Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH23173
RESEARCH ARTICLE (Open Access)
Contents Vol 21(2)

Acceptance and use of condoms among school-aged young people in Australia

Jennifer Power https://orcid.org/0000-0002-6566-3214 A * , Sylvia Kauer https://orcid.org/0000-0001-9797-9822 A , Christopher Fisher https://orcid.org/0000-0001-8757-0847 B and Adam Bourne https://orcid.org/0000-0001-5299-8835 A C
+ Author Affiliations
- Author Affiliations

A Australian Research Centre in Sex, Health and Society, La Trobe University, Building Nr6, Bundoora, Vic. 3086, Australia.

B Victoria University, VU Online, PO Box 14428, Melbourne, Vic. 8001, Australia.

C Kirby Institute, UNSW, Wallace Wurth Building (C27), UNSW, Kensington, Sydney, NSW, 2052, Australia.

* Correspondence to: Jennifer.power@latrobe.edu.au

Handling Editor: Cheng Wang

Sexual Health 21, SH23173 https://doi.org/10.1071/SH23173
Submitted: 13 October 2023  Accepted: 29 February 2024  Published: 21 March 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Despite availability of vaccines or medical prophylaxis for some sexually transmissible infections (STIs), promoting condom use remains an important public health strategy for the prevention of STIs. Recent research shows that regular condom use among young people in Australia has declined over the past decade, while the rate of common STIs has increased.

Method

In this paper, we report findings from a large survey of school-aged young people in Australia (14–18 years old) in which we looked at the association between condom use and positive feelings about sex, beliefs about social acceptability of condoms and confidence talking with partners about sex and condoms.

Results

Communication and relational factors supported more consistent condom use. Participants were more likely to regularly use condoms if they discussed condom use with a sexual partner, perceived condom use to be easy (a measure that included perceived ease of discussing condoms with a partner) and perceived condom use to offer social or relational benefits, including perceiving condom use as a demonstration of care for a partner. Young men were more likely to report positive feelings about sex and regular condom use than young women. Young women were less likely than young men or trans and non-binary young people to report regular condom use.

Conclusions

The study shows the importance of supporting young people to build confidence expressing sexual needs and wants with partners. Public health approaches to STI prevention need to consider condom promotion in the context of young people’s contemporary sexual, gendered and relationships cultures.

Keywords: Australasia, condom use, relationships and sexuality education, sexual communication, sexual health promotion, STI prevention, young people.

References

1  Australian Department of Health. Fourth national sexually transmissible infections strategy. Canberra: Commonwealth of Australia; 2018.

2  Hillier L, Harrison L, Warr D. “When you carry condoms all the boys think you want it”: negotiating competing discourses about safe sex. J Adolesc 1998; 21(1): 15-29.
| Crossref | Google Scholar | PubMed |

3  Gruskin S, Yadav V, Castellanos-Usigli A, Khizanishvili G, Kismödi E. Sexual health, sexual rights and sexual pleasure: meaningfully engaging the perfect triangle. Sex Reprod Health Matters 2019; 27(1): 29-40.
| Crossref | Google Scholar |

4  Evans WD, Ulasevich A, Hatheway M, Deperthes B. Systematic review of peer-reviewed literature on global condom promotion programs. Int J Environ Res Public Health 2020; 17(7): 2262.
| Crossref | Google Scholar | PubMed |

5  Braun V. ‘Proper sex without annoying things’: anti-condom discourse and the ‘nature’ of (hetero) sex. Sexualities 2013; 16(3–4): 361-82.
| Crossref | Google Scholar |

6  Gavey N, McPhillips K, Doherty M. “If it’s not on, it’s not on”–or is it? Discursive constraints on women’s condom use. Gend Soc 2001; 15(6): 917-34.
| Crossref | Google Scholar |

7  Rosenthal D, Gifford S, Moore S. Safe sex or safe love: competing discourses? AIDS Care 1998; 10(1): 35-47.
| Crossref | Google Scholar | PubMed |

