Cash, cars, and condoms: Economic factors in disadvantaged adolescent women’s condom use

• Type of Material: Article
• Authors: Janet Rosenbaum, University of Maryland; Jonathan Zenilman, Johns Hopkins University; Eve Rose, Emory University; Gina M Wingood, Emory University; Ralph Joseph Diclemente, Emory University
• Language: English
• Date: 2012-09-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Society for Adolescent Health and Medicine.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jadohealth.2011.12.012
• Title of Journal or Parent Work: Journal of Adolescent Health
• ISSN: 1054-139X
• Volume: 51
• Issue: 3
• Start Page: 233
• End Page: 241
• Grant/Funding Information: This research was funded by T-32 AI050056 from the Sexually Transmitted Diseases Division of the Centers for Disease Control and Prevention (Dr. Zenilman.); The data collection was funded by R01 MH061210 from the Center for Mental Health Research on AIDS, National Institute of Mental Health, Bethesda, Maryland (Drs DiClemente and Wingood).
• Keywords: HIV PREVENTION; Public, Environmental & Occupational Health; Psychology, Developmental; Sexual partners; Psychology; Safe sex; GIRLS; Life Sciences & Biomedicine; Prostitution; Negotiating; Sexual behavior; AGE-DISPARATE; SOUTHERN AFRICA; Economic factors; Social Sciences; UNTREATED SUBJECTS; SEXUAL RELATIONSHIPS; Science & Technology; UNINTENDED PREGNANCY; HIGH-RISK; UNITED-STATES; INTIMATE PARTNER VIOLENCE; Pediatrics; adolescent
• Research Categories: Psychology, Behavioral; Health Sciences, Public Health

Abstract

Evaluate whether adolescent women who received economic benefits from their boyfriends were more likely never to use condoms. Data are obtained from a longitudinal HIV prevention intervention study with 715 African American adolescent women in urban Atlanta surveyed at baseline, 6 months, and 12 months. The primary outcome was never using condoms in the past 14 and 60 days at 6 and 12 months. The primary predictor was having a boyfriend as primary spending money source at baseline. Analysis minimized confounding using propensity weighting to balance respondents on 81 variables. A boyfriend was the primary spending money source for 24% of respondents, who did not differ in neighborhood or family context but had lower education, more abuse history, riskier sex, and more sexually transmitted infections. After propensity score weighting, no statistically significant differences for 81 evaluated covariates remained, including age distributions. Women whose boyfriend was their primary spending money source were 50% more likely never to use condoms at 6 and 12 months and less likely to respond to the intervention at 12 months. Women whose boyfriend had been their primary spending money source but found another spending money source were more likely to start using condoms than women who continued. Women whose boyfriends owned cars were more likely never to use condoms. Receiving spending money from a boyfriend is common among adolescent women in populations targeted by pregnancy and sexually transmitted infection prevention interventions, and may undermine interventions' effectiveness. Clinicians and reproductive health interventions need to address females' economic circumstances.