Research on attachment and condom use has been limited to correlational studies of self-report measures, yielding inconsistent results. Here, we examined the causal effects of attachment priming on self-reported condom use attitudes and an observational measure of condom acquisition behavior. In three experiments, participants were exposed to one of three attachment primes (security, anxiety, or avoidance) or a control prime. For Study 1, participants in the security and anxiety conditions preferred condom non-use to a greater extent, compared to participants in the avoidance condition. This effect was replicated in Study 2, and was mediated by perceptions of sexual health threat. In Study 3, the effect of security priming on condom acquisition behavior was eliminated through the use of a framing manipulation, though the effect of primed attachment on condom use attitudes was not significant. A meta-analysis, however, revealed that the predicted effects of attachment priming were consistent across the three studies, supporting the role of attachment in evaluations of condom use. Priming attachment security or anxiety leads participants to perceive their sexual partners as less of a sexual health threat, resulting in a devaluation of condom use. Primed security also reduced condom acquisition behavior, though this negative effect eliminated by framing condoms as protecting a partner’s sexual health. Overall, these studies suggest that relational factors, such as attachment, require greater consideration when studying sexual health and designing interventions.
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For all three studies, we conducted χ 2 tests to examine whether rates of non-compliant responses differed by attachment priming condition. All tests were non-significant, indicating comparable rates of non-compliant responses in each condition.
A confirmatory factor analysis by Sakaluk and Muehlenhard (2012) supported considering consistent condom use and condom non-use as distinct attitudinal objects.
Results were similar when attitudes toward consistent condom use and condom non-use were analyzed as levels of repeated measures in a mixed 4 × 2 design. For the sake of simplicity, we have therefore presented the results of analyzing the difference scores.
We also explored controlling for participants relationship status. Although relationship status was a significant predictor of condom use attitudes in Studies 1 and 2, it was not a significant predictor of number of condoms taken in Study 3, and more importantly, it did not substantively impact the pattern of effects we observed throughout Studies 1–3.
We also explored whether attachment priming effects were moderated by measures of trait attachment style in portions of Studies 1 and 2 samples, but these interactions were not significant. However, as our focus was on primed and not measured attachment, our four-condition design was not optimally suited for testing these interactions; we return to this point in the discussion section on future research.
Participants were told during debriefing that the number of condoms they took would be counted as a source of data. No participants indicated discomfort with this minor deception. Nevertheless, research assistants delayed the actual counting until participants left.
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Sakaluk, J.K., Gillath, O. The Causal Effects of Relational Security and Insecurity on Condom Use Attitudes and Acquisition Behavior. Arch Sex Behav 45, 339–352 (2016). https://doi.org/10.1007/s10508-015-0618-x