Health psychology

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Article 24

WHY DO N’ T YO U

USE A C O NDO M ?

The re a so ns a re d e c e p tive ly sim p le a nd he a rtb re a king ly c o m p le x

BY JEANNINE AM BER I don’t see it coming, but about half an hour into my conversa- tion with Leoni, she starts to cry. We’ve been talking about men and sex and dating, and I ask her if she uses condoms.

“Maybe half the time,” she answers, sounding so cavalier you’d think she was talking about taking a multivitamin. “I don’t like how they feel.” Then Leoni, who is 26 and manages a New Orleans dress shop, admits she has never used one with the guy she’s seeing now. “He seems different from all the rest,” she says. “He pays attention to me; he talks to me. And not using a condom makes me feel more emotionally attached, as if what I’m doing is special for him.” Then she tells me she’s only been dating this guy a month. Finally she blurts out, “I have issues with men: I don’t trust them to stick around.” She explains that her father abandoned the family when she was a child.

And that’s when she starts to cry. You wouldn’t think growing up fatherless might lead a

woman to practice unsafe sex, but that just goes to show that the reasons we don’t use condoms run deep. For almost two de- cades we’ve been warned by everyone from our doctors to our best friends to protect ourselves. Yet ask any woman who’s dating how often she uses condoms, and chances are that even those who insist they’re careful will likely break down and admit, “Not always.” As in: Not after the first few times. Not if I know where he’s been. Not if I’m on the Pill. Not if I love him. Not if he loves me. Not if it’s going to spoil the mood. And de- spite all our finger-waving, I-don’t take-no-mess posturing, it appears that no one is more likely to make exceptions to the condom rule than Black women.

The Pric e We Pa y Not only do Black women seem more inclined to leave the condom unopened on the nightstand, but statistics from the Centers for Disease Control and Prevention show that we are paying dearly for those moments of reckless abandon. While an estimated one in 3,000 White women and one in 400 Latinas is HIV-positive, that ratio soars to one in 160 for Black women.

And the largest number of these cases are the result of unpro- tected heterosexual sex.

The most deadly repercussion of not using a condom may be AIDS, but it’s certainly not all we need to worry about: Almost 75 percent of pregnancies among Black women are unintended (compared with 43 percent for White women), according to the Alan Guttmacher Institute, a nonprofit research organization. Gonorrhea rates among African-Americans are more than 30 times higher than among Whites and 11 times higher than among Latinos. We also suffer disproportionately from syphilis and chlamydia, which, if left untreated, can cause blindness and infertility, respectively. And while one in five Americans is living with genital herpes, nearly half of all Black folks are es- timated to be carrying the virus.

But why do we continue to put ourselves at such risk? I reached out to Black women across the country, all of whom con- fessed a less-than-stellar track record with condoms. At first I was given plenty of excuses, from the familiar I don’t like how they feel to the troubling If I insist on a condom, he’ll find someone who doesn’t. But the more I pressed for underlying reasons, the more unnerved each woman became. It seemed that what linked these women was a lethal mix of desire and denial, a longing for a deeper connection to the men they were dating. Perhaps most disturbing of all, skin-to-skin contact seemed to be the great sig- nifier of intimacy—a magic talisman that would make him stay.

‘Wha t Will He Think?’ “I don’t think any woman consciously says, ‘I’m willing to die so I can go on a second date with him,’ ” says Phill Wilson, founding director of the Los Angeles–based African American AIDS Policy and Training Institute. “But many Black women feel they are not worthy of love or that it’s not attainable. So if someone offers the promise of love, they are willing to pay any price, including risking their lives by not wearing condoms.”

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Take the case of Beverly, 24, a Chicago graphic designer. She remembers the star football player she dated in high school. “Everyone told me, ‘You’d better be careful,’ and I still did it without a condom because I didn’t want him to talk about me,” she says. “I figured if I said, ‘Wait! STD rates are up 40 percent in our community,’ it would be around the whole school, and everyone would think I was whack. So I just went home and said a prayer afterward.”

Beverly continued to say her prayers right through college, where she dated another campus big shot, who would beg to “just put it in for a minute.” She ended up with genital warts. After the diagnosis she tried to talk to her boyfriend about it but was crushed when “he got a really mean look and physically backed away from me.” That was the end of their relationship.

“It’s so weird because magazine articles all say you can talk to your man,” Beverly reflects. “But in my experience it never happens like that.” She remembers the night she asked her cur- rent boyfriend if he’d been tested for HIV. They were having dinner, and his fork dropped to his plate. “He was like ‘What are you saying? Where is this coming from?’ ” Beverly recalls. “He was asking if there was something wrong with me.”

