Abstract
Objective: This paper aims to qualitatively analyze social interactions leading to consistent non-use of condoms among sexually active Japanese high school girls.
Methods: Between 2001 and 2003, we conducted 8 focus groups with 41 high school girls (median age 17, 35/41 had sexual experience) from 2 provincial cities in southwestern Japan. The data was analyzed by grounded theory approach.
Results: We found 3 social interactive processes regarding their non-use of condoms: 1 core process and 2 sub-processes (A and B).
The core process revealsthat, as the high school girls become sexually experienced, they come to view their body as pregnant-free and withdrawal as an effective contraceptive method. Their major concern is unwanted pregnancy and not STD infection. Although they know condom is the most available contraceptive, the decision of its use is left to their partners who are mostly unwilling to use it. After practicing withdrawalor the rhythm method for several months, they empirically learn that they do notget pregnant so easily. These experiences allow them to reason that their body is pregnant-free; and, withdrawal is a reliable enough contraceptive method.
The sub-process A reveals the perception of some minorities who do not regard pregnancy as a risk, and some factors associated with condom-acquisition impediments and condom repulsion. The sub-process B shows how some participants develop their unique pseudo-safesex perceptions. All of these contribute to their non-useof condom.
Conclusions: Since the social interactive processes regarding non-use of condoms by high school girls unfold in and beyond sexual encounters, they must be dealt holistically. Moreover, we cannot simply expect them to act always rationally regardless of social interactive processes in which they are engaged. To devise truly effective HIV/STD prevention measures for Japanese youth, further investigation of their social interactive processes regarding (non-) use ofcondoms is indispensable.
