CONDOM USE IN OLDER AFRICAN AMERICANS: AN EXPLORATORY STUDY
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The purpose of this mixed methods exploratory study was to examine perceptions regarding condom use and sexual intercourse among African Americans 50 to 65 years of age, specifically attitudes, norms, self-efficacy and barriers regarding condom use behavior. There were three study phases: 1) a pilot study of the survey instrument (N=31), 2) an on-line survey (N=175), and 3) post survey explanatory interviews (N=10). The online survey contained items from the Sexual Risk Behavior Beliefs and Self-Efficacy Scales (SRBBS) (Basen-Enquist et al., 1999). Pilot study data indicated the online survey was understandable, acceptable, readable and appropriate for use by this sample of African Americans. Factor analyses of the survey items yielded similar constructs to the original SRBBS with seven of eight scales demonstrating internal consistency; Cronbach's alpha reliabilities ranged from .49 to 1.0. Logistic regression models found two independent variables increased the likelihood of condom use (condoms should be used even if people know each other well and friends feel condoms should be used even if pregnancy isn't possible) and two decreased the likelihood of condom use (friends feel you should use condoms even if people know each other well, and using condoms would be a hassle). A logistic regression model of significant independent variables found that provider speaking to patients about safer sex and male gender increased condom use, while being married and lower educational level decreased condom use behavior. Post-survey interviews, where participants (N = 10) were asked to elaborate on study findings, yielded six themes (the importance of trust and relationships, lack of knowledge, attitudes about condom use, sexual activity, health care providers, and friends opinions) that further explained statistical findings. Findings from this study have the potential to reduce the spread of HIV/STDs in this population through the use of educational programs that include empowerment and risk reduction components. Additionally, health care providers can potentially play a key role in these efforts and should be trained on how to communicate effectively with older adults around sexual health.