Examining Jamaicans’ opinions about condom safety, effectiveness

NEGATIVE reactions to the suggestion of wearing a condom before sex was experienced both by females and males in the 2021 Reproductive Health Survey, Jamaica, with the most stated negative response being their partner’s outright refusal to wear a condom.

During the survey, females and males 15-49 years old were asked to relate how their partner responded to their suggestion to wear a condom. Most females (84.3 per cent) said they had asked their partner to wear a condom. Of the females who recalled a negative reaction from their partner after this request, 16.5 per cent said he refused to wear a condom; 6.1 per cent refused to have sex; and 4.4 per cent forced them to have sex without a condom, with 1.1 per cent reporting their partner threatened to hurt them.

“More females who experienced negative responses after asking their partners to use a condom resided in the Kingston Metropolitan Area (KMA), were at the lower end of the education scale, and had four or more lifetime sexual partners,” the study noted. “They were also more likely to be in common-law unions or visiting relationships, than being married.”

On the contrary, most males (79.3 per cent) surveyed had suggested to a female partner the use of condoms during sex. There was, however, pushback noted too, and among the negative reactions reported by males was a refusal by their partners to them wearing a condom (12.3 per cent). Seven point six per cent of makes said their partner refused to have sex, and 4.0 per cent said their partner forced them to have sex without a condom. Less than 1.0 per cent of males reported that their partner threatened to hurt them or that their partner had actually hurt them. A higher proportion of males who resided in other urban centres (OUCs – parish capitals and urban centres in all parishes except Kingston and St Andrew) and males with four or more lifetime sexual partners reported negative responses from female partners. A greater proportion of males with secondary level education reported these occurrences compared to males with less than secondary and post-secondary level education.

Males were further asked if a female partner had ever asked them to use a condom and their reaction to this request. Six out of every 10 males said a female partner had asked them to use a condom (61.4 per cent). Most males (82.6 per cent) said they adhered to the request and used a condom. However, 17.5 per cent said they made their partner have sex without a condom; 5.4 per cent said they refused to have sex with their partner; 2.0 per cent got angry; and 1.2 per cent said they threatened never to date their partner again. A larger percentage of males in the 30-34 age group said they ‘made her have sex without a condom’ (21.9 per cent) or ‘refused to have sex with her’ (7.5 per cent). Males in unions and those with secondary education were more likely to react negatively to their partners’ requests to use a condom during sex.

The study showed that while most females and males believed that the condom effectively prevented conception and sexually transmitted infections (STIs) and is safe, the data show that the condom is not being used consistently by people with either a steady or non-steady partner.

The condom is the only contraceptive method that protects against pregnancy and STIs when used correctly. In Jamaica, the condom is well known and widely accessible. The survey data confirmed that there is a high level of awareness of the condom as virtually all females and males were knowledgeable, and the majority had used the condom at some point in their life. However, only a small proportion of females and males stated that they were currently (ie, last 30 days) using the condom as a method of contraception or with a steady partner in the last 12 months. Additionally, more females than males stated that they had never used a condom with a non-steady partner in the last 12 months.

During the study, males and females were asked how safe they perceived the condom to be when used correctly. A higher percentage of males than females considered the condom to be ‘very safe’ (males 24.8 per cent; females 17.9 per cent ) and ‘safe’ (males 40.6 per cent ; females 37.7 per cent ). A higher percentage of females (31.8 per cent ) than males (24.5 per cent) said the condom was ‘somewhat safe’. More females (4.9 per cent) than males (3.3 per cent ) said the condom was ‘not safe’. Approximately 24.4 per cent of females who had never used a condom stated that they did not know if it was safe. A higher percentage of females not in a union (14.6 per cent) were unsure if condoms were safe compared to females in a union (3.8 per cent). Fourteen point nine per cent of males who have never used a condom and 10.7 per cent of those not in a union said they did not know if condoms were safe.

For the record, among females who had sex with a non-steady partner, the most consistent users were those who lived in KMA (45.1 per cent ), in the 25-34 age group (43.4 per cent ), females in no steady relationship (57.4 per cent), those with post-secondary level education (41.8 per cent) and females with four or more lifetime sexual partners (45.2 per cent). Among males, the most consistent condom users with non-steady partners were males who lived in KMA (71.8 per cent), males in the 35-49 age group (69.7 per cent) and those in no steady relationship (71.9 per cent). There was no association between education and consistent use of a condom with a non-steady partner among males. Two-thirds of males with less than secondary level education (66.6 per cent) and secondary level education (65.8 per cent) used a condom every time with a non-steady partner when compared to males with post-secondary level education (63.1 per cent ).

The household survey was conducted by Statistical Institute of Jamaica on behalf of National Family Planning Board. It covers fertility; contraceptive use, knowledge, attitude and practice; reproductive health; maternal and newborn care; infant and child mortality; sexually transmitted infections including HIV/AIDS; gender-based violence; and the reproductive health of respondents 15-49 years. The data also generated indicators on Jamaica’s progress towards achieving UN Sustainable Development Goal (SDG) #3 on good health and well-being, including SDG 3.7.1 on contraceptive use, and estimates for SDG #5 on gender equality. The information gleaned is used in determining programme implementation and other vital issues specific to how the country deals with matters relating to reproductive health.

There were 5,008 participants — 3,224 females and 1,784 males. Close to one-half (46.1 per cent) of respondents resided in rural areas, less than one-third (31.6 per cent) resided in other urban centres, while 22.3 per cent lived in the KMA.