Why Aren’t Women Using Condoms?

By Kait Scalisi, MPH

Nearly 4,000 women divulged their sexual health habits in a new survey given by Planned Parenthood and Women’s Health magazine. The results will either totally surprise you or confirm what you already knew: women aren’t using condoms, getting tested for STIs or talking to their sexual partners about safe sex.

More specifically, the survey found the following results.

Condom Use

58% of women rarely or never use condoms.
16% say they always do.
95% rarely or never use condoms during oral sex.

STI Testing

One-third of women have never been tested for any STD.
3% of women are not sure if they have.
38% of women have never been tested for HIV.
6% are unsure if they have.

Talking to Partners About Safer Sex

37% report they’ve never talked to a partner about STD prevention

The magazine does not provide information on the survey’s methodology or the respondents’ demographics. This information is extremely important as age is known to influence condom use with rates of it decreasing over time. It is somewhat safe to assume that respondents have similar characteristics to the magazine’s readership. This would place most of the respondents in their 20s and 30s, the ages when condom use begins to decline from adolescence.

The results of this are alarming if not totally surprising to those of us in the field. They support past findings from the National Survey of Sexual Health and Behavior as well as anecdotal evidence from our colleagues, peers, and family members. As Planned Parenthood’s Vice President for External medical affairs said:

Unfortunately, it’s not uncommon for smart, educated, otherwise safe-playing women to forgo all caution when it comes to STD prevention. (Source)

The Women’s Health piece does a decent job of outlining why condom use, regular STD testing, and talking to partners is important. Instead I’ll focus on what else the results offer: an opportunity to make change. Condom rates seem to be static, if not declining. This implies that public health’s efforts to promote safer sex practices need some reworking. Scare tactics, shame, and “come on you should no better” clearly aren’t working. Our questions then should shift from simply describing what’s happening to exploring, in-depth, the motivations behind these behaviors. For example, why aren’t women talking to their partners about safer sex? What practical strategies can we teach them to normalize this conversation and make it easier and less awkward? Can we eroticize safer sex in some way so that it becomes, in fact, sexy? How can we better market safe sex? How can healthcare providers be better trained to talk about sex with patients? These questions are where the true value of this survey lies.

In my opinion, the whole point of research is to influence policy and programming. It is fairly useless to simply state the facts and move on. Will Women’s Health use this data to influence the content that will appear in their magazine and website? Will Planned Parenthood and other sexual health organizations, which already do fabulous and extensive outreach during STD Awareness Month, focus a bit more on sex education for adults? I recognize this all is much easier said than done but looking into new ways to approach this issue is vital if we want to make long-lasting, macro-level changes.

Lastly, I hope the organizations conduct follow-up surveys that not only ask these questions again but also delve into the why behind this data. As the condom landscape changes and becomes more female-friendly (brands like Sustain and Loveability focus almost exclusively on millenial women), it will be interesting to see if and how the data changes.