Why do young people use or not use condoms at first sexual intercourse? A qualitative study in Mexico City

In many settings, condoms are well-known and widely available, yet premarital first intercourse is frequently unprotected. This detailed ethnographic study explores this mismatch in low-income areas of Mexico City. Methods include participant observation and 154 in-depth interviews with young people from marginalized areas. Two key overarching themes emerged: gender and communication. Young people reinterpreted traditional gender roles to allow premarital sex under certain circumstances. Spontaneity was favored because this allowed behavior to fit more closely to traditional norms, potentially making planning of condom use difficult. The barrier to condom use created by this desire for spontaneity was overcome by some young people in the study through prior discussion of coitus and verbal agreement in advance. Good communication allowed the desired spontaneity without jeopardizing protection. To increase condom uptake, interventions must include a focus on improving communication skills and take into account the fact that spontaneity is valued.