8  Waldby C, Kippax S, Crawford J. Theory in the bedroom: a report from the Macquarie University AIDS and heterosexuality project. Aust J Soc Issues 1990; 25(3): 177-85.
| Crossref | Google Scholar |

9  Flood M. Lust, trust and latex: why young heterosexual men do not use condoms. Cult Health Sex 2003; 5(4): 353-69.
| Crossref | Google Scholar |

10  Kirkman M, Rosenthal D, Smith AMA. Adolescent sex and the romantic narrative: why some young heterosexuals use condoms to prevent pregnancy but not disease. Psychol Health Med 1998; 3(4): 355-70.
| Crossref | Google Scholar |

11  Rosenthal D, Reichler H. Young heterosexuals, HIV/AIDS and STDs: report prepared for the Department of Human Services and Health, September 1994. Canberra: Commonwealth of Australia; 1994. Report No.: 0644427914

12  Byron P. The intimacies of young people’s sexual health and pleasure. J Youth Stud 2017; 20(3): 332-48.
| Crossref | Google Scholar |

13  Byron P. Friendship, sexual intimacy and young people’s negotiations of sexual health. Cult Health Sex 2017; 19(4): 486-500.
| Crossref | Google Scholar | PubMed |

14  Holland J, Ramazanoglu C, Scott S, Sharpe S, Thomson R. Between embarrassment and trust: young women and the diversity of condom use. In: Aggleton P, Davies P, Hart G, editors. AIDS: Responses, interventions and care. Routledge; 2003. pp. 132–52.

15  Power J, Kauer S, Fisher C, Bellamy R, Bourne A. The 7th national survey of secondary students and sexual health, 2021. Melbourne: The Australian Research Centre in Sex, Health and Society, La Trobe University; 2022.

16  Adam P, de Wit J, Ketsuwan I, Treloar C. Sexual health-related knowledge, attitudes and practices of young people in Australia: results from the 2018 Debrief Survey among heterosexual and non-heterosexual respondents. Centre for Social Research in Health, UNSW Sydney; 2019.

17  Eddy S, Douglass C, Raggatt M, Thomas A, Lim M. Trends in testing of sexually transmissible infections (STIs), sexual health knowledge and behaviours, and pornography use in cross-sectional samples of young people in Victoria, Australia, 2015–21. Sex Health 2023; 20(2): 164-72.
| Crossref | Google Scholar | PubMed |

18  Fisher CM, Waling A, Kerr L, Bellamy R, Ezer P, et al. 6th national survey of Australian secondary students and sexual health 2018. Melbourne: La Trobe University; 2019.

19  McCarthy M, Kauer S, Fisher C. Descriptive norms about condom use predict odds of using a condom during last sexual experience in a large, national survey of adolescents from Australia. Sex Health 2022; 19(3): 157-63.
| Crossref | Google Scholar | PubMed |

20  Nguyen J, Williams H, McNamee K, Shaffeu N, Vaisey A, et al. Condom use among young women in Australia using long-acting reversible contraceptives or other hormonal contraceptives. Sex Health 2019; 16(6): 574-9.
| Crossref | Google Scholar | PubMed |

21  Gruskin S, Kismödi E. A call for (renewed) commitment to sexual health, sexual rights, and sexual pleasure: a matter of health and well-being. Am J Public Health 2020; 110(2): 159-60.
| Crossref | Google Scholar | PubMed |

22  Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2018. Sydney: Kirby Institute, UNSW; 2018.

23  Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2021. Sydney: Kirby Institute, UNSW; 2021.

24  Kirby Institute. Tracking the progress 2020: national sexually transmissible infections strategy. Sydney: Kirby Institute, UNSW; 2021.

25  Australian Bureau of Statistics (ABS). Table 43a full-time equivalent students, 2006–2018. Canberra: Australian Bureau of Statistics; 2019.

