1 
 

 

Attitudes to and use of lubrication during heterosexual sex by students at Wits 

University 

 

Prepared by: Victoria John (971068) 

Supervisor: Prof. David Dickinson 

 

A research report submitted to the Faculty of Humanities, University of the 

Witwatersrand, in partial fulfilment of the requirements for the degree of Masters of 

Arts in Development Studies 

 

March 2021 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 



2 
 

Table of Contents  

DECLARATION..................................................................................................................... 4  

ABSTRACT ............................................................................................................................ 5   

ACKNOWLEDGEMENTS ................................................................................................... 7  

CHAPTER 1: INTRODUCTION ......................................................................................... 8  

CHAPTER 2: LITERATURE REVIEW ........................................................................... 10  

2.1: Introduction ..................................................................................................................... 10  

2.2: Attitudes to vaginal lube in Sub-Saharan Africa ……………………….…………..….. 10 

2.3: Gender, power and attitudes to female sexuality............................................................. 11   

2.4: Lube and Condoms……………………………………………...................................... 13 

2.5: Condom and lube and the response to HIV………………………………….…............. 13  

2.6: Sex for pleasure................................................................................................................ 14 

2.7: Conclusion……………………………………………………………………………… 16 

CHAPTER 3: METHODOLOGY .....................................................................................  18 

3.1: Introduction ..................................................................................................................... 18 

3.2: Focus Groups .................................................................................................................. 18 

3.3: Survey ............................................................................................................................. 19  

CHAPTER 4: RESULTS……………………….................................................................. 22  

4.1: Introduction ..................................................................................................................... 22   

4.2: The Respondents ………………………………............................................................. 23  

4.3: Sexual Frequency, Sex Education and Relationships……... .......................................... 25  

4.4: Condom Failure ............................................................................................................... 26  

4.5: Sex Becoming Dry Unintentionally................................................................................. 37 

4.6: Impact of Dryness on Quality of Sex……………………............................................... 40 

4.7: The Use of Introduced Lubrication ……………………………………......................... 41  

4.8: Sex Education, Lube and Pleasure................................................................................... 44 

4.9: Lube and Condom Failure……………………………………………………………… 46 

4.10: Pain During Sex………………………………………………………………………. 46 

4.11: Pleasure……………………………………………………………………………….. 49 

4.12 Access to free lubrication……………………………………………………………… 51 

4.13 Conclusion…………………………………………………………………………..…  51 

CHAPTER 5: CONCLUSION ............................................................................................ 53  

5.1: Introduction ..................................................................................................................... 53 

5.2: Dryness During Sex………………………………………............................................. 53   



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5.3: Use of Lube…………………………………………….................................................. 54   

5.4: Pain During Sex ……………………………………………………………………...... 55   

5.5: Gender and its role in sexual experiences ....................................................................... 55 

5.6 Sex Education………………………………………………………………………….... 56  

5.7: Recommendations ………….……………………………………………...................... 58   

5.8: Areas for Further Research.............................................................................................. 60   

5.9: Conclusion……………………………………………………………………………… 61 

REFERENCES...................................................................................................................... 62   

APPENDICES ...................................................................................................................... 68 

Appendix A: Participant Information Sheet and Consent Form: Focus Group………..…… 68 

Appendix B: Focus Group Questions………………………………………………………. 72 

Appendix C Survey Questions…………………………………………………………….... 74 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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Declaration  

 

I declare that this research report is my own unaided work. It is being submitted for the 

degree Masters of Arts in the Faculty of Humanities (Development Studies) at the University 

of the Witwatersrand, Johannesburg. It has not been previously submitted for any degree or 

examination at any other university.  

 

Name: Victoria John (971068)  

Signature:  

 

Date: 21 March 2021 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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Abstract 

This research explores the attitudes to and use of lubrication during heterosexual sex by Wits 

University students in Johannesburg in the context of Sexual and Reproductive Health and 

Rights (SRHR) organisations and researchers finding that wetter sex is safer sex. Coupled 

with lubrication, sex is made safer for three reasons: it reduces condom usage failure, reduces 

the chance of vaginal lesions and increases pleasure. 

But introducing the topic of lubrication seems a concept out of reach for many education and 

public health sites in South Africa. The Abstain, Be Faithful, Condomise (ABC) approach to 

safe sex has been employed for decades at sites of formal sex education and shifts from its 

largely conservative positions are not always welcome: the introduction of the 

Comprehensive Sexualities Education (CSE) syllabus into sex education at schools triggered 

hostilities among parents and school bodies across the country. The ABC approach has been 

called into question, however, by research showing that denying all-gendered pleasure – 

including lubrication’s role - a place at the table of these discussions results in missed 

opportunities to affect behavioural change and safer sex.  

Much research has been done on the biomedical benefits of introducing lubrication during 

sex. Lubrication enhances the environment for successful condom use and safer sex: enough 

wetness to reduce the chance of friction that can cause condom failure as well as lesions in 

the vagina both of which increase the risk of exposure to STIs. But speaking about lubrication 

cannot take place without speaking about sexual pleasure for both men and women because 

wetness during sex is a result of sexual arousal by men, and women in particular.  

The first step in understanding how resistant South Africans would be to the policy of using 

lubrication with condoms, however, would be establishing what exactly their understanding, 

and experience, is of lubrication, pleasure and pain. 

An anonymous survey invited students to answer questions about why and how they 

understand sex, pleasure, communication with their partner/s and their experience of sex 

education. They were asked about the mechanics of sex: their condom use and failure, 

dryness during sex, their reasons for using – or not using – lubrication, pain during sex and its 

opposite experience: pleasure.  

The data showed a prevalence of dryness during sex which respondents said was one of the 

main causes of condom failure. Apart from the risk of exposure to STIs presented by condom 



6 
 

failure, dryness was also one of the main causes of pain during sex. This is significant 

because respondents indicated that the opposite sensation - pleasure - was one of the main 

reasons respondents had sex.  

Despite this, a large proportion of respondents had not used lubrication before and their 

responses indicated poor knowledge of its benefits. This is likely due to, in part, the sex 

education many of them received at schools which did not mention lube or pleasure.  

The data were also analysed according to gender because of the difference in how, 

biologically, men and women experience sex – like who produces natural lubrication - but 

also because of the powerful influence that gendered identities, beliefs and biases have on 

sexual experiences. 

The data revealed that respondents’ experiences of dryness, their perceptions of reasons for 

condom failure, and pain during sex, among other experiences, were different depending on 

their gender. The data showed that men and women perceive and understand sex in different 

ways and, because of social conditioning around this, do not adequately communicate these 

experiences to their partners. This can exacerbate condom failure and pain during sex. 

This research therefore recommends more comprehensive, gender-inclusive, sex education at 

schools and other institutions that explicitly addresses lubrication and its benefits as well as 

pleasure. It also recommends that free lubrication be far more accessible to South Africans. 

This research can reliably be used to inform campaigns by SRHR organisations to encourage 

South Africans to use lubrication to ensure more pleasurable and safer sex. 

 

 

 

 

 

 

 

 

 



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Acknowledgements 

Thank you to my family and friends and, in particular, my mother, for encouraging me 

through this degree.  

Thank you, too, to my supervisor who was as attentive, supportive and insightful as I was 

told he would be. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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Chapter 1: Introduction  

This research proposes to answer the question, ‘What are the attitudes to and use of 

lubrication during penetrative, heterosexual vaginal sex by Wits University students? 

Lubrication is any substance that reduces friction between two moving parts. During 

penetrative vaginal sex, lubrication (lube) can either refer to the vaginal and penile fluids 

produced naturally during female and male arousal or introduced lube which can either refer 

to other bodily fluids such as saliva or processed or synthetic lube in the form of a water-

based or silicone-based gel. Other forms of lube that are used are water, body lotion, baby oil, 

olive oil, margarine and butter yet most of these are deemed unsafe by Sexual and 

Reproductive Health and Rights (SRHR) organisations. Introduced lube can be used in the 

absence of, or to supplement naturally-produced lubricating fluids and aims to facilitate 

smoother, pain-free, penetrative sex, either vaginally or anally, with or without condoms. Not 

only can it reduce pain but it can also increase sexual pleasure for both men and women 

although this view remains contested (see below about attitudes to vaginal lube in Sub-

Saharan Africa). 

South Africa is the site of the world’s biggest HIV epidemic (UNAIDS, n.d.) and condoms 

are the most effective barrier to HIV and sexually transmitted infections (STIs) (Stanton et 

al., 2009). Yet condom failure such as tearing or slipping (Simbayi & Kalichman, 2007) and 

non-use (Shisana, Rehle, Simbayi, Zuma, Jooste, Zungu, Labadarios, Onoya et al, 2014) is 

unsustainably high and one of the causes of these is condoms becoming dry during sex 

(UNAIDS, WHO, UNFPA, 2015). This can occur, despite condoms being packaged in lube, 

when natural lubrication as a result of arousal is insufficient.  

These realities have led several major SRHR organisations such as UNAIDS and the World 

Health Organisation to adopt policy that condoms should be used with additional lube for 

safer sex.  

But the question of how a policy like this would translate in a country like South Africa 

merits exploring. Conservative religious and cultural beliefs limit free discussion about sex 

(Agha, Kusanthan, Longfield, Hattori, & Berman, 2002), much less about the topic of lube. 

