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Condom Bias and Stigma
While condom use is generally considered the best option available for
STI prevention (including HIV), providers and clients alike may have biases against
the condom that need to be addressed. Rumors, myths, and misconceptions
about condoms are common. For example, common myths and biases include:
- Condom use is associated
with stigmatized behaviors, such as infidelity or sex work.
- Condoms are primarily for
certain groups of people, such as people with STIs, sex workers and
their clients, men in the military, or adolescents.
- Condoms break readily,
and HIV can pass through a latex condom.
- Suggesting condom use to
a partner implies that a person is unfaithful or accuses the partner
of being unfaithful.
In addition, some condom
features make condoms unappealing to some people. These ideas about
condoms can often be overcome through education and counseling. They
include, for example:
- Condoms ruin the spontaneity
of sex.
- Condoms cause a loss of
sensation.
- Condoms require additional
lubrication.
- Condoms have an unpleasant
odor.
Provider bias
Providers themselves may
have the same biases, as listed above, as communities in general, and
may find condoms unappealing on a personal level; therefore, they may
hesitate to actively and positively promote condom use. Furthermore,
family planning providers in particular may have professional biases
against condoms due to long-standing perceptions in the family planning
field of condoms and other barrier methods as less effective forms of
family planning than other methods. In fact, condoms, when used consistently
and correctly, can be as effective or more effective than many other
methods. Other condom biases that providers may have include:
- Providers may not trust
clients to be responsible enough to use condoms consistently and correctly.
- Providers may consider
condoms a serious option as an STI prevention method but not as a family
planning method.
- Providers may consider
condoms as a backup method if, for example, a woman forgets to take
her pills or needs to use another method temporarily until a longer-term
method can take effect.
- Providers
may assume that clients do not want condoms or will be offended if they
bring them up as an option.
It is, therefore, important
to increase provider acceptance and comfort with condoms in order to
promote their use effectively with clients.
Condom Promotion and
Dual Protection
Effective condom promotion
means that providers:
- Ensure an adequate supply
of condoms
- Discuss condoms within
the context of family planning and reproductive health
- Conduct condom demonstrations
using penis models and have clients practice on the models themselves
- Address client strategies
for communication about condom use with partners, including, for example,
role plays with clients about how they might talk to partners
- Make efforts to destigmatize
condoms by emphasizing their fun and erotic possibilities, as well as
their benefits for pregnancy prevention
Dual protection
can be defined as a strategy to prevent both STI transmission (including HIV) and
unintended pregnancy through the use of condoms alone, the use of condoms
combined with other methods (dual method use), or the avoidance of risky
sex. More specifically, dual protection can include:
- The use of condoms alone:
- The use of a condom (male or female) alone for both purposes
- Dual-method use:
- The use of a condom plus another contraceptive method
for extra protection against pregnancy
- The use of a condom plus emergency contraception, should
the condom fail
- Selective condom use plus another family planning method
(for example, using the pill with a primary partner, but the pill
plus condoms with secondary partners)
- The avoidance of risky sex:
- Abstinence
- The avoidance of all types of penetrative sex
- Mutual monogamy between uninfected partners while using
a contraceptive method to prevent pregnancy
- Delaying the sexual debut for young people
© 2007 EngenderHealth
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