Adolescent condom negotiation: a concept analysis and conceptual framework

Introduction: Adolescents are at risk of sexually transmitted infections and unintended pregnancies. Consistent condom use is effective in curbing the double burden of diseases and unplanned conceptions. Condom negotiation influences consistent condom use. However, a clear operational definition is lacking. This paper analyzes the concept of adolescent condom negotiation and examines its defining attributes, antecedents, and consequences to promote conceptual clarity and enhance sexual health research and practice. Methods: Norris's (1982) concept clarification method guided this analysis. This framework systematically observes, describes, and organizes conceptual evidence to support the development of an operational definition and a preliminary conceptual model of adolescent condom negotiation. A comprehensive literature review was conducted using PubMed, CINAHL, and PsycINFO, as well as the reference lists of relevant studies. Studies were included if they addressed communication, negotiation, or decision-making related to condom use among adolescents. Results: Twenty-seven sources met the inclusion criteria. Two core attributes of adolescent condom negotiation were identified: (1) communication strategies used to express preferences regarding condom use, and (2) negotiation behaviors aimed at reaching mutual agreement with a partner. The analysis resulted in an operational definition and a preliminary conceptual model that illustrates how communication and negotiation processes influence condom use among adolescents. No existing instrument designed to specifically measure adolescent condom negotiation was identified. Discussion: The findings of this study will help researchers, nurses, doctors, and sexual health educators design more precise measurements and focused interventions for teenagers, especially in environments with high STI and teenage pregnancy burdens and gendered power inequalities. Operationalizing adolescent condom negotiation marks a critical step toward advancing adolescent sexual health research and practice. A clear, evidence-based definition supports targeted education and interventions to promote consistent condom use among adolescents, thereby reducing the risks of sexually transmitted infections STIs and unintended pregnancies.