Consultant Reports > Use of Condoms

EC Funded Project on HIV Prevention

"The usage of condoms by the young people"
Report on the results of a sociological research

Kiev 2002

Table of contents

1. Characteristics of sexual behaviour among different groups of young people
2. Condom usage
3. Respondents' awareness of sexually transmitted diseases, and the evaluation of the risk to become infected
4. Motivation for using or rejecting a condom.
5. Sources of information about the correct usage of a condom
6. Preferences in brands, price, package, or where to buy condoms
7. Summary & conclusions
8. Recommendations

1. Characteristics of sexual behaviour among different groups of young people.

In response to the question "Have you had sexual intercourse?" 82 % of all the respondents answered "Yes". This included 33% of these in the age group 14 to 15 years, 47 % in the 16 to 17 age group, 83 % in the 18 to 22 age group, and 96 % of those respondents who were 23 to 28 years old. Apart from those who denied having sexual experience, 8 % of the respondents stated that they did not have sexual intercourse during the last 6 month: these included 11% among 14-15 year olds, 12 % among 16-17 years old, 8 % of 18 to 22 years old, and 6 % of the 23-28 years old. 7%, 19 %, 47 %, and 66%, respectively, of the respondents have sexual intercourse once a week or more often.

Young men have their first sexual experience somewhat earlier (Table 1) and only by the age of 23 the percentage of young men and young women who have had sexual experience becomes approximately equal.

Table1

Percentage of young men and women who responded "yes" to the question "Have you had sexual intercourse?", %

According to the Table 2, the number of sexual contacts among 12 to 17 years old is higher among the young men, and among the 23 to 28 years old it is higher among young women.

Table2

Percentage of young men and women in different age groups that have sexual contacts once a week or more often, %

No substantial differences with regard to sexual experience were found between young people in Crimea and Lviv Region. The data obtained in Sevastopol City were somewhat specific. Thus 85% of the interviewees in Lviv Region and Crimea said they had some sexual experience, while only 61% in Sevastopol. To some extent that may be explained by the sample structure in Sevastopol: in Crimea and Lviv Region those under 16 years of age constituted only 1% of all interviewed while 9% in Sevastopol. As one can see from the data above this age group is least likely to have an experience of sexual intercourse. However as table 3 demonstrates, there are considerable differences even between the same age groups in Sevastopol and Crimean Autonomous Republic, and Lviv Region.

Table3

Percentage of those who responded "yes" to the question "Have you had sexual intercourse?" by regions, %*

* The data on 14-15 year olds are not given as few respondents of this age group were interviewed.

Thus young people in Sevastopol demonstrated a somewhat lower level of sexual activity than those in Crimea and Lviv Region. This refers to all age groups, although the sample size for this survey is relatively small (Sevastopol 100 persons).

Different levels of sexual activity amongst those 16-17 years of age in Lviv Region and Crimea may be explained by the sample structure: in Lviv Region women constituted 56% of all interviewed of this age group, while in Crimea the percentage of women among the interviewed youth 16-17 years old was 45%. As it is said above, the age of first sexual experience is higher for women.

Among the young people who were 18 years and above and who were single, 18 % have not had sexual experience and 43 % have sexual intercourse once a week or more often, whereas for the young people who are officially married the number is 82 %, and among those in a civil marriage it is 85 %.

Among all the people interviewed, 46 % had a constant sexual partner during the last 6 months, 24 % had random sexual contacts, and 2 % had sexual relations with sex-workers.

Among young people over 17 who are single, 36 % had a constant sexual partner for the last 6 months, 31 % had casual sexual contacts, and 3 % had sexual relations with sex-workers. Among the same age group, 13 % of those who were legally married had casual sexual contacts, and 9 % or the people who were in a live-in relationship had casual sexual partners. None of the people who are married admitted sexual relations with sex-workers.

During the research on the sexual behaviour of the respondents, three risk groups were identified. The first group includes the people who have had only a constant sexual partner (low risk group, 46 % of respondents); the second group are those who have casual sexual contacts or contact with commercial sex workers, yet use always condoms (medium risk, 7%), and the third group includes people who have both casual sexual contacts and sexual relations with the sex-workers, yet do not use condom every time (high risk group, 18 % of the respondents).

Among the respondents, 54 % of young women and 37 % of young men belonged to the low risk group, 2 % of the women and 13% of the men to the medium risk group and 11% of the women and 26 % of the men to the high-risk group.

