A psychosocial framework for understanding condom use among urban Black adolescents.
Using lessor's psychosocial framework of risk behaviour, this study examined the impact of variables within a number of risk domains on condom use at last sex. The sample was 587 sexually active male and female black youth between the ages of 16 and 20 years old from the township areas of Soweto (Johannesburg), Umlazi (Durban) and Khayelitsha (Cape Town). Binary logistic regression models were used in the analysis. Within the biological risk domain, gender was a significant predictor of condom use at last sex. None of the proximate social context variables, viz. parental education, family structure, and parent-adolescent communication, were significant predictors. Health services' promotion of condom use was a significant predictor within the distal social context. Within the perceived environment in relation to the self, perception of risk and perception of barriers were significant predictors of condom use at last sex. None of the variables within the perceived environment in relation to peers domain, viz. perceived peer attitudes to condoms and peers suffering the negative consequences of unprotected sex, were significant. The personality domain contained measures of self-esteem, future time orientation, locus of control and fatalism. Locus of control was the only significant predictor within this domain of condom use at last. Engagement in other risk taking behaviour, such as smoking cigarettes, alcohol and drug use, was a significant predictor within the general behaviour domain. Within the sexual behaviour domain, partner discussion and contraceptive use were significant predictors of condom use at last sex. 2 In the final model, the significant predictors in order of importance, were the perception of risk, the promotion of condom use by a health professional, locus of control, discussion with a partner, the perception of barriers, the use of contraceptives, and risk taking behaviour. The only interaction in the final model of condom use at last sex was between the promotion of condom use by a health professional and concurrent use of other forms of non-barrier contraception.