In the Heat of the Moment: A Qualitative Study on Motivating Condom Use Among Sexually Active Young People

Excerpts from the evaluation follow:

Introduction:

The findings presented in this report are the result of a series of 14 focus group sessions conducted in July and August, 2000, with a total of 92 sexually-active young people ages 15-20 in five American cities. The research was designed to inform the development of public education campaigns that will resonate with sexually active youth, effectively encourage more consistent condom use and, ultimately, reduce the incidence of sexually transmitted diseases...

To examine potential communications strategies and develop a series of concepts and messages that hold promise for prompting behavior change among targeted groups of young people, these focus group research sessions were staged in three phases:

• Initial sessions were held with two groups of sexually-active 15- to 17-year old white males.
• A series of six groups, segmented by sex, race and ethnicity, was conducted with 18- to 20-year old young people who report they consistently or always use condoms.
• Finally, six sessions were conducted with similarly segmented groups of 18- to 20-year-olds who admit to being inconsistent or infrequent condom users.

The intent of conducting sessions in this manner was to probe for and examine the experiences, attitudes and emotions of consistent condom users to identify, isolate and exploit motivating strategies and messages that could be subsequently tested for resonance and credibility among young people who are less consistent or even opposed to condom use...

Summary of Findings:

...However stereotypical it may seem, the expectations of young men and young women differed significantly when they spoke of their attitudes toward sex. Most young women said they have sex with those they "trust" and with whom they have or expect to develop an emotional relationship. Young men generally sought sexual satisfaction, the excitement of the conquest and certainly not a "committed" relationship at this point in their lives. For most young men and women interviewed, especially those who consistently use condoms, condoms are seen as a way of insuring that there will be no outcome (pregnancy or disease) that would force an unwanted relationship.

Young people participating in these sessions...reported with near unanimity that they were strongly motivated to use condoms for "protection" when they have sex with someone for the first time or with someone they do not "trust" or whose sexual history they do not know...

Still, for most young people, especially those in their teens, the risk of pregnancy from unprotected sex is of far greater concern than the perceived risk of contracting a sexually transmitted disease...

Importantly, because they so strongly connect condom use with pregnancy prevention, many of the young people in these groups see the "safe sex" or "safer sex" message as promoting efforts to avoid pregnancy as much as preventing sexually transmitted disease.

One of the most notable findings to emerge from these sessions is the authority that young women have over the use of condoms - if they choose to exercise it...Significantly, many young men said they were highly unlikely to challenge that demand because they might risk losing the opportunity for sex, that they fully expected women to want to use condoms or that they would be "suspicious" of a woman who didn't insist on condoms...

Most of the young people in these sessions, consistent and inconsistent condom users alike, found it difficult to believe that there were people their age who use condoms every time they have sex...

It is clear from these sessions that even as young people acknowledge that "everyone's at risk" for sexually transmitted diseases and can easily articulate the disease-prevention benefits of condom use, they judge their risk to be minimal in most of their sexual encounters and admit to having unprotected sex with varying degrees of frequency. In these groups, messages aimed at increasing young people's perceptions of risk, and their condom use, were most effective when reminding them of the long list of sexually transmitted diseases that do not exhibit symptoms or when clearly stating the number of young people who get or have sexually transmitted diseases...

In exploring young people's reactions to the styles and key messages of television public service announcements (PSAs) designed to encourage safer sex practices, some consistent patterns emerged. Young people revealed that they were most affected by PSAs that focused on experiences similar to theirs and with people who were most "like them." They were more likely to be emotionally involved when the PSA focused on one individual rather than an abstract group and when the message attached to beliefs or knowledge they already held. Although a few young people claimed that media messages rarely had a lasting impact on their behavior, many others clearly saw potential for well-conceived and designed PSAs...

A recording of one young man's statement about condom use not being an issue of "trust" because "she didn't know she had something" resonated very strongly with groups of inconsistent condom users. This message appeared to have such potency because it reconciled young people's general awareness of the risks of sexually transmitted diseases with their understanding that they can't "always tell" about a partner, all without the need to raise questions of "trust" when insisting on condoms.

It is important to note that the issues, concerns and attitudes expressed by young people in these groups were generally consistent across racial and ethnic lines. One distinct exception did emerge, however. Young people of color were clearly more strongly affected when messages intended to influence their behavior were delivered by other people of color in media they perceive to be attuned to their needs and interests.

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