Prophylactic Predilections

In the early 1990s, promoting condom use was the most potent weapon in policymakers’ anti-HIV arsenal. However, efforts to encourage prophylactic use were hampered by the dearth of publicly available data on men’s preferences. For those who lacked access to condom manufacturers’ internal marketing data, the findings reported by William Grady and colleagues in the March/April 1993 issue of Perspectives were a treasure trove of information.

Drawing on data from the 1991 National Survey of Men, the researchers found, encouragingly, that three-fourths of men felt that using a condom showed that “you are a caring person.” But other findings suggested that condoms had an image problem, especially among certain subgroups. For example, although black men were especially likely to agree that condom use was a sign of caring, they were more likely than white men to say that using a condom makes your partner think you have AIDS, or is a sign you think your partner has the disease.

Not surprisingly, 27% of men found buying condoms embarrassing. But men’s concerns did not end once they had their condoms in hand. Three-quarters said that condoms reduced sensation, and two-thirds were concerned about breakage. Other common complaints were that condoms were difficult to put on, frequently came off during sex and cost too much. Even disposal was problematic—one in five men said that discarding condoms made them uncomfortable.

When asked which characteristics they looked for in a condom, most users reported wanting a product that was easy to put on and stayed on, and that had the “right amount” of lubrication. Smell mattered—a third said they avoided condoms with an unpleasant odor. But appearance did not: Only 7% cared about color. Only a quarter took into account their partner’s preferences.

The findings, according to the researchers, provided an opportunity to shift the focus of condom research from pregnancy prevention to condoms’ characteristics and men’s perceptions and attitudes. However, the fact that “using a condom sends unwanted messages to one’s partner” indicated that “educational and condom promotion programs need to address the interpersonal issues inherent in condom use.”

Cover illustrations of Margaret Sanger © Matthew and Eve Levine