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Objectives: To identify characteristics of individuals and characteristics of sexual encounters that predict whether people using contraception will also use condoms (dual use), and to determine whether dual use is prompted by concerns about unplanned pregnancy and/or sexually transmitted infections (STIs)., Design: A longitudinal prospective design was used to identify characteristics of individuals and characteristics of specific sexual encounters that predict condom use., Methods: A sample of 349 sexually active heterosexual young adults was recruited at universities and trade colleges in Melbourne, Australia. Participants completed a self-administered questionnaire, and a representative subsample (N=103) completed a structured condom use diary in which they reported on up to 10 instances of vaginal intercourse. Respondents reported use of condoms and other forms of contraception during 919 instances of vaginal intercourse., Results: In multivariate analyses, dual use of condoms in addition to other contraception was predicted by attitudes toward condoms, intentions to use condoms, partner type and discussion of condom use with sexual partners. Dual use was not related to greater concern about HIV/STIs or unplanned pregnancy., Conclusions: Encouraging heterosexual young adults to discuss condom use, and developing their skills for negotiation of condom use will increase rates of condom use, thereby reducing current high rates of unplanned pregnancy and STIs.

The aims of this exploratory qualitative study were to increase our understanding of heterosexual young adults' knowledge and beliefs about sexually transmitted infections (STIs) other than HIV, to explore their beliefs about the factors that influence condom use for STI prevention, and to explore their ideas about how best to promote condom use for STI prevention. Data came from a qualitative study that used 11 group discussions with 53 heterosexual men and women aged 18-25. Respondents thought that STI infection and unplanned pregnancy were equally likely, but were less concerned about STIs than unplanned pregnancy. Respondents gave several reasons for their low levels of concern about STIs. They also suggested several means to promote condom use for STI prevention. They supported multi-faceted condom promotion campaigns, using multiple styles of communication and a variety of media. The range of suggestions given by participants suggests that rather than employing a 'one size fits all' strategy, a variety of different approaches are needed to promote condom use for STI prevention.

The aim of this study was to examine delayed application of condoms and withdrawal among heterosexual young adults. Seven focus group discussions were conducted with heterosexual men and women aged 18-25 in Melbourne, Australia. The data revealed that delayed application of condoms and withdrawal are widespread. Delayed application of condoms can be divided into two categories--condom use 'after limited unprotected penetration' and condom use 'for ejaculation only'. The data reveal parallels between withdrawal and condom use 'for ejaculation only'. These two behaviours share the goal of avoiding unprotected ejaculation inside a partner, while allowing some unprotected intercourse. They are both more likely to occur in regular relationships than casual encounters, both are likely to be negotiated and both occur when there is no perceived risk of STI infection. In contrast, condom use 'after limited unprotected penetration' was likely to occur in casual encounters, and was likely to be unplanned and not negotiated. There is a need to ensure that heterosexual young adults use condoms and use them correctly. There is also a need to ensure that heterosexual young adults have the required skills to negotiate sexual activity and to negotiate condom use.

A common finding in studies of heterosexual young adults is that condom use is more likely with casual partners than with regular partners. However, few studies have examined whether correlates of condom use differ with different partners. In this study, 103 heterosexual men and women completed a condom use diary for a period of up to 6 months. Condom use during sexual encounters with regular partners was mainly determined by established patterns of behavior. In contrast, condom use with casual partners was determined by the interaction between the sexual partners during the encounter, and was not influenced by the attitudes and beliefs of the individual. These differences have implications for interventions. They suggest that condom use with casual partners may be increased by furnishing young adults with skills and confidence for negotiating condom use. For young adults in regular relationships, we must ensure that routine patterns of condom use are appropriate for the levels of risk to which the partners are exposed.

Condoms are most effective when they are applied before intercourse. This study assessed the prevalence of 'condom cheats'--instances of condom use in which the condom is put on after initial penetration. As part of a prospective study of safer sexual behaviour, 103 heterosexual tertiary students completed a condom use diary over a period of up to 6 months. Of the 464 condoms used by study participants, 13% were put on after initial penetration. Thirty-eight percent of condom users reported at least one instance of late application of a condom. Late application of condoms is common and places individuals at risk of infection with HIV and many other STDs. The widespread practice of this behaviour casts doubt on the validity of self-reports of condom use. Assessments of risk based on self-reported condom use may lead to underestimates of the risk entailed in heterosexual young adults' condom use behaviour, and may also lead to underestimates of condom efficacy.

People who sometimes use condoms present a challenge to the utility of traditional models of health-protective behaviour in safe sex research. This study used a prospective condom use diary to identify predictors of condom use among heterosexual young adults who use condoms inconsistently. Rather than being influenced by the trait-like attitudes and beliefs central to traditional models of health behaviour, condom use was predicted by characteristics of the sexual encounter, particularly negotiation of condom use. The results of this study highlight the limitations of attempts to explain condom use solely on the basis of trait-like characteristics of individuals. The results also show that if we wish to increase rates of condom use among people who use condoms inconsistently, then we must instil in them skills for negotiating condom use, and confidence in their ability to use these skills. [ABSTRACT FROM AUTHOR]