Background and aims: Condom use at sexual debut is associated with subsequent condom use and with decreased risk of sexually transmitted infections. There is a dearth of data on determinants of condom use at first sexual intercourse. We aimed to determine factors associated with condom use at first sexual intercourse before marriage among Vietnamese adolescents and youths.

Methods: The study involved the analysis of data from the Survey Assessment of Vietnamese Youth, 2003, the first nationally representative survey of young people in Vietnam. The survey included 7584 adolescents and youths aged 14–25 years. In this study, data of 605 adolescents and youths who had engaged in premarital sex were analyzed for factors associated with condom use using descriptive analyses, and regression techniques, allowing for sampling weights, clustering and stratification.

Results: Of 605 adolescents and youths who had engaged in premarital sex, 28.6% reported condom use at first sexual intercourse. Condom use at sexual debut was less common in females than males [odds ratio (OR)=0.15; 95% confidence interval (95% CI)=0.07–0.30] and less common in those who experienced peer pressure to engage in social higher risk behaviors (OR=0.57; 95% CI=0.32–0.99). Condom use was more common if a friend/acquaintance or a stranger/sex worker was the first sexual partner (OR=2.20; 95% CI=1.16–4.17 and OR=17.90; 95% CI=6.88–46.54) respectively, each compared with fiancé/boyfriend/girlfriend as first sexual partner.

Conclusions: These data suggest that approximately one in three unmarried Vietnamese youths used a condom at first sexual intercourse. Gender, peer pressure and the nature of the relationship to the first sexual partner were independently associated with condom use. These results can inform programs directed at preventing HIV and other sexually transmitted infections among young Vietnamese.