ATHENS, Ga. Massive international publicity about the risks of AIDS and other sexually transmitted diseases appears to have had little impact on condom use. While as many as 85 percent of college students may be sexually active, only 40 percent have ever used a condom, according to one study.
Numerous theories have been cited for this failure, but an overwhelming factor is the embarrassment of bringing the subject up at all. A new study by a professor of speech communication and two graduate students at the University of Georgia, however, has shown for the first time that the use of condoms, especially in first-time sex, may lead to closer, more intimate and longer-lasting relationships. And it sends the message that the male is less likely to have a sexually transmitted disease.
"The folklore of this issue is that insisting on condom use sends a negative message to a partners," said John Hocking, a professor at UGA."But we found that for both males and females, insisting on condom use sends a positive message to the partner. It may well be that both males and females would prefer that condoms be used but that they don't bring the subject up because they're afraid of the partner's perception. This information could have a major impact on public health, we believe."
The study by Hocking and graduate students Don Turk and Alex Ellinger, was published today in the Journal of Adolescence.
The research involved some 268 University of Georgia students, who took part in what Hocking calls an "extremely effective and realistic" role-playing survey. Male and female participants imagined that they were about to engage in first-time sex with his or her new partner, and participants were randomly assigned to a condom or no condom condition in which the partner either insisted on using one or made it clear that one would not be used. The participants then responded in writing to measures designed to assess their post-sex attitudes toward the partner, the relationship and the sexual experience.
The issue of condom use has long perplexed researchers in a number of studies. One research group found in 1992 that only 6 percent of 588 randomly selected undergraduates talked about condom use prior to intercourse. Another study discovered that although some 44 percent of their sample used a condom during their most recent sexual encounter, only 6 percent recalled talking about the use of condoms prior to sex.
One serious problem in understanding the dilemma, obviously, is that it can be conducted only through surveys. Hocking believes the design of his study, with its controls and scientific rigor, give for the first time a serious look at how men and women communicate on issues like condoms prior to sexual encounters.
"The conclusion we found was startling," said doctoral student Don Turk. "If you insist on the use of condoms, your partner will like you better."
Scientists have been divided for years on the validity of research conducted through role playing. But growing evidence, Hocking said, shows that role playing can be a powerful predictor of behavior if it is designed well.
Participants in the study at the University of Georgia took part in one-hour sessions in which those involved were given either a male or female version of a 13-page packet that contained role playing materials. A pilot study with some 20 participants was successful enough to move forward with a full study.
"The pilot study helped us craft our research so that the participants could decide for themselves how long they had been dating their imaginary partner before their first sexual encounter," said Hocking.
The stage was set by having participants read to themselves a scenario in which a male and female student meet, date and decide to have sex. At the point at which sex looks likely, some role-playing booklets made it clear that their partner insisted on using a condoms (for male) or that one be used (for females) and others made it clear the partner proceeded with sex without use of a condom.
Those in the study were then asked to rate how they felt after the encounter. Each participant was asked if they felt confident-insecure, responsible-irresponsible, desirable-undesirable, physically attractive-physically unattractive, in control-out of control, scared-calm, moral-immoral, at risk-risk free, and at ease or worried. They were also asked to evaluate their imaginary partners on the basis of being responsible-irresponsible, promiscuous-chaste, heterosexual-bisexual, attractive-unattractive, care about me-does not care about me, physically attractive-physically unattractive, moral-immoral, someone I respect-someone I do not respect, likely to have a sexually transmitted disease-not likely to have an STD.
The results of the study were consistent and surprising to the researchers.
"Those participants whose partners insisted on condom use evaluated those partners as more deserving of respect," said Hocking. "Insistence on condom use also led to feelings of greater safety and less regret following the sexual encounter. And the use of a condom had no apparent effect on beliefs about the partner's perception that the participant had an STD."
Thus it may well be that both males and females would prefer condoms be used but that the issue is just never discussed. Males may fear their partner's negative perception of them if the subject is brought up.
"The response of the partners clearly showed that people feel much better in many ways if a condom is used," said Turk.
While the authors admit that the "role-play nature of the present research cannot be generalized with complete confidence to an actual sexual encounter," they suggest that the study gives powerful clues about why condoms are too infrequently used. They note that further studies on the issue should be done, especially in regard to the relationship between condom use and socioeconomic status and the length of the relationship.
"In addition, the scenario we used described one particular kind of sex a first-time heterosexual encounter with a boyfriend or girlfriend," said Hocking. "We don't know if the results would apply to other kinds of sex, such as repeat sex with the same girlfriend or boyfriend, casual sex such as one-night stands or same-sex encounters."
Still, the new study indicates that condom use can be positive for both partners in ways that have not been widely recognized. Hocking and Turk believe that the results could be incorporated immediately into sex education classes. Students, they said, could be truthfully told, "If you use a condom, or insist that your partner does, your partner will like you more, respect you more, be more likely to want a long-term relationship with you, feel that the sexual encounter was more intimate and meaningful, and be no less likely to think that you have a sexually transmitted disease, or that you think that he or she has one either."
"The best available empirical evidence indicates that use of a condom sends a positive message to your partner about you, about the relationship and the experience and about what you think of them," Hocking adds.
(Writers: Copies of the study are available from Hocking. Call the number above.)
Journal
Journal of Adolescence