Barriers and Facilitators Influencing Inconsistent Condom Use in Young Adults in Philadelphia

Introduction:  Rates of chlamydia and gonorrhea in Philadelphia are three to four times higher the national rates, respectively, and clients served by Planned Parenthood of Southeastern Pennsylvania (PPSP) have the highest rates in the city. Though it is well known that condoms are one of the most effective ways to prevent sexually transmitted infections (STIs), reasons behind inconsistent condom use are not fully understood. This study aims to identify the barriers and facilitators that influence inconsistent condom use to better inform future interventions to promote their use.

Methods: PPSP engaged male and female clients (ages 18-29) to participate in a qualitative exploration of barriers to consistent condom use. Verbatim transcripts from 1 focus group and 10 in-depth interviews were shared with the study team and Nvivo10 software and common coding techniques were employed to identify salient themes. 

Results: Relationship factors that influenced participants’ decisions to use or not use condoms were predominantly issues of trusting their partner or having multiple sexual partners. On an individual level, participants described condoms inhibiting physical pleasure, and environmental constraints such as access and cost, as well as condom quality as leading to inconsistent condom use.

Discussion: PPSP’s clients identified several important barriers to consistent condom use. Interventions to promote consistent condom use in this context and other similar settings should include a focus on increased self-efficacy related to acquisition and proper use of condoms. Additionally inter-partner trust and multiple sexual partners are important concepts to be considered.