Despite this, and the lack of public awareness campaigns addressing lube specifically, let 

alone research about the use of lube by South Africans, the South African Department of 

Health procured 60 million sachets of lube for public use between 2015 and 2018 (South 

African Department of Health, 2015). This is compared to the three billion male condoms and 



9 
 

54 million female condoms procured in the same period. For every sachet procured, 

approximately 51 condoms are procured which stands as an indication of government’s 

priorities. 

This proposal now describes the research site, an overview of the literature as well as an 

explanation of the methodology to be employed. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



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Chapter 2: Literature Review 

 

2.1 Introduction 

This literature review focuses on five themes relevant to attitudes to and use of lube. 

The first theme covers attitudes to vaginal lube and types of sex that people in Sub-Saharan 

Africa are having and how lube features in this. The second theme is gender and how the 

power dynamic present in heterosexual relationships impacts attitudes to female autonomy, 

female sexual pleasure, and natural and introduced lubes. The third theme is a biomedical 

overview of how exactly lube affects condoms. The fourth theme covers the public responses 

to HIV and to what extent the use of lube is a consideration in the development of public 

health policy by government and civil society. The last theme is about sexual pleasure, how 

lube can enhance this, what place pleasure holds in sex education and public health 

messaging, and how this is important for global strategies around HIV prevention. 

 

2.2 Attitudes to natural, vaginal lube in Sub-Saharan Africa 

Understanding attitudes to introduced lube requires first understanding attitudes to natural, 

vaginal lube and the sexual practices these trigger. Norms around vaginal lube are rooted in 

various “sociocultural ideas about sexuality and the body… access to education and health 

information; geographic area within a country; ethnic group; rural versus urban setting...” 

(Braunstein & Wijgert, 2005, p. 18) among others. For the study’s South African participants, 

a common norm was the association of excessive lube with “a loose vagina, which reduces 

men’s sexual satisfaction” (p. 47). In Kwa-Zulu-Natal, Preston-Whyte found that young girls 

were advised by peers that “too much wetness” is not only disliked by men “but may be taken 

as a sign that the woman has been having sex with another partner” and “is also often 

associated with the use of contraceptives” (1994, p. 250). Vaginal lube therefore “takes on 

the mantle of all that is regarded as bad in a female sexual partner: lack of fidelity and a wish 

to prevent conception” (p. 250), which stands in contrast to ideals of femininity in that 

context. Such attitudes have contributed to the practice of ‘dry sex.’  

The practice has been reported in South Africa, Malawi, Zambia and Zimbabwe (Mbikusita-

Lewanika et al, 2009) and is “the use of traditional medicines to dry up the vaginal passage 

prior to sexual intercourse” (p. 227 – 228). It is believed this will “heighten sexual pleasure, 



11 
 

especially for the male partner” (p. 228). But excessive vaginal dryness can “foster epithelial 

trauma during coitus, both for the woman and for her partner… which may promote the 

passage of organisms that cause AIDS and other sexually-transmitted diseases” (Brown, 

Ayowa, & Brown, 1993, p. 989).  

Even if intentional drying is not practiced, vaginal dryness can occur due to physiological 

reasons such as inadequate arousal, hormonal changes, age or rough sex. This type of vaginal 

dryness poses similar risks for lesions as the intentional practice of dry sex does. It can also 

compromise the integrity of condoms, which although packaged in lube, can become 

vulnerable to tearing and slipping (UNAIDS, WHO, UNFPA, 2015) and potentially reduce 

sexual pleasure for both partners, but particularly for women. Yet gendered attitudes to 

female sexuality and the dearth of related research compromise meaningful public 

engagement on the benefits of introduced lube for safe sex. Attitudes to female sexuality and 

the implications for safe sex are addressed in the section below. 

 

2.3 Gender, power and attitudes to female sexuality 

This section explores gendered attitudes to female sexual pleasure and natural, vaginal 

lubrication as a result of female arousal. More specifically, it investigates what significance 

female pleasure holds within a heterosexual, sexual relationship and in the context of a 

patriarchal society that values and affirms male experience over female experience (Taylor, 

2015). 

McClelland found that “while women imagined the low end [of sexual satisfaction] to 

include the potential for extremely negative feelings and the potential for pain, men imagined 

the low end to represent the potential for less satisfying sexual outcomes, but they never 

imagined harmful or damaging outcomes for themselves” (as cited in Loofbourow, 2018, 

para. 15).  Taylor’s 2015 research on biopolitical forces on gendered pleasure, describes how 

feminist sexologist doctors Jenifer and Laura Berman noted that “while nerve-sparing 

surgeries for prostate cancer were developed in the 1970s so that men could retain erectile 

function post-surgery, no similar nerve-sparing techniques have been developed for female 

genital operations, reflecting the lower value attributed to female sexual pleasure by the male-

dominated medical establishment” (Taylor, p. 267). As Pettine succinctly puts it: “The social 

prioritization of male pleasure over female pain is demonstrated in the research done on male 

pleasure compared to research done regarding female pain… There are almost five times as 



12 
 

many clinical trials on male sexual pleasure as there are on female sexual pain” (2018, para. 

20 - 21).  

Not only will women place their partner’s sexual pleasure above their own as a result of 

social conditioning rooted in patriarchal ideas about sexuality, but some will also risk their 

health for this, a 2010 study found that the acceptability of microbicides (used to combat HIV 

infection in the form of a gel) by women was dependent on how covertly they could be used 

for fear their use would introduce conflict in their relationship and affect their partner’s 

pleasure (Hoffman et al., 2010).  

What this means is an environment that appears to allocate little space for women’s sexual 

comfort, let alone pleasure and lube. Although we do not know the extent these views are 

held in different communities, including among Wits university students, it is clear that 

addressing a lack of natural lube is likely to be difficult and raising the topic of introduced 

lube even more so. In relationships that are intergenerational or transactional – relatively 

common among university students - male privilege and power is amplified which 

consequently affords even less space to talk about female pleasure and lube. Yet the necessity 

to consider lube’s place not only in female sexuality but in female and male health is 

significant and more research is needed on this subject as the section below will explore. 

 

2.4 Lube and condoms 

Given condoms’ status as, relatively, the most effective barrier against STIs (Stanton et al., 

2009), it is necessary to talk about the barriers to using them in the first place, as well as 

causes of their failure. This section provides a biomedical overview of SRHR organisations’ 

positions on introduced lube and their relationship to condoms. 

HIV is transmitted through exposure of mucous membranes, or bloodstreams, to infected 

bodily fluids. Condoms can protect against this exposure and their efficacy is measured by 

their physical integrity during use as well as challenges for choosing to use them in the first 

place. Condoms can tear or slip off for a variety of reasons. These include incorrect use such 

as applying them incorrectly or using the wrong size, dry sex, and using lube that is not 

compatible with the material of the specific condom being used (UNAIDS, WHO, UNFPA, 

2015). One of the main causes for non-use is discomfort for men and women (Pool et al., 

2000). Philpott, Knerr, & Boydell assert, however, that “water-based lube can make sex feel 

wetter and better, prevent condom breakage during dry or rough sex and enhance safety” 



13 
 

(2006, p. 24). If lube can make sex with a condom feel better and if condoms are a safer and 

more reliable prophylaxis to STIs, this should be an important component of condom 

education and safe sex campaigns. As Higgins and Fennell (2013) state, condoms are “a 

relational technology—one that affects both people in the sexual experience” and “to ignore 

these aspects of condoms and pleasure would lead not only to sub-par science, but a missed 

opportunity to increase global condom acceptability and improve global health” (p.3). 

This research has prompted SRHR organizations to develop new policy in support of the use 

of lube. The UNAIDS, WHO, UNFPA position statements, outline that “condom 

programmes should ensure that condoms and lubricants are widely available” (2015, para. 

18) because lube minimizes “condom usage failure, especially for anal sex, vaginal dryness 

and in the context of sex work” (para. 14). Yet, much more comprehensive research on lube 

is necessary in order to meaningfully contribute to the debate on condom efficacy.  

 

2.5 Condoms and lube and the response to HIV 

Establishing what supports or compromises condom efficacy, can improve responses to STIs 

and more people practicing safe sex. This section covers HIV statistics and positions of 

condoms and lube in safe sex and HIV research. 

In South Africa, HIV is mainly spread through heterosexual sex (Aids Foundation South 

Africa, n.d.) and according to UNAIDS, there were approximately seven million people 

living with HIV in South Africa in 2017 (UNAIDS, n.d.). Public health campaigns in South 

Africa have focused on the ‘ABC’ approach which stands for ‘Abstain, Be Faithful, 

Condomise’ but research by Moodley in 2007 showed that this strategy “did not reflect young 

people's´ behavioural patterns, and therefore was not able to always offer solutions to the 

complexities of their sexual interactions” (p. 13). Some school-based and community-based 

interventions promote abstinence as their response to the disease, therefore negating condom 

use and what supports or compromises their efficacy. Yet there is “high-quality evidence that 

abstinence-only education is ineffective in preventing HIV, incidence of sexually transmitted 

infections and adolescent pregnancy” (Patton et al., 2016). Abstinence is an unreasonable 

programme goal, Barnett and Parkhurst argue, because it is based on “misapprehension as to 

the balance between environmental and contextual factors and individual choices in 

determining why and how people have sex” (2005, p. 590). One of the main reasons people 

have sex is for pleasure yet this fact remains mostly excluded from sex education and public 



14 
 

health campaigns. These reasons compromise the effectiveness of public and community-

initiated campaigns. The contested idea of communicating sex for pleasure will be addressed 

in the next section. 

