The Gender Dimension of Condom Use: Implications for Cognitive Dissonance Interventions

Mounting evidence suggests that a variety of health behaviors, including condom use, can be effectively altered using cognitive dissonance-based interventions (Freijy & Kothe, 2013). The most commonly applied and most effective research paradigm uses hypocrisy to arouse dissonance by exposing an inconsistency between a present attitude (e.g., pro-health) and a past transgression (e.g., failure to use a condom; Aronson, Fried, & Stone, 1991). Following hypocrisy induction, dissonance is reduced primarily through behavior change (e.g., consistent condom use) and, when effective, this form of self-persuasion can lead to particularly intense and enduring effects (Aronson, 1980). However, the efficacy of cognitive dissonance-based interventions is impacted by the degree of perceived responsibility for the transgression (Stone & Fernandez, 2008), and women often wield less control over condom use decision-making. Thus, increased consideration for the gender dimension (e.g., norms and inequalities) of cognitive dissonance interventions targeting increased condom use is warranted. The present study qualitatively examined 42 college students’ (78.5% female, 76.2% White/European American, 83.3% first or second year students, 95.2% heterosexual) “transgression narratives,” submitted as part of a safe sex intervention using the hypocrisy paradigm to increase condom use. Thematic analysis (Braun & Clarke, 2006) was used to examine participants’ descriptions of “a past instance in which [they] failed to use a condom” and “what prevented [them] from using a condom in this instance.” Most commonly, male and female participants described condom-use failure as a result of being in a committed relationship, certainty about partners’ STI status, and contraceptive-use. Being in a rush without a condom available was also a common transgression story for both men and women. However, several female (but no male) participants described partner preferences (e.g., for pleasure, endurance) as the sole reason for condom use failure. Moreover, female participants were much more likely to use relational phrases (e.g., “we”, “us”) when referring to condom-use decision-making. Findings suggest that cognitive dissonance interventions solely targeting condom use, rather than condom negotiation, may be off the mark for women for two reasons. First, gender may impact the nature of the transgression (e.g., perceived responsibility) and thus the potency of the dissonance induced. More importantly, however, the decision to use a condom is not an individual one, and gendered expectations (e.g., to be non-confrontational) and power inequalities must not be overlooked. Implications for cognitive dissonance interventions targeting safe sex are discussed.