2. Condom usage

Among the respondents that have had sexual intercourse 70 % think it is necessary to use condoms. It has to be said that in Sevastopol the percentage of those with sexual experience who say that condom must be used is lower than in Crimea and Lviv Region (57%, 73% and 69% respectively). It is important to note here that the more active the sexual life of the respondent is, the less they are inclined to think it is necessary to use a condom. For example, among the respondents that did not have sexual relations during the previous 6 months or had them 1 to 3 times a month, 79% think it is necessary to use a condom. Among those who had sexual relations once or several times a week, 66 %, and among those who have sexual intercourse everyday only 56 % think it is necessary to use a condom.

100% of those in the medium risk group (i.e. those having occasional sex yet use condom every time) said that condom must be used. At the same time, only 65% of the high risk group (i.e. those practising occasional sex, sometimes unprotected), shared this opinion.

Young men more often think that condom usage is necessary than do young women , 74 % to 65 % respectively.

The awareness of how important it is to use a condom does not necessarily depend on the age. 77 % among the 16 to 17 years old who have had sexual experience, 70 % among the 18 to 22 years old, and 70 % among the 23 to 28 years old were aware. In addition, educational or economic levels had no impact on the awareness of condom use.

As it was said above, over 70% of those with sexual experience believe that condom must be used. Yet only 22% use it "often", 38% use it "rarely", while 15% said they never used condom. Amongst those who said that condom must be used, 32% claimed that they used it "always", 33% said they used it "often", 28% - "rarely", 7% - "never". Amongst those who said that condom was unnecessary, none said they used it "always", 6% said they used it "often", 61% - "rarely", 33% - "never" (see: table 4).

Table4

Frequency of condom use by groups of interviewed, %

Among the young men who had sexual relations 28 % said they always use a condom, 27% use condoms often, 34% rarely use them, and 11% never use condoms. The corresponding figures for women are that 17% claimed that their partners always use a condom, 23% claim that their partners often used condoms, 41% reported rare usage and 19% claimed that their partners never use condoms. But here it is important to note that young women do not have random sexual contacts as often as young men do.

As table 5 demonstrates, young people with sexual experience in Sevastopol are less likely to use condom than those in Crimea and Lviv Region.

Table5

Distribution of responses to the question "Do you or your sexual partner use condom?" among the respondents with sexual experience by regions, %

The more active the sexual life of the respondent, the less likely they are to use a condom. The study showed that among the people who had sexual contacts 1 - 3 times per month during the last 6 months, 31 % claimed to always use a condom, 27% claimed to use a condom often, 34% claimed to rarely use condoms and 9% claimed they never used protection. Among the people who had such contacts once a week or more often, 16 % claim to always use a condom, 25 % claim to often use a condom, 40 % claim to rarely use a condom, and 18 % claim never to use a condom.

One can observe the same tendency in the group of those having occasional sexual contacts or sex with commercial sex workers (see: table 6).

Table6

Frequency of condom use in the group of those having sex with occasional partners or commercial sex workers sex by level of sexual activity, %

Respondents were also asked whether they will use condoms in the future. 61 % said "Yes', 11 % said that they would not, and 28 % stated that they do not know. Among those who have a sexual experience, the numbers were 63 %, 8 %, and 29 % respectively, and among the people who have not had sexual relations the percentages were 51 %, 25 %, and 24 %.

3. Respondents' awareness of sexually transmitted diseases, and the evaluation of the risk to become infected

When asked to name the diseases that are transmitted sexually, only 2 % of the total respondents could not do so, and 4 % said "venereal disease" without being able to name any specific ones. Most often respondents named diseases like HIV/AIDS (85 %), syphilis (73 %), gonorrhoea (62 %). Other diseases were less mentioned: trichomonisais (19 %), chlamydia (14 %), herpes ( 6 %), candidiasis (4 %).

While evaluating the risk of being infected with a sexually transmitted disease, 23% of the sexually active young people think that there is no danger, 43 % think that risk exists but that it is not great, and 28 % think that the risk to be infected is very high.

Table7

Self evaluation of the possible risk of being infected with sexually transmitted diseases among different risk groups. (in percentage)

As it is demonstrated by table 7, those in the medium risk group are more likely to acknowledge the possibility of being infected with STD as compared with those in the high-risk group. As it was said above, the criterion was condom use while occasional sex: the interviewees in the medium risk group claimed to use it "always", while those at high risk said they did not use condom "always" or did not use it at all. It could be suggested that such a low evaluation of the risk becomes in many cases a reason for not using a condom during sexual contacts.

