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  • Title: Attitudes toward condom use and AIDS among patients from an urban family practice center.
    Author: Stewart DL, DeForge BR, Hartmann P, Kaminski M, Pecukonis E.
    Journal: J Natl Med Assoc; 1991 Sep; 83(9):772-6. PubMed ID: 1942110.
    Abstract:
    As part of an effort to better educate patients about using condoms, a survey was done to assess the sexual practices, attitudes toward acquired immunodeficiency syndrome (AIDS) and condom use by patients who visit an urban family practice center. A self-administered questionnaire was given to 126 patients of whom the majority were black and single. Seventeen percent indicated they had sex with more than one person in the 3 months before the survey. Within the last 5 years, 10% had sex with an intravenous drug abuser, and 6% with someone of the same sex. Fifty percent believed that condoms decrease sexual pleasure for men and 31% thought condoms made sex inconvenient. Twenty-seven percent of those surveyed believed that a man's penis may be too large for a condom and 18% believed that uncircumcised men could not use condoms. Forty-five percent believed they should be screened for human immune deficiency virus exposure. The results highlight attitudes and beliefs that may function as barriers to condom use and should be addressed when encouraging condom use with this population. Attitudes toward condom use and AIDS were examined in a study of urban family planning clinic clients in Baltimore, Maryland. 126 respondents (71% response rate) out of 12,000 encounters per year participated in the 51-term questionnaire. Clinic clients are predominantly black, female, and young, although 20% are males. Respondents' mean age was 30 and most were black, never-married females. 89% engaged in sexual activity within the prior 3 months of the survey. 73% had 1 partner, 9% had 2 partners, 3% had 4 partners, and 11% had no partners. The average occasion of intercourse was 6.4 times/week. 14% used condoms all the time. 25% used at least 1 drug prior to intercourse. 10% had had intercourse with an iv drug user in the past 5 years. 1% had sex with an acknowledged AIDS patient. 23% knew 1 individual with AIDS. Attitudinal results indicated a wide variety of opinions on condoms and AIDS. 91% considered carrying condoms all right, 92% insisting on condom use, or 88% refusing sex without a condom; women found these statements more acceptable than men. In spite of beliefs, 50% or less of respondents indicated partner use of condoms. 52% of those finding decreased sexual pleasure for men and 56% finding decreased sexual pleasure for women had never used condoms. 75% expressed concern about contracting AIDS. 25% had been screened, and 40% believed they should be screened, of which 39% had never used a condom. 78% believed that condoms prevent AIDS, while 87% believed condoms prevent gonorrhea or 86% syphilis. 27% believed that a penis could be too large for a condom, and 18% believed condoms could not be used by circumcised men. 14% believed a condom could be used on a flaccid penis. It is concluded that use and beliefs about condoms do not coincide. Barriers to use were identified as cost of condoms (38% of men believed condoms were expensive) and embarrassment (26% of women were embarrassed to by condoms). Decrease in sexual pleasure was another deterrent to use. Misconceptions need to be confronted; i.e., the belief that religious people do not use condoms or only homosexuals get AIDS. It is recommended that the cultural basis of these attitudes be determined or the source of misconceptions. Educational strategies for racially distinct groups by sex need to be designed, implemented, and evaluated.
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