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How do the youth in two communities make decisions about using condoms?

CSSR Working Paper No. 2

Donald Skinner

Centre for Social Science Research (CSSR)
University of Cape Town

SARPN acknowledges UCT's Centre for Social Science Research as a source of this document: http://www.cssr.uct.ac.za/pubs_cssr.html
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Abstract

From the behavioural perspective, there is a key problem that needs to be overcome to enable effective action against the HIV epidemic. Why do people who are aware of and understand the nature of the HIV epidemic and how to protect themselves, choose to behave in a manner that puts them at risk? Historically, the social sciences have proposed multiple theories that attempt to explain how people make decisions, about the nature and structure of conscious thought, and how information is processed. There are acknowledged gaps in these theories, but what will be argued here is that an improved application of this theory may give us better direction.

This paper will examine how the youth in two communities near Cape Town make decisions about condom usage. Three theories will be employed to attempt to understand the data collected - namely Lay Theory, Theory of Reasoned Action and Theory of Planned Behaviour. During the research, information was obtained from 43 depth interviews, two focus groups and a survey of 406 respondents. The theories are able to examine, from different perspectives, problems behind the behaviour choice. Using the data from the depth interviews and the focus groups, Lay Theory offered the following explanations: culture was influential in supporting gender dominance and multi-partner sexuality; and in social situations, both men and women felt a pressure to conform to pre-set roles, to undermine condom usage and to emphasize sexual pleasure. The Theories of Reasoned Action and Planned Behaviour offer more insight into individual decision processes by examining the roles of attitudes, the influence of those close to the person, and perceived controls of behaviour. Factors that were important included sexual desire, love, fear of partner’s anger and whether there was knowledge of where to get condoms and how to use them. The data generally showed a lack of belief on the part of the respondents that AIDS really would affect them. These theories do not provide all the answers, but taken together they could provide some useful insights into the contribution of psychology theory and on how to design and implement intervention campaigns.

Introduction

One of the principle methods that help to limit the spread of HIV is the use of condoms. It is also one of the best-known pieces of information in relation HIV and AIDS. So the question of lack of knowledge of the importance of condoms cannot be a problem in the implementation of this safer sexual practice, although knowledge on how to use them may not be as generalised. The problem is that many people are still not using condoms in potentially risky situations. In trying to change this behaviour, it is necessary to develop a deeper understanding of how people make such decisions.

This approach draws on material covered in many old discussions, such as why people do not stop smoking, or why racist patterns of behaviour are difficult to change. Theories developed in these and other contexts can be useful in understanding the hidden processes and blocks affecting condom usage. This paper will draw on those theoretical approaches which have relevance to the subject from the discipline of psychology. Two sets of theories are identified for discussion. The first is broadly termed “Lay Theory” and examines how lay people develop theories for themselves about the world, and how these theories assist them to make sense of the world around them (Furnham, 1988). The second theory is Planned Behaviour (Ajzen, 1988), a development on the Theory of Reasoned Action (Fishbein and Ajzen, 1975). These fall more into a cognitive behavioural framework and are centrally based on the construct of individual attitudes. The key objective is to outline the importance of the application of theory to a context.



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