Distress a "powerful barrier" to teens' condom use

NEW YORK (Reuters Health) - Teens with psychiatric problems who have confidence in their ability to use condoms effectively while experiencing distress are more likely to use the prophylactics consistently, a new study shows.

The results "suggests the importance of self-efficacy during distress in maintaining safer sexual behavior," Dr. Celia M. Lescano of Brown University School of Medicine in Providence, Rhode Island and colleagues report, while showing "that lack of self-efficacy when confronted with the stress of using condoms is a powerful barrier to their use."

The findings probably apply to many adolescents and teens, not only those with psychiatric issues, the researchers add.

Lescano and her team surveyed 222 male and females between 13 and 18 years old who had psychiatric problems, most commonly depression, disorders in impulse control, or post-traumatic stress disorder. About 40% reported past sexual abuse.

Students completed a series of questionnaires about condom use, sexual behavior, knowledge about HIV, and other topics.

The higher individuals scored on self efficacy - how confident or self-assured they were -- for condom use during distress, the more knowledgeable they were about HIV and the stronger their intentions to avoid behaviors that could put them at risk of HIV, such as unsafe sex or intravenous drug use, the researchers found.

Higher scores on condom use self-efficacy during distress also were tied to greater condom use over the past six months, as well as more condom use during the past month and more consistent condom use.

Teens who had been sexually abused in the past were no more likely to report distress regarding condom use, suggesting that such problems may be seen in among adolescents in general, the researchers report.

To improve teens' self-efficacy in condom use, the researchers suggest that an active approach to helping them manage their feelings effectively is likely required.

"Difficulty with distress during condom use is not confined to those who are clinically depressed or emotionally labile," they add. "Assisting adolescents in managing their emotions may be as important as acquiring practical behavioral skills in order to consistently enact safe sexual behavior."

SOURCE: Journal of Prevention and Intervention in the Community, 2007.