An Article in this week's issue of the Lancet reveals the social and cultural factors that shape young people's sexual behaviour. The results could help make safer sex campaigns more effective, state the authors.
Cicely Marston (London School of Hygiene and Tropical Medicine, UK) and Eleanor King (Medical Research Council, UK) reviewed 268 qualitative studies on young people's (under 25's) sexual behaviour published between 1990 and 2004. Data from a number of countries, including the UK, Australia, Mexico, and South Africa, were included in the review.
They found that the factors that influence young people's sexual behaviour are strikingly similar worldwide. The researchers identified seven key themes from their analysis: five related to sexual behaviour in general and two to condom use in particular. For example, they found that young people assess whether they needed to use a condom with a potential partner on the basis of whether they thought they were 'clean' or 'unclean'. The researchers found they make this decision based on unreliable indicators such as how well they know their partner socially or their partner's appearance. The study also found that young people felt that carrying or buying condoms could imply sexual experience, which was undesirable for women and sometimes desirable for men.
Dr Marston concludes: "Our findings help explain why many HIV programmes have not been effective. Researchers have identified many reasons for young people not using condoms beyond the most obvious: 'ignorance' and 'barriers to access to contraception'. Therefore, programmes that merely provide information and condoms, without addressing the crucial social factors identified are only tackling part of the problem."
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