AUTHOR=Chambers Rachel Strom , Rosenstock Summer , Lee Angie , Goklish Novalene , Larzelere Francene , Tingey Lauren 

TITLE=Exploring the Role of Sex and Sexual Experience in Predicting American Indian Adolescent Condom Use Intention Using Protection Motivation Theory

JOURNAL=Frontiers in Public Health

VOLUME=Volume 6 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2018.00318

DOI=10.3389/fpubh.2018.00318

ISSN=2296-2565

ABSTRACT=Introduction: American Indian (AI) youth experience poor sexual health outcomes.  Research indicates the Protection Motivation Theory (PMT) is a robust model for understanding how sexual risk and protective behaviors are associated with condom use intention (CUI).  Studies indicate the constructs of the PMT which influence CUI vary by sex and sexual experience.  This analysis explores associations between PMT constructs and CUI by sex and sexual experience among AI youth who participated in the Respecting the Circle of Life (RCL) trial, a sexual and reproductive health intervention.  
Methods: We analyzed baseline data from the sample of 267 AIs, ages 13-19, who participated in the evaluation.  We examined CUI and PMT construct scores by sex and sexual experience utilizing generalized estimated equations and multiple regression models to test which PMT constructs predicted CUI across sex and sexual experience.
Results: 22% of participants were sexually experienced; 56.8% reported CUI at baseline.  We found several differences in scores in PMT constructs by sex and sexual experience including self-efficacy, response efficacy, vulnerability, severity and extrinsic rewards.  We also found constructs varied in predicting CUI across sex and sexual experience. No PMT constructs predicted CUI among sexually experienced youth.
Conclusion: Results provide support for developing and delivering sexual health programs by sex and sexual experience in American Indian communities. Girls programs should focus on internal satisfaction and self-worth while boys should focus on negative impacts of not using condoms.  Programs for youth who are not sexually active should focus on negative impacts of not using condoms.  All programs should work to change peer norms around condom use and improve knowledge about the efficacy of condom use.