Barriers to Condom use Among "Socially Damaged Women": A Qualitative Study in Iran

One of the most effective strategies to prevent transmission of sexually transmitted infections (STIs) is use of condom, but obstacles to its use in high-risk groups have not yet been fully understood. The main objective of our study is to evaluate barriers to condom use among "Socially damaged women" (SDW). A qualitative method was utilized. Two focus group discussions (FGDs) and eighteen semi-structured in-depth interviews were conducted with SDW, 15-45 years old, at shelters and harm-reduction drop-in-centers in Tehran, Iran. Data was analyzed using the content analysis approach. All women in the study were sexually active and most of them were divorced. They all had primary school education at a minimum, and a limited knowledge of HIV and STIs, yet the rate of condom use in these high-risk groups are low. The most common obstacles to consistent condom use among "SDW" included misperception, low perceived sensitivity and self-efficacy partner objections. Hence, preventions strategies based on increasing knowledge about STIs and condom use, self-efficacy, perceived sensitivity must be designed and improvised to induce condom use. These data will be useful in designing and improving STIs prevention outreach programs in Iran.