The present study examined the correlates of consistent condom use among African-American women and prospectively evaluated the stability of these significant variables to predict consistent condom use at 3-month follow-up. A sample of 128 African-American women, 18-29 years of age completed a baseline interview and 3 months later completed a similar follow-up interview (n = 100). Compared to women who were inconsistent condom users, women who were consistent condom users were more likely to: have high assertive communication skills (OR=13), desire not becoming pregnant (OR=8.6), have high sexual self-control over condom use (OR=7.6), perceive having control over their partners' use of condoms (OR=6.6), be younger (OR=5.8), and report having a partner that was not committed to the relationship (OR=3.3). Prospective analyses identified baseline level of condom use as the best predictor of condom use at 3-month follow-up. Women who were consistent condom users at baseline were 6.3 times as likely to be consistent condom users at 3-month follow-up. In conclusion, HIV prevention programmes for women need to be gender specific and need to be implemented before high-risk behaviours are established and may be more difficult to modify.
PIP: Consistent condom use represents the primary HIV prevention strategy for US women. Baseline and follow-up interviews conducted in 1993 with 128 African-American women 18-29 years of age recruited from a low-income community in San Francisco, California, sought to identify the predictors of consistent condom use. 90.6% of respondents were unmarried, 71.9% had at least 1 child, and 71.9% received public assistance. Compared with inconsistent condom users, the 36 women (28.1%) who reported condom use on all occasions were significantly more likely to have high assertiveness communication skills (odds ratio (OR), 13.0; 95% confidence interval (CI), 3.9-43.8), not desire pregnancy (OR, 8.6; 95% CI, 2.2-34.5), have high sexual self-control over condom use (OR, 7.6; 95% CI, 2.5-23.0), perceive themselves to have control over their sexual partner's condom use (OR, 6.6; 95% CI, 2.1-20.6), be under 25 years of age (OR, 5.8; 95% CI, 1.8-19.2), and be in a relationship with a partner with a low commitment to the relationship (OR, 3.3; 95% CI, 1.2-9.4). Baseline level of condom use was the best predictor of condom use at the 3-month follow-up interview. Specifically, women who were consistent condom users at baseline were 6.3 times more likely to be consistent users at follow-up. These findings underscore the need to contextualize women's condom use and HIV prevention within the framework of gender relations.