Abstract: Understanding Factors Influencing Communication Skills around Condom Use Among Young Adults

◆ Autumn Shafer, University of Oregon
◆ Kisa Clark, University of Oregon
◆ Ed Madison, University of Oregon

Sexually transmitted infections (STIs) are a major concern for public health officials. A recent CDC analysis of U.S. STI data between 2013-2017 noted that rates of gonorrhea increased 67%, syphilis rates nearly doubled, and more than 1.7 million new cases of chlamydia were reported to the CDC in 2017 (CDC, 2018). Additionally, epidemiologists have warned that progress in HIV prevention has stalled, such that U.S. HIV infection rates are no longer declining, but have plateaued in recent years (CDC, 2019). Health professionals consistently recommend the male condom as the most effective method to prevent the spread of STIs and HIV (WHO, 2015). Yet, condom use rates are low. A national study conducted between 2011-2015 found that of women and men between the ages of 15-44 years old who had sex with someone they were not married, engaged, cohabiting, or in some steady relationship with only 41.5% said they used a condom the last time they had sex (Copen, 2017).

Research has found that most people don't use condoms despite understanding their benefits. While many factors influence condom use, studies have identified condom communication as a key factor (French & Holland, 2013; Noar et al., 2006; Peasant, et al., 2015). A meta-analysis of 121 condom use studies that compared 44 different psychosocial variables on their association to reported condom use concluded communication about condoms had the largest effect size of all of the analyzed variables (Sheeran et al., 1999). Despite emphasis in the literature that condom communication is associated with condom use, very little research about how to encourage healthy condom communication exists especially research that considers the impact of dating apps. Understanding how sexual communication about condoms occurs and where the gaps in understanding of skill may be is critical to addressing this public health crisis.

10 focus groups were conducted with a total of 40 undergraduate students (12 males and 28 females) enrolled at a large public university. The focus groups were conducted separately by gender with one specifically advertised as an LGBTQ identifying group. Moderators were trained students of the same gender as the focus group participants. The focus group topic guide asked about knowledge, attitudes, practices, and behaviors toward condom use with a focus on communication about condom use. All focus groups were audio recorded and transcribed. A coding scheme was developed based on the theory of planned behavior (TPB) constructs (i.e., attitudes, norms, perceived behavioral control) and after an initial review of the transcripts, non-TPB themes were also identified for coding. Transcripts are being coded using the Coding Analysis Toolkit (CAT) software for organization and to establish intercoder reliability.

Preliminary Results and Conclusion
Preliminary analysis reveals a consistent lack of condom use among college students associated with perceived norms around casual sex within friend groups, persistent double-standards for college-aged women regarding stigma around initiating condom use, and overall lack of communication efficacy. Findings suggest that students are open to learning condom communication skills. The full analysis will be completed in Feb. 2020.