Was there widespread resistance to condom wearing during the height of the HIV/AIDS epidemic?

by TooOfEverything
theytookthemall

From figures of authority, such as the federal government? Yes, and no.

In the 1960s, the rate of condom usage in the United States dropped dramatically. Strong public health campaigns aimed at the military, and the ready availability and comparative affordability of latex condoms, had led to a significant increase centered around WWII. Latex condoms were easier to use, more reliable, more affordable, and thinner than rubber or "skin" (usually chemically-treated animal intestine) condoms, and there was an increasing awareness of condoms as the best way to prevent STIs. Regardless, condoms and discussion of sexual health remained a deeply-ingrained taboo throughout much of American society: people knew what they were and how to use them, and many people did use them, but there was very little discussion of it as a health topic in mainstream society.

Several factors combined in the 1960s to lead to the reduction in condom popularity. The first oral contraceptive was approved for use in 1960, and within a few years over three million American women had been prescribed it. Social attitudes and norms changed dramatically and rapidly, and more people were moving away from traditional ideas such as abstinence before marriage and sex for procreation only. Antibiotics were now easily available, and as a result gonorrhea, chlamydia, and particularly syphilis had stopped being a terrible pox, and become an irritation easily cleared up by a visit to the doctor. In short, there were fewer reasons to use condoms.

AIDS was first publicly identified as "likely" to be caused by a sexually-transmissible pathogen in 1983. Ronald Reagan was well established in office by that point, and famously remained quiet on the topic. Even as the body count grew, the Reagan administration said nothing of substance, and when they did speak, it was to promote abstinence. AIDS was known as a "gay disease" for a very long time (and arguably still is in many sectors). In 1987, Senator Jesse Helms led the push for a law which severely limited federal funding for any anti-AIDS education programs that did not stress abstinence first and foremost. Throughout the 80s, remained a somewhat taboo topic. Advertising was strictly limited by television and radio networks, and very often, attempts to promote condom usage was seen as promotion of "un-American" and "non-traditional" lifestyles. This was a major factor in the development of what has become a major sociopolitical divide we now take for granted: the idea of sexual morality as something that not just could but should be regulated was seized upon by a comparatively small and new faction of the political right.

At the same time, though, Reagan's Surgeon General, C. Everett Koop, wasn't having it. He became an extremely vocal advocate for education about and prevention of HIV/AIDS. In 1986, he issued the Surgeon General's Report on AIDS, which emphasized the important role of condoms. 1988, he sent out the largest mass mailing in American history, to over a million American households. It was an 8-page pamphlet called Understanding AIDS, and included an entire half-page section about condoms.

There was approximately a 20% increase in condom sales in the year after the Surgeon General's Report in 86. The degree to which that's attributable to the Report rather than changing social norms is obviously debatable, but sales did increase more consistently in areas hit hardest by HIV. Advertising, not for condom brands but for condom usage in general, did begin to be seen as more acceptable by the early 1990s, and went through an interesting shift in tone from fearmongering in the 80s to more lighthearted and normalizing in the 90s. Much less well documented is a tremendous, tremendous amount of grassroots organizing and advocacy promoting condom usage and safer sex practices, lead largely by the queer community. People did not want to contract HIV: however, knowing when one had to use a condom to prevent it was obviously difficult with a virus which could be entirely asymptomatic.

Sources & recommended reading:

The Humble Little Condom: A History by Anne Collier

Red Families v. Blue Families: Legal Polarization and the Creation of Culture by Naomi Cahn & June Carbone

And The Band Played On: Politics, People, and the AIDS Epidemic by Randy Shilts

A Timeline of HIV and AIDS

Reagan calls AIDS Enemy No. 1, advises abstinence By JAMES GERSTENZANG

Valdiserri RO. Cum hastis sic clypeatis: the turbulent history of the condom. Bull N Y Acad Med. 1988;64(3):237-245.

Moran JS, Janes HR, Peterman TA, Stone KM. Increase in condom sales following AIDS education and publicity, United States. Am J Public Health. 1990;80(5):607-608. doi:10.2105/ajph.80.5.607

Ku L, Sonenstein FL, Pleck JH. Patterns of HIV risk and preventive behaviors among teenage men. Public Health Rep. 1992;107(2):131-138.

Boone LE, Kurtz DL. AIDS and the marketing of condoms. Health Mark Q. 1988;5(3-4):47-60. doi:10.1300/j026v05n03_05

O'Reilly KR, Higgins DL. AIDS Community Demonstration Projects for HIV prevention among hard-to-reach groups. Public Health Rep. 1991;106(6):714-720.