Relationship factors and American Indian men's condom use intentions

Abstract

Sexually transmitted infections (STIs) pose a major threat to the public health of the United States. American Indians are disproportionately affected by STIs, including chlamydia and human immunodeficiency virus (HIV). Roosevelt County, which lies within the Fort Peck Indian Reservation in northeastern Montana, has consistently reported chlamydia rates two to five times higher than national rates. Community leaders from the Fort Peck Indian Reservation partnered with researchers from Montana State University to address the reservation's sexual and reproductive health needs. The purpose of this study was to investigate the heterosexual relationship factors that were associated with condom use intentions for STD and HIV prevention in a purposive sample of American Indian men, ages 18 to 24, living on the Fort Peck Indian Reservation. A community based participatory research (CBPR) approach was used for this study. A non-probability sample of American Indian men (n=122) were recruiting using consecutive and snowball sampling techniques. Study hypotheses were tested using Pearson's chi-squared and one way analysis of variance (ANOVA) analysis for bivariate associations and multinomial logistic regression for multivariate associations. Variables examined for their association with condom use intentions included age, educational attainment, relationship type, relationship duration, relationship commitment, condom use communication, condom use decision making, control of condom use, and negative partner reaction to condom use. Results indicated that American Indian men were less likely to use condoms for disease prevention as their age and their relationship commitment increased. Factors resulting in an increased likelihood of future condom use included high participation in the condom use decision making process and female control over condom use. Culturally relevant sexual risk prevention programs that work towards changing the perception of condoms in committed relationships and that engage men in sexual health decision making could help reduce the disproportionate burden of sexually transmitted disease carried by young American Indians living on the Fort Peck Indian Reservation.