Although Beverly’s boyfriend assured her he got tested reg- ularly, a part of her knew he was lying. Still, she was comforted by the fact that he didn’t leave her as her college boyfriend had. Wilson says it’s not uncommon for a woman to be afraid of how her partner may react if she insists on protection or even just broaches the subject of getting tested. “The last thing she wants to do is scare him away,” he says.

‘I Wa nt Him to Sta y’ Like Beverly, many women believe that by not demanding a condom, they’ll send the message that they are not going to create conflict, says Gail Elizabeth Wyatt, Ph.D., author of Stolen Women: Reclaiming Our Sexuality, Taking Back Our Lives (Wiley). Women may also choose not to use condoms as a way of making the relationship more attractive to their partners. “These women want a man to feel they are open-minded and ready for ex- perimentation and that when he comes over they are just going to want to play,” she explains. “It’s part of the romantic myth: My man can be having trouble looking for a job or paying his rent, but when he comes to me I am not going to give him trouble.”

For Leoni, that usually means not bothering her partner with little details like wearing a condom. But although she attributes that sort of behavior to an absent father (“If your own father doesn’t want you, how can you expect a stranger to stay and love you?” she asks rhetorically), many experts say that the longing for male affirmation is common even among Black women who grew up with both parents. “I find that many African-American women look outside themselves when it comes to love and ap- proval,” says Wyatt. “They look for someone else to make the decisions, someone else to be in charge. I don’t think that neces- sarily comes from not having a father in the house. It comes from not seeing yourself as the person who is responsible for you.”

Wilson adds that while growing up without a father can cause relationship problems for some women, society’s negative mes-

sages to Black girls are far more to blame for our failure to con- sistently protect ourselves. “The first message is that girls are not as important as boys,” he says. “The second message is that no matter how successful, beautiful or accomplished a Black woman is, there is something wrong with her if she can’t keep a man.” Wilson believes that the way to empower Black women to use condoms is to first reprogram how they see themselves within the wider culture. “If we want Black women to protect themselves, then we need to teach Black girls that they are worthy and their identity is not dependent on their relationship to a male partner,” he explains. “That is absolutely germane.”

Leoni realizes things have to change: Although she has never been pregnant, over the last two years she has been treated for gonorrhea and crab lice, and before that trichomoniasis. Now she’s considering therapy. “I’m aware of the consequences of not using condoms, yet it hasn’t really altered my behavior,” she says. “I need to get myself in line before something more se- rious catches up with me”—something without a cure.

‘He Looks Sa fe ’ Vera, a 41-year-old administrative assistant at a counseling center and the mother of four children, lives in San Diego. A few years ago she and her husband decided to separate, and Vera started dating a clean-cut minister she met through work. “You’d never think there was something wrong with him,” she says. “He was very conservative, a real square.” Vera and the minister dated for about a year and never used condoms because Vera’s tubes had been tied, so getting pregnant wasn’t a concern.

After the relationship ended, Vera got back with her hus- band. “Then I started getting yeast infections all the time,” she recalls. “I went to the doctor, and when I got the call from the health department, I knew something was wrong.”

Vera was diagnosed with HIV in 1998. It turns out that be- fore the minister found God, he took solace in IV drugs. “He didn’t look as if anything was wrong with him at all,” she says. “Until you get to the final stages of full-blown AIDS, you don’t look as if you have it. This disease is very, very tricky.”

But it’s not just the insidious nature of AIDS that gets us in trouble, observes Wyatt. Most of us simply use the wrong cri- teria to evaluate our partners. “Women are looking at jobs and clothes and appearance and what the person says and how much money he makes,” she says. Those may be appropriate criteria for deciding whether to have dinner with someone, but they’re hardly worth considering when it comes to deciding whether to have unprotected sex. Instead, says Wyatt, you should ask: Is this person a player? Has he been in prison? Does he use drugs? Is he sleeping with more than one person? Does he have my well-being at heart? And most important: Has he been tested recently, and does he practice safe sex? Keep in mind that one in 50 Black men is HIV-positive or has full-blown AIDS. “Once the virus becomes prevalent in a community, as it is in ours, your risk of bumping into it becomes much higher,” says Helene Gayle, M.D., M.P.H., senior adviser for HIV/AIDS with the Bill & Melinda Gates Foundation in Seattle. As a re- sult, she says, Black women need to evaluate their sexual part- ners much more carefully.

Article 24. WHY DON’T YOU USE A CONDOM?

