Exploring condom use decision-making among adolescents: the synergistic role of affective and rational processes

Abstract

Background Condom use remains the most effective behavioural method for the prevention of HIV and unplanned pregnancies. However, condom use remains inconsistent among young people. Exploring the condom use decision-making processes that adolescents engage in might provide information that would assist in the prevention of many challenges related to poor sexual and reproductive health outcomes. This study therefore aimed to explore the factors that influenced decision-making about sexual debut and condom use of adolescents from two schools in the Western Cape, South Africa. Methods A sample of 16 adolescents were selected using purposive sampling. Data were collected using semi-structured, individual interviews. Thematic analysis was used to analyse the data generated. Results The link between sexual debut and affective processes was frequently discussed in condom use decision-making. Decisions about sexual debut were influenced by the belief that sex was a perceived symbol of ‘true love’ on the one hand, and respect for perceived parental expectations of age-appropriate sex, on the other. Condom use decision-making was shaped by adolescents’ concerns about their future and lack of stability in their lives. Adolescents’ fears of pregnancy, parenthood and disease shaped their condom use decision-making. It became evident that rational and affective decision-making in condom use choice were not mutually exclusive, but that these processes happened simultaneously. Conclusions The study highlighted the role of affective states as part of the process of examining alternatives when deciding to use a condom or not. Interventions to strengthen condom use decision-making should therefore incorporate not only rational but also affective processes to improve adolescent sexual and reproductive outcomes.

Motivators and Influencers of Adolescent Girls’ Decision Making Regarding Contraceptive Use in Four Districts of Zambia

“…Adolescent girls who did not want to use hormonal contraceptives opted to use condoms, particularly male condoms. Comparable findings have been reported in other studies [ 27 , 31 , 32 , 33 ]. Condoms are viewed as both a means of protection against diseases and prevention of pregnancy [ 33 ], although most use them for disease protection rather than the dual role that condoms provide (disease prevention and prevention of pregnancy) [ 34 ].…”

Perceived motivators, knowledge, attitude, self-reported and intentional practice of female condom use among female students in higher training institutions in Dodoma, Tanzania

“…In line with the quality, scholarly work by Gambir et al [ 32 ] on the opportunities and challenges for the introduction of female condoms among young people in Zambia revealed that very few participants acknowledge female condoms due to misconceptions about their safety, how correct would they use them, availability, affordability of the condoms to them, and the limited power they had over the decisions on sexual activities. Nevertheless, the descriptive qualitative findings observed by Davids et al [ 33 ] on condom use decision-making among adolescents in South Africa depicted that male condoms were more promoted and distributed than female condoms, which again may be linked to the low use of female condoms and that sexual masculinity over sexual intercourses still prevails among young people.…”

“Compared to COVID, HIV Is Nothing”: Exploring How Onshore East Asian and Sub-Saharan African International Students in Sydney Navigate COVID-19 versus BBVs/STIs Risk Spectrum

“…While this is important, it is also beneficial to recognise that knowledge is not enough to trigger behaviour change. Therefore, beyond knowledge, it is important to understand whether and how emotions, intuitions and experiences shape BBVs/STIs risk and protective practices during the COVID-19 pandemic, as we still do not fully understand how these affective states shape health behaviours [21].…”