Only a small fraction of sexually active young adults use condoms strictly to prevent AIDS or other sexually transmitted diseases, while the vast majority use them exclusively or in part to prevent pregnancy, according to researchers at the University of Missouri, Columbia.
"Efforts to understand and promote condom use typically emphasize disease prevention motives, including perceived vulnerability to AIDS and other STDs," said M. Lynne Cooper, Ph.D., head of the study. "We suspect, however, that such factors are relatively unimportant among those who use condoms for pregnancy prevention."
"Promoting the view that condoms serve a dual purpose as both contraception and prophylaxis might encourage more consistent and reliable use," said Cooper.
The researchers surveyed 1,290 adults, ages 17 to 25. The respondents, who were equally divided between men and women and whites and non-whites, completed questionnaires assessing how frequently they had sex, their number of sexual partners, and their reasons for using condoms or other contraceptive techniques.
Nearly 70 percent of the group had used condoms at least once during the past six months, the researchers found. Among these adults, only 11 percent used condoms strictly to prevent AIDS and STDs, whereas 41 percent used condoms exclusively to prevent pregnancy and 48 percent used them to both prevent disease and pregnancy.
"Individuals use condoms to achieve different prevention goals, and these differences serve as reliable markers for distinct patterns of attitudes, beliefs, and behaviors related to both condom use and risky sex," said Cooper.
For example, people who use condoms to prevent pregnancy are more likely than other condom users to be in an exclusive relationship. They engage in the least risky sexual behavior, and they see themselves as the least vulnerable to disease.
People who use condoms to prevent disease, in contrast, are less likely than the pregnancy-prevention group and non-users to be in an exclusive relationship and more likely to engage in risky sexual behavior. Condom use was lowest among this group, and their negative attitudes toward condoms were 'indistinguishable' from those of nonusers.
Young adults who used condoms for both pregnancy and disease prevention were least likely of all to be in an exclusive relationship. They were similar to the disease prevention group in their practice of risky sexual behavior in the past six months, but they also reported the highest rates of condom use during that same period.
"This group appears to be pragmatic and flexible in their condom use," said Cooper. "These individuals correctly perceived their recent risk exposure and took appropriate precautions."
"Considered together, the data suggest that future efforts to understand and change condom use behaviors will be most successful if the heterogeneous nature of condom users is taken into account," said Cooper. "Our data point to the potential utility of tailoring interventions to the unique concerns and lifestyles of subgroups of condom users and nonusers."
The study was funded by a grant from the National Institute on Alcohol Abuse and Alcoholism.
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Health Psychology