Sex Differences in Health: Evidence and Explanations 377SIDEBAR 10.3:Condom Use
Condoms are used to prevent the spread of HIV and other sexually transmitted diseases (STDs)
as well as provide a form of contraception to prevent pregnancy. The number of women in the
United States who use condoms during sexual intercourse has risen sharply over the past 30
years since the onset of the AIDS epidemic. In 1982, just over half (52%) of women of ages 15–44
had ever used a condom during sex, whereas the corresponding figure from the 2006–2008 sur-
vey was 93% (U.S. Department of Health and Human Services, 2010). The figures are highest
for Whites and African Americans (96% and 95%) and lowest among Hispanics (81%). Among
sexually active teens, 45% report that they consistently use a condom (Manning et al., 2009). The
rate is lower for Hispanics and higher for African Americans compared to Whites (Manlove,
Ikramullah, & Terry-Humen, 2008). Unfortunately, some studies have shown that adolescents
and adults are less likely to use condoms when engaging in casual sex than sex with a more seri-
ous romantic partner (Corbett et al., 2009; Manlove et al., 2008).
Condom usage among high-risk individuals is low. In a study of illicit drug users, part-
ners of IV drug users, homeless and poor people, and commercial sex workers, a majority of
persons reported that they never used a condom (Corbett et al., 2009). People purposefully re-
frained from using a condom to try to communicate to their partners that they are interested in
establishing a serious relationship. They try to establish trust in the relationship by not using a
condom—a behavior they think communicates that they are not having sex with someone else.
Thus, the people who are at most risk are least likely to take precautions to protect themselves.
College students who use condoms are more likely to believe in the effectiveness of condoms
in preventing pregnancy, HIV, and STDs (Ma et al., 2009; Sturges et al., 2009). They also believe that
they are vulnerable to these problems without the use of a condom. Earlier age at first sexual inter-
course is a predictor of lower condom usage for men but not women. When men and women believe
that condoms have a negative effect on men’s sexual experience, they are less likely to use condoms.
The nature of condom usage presents different challenges for heterosexual females and
males. Whereas men are deciding whether or not to use a condom, women are deciding whether
or not to persuade their partner to use a condom. A study of Mexican adolescents revealed that
both women and men believe that the male should initiate condom use (Martinez-Donate et al.,
2004). The nature of female and male roles may make the behavior required of women more
difficult. Women are more concerned than men that asking a partner to use a condom raises
issues of trust and fidelity (Williams et al., 2001). When relationships are troubled, women are
less likely to ensure that condoms are used during sex (Manning et al., 2009). Women also have
less power in their relationships compared to men, making them less assertive in sexual matters.
Both males and females report that they would have more difficulty using a condom when they
felt they had less power over the sexual situation (Woolf & Maisto, 2008). The most effective
strategy to get one’s partner to use a condom is direct communication (Tschann et al., 2010).
Among Latino youth, males are more likely than females to employ a direct strategy. Women are
also socialized to be the more passive sexual partner. These aspects of the female gender role may
make it more difficult for women to ensure their partners use a condom.the 1950s compared to the teens of the 1960s
or 1970s. The diminishing sex difference may
be due to greater opportunities for girls to en-
gage in risky activities today.Risk-taking behavior has been evalu-
ated in children. Numerous studies show that
boys engage in riskier behavior than girls,
whether this is documented by self-report,M10_HELG0185_04_SE_C10.indd 377 6/21/11 8:54 AM