BMJ public health · 2026
Influence of individual and partner preferences on joint condom use during vaginal sex among young people in the Netherlands: a statistical modelling study.
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de Vries Alcira, Hansson Disa, de Wit John B F, den Daas Chantal, Heijne Janneke C M
Аннотация
INTRODUCTION: Condom use during penile-vaginal sex is decreasing among youth. Little research exists on the potential influence of both partners on joint condom use, especially including individual psychosocial factors and sex. Condom dispositions are individuals' behavioural tendencies to use a condom or not. Using statistical models, we aimed to understand how psychosocial factors influence condom dispositions and joint condom use.
METHODS: We used data from a Dutch online sexual behaviour survey conducted in 2023 among 752 16-24 years old engaging in penile-vaginal sex. Partner type (one-time or recurring), condom use and psychosocial factors (attitudes and social norms regarding condom use and self-efficacy regarding condom use and condom negotiation) were assessed. Existing probabilistic maximum likelihood models were used and extended to estimate condom dispositions. For one-time partners, individuals were allocated a binary condom disposition: 0 (non-condom) and 1 (pro-condom). For recurring partners, dispositions ranged between 0 and 1. We estimated individual disposition distributions and condom use probabilities when people with opposite dispositions meet. Sex and psychosocial factors were incorporated to determine their influence on dispositions and condom use probabilities.
RESULTS: For both partner types, the model including attitudes fit the data best. For one-time partners, 96% of participants with strongly positive attitudes had pro-condom dispositions, compared with 54% of participants with moderately positive attitudes. The probability of using a condom when two opposite dispositions meet was 6%. For recurring partners, people with moderately positive attitudes showed only non-condom dispositions. In contrast, individuals with strongly positive attitudes exhibited more diverse dispositions, though they were mostly concentrated around pro-condom dispositions.
CONCLUSIONS: Attitudes mostly influenced condom dispositions. One-time partnerships between persons with opposite dispositions rarely involve condom use. Interventions focusing on joint condom use decision-making and on improving attitudes towards condom use, particularly within one-time partnerships, may positively impact condom use among youth.
METHODS: We used data from a Dutch online sexual behaviour survey conducted in 2023 among 752 16-24 years old engaging in penile-vaginal sex. Partner type (one-time or recurring), condom use and psychosocial factors (attitudes and social norms regarding condom use and self-efficacy regarding condom use and condom negotiation) were assessed. Existing probabilistic maximum likelihood models were used and extended to estimate condom dispositions. For one-time partners, individuals were allocated a binary condom disposition: 0 (non-condom) and 1 (pro-condom). For recurring partners, dispositions ranged between 0 and 1. We estimated individual disposition distributions and condom use probabilities when people with opposite dispositions meet. Sex and psychosocial factors were incorporated to determine their influence on dispositions and condom use probabilities.
RESULTS: For both partner types, the model including attitudes fit the data best. For one-time partners, 96% of participants with strongly positive attitudes had pro-condom dispositions, compared with 54% of participants with moderately positive attitudes. The probability of using a condom when two opposite dispositions meet was 6%. For recurring partners, people with moderately positive attitudes showed only non-condom dispositions. In contrast, individuals with strongly positive attitudes exhibited more diverse dispositions, though they were mostly concentrated around pro-condom dispositions.
CONCLUSIONS: Attitudes mostly influenced condom dispositions. One-time partnerships between persons with opposite dispositions rarely involve condom use. Interventions focusing on joint condom use decision-making and on improving attitudes towards condom use, particularly within one-time partnerships, may positively impact condom use among youth.