Barriers to condom use among women at risk of HIV/AIDS: a qualitative study from Iran

BACKGROUND The growing trend of women infected with HIV through sexual transmission is alarming. Factors influencing condom use have not yet been fully identified, especially in countries with conservative cultures and backgrounds. The present study aimed to explore the barriers of condom use in Iranian women at risk of HIV. METHODS Using the grounded theory methodology, participants' experiences and their perceptions regarding condom were collected during semi structured in depth interviews. Participants were 22 women, aged 21-49 years, considered to be at risk for HIV, due to their own or their partner's sexual behaviors. Qualitative analysis of the data was conducted manually and was guided by constant comparative analysis. RESULTS Two main barriers, personal and socio-environmental emerged from data analysis. Lack of perceived threat, absence of protective motivation, inadequate knowledge, perceived lack of control, negative attitudes towards condom and misperception were the major personal barriers, while unsupportive environments and cultural norms were the common socio-environmental barriers to condom use among these at risk women. CONCLUSIONS These critical barriers have to be addressed for implementing effective prevention programs against HIV among populations at risk for HIV.