Condom Use Among Young Women: Modeling the Theory of Gender and Power

Objective: This study sought to articulate pathways between constructs from the theory of gender and power and their associations with sexual behavior. Design: The data were collected preintervention during a randomized controlled HIV prevention trial. Participants were 701 sexually active, unmarried African American females, aged 14-20, who were not pregnant, and were recruited from three health clinics in a southeastern US city. Structural equation modeling was used for the analyses. Main Outcome Measure: Self-reported condom use. Results: Theoretical associations yielded a well-fitting structural model across initial and cross-validation samples. A significant amount of variance was explained for the variables of condom use (R-2 = .31, .18), partner communication (R-2 = .30, .26), substance use during sex (R-2 = .32, .51), and negative personal affect (R-2 = .36, .48). Partner communication (.35, .38) was the strongest predictor of condom use, negative personal affect (-.41, -.37) was the strongest predictor of partner communication, and physical risk (.54, .54) was the strongest predictor of negative personal affect. Conclusion: This model provides evidence to support both direct and indirect associations between social and behavioral risk factors and condom use. Associations between theory of gender and power constructs and condom use can facilitate future development and analyses of interventions based on this theory.