The Psychology of Do or Don’t I....

This article was created by ACAA's Project Manager of Bow Valley. To learn more about the programs and services ACAA offers in Bow Valley visit http://www.aidscalgary.org/supportservices/bowvalley.cfm or contact info@aidscalgary.org.

Every day we make choices and decisions that involve a certain amount of risk, how we decide in each circumstance depends on both external and internal factors. Add other people to our decision making process and it gets even more complicated, at least it does for most people.

In our prevention efforts at AIDS Calgary I think it would be safe to say that we are all working towards preventing the spread of HIV and other STIs and a big piece of that work is around education and promoting condom use.

We share the process of how HIV and other STIs are transmitted, we talk about the risk involved and in our efforts to move more people towards using condoms and we also look to indentify the barriers that get in the way of people using them.

We acknowledge that there are many circumstances that contribute to a person’s decision not to use protection, but for this conversation I want to address the decision to have unsafe sex when a person does have all the facts, knows all the risks and has access to condoms.

There is likely no definite answer here, especially when we’re talking about investigating choices and decisions, but there may be evidence of how complicated our minds and choices really are.

I believe the complexity to how we each make decisions everyday travels down a path of both conscious and unconscious choices. There are many people who knowingly take the risk of getting HIV or other STIs through having unsafe sex, which raises a couple of questions for me.

Is there a moment when the person has a thought, impulse or even a conversation that they should wear protection but yet they still continue forward with having unprotected sex?

If they do then my next question is… what is it that overrides those thoughts?

Think about it, does a person with all the facts and access to condoms actually consciously say to themselves “I am choosing to have unprotected sex right now”?

I am interested to understand and identify if there is indeed an internal struggle with our decision making processes. If there is an internal conflict right before a person engages in sex, then I would suggest that understanding this dynamic is one of greatest barriers once education on all the facts is presented.

When I stand up in front of a group to provide education on HIV and STIs I am always curious to ask the question, “What are the reasons why you think people don’t wear condoms?” Some people will answer from personal experience and others from an outside perspective.

Each group will come up with different reasons such as:
They were too intoxicated
Shows a sign of lack of trust if you wear a condom
There are no condoms in the vicinity
Financially cannot afford to buy condoms
Doesn’t feel as good
You know the person well enough
Laziness

These are just a few of the examples that I hear during my presentations and for me they represent answers to more questions. It’s the tip of the ice berg when it comes to how we make our individual choices, especially when it comes to the psychology of do I or don’t I put this condom on.

It is a lot easier to have a discussion about condoms before having sex but that conversation can be tricky and sometimes uncomfortable. Generally speaking it’s not a talk that many of us prepare for, so that in itself can build the momentum towards experiencing such a conversation as embarrassing or if left unspoken creating that elephant in the room.

How will the other person respond, will they get insulted? Will I ruin the mood? And what are the chances this person has HIV or an STI? These are just some examples that I have heard when talking with very honest people about their internal struggles of deciding to bring the topic up or not.

I knew a young man that used to have multiple partners when he was younger and most of the time it was with strangers. He was extremely intelligent, knew the facts of how HIV and STIs were transmitted and often had a condom in his pocket when he was engaging in sex, yet he almost never used it.

Once when we were talking about why he had condoms in his pocket and why it was that he never used them. He replied with “I don’t know, I know better but when I get to that moment my attitude changes. It’s as if I don’t care in that moment and then spend the entire next day worrying about the consequences.”

At the end of the day we are all adults who have the right to choose the kind of sex we want to experience. I believe that self awareness is good for all of us and each of us thinks, acts and responds differently. With a better understanding of ourselves we can better support our decisions.