Factors associated with condom use among at-risk women students and nonstudents seen in managed care.

Objectives: Sexually transmitted diseases (STD) research has focused on high-risk populations such as STD clinic patients and college students. This report examines predictors of unprotected sex among nonstudent women seen in primary care.

Study Design: Data are taken from the baseline survey of an intervention trial testing tailored print materials to encourage condom use.

Population: Eligible women were identified from automated databases of two managed care organizations and were ages 18-25, unmarried, heterosexually active in the prior 6 months, and not in a long-term monogamous relationship.

Outcomes: The frequency of and relative contribution of risk behaviors to occurrences of unprotected vaginal sex were compared among non-full-time students (n=711) and full-time students (n=390).

Results: STD risk behaviors were prevalent and had similar associations with unprotected sex in both subsamples. Older age, using hormonal or no usual contraception, and having a "primary" partner increased unprotected sex; partner approval of condoms and having bought or carried condoms decreased unprotected sex.

Conclusion: While sexually active single women seen in primary care perceive themselves at low STD risk, their risk profiles are similar to those of higher risk populations. Clinic-based interventions that include proactive identification of at-risk women and systems for encouraging safer sex practices are needed.