Adolescents' Self-Efficacy to Communicate about Sex: Its Role in Condom Attitudes, Commitment, and Use

Article excerpt

The 2001 National Youth Risk Behavior Survey (YRBS) showed that nearly half of all high school students report a history of engaging in sexual intercourse (45.6%), with males reporting higher rates than females (48.5% and 42.9%, respectively) and African-American students reporting higher rates than Caucasian and Latino students (60.8% versus 43.2% and 48.4%, respectively; CDC, 2002). The primary risks involved in sexual behavior among adolescents are STDS, including HIV, and pregnancy, both of which are preventable through consistent and correct condom use. Although adolescents' use of condoms has increased over the last decade, actual condom use is still inconsistent and less than optimal. Results from the 2001 YRBS indicate that among sexually active students, the prevalence of condom use, which was increasing throughout the 1990s, has leveled off since 1999 with no increase in condom use reported since that time. Condom use during last sexual intercourse was reported by 57.9% of students, with reported rates significantly lower for females (51.3%) than for males (65.1%; CDC, 2002). Identifying factors that lead to increased condom use among sexually active adolescents is therefore paramount to reducing adolescents' risk for STDs, HIV, and unplanned pregnancy.

A long-standing body of literature shows that adolescents who communicate with their parents about sex are less likely to engage in risky sexual behavior than adolescents who do not have such conversations (for a review of the literature, see Holtzman & Robinson, 1995; Jacard & Dittus, 1993). Overall, the majority of research indicates that adolescents whose parents talk with them about sexual issues are more likely to delay sexual onset, and when sexually active, are more likely to use contraceptives, use condoms, and have fewer sexual partners than those adolescents for whom this communication does not occur (Adolph, Ramos, Linton, & Grimes, 1995; DiClemente, Wingood, Crosby, Cobb, Harrington, & Davies, 2001; Fox & Inazu, 1980; Holtzoman & Robinson, 1995; Hutchinson & Cooney, 1998; Jaccard, Dittus, & Gordon, 1996; Miller, Levin, Whitaker, & Xu, 1998; Pick & Palos, 1995; Whitaker & Miller, 2000; Whitaker, Miller, May, & Levin, 1999; Wilson, Kastrinakis, D'Angelo, & Getson, 1994). Parental comfort with the interaction (Shoop & Davidson, 1994), the content of the discussions (Jaccard & Dittus, 1993; Miller, Kotchick, Dorsey, Forehand, & Ham, 1998; Pistella & Bonati, 1998), and the frequency of communication (Sigelman, Derenowski, Mullaney, & Siders, 1993) have been shown to influence the effectiveness of such communication on adolescent sexual behavior.

Although the research base on peer communication and its relation to adolescent sexual behavior is more limited, there is evidence that adolescents' perceptions that their peers support condom use is associated with more consistent condom use (Boyer, Shafer, Wibbelsman, Seeberg, Teitle, & Lovell, 2000; DiClemente, 1991; Romer, Black, Ricardo, & Feigelman, 1994; Whitaker & Miller, 2000); and the perception that peers are sexually active is linked to greater adolescent sexual activity (Boyer et al., 2000; Holtzman & Robinson, 1995; Kinsman, Romer, Furstenberg, & Schwartz, 1998; Romer et al., 1994; Whitaker & Miller, 2000). There is also empirical evidence that adolescents who communicate with their sex partners are more likely to use condoms (Crosby, DiClemente, Wingood, Cobb et al., 2002; DiClemente, 1991; Shoop & Davidson, 1994; Stone & Ingham, 2002). Therefore, it is reasonable to expect that conversations among adolescent peers about sex would also play a critical role in adolescent sexual risk behavior.

Very few studies have examined the simultaneous influence of parent and peer communication on adolescent sexual behavior. Holtzman and Robinson (1995) found that high school students who talked to their parents about HIV were less likely to have unprotected sex, while students who reported discussing HIV with peers were more likely to have unprotected sex. …