Abstract
Background: Given the young structure of Iran’s population and the fact that extramarital sexual relationships are both
prohibited by legislation and shunned by society and religion, examining condom use practices among Iranian youth
is highly important. The aim of this study was to explore condom use and its correlates among Iranian young adults.
Methods: In a sample of 3,045 individuals aged 19-29 who were recruited from a nation-wide study, we analyzed data
from 633 participants who reported a history of extramarital sex. Subjects were asked about their condom use practices
during their last penetrative sex. Data were collected through a self-administered questionnaire where the respondents
completed the survey on their own and passed it to trained gender-matched interviewers. Multivariable regression
models were constructed to report adjusted odds ratios (AOR) along with 95% CI.
Results: Of the 633 participants, 222 (35.1%) reported condom use at last sex. Men reported significantly higher condom
use than women (38.5% vs. 25.7%). Having a stable job (AOR = 1.86, 95% CI: 1.01, 3.43), higher knowledge of condom
use (AOR = 1.57, 95% CI: 1.03, 2.37) and sexual transmission of HIV (AOR = 1.83, 95% CI: 1.18, 2.85) were positively
associated with condom use at last sex. Conversely, experience of sex under the influence of substances (AOR = 0.66, 95%
CI: 0.45, 0.94) was significantly associated with reduced odds of condom use at last sex.
Conclusion: This study shows that only one out of every three young adults reported using condoms at last sex.
While educational programs are helpful, multi-sectoral approaches (eg, individual-, community-, and structural-level
interventions) are required to change sexual behaviours towards safe sex practices and reinforce negotiating condom
use among youth.