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Household-level correlates of condom use among a representative sample of Canadian adolescents

Brandon D. L. Marshall A B , Mieke Koehoorn B and Jean A. Shoveller B C
+ Author Affiliations
- Author Affiliations

A British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608–1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.

B School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC V6T 1Z3, Canada.

C Corresponding author. Email:

Sexual Health 7(4) 441-447
Submitted: 25 August 2009  Accepted: 17 February 2010   Published: 10 November 2010


Background: The relationship between an adolescent’s micro-environment (e.g. the home) and the likelihood of engagement in sexual risk behaviour is poorly understood. Therefore, we sought to examine the household-level correlates of condom use at last intercourse among a nationally representative sample of Canadian adolescents aged 15 to 19. Methods: Using data from the 2005 Canadian Community Health Survey, we conducted logistic regression analyses to determine whether factors related to characteristics of the household environment were associated with self-reported condom use at last intercourse. Results: Among 3974 sexually active adolescents, condom use at last intercourse was reported by 74.8%. After adjusting for household education and income, participants who reported living in larger dwellings were less likely to report condom non-use, while those reporting greater numbers of persons in the household were more likely to report condom non-use. Other significant correlates of condom non-use included older age, female sex, alternative birth control methods and having a weak sense of community belonging. Conclusion: Our results demonstrate that factors related to the household environment are independently associated with condom use among adolescents. Policies and programs that aim to promote condom use should seek to address issues such as privacy, which may limit adolescents’ ability to engage in safer sexual practices.

Additional keywords: environment, safer sex, sexual behaviour, statistics.


We would like to acknowledge Evan Wood and Anne Harris for their advice and assistance regarding the analysis. Brandon Marshall is supported by a Canada Graduate Scholarship Doctoral Award from the Canadian Institutes of Health Research (CIHR) and a Senior Graduate Trainee Award from the Michael Smith Foundation for Health Research (MSFHR). Mieke Koehoorn holds a Senior Scholar Awards from MSFHR. Jean Shoveller holds a Senior Scholar Award from MSFHR and an Applied Public Health Chair in Improving Youth Sexual Health from CIHR.


[1] Weinstock H,  Berman S,  Cates W. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36 6–10.
CrossRef |

[2] Public Health Agency of Canada. 2004 Canadian sexually transmitted infections surveillance report. Ottawa: Public Health Agency of Canada; 2007.

[3] Miller WC,  Ford CA,  Morris M,  Handcock MS,  Schmitz JL,  Hobbs MM, et al. Prevalence of chlamydial and gonococcal infections among young adults in the United States. JAMA 2004; 291 2229–36.
CrossRef |

[4] Public Health Agency of Canada. STI data tables: reported cases and rates by age group and sex to 2007. Ottawa: Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada; 2008.

[5] Miller WC,  Zenilman JM. Epidemiology of chlamydial infection, gonorrhea, and trichomoniasis in the United States – 2005. Infect Dis Clin North Am 2005; 19 281–96.
CrossRef |

[6] Public Health Agency of Canada. HIV/AIDS epi updates, November 2007. Ottawa: Surveillance and Risk Assessment Division, Centre for Infectious Disease Control and Prevention, Public Health Agency of Canada; 2007.

[7] Pinkerton SD,  Abramson PR. Effectiveness of condoms in preventing HIV transmission. Soc Sci Med 1997; 44 1303–12.
CrossRef |

[8] Centers for Disease Control and Prevention Youth risk behavior surveillance – United States, 2005. Surveillance Summaries, June 9, 2006. MMWR Morb Mortal Wkly Rep 2006; 55 SS-5.

[9] Hendriksen ES,  Pettifor A,  Lee SJ,  Coates TJ,  Rees HV. Predictors of condom use among young adults in South Africa: The Reproductive Health and HIV Research Unit National Youth Survey. Am J Public Health 2007; 97 1241–8.
CrossRef |

[10] Calazans G,  Araujo TW,  Venturi G,  Gustavo FI. Factors associated with condom use among youth aged 15–24 years in Brazil in 2003. AIDS 2005; 19 S42–50.
CrossRef |

[11] DiClemente RJ,  Lodico M,  Grinstead OA,  Harper G,  Rickman RL,  Evans PE, et al. African–American adolescents residing in high-risk urban environments do use condoms: correlates and predictors of condom use among adolescents in public housing developments. Pediatrics 1996; 98 269–78.

[12] Wilson MD,  Kastrinakis M,  D’Angelo LJ,  Getson P. Attitudes, knowledge, and behavior regarding condom use in urban black-adolescent males. Adolescence 1994; 29 13–26.

[13] Friedman SR,  Flom PL,  Kottiri BJ,  Neaigus A,  Sandoval M,  Fuld J, et al. Consistent condom use among drug-using youth in a high HIV-risk neighbourhood. AIDS Care 2002; 14 493–507.
CrossRef |

[14] Marston C,  King E. Factors that shape young people’s sexual behaviour: a systematic review. Lancet 2006; 368 1581–6.
CrossRef |

[15] Fortenberry JD,  Tu W,  Harezlak J,  Katz BP,  Orr DP. Condom use as a function of time in new and established adolescent sexual relationships. Am J Public Health 2002; 92 211–3.
CrossRef |

[16] Crosby RA,  DiClemente RJ,  Wingood GM,  Cobb BK,  Harrington K,  Davies SL, et al. Condom use and correlates of African American adolescent females’ infrequent communication with sex partners about preventing sexually transmitted diseases and pregnancy. Health Educ Behav 2002; 29 219–31.

