Table 5.

Primary Care Strategies for Encouraging Paternal Provision of Condom Use Guidance

Topic	Challenge	Father-Focused Communication Strategy
Paternal perceptions of adolescent male sexual activity	While fathers who believe that their sons are already sexually active are more likely to provide condom-specific guidance, many fathers are unaware that their sons are having sex.	Explicitly encourage paternal condom-specific guidance as a preemptive rather than reactive strategy.
Adolescent male age	There is no strong association between adolescent male chronological age and the paternal provision of condom use guidance.	Reinforce that there is not a specific age to communicate about sex and condoms, but that it is important to provide guidance regarding correct and consistent condom use before sexual initiation.
Readiness for sex based on:
Completion of life opportunity trajectory milestones	Some fathers believe that their sons should wait to have sex until they have achieved important milestones, such as academic success (eg, high school graduation, college enrollment, etc), financial independence, or a stable long-term relationship to avoid jeopardizing their long-term life opportunities.	Emphasize that a comprehensive strategy for preventing negative academic, economic, and social consequences of sex among adolescent males includes paternal guidance regarding correct and consistent condom use.
Social–emotional–cognitive maturity	Fathers believe starting to have sex engenders responsibilities that call for a level of social–emotional–cognitive maturity that their adolescent sons do not always exhibit; as a result, some fathers prefer that their sons do not have sex during this part of their lives.	Remind fathers that providing guidance about correct and consistent condom use is not synonymous with encouraging their sons to have sex. Advise fathers to clearly communicate their expectations about waiting to have sex while also beginning to provide condom guidance in preparation for when their sons start to have sex.
Preparedness for safe sex	Fathers believe that being prepared to have sex safely, including by using condoms correctly and consistently, is an important element of their sons’ readiness for sex; however, fathers frequently wait to provide condom-specific guidance until after their sons have already started having sex.	Emphasize the important role of fathers in preparing their sons for safe sex via the correct and consistent use of condoms. Ensure that fathers (a) know how to start conversations about using a condom every time during sex, (b) can demonstrate how to use a condom correctly, (c) are willing to provide condoms to their sons, and (d) are comfortable encouraging their sons to practice using a condom.