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Taraneh Shafii, MD, MPH, Katherine Stovel, PhD and King Holmes, MD, PhD

Taraneh Shafii is with the Section of Adolescent Medicine, Department of Pediatrics, University of Washington, Seattle, and the University of Washington’s Center for AIDS and STD. Katherine Stovel is with the Department of Sociology, University of Washington, Seattle. King Holmes is with the Division of Allergy and Infectious Diseases, Department of Internal Medicine, and the Center for AIDS and STD, University of Washington, Seattle.

Correspondence: Requests for reprints should be sent to Taraneh Shafii, MD, MPH, 325 9th Ave, Box 359777, Seattle, WA 98104 (e-mail: tshafii{at}u.washington.edu).

Objectives. We compared subsequent sexual behaviors and risk of sexually transmitted infections among adolescents who did and did not use a condom at their sexual debut.

Methods. We derived data from the National Longitudinal Study of Adolescent Health, which followed a sample of 4018 sexually active adolescents between 1994 and 2002. During waves I, II, and III of the study, data on sexual behavior were gathered, and at wave III urine specimens were collected to test for sexually transmitted infections.

Results. Among interviewed adolescents, those who reported condom use at their debut were more likely than those who did not use condoms at their debut to report condom use at their most recent intercourse (on average 6.8 years after sexual debut), and they were only half as likely to test positive for chlamydia or gonorrhea (adjusted odds ratio=0.50; 95% confidence interval=0.26, 0.95). Reported lifetime numbers of sexual partners did not differ between the 2 groups.

Conclusions. Adolescents who use condoms at their sexual debut do not report more sexual partners, are more likely to engage in subsequent protective behaviors, and experience fewer sexually transmitted infections than do adolescents who do not use condoms at their sexual debut.

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