[17] Marshall BDL. The contextual determinants of sexually transmissible infections among street-involved youth in North America. Cult Health Sex 2008; 10 787–99.
CrossRef |

[18] Langille DB,  Hughes J,  Murphy GT,  Rigby JA. Socio-economic factors and adolescent sexual activity and behaviour in Nova Scotia. Can J Public Health 2005; 96 313–8.

[19] Blake SM,  Ledsky R,  Goodenow C,  Sawyer R,  Lohrmann D,  Windsor R. Condom availability programs in Massachusetts high schools: relationships with condom use and sexual behavior. Am J Public Health 2003; 93 955–62.
CrossRef |

[20] Cohen DA,  Spear S,  Scribner R,  Kissinger P,  Mason K,  Wildgen J. “Broken windows” and the risk of gonorrhea. Am J Public Health 2000; 90 230–6.
CrossRef |

[21] Frye V,  Koblin B,  Chin J,  Beard J,  Blaney S,  Halkitis P, et al. Neighborhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis. AIDS Behav ;
CrossRef |

[22] O’Callaghan FV,  O’Callaghan M,  Najman JM,  Williams GM,  Bor W,  Alati R. Prediction of adolescent smoking from family and social risk factors at 5 years, and maternal smoking in pregnancy and at 5 and 14 years. Addiction 2006; 101 282–90.
CrossRef |

[23] Bränström R,  Sjöström E,  Andréasson S. Individual, group and community risk and protective factors for alcohol and drug use among Swedish adolescents. Eur J Public Health 2008; 18 12–8.
CrossRef |

[24] Cohen DA,  Farley TA,  Taylor SN,  Martin DH,  Schuster MA. When and where do youths have sex? The potential role of adult supervision. Pediatrics 2002; 110 e66.
CrossRef |

[25] DiClemente RJ,  Wingood GM,  Crosby R,  Sionean C,  Cobb BK,  Harrington K, et al. Parental monitoring: association with adolescents’ risk behaviors. Pediatrics 2001; 107 1363–8.
CrossRef |

[26] Statistics Canada. Canadian Community Health Survey (CCHS) Cycle 3.1 (2005): Public use microdata file (PUMF) user guide. Ottawa: Statistics Canada; 2006.

[27] Handy P. Condom use amongst men and women attending a genitourinary medicine clinic. J Fam Plann Reprod Health Care 2004; 30 159–62.
CrossRef |

[28] Zenilman JM,  Weisman CS,  Rompalo AM,  Ellish N,  Upchurch DM,  Hook E, et al. Condom use to prevent incident STDs: the validity of self-reported condom use. Sex Transm Dis 1995; 22 15–21.

[29] Hsieh FY,  Bloch DA,  Larsen MD. A simple method of sample size calculation for linear and logistic regression. Stat Med 1998; 17 1623–34.
CrossRef |

[30] Brisebois F , Thivierge S . The weighting strategy for the Canadian Community Health Survey. Alexandria: American Statistical Association; 2001.

[31] Frappier JY,  Kaufman M,  Baltzer F,  Elliott A,  Lane M,  Pinzon J, et al. Sex and sexual health: a survey of Canadian youth and mothers. Paediatr Child Health 2008; 13 25–30.

[32] Kumi-Kyereme A,  Awusabo-Asare K,  Biddlecom A,  Tanle A. Influence of social connectedness, communication and monitoring on adolescent sexual activity in Ghana. Afr J Reprod Health 2007; 11 133–47.

[33] Gutierrez JP,  Bertozzi SM,  Conde-Glez CJ,  Sanchez-Aleman M.-A. Risk behaviors of 15–21 year olds in Mexico lead to a high prevalence of sexually transmitted infections: results of a survey in disadvantaged urban areas. BMC Public Health 2006; 6 49.
CrossRef |

[34] Buhi ER,  Goodson P. Predictors of adolescent sexual behavior and intention: a theory-guided systematic review. J Adolesc Health 2007; 40 4–21.
CrossRef |

[35] Juarez F,  LeGrand T. Factors influencing boys’ age at first intercourse and condom use in the shantytowns of Recife, Brazil. Stud Fam Plann 2005; 36 57–70.
CrossRef |

[36] Kerrigan D,  Witt S,  Glass B,  Chung S,  Ellen J. Perceived neighborhood social cohesion and condom use among adolescents vulnerable to HIV/STI. AIDS Behav 2006; 10 723–9.
CrossRef |

[37] Shew ML,  Remafedi GJ,  Bearinger LH,  Faulkner PL,  Taylor BA,  Potthoff SJ, et al. The validity of self-reported condom use among adolescents. Sex Transm Dis 1997; 24 503–10.
CrossRef |

[38] Statistics Canada. Income and earnings, 2006 Census (Catalogue no. 97–563–XWE2006045). Ottawa: Statistics Canada; 2008.

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