Unprotected sex is not the new engagement ring: An examination of factors associated with condom use behavior among U.S. young adult males

Background: Unprotected sexual intercourse can lead to serious and long-lasting effects, most notably unplanned pregnancy and STI transmission. Increasing rates among people in their twenties indicate that young adults are just as vulnerable to the consequences of unprotected sex as sexually-active teenagers. Additionally, there is strong support for the inclusion of men in reproductive health and STI research. The presence of males in these studies is imperative to gaining a comprehensive view of the most relevant factors influencing decisions of barrier protection during penile-vaginal sex. This dissertation aims to examine the associations of reproductive health factors on consistent condom use among U.S. young adult men.;Methods: Data originated from interviews conducted for the 2006-2008 cycle of the National Survey of Family Growth (NSFG). Respondents were sexually active 18-29 year old males who were not currently trying to impregnate a female partner (N = 2,010 total sample). Multinomial logistic regressions, adjusting for age, marital status, race/ethnicity, work status and educational level, assessed the likelihood of consistent condom use in the past four weeks (n = 1,512) and in the past 12 months (n = 1,856). Mediation analyses, using binary variables, investigated the potential mediating effects of fertility desires and HIV concerns on consistent condom use.;Results: Older age at sex debut, current pregnancy, multiple female partners, female contraceptive use at last sex, a high chance of feeling less physical pleasure, concerns about HIV, and ever having tested for HIV were significantly associated with both outcomes assessing consistent condom use. Fertility desires did not serve as a mediator on either association of parity and consistent condom use. Males with multiple female partners in the past 12 months were more likely to have HIV concerns but those with HIV concerns were less likely to wear condoms consistently.;Conclusions: Evidence from this study suggests that various reproductive health factors are associated with consistent condom use among males. Additional research may provide further clues on the association of fertility desires on consistent condom use. Promoting condoms as both an effective family planning and disease prevention strategy stand to have a great impact among young adults.