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Background: In the 1980’s, researchers at the Centers for Disease Control and Prevention (CDC) assumed that Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) grew to epidemic proportions due to unsafe practices by sexually active gay men and intravenous drug users. Policymakers who did not wish to associate themselves with these two populations did not promote educational tactics for prevention among the general population. Times have changed since then, but there are still populations mistakenly assumed to be safe from Sexually Transmitted Diseases (STDs). Older Baby Boomer Women are in a different world than their mothers and grandmothers. This population also has different sexual histories, emphasizing the need for greater awareness of STDs. There is a need for preventive action to protect older women against STDs, particularly Human Papillomvirus (HPV). This virus causes over 97% of cervical cancer and is related to the causes of vulva, vagina, penis, and oropharynx cancers. Because their rates of STDs are increasing fast, this dissertation strives to examine and explore the factors that impact condom use self-efficacy and sexual activity among postmenopausal women. As a result of improvements in healthcare and a decrease in disability, postmenopausal women experience higher life expectancies and are now becoming victims of STDs. Many women place themselves at greater risk for STDs by not using protection during intercourse. Research Objective: To better understand the factors that impact current condom use self-efficacy among postmenopausal women, the researcher examined factors that also impacted younger populations. Furthermore, this study sought to understand if there are differences of these factors between sexually active and sexually inactive women. Methods: The conceptual framework of this study utilized many assumptions related to the Health Belief Model (HBM) (Rosenstock, 1974), the Theory of Reasoned Action (TRA) (Ajzen & Fishbein, 1980), the Theory of Planned Behavior (TPB) (Ajzen &Fishbein, 1980), and the AIDS Risk Reduction Model (ARRM) (Catania, 1990). This exploratory study design examined these factors among a purposive sample recruited at an outpatient OB/GYN clinic in a major hospital. Results: The major findings about condom use and STDs did not differ between sexually active and inactive women. Results are presented in terms of descriptive statistics due to the risk of type 1 errors. On a bivariate level high number of lifetime partners, being aware of HPV, perceiving limited partner barriers, and having positive views about self-perceived behavior control all significantly contributed to higher levels of condom use self-efficacy. The overall results, however, showed a mostly homogeneous group of women in terms of their awareness, attitudes, knowledge, and behaviors. The results of this dissertation emphasize that there is a strong need for more awareness of STD risks. The outcomes of this awareness could lead to more tolerance of condom use and knowledge of risk among this population.



Older women, Older adults, Postmenopausal women, STD awareness, Condom use, Condom efficacy