 

2.6 Sex for pleasure 

This section attempts to establish why, if ‘wetter’, more pleasurable sex is safer sex because 

of lube’s ability to reduce the chance of vaginal lesions and increase condom use and 

efficacy, pleasure remains a taboo topic in sex education (Philpott et al., 2006). The ideal 

environment for successful condom use is a lubricated one because of arousal or introducing 

lubrication. 

As mentioned previously, ABC messaging continues to dominate South African public health 

discourse because of conservative attitudes to sex which are rooted in religious and cultural 

beliefs around sexuality, family and gender (Agha et al, 2002). This is despite the South 

African government adopting a Comprehensive Sexualities Education (CSE) approach two 

decades ago that covers both abstinence and safe sex practices but incorporates sex-positivity 

(Panday, 2009). In a context that promotes abstinence as the solution to avoiding HIV 

infection, therefore negating condom use, engaging meaningfully about the safer sex benefits 

of using condoms with lube for safe sex is a step too far for many South Africans. This is 

made even more difficult by the reported apprehension around talking about lube’s role in 

sexual pleasure (Philpott et al., 2006).  

 

School-based sex education programmes are a powerful site for delivering sexual health 

content yet these programmes are also limited by their failure to address the full sexual health 

experience, including pleasure (Blake, 2016). Blake’s research participants indicated that the 

topic was missing from the sexual health education they had received at school.  

 

…the message that sex is pleasurable for men was implied, but that female 

pleasure was mostly absent. Their [sex education] only covered the negative 

consequences of sex, with no mention of positive elements, leaving a gap in the 

curriculum regarding why people would have sex, if not for procreation (2016, 

p. 66) 

 



15 
 

Life Orientation teachers are the main disseminators of sex education in South African 

schools yet it is their attitudes to sexuality that present barriers to including pleasure in these 

sessions (Francis & DePalma, 2013). 

 

One process evaluation of teacher training for an HIV prevention programme 

found teachers to be anxious about safe sex lessons, which several felt went 

against their personal values. One teacher skipped the condom demonstration, 

citing religious beliefs that prohibited him from teaching about condoms. 

Some feared the loss of respect of students who may consider them as 

condoning sexual activity among youth by communicating that there is a safe 

way to have sex (p. 83) 

 

Michelle Fine’s 1988 research “examines the desires, fears, and fantasies which give 

structure and shape to silences and voices concerning sex education and school-based health 

clinics” (p.30) in New York City in the United States. She says adolescents’ sexual health, 

and in particular that of girls from low-income groups, is compromised by three prevailing 

discourses of female adolescent sexuality: sexuality as individual morality, sexuality as 

violence and sexuality as victimisation. The latter has a large following, she says and is based 

on the concept that female sexuality “is represented as a moment of victimization in which 

the dangers of heterosexuality for adolescent women… are prominent” (p. 31). “While sex 

may not be depicted as inherently violent, young women… learn of their vulnerability to 

potential male predators” (p. 31) and “to avoid being victimized, females learn to defend 

themselves against disease, pregnancy, and "being used." (p. 32). 

These concepts hold a comfortable place in South African sites of sex education in which 

children and teenagers continue to be denied the information they need to make informed and 

responsible decisions about sex. The fact that gender-based violence is so prevalent further 

bolsters the framing of sex as an act of violence done to women. 

The South African Basic Education Department’s CSE through Life Orientation classes, 

“which gives learners a greater understanding of their health and human rights, and the 

essential health services to which they are entitled” (Chaskalson et al, 2019, para. 20) has 

been in effect since 2000 yet prevailing conservative religious and cultural beliefs have 

precluded the full dissemination of all its content at many sites by many educational 



16 
 

institutions. Not only this but the announcement in 2019 of its expansion to younger grades 

triggered the establishment of a passionate anti-CSE lobby whose actions included multiple 

marches against the policy in major centres. In a climate like this, it is very easy for 

discourses of sexuality as victimisation, for example, to continue to flourish and the space to 

speak openly about pleasure and lubrication in a gender-inclusive recedes.  

But not speaking about desire has dire consequences, Fine says. She concludes that “the 

absence of a discourse of desire, combined with the lack of analysis of the language of 

victimization, may actually retard the development of sexual subjectivity and responsibility in 

students” (p. 49).  

 

Those most "at risk" of victimization through pregnancy, disease, violence, or 

harassment — all female students, low-income females in particular, and non-

heterosexual males — are those most likely to be victimized by the absence of critical 

conversation in public schools.... it is important to understand that by providing 

education, counselling, contraception, and abortion referrals, as well as meaningful 

educational and vocational opportunities, public schools could play an essential role 

in the construction of the female subject — social and sexual. And by not providing 

such an educational context, public schools contribute to the rendering of 

substantially different outcomes for male and female students, and for male and 

female dropouts (Fine, 1986, p. 50) 

 

The discourses around sex that form the foundation of Fine’s research are major contributors 

to low levels of understanding about HIV transmission and high levels of violence in South 

Africa. As Chaskalson et al say, the actions of violent criminals “point not just to the crimes 

of an individual, but to the workings of a society in which sexual violence and assault are not 

aberrant, but normative” (2019, para 8) 

 

2. 7 Conclusion 

This literature review provided context on attitudes to female sexuality, how condoms 

interact with lubrication, sexual pleasure and how the intersection of these three concepts are 

significant for the prevention of STIs. 



17 
 

The practice of dry sex is one example provided in the literature review that demonstrates a 

rejection of women’s response to sexual pleasure: the production of arousal fluids or, simply, 

wetness. This review also referred to research that showed the extent to which men’s 

pleasure, through examples of nerve-sparing surgeries available to men and what constituted 

‘bad’ sex for men compared to women, is prioritised over women’s pain. Through an 

unpacking of gender, power and attitudes to female sexuality it became clear that there is 

little space to talk about women’s pleasure and speaking about natural and introduced 

lubrication, therefore, is likely to be difficult. 

But denying female sexuality, pleasure and lubrication would result in a missed opportunity 

for encouraging the use of condoms, this review found, and promoting safe sex. SRHR state 

that using lube reduces condom failure as well as vaginal lesions caused by dryness during 

sex. Lube reduces friction which can cause pain, and therefore also makes sex with a condom 

more pleasurable. This is significant because condoms are the most effective barrier to STIs 

but their non-use is often as a result of users saying they reduce sexual pleasure. Vaginal 

lesions can also become entryways to pathogens. In the country with the highest HIV 

incidence in the world, this knowledge is critically important. 

If lube can make sex with a condom feel more pleasurable and if condoms are a safer and 

more reliable prophylaxis to STIs, this should be an important component of condom 

education and safe sex campaigns. South Africa’s sex education sites have, however, adopted 

the ABC approach to sex education, which negates condom use and does not address sexual 

pleasure. Shifting this approach, such as through the recent adoption of CSE, has proved 

difficult in a country of conservative religious and cultural beliefs. 

This review demonstrates there is need for more research on attitudes to and use of lube and 

what role this plays in the response to STIs but also on the environment in which these 

features of sex, pleasure and gender are understood.  

The following section will describe the methods that were employed in conducting this 

research. 

 

 

 



18 
 

Chapter 3: Methodology 

 

3.1 Introduction 

To be able to answer the question of attitudes to and use of lube by Wits University, 

heterosexual, students, the research used mixed, reactive methods with qualitative and 

quantitative components. There were two main, linked, parts to the research. The first was 

focus groups and the other was a survey. 

I chose Wits University students because they fall into the age group most vulnerable to new 

HIV infections (South African National Aids Council, 2017) and because of my proximity to 

them being a student there myself. I conducted two focus groups which represented the 

purely qualitative component of my research. These focus groups informed the design of a 

survey which I conducted among 1361 students. This was the number of respondents who 

responded to all the questions in the survey. These, together, generated both quantitative and 

qualitative data.  

 

3.2 Focus Groups 

The language and concepts attached to sexual behaviour and attitudes are constantly and fast-

evolving (Dent, 2018) and to be able to paint a true portrait of attitudes to sexual behaviour 

and lube, the concepts and language of the survey needed to be relevant and accessible to the 

target population. Conducting focus groups before publishing the survey assisted with 

“identifying variables and framing hypotheses for quantitative research”, as Weiss puts it 

(1994, p. 310). 

A discussion with a smaller group of students enabled me to identify specific attitudes, 

practices and topics that I might not have known about before, as well as establish a useful 

language for these. This helped me exclude outdated and irrelevant content and include 

accessible and clear terminology and language. In sum, the perspectives garnered from the 

focus groups informed the language and direction of the survey and contributed to its 

effectiveness.  

I conducted two focus groups, one for women and the other for men. The gender split was 

necessary to facilitate deeper comfort and more honest feedback among participants. I used a 



19 
 

male assistant to facilitate the male focus group. The focus group for women contained five 

participants and the one for men contained 12. Although I would have preferred the number 

of participants in each group to be more similar, this is how many invitees actually arrived on 

the day. 

