Consistent condom use in the heterosexual relationships of young adults who live in a high-HIV-risk neighbourhood and do not use "hard drugs"

This study was set up to determine the predictors of condom use in the hete rosexual non-commercial sexual relationships of young adults who neither in ject drugs nor use cocaine, heroin or crack, in a neighbourhood with widesp read drug-use-connected HIV. The analytic sample is 279 young adults, aged 18-24, who have never injected drugs and who have not used heroin, cocaine or crack in the last year. They were recruited in the Bushwick neighbourhoo d of New York City, July 1997 to September 1999. A face-to-face interview i ncluded items about their sociodemographic background, substance use and se xual networks. Sexual relationship and self-reported consistent (100%) cond om use over the prior year with the partner in a given relationship was exa mined. Subjects had 337 heterosexual non-commercial relationships. Consiste nt condom use was reported in 32% of these relationships. In multiple logis tic regression, consistent condom use was more likely in relationships that are not 'very close' (odds ratio = 3.92; 95% confidence interval = 2.08, 7 .52); in the relationships of subjects whose peer norms support condom use (OR = 1.94; 95% CI = 1.43, 2.69), who are not problem drinkers (OR = 8.70; 95% CI = 2.22, 58.8), and (perhaps as a result of measurement issues) who a re men (OR = 1.95; 95% CI = 1.04, 3.68). In conclusion, consistent condom u se remains uncommon among youth in this high-risk neighbourhood. It is thus important to keep HIV from entering the sexual networks of youth in commun ities like this through programmes aimed at drug injectors and their sexual partners. Programmes to increase condom use among young adults should focu s on strengthening norms that promote safer sex to protect oneself and othe rs. In addition, assistance should be provided to youth who are problem dri nkers.