Prospects for increased condom use within marriage in Thailand

The transmission of the human immunodeficiency virus (HIV) from infected husbands to their wives is now an important component of the AIDS epidemic in Thailand. Although the value of condoms in reducing the spread of HIV is well-known among Thai men and women, the rate of condom use for contraception among married couples has never exceeded 2%. Focus groups and individual interviews with both urban and provincial Thai men and women reveal a number of formidable barriers to increasing the rate of marital condom use: Condoms are widely perceived as interfering with male sexual pleasure, and they are primarily considered to be a prophylactic for use with prostitutes. The potential for increasing the use of condoms as a method of marital contraception appears limited, as highly effective alternatives are widely available. Thus, condoms will need to be promoted directly as a prophylactic. Findings suggest that general promotion of condoms for use during extramarital sex, together with advocacy of voluntary HIV testing for individuals at high risk of infection and counseling for those testing positive, are practical recommendations.