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Play with fire, play with you sometimes: Social aspects of condom use among young people in Sweden
Stockholm University, Faculty of Social Sciences, Department of Sociology.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Although Sweden invests a great deal of money and effort in prevention work, STIs are a major problem in our society. Young people are at high risk both when it comes to unwanted pregnancies and STIs and several studies have revealed that the condom use is quite low. Condom use is a complex issue. There are often several factors that interact and affect the decision to use or not use condom. The result in this thesis shows that young people have behavioral expectation to use condom, especially for anal sex and vaginal sex with a casual partner (both known and unknown). At the same time, the condom use is low irrespective of type of partner and type of sex. Approximately 20 % of the participants never used a condom during the preceding 12 months. Most of the participants said that reason for their use or non-use was based on partner evaluation. However, our participants indicate that there often is a deeper reason why they do not use condoms. Women talk about their male partner’s resistance against condom use. Men in the other hand mention the problem with fit and feel especially problems related to erection problems when they have been drinking alcohol. One of the most interesting findings is that the participants’ view of sex affected their condom use. Those with a relaxed view (e.g., did not connect love with sex and had had more sexual partners during the past 12 months) had fewer occasions of unprotected vaginal intercourse compared with the participants with a traditional view (e.g., often associated sex with vaginal penetration).The most important thing we need to do is increase ’men’s sense of responsibility and involve them in the prevention work. It is also important that the condom counseling is individualized. It is not enough to simply speak about condom use in general; instead we need to relate condom use to sexual practice and partner type but also to the individuals’ specific condom problem.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University , 2014. , 133 p.
Series
Stockholm studies in sociology, ISSN 0491-0885 ; N.S., 58
Keyword [en]
adolescents, alcohol, behavioral expectations, Chlamydia Trachomatis, condom use, contraceptive use, gender, mixed-methods, sexual behavior, sexual practice, sexual relationships, STI, Sweden, youth
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-108900ISBN: 978-91-7649-038-9 (print)OAI: oai:DiVA.org:su-108900DiVA: diva2:761463
Public defence
2014-12-12, De Geersalen, Svante Arrhenius väg 14, Stockholm, 10:00 (Swedish)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Epub ahead of print. Paper 2: Manuscript. Paper 3: Manuscript.

Available from: 2014-11-20 Created: 2014-11-06 Last updated: 2014-12-05Bibliographically approved
List of papers
1. Condom use: the discrepancy between practice and behavioral expectations
Open this publication in new window or tab >>Condom use: the discrepancy between practice and behavioral expectations
2014 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 8, 759-765 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The overall aim of this paper is to examine sexually active young people’s behavioral expectations of condom use.

Methods: We collected data at nine youth clinics and one sexually transmitted infections (STI) clinic in Sweden. We included participants whom had been sexually active during the past 12 months: A total of 1022 participants between the ages of 15 and 31 were included. We analyzed the data separately, for different types of sexual practices and types of sexual partners. Multinomial logistic regression was used to analyze age and gender differences for discrepancies.

Results: The behavioral expectation of condom use differed, depending on the type of sexual practice and the type of partner. For all types of sex, the overall pattern showed that the participants were most likely to use a condom with a casual unknown partner, followed by a casual known partner, regular partner and lastly, a main partner. Our results also demonstrated that there is a discrepancy between the behavioral expectation of condom use and the self-reported condom use. The lowest discrepancy was for oral sex, especially with a main partner, and the largest discrepancy was for anal sex and vaginal sex with a casual partner.

Conclusions: Our results imply that the participants had a greater expectation of condom use than actually occurs, especially for casual unknown partners. There is a lack of knowledge about the risks associated with oral sex, which is evident in the results of the participants’ behavioral expectations of condom use under those conditions.

