Trajectories of Condom Nonuse and Predictors of Trajectory Group Membership Among African-American Adolescents

Abstract

Background. Although condom use among adolescents has been researched extensively, fewer studies have captured changes in this behavior over time. The purpose of this study was to identify developmental trajectories of condom nonuse between the ages of 10 and 18 years, and to determine predictors of the trajectory group membership. Methods. Study participants included1285 adolescents, aged 10 to 18 years, who were part of the Mobile Youth Survey, a multiple cohort longitudinal study of adolescents living in the Mobile, Alabama, Metropolitan Statistical Area. Using the SAS macro PROC TRAJ, semiparametric group-based modeling was used to identify trajectories of condom nonuse. Multivariate logistic regression was used to examine variables that predict membership to the trajectories groups. Results. Results indicated that the best model comprised three distinct trajectory groups of condom nonuse: low, decreasing and increasing-decreasing, and they comprised 80.2%,15.2% and 4.6% of participants, respectively (Figure1). In the multinomial logistic regression analysis, the low trajectory group was used as the reference group. After controlling for other variables, gender, alcohol use and suicide ideation predicted belonging to the decreasing group. Males (OR = 4.09; P <0.001), alcohol users (OR = 1.69; P = 0.003) and those who had thought of suicide (OR = 1.84; P = 0.004) were more likely to belong to the decreasing group vs. the low group. None of the variables predicted membership to the increasing-decreasing group. Conclusion. Sexual risk behaviors such as condom nonuse may cluster and follow distinct trajectories. Some trajectories form while adolescents are still young. This has implications for STI/HIV preventive programs, which should pay attention to factors that may infuence adolescents' belonging to diferent trajectory groups of behaviors that put them at risk for STIs HIV infection. Interventions for alcohol use and suicide should be initiated when adolescents are still young. [Figure Presented].