Young women and limits to the normalisation of condom use: A qualitative study

MRC Social and Public Health Sciences Unit, Glasgow, UK.
AIDS Care (Impact Factor: 1.6). 06/2009; 21(5):561-6. DOI: 10.1080/09540120802301857
Source: PubMed


Encouraging condom use among young women is a major focus of HIV/STI prevention efforts but the degree to which they see themselves as being at risk limits their use of the method. In this paper, we examine the extent to which condom use has become normalised among young women. In-depth interviews were conducted with 20 year old women from eastern Scotland (N=20). Purposive sampling was used to select a heterogeneous group with different levels of sexual experience and from different social backgrounds. All of the interviewees had used (male) condoms but only three reported consistent use. The rest had changed to other methods, most often the pill, though they typically went back to using condoms occasionally. Condoms were talked about as the most readily available contraceptive method, and were most often the first contraceptive method used. The young women had ingrained expectations of use, but for most, these norms centred only on their new or casual partners, with whom not using condoms was thought to be irresponsible. Many reported negative experiences with condoms, and condom dislike and failure were common, lessening trust in the method. Although the sexually transmitted infection (STI) prevention provided by condoms was important, this was seen as additional, and secondary, to pregnancy prevention. As the perceived risks of STIs lessened in relationships with boyfriends, so did condom use. The promotion of condoms for STI prevention alone fails to consider the wider influences of partners and young women's negative experiences of the method. Focusing on the development of condom negotiation skills alone will not address these issues. Interventions to counter dislike, method failure, and the limits of the normalisation of condom use should be included in STI prevention efforts.

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    • "'Finding fit' was also located in dominant discourses of (hetero)sex and heterosexuality, where the naturalness and pleasure of (hetero)sex is prioritised. Previous work has similarly indicated pleasure is an important factor influencing the discontinuation of condoms (Braun, 2013; Williamson, Buston & Sweeting, 2009). Women expressed agency by highlighting the lengths they went to, in order to find suitable contraception, drawing on embodied evidence to legitimise their accounts. "
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    • "For instance, in the case of male condoms, many men in SSA may interpret a request to use condoms as an insult, a sign of mistrust, and a hindrance to sexual fulfillment [31–35]. Additional determinants of condom use are female decision-making power [36, 37], socioeconomic factors, access to and availability of condoms [38, 39] technical issues with substandard condoms [40–43], and myths and misconceptions about condoms and fertility aspirations. It is important therefore that efforts to increase condom use address the barriers that have been highlighted in the literature. "
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