Correct condom application among African-American adolescent females: The relationship to perceived self-efficacy and the association to confirmed STDs

Purpose: To assess condom application ability and the relationship between perceived ability and demonstrated ability. Also, to examine the associatio n between high-demonstrated condom application ability and recent sexual ri sk behaviors and laboratory-diagnosed sexually transmitted diseases (STDs) among African-American adolescent females. Methods: A purposeful sample of sexually active African-American females (n = 522) completed a structured interview and provided vaginal swab specimen s for STD testing. Subsequent to the interview, adolescents demonstrated th eir condom application skills using a penile model. A 9-item scale assessed adolescents' perceived self-efficacy to apply condoms. Sexual risk behavio rs assessed by interview were noncondom use at last inter-course and the la st five intercourse occasions for steady and casual sex partners as well as any unprotected vaginal sex in the past 30 days and the past 6 months. Results: Approximately 28% of the sample tested positive for at least one S TD and nearly 26% self-reported a history of STDs. Controlled analyses indi cated that adolescents' self-efficacy for correct use was not related to de monstrated skill. Adolescents' demonstrated ability was not related to any of the sexual risk behaviors. Likewise, recent experience applying condoms to a partner's penis and demonstrated ability were not related to laborator y-diagnosed STDs or self-reported STD history. Conclusions: Adolescents may unknowingly be at risk for human immunodeficie ncy virus and STD infection owing to incorrect condom application. Further, high-demonstrated ability to apply condoms was not related to safer sex or STDs. Reducing sexual risk behaviors may require more than enhancing adole scent females' condom application skills and may require addressing other r elational skills. (C) Society for Adolescent Medicine, 2001.