The Causal Effects of Relational Security and Insecurity on Condom Use Attitudes and Acquisition Behavior

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.