Primacy of Affect Over Cognition in Determining Adult Men's Condom–Use Behavior: A Review¹

Prior research suggests that failure to use condoms can be understood within the context of condom‐related attitudes. We reviewed quantitative and qualitative literature on adult men's condom‐use attitudes; condom‐related attitudinal beliefs were classified as cognitive (e.g., effectiveness) or affective (e.g., pleasure‐related), and their relationships to behavior were examined. To determine differences in the effects of cognitive and affective beliefs, we conducted a critical qualitative review, a meta‐analysis, and a “vote‐count.” In support of the primacy of affect hypothesis (Zajonc, 1984), cognitive beliefs were weaker predictors of condom use than were affective beliefs. Results suggest that HIV‐prevention interventions will have greater success by addressing negative affective reactions to condom use in addition to promoting the protective value of condoms.