Boys who think they know condoms may not use them

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When it comes to teenage boys, those who are most confident in their condom know-how may be least likely to use them, new research suggests.

The study of 404 15- to 17-year-old boys found that those who had little knowledge about proper condom use yet considered themselves well versed were less likely than their peers to use a condom the first time they had sex.

In fact, compared with boys who knew little about condoms and acknowledged as much, those who were overconfident in their know-how were three times less likely to use a condom at first sexual intercourse.

The findings suggest that addressing teens’ “perceived knowledge” about condom use, rather than just giving them the facts, could help encourage safer behavior, according to Dr. Ellen M. Rock.

Rock and her colleagues studied a nationally representative sample of high school boys who were interviewed twice, one year apart, about social and health-related behaviors. Rock and her colleagues focused their analysis on 404 boys who said they were virgins at the first interview, but had had sex by the second interview.

The boys were asked several questions about proper condom use to assess their objective knowledge. To gauge the teenagers’ perceived knowledge, the researchers asked them how confident they were about their answers for each question. The results are reported in the March issue of the journal Pediatrics.

At the second interview, about 40 percent of the boys said they had used a condom the first time they had sex. Those who had greater objective knowledge about condoms, or had relatively little knowledge but were aware of it, all had similar rates of condom use—between 37 percent and 44 percent used them the first time they had sex.

In contrast, the rate of condom use was only 18 percent among boys who had little objective knowledge but considered themselves knowledgeable.

Whether addressing boys’ perceptions of their own knowledge will lead to more condom use is unclear and requires further research, Rock told AMN Health.

One way to get at teens’ perceived knowledge, she noted, would be for healthcare providers to directly ask, “Do you know a lot about using condoms? Please tell me what you know.” That would allow doctors to spot discrepancies between what teenagers know and what they think they know, according to Rock.

She added that sex education programs could also assess kids’ perception—by, at the outset, asking teenagers fact-based questions to see what they know, then asking them to rate their confidence in their answers.

SOURCE: Pediatrics, March 2005. 

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