But during the research it was found that some of the respondents who are aware of the risk are unwilling to use a condom. For instance, among the respondents that evaluate the risk of being infected as very high, only 68% are going to use condoms and 5 % are sure they will not use them. And among those who think that the risk exists but it is not great, 65% said that they would use condoms in the future and 10 % stated that they would not use them.

4. Motivation for using or rejecting a condom.

Among the motives for using a condom the most frequently stated: "to prevent sexually transmitted diseases" (61 % of sexually active respondents), "to prevent pregnancy" (59%), "my partner insists upon it" (13 %).

The motive "to prevent disease" is more often used by men (66% of sexually active men) as compared to women (55%), the same for "my partner insists upon it" (16 % and 9 % respectively), but the motive "to prevent pregnancy" is mentioned more often by women compared to men (52 % and 66% respectively).

It is interesting to point out that the motive "to prevent diseases" is mentioned by 54 % of the people who have a constant sexual partner. At the same time among the representatives of the high risk group this motive is stated by 60 %, which is not significantly more than the low risk group (88% of the medium risk group).

The level of education does not influence the frequency of mentioning this motive, whereas the motive "to prevent pregnancy" was more often mentioned by young people with university degree 69%, compared to young people who had only secondary level education 51%.

Responding to the question why they do not use condoms the most frequent answer was that "the sensation is not as sharp" (18 % of sexually active respondents) and "my partner insists upon it" (7%). And only 4% stated that their main motive was not having sufficient finances to buy a condom.

There is no clear distinction between the frequencies of these three main motives among representatives of different groups among young people. Only the motive of "not having enough finances" was mentioned by young people with low income more often (67 % of people who mentioned this motive are young people with an income level of less that UAH 100 per month). But even in this group this motive is not the primary one. 21% stated that "the decrease in the sensation" is the main motive, 9 % that "their partner insists upon it" and 8% said "not enough finance'.

Respondents who do not think the usage of condoms is necessary will find a number of reasons for not using condoms.

5. Sources of information about condoms

The research shows that there are a variety of sources of information about how to use a condom correctly. The most frequently mentioned by sexually active respondents are: the direction on the condom package (37 %), leaflets, booklets (23%); information from friends (23 %), from medical personnel (18 %), magazines for young people (13%), popular literature (13 %), TV programmes (8%), movies/films (7%), from teachers (5%), from parents (4%), from the radio (2 %). Among the same group, 16 % could not remember from where have they received this information, and only 4 % said they did not receive any information.

It is important to note that information from parents and teachers is most often received by respondents from the youngest age group (among those 16 - 17 years old, 9% receive information from parents and 12 % from teachers, while in the group of 18-22 year olds - respectively 5% and 5%, and among those 23-28 years of age - respectively 2% and 4%) (see: table 8).

Table8

Distribution of responses to the question "Where did you learn about how to use condom correctly?" among sexually active respondents by age, % *

* No data on the age group of 14-15 years are given as only 3 persons in this age group said they had sexual experience.

Many of those 16-17 year old said that they did not receive any information (12%), while only 3-4% in older age groups. The respondents 18-28 years of age were more likely to receive information from the direction on the condom package. Young women more frequently than men mention teachers ( 8% to 2 % respectively) and doctors (21% and 16 % respectively) as their source of information.

Sources of information such as booklets and leaflets are more often mentioned by people who live in the agricultural areas (32%) and not nearly as often in the industrial area (21%) or resort area (17%).

The respondents in the high and medium risk groups were more likely than those of the low risk group to mention friends as a source of information (respectively 33%; 34% and 18%). Also those in the medium risk group were more likely to mention brochures and leaflets (respectively 15%; 34% and 24%), as well as video-films (respectively 5%, 14% and 7%). It is also important that the percentage of those who have not received any information in the high and medium risk groups was no higher that in the low risk group. One can assume that it is the source and character of information that might be factors contributing to risk behaviour.

In response to how they would like to receive information about condoms, 39% of respondents said medical workers, 35 % suggested specialised, popular literature, 22 % preferred newspapers and magazines for youth, 17 %TV programs, 14 % electronic media. 10 % also mentioned friends, 10 % teachers, 9 % from parents, and 6 % from radio programs. In the agricultural areas much more often that in the cities, people would want to receive information from a medical worker (50 %).

