Safer sex self-efficacy and condom use among adolescents: A systematic review and meta-analysis

Inconsistent condom use puts adolescents at risk for HIV/STIs and unintended pregnancy. A recent meta-analysis identified safer sex self-efficacy as one of the strongest correlates of U.S. adolescent condom use ( r _avg  = .22), but with significant heterogeneity in effect sizes. This secondary analysis synthesized measures of self-efficacy and examined measurement as a moderator of the link between self-efficacy and condom use. We included 36 studies of self-efficacy and condom use with 12,205 adolescents ( M _age  = 16.1). Across studies, there was no “gold-standard” for self-efficacy measurement. We identified 16 different measures; only five met our criteria for validated measurement, and only one was validated with adolescents. Four measurement characteristics were examined as moderators of the association between self-efficacy and adolescent condom use. None were significant. Findings provide insight into safer sex self-efficacy measurement and emphasize the importance of validating measures across diverse samples to help guide and support future research and practice.