Prospects for Increased Condom Use in Marital Unions in Thailand

Thailand is currently experiencing a serious HIV/AIDS epidemic in which transmission of HIV from infected husbands to their wives is now an important component. Despite the value that wider use of condoms within marriage in Thailand would have in reducing the spread of HIV to wives, qualitative research reveals that a number of formidable barriers stand in the way of increasing marital condom use. Because condoms are widely perceived as interfering with male sexual pleasure and are primarily associated as being a prophylactic means used with prostitutes, use as the current contraceptive method among married women has never exceeded 2 percent. The wide availability of more effective alternative methods that do not share these perceived disadvantages limits the potential for increased condom use as a marital contraceptive.

Thus condoms will need to be promoted directly as a prophylactic means. However, since the suggested use of a condom by a spouse is seen as unusual, it is likely to arouse suspicion of commercial sex patronage by the husband. This in turn can lead to marital conflict since, despite the fact that occasional prostitute visitation by married men is not unusual as a form of male social activity, most wives strongly disapprove of such behavior. Rather than general promotion of marital condom use, a more limited strategy that combines voluntary testing with counseling for those testing positive will likely be more efficient. In addition, promotion of condom use with extramarital sexual contacts is likely to be a more feasible general strategy for protecting married women from the HIV threat than the promotion of their use in the marital union itself.

Dataset(s): focus group discussions.