Objective: To model condom usage by jail-incarcerated women incarcerated in U.S. local jails and understand results in terms of fundamental cause theory. Design, Sample, Measurements: We surveyed 102 women in an urban jail in the Midwest U.S. Chi-square tests and generalized linear modeling were used to identify factors of significance for women who used condoms during last-sex compared with women who did not. Stepwise multiple logistic regression was conducted to estimate the relation between the outcome variable and variables linked to condom use in the literature. Results: Logistic regression showed that for women who completed high school odds of reporting condom use during last sex were 2.78 times higher (p =.043) than the odds for women with less than a high school education. Among women who responded no to ever having had a sexually transmitted infection, odds of using a condom during last sex were 2.597 times (p = .03) higher than odds for women who responded that they had had a sexually transmitted infection. Conclusions: Education is a fundamental cause of reproductive health risk among incarcerated women. We recommend interventions that creatively target distal over proximal factors.

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