Findings from Project PHRESH reveal the social
and cultural contexts of sexual behaviors among our
participants while suggesting key conceptual, attitudinal,
and behavioral factors that may help
explain high rates of STDs in the communities
and age groups of concern. Study participants have
learned to be cautious about commitment in
romantic relationships and tend to hedge their bets
by having multiple partners and various kinds of
relationships. Moreover, four contextual factors
appear to be critical in limiting condom use: (1)
condoms are not always available when passions
run high; lack of a condom is often not a barrier to
having sex; (2) the decision to use a condom flows
from a culturally informed assessment of a partner’s
presumed level of risk rather than from a public
health understanding of risky behaviors; (3) emotional
involvement in relationships runs counter to
continued condom use; the decision to curtail
condom use is made quickly; and (4) relationships
in which condoms are not used are multiple,
overlapping and sequential. The result is a high
level of risk for STD. This risk is not random or
meaningless; it is conditioned by socioeconomic
factors that press participants to focus on shortterm
pleasure and emotional and material gains
rather than on long-term planning and monogamous
partnerships. It is, in short, a rational
response to social disparity. The results of our
investigation, however, lead us towards pessimistic conclusions regarding STD prevention and risk
reduction behaviors with current methods. While
existing prevention efforts have succeeded in teaching
participants about condoms, the context of their
utilization creates multiple opportunities for sexual
disease transmission.