From Words to Actions: Latino Youth and Emerging Adults' Comfort with Sexual Communication and Reported Condom Use

Background and Purpose: Latino youth are at higher risk for both early pregnancy and sexually transmitted infections than non-Hispanic Whites in the U.S. Condom use, as the only method that effectively protects against both pregnancy and STIs, has the potential to reduce these disparities. Research examining adolescents’ and emerging adults’ comfort with sexual communication and condom use has been mixed, necessitating further examination into this critical issue. Using cross-sectional data from Latino adolescents and emerging adults, this presentation will address the following research questions: 1) What are the condom use reporting discrepancies between partners in a couple? 2) Is condom use associated with comfort with sexual communication or other relevant covariates at a bivariate level? 3) Is comfort with sexual communication associated with last month condom use after controlling for relevant covariates when employing random intercept logistic regression?

Methods: A sample of 454 sexually active Latinos (227 couples) aged 16–29 living in San Francisco were surveyed between 2003 and 2006. Condom use in the last month was dichotomized for analysis. Comfort with sexual communication was assessed through eight items informed by the qualitative component of the original mixed methods study. Hierarchical modeling was used by applying a random intercept logistic regression analysis to examine associations between comfort with sexual communication and condom use, adjusting for covariates (age difference, length of sexual relationship, gender, age, parents’ marital status, and maternal education).

Results: There was notable variation in condom use reporting within couples. At the bivariate level, condom use was significantly related to comfort with sexual communication (r(454) =-.11, p = .02). In adjusted models, this relationship did not hold. When examining the couples’ mean level of comfort with sexual communication and last month condom use, a significant relationship emerged – the estimated coefficient for the couple mean comfort with sexual communication indicated that for every one-unit increase in the mean comfort score, the estimated odds for condom use decreased by 79% (p < .05). In addition, the length of a couple’s sexual relationship was significant, suggesting that for each additional month of relationship length, the estimated odds of condom use decreased by 4%, when controlling for other covariates (p<.05).

Conclusion: Results from this cross-sectional analysis indicate that comfort with sexual communication is negatively associated with condom use among Latino couples. This finding affirms existing literature that indicates condom use is more common at the beginning of a relationship and then decreases. This study points to the importance of researching couples, as opposed to individuals. The significance of the couple-level (averaged) comfort with sexual communication variable and not the individual-level variable is interesting because it suggests that there may be something about examining the couple that is more predictive than looking at each partner. These results challenge the gendered approach to understanding contraception in the U.S., which places the bulk of contraception responsibility on women and girls and suggest that relationship context may play a critical role in condom use decisions among Latino youth.