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‘The y Don’t Fe e l Na tura l’ Jennifer, 33, says she often wondered about risks a man she used to date had taken. “He refused to wear a condom; he said it didn’t feel natural,” she says. Jennifer worried that he never used a condom with anyone he slept with before her. So she argued, in- sisted and tried to excite him with extravagant foreplay: “But the bottom line was, if we were going to have sex, it was going to be without a condom,” she sighs. “What I wanted was secondary.”

Phill Wilson points out that many men have a sense of enti- tlement when it comes to sexual relationships—a feeling that sex is for their own pleasure rather than an act of mutual inti- macy. He adds that when a woman concedes to a man’s request to forgo condoms despite concerns for her own well-being, she reinforces the message that her primary purpose in bed is to pro- vide tactile sensation. And that creates even greater problems: “If all a woman is offering is physical pleasure, then why should a man feel any incentive to be faithful?” Wilson asks. “Because really, she has just abdicated all her uniqueness.”

‘Our Love Is Spe cia l’ The irony is that a craving to feel special is what drives so many of us to take risks. According to Wyatt, many women fall prey to the romantic fantasy of an everlasting, unconditional love. As- satta, 29, a Boston kindergarten teacher, knows what she means. “I always used condoms when I was in college because there was no excuse not to,” she says. “They gave them out free at the clinic. But then I got a steady boyfriend, and I was with him so much we didn’t always have one. And we were very much in love, so there was this element of doing something that might not be in your best interest for someone you really care about.”

Then Assatta got pregnant. She had an abortion, but six months later she was pregnant once more. She felt stupid and ir- responsible and promised herself it would never happen again. When she and her boyfriend broke up, Assatta swore she would use condoms all the time. And she did—until she reconciled with her ex. “I felt he was someone I was meant to be with,” she says. “Of course, I got pregnant again”—and had a third abor- tion before breaking up for good.

As Assatta discovered, the pursuit of a love that seems des- tined can be a powerful inducement to toss caution aside. Ana, a 39-year-old restaurateur with a 5-year-old daughter, has been separated from her husband for less than a year. She says she’s “shocked” to find herself not using condoms with the man she’s been dating, especially because this man is married to someone else. “Our connection is uncannily deep,” Ana explains. Maybe it’s because single mothers can get so worn down by the respon- sibility of parenting solo, and they fantasize about a place—or someone’s arms—they can escape to. “I’ve sort of abdicated control on many levels,” Ana admits. “A large part of the dy- namic is him taking care of me.”

‘I Wa nt to Ha ve a Ba by’ My friend Carolyn is now a single mother. Six months ago she gave birth to her son. She recently confessed to me that wanting a baby was the main reason she didn’t use condoms. “I was tired of waiting for some perfect guy to come along and marry me,” she says with the clarity of hindsight. “I just really wanted to have a child.” Carolyn says she’d been very clear about her in- tentions. “I would tell a man I wanted to get pregnant, then I pretty much left the condom use up to him,” she says. “The last man I was seeing never used one, so I assumed he would be okay if I got pregnant.”

That was a mistake. “When I told him the news, he flipped,” Carolyn recalls. “He spent months talking about how this was going to ruin his life. And after my son was born, he split.” Car- olyn says that looking back she realizes that the guys who had chosen to use condoms—those were the responsible ones. Those were the men who would one day make good fathers. “The guy I was dating obviously wasn’t thinking beyond the moment,” she says. “It was as if he was shocked that his actions had conse- quences.” Carolyn realizes now that as much as she wanted a child, she used poor judgment in being so passive with her partner.

‘If You Don’t We a r a Condom… ’ Of course, being assertive in the bedroom isn’t always easy. “History, culture and gender roles have dictated that women take a passive stance in sexual negotiations,” Wyatt observes. “But women need to realize that when you insist on a condom, you are in fact acknowledging to your partner and to yourself that your future is under your control.”

Sondra, 27, is a case in point: An audio engineer who lives in Baltimore, she says she has used condoms religiously since she found out her college boyfriend was cheating on her with a girl who had multiple partners. “Aside from breaking my heart, this experience taught me that you just never know whom to trust, so you should take care of yourself the best way you can,” she says.

Sondra believes women underestimate the power they have to negotiate for what they want in the bedroom. And although she’s never had a man refuse her condom request, she says in that situation she’d know exactly what to say. “I’d tell him, ‘If you don’t wear a condom, then I’m not having sex,’ ” she says simply. “Sex is the biggest incentive. So many women just don’t seem to understand that.”

Note: To protect subjects’ privacy, names and identifying details have been changed.

Jeannine Amber is a contributing writer for ESSENCE.

From Essence, August 2002, pp. 118-122. © 2002 by Essence Communications Partners. All rights reserved.