Prospects for Increased Condom Use Within Marriage in Thailand

however, indicate that the risk of HIV infection threatens not only the narrowly defined risk groups of commercial sex workers and their patrons, but the general public as well. In particular, women who are married to men who visit prostitutes (or who have done so in the past) are at risk.3 Indeed, both commercial sex patronage and noncommercial sexual contacts are common for married Thai men.4 Thus, greater attention needs to be directed toward measures that will reduce the risk of HIV infection among mainstream population groups, particularly among married couples. Given the government’s apparent success in promoting condom use in many commercial sex encounters, one logical strategy to stem the spread of HIV from men infected through commercial sex patronage (or other, noncommercial sex partners) to their wives is to encourage condom use within marriage. This is already being advocated in brochures developed by a prominent nongovernmental organization, the Program for Appropriate Technology in Health. These brochures specifically advise wives to encourage husbands who have engaged in risky behavior in the past or who do so currently to use condoms during marital sex. This may prove to be a difficult task: Despite the high prevalence of contraceptive use among Thai couples, condoms are seldom the method of choice. While close to 70% of Thai couples of reproductive age John Knodel is professor of sociology at the University of Michigan, Ann Arbor. Anthony Pramualratana is assistant professor at the Institute for Population and Social Research, Mahidol University, Bangkok, Thailand. This article is part of the project “The Influence of Primary Female Partners and Male Peers on Male Extramarital Sexual Behavior in Thailand” funded by The Rockefeller Foundation and conducted jointly by the Institute of Population Studies, Chulalongkorn University, and the Population Studies Center, University of Michigan. The authors gratefully acknowledge useful discussions with our two project co-investigators, Chanpen Saengtienchai and Mark VanLandingham, as well as Tim Brown and Tony Bennett during the preparation of the article. Prospects for Increased Condom Use Within Marriage in Thailand