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condoms

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Why people do not use condoms

Many men and women prefer unprotected intercourse or using another contraceptive method rather than using a condom. Among currently married women of reproductive age, only 5 percent use condoms for contraception worldwide, and only 3 percent in less developed regions of the world, according to United Nations estimates of contraceptive use. In this chapter we a re going to analyze or try to explain why some people don’t use condoms. In order to do this, we used some theory of the book ‘Social Psychology’ (7th edition) by David G. Meyers. Also we used much information that we got from the internet.
In the above mentioned book, they explained that each construes the human skin as a special boundary that separates one set of casual forces from another. On the sunny side of the epidermis are the external or situational forces that press inward upon the person, and on the meaty side are the internal or personal forces that exert pressure outward. Sometimes these forces press in conjunction, sometimes in opposition, and their dynamic interplay manifest itself as observable behavior.
In the figure below you can see a figure which explains Harold Kelly’s theory of attribution.









Through the figure above, you can conclude yourself whether the following reasons are internal or external attribution. In addition we divided the causes in two parts. The first one is the reasons of the people in the developed countries and the second part is about the reason of the people in the developing countries.
Developed Countries

The most frequent reasons people in the developed countries give for not using a condom relate to the following issues: lack of sensation or interrupted sexual pleasure; psychological and social factors, including couple communication and assumptions that condoms are for use in extramarital relationships and with prostitutes; lack of availability of condoms, including policies that prohibit condom distribution to youth; and lack of confidence in the reliability of condoms themselves. To make condoms more acceptable and more widely used, all of these issues should be addressed.
Factors affecting the acceptability of condoms can be thought of as a series of concentric circles that interact with each other -- from the individual at the center to the couple, the health-care system, the community and the entire world. An individual's knowledge, attitudes, habits, perceptions, awareness of the need and other internalized factors are critical to condom use. But what forms those belief systems and determines individual behavior? The dynamics between sexual partners play a crucial role and depend on many factors, such as whether sex is with a regular partner or not, whether the couple talks about sex and protection against disease and unwanted pregnancy, and whether sex is voluntary for both parties.
At the community level, many programmatic issues are involved, from counseling in health-care systems to condom logistics and distribution systems. National as well as local policies about condoms affect acceptability, as do attitudes and pronouncements about condom use by parents, church leaders, peers, entertainment figures, political leaders and others. For example in Virginia, USA, it was not legal to have sex whitout a wedding ring. Until earlier this year, couples who were hitched could be fined $250 each time they got caught. Worldwide priorities for AIDS prevention campaigns influence the messages that communities receive and how they respond.
Persuading people at risk of STD/HIV to use condoms is one of the primary strategies of AIDS prevention programs throughout the world. In general, lessons from AIDS prevention campaigns show that product attributes play a minor role in initial condom acceptance compared to strategies that influence an individual's perception of the importance of condom use. Once a person starts using condoms regularly, product attributes may play a more significant role in continued use. Condoms are most effective if used consistently, which requires sustained behavior change. If preferences regarding product attributes can encourage consistent condom use over a sustained period of time, choices among various types of products may be important.
Among 544 men attending STD clinics and a university health service in Australia, about one out of five were no longer using condoms. The major reasons were that his partner(s) were using another contraceptive, he was not sexually active, he thought his partner(s) did not have an STD, and he did not like how condoms felt.
In a nationally representative sample of more than 3,000 U.S. men interviewed about condoms, the most frequently cited negative reactions were: reduces sensation, requires being careful to avoid breakage, requires withdrawing quickly, embarrassing to buy, difficult to put on, often comes off during sex, embarrassing to discard, shows you think partner has AIDS, and makes partner think you have AIDS.
Another U.S. study of 652 sexually active people found that 61 percent reported not using a condom with their last sexual partner. Low perceived risk of HIV infection was the main reason given, although most did not know enough about their partner to be sure.

