FRONTIERS
Publications/Resources

• Focus group participants defined successful condom use in terms of personal benefits, such as avoiding pregnancy, preventing STIs, feeling secure, or improving hygiene. This contrasts with previous studies that have defined successful condom use in terms of frequency and consistency of use. 
   
• The major reasons for using condoms were preventing pregnancy (the main reason for women) and protecting against STIs (the main reason for men). A third major reason was that the protection of condoms gave a sense of security and peace of mind. Participants liked the convenience and easy availability of condoms, and some women said that they used condoms because they were dissatisfied with other contraceptive methods.
   
• The majority of participants said that condom use did not diminish sexual satisfaction but instead enhanced their sexual enjoyment. They reported that the security of condom use made them feel safer and more relaxed.
   
• Condom use was more likely with casual or irregular partners. Almost three-fourths of the sex workers interviewed in the Dominican Republic reported always using condoms with clients; use with non-clients was much lower. Over half of students and factory workers in both countries used condoms with casual partners. However, a significant proportion said that even with casual partners, they rarely or never used condoms (see Figure).
   

  Frequency of condom use by students or factory workers during a six-month period, by type of partner
  	Always (%)	Often (%)		Seldom or never (%)
  Students
  Stable partner (n=180)	32		36	32
  Casual partner (n=104)	59		27	13
  Factory workers
  Stable partner (n=129)	31	21		47
  Casual partner (n=61)	66	11		25

                         Source: Survey answers from students or factory workers who reported having
                         had a sexual partner during the past six months.
   
• About a third of students and factory workers reported always using condoms even with stable partners. In focus group discussions, participants cited several reasons for this, including mistrust of regular partners, desire for protection from pregnancy or STIs, and the convenience and hygiene of condom use.
   
• Focus group participants disclosed various strategies to persuade partners to use condoms, including bringing a supply of condoms, eroticizing condom use, and refusing sex without a condom. Members of all three groups mentioned talking about condoms to encourage use. However, some participants were reluctant to bring up condoms with regular partners because it would imply infidelity.
   
• Buying condoms in public venues, such as pharmacies, remains stigmatized and embarrassing, even for experienced users. They urged that condom dispensers be available at alternative outlets, such as discos, workplaces, and universities.

Utilization

• Local organizations in both countries have reviewed their condom promotion strategies and materials. Revised materials will be tested in both countries.

Policy Implications

• Condom education campaigns should increase their focus on the benefits of condom use. Suggestions include promoting condoms for protection of families, for increased security and pleasure, and as a show of love and respect for the partner. Condom users should be depicted as responsible role models.
   
• Programs are needed to encourage discussion of responsible and safe sexuality by many stakeholders including parents, adolescents, businesses, and physicians. Messages should also touch on the link between self-esteem and condom use, such as “if you love yourself, you will use a condom.”

 February 2005
 

Sources: García, Sandra G. and Lisa Goldman. 2004. “Understanding successful condom use in the Dominican Republic,” FRONTIERS Final Report. Washington, DC: Population Council.

García, Sandra G. and Lisa Goldman. 2003. “Understanding successful condom use in northern Mexico.” Final Narrative Report. New York: Population Council.

These projects were conducted with support from the U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT under Cooperative Agreement Number HRN-A-00-98-00012-00 and from the Moriah Fund.