Exploring Condom Intentions and Sexual Risk Behaviors Among Urban Black Emerging Adult Males: The Role of Nurse Practitioners

Abstract

Category/Date

Clinical Research Podium Presentations: NAPNAP Research Agenda Priorities: Mental Health, Pediatric Workforce and Infectious Disease Prevention. Presented at NAPNAP’s 46^th National Conference on Pediatric Health Care, March 11, 2025.

Background & Significance

Sexually transmitted infections (STIs) disproportionately impact young Black emerging adult men (BEAMs) in the United States, showcasing high STI rates and risky sexual behavior. Understanding the factors influencing condom use intentions among BEAMs is crucial in developing effective sexual health interventions.

Purpose/Aims

This analysis focuses on identifying risk factors that influence condom use intentions among Black emerging adult males (BEAMs) in urban settings and investigates the challenges BEAMs face in making condom use decisions during the critical developmental stage of 18 to 24 years of age. This age group is of particular significance due to its association with key transitional factors, including the shift from pediatric to adult care, low rates of health insurance coverage, and growing independence. Despite the importance of this stage, there is a notable lack of targeted health agendas addressing the sexual and reproductive health needs of young men. By analyzing existing best practices and identifying areas for improvement, this research aims to inform more effective, tailored strategies and clinical discussion to support the sexual and reproductive health of BEAMs in urban communities such as Detroit.

Methods

Findings were reported from the Philadelphia Barbershop Study - Shape Up! Barbers Build Better Brothers, an HIV risk reduction intervention, a cross-sectional data set. Risk factors were examined impacting intentions to use condoms among Black emerging adult males ages 18-24 (N=618) in urban settings. The study analyzes factors including demographics, past sexual history, hypermasculinity, manhood stress, and Black manhood vulnerability to understand behaviors promoting condom use intentions within this demographic.

Results

The regression analysis revealed that higher subjective norm (β = 0.16, p <.001), descriptive norm (β = 0.08, p <.01), attitudes about using condoms (β = 0.30, p <.001), self-efficacy (confidence) (β = 0.41, p <.001), and hypermasculinity (e.g. protecting one’s manhood) (β = 0.06, p <.01) were associated with greater condom use intention.

Discussion & Conclusions

The findings are crucial for addressing public health efforts to prevent the spread of HIV and STIs. It is important to understand the intentions and motivations related to condom use at the time of sexual activity, especially among Black emerging adult males, to promote positive sexual reproductive health and reduce risk behaviors. Advanced Practice Registered Nurses, particularly nurse practitioners specializing in pediatric, ER, and adolescent health, play a vital role in testing, treatment, and providing anticipatory guidance on increased condom use, consistent condom usage over time, and protective factors that impact adolescent and emerging adult populations.