Most people's behavior concerning condoms is unlikely to change, however, unless social norms change (74). In some cultures powerful norms about masculinity discourage condom use and encourage sexual risk-taking by men, such as visiting commercial sex workers (CSWs) and having multiple sex partners. Some people may think, wrongly, that they face little or no risk. Others may avoid condoms because they distrust them or dislike their image.

Of course, more people would use condoms if they were more accessible and promoted more (see Chapter 6, Improving Access). But access and promotion are not enough. As the need for condom use and for attention to safe sexual relationships has grown, issues of trust, negotiation, and communication between partners are becoming increasingly important for programs to address.