Many Men Don't Use Condoms

Jan. 26, 2004 -- Many low-income, straight men don't use condoms for disease prevention, despite knowing the risks, a new study shows.

Rather than wear a condom to prevent syphilis, gonorrhea, or other sexually transmitted diseases (STDs), they would rather take a chance -- and deal with the consequences later, researcher Diane M. Grimley, PhD, chair of the Department of Health Behavior at the University of Alabama at Birmingham.

Her paper appears in the current American Journal of Health Behavior.

Public health warnings regarding STD prevention have made some impact, she notes. Rates of syphilis and gonorrhea are at a 50-year low. However, there's still a big problem -- rates of syphilis, gonorrhea, and chlamydia remain far higher in the U.S. than in other industrialized nations, writes Grimley.

Her concern focuses specifically on sexually active men who have multiple partners and/or overlapping relationships. She explains that infected men can readily infect a woman only after one sexual encounter. Typically STD prevention programs target women and this lack of emphasis on heterosexual men is troublesome given their contribution to continuing STD transmission, she writes.

How Safe Are You?

In their study, Grimley and her colleagues focused on 224 men -- all with STD symptoms -- who sought treatment in a Birmingham STD clinic. The average age was 26, and most men were black.

In face-to-face, private interviews, each was asked the same set of questions.

Among them:

• How often have you used a condom in the past month?
• How long have you been using condoms?
• Do you have any intention of starting condom use?
• Why do you use condoms?
• Do you wear condoms for STD prevention or to protect your partner from pregnancy and disease?
• Why don't you use condoms?

And the results:

• 80% reported that most people their age did not use condoms consistently. They also said that 61% of people their age had gonorrhea.
• 81% acknowledged sexual contact with two or more partners during the preceding six months.
• 45% reported sexual relationships that overlapped.
• 65% said they had been diagnosed with one or more STDs in the past.

Despite strong beliefs that condoms could be effective in STD prevention, many men were not motivated to use condoms consistently, Grimley reports.

Of those men with one main sexual partner, two-thirds were not motivated to use condoms.

These men also gave little indication they would start using condoms for STD prevention, she explains.

"They wanted their partners to know that they were committed to the relationship," she writes. Other studies show similar attitudes, indicating that intimate relationship issues are important to many men, as well as women, she says.

Safety Is Often Not a Concern

Also, alcohol and drug users gave the least indication they would use condoms.

For many men, safety from disease does not play a central role in their decision-making about condoms, writes Grimley.