Attitudes and Beliefs Related to Risk of Sexually Transmitted Infection in Swingers Who Do Not Use Condoms

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and beliefs of swingers related to the risk of contracting STI among swingers who do not use condoms. The health belief model formed the theoretical framework of the study. A description of the individual swinger’s experiences, attitudes, and beliefs was collected during face-to-face interviews with 18 participants. Results showed that participants were knowledgeable about the nature and consequences of STI, and they continued to engage in high risk sexual behaviors. The findings identified cognitive dissonance—a distinct separation between logical/cognitive and emotional/affective factors in decision making related to sexual health, specifically condom use. This was due to the pleasure-seeking norms of this group and the lack of expectations and requirements related to condom use. It was determined that only when condoms were required in order to have sex, participants would utilize them. Implications for social change include the development of prevention strategies that address the cognitive dissonance present in high risk sexual behaviors