Condom use by heterosexuals attending a department of GUM: attitudes and behaviour in the light of HIV infection

Abstract

The use of condoms to prevent the further spread of human immunodeficiency virus (HIV) infection is one of the main themes of the government's health education campaign against AIDS. A study of the use of and attitudes towards condoms in 222 heterosexual men and women attending a department of genitourinary medicine (GUM) in central London showed that 55% (50/91) to 59% (41/70) of men or women never, and 6% (6/95) to 15% (14/91) always, used condoms with their regular or non-regular sexual partners. No major differences were found in the use of or attitudes to condoms according to age, sex, social class, or civil status. Attitudes towards the use of condoms were generally negative. These attitudes, in combination with the infrequent use of condoms with regular (and even more with non-regular) sexual partners, must be a cause for concern if the further spread of HIV is to be avoided.

PIP: A questionnaire administered to 222 consecutive heterosexual men and women presenting to a central London department of genitourinary medicine in 1987 revealed generally negative attitudes toward the use of condoms. The 108 male and 114 female respondents were largely from the 21-35 year age group and 68% were single; the median number of sexual partners in the preceding year was 2. 50 (55%) of the men and 52 (57%) of the women had never used condoms with their current regular sexual partners and 55 (59%) men and 41 (59%) women had never used condoms with nonregular sexual partners in the year preceding the survey. Only 7 (8%) men and 14 (15%) women reported always using a condom with current regular sexual partners and 6 (6%) men and 7 (10%) women always used condoms with nonregular sexual partners in the previous year. There was no association between condom use or nonuse and personal characteristics such as age, social class, sex, or marital status. 26% of condom users identified the prevention of sexually transmitted diseases as the major reason for use of this method. Only 24 study subjects (12 men and 12 women) claimed to like condom use. Reasons cited for not liking condoms included reduced sensitivity leading to diminished sexual pleasure, loss of spontaneity resulting from interruption of the sexual act, and general discomfort. 64 (40%) of respondents had experienced condoms splitting of slipping off the penis during intercourse. Although 90% of respondents felt that condoms were readily available, sales in supermarkets, newspaper stands, and vending machines in women's lavatories were recommended. 40% indicated they were embarrassed to purchase condoms. The obstacles to more widespread condom use identified in this study should be addressed by health education campaigns against AIDS.