Access Type

Open Access Dissertation

Date of Award

January 2019

Degree Type


Degree Name




First Advisor

April Hazard Vallerand



Background: Sexually transmitted infections (STIs) are one of the most common global health problems, having a profound impact on sexual and reproductive health worldwide. The CDC estimates that approximately 20 million new infections occur each year in the U.S., and almost half of them are among adolescents age 15–24. Despite government initiatives on STI prevention programs for adolescents, there is dearth of knowledge regarding the lack of condom use among adolescent high school students, especially concerning African American females who live in urban areas.

Purpose: The purpose of this research was to explore attitudes towards condoms, subjective norms and perceived behavioral control and the effect these variables have on urban African American adolescent females' intention to use condoms and condom use. A second aim in this study was to determine the relationship between attitudes and perception of masculine norms and its effect on intentions to use condoms among this population.

Methods: This study is a secondary analysis of baseline data from 213 participants ages 14–19 who participated in a community service STI and Safer Sex intervention for African American adolescent females. Descriptive statistics was used to examine the effect of attitudes towards condoms, subjective norms and perceived behavioral control factors on condom use and intention to use condoms among urban African American adolescent females with a history of having an STI and those without a history of an STI. The Theory of Planned Behavior (TPB) was used used as a guide to predict and explain participant’s intent to use and condom use during sexual intercourse. A path analysis, using Amos graphics 25 was used to test the hypothesized relationships among the independent variables (attitudes, subjective norms and perceived behavioral control) and dependent variables (intention to use condoms and condom use).

Results: As predicted by the TPB, results showed attitude and subjective norms towards condoms were significantly associated with intentions to use condoms. Contrary to the TPB, perceived behavioral control was not significantly associated with intentions to use condoms. The moderation effect of masculine norms on intention to use condoms was not significant.

Conclusion: Future prevention intervention programs should adopt a wide range of educational approaches to help increase condom use, including female condom use skills, and condom use negotiation skills, especially among those in long-term relationships. Also, recommendations from this study may help to develop more creative and effective prevention programs that aim to increase the likelihood of empowering urban African American adolescent girls to use condoms 100 percent of the time.

Keywords: African American adolescent females, condom use, intentions, attitudes and beliefs, recurrent or repeat sexually transmitted infections, Theory of Planned Behavior

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Nursing Commons