Abstract

PIP: Attitudes toward condom use and AIDS were examined in a study of urban family planning clinic clients in Baltimore, Maryland. 126 respondents (71% response rate) out of 12,000 encounters per year participated in the 51-term questionnaire. Clinic clients are predominantly black, female, and young, although 20% are males. Respondents' mean age was 30 and most were black, never-married females. 89% engaged in sexual activity within the prior 3 months of the survey. 73% had 1 partner, 9% had 2 partners, 3% had 4 partners, and 11% had no partners. The average occasion of intercourse was 6.4 times/week. 14% used condoms all the time. 25% used at least 1 drug prior to intercourse. 10% had had intercourse with an iv drug user in the past 5 years. 1% had sex with an acknowledged AIDS patient. 23% knew 1 individual with AIDS. Attitudinal results indicated a wide variety of opinions on condoms and AIDS. 91% considered carrying condoms all right, 92% insisting on condom use, or 88% refusing sex without a condom; women found these statements more acceptable than men. In spite of beliefs, 50% or less of respondents indicated partner use of condoms. 52% of those finding decreased sexual pleasure for men and 56% finding decreased sexual pleasure for women had never used condoms. 75% expressed concern about contracting AIDS. 25% had been screened, and 40% believed they should be screened, of which 39% had never used a condom. 78% believed that condoms prevent AIDS, while 87% believed condoms prevent gonorrhea or 86% syphilis. 27% believed that a penis could be too large for a condom, and 18% believed condoms could not be used by circumcised men. 14% believed a condom could be used on a flaccid penis. It is concluded that use and beliefs about condoms do not coincide. Barriers to use were identified as cost of condoms (38% of men believed condoms were expensive) and embarrassment (26% of women were embarrassed to by condoms). Decrease in sexual pleasure was another deterrent to use. Misconceptions need to be confronted; i.e., the belief that religious people do not use condoms or only homosexuals get AIDS. It is recommended that the cultural basis of these attitudes be determined or the source of misconceptions. Educational strategies for racially distinct groups by sex need to be designed, implemented, and evaluated.