The groups were not specifically homogenous nor heterogeneous in terms of race or level of 

study: I included students who have had heterosexual sex, and who are below the age of 25 

therefore falling into the category of people most vulnerable to new HIV infections (South 

African National Aids Council, 2017). I viewed the participants as representing a sample of 

the university students which, in turn, represents a sample of the age group mentioned above. 

The male assistant was a staff member in the department of sociology and extended the 

invitation to participate in the focus groups to his students, letting them know the 

requirements for participation. This is how the sample for the focus groups was drawn. 

A copy of the Focus Group Participant Information Sheet and Consent Form can be found in 

Appendix A. The information sheet assured participants their identities would be protected 

and their contribution would be anonymous. 

The male assistant and I facilitated the two focus groups, respectively, and prompted 

discussion around a list of eight semi-structured questions to allow for the group to stay on 

topic while also allowing sub-topics to emerge naturally. See Appendix B for the list of 

questions.  

Focus groups are valuable in that participants are able to discuss the issue with each other 

which can contribute to a “deeper understanding of the problem” (Bless et al, p. 200) but their 

limitations include participants influencing each other as well as some participants 

dominating the discussion and hampering other participants’ contributions (p. 201). Both 

focus groups seemed to offer participants a comfortable space to share their experiences: 

there was never a lull in the discussion and no prompting was needed b the facilitators to get 

the participants to engage. All five participants in the women’s focus group contributed, 

largely, equally. I could not tell from the audio recording of the men’s focus group, however, 

if the same occurred there. In the women’s focus group, participants seemed to enjoy 

speaking about their experiences and building on each other’s stories offering more detail and 

deeper explanations the longer the group spent together. They asked questions and expressed 

surprise and interest at new learnings.  



20 
 

I recorded the discussion using an audio recorder and interpreted it via thematic analysis. I 

took note of terminology used and any topics or specific attitudes that should be included in 

my survey or, by that same token, to be aware of which of my assumptive questions to 

exclude. 

 

3.4 Survey 

Permission from the university’s registrar’s office was granted to disseminate the survey to 

the whole of the student email database requesting them to participate in an online survey 

about sexual behaviour. Included in the email was a link to the online, anonymous, survey, 

which was hosted by Survey Monkey. The questionnaire contained a list of 52 questions 

seeking to know more about a sample of students’ sexual behaviours and attitudes, 

contraceptive use, understanding of and use of lube, and attitudes to gender in relation to 

sexual behaviour. I designed the list of questions using insights from the focus group and 

existing literature as well as my own professional exposure in the field. This professional 

exposure included work done as a journalist reporting on sexual health and sexual education 

issues as well as working as a partner manager in the youth development and employment 

space. This work involves understanding the work of partners in the public health sector who 

host youth for work experience including the research and experience that influences these 

organisations’ campaigns and training programmes for employees. I asked factual questions 

in the survey with the option to respond in an open-ended way. A pilot study was conducted 

in which I requested a few people to complete the questionnaire to make sure that the 

questions were easy to understand and respond to. 

The main advantage of this type of quantitative research is that “a large coverage of the 

population can be realised with little time or cost” (Bless, Higson-Smith, Sithole, p. 199). 

However, it was important to be prepared for a low response rate to these ‘mailed’ 

questionnaires of around 20 – 40% (p. 199) which compromises the representative of the 

sample. Additionally, “identity of the actual respondent is not ensured” (p. 200). I aimed for 

300 students to complete the survey as I believed this to be an adequate sample size which 

would allow my data to be generalised to the whole student population (Bless et al, p. 164) 

while ensuring my research remains logistically practical. Many more than this amount 

actually responded. 



21 
 

The survey link was distributed to the whole of the Wits student body - 38 960 students - on 

17 August 2020. It is not possible to know how many students who received the email would 

have met the criteria to respond to the survey (have had heterosexual, penetrative sex before) 

but 2612 students responded to the first question. Of those, 2285 confirmed that they met the 

criteria to participate. For the very next question, there were 2237 respondents. Many 

respondents left the survey, as it progressed, but for the majority of questions, there were over 

1700 respondents. By the final question, there were 1361 respondents.  

A thematic analysis of the data were done and much of them are presented in table or graph 

format.  

Many of the questions allowed respondents to select multiple responses. In these cases, the 

percentages presented are, therefore, the proportion of total respondents who chose a 

particular answer. The percentages cannot, therefore, sum to 100% because the total 

responses are not being divided up amongst the respondents equally. To explain this via an 

analogy: in a room of 100 women, when presented with a certain answer option 20 of those 

women can put their hand up which represents 20% of the women. For another answer 

option, 80 women (80% of the women and some of them the same women) can put their 

hands up again. For a third option, about 50 women (50% of the women) can put their hand 

up. This brings the total percentage to 150%. Another way to present the data would have 

been to establish the proportion of total responses a certain answer option received. This 

would not be as valuable, however, as knowing what proportion of respondents chose certain 

options.  

Results from different questions were compared to allow for deeper analysis. For example, it 

was useful to know if there was a gender bias to the way the population responded or whether 

there was a pattern in the way respondents who selected certain responses around lube also 

responded to questions around pain and dryness. These comparisons were tested for statistical 

significance using the Chi Square test. 

The results and related commentary are contained in the following chapter. 

 

 

 



22 
 

Chapter 4: Results 

4.1 Introduction 

This chapter will report on the findings from the survey sent to Wits students asking them 

about their attitudes to and use of lube.  

This research began with two focus groups which aimed to establish the themes and 

languages around lube which was then used to design the survey. The survey was then 

published on Survey Monkey and distributed to Wits students via email. This was facilitated 

through the Registrar’s office who sent a link to the survey in an email to all 38,960 Wits 

students. There were 2,612 respondents who clicked on the survey link and 2,237 confirmed 

they were Wits students, over 18 years old, and had had heterosexual, penetrative sex – 

thereby confirming their eligibility to participate in the survey (7% of all students contacted, 

though it is not known what the number of students eligible to complete the survey was). The 

number of those initially starting the survey, responding to questions, fell gradually but 

approximately 1,700 respondents answered the majority of questions (65% of those who 

started). There were 1,361 students who fully completed the survey (60% of those who 

started). 

Analysis of the data will begin with a description of the respondents. The data will then be 

analysed according to three topics. Condom failure during sex is the first topic and is 

interrogated according to three types of failure: condoms being taken off during sex because 

they are uncomfortable, condoms coming off and condoms tearing or breaking. Condoms 

being taken off during sex is considered a type of condom failure in this research because 

non-use equates exposure to risk as condoms coming off and condoms tearing do.   

The second topic is the use of introduced lubrication (to be referred to as lube from here on, 

in sticking with the preferred term from the focus groups) which will be analysed according 

to reasons for not using it. The third topic is pain during sex is interrogated by questioning 

reasons for the pain. 

The data will also be analysed considering the respondents’ gender and whether they had 

used lube before. Considering gender is important because the power dynamics inherent in 

heterosexual relationships, where, as was explained in the literature review, men’s comfort 

and pleasure during sex is superior to women’s, could have implications for condom use and 

efficacy, among other sexual experiences. Communication between partners, or lack thereof, 



23 
 

as a result of gender biases, could also have significant implications for these experiences. 

Students’ formal sex education and whether this included mention of lube and pleasure could 

also have implications for their understanding of sex including reasons for condom failure. 

Data will be further analysed by considering how the use of lube affected pain during sex and 

how lube interacted with the use of condoms and condom failure. This is important because 

dryness during sex can affect condom integrity and lube could be an antidote for that. 

 

4.2 The Respondents 

The respondents were asked about their age, level of study, university faculty and race. 

Most of the respondents (72%) were under the age of 25 and 28% were older than 25 and 

most of them were undergraduates (65%) compared to postgraduates (34%) which is largely 

representative of the level of study for the whole student body, as reported by Wits in its 

‘Facts and Figures, 2018/2019’ report (Wits, 2019). In 2018, 62.97% of students were 

enrolled as undergraduates and 34,84% as postgraduates and around 2% were ‘occasional’ 

students and their undergraduate or post-graduate status is not provided (Wits, 2019). 

There are five faculties at Wits University. Most respondents were in the Humanities faculty 

(27%) followed by Commerce, Law and Management (21%) and then Engineering and the 

Built Environment (19%), see Table 2. These numbers largely correspond with the numbers 

in the university’s ‘Facts and Figures, 2018/2019’ report. 

 

Table 2: Response to Question 4 ‘Which faculty are you part of?’ 

n = 2,237     

 Responses Wits’ Facts and Figures, 

2018/2019’ report 

Humanities 605 27.05% 25.71% 

Science 354 15.82% 13.48% 

Commerce, Law and 

Management 

460 20.56% 24.44% 

Health Sciences 361 16.14% 16.44% 



24 
 

Engineering and the Built 

Environments 

415 18.55% 19.93% 

I don’t want to say 42 1.88% - 

Total Respondents 2,237 100% 100% 

 

Fifty-eight percent of respondents identified as female, 40% identified as male, 1% identified 

as non-binary, and under one percent as other. There are slight differences between this 

representation and that in the university’s ‘Facts and Figures, 2018/2019’ report which found 

that 55% of students were female, 45% were male and under 1% were “undisclosed gender”. 

