Inner-city youths and condom use: health beliefs, clinic care, welfare, and the HIV epidemic.

This paper examines questions concerning condom use and determinants of change in use by inner-city youths who appear to be in the direct path of the AIDS epidemic. Detailed information gathered in interviews with 548 youths in 1989-90 and 1991-92, provide a history of change in condom use and HIV-related high-risk behaviors. Condom use as a whole increased with time and age. Positive beliefs concerning condoms and awareness of HIV transmission were determinants of increases in use, and negative beliefs were determinants of decreases. Nevertheless, those youths who engaged in the highest HIV-risk behaviors (prostitution, IV drug use, and male homosexuality) were no more likely than lower-risk youths to increase their condom use. Financial need, indicated by receipt of welfare, appeared to be a significant barrier to increasing condom use. Also noteworthy was the negative association between using health clinics and condom use. Although youths with high-risk behaviors make more clinic visits, those visits do not result in condom use.