Self-Efficacy is a Strong Independent Correlate of Condom Use Among Adolescents: A Cross-Sectional Study in a Southeastern European Country

Background: Adolescents’ self-efficacy may influence their engagement in safer sexual behaviors, including consistent condom use. Aim: Our aim was to assess the independent association of self-efficacy with condom use among adolescents in a Southeastern European country. Methods: A cross-sectional study, conducted in Albania in 2022, included a nationwide representative sample of 1877 schoolchildren aged 15 (≈55% girls; response: 96%). Data on condom use, self-efficacy, child maltreatment, and sociodemographic characteristics were collected. Binary logistic regression was used to assess the independent association of condom use with self-efficacy. Results: 280 schoolchildren who reported engagement in sexual intercourse also provided valid data on condom use, self-efficacy, and covariates (14.9% of the total). Of these, 172 (≈61%) reported condom use at last sexual intercourse. Mean score of self-efficacy (range: 2 [lowest] to 10 [highest]) was 8.3 in condom users compared to 7.5 among non-condom users (P < 0.001). Furthermore, about 78% of condom users exhibited a high self-efficacy level (scores: 8–10) compared with only 57% of schoolchildren who did not use a condom at their last sexual intercourse. Irrespective of a wide range of sociodemographic factors and child maltreatment indicators, higher scores of self-efficacy were strongly positively associated with condom use at their last sexual intercourse (OR = 2.5, 95%CI = 1.3–4.6). Conclusions: Findings from this study underscore the importance of interventions aimed at enhancing self-efficacy to promote safer sexual practices among adolescents globally. Self-efficacy-building strategies should be integrated into sexual health education programs to reduce the prevalence of sexually transmitted infections and unintended pregnancies among adolescents worldwide.