Cultural Barriers To Condom Use
In much of the Western world, the introduction of the pill in the 1960s was associated with a decline in condom use. In Japan, oral contraceptives were not approved for use until September 1999, and even then access was more restricted than in other industrialized nations. Perhaps because of this restricted access to hormonal contraception, Japan has the highest rate of condom usage in the world: in 2008, 80% of contraceptive users relied on condoms.
Cultural attitudes toward gender roles, contraception, and sexual activity vary greatly around the world, and range from extremely conservative to extremely liberal. But in places where condoms are misunderstood, mischaracterised, demonised, or looked upon with overall cultural disapproval, the prevalence of condom use is directly affected. In less-developed countries and among less-educated populations, misperceptions about how disease transmission and conception work negatively affect the use of condoms; additionally, in cultures with more traditional gender roles, women may feel uncomfortable demanding that their partners use condoms.
As an example, Latino immigrants in the United States often face cultural barriers to condom use. A study on female HIV prevention published in the Journal of Sex Health Research asserts that Latino women often lack the attitudes needed to negotiate safe sex due to traditional gender-role norms in the Latino community, and may be afraid to bring up the subject of condom use with their partners. Women who participated in the study often reported that because of the general machismo subtly encouraged in Latino culture, their male partners would be angry or possibly violent at the woman's suggestion that they use condoms. A similar phenomenon has been noted in a survey of low-income American black women; the women in this study also reported a fear of violence at the suggestion to their male partners that condoms be used.
A telephone survey conducted by Rand Corporation and Oregon State University, and published in the Journal of Acquired Immune Deficiency Syndromes showed that belief in AIDS conspiracy theories among United States black men is linked to rates of condom use. As conspiracy beliefs about AIDS grow in a given sector of these black men, consistent condom use drops in that same sector. Female use of condoms, interestingly, was not similarly affected.
In the African continent, condom promotion in some areas has been impeded by anti-condom campaigns by some Muslim and Catholic clerics. Among the Maasai in Tanzania, condom use is hampered by an aversion to "wasting" sperm, which is given sociocultural importance beyond reproduction. Sperm is believed to be an "elixir" to women and to have beneficial health effects. Maasai women believe that, after conceiving a child, they must have sexual intercourse repeatedly so that the additional sperm aids the child's development. Frequent condom use is also considered by some Maasai to cause impotence. Some women in Africa believe that condoms are "for prostitutes" and that respectable women should not use them. A few clerics even promote the idea that condoms are deliberately laced with HIV.
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