HIV risk and condom use in the adult heterosexual population in France between 1992 and 2001: return to the starting point?

OBJECTIVE: The aim of this paper is to measure changes in protection behaviours from 1992 to 2001, in assessing trends in condom use over time in the heterosexual adult population.
DESIGN: These changes are measured through repeated AIDS KABP surveys comparing, over time, condom use during the 12 months prior to the surveys and condom use at first sexual intercourse before and after the beginning of the AIDS epidemic.
METHOD: National telephone surveys were conducted in 1992, 1994, 1998 and 2001. A total sample of 7026 heterosexual individuals, aged 18-54 years, was obtained.
RESULTS: Two temporal phases are highlighted in condom use. The first shows an increase in both condom use at first sexual intercourse from 1985 to 1998, and in condom use during the 12 months prior to the surveys between 1992 and 1998, suggesting that sexual health promotion messages may have increased HIV/AIDS preventive behaviours. The second phase shows a decrease in condom use. Compared with 1998, condom use at first sexual intercourse in the 2001 survey still remains high; however, condom use in the 12 months prior to the survey is clearly decreasing, particularly among those with multiple sexual partners during the past 12 months.
CONCLUSIONS: Reasons for this relapse in condom use in the general population include changes in social and individual representation due to the introduction of highly active antiretroviral therapy, the difficulties in sustaining long-term preventive behaviours, and a high level of awareness in the population and/or the decrease of large HIV prevention campaigns.