THURS-114 - Empowering Safer Sex Decisions Through Education: A Systematic Review of Condom Negotiation Strategies

Brief Abstract Summary: Condom use is one of the most effective ways to prevent transmission of STIs and unintended pregnancy however, use still remains low. Condom negotiation strategies (CNS) are ways that individuals persuade partners to use condoms and consist of four distinct forms of communication. CNS has been widely studied, but the past decade has limited comprehensive reviews that synthesize findings relating to how CNS can be taught. This study aims to fill the gap by providing an updated synthesis from 2015 to 2025 to inform sexual health education and programming. A literature search was conducted using PRISMA in two major health databases that used the key term “Condom Negotiation Strategies”. Articles published in the above databases, using the key-term, and published in peer-reviewed journals between 2015 and 2025 were selected for inclusion (n = 29). These findings provide valuable insights for strengthening interventions to address this pressing public health issue of condom use and STIs.

Detailed abstract description: Condom use is one of the most effective ways to prevent transmission of STIs and unintended pregnancy; however, many individuals continue not to use them for various reasons, including a lack of knowledge surrounding the importance of condoms and how to communicate condom use with their sexual partners. Condom negotiation strategies (CNS) are the different ways that individuals communicate and persuade their partners to use condoms during sex. CNS methods can be classified into four distinct forms of communication: verbal-direct requests (e.g., directly asking), verbal indirect requests (e.g., commenting on a mutual friend getting pregnant), nonverbal direct requests (e.g., placing a condom on a partner), and nonverbal indirect requests (e.g., placing condom information in sight). Additionally, there are many factors that both positively and negatively influence the use of CNS. Many CNS strategies can be taught through various interventions and sex education programs to help increase the confidence and self-efficacy that individuals have surrounding using them in various real life situations. Although CNS have been widely studied, the past decade has seen limited comprehensive reviews that synthesize findings across populations, contexts, contributing factors, and interventions that have been implemented. This study aims to fill that gap by providing an updated research synthesis from 2015 to 2025 to inform sexual health education and public health programming surrounding CNS and condom use. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in CINAHL Ultimate (EBSCOHost) and PubMed Central to extract articles from the databases that used the key term “Condom Negotiation Strategies”. Only articles published in the previously mentioned databases, using the keywords related to the research question, and that were published in peer-reviewed journals between 2015 and 2025 were selected for inclusion (n = 29). The findings from this review will provide valuable insights for strengthening interventions, specifically, sexual education programs, to address this pressing public health issue of condom use and STIs. Through the findings of this systematic review, only two interventions evaluating the efficacy of sexual education were identified. These findings demonstrate that there is a gap in the amount of sexual education interventions related to condom use and CNS or that current educational interventions have not been evaluated. More sexual health education interventions need to be created and evaluated on which CNS methods are effective.