Almost 60% of respondents identified as Black African, 23% were white, 9% were Indian 

and 4% were Coloured, see Table 3. There were differences here, too, compared to the 

figures in the university’s ‘Facts and Figures, 2018/2019’ report. The report found that 56% 

of students were Black African, 16% were White, 12% were Indian and 4% were Coloured. It 

is worth noting, however, that the report also considers “International” students which 

constituted 9% of the student population. There were 73 respondents who said they did not 

want to say what their race is. 

 

Table 3: Response to Question 6, ‘What race do you identify as?’ 

n = 2,237     

 Responses Wits’ Facts and Figures, 

2018/2019’ report 

Black African 1,307 58.42% 58.55%  

White 510 22.80% 16.33% 

Indian 211 9.43% 11.70% 

Coloured 100 4.47% 3.93% 

I don’t want to say 73 3.26% - 

Other (please specify) 24 1.07% - 

Chinese 12 0.54% 0.39% 

Total Respondents 2,237 100% - 

 

 



25 
 

4.3 Sexual Frequency, Sex Education and Relationships 

Respondents were asked the frequency with which they have sex, about the sex education 

they’ve received and the nature of their sexual relationships. 

Respondents needed to have had at least one penetrative, heterosexual sex experience in their 

lives to qualify to participate in the survey They were also asked how frequently they had had 

sex in the last 12 months. Most respondents had had sex more than once a week (21%), see 

Table 4. The next biggest group of respondents had had sex once in the last 12 months (17%). 

 

Table 4: Response to Question 13 ‘Approximately how often have you had sex in the last 

12 months?’ 

n = 2,043     

 Responses Percentage of respondents 

who selected this answer 

Once 348 17.03% 

Twice 143 7.00% 

Three times 259 12.68% 

Once a month 188 9.20% 

Twice a month 182 8.91% 

Three times a month 235 11.50% 

Once a week 251 12.29% 

More than once a week 437 21.39% 

Total Respondents 2,043 100% 

 

 

Respondents were asked about the relationship context in which they generally have sex and 

2,043 students responded. Most of them have sex within the context of a monogamous 

relationship (75%) defined in the survey as “only have sex with the person you are in a 

relationship with”. Fourteen percent of respondents have casual sex which is sex outside of a 

committed relationship and/or sex with more than one partner. Eleven percent of respondents 

have sex both with a main partner and with casual partners. 



26 
 

Respondents were also asked about formal sex education, which 60% of the 2,205 

respondents had received, leaving 40% of respondents who had not. Sex education was 

predominantly received at school (96%) and mostly from female sex educators (55%). 

Thirty-six percent of respondents also said they had received this education from both male 

and female sex educators and the balance of 9% of respondents said they had received this 

from male sex educators. Some of the content of this sex education will be interrogated later 

on in this section. 

 

4.4 Condom Failure 

As the literature review explained, condoms hold the status of being the most effective barrier 

against STIs (Stanton et al., 2009), outside of monogamy, if used correctly and are not 

compromised by tearing, for example. It was, therefore, important to interrogate students’ 

experience of using them, in particular the issues of their physical integrity during sex as well 

as challenges to choosing to use them in the first place.  

Before describing the frequency of, and reasons for which, respondents experienced condom 

failure, however, it is useful to first present the findings on condom usage.  

The data showed that of the 1,953 respondents who answered this question, 31% said they 

always use condoms during sex, 26% said they only use them sometimes, 24% said they do 

not use condoms, ever, and 20% said they use them most times.  

The responses were compared according to the relationship context the respondents said they 

generally have sex in, see Table 5.  

Most of the respondents who answered this question have sex within a monogamous 

relationship and one of the main reasons given for not using condoms is that respondents are 

in these committed relationships. What was important to establish, however, is how many 

respondents had generally had casual sex, which is sex outside of a committed relationship 

and/or sex with more than one partner and had not used condoms. The data showed that of 

the 267 respondents who answered the questions around use of condoms, and said they 

generally had casual sex, only half always use condoms (50%). Furthermore, only a quarter 

of the respondents (25%) who said they had generally had casual sex and sex with a main 

partner, said they always use condoms though it is possible they do not use condoms with 

their main partner but do with their causal partner or partners. These findings are alarming 



27 
 

because the chance of STI’s spreading in a population are far higher in the casual sex context 

than in a committed relationship context and, despite South Africa’s HIV epidemic and that 

most students are in the age group that is at highest risk of contracting the disease, condoms 

are not used by a quarter of the total respondents and that another quarter only uses them 

sometimes. Even if most of these experiences are happening in the context of a committed 

relationship, STIs can still be introduced from previous relationships and it is not known how 

many of these respondents tested for STIs before deciding to not use condoms in their 

monogamous relationships. 

 

Table 5: Response to Question 20 ‘Do you use condoms during sex?’ 

n = 1,953  

 Condom Use 

Relationship 

context  

 

No Sometimes Most 

Times 

Always Total 

Respondents 

Casual sex 

(13.67% of 

respondents to this 

question have 

casual sex) 

 

11 61 62 133 267 

4.12% 

 

22.85% 23.22% 

 

49.81% 100% 

A monogamous 

relationship 

(74.76% of 

respondents to this 

question are in a 

monogamous 

relationship) 

 

434 355 264 407 1,460 

29.73% 24.32% 18.08% 27.88% 100% 

Both with a main 

partner and other 

casual partners 

(11.57% of 

respondents to this 

question have sex 

both with a main 

partner and other 

casual partners) 

26 85 58 57 226 

11.50% 

 

37.61% 

 

25.66% 

 

25.22% 

 

100% 



28 
 

Total Respondents 471 501 384 597 1,953 

 

As has already been mentioned, the most common reason selected by respondents for never 

using condoms, or not using them every time they have sex is because they are in a 

committed relationship and they use other forms of protection (82% and 66%), see Tables 6 

and 7. Another major reason selected by respondents for never using them, or not using them 

every time, was that they are uncomfortable (21% and 17%). Other major reasons selected 

were that they don’t feel natural and that respondents don’t always have a condom with them 

when they want to have sex and that is not going to stop them having sex.  

It is useful, at this point, to be reminded that when analysing the data in cases where 

respondents could select multiple answer choices, the number of responses per answer choice 

were divided by the number of respondents. They were not divided by the number of total 

responses, since respondents could select multiple answers and it is more valuable to know 

how many different respondents selected a certain answer than how many times a certain 

answer was selected as one answer among potentially multiple other answers selected by a 

respondent. 

 

Table 6: ‘Response to Question 21 ‘Why do you never use condoms?’. Respondents 

could select multiple reasons. 

n = 468 

 All 

Responses 

Percentage of respondents 

who selected this answer 

I am in a committed relationship and we use 

another kind of protection 

386 82,47%*                    

They are uncomfortable, cause me or my 

partner pain, sex is better without them 

97 20,72% 

Other 43 9,18% 

My partner/s don’t like them 58 12,39% 

They kill the mood 48 10,25% 

I don’t like the free ones and I don’t want to 

buy them 

11 16,17% 

Total Responses 643 



29 
 

 

*Percentages do not sum to 100% because respondents could select multiple answers 

 

Table 7: Response to Question 22 ‘Why do you not use condoms every time you have 

sex?’. Respondents could select multiple options. 

n = 1,204 

 All 

Responses 

Percentage of respondents 

who selected this answer* 

I am in a committed relationship and we use 

another kind of protection 

789 65,53% 

They are uncomfortable, cause me or my 

partner pain, sex is better without them 

208 17,27% 

Other 128 10,63% 

We don’t always have one with us and that’s 

not going to stop us having sex 

179 14.86% 

They don’t feel natural 187 15,53% 

My partner/s don’t like them 162 13,45% 

They kill the mood 107 8,88% 

I don’t like the free ones and I don’t want to 

buy them 

27 2,24% 

Total Responses 1,787 

*Percentages do not sum to 100% because respondents could select multiple answers 

 

The responses in the ‘Other’ category across both the ‘never’ and ‘not every time’ groups 

required interrogation because of how many there were. Where they matched existing answer 

options, they were reallocated there. There were very few respondents across both groups 

who selected the option of ‘There are no free ones left and I don’t want to buy them’. These 

responses were therefore moved into the ‘Other’ category. There were also very few 

respondents who said they don’t think condoms actually protect against infections so these 

responses they were also moved into the ‘Other’ category. 

In summary, the main reason for not using condoms – apart from being in a monogamous 

relationship - point to discomfort during sex. Respondents who explained the nature of this 

discomfort in the ‘other’ responses described dryness, general pain that sometimes lasted for 

days after having sex, itchiness, rashes and other allergic reactions to condoms. The main 



30 
 

type of discomfort that was reported, however, was caused by dryness as a result of 

insufficient natural lubrication, which seemed to be exacerbated by using condoms.  

The interplay between condom non-use and insufficient lubrication was raised in the 

women’s focus group where one participant said insufficient lubrication was “the reason we 

stopped using condoms… Because he was hurting me... He was not waiting for me to be wet 

enough”. This dryness and pain, as well as the power dynamic between men and women 

sexual partners, was a major theme running through the focus groups as well as the results 

and will be explored further. 

