Condoms, Trust and Stealthing: The Meanings Attributed to Unprotected Hetero-Sex.

Najiha Alam,Pam Alldred

doi:10.3390/ijerph18084257

Abstract

University students tend to have greater sexual health knowledge than the general public, yet condom use among this group continues to be a public health concern because effective condom use could reduce sexually transmitted infections and, for heterosexual women, unwanted pregnancies. We report findings from a small, qualitative study of condom use among sexually active heterosexual university students in the UK. In interviews, students shared their views about condom use and sometimes their personal experiences too. This paper identifies some of the meanings attributed to condom use in the accounts of nine heterosexually active 20–25 year-olds. Participants explained that when they felt comfortable communicating with their partners, they were more likely to use condoms, and those with negative sexual experiences or under social or psychological pressure were less likely to use them. The findings highlight issues of trust and power between men and women in heterosexual relationships, and describe contexts for dishonest sexual practice, including the traditional notions of femininity that were linked to condom use by this group. The issue of stealthing arose in one woman’s account of her experience and in several others’ reports of what occurs commonly. Stealthing, the secretive removal of a condom by a (usually male) partner during sexual intercourse without a partner’s knowledge or permission, produces non-consensual unprotected sex. We present stealthing as a product of the sexual double-standards described and as a form of interpersonal violence (IPV) and, among these heterosexual partners, as a form of gender-based violence. This study provides a glimpse into university students’ decision-making regarding condom use and highlights how gendered inequalities shape heterosex, in particular, communication about safer sex, that in some cases, compromise women’s decisions about (safer) sex.

Highlights

Inadequate condom use is linked to higher rates of terminations and sexually transmitted infections (STIs) and when acquired in youth, STIs can jeopardise sexual and reproductive health later in life and, for women, the health of babies [1]
Participants in this study reported that they would not discuss condom use with a partner they did not feel comfortable with, anticipated loss of pleasure was identified as the biggest disadvantage of condom use, and greater emotional intimacy as an advantage of unprotected sex
We found that, with greater age or sexual experience, participants’ levels of confidence or self-efficacy were reported to increase, making them more likely to voice their desire for condom use to a partner

Summary

Introduction

Inadequate condom use is linked to higher rates of terminations and sexually transmitted infections (STIs) and when acquired in youth, STIs can jeopardise sexual and reproductive health later in life and, for women, the health of babies [1]. One demographic of young people, university students, are more likely to have knowledge about sexual health risks than the general public [2,3,4,5,6]. This study set out to identify the barriers to and facilitators of condom use amongst young sexually active heterosexual university students in the UK, but in documenting talk about condom use, we frame this as a study of the meanings attributed to using or not using condoms. In these 14 articles, four types of factor are found to impact condom use: psychosocial; sociocognitive; environmental; and economic and structural factors. Environmental factors, like access to condoms, clearly restrict access, as do economic and structural issues like poverty and the legality of young people buying condoms. Psychosocial factors include confidence and self-efficacy, shame, embarrassment and guilt, loss of pleasure, comfort communicating with partners, lack of emotional intimacy, and an association with impurity or lack of trust

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Results

Conclusion