Sexual Behaviors and Condom Use: A Study of Suburban Male Adolescents

Article excerpt

The sexual revolution of the 1960s, characterized by more permissive attitudes toward sexual relations (Hamburg, 1986), resulted in a substantial increase in sexual activity in adolescents (Chilman, 1986). The percentage of sexually active adolescents increased from 10 to 20% in the early 1960s to approximately 50 to 60% by the end of the decade and has remained at this level (Brooks-Gunn & Furstenburg, 1989; Centers for Disease control, 1992; King et al., 1989; Sante Quebec, 1991).

A consequence of greater sexual permissiveness was an increase in sexually transmitted diseases (STDs). According to Werner and Biro (1990), sexually active adolescents have the highest rates of gonorrhea and chlamydia, infections which are responsible for more than half the cases of pelvic inflammatory disease (PID) (Stewart, 1987) and can result in infertility (Elkins, McNeeley, & Tabb, 1986; Johnson, 1987; MMWR, 1991). Also, an increasing number of adolescents are being infected by HIV (Elmslie, 1990; Siegel et al., 1991).

STDs could be prevented if adolescents adopted adequate preventive behaviors. Yet the condom, considered to be the most effective protection against their spread, was until the mid-1980s used by only a third of adolescents at their first sexual intercourse and by less than a quarter at their most recent intercourse (Ellefsen, 1985; Herold, 1984; Zelnik & Kantner, 1980). Recent studies have found that condom use at first intercourse has doubled, yet less than a third use condoms at each intercourse (Hingson et al., 1990; Sonenstein & Ku, 1991).

Because of these risks behaviors, efforts have been initiated throughout North America and the international community to control the spread of STDs and, in particular, that of AIDS (Nutbeam & Blakey, 1990). For the past five years, in the Province of Quebec, Canada, publicity about STDs and AIDS has been mainly through television and radio. For three years, in certain junior colleges, universities, and other public places, the provincial government has made condoms available in vending machines. In 1988, the Quebec Ministry of Health and Social Services launched a multi-media campaign to promote condom use and STD prevention. This campaign lends support to ongoing educational activities already begun in schools by educators and health professionals.

Historically, sexually risky behaviors have more often been found in boys than in girls (Chilman, 1986; Earle & Perricone, 1986). Boys tend to have their first sexual experience at a younger age than do girls, and are more prone to have relations with an acquaintance. Sociocultural norms also tend to be more permissive for boys. Given the sporadic nature of adolescent sexual activity and the fact that sexual relations are more often initiated by the male partner, the decision to use condoms is usually relegated to boys.

The purpose of this study, therefore, was to examine sexual behaviors and condom use in boys. To do so, a survey was conducted on 1,312 male adolescents in Laval, Quebec. The influence of age, certain sociodemographic variables, and school structure on sexual behaviors and condom use was also assessed in the sample.

METHODS

The survey was conducted from April to June 1989 on a sample of male adolescents registered in French secondary schools in Laval. Laval is a mainly French-speaking middle-class suburb of Montreal and is the second most populous city in the province of Quebec (population 314,398). Out of 16 secondary schools, six were chosen to participate in the study. The schools were selected in order to represent different school structures: junior high only (grades 7-8), high school only (grades 9-11) and junior high and high school combined (grades 7-11), as well as different socioeconomic milieus (upper-middle-, middle-, and lower-class). In each school, three to five classes were sampled by grade level, providing a total population of 1,328 male adolescents from grades 7 to 11. …