When condoms are used, however, there are three major ways they could fail and these were 

interrogated with survey respondents. They were asked if they had ever taken a condom off 

because it became uncomfortable. They were also asked if condoms had come off during sex 

and if condoms had torn or broken during sex.  

 

4.4.1 Condoms Becoming So Uncomfortable that Respondents Took Them Off 

Of the 1795 respondents who answered the question ‘Has a condom ever become so 

uncomfortable that you took it off?’, 34% answered ‘yes’. For 56% of these respondents, this 

had happened less than three times. This had happened three to five times for 23% of them 

and more than five times for 22% of them.  

The most common reasons selected by respondents for the condom becoming so 

uncomfortable that they took it off were that the vagina became dry (47%) and erection loss 

(25%). The second most selected option, however, was ‘I don’t know’ (28%).  

The cause of this condom failure is explicitly discomfort to the extent that the condom was 

removed from the penis. This is different to the other types of condom failure that are 

interrogated in this report which are caused by the condom either coming off or breaking or 

tearing although all three present the same risk of exposure to STIs. The respondents to the 

question above are, therefore, actually being asked what caused so much discomfort that the 

condom was removed.  

When compared by gender (Table 8) similar proportions of men and women indicated that 

vaginal dryness was one of the major causes of this discomfort. Similar proportions of both 

groups said a reason was because the vagina was dry and the same applied for the reason ‘the 



31 
 

vagina became dry’. The women’s focus groups showed that it was difficult for some women 

to communicate vaginal dryness to their partners so it is possible that women may be 

underreporting this as a perceived reason for condom failure in this survey. The extent of this 

possible underreporting is difficult to establish, however. There may also be another reason 

why men and women seemed to be more aligned in selecting this as a major reason for this 

particular type of condom failure. The nature of deciding to remove the condom, and 

specifically so because of vaginal dryness, might allow for more of a pause during sex and 

greater communication and consensus between partners around the reason for removing the 

condom. 

In contrast, there were discrepancies around two other reasons perceived to be the cause of 

the condom becoming uncomfortable: a statistically significant higher proportion of men than 

women said the condom became so uncomfortable that it was removed because it was a bad 

condom (25% versus 13%, p = 0.0002) and because of erection loss (32% versus 19%, p = 

0.0004) 

 

Table 8: Response to Question 23, ‘Why do you think this happened?’ (condom 

becoming so uncomfortable that respondents took them off).  

Respondents could select multiple reasons. 

n = 588 (336 female respondents and 252 male respondents) 

 

 It was a 

bad 

condom 

I, or my 

partner, 

didn’t put it 

on correctly 

The 

vagina 

was dry 

The 

vagina 

became 

dry 

I, or my 

partner, lost 

my/his 

erection 

I don’t 

know 

Other* 

Female 

(336) 

44 49 63 165 65 99 21 

13.10% 14.58% 18.75% 49.11% 19.35% 29.46% 6.25% 

Male 

(252) 

63 26 38 110 81 66 18 

25.00% 10.32% 15.08% 43.65% 32.14% 26.19% 7.14% 

Total 

Responses 

per Reason 

107 75 101 275 146 165 39 

*Percentages do not sum to 100% because respondents could select multiple answers 

 



32 
 

These differences in how men and women selected the condom being bad and erection loss as 

reasons for removing condoms possibly point to inadequate communication by men to their 

partners about what they are experiencing: problems with the condom when they are applying 

it, for example. Not communicating these experiences to their partners could be a result of 

societal expectations of male sexual performance which will be explained below. 

Logically men and women might notice changes to their body before their partners do as they 

are experiencing these first-hand. It would make sense then that men would feel erection loss 

occurring more easily than women would notice it. Apart from possibly not communicating 

this erection loss as it happens in the moment to their female partners, men may, furthermore, 

actually be hiding it from their partners in response to the previously mentioned societal 

expectations that men need to be ever ready to perform sexually. Men might hide erection 

loss to avoid “being stigmatised, feeling shame and experiencing guilt” (Peate, 2012, p.1) 

which would make it difficult for their partners to identify this as the reason for this condom 

failure.  

This reasoning could also be supported by men blaming removing condoms on ‘bad’ 

condoms in a significantly greater proportion than women did. If it is assumed that men, 

rather than their female partners, put the condom on it is more likely that men may have 

perceived a possible defect in the condom when handling it and, later, taken it off. But the 

differences in proportions of men and women selecting these last two reasons for taking the 

condom off may be linked in another way: not only do men blame removing the condom on 

the condom being bad but it is possible that men could blame the bad condom for their 

erection loss. Condom use in itself, and particularly an ill-fitting condom, can cause loss of 

sensation or discomfort resulting in erection loss (Graham et al, 2006) and, ultimately, 

removal of the condom during sex. It may also be easier for men, in a climate that reveres 

male virility, to blame a bad condom for erection loss rather than another cause such as 

simply not feeling sexual desire. 

 

4.4.2 Condoms Coming Off During Sex 

There were 1,788 respondents who answered the question ‘Has a condom ever come off 

during sex?’ and 33% percent of them said they had had this experienced before. This had 

happened less than three times for 80% of these respondents and three to five times for 14% 

of respondents. It had happened more than five times for 6% of respondents.  



33 
 

Respondents who had experienced this type of condom failure indicated the most common 

reasons selected for a condom coming off were because the sex was rough (33%), and the 

condom was put on incorrectly (25%). The second most selected answer, however, was - as it 

was for the question on taking the condom off - ‘I don’t know’ which was selected by 30% of 

respondents.  

When compared by gender, a significantly higher proportion of women than men said a 

reason for the condom coming off was because of the vagina becoming dry (11% versus 7%, 

p = 0,0263) and that the condom was put on incorrectly (30% versus 19%, p = 0,0021), see 

Table 9. A significantly higher proportion of men than women attributed this type of failure 

to the condom being ‘bad’ (21% versus 13%, p = 0,0205). 

 

Table 9: Response to Question 28: ‘Why do you think this happened?’ (condoms coming 

off during sex). Respondents could select multiple options 

n = 584 (342 female respondents and 242 male respondents) 

 

 It was a 

bad 

condom 

I, or my 

partner, 

didn’t put it 

on correctly 

The sex 

was 

rough 

The 

vagina 

was dry 

The 

vagina 

became 

dry 

I, or my 

partner, lost 

my/his 

erection 

I don’t 

know 

Other* 

Female 

(342) 

46 102 103 38 76 58 105 13 

13.45% 29.82% 30.12% 11.11% 22.22% 16.96% 30.70% 3.80% 

Male 

(242) 

50 45 82 16 36 50 74 13 

20.66% 18.60% 33.88% 6.61% 14.88% 20.66% 30.58% 5.37% 

Total 

responses 

per Reason 

96 147 185 54 112 108 179 26 

*Percentages do not sum to 100% because respondents could select multiple answers 

 

The differences between men and women’s responses can be approached from three angles: 

body awareness, responsibility for putting the condom on, and communication between 

partners. 



34 
 

Logically, women are more likely to recognize their own vaginas’ dryness, than men are to 

notice their partners’ dryness because women are experiencing this first-hand, in their own 

bodies. Given the nature of a condom coming off - and possibly only discovering it has come 

off some time after the fact - there may not be as much communication, and consensus 

reached, between partners around the reason for this happening as there might be when 

partners decide to remove the condom as described in the previous sub-section. These factors 

could account for men possibly not considering vaginal dryness as a cause of this type of 

condom failure as commonly as women do. 

As already mentioned, a significantly higher proportion of women, compared to men, also 

said a reason for the condom coming off was because the condom was put on incorrectly. If it 

is assumed that men more than their female partners, put the condom on then a reason for this 

discrepancy could be because it is easier for women to assume the condom was put on 

incorrectly and/or assign the blame to men for putting it on incorrectly, than it is for men to 

take responsibility for putting it on incorrectly. This suggestion could also be influenced by 

the pressure on men to present an image of sexual prowess (Shefer, Kruger & Schepers, 

2015) which would be compromised by not handling the condom correctly. This could be 

further supported by how a significantly higher proportion of men than women blamed the 

integrity of the condom selecting ‘It was a bad condom’ as one of the major reasons for this 

condom failure. This latter reason may also, however, point to men knowing a condom was 

ill-fitting and therefore slipped off during sex.  

The discord between reasons selected by men and women point, generally, to inadequate 

communication between sexual partners about their experiences, specifically dryness. This 

was raised in both the women’s and men’s focus groups. The women’s focus group 

participants confirmed that beyond just noticing dryness, women felt talking about vaginal 

dryness to their partners would not be received well by some of them. One participant said: 

“You don’t want to ruin the mood by asking for lube in the middle of sex… you don’t want 

to pause”. One male participant even recognized the discomfort of women to raise the issue 

of vaginal dryness: “Sometimes you will see a girl is uncomfortable because she's dry but 

won't say anything”, he said.  

 

4.4.3 Condoms Tearing or Breaking During Sex 



35 
 

There were 1,779 respondent who answered the question ‘Has a condom ever torn or broken 

during sex?’. Thirty-six percent of the respondents had experienced this type of condom 

failure but this had, mostly, happened less than three times (78%). It had happened three to 

five times for 14% of them and more than five times for 8% of them. 