Developing countries
National surveys generally do not record condom use among unmarried persons and in sexual activity outside of marriage, arenas that are critical for disease prevention. Some recent Demographic and Health Surveys have found that men report higher condom use than women and that men report higher condom use with partners other than spouses. In the Zimbabwe DHS, for example, of those men having sex in the last four weeks with their spouse, 12 percent had used a condom, while men having sex with other partners reported using a condom 60 percent of the time. Nevertheless, one analysis estimated that overall condom use is less than half of what is needed to protect the health and lives of men and women.
Studies in many parts of the world indicate that couples do not use condoms for many reasons, including fear of partners' reactions/partner opposition, lack of confidence in the product, decreased pleasure, and not perceiving the risk of disease.
Among 620 women interviewed at a family planning clinic in Jamaica, respondents gave three primary reasons for non-use of condoms. Most often the women said they did not need protection in addition to their primary contraceptive method because they were not at risk of STDs. Also, condoms were uncomfortable or decreased pleasure, and their partner was opposed to using condoms.
A study in Uganda interviewed 130 women, half of whom were infected with HIV. "I have never used a condom and would not like to use one," said one young woman in the survey, because she incorrectly thought "it is risky since sperm can pass through the condoms." The view of the husband was also a critical factor. An HIV-positive woman, age 21, who knew that condoms can prevent HIV transmission, said, "Though I have never used a condom, I would use it if my husband is the one who suggests it." Many women also said they feared that if they requested their husbands use a condom, their partners would think that they were prostitutes or unfaithful.
Focus groups in China's most populous province of Sichuan discussed condom use among 106 people, divided into male condom users, wives of condom users, men whose wives used other contraceptives and women who were using other forms of contraception. Many participants thought of condoms as troublesome to use, easy to forget and causing a decrease in sexual satisfaction.
Forty million people are living with HIV or AIDS worldwide, yet only 5 to 10 percent of those infected know their status. Millions of people have still never heard of AIDS, or have few or inaccurate ideas about how it is transmitted. UNICEF reports that more than half of young people aged 15-24 in more than a dozen countries—representing all the developing regions—are in this situation. Such a lack of knowledge is particularly disturbing given the increasing toll the disease is taking on young people. A study among youth in Rwanda showed that fewer than 20 percent knew how to use condoms correctly.22 In Pakistan, as in India, where condoms have been promoted for family planning for decades; many individuals at high risk of acquiring HIV do not know that condoms can protect them against HIV transmission.

Concepts of masculinity lead men in many settings to take sexual risks, including seeking out multiple partners, engaging in unprotected sex, and avoiding clinical settings as sources of information and services. Notions of femininity make it difficult for women to discuss sex and reproduction with their partners, and may also inhibit their mobility, restrict their access to health services and the resources to pay for them, and subject them to violence or coercive sex.

Many governments still hinder condom-related activities in their countries, despite the obvious need to guarantee unimpeded access to all forms of protection from life-threatening dangers such as HIV, and the international community’s stated commitment to such access. Policy-level obstacles to condoms vary among countries, and may be applicable at national, district or community levels, but can include: restrictive measures and legislation on distribution of and public communication regarding condoms; prohibition of information on condoms for young people and in schools; prohibitions against the free distribution of condoms— anywhere; taxes and tariffs on imported or even locally manufactured condoms or on the raw materials needed for their production; and policies that require condom procurement from local manufacturers at prices much higher than available from other countries.

In spite of evidence to the contrary, a common and dangerous misconception is that condom promotion results in increased sexual activity and promiscuity, especially among young people. Fearing that it will promote sexual activity out-of-wedlock, many service providers and pharmacists do not make condoms easily accessible to youth. Adolescents may hesitate to obtain condoms available at clinics because service providers act judgmentally towards them. Young women may be especially timid because it is considered inappropriate for them to seek condoms.

Limited distribution systems complicate access, especially in rural areas. Government outlets may be relatively few and widely dispersed or private-sector sources may favor wealthier urban areas, resulting in uneven availability within a country.

In 2000, donors provided less than one billion of the estimated eight billion condoms required in developing countries and Eastern Europe to greatly expand access for those in need. Many developing country governments are providing and promoting condoms as part of their HIV prevention strategies, but for the poorest countries, assistance from the wealthier developed countries remains the main source of condoms. In other countries, sustainable prevention efforts that include promotion and provision of condoms are hurt by inadequate government commitment.



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