During the 1980s, efforts increased to alert the public to the dangers of the human immunodeficiency virus (HIV), other sexually transmitted diseases (STDs), and unwanted pregnancies, but these problems have increased. Adolescents and young adults have been particularly hard hit. Teen pregnancy and birth rates are at their highest levels in two decades. Research has shown that consistent condom use is an effective way to prevent the transmission of HIV and other sexually transmitted diseases and in preventing pregnancy. Analysis of the Urban Institute's National Survey of Adolescent Males (NSAM) shows that although most sexually experienced male adolescents have used condoms at least once, many do not use them consistently. Only 35% reported using a condom every time they had sex in the past year. But male adolescents use condoms more than older men, and between 1979 and 1988 condom use among male adolescents doubled. These patterns indicate that adolescents are a promising target population for condom promotion efforts because they appear more ready than older men to change their behaviors. Unfortunately, condom use among youth appears to have plateaued since 1988. Comparisons between 1988 and 1991 NSAM data show little change in usage rates. Attitudes Related to Use Condom use is higher among young people who worry more frequently about AIDS when the effects of other factors are held constant. Between 1988 and 1991, however, sexually experienced adolescents showed declines in the frequency with which they worried about AIDS, the severity of their views about AIDS, and the likelihood of contracting AIDS. These reductions were associated with lower levels of condom use. Male adolescents who think they will be embarrassed to purchase or use condoms use them less consistently than those with higher embarrassment thresholds. If they think that using a condom will reduce the physical pleasure associated with intercourse, they are even less likely to use a condom. Early loss of pleasure is one of the strongest correlates of reduced condom use. Beliefs about male responsibility for contraception are also associated with condom use. Adolescent males use condoms more often when they believe they have the responsibility to initiate a discussion about contraception with their partners, to refuse sexual intercourse if contraception is not used, to help pay for the contraceptive pill, and to take responsibility financial for any resulting children. Further work has shown that young people's views on their contraceptive responsibility are closely linked to their beliefs about masculinity.