Relationship dynamics and consistency of condom use among adolescents.

CONTEXT Research on adolescent condom use often focuses on the influence of parents, peers and environmental factors. Although most sexually active teenagers have sex within dating relationships, little is known about associations between the characteristics of these relationships and consistency of condom use. METHODS Data on 269 participants in Wave 1 of the Toledo Adolescent Relationships Study who had had sex in their current or most recent dating relationship were analyzed in logistic regression models to examine how positive and negative relationship qualities are associated with consistent condom use. RESULTS Among teenagers who had had sex with their dating partner, both negative relationship dynamics (conflict, partner's controlling behavior, mistrust, jealousy, perceived partner inferiority) and positive qualities (love, enmeshment, salience, self-disclosure) were negatively associated with consistent condom use (odds ratios, 0.7-0.9). Asymmetries in partners' age, race and school were not related to consistent condom use. Relationship duration was negatively associated with consistency (0.98-0.99), but the association was explained by feelings of relationship importance. Findings for relationship qualities were similar for males and females, with the exception of conflict, which was positively associated with consistent condom use among females but not males. CONCLUSIONS Although the relationship processes associated with consistent condom use are complex, such processes appeared to be more strongly associated with consistent condom use than were social and demographic characteristics. Programs should focus on relationship qualities and dynamics, recognizing that both negative and positive relationship features are associated with consistent condom use.