Among the high risk group, the most desirable sources of information mentioned were medical personnel (40 %), specialised, popular literature (35%), TV programs (22%), leaflets (18 %), magazines (16%), video-materials (15%), radio programs (11 %), teachers (11%), and friends (10%).

6. Preferences in brands, price, package, or where to buy condoms

Among the respondents who use condoms, the most popular company was "Durex" (23 % of people in this group named it), "Innotex" (18%), and "Lifestyles" (15%). 11 % percent said "different brands of condoms", and 14 % do not remember the brand name of condoms. "Durex" and "Lifestyles" are mentioned more often by men (19 % and 26 % respectively). For women, the feedback was 10% and 19 % respectively. "Innotex" is mentioned more often by women (20 % ) than men (15%). Among the representatives of the High risk group the preferences were less obvious, but more frequently they used those that could be found in the nearest kiosk, pharmacy or marketplace.

The lower the age group of the respondents the harder it was for them to say what brand name they use. Among the 16-17 years old, 25 % compared to the 11% in the 23 to 28 year olds were able to be specific.

Respondents with low income (less than UAH 100 per month) and who use condoms found it difficult to remember what brands they were using (21%) compared to the group with higher income.

Among those who use condoms the most common reason for using a brand is perceived reliability (52%), and only 11 % are attracted by the fact that the condom is cheap. Reliability was a factor among 90% of "Lifestyles", 77% of "Durex" and 71% of "Innotex" users.

When buying condoms, the qualities that the respondents looked for were quality (72%) and sensitivity (45%). The reputation of the manufacturer (20%), or size (19%), smell (19%), features that increase sensitivity (19 %) were less important.

Those who use condoms very often buy them in pack of three (47%) or one per pack (16 %). Usually respondents with low income buy one per pack (for example, people with incomes of less than UAH 100 per month, 36 %, while those with incomes 501 to UAH 1,000, it is 21 %). This is also true of the younger age group (among 16 to 17 years it is 45 % compared to those who are 23 to 28 years old where it is 17 %).

Answering the question in what pack they would like to buy condoms, 26 % stated that it does not matter, 34 % said that in a pack with several condoms, most often with three -19 %. 17 % want to buy one per pack, and 9 % in a set together with a card or a calendar. Women more often than men said that they do not care in what pack to buy condoms (30 % and 22% respectively), and also the representatives of the older age group stated the same ( 32% of the 23 to 28 years old ). 21% of those in the age group of 16 to 17 years would prefer to buy one per pack .

As to the picture on the cover, 34% respondents stated that it was not an important factor (34 % of 22% preferred a neutral picture, 17 % said that they choose one with warning messages, 17 % wanted a picture of a man and a woman, 14 % preferred a picture of a woman, 7 % showed a preference for a picture of a celebrity, and 3 % selected the picture of a man. The gender breakdown of responses are: "picture of a man" (5% women 1.5 % men), "picture of a man and a woman" (women:20 % and men: 13 %), "warning messages" (21% and 13 % women and men respectively), "neutral picture" (women:28% and men :16 % ), "picture of a woman" (3% women and 25 % men), "picture of a celebrity" (3% and 10 % women and men respectively). 37% of those who said that "the picture on the pack does not matter" were above 18 years.%). The response "the picture on the pack does not matter" was given most often by the respondents over 18 years of age (37%).

Only 18 % of those who use condoms give preferences to the cheapest condoms (up to UAH 2 per one), 15 %- for condoms around UAH 2, 16 % give preferences to condoms up to UAH 2.1 to UAH 3 and 20 % give preference to condoms from UAH 3.1 to 5 Therefore the result that the lower the income level among the respondents the lower is the price at which the condoms are bought is not surprising. No connection between other social and demographic factors and preferences about the condoms bought were discovered.

It has to be mentioned here that young people in the high risk group are more likely to purchase cheap condoms (under UAH 2) than those in the medium and low risk groups (respectively 25%, 12% and 13%).

56 % of the respondents that use condoms buy them in a pharmacy, 24 % in a kiosk, 4 % in a shop, 4 % in a marketplace, and 9 % "anywhere". The lower the income the greater the possibility that the condoms are bought in a kiosk (35% among the group with income less then UAH 100).

Those in the high risk group are more likely to purchase condoms at kiosks (i.e. the most available selling points) than those in the medium and low risk groups (respectively 41%, 22% and 16%.

In response to the question where would they like to buy condoms, 64% of all respondents stated pharmacies and 42% mentioned vending machines. Vending machines are mentioned mostly by young men (47%) rather than young women (37 %), and pharmacies 60% (young men) and 68 % (women).

