BARRIERS TO CONDOM USE AND BARRIER METHOD PREFERENCES AMONG LOW-INCOME AFRICAN-AMERICAN WOMEN

Low-income African-American women (N = 178) entering health clinics co mpleted surveys assessing perceived barriers to condom use for themsel ves personally and for African-American women generally. Following the survey, each woman received a demonstration of five barrier contracep tive methods and then rated her preference among those methods. The wo men perceived relatively few personal barriers to use of the male cond om but perceived significantly greater barriers for other African-Amer ican women (all p <.0001). The male condom was first choice of the lar gest percentage of women (45%) and last choice of the smallest percent age of women (11%). The male condom was preferred for its convenience, availability, and safety, although the necessity for active cooperati on by the male partner was considered a hindrance to using the method. Only 23% of women ranked the female condom as first choice and 35% ra nked the female condom as last choice. Reasons for selecting the femal e condom included preference for a female-controlled method, safety, a nd protection. However, the female condom was perceived to be uncomfor table, to require the partner's acquiescence, and to interfere with se xual experience. Differences in the women's perceptions of barriers to condom use for themselves and for other African-American women are co nsistent with Weinstein's theory of optimistic bias. Preferences among barrier methods indicate that further research and product developmen t are needed to develop barrier methods that are female-controlled, do not require the awareness of the male partner, and are safe, comforta ble, and convenient.