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Norton, Bogart, Cecil, and Pinkerton (2005)
reviewed both quantitative and qualitative research and imposed a theoretical framework on the findings of 57 studies that examined men's attitudes toward condom use. Attitudinal beliefs were classified as cognitive or affective, and their relationships to behavior were examined. ... [C]ognitive beliefs about condoms were weaker predictors of condom-use intentions and behavior than were affective beliefs about condoms across both qualitative and quantitative analyses. Although the majority of participants across studies believed that condoms protected against HIV and pregnancy, effectiveness beliefs were inconsistently and weakly associated with condom-use behavior. In contrast, beliefs about the reduced pleasure associated with condom use were common and robust predictors of condom use. Men who believed that condoms reduce pleasure were less likely to intend to use condoms and to practice actual condom use. Other affective beliefs, although less frequently studied, also had strong relationships with condom-use behavior. For example, the beliefs that condoms interfere with spontaneity and intimacy during sex, or that condoms create distrust or embarrassment between partners, were related to lack of condom use. (p. 2523)
Norton and colleagues conclude that this
comprehensive review of the literature suggests that condom attitudes can be conceptualized best in terms of the tension between cognition and affect. Affective beliefs about condoms tend to be based on direct experience with condoms and, therefore, are likely to be more robust predictors of behavior. Interventions designed to stem the spread of HIV and other STDs [sexually transmitted diseases] need to take into account the primacy of affect in driving condom-use behavior by addressing perceived loss in pleasure and spontaneity as a result of condoms, as well as anticipated negative partner reactions to condom use. (p. 2525)
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Summer 2006 Newsletter / Volume 7, Issue 4 
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