title: Reasons for not using condoms of clients at urban sexually transmitted diseases clinics.
abstract: OBJECTIVE
  Greater understanding of the factors related to inconsistent condom use is essential in the development of strategies to promote condom use among clients who access public, inner-city sexually transmitted diseases (STD) clinics. Therefore, this study aimed to explore reasons for not using condoms among 260 predominantly African American heterosexual male and female clients presenting for care at two inner-city STD clinics.
  
  
  METHODS
  Clients selected for this descriptive analysis reported having had at least one unprotected episode of sexual intercourse in the last 10 episodes. In face-to-face interviews, clients provided information about sexual activity, sexual partners, and condom use in the previous 30 days. In addition, they were asked to indicate the main reason for not using condoms when having unprotected sex.
  
  
  RESULTS
  Content analysis showed six major categories of reasons for not using condoms: reasons related to partner relationships, reasons related to sexual sensation, reasons related to situational constraint, reasons related to condoms themselves, reasons related to pregnancy, and reasons related to types of sexual activity. Most frequent explanations given for not using condoms included partner trust (19.6%), the feel of condoms (11.9%), and lack of condom availability (11.5%). Clients also reported barriers to condom use that included beliefs about condom sensation and partner relationships.
  
  
  CONCLUSIONS
  These results show the continued barriers that exist with respect to condom use in at-risk populations and emphasize the need to tailor meaningful interventions in order to promote condom use among persons who, for differing reasons, choose not to use them.
authors.affiliation: Center for Nursing Research, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Jadack
authors.forename: A
authors.initials: A
authors.lastname: Fresia
authors.forename: A M
authors.initials: AM
authors.lastname: Rompalo
authors.forename: J
authors.initials: J
authors.lastname: Zenilman
mesh_terms: D000328:Adult; D017280:Condoms; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012749:Sexually Transmitted Diseases / Q000517:prevention & control