Do people use condoms

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(1989) argued that increased condom use and not abstinence or non-penetrative sex or a
reduction in the number of partners is likely to be the best approach to HIV. As a result,
research has examined the prerequisites to safer sex and condom use in an attempt to
develop successful health promotion campaigns.
Do people use condoms?
Young people
Some researchers have suggested that the mass media campaigns have not changed
teenagers’ sexual behaviour (Sherr 1987) and that there has even been an increase in
sexually transmitted diseases (STDs) among this age group in the USA (Boyer and Kegles
1991). In the UK, data indicate that there has been an increase in Chlamydia and that
the dramatic reduction in gonorrhoea seen in the older population is not evident
among younger people. Richard and van der Pligt (1991) examined condom use among
a group of Dutch teenagers and report that 50 per cent of those with multiple partners
were consistent condom users. In an American study, 30 per cent of adolescent women
were judged to be at risk from STDs, of whom 16 per cent used condoms consistently
(Weisman et al. 1991). The Women, Risk and AIDS Project (WRAP) (e.g. Holland et al.
1990b) interviewed and collected questionnaires from heterosexual women aged 16–19
years. It reported that 16 per cent of these used condoms on their own, 13 per cent had
used condoms while on the pill, 2 per cent had used condoms in combination with
spermicide and 3 per cent had used condoms together with a diaphragm. Overall only
30 per cent of their sample had ever used condoms, while 70 per cent had not. Fife-Schaw
and Breakwell (1992) undertook an overview of the literature on condom use among
young people and found that between 24 per cent and 58 per cent of 16- to 24-year-olds
had used a condom during their most recent sexual encounter.
Homosexuals
Research has also examined condom use among homosexually active men. Weatherburn
et al. (1991) interviewed 930 homosexually active men in England and Wales and
reported that 270 of them had had insertive anal intercourse in the preceding month,
with 38.9 per cent reporting always using a condom, 49.6 per cent never using a
condom and 11.5 per cent sometimes using a condom. Of the 254 who reported having
receptive anal sex in the preceding month, 42.5 per cent had always used a condom,
45.7 per cent had never used a condom and 11.8 per cent had sometimes used a
condom. Weatherburn et al. reported that condom use was associated with casual not
regular sexual partners and was more common in open and not monogamous relationships. Therefore, within this high-risk group, condom use is low.
Bisexuals
In one study, Boulton et al. (1991) asked 60 bisexual men about their sexual behaviour
and their condom use. Over the previous 12 months, 80 per cent had had male partners,
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73 per cent had had female partners and 60 per cent had had at least one male and one
female partner. In terms of their condom use with their current partner, 25 per cent
reported always using a condom with their current male partner, 12 per cent reported
always using a condom with their current female partner, 27 per cent reported sometimes/never using a condom with their male partner and 38 per cent reported sometimes/never using a condom with their female partner. In terms of their non-current
partner, 30 per cent had had unprotected sex with a man and 34 per cent had had
unprotected sex with a woman. Bisexuals are believed to present a bridge between the
homosexual and heterosexual populations and these data suggest that their frequency of
condom use is low. This highlights a need to identify possible reasons for this behaviour.
Changes in condom use
In an attempt to examine the effects of HIV prevention educational campaigns in The
Netherlands, Hooykaas et al. (1991) examined changes in sexual behaviour in 340
heterosexual men and women and prostitutes. They reported that over the one-year
follow-up, condom use during vaginal intercourse with prostitutes/clients was high and
remained high, condom use with private partners was low and remained low, but that
both men and women reduced their number of sexual partners by 50 per cent.
The results from the General Household Survey (1993) provided some further insights
into changes in condom use in Britain from 1983 to 1991 (see Figure 8.3). These data
indicate an overall increase in condom use as the usual form of contraception, which is
particularly apparent in the younger age groups. However, not all research indicates
such an increase. Early data from San Francisco, which had one of the highest homosexual incidences of HIV, showed that by the late 1980s the incidence of new HIV
infections had fallen dramatically and that by the late 1990s had become essentially
stable (Katz 1997; Schwarcz et al. in press). However, since this time there has been an
increase in rectal gonorrhoea and clinical experience, cross-sectional and longitudinal
Fig. 8-3 Changes in the use of condoms as the usual method of contraception by age,
1983–91 (after General Household Survey 1993)
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