Place, publisher, year, edition, pages
London: Sage Publications, 2014
Keyword
Behavioral expectations, Sweden, condom use, disease prevention, sexual behavior, sexual practices, sexual relationships, sexually transmitted disease, youth
National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-108894 (URN)10.1177/1403494814550518 (DOI)000345988800006 ()
Available from: 2014-11-06 Created: 2014-11-06 Last updated: 2017-12-05Bibliographically approved
2. The association between condom use, type of sexual relationship and sexual practice in a Swedish region
Open this publication in new window or tab >>The association between condom use, type of sexual relationship and sexual practice in a Swedish region
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Despite large investments in prevention, the spread of sexually transmitted diseases (STIs) continues to be a severe problem in Sweden, especially among young people. In Sweden, condoms are recommended for use in tan-dem with another contraceptive in new or casual sexual relationships. Con-dom use to prevent STI transmission differs from its contraceptive in that it must be used in a much larger scale in order to serve as an adequate protec-tion. Here we address questions if—and how—condom use differs between a broad categorization of sexual relationships and sexual practices than what commonly are used in this type of study. Detailed data on the sexual behav-ior of participants during the previous 12 months were collected at nine youth clinics in the Västra Götaland region of Sweden. Participants were sexually active women and men between 15 and 26 years old who visited these clinics for a STI test. Overall, condom use was low irrespective of type of partner and type of sex. Approximately 20 percent of the participants nev-er used condoms during the preceding 12 months. For vaginal sex, the par-ticipants were more likely ‘always’ to use condoms with casual known part-ners as compared to casual unknown partners. If participants had a main or regular partner, they were more likely to use condoms ‘sometimes’ rather than ‘never’ compared to if they had a casual unknown partner. All sexual practices followed this basic pattern. There were few age and sex differ-ences. It is important to understand that young people visiting youth clinics in Sweden—despite efforts to promote condoms use—have unprotected, oral, vaginal, and anal sex, with both known and unknown partners. More effective programs must be developed in Sweden to promote condom use in relationships where the partners are not monogamous as in casual contacts and non monogamous regular contacts (e.g. ‘fuck buddies’).

National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-108896 (URN)
Available from: 2014-11-06 Created: 2014-11-06 Last updated: 2014-11-07
3. Condom or no condom – That’s the question
Open this publication in new window or tab >>Condom or no condom – That’s the question
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The aim of this paper was to examine common factors that affect condom use for sex (anal, oral and vaginal) with casual partners both known and unknown. Data were collected through in-depth interviews at one STI clinic in Stockholm, Sweden, with 29 people (14 men, 14 women and one transgendered person) aged 21-32 years participating in the study. Open questions were asked about the participant’s background, reason for STI test, reasons for condom use, reasons for condom non-use, and their definition of sex. The interviews were audio recorded and transcribed. Data were ana-lyzed according to thematic analysis. The results show that there are several reasons why people do not use a condom. Women encounter resistance from men when they suggest a condom, and often have strategies for avoiding threatening or unpleasant situations. For men, alcohol is a common reason for non-use. This is mostly connected to the effect alcohol has on their sen-sation and their erection. These findings suggest that condom use is a com-plex issue and that there are often underlying reasons why people do not use a condom. To help people be better condom users, we need to identify these underlying reasons and help patients deal with them.

National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-108899 (URN)
Available from: 2014-11-06 Created: 2014-11-06 Last updated: 2014-11-07
4. The prescription of oral contraceptives and its relation to the incidence of chlamydia and abortion in Sweden 1997-2005
Open this publication in new window or tab >>The prescription of oral contraceptives and its relation to the incidence of chlamydia and abortion in Sweden 1997-2005
2012 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 1, 85-91 p.Article in journal (Refereed) Published
Abstract [en]

Aims: The aim of this study is to examine the association between the prescription of oral contraceptives and the incidence of chlamydia, and between the prescription of oral contraceptives and the number of abortions in a population-based ecological study. Methods: For this study we used register data from the Swedish Institute for Infectious Disease Control (chlamydia incidence), the Swedish National Board of Health and Welfare (number of abortions), Statistics Sweden (population data), and Apoteket (Swedish pharmacy) (prescriptions for oral contraceptives). We conducted ordinary least squares regression analysis of the association between chlamydia or abortions and the prescription of oral contraceptives. Results: The prescription of oral contraceptives has a positive association on both the incidence of chlamydia and the numbers of abortion. Our best model predicts that prescription of 100 yearly doses of oral contraceptives increase the abortions by 3.3 cases among 16-year-old women and 0.7 cases among 29-year-old women, while cases of chlamydia increase by 6.7 among 16-year-old women and 1.5 among 29-year-old women. Conclusions: Our findings indicate that the use of oral contraceptives among young people and young adults is positively associated with the chlamydia incidence and the abortion rate in these populations in Sweden.

Keyword
Abortion, chlamydia, oral contraceptive, Sweden
National Category
Sociology
Identifiers
urn:nbn:se:su:diva-76318 (URN)10.1177/1403494811421977 (DOI)000299735800011 ()
Note
3Available from: 2012-05-15 Created: 2012-05-10 Last updated: 2017-12-07Bibliographically approved

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