26  R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2022.

27  Posit team. RStudio: integrated development environment for R. Boston, MA: Posit Software, PBC; 2022.

28  Revelle W. psych: procedures for psychological, psychometric, and personality research. R package version 2.3.3. Evanston, IL; 2023. Available at https://cran.r-project.org/web/packages/psych/index.html

29  Sjoberg DD, Whiting K, Curry M, Lavery JA, Larmarange J. Reproducible summary tables with the gtsummary package. R J 2021; 13(1): 570-80.
| Crossref | Google Scholar |

30  Wickham H, Averick M, Bryan J, Chang W, McGowan LDA, et al. Welcome to the Tidyverse. J Open Source Softw 2019; 4(43): 1686.
| Crossref | Google Scholar |

31  Gohel D, Skintzos P. flextable: functions for tabular reporting; 2023. Available at https://cran.r-project.org/package=flextable

32  Kaiser HF, Rice J. Little jiffy, mark IV. Educ Psychol Meas 1974; 34(1): 111-7.
| Crossref | Google Scholar |

33  Goldfarb ES, Lieberman LD. Three decades of research: the case for comprehensive sex education. J Adolesc Health 2021; 68(1): 13-27.
| Crossref | Google Scholar | PubMed |

34  Allen L. ‘Say everything’: exploring young people’s suggestions for improving sexuality education. Sex Educ 2005; 5(4): 389-404.
| Crossref | Google Scholar |

35  Hirst J. ‘It’s got to be about enjoying yourself’: young people, sexual pleasure, and sex and relationships education. Sex Educ 2013; 13(4): 423-36.
| Crossref | Google Scholar |

36  Carmack C, Roncancio AM, Gerecht L, Ansari M. Perceived partner beliefs about condoms and self-efficacy communication within the context of the theory of gender and power. J Community Psychol 2020; 48(5): 1424-37.
| Crossref | Google Scholar | PubMed |

37  Wingood GM, DiClemente RJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Educ Behav 2000; 27(5): 539-65.
| Crossref | Google Scholar | PubMed |

38  Bay-Cheng LY. Agency is everywhere, but agency is not enough: a conceptual analysis of young women’s sexual agency. J Sex Res 2019; 56(4-5): 462-74.
| Crossref | Google Scholar | PubMed |

39  Waling A. Understanding how young cisgender heterosexual men navigate sexual health conversations and practices during casual sex: a qualitative study. Sex Health 2023; 20(4): 347-56.
| Crossref | Google Scholar | PubMed |

40  Dowsett GW. Understanding cultures of sexuality: lessons learned from HIV/AIDS education and behaviour change among gay men in Australia. In: Caldwell JC, Caldwell P, Anarfi J, Awusabo-Asare K, Ntozi J, Orubuloye IO, Marck J, et al., editors. Resistances to behavioural change to reduce HIV/AIDS infection in predominantly heterosexual epidemics in third world countries. Canberra: Australian National University; 1999. pp. 223–31.

41  Dowsett GW, Bollen J, McInnes D, Couch M, Edwards B. HIV/AIDS and constructs of gay community: researching educational practice within community-based health promotion for gay men. Int J Soc Res Methodol 2001; 4(3): 205-23.
| Crossref | Google Scholar |

42  Haire B, Murphy D, Maher L, Zablotska-Manos I, Vaccher S, et al. What does PrEP mean for ‘safe sex’ norms? A qualitative study. PLoS ONE 2021; 16(8): e0255731.
| Crossref | Google Scholar | PubMed |

43  Kolstee J, MacGibbon J, Prestage G, Clackett S, Paynter H, et al. Changing attitudes towards condoms among Australian gay and bisexual men in the PrEP era: an analysis of repeated national online surveys 2011-2019. AIDS Educ Prev 2022; 34(6): 453-66.
| Crossref | Google Scholar | PubMed |

44  Ramchandani MS, Golden MR. Confronting rising STIs in the era of PrEP and treatment as prevention. Curr HIV/AIDS Rep 2019; 16: 244-56.
| Crossref | Google Scholar | PubMed |