Primacy of affect over cognition in determining adult men's condom-use behavior: A review

Prior research suggests that failure to use condoms can be understood within the context of condom-related attitudes. We reviewed quantitative and qualitative literature on adult men's condom-use attitudes; condom-related attitudinal beliefs were classified as cognitive (e.g., effectiveness) or affective (e.g., pleasure-related), and their relationships to behavior were examined. To determine differences in the effects of cognitive and affective beliefs, we conducted a critical qualitative review, a meta-analysis, and a "vote-count." In support of the primacy of affect hypothesis (Zajonc, 1984), cognitive beliefs were weaker predictors of condom use than were affective beliefs. Results suggest that HIV-prevention interventions will have greater success by addressing negative affective reactions to condom use in addition to promoting the protective value of condoms.