Electronic Journal of Human Sexuality, Volume 1, November 10, 1998




Lisa Kirsten Hunter


The present study evaluated the impact of interventions focused on improving attitudes toward condoms, willingness to use condoms, and safer sex practices. Results on the attitude measures revealed no significant differences between groups, no significant differences between posttest and follow-up, and no significant interactions for any measure. The differences between groups approached significance for the CUSES with the role play obtaining the highest scores. Contrary to previous studies (Maibach and Flora, 1993; Ploem and Byers, 1997), the addition of modeling and role play were not significant in producing attitude change. Findings of the study do not support the hypothesis that women exposed to the covert modeling/rehearsal and the role play conditions would have more favorable attitudes toward condoms and higher actual condom use than an information only group. This may be due, in part, to a ceiling effect. Participants in all groups scored at the high end of each scale, leaving little, if any room for improvement. In addition, a larger sample size in each group might have been helpful, though the differences between groups were small on all measures.

Although no significant changes were found on the attitude measures, significant changes in behavior occurred. Four behavioral indicators changed significantly in the anticipated direction: sex with someone without discussing using a condom first, having sex when your partner did not use a condom, and sex after drugs and alcohol all decreased, and purchasing condoms increased. In contrast to previous research (Carroll, 1991; Jadack, et al., 1995; Juran, 1995), women exposed to interventions incorporating proper condom use and condom buying/carrying effectively changed behavior in all three conditions in the present study. This suggests that just being exposed to supportive condom buying/carrying information, as in the information group, can positively effect behavior change. Empowering women with this knowledge will help them feel more comfortable buying/carrying condoms, using condoms at next sexual encounter and thus help to break the sexual double standard.

Several methodological problems may have affected the results of this study. Participants in all groups were told at the start not to discuss information revealed until the end of the study, however, this may have had a paradoxical effect and increased discussions between students. If this occurred, the differences between the three conditions may have been diluted. In addition, the experimenter could not control for spontaneous interactions of the participants, making it difficult to standardize the interventions. During one session one of the participants divulged that she had a sexually transmitted disease. This evoked conversation about safer sex practices and that she wished she had know how to use a condom then. This led to playfulness with the modeling demonstration including playing with the condoms. Also, participants may have had an idea as to what the study was measuring and may have answered according to what they thought the researcher wanted.

Other possible methodological problems with the study include experimenter bias and reliability of measures, particularly behavioral measures associated with such a sensitive issue. With the use of self-report, there is no direct measure of behavior change in high-risk, real-life situations. Additional limitations include small sample size and short follow-up.

For future studies, it may be that training time needs to be increased or that short daily or weekly training sessions need to be implemented for long-term maintenance. Future work in this area, with a larger sample size and diverse interventions, is needed to learn what combination and length of intervention strategies should be used for optimal results.

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