Respondents indicated that the most common reasons for a condom tearing or breaking were 

because the sex was rough (46%), it was a bad condom (36%) and because the vagina 

became dry (28%).  

When compared by gender (Table 10) men and women seemed to be more aligned over the 

major reasons for this type of failure compared to the other types of condom failure analysed 

in previous subsections. The exception was the option for ‘it was a bad condom’ where there 

was a notable discrepancy. This reason was selected by significantly more men than women 

(44% versus 30%, p = 0,0004). As suggested when commenting on other types of condom 

failure and the reason for men selecting this answer option more than women did, this could 

be because, if it is assumed that men rather than their female partners are applying the 

condom, men would be more likely to have noticed that it was ill-fitting but proceeded with 

sex anyway. 

Men might also, however, find it is easier to assign some of the blame for condom failure on 

the condom being bad than it is to assign it to other reasons such as putting it on incorrectly 

or their partners’ vaginal dryness. This could be because they find it more difficult to admit to 

their possible role in making a mistake during sex or not arousing their partner enough to 

ensure continued wetness as these would both call their sexual prowess into question. This 

was supported by a comment by a participant in the women’s focus group who said asking a 

partner if they could introduce lube during sex might be seen “as a threat to their [men’s] 

sexual prowess… ability to make a woman wet”. 

 

Table 10: Response to Question 31 ‘Why do you think this happened?’ (condoms 

tearing or breaking during sex). Respondents could select multiple reasons.  

n = 620 (330 female respondents and 290 male respondents) 

 

 It was a 

bad 

condom 

I, or my 

partner, 

didn’t put it 

on correctly 

The 

sex 

was 

rough 

The 

vagina 

was dry 

The 

vagina 

became 

dry 

I, or my 

partner, lost 

my/his 

erection 

I 

don’t 

know 

Other* 



36 
 

Female 

(330) 

99 82 153 54 98 8 5 17 

30.0% 24.55% 46.36% 16.36% 29.70% 2.4% 1.5% 5.15% 

Male 

(290) 

127 62 128 46 76 8 2 16 

43.79% 21.38% 44.14% 15.86% 26.21% 2.76% 0.68% 5,51% 

Total 

responses 

per 

reason 

226 144 281 100 174 16 7 33 

*Percentages do not sum to 100% because respondents could select multiple answers 

 

4.4.4 Dryness as a Major Reason for Condom Failure 

Drawing on the three previous sub-sections, it is evident that the vagina becoming dry was a 

major influence on condom failure. It was the main cause of two types of condom failure as 

selected by both men and women: condoms becoming so uncomfortable that they were taken 

off and condoms tearing or breaking. For the third type of condom failure – condoms coming 

off – the vagina becoming dry was one of the main reasons selected by women.  

These findings about condom failure and how dryness during sex is a major cause of this are 

also supported by the results around unintentional dry sex and pain during sex which will be 

explored in the following sections. The findings are revealing in itself – and pose further 

questions around the cause of this dryness and how it is being communicated between sexual 

partners as well as in a sex education setting. But the vagina becoming dry also presents an 

option for remedying condom failure: making the vagina wet through the use of introduced 

lubrication. Introducing lubrication could also be a remedy for another major cause of 

condom failure selected by respondents: rough sex. 

 

4.4.5 Inadequate Communication During Sex 

As outlined in previous sections, men and women were mostly aligned around the major 

causes for condom failure -vaginal dryness and rough sex – except in the case of the condom 

coming off during sex where significantly more women pointed to vaginal dryness as a 

reason than men.  



37 
 

Men and women responded differently, however, over other possible causes: applying the 

condom incorrectly and the condom being ‘bad’. The reasons for this, as were previously 

explained, could be related to the fact that men as the usual handlers of the condom noticed 

problems with the condom more easily than women did. It could also be related to the male 

ego, however, and the societal pressure to have sex and perform all sex-related activities with 

sexual prowess.  

The discrepancies in the way men and women selected their answers, regardless of the actual 

answers, point to general, inadequate communication between partners. There could be 

various reasons for this, some of them related to both men and women’s discomfort around 

speaking about dryness as well as expectations for how men and women should behave 

during sex: men with prowess and women prioritizing men’s pleasure over their own, to 

name just two of them. 

Add these discrepancies between how men and women perceive reasons for condom failure 

to the high proportion of respondents saying they did not know why condom failure happened 

and not only is a situation of poor communication between partners presented but poor 

knowledge and understanding around reasons for condom failure, generally, is also evident.  

There could be multiple, concurrent, reasons for condom failure and it is almost impossible to 

determine what the definite causes are but what is significant, however, is that the results 

above show that men and women do at times, perceive the causes of this failure, differently, 

and that this is because of their gender. Importantly, both parties may not be communicating 

their perceptions to their partners for reasons related to their gendered identities and beliefs 

that are created by social experiences. This inadequate communication plus general lack of 

knowledge around the reasons for condom failure poses a threat to safe sex. 

 

4.5 Sex Becoming Dry Unintentionally 

Given this report’s main aim of establishing attitudes to and use of lube, it is valuable to 

interrogate the main reason it is produced: to be used when sex unintentionally becomes dry. 

The differentiation between describing it as such instead of, simply, as ‘dry sex’ is important 

because of the existence of the practice of dry sex which entails making the vagina dry before 

having sex, as was mentioned in the literature review. Respondents were asked if they 



38 
 

participated in this practice of Dry Sex but only 2% of them had so it was decided to not 

interrogate this practice further.  

Further into the survey respondents were asked if the sex had ever become dry for them, 

unintentionally, Table 11. Just under half of the 1,846 respondents who answered the 

question said yes, they had experienced dryness of some frequency, 31% said ‘no’, indicating 

sex was made wet, and comfortable, for them by natural lube and just under a quarter said 

they hadn’t experienced unintentionally dry sex because they already used introduced lube. 

When compared by gender, the answer choices referring to first-hand experiences of wetness 

were, logically, selected by significantly more women and the answer choices referring to a 

partner’s wetness were selected by significantly more men than women.  

 

Table 11: Response to Question 33 ‘Has the sex ever become dry for you 

unintentionally?’ Respondents could select multiple options. 

n = 1,846     

 

 Responses  Percentage of respondents who 

selected this answer* 

Yes, my partner doesn’t get wet 31 1.68%  

Yes, I never get wet 28 1.52% 

Yes, my partner sometimes becomes 

dry during sex 

274 14.84% 

Yes, I sometimes become dry 

during sex 

664 35.97% 

No, my partner always gets wet 343 18.58% 

No, I always get wet 342 18.53% 

No, my partner and I use lubrication 

if sex becomes dry 

418 22.64% 

No, my partner and I always use 

lubrication, no matter what 

102 5.53% 

Total Responses 2,202 

*Percentages do not sum to 100% because respondents could select multiple answers 

 



39 
 

Respondents were asked what they thought the cause of sex becoming dry unintentionally 

was and two main reasons emerged (Table 12). The option, ‘I don’t know why but sometimes 

the sex just becomes dry’, was selected, as one of possible multiple reasons, by half of the 

940 respondents who responded to this question. It was the same percentage for respondents 

who said the sex was going on for too long. This was supported by comments made in the 

men’s focus group where one participant said he had experienced sex becoming dry after he 

and his partner had gone “for many rounds” and his partner became dry to the point of 

bleeding. After he and his partner did some research, “that’s where we found out about 

lubricant”, he said. 

Another reason selected frequently was, ‘the sex started hurting so I became dry’ (25%) and 

‘condoms make it dry’ (17%) was a reason that was also selected frequently by respondents.  

A small percentage (6%) of the respondents said a reason was ‘My partner is doing 

something to make the sex dry’. This reason was selected by mostly women. This group is 

different to the less than 2% of respondents who said they had participated in the practice of 

intentional dry sex because it’s assumed that those having dry sex are going into that 

intentionally whereas the respondents, here, saying their partner did something to make the 

sex dry are perhaps referring to things they did not really agree to or planned for. They could 

also be referring to things their partner did that diminished their arousal and made them, the 

women, dry. 

To summarise, respondents felt that sex had become dry for different reasons on different 

occasions and they did not necessarily know why. It is significant, however, that such a high 

number of respondents had experienced sex becoming dry unintentionally. 

 

Table 12: Response to Question 34 ‘What do you think the cause of this was?’ (sex 

becoming dry unintentionally). Respondents could select multiple options.  

n = 940     

 

 Number of responses Percentage of respondents 

who selected this answer* 

My partner doesn’t enjoy sex 21 2.23% 

My partner/s has a medical 

problem 

20 2.13% 



40 
 

I don’t know why but sometimes 

the sex just becomes dry 

471 50.11% 

I don’t enjoy sex 55 5.85% 

I have a medical problem 40 4.26% 

My partner is doing something to 

make the sex dry 

53 5.64% 

The sex was going on for too long 470 50.00% 

The sex started hurting so I 

became dry 

237 25.21% 

Condoms make it dry  157 16.70% 

Other (please elaborate) 94 10.00% 

Total Responses 1,618  

*Percentages do not sum to 100% because respondents could select multiple answers 

 

 

4.6 Impact of Dryness on Quality of Sex 

When asked if this dryness had an impact on the quality of sex, 66% of the 940 respondents 

to this question said it caused the sex to not be as pleasurable and 55% said it caused the sex 

to be painful (respondents could select multiple answers). A participant in the men’s focus 

group said his partner went to the clinic after discovering an infection where she was told by 

the nurses that sex that became dry could cause vaginal tearing which could become infected. 