Summary & conclusions

• According to the data obtained, about one in five (18%) interviewed practised sexual behaviours that refer them to the group at high risk.
• The percentage of respondents, that are in the high risk group is approximately equal for the different age groups and does not depend on the area or region of living.
• Even though among the respondents that had sexual experience 70 % think it is necessary to use a condom, the higher the intensity of the sexual life of the respondents the less likely they are inclined to think that using a condom is necessary, and the lowest level of awareness about the importance of using a condom is seen in the group with very risky sexual lifestyle.
• The percentage of those with sexual experience who believed condom must be used was lower in Sevastopol City than in Crimea and Lviv Region
• Also a great part (about one in three) of people who think that it is important to use a condom use it very rarely or do not use it at all.
• Awareness of the importance of using a condom does not completely depend on the respondent's age, educational level, or income levels.
• As the results of the research have shown there are a variety of sources of information about how to use condoms correctly. The most popular sources are: directions on the condom package, leaflets, booklets, friends, medical personnel, magazines for youth, and specialised, popular literature.
• In the 16 to 17 years age group the percentage of young people who have not received any information about how to use a condom correctly is relatively high (11%).
• Those in the high and medium risk groups were more likely to mention their friends as a source of information about how to use condom properly. At the same time, the percentage of the respondents in the high and medium risk groups who have not received any information was no higher that the one in the low risk group. One can assume that it is the source and character of information might be factors contributing to risk behaviour.
• In response to the question from whom would they like to receive information on correct usage of condoms most often young people have mentioned medical personnel (especially in the rural area) and specialised, popular literature.
• Among the young people the most popular brands of condoms are "Durex", "Innotex", and "Lifestyles".
• The lower the age of the respondent the harder it is for them to say what brand of condoms they are using.
• The representatives of the high-risk sexual behaviour group most often said that they buy different varieties of condoms. In other words condoms that would be the easiest to find in the places that sell them and which would meet the requirements of people in this group.
• People who use condoms usually buy them in packs of three or one per pack. One condom per pack is often bought by people with low income and by the younger people.
• Women more frequently than men respond that it does not matter what picture is on the pack. The same is true of the oldest age.
• In general, characterising the qualities of the condom that are desirable for young people, the primary one is perceived reliability (most often it is associated with famous brand names and manufacturers) and providing increased sensitivity. Low price attracts only people with low income, as to the rest of the respondents it might actually scare them away, because it raises suspicions about the quality of the product. The most desirable pack is with three or one condom.
• For the representatives of the youngest age group (16 to 17 years old) "sensitivity", "colour", "size", "smell" is less important than for those who are 18 and older. For men "sensitivity" and "size" is more important than for women.

Recommendations:

• Judging by the fact that young men acquire sexual experience earlier than girls, it is important to work with younger groups of young men to raise their awareness about the importance of using condoms as a way of preventing the sexually transmitted diseases and unintended pregnancies.
• Nevertheless, even some of the respondents that understand the risk are not intending to use a condom. Therefore, one of the directions in working with the young people should not only be explanation of the level of risk involved in rejecting the use of a condom (especially with the random sexual contacts), but also developing an attitude among the young people that would treat health as something precious.
• In general it could be said that in order to raise the level of willingness to use condoms among the young people it is important not only to inform about the necessity of using it, but also to create a behavioural stereotype for using a condom. In other words there is a need to create and establish favourable social and cultural patterns of behaviour (through the means of mass media for the general public, and for the representatives of the risk groups and also through psychological group training programmes).
• Only 4% of respondents that had sexual experience said that they do not have enough finances as their main reason for not using condoms. Mostly they are young people with income level of less that UAH 100, per month. Yet, even within this group this motive was not the primary one. However the fact that those practising sex frequently (more often than once a week) use condoms less frequently than those who have sex as often as 2-3 times a month, might indicate that high price is a factor contributing to condom non-usage: young people who have sex frequently simply can not afford a condom every time they need it. Considering this and bearing in mind that those at high risk are more likely to buy cheap condoms, one may assume that a social policy aimed at saturating the market with cheap (yet high quality) condoms might increase the level of condom use by young people, in particular, those currently practising risk behaviours.
• Young men would most likely want to buy condoms in pharmacies and vending machines. Vending machines are more often mentioned by young men than women. Therefore, introduction of special vending machines for selling condoms might raise the level of condom purchase among the young men.