“Beyond the latex barrier”: The dominance of age and gender dynamics over individual perceptions in condom negotiation

Background: Consistent condom use is a key preventive measure against sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection. However, condom use remains inconsistent among individuals attending STI clinics. Objective: To assess perceived barriers to condom use across six theoretical domains and identify independent predictors of condom non-use among our STI clinic attendees. Materials and Methods: A cross-sectional study was conducted among 200 adults at our STI clinic in South India. Perceived barriers to condom use were measured using a 26-item questionnaire covering six domains. Condom non-use during the last five sexual encounters was the primary outcome. Internal consistency was assessed using Cronbach’s α. Mann–Whitney U -test analyzed the differences between condom users and non-users. Multivariable logistic regression identified predictors of condom non-use after adjusting for sociodemographic variables. Results: Condom non-use was reported by 140 participants (70.0%; 95% confidence interval: 63.5–76.0). The stigma associated with condom purchase showed the highest barrier scores. The questionnaire showed acceptable internal consistency (Cronbach’s α = 0.79). Condom non-users had higher misconception-related barrier scores ( P = 0.025). In the multivariable analysis, male sex (adjusted odds ratio [aOR]: 0.17; P = 0.008) and unmarried status (aOR: 0.25; P = 0.001) were associated with lower odds of condom non-use. The model exhibited a good discrimination (area under the curve = 0.78). Conclusion: Condom non-use remains prevalent among STI clinic attendees. Sociodemographic and relationship factors outweigh perceived barriers in influencing condom use, highlighting the need for targeted STI prevention interventions.