Condoms; Health behavior; Health surveys; HIV; Human immunodeficiency virus; Impact analysis; Latex; Males; Prevalence; Risk behavior; Sexual behavior; Sexual intercourse; Sexually transmitted diseases; Slang; STD; Surveillance systems; Technology; Unwanted pregnancy; Asia; United States > US; Europe; Africa
• ISSN: 1054-139X; 1879-1972

Purpose: According to the joint United Nations Programme on HIV and AIDS, the male latex condom is the single, most efficient, available technology to prevent the sexual transmission of HIV and other sexually transmitted infections, and is moderately effective for prevention of pregnancy. Condoms are also often the method used at sexual debut for contraception and sexually transmitted infection prevention. We examined the global prevalence and trends of condom use at last sex among adolescents by country since 1991. Methods: We considered only publicly available prevalence data from nationally representative household- or school-based surveys of male and female adolescents aged 13-19 years or in a respective grade of school from 1991-2017, from countries in the following regions: Americas, Europe, sub-Saharan Africa, north Africa, central Asia, south/southeast Asia, and western Pacific. We present condom use prevalence for the first available year(s), the year(s) use peaked, and the most recent year(s) if different from peak year(s) from a total of 72 countries, by region (except the U.S), from the following surveys [question used in brackets]: Youth Risk Behavior Surveillance System (YRBSS)[the last time you had sexual intercourse, did you or your partner use a condom?]. Health Behavior of School-Aged Children (HBSC)[ the last time you had sexual intercourse, did you or your partner use a condom?). Global School-Based Student Health survey (GSHS)[ the last time you had sexual intercourse, did you or your partner use a condom (or country-specific slang term for condom)?). and the Population-based HIV Impact Assessments (PHIA)[was a condom used the last time you had sex with a non-marital. non-cohabiting partner in the last 12 months?]. Results: U.S. YRBS data show that. among males, condom use at last sex increased between 1991 and 2005 from 55% to 70%, then declined to 61% in 2017; among females, it increased from 38% in 1991 to 57% in 2003, then declined to 47% in 2017. Among 41 European countries participating in HBSC, the mean prevalence of condom use among males was 80% in 2001-2002, increased to 81% in 2005-2006, then declined to 68% in 2013-2014; among females the mean prevalence was 70% in 2001-2002, increased to 76% in 2009-2010, and declined to 62% in 2013-2014. Among 21 African, South American, southeast Asian, and western Pacific countries participating in GSHS, from 2012-2014 to 2015-2017, the respective mean prevalence of condom use changed from 52-55%, 51-62%, 59-53% (one country), and 4451%. Additional nationally representative data from PHlA support the GSHS data from African countries. Conclusions: Among adolescents across the globe, the use of condoms at most recent sex has declined in recent years in the United States and Europe, while it has increased in African, South American, and western Pacific countries, reaching prevalences of 51-62% worldwide in most recent years. While these data suggest that use of condoms has increased in many regions, many adolescents remain at risk for sexually transmitted infections, including HIV, and unintended pregnancy. The recent declines in North America and Europe bear further investigation.