Another participant said during the third round of sex “my dick got scratched… I don’t know 

if it was because I was an amateur… I don’t know why these things happened but chances are 

she was dry”. He said this precluded the pair from “going for another round”. In response to 

this story, another participant said, “I think most of us have had that experience”. 

The women’s focus group participants had also experienced this pain with one participant 

saying, “when I’m still getting into the mood, it can be dry when he penetrates and just before 

he finishes it’s really painful”. Another participant said when she is dry it will be sore for one 

to two days after”. 



41 
 

The third most common answer to this question that was selected supported some of the 

findings on condom failure: 22% of respondents said it made the condom uncomfortable and 

21% said this dryness made them feel like they weren’t arousing their partner enough. 

The intersection of dryness, pain and discomfort with condoms, as described in responses to 

the questions above, as well as the section on condom failure, presents fertile conditions for 

condom failure as well as lesions in the vagina. Both of these present increased risk for 

exposure to pathogens such as HIV and other STIs (Brown, Ayowa, & Brown, 1993, p. 989). 

 

4.7 The Use of Introduced Lubrication 

This section will explore experiences of introduced lube as well as the reasons why 

respondents do not use it. Introduced lube will be referred to as ‘lube’ from this point on. 

Respondents were asked if they had used lube before and 59% of the 1,830 respondents said 

they had. The most common reason for doing so is because sex is sometimes dry or becomes 

dry (64%). The other common reasons selected are that it makes sex feel better (54%) and 

they can have sex for longer (31%). 

 

Table 13: Response to Question 40 ‘Why do you use introduced lube?’. Respondents 

could select multiple options.  

n = 1,070    

 Number of responses Percentage of respondents 

who selected this answer* 

Because sex is sometimes dry or 

becomes dry 

682 63.74% 

It makes sex feel better 582 54.39% 

We can have sex for longer 330 30.84% 

It stops the condom from breaking 138 12.90% 

It stops the condom coming off 54 5.05% 

It makes sex safer 89 8.32% 

Other 97 9.07% 

Total Responses 1,972 

*Percentages do not sum to 100% because respondents could select multiple answers 

 



42 
 

Respondents said they only use lube sometimes (31%) or only when sex becomes dry (24%). 

Eighteen percent of respondents said they use it most times they have sex and the same 

percentage said they have only used it once before. 

In terms of the types of commercial lube respondents said they use, a major brand used is 

Durex (67%), although it is not known what type of Durex lube was used, exactly. KY jelly 

(18%) and Lovers+ (14%) were the second most used lubes. The second most used lube that 

is not commercial is saliva which 34% of respondents said they used.  

Forty percent of respondents said they have never used lube before and their reasons for this 

suggest poor education around the function of, and need for, lube as well as what constitutes 

conditions for needing it. 

The most common reason selected by respondents for never using lube is because they say 

they don’t need it (52%). A large proportion of respondents (21%) said they would like to 

start using lube but they don’t know enough about it/are scared/don’t know where to get it 

from. The third most selected reason was ‘I don’t know what it is’ (11%) followed by ‘I feel 

uncomfortable asking for it from health centres (10%). 

 

Table 13: Response to Question 43 ‘Why do you not use introduced lube?’. Respondents 

could select multiple options.  

n = 762    

 Number of responses Percentage of respondents 

who selected this answer* 

I don’t know what it is 87 11.42% 

I don’t need it 397 52.10% 

I don’t know where to get it from 59 7.74% 

I feel uncomfortable asking for it 

from health centres 

75 9.84% 

I can’t afford it 38 4.99% 

My partner doesn’t like it 21 2.76% 

It makes sex too wet 25 3.28% 



43 
 

I don’t think it’s safe for my 

health 

57 7.48% 

I don’t want to talk to my partner 

about it  

22 2.89% 

It makes the condom slip off 10 1.31% 

I would like to start using it but I 

don’t know enough about it/I am 

scared/I don’t know where to get 

it from 

158 20.73% 

Other (please elaborate) 76 9.97%% 

Total Responses 1,025  

*Percentages do not sum to 100% because respondents could select multiple answers 

 

The data around respondents who said they do not use lube because they do not need it 

showed that a large proportion of respondents experienced dryness and pain during sex. This 

will be further analysed in later sub-sections.  

The results around reasons for not using lube point to a lack of knowledge about, and 

understanding of, lube among at least half of the respondents to this question. This suggests 

that accessible information about lube and its benefits are lacking which justifies 

interrogation of one of the biggest sites of sex education, as confirmed by this survey: 

schools, which will be tackled in the following section. 

It also raises questions around another source of information around sexuality: public health 

centres. Ten percent of respondents who said they do not use lube said they were not 

comfortable asking for lube from health centres. This could be because of the presiding 

conservative religious and cultural beliefs that limit free discussion about sex (Agha, 

Kusanthan, Longfield, Hattori, & Berman, 2002) which create a reticence for asking for lube 

at these centres. It could also be because of previous, negative experiences at health centres. 

The tension between South African clinics providing adequate sexual healthcare services and 

“traditionally conservative moral judgments of the community and society” (Hoffman-

Wanderer, Carmody, Chai & Röhrs, 2013, p. 26) has been well documented. This research 

points to nurses harbouring their own conservative attitudes to sexuality as well as a lack of 



44 
 

training around a health promotion approach, even if there is willingness by nurses to provide 

this.  

 

… the majority of South African nurses have had little, if any, training in the 

principles and pragmatics of a health promotion approach. This suggests a knowledge 

translation gap from health policy to nursing practice.” (Hoffman-Wanderer, 

Carmody, Chai & Röhrs, 2013, p. 27) 

 

These gaps in training and knowledge at health centres might have been an influencing factor 

in respondents’ reluctance to approach clinics about lube. The risk this poses of discouraging 

lube use - where using it could encourage safer sex - is concerning. 

 

4.8 Sex Education, Lube and Pleasure 

Sixty percent of respondents had received formal sex education, leaving 40% of respondents 

who said they had not received this education. Of the 60%, respondents had predominantly 

received this education at school (96%) and mostly from female sex educators (55%).  

Sixty-seven percent of respondents said their sex educators had not spoken about lube during 

these educational sessions. This is worrying because of the link between lube, condom 

integrity and safe sex. Condoms depend on lube to maintain their integrity which is indicated, 

at the least, by how they are packaged in lube. One of the most common causes of their 

failure is their becoming dry during sex (UNAIDS, WHO, UNFPA, 2015): a global position 

taken by sexual health organisations and now supported by the findings in this research 

report. The ‘Condom Failure’ section’ above showed that one of the main causes of three 

different types of condom failure was, according to respondents, the vagina becoming dry. If 

the vagina is dry it would, logically, cause the condom to become dry which would either 

cause the people having sex to become so uncomfortable that they take the condom off, or it 

would cause the condom to come off, tear or break. 

If condoms are a fundamental feature of one of the ways of practicing safe sex then education 

around what might cause their failure or, on the other hand, increase their efficacy – such as 



45 
 

ensuring adequate lubrication while using them – should accompany education around 

condoms. 

Sex educators’ failure to educate youth on lube is further concerning given the South African 

Department of Health’s procurement of 60 million sachets of lube for public use between 

2015 and 2018 (South African Department of Health, 2015). Education around the benefits of 

lube use is important if the government is going to be successful when advocating people use 

it. 

Talking about lube cannot take place without talking about pleasure. This is because the 

production of natural lubrication is a response to sexual arousal which is a feature of pleasure. 

As was explained in the literature review, however, it is just as important to acknowledge this 

response as it is to know when this response or lack thereof - is not adequate in providing the 

amount of lube to prevent friction during sex. Preventing friction helps to prevent vaginal 

tearing while using a condom or not using one. It also helps to prevent condom failure. It is 

also important to know that the opposite of pleasure - pain – can cause dryness which was 

described in the reasons given by respondents for why sex became dry. Knowing when other 

lubrication should be introduced to substitute natural lubrication is critical for ensuring safe 

sex.  

Despite research around the intersection of pleasure, lube and safe sex, as described in the 

literature review, 33% of respondents to the question ‘Did the educator ever talk about sex as 

a pleasurable experience…’ said their sex educators had not spoken about pleasure and 21% 

said they could not remember – implying, perhaps, that pleasure, even if it was spoken about, 

was probably not spoken about a lot. Thirty percent of respondents to this question said their 

educators had spoken about both female and male pleasure. In contrast, only 1% of 

respondents said their educator had spoken about both gender’s pleasure but mostly female 

pleasure compared to 8% of respondents who said their educators has spoken about mostly 

male pleasure. 

This was supported by comments made in the men’s focus group around “gaps in sex ed such 

as around pleasure”. One participant said he “learned mostly about sex from friends and from 

experience… School only teaches about protection, not how to do it [sex] on the daily”. 

Another participant said, “only with experience did we learn about girls’ pleasure… we were 

taught at school to be anti-pleasure but we know women enjoy oral sex”. 



46 
 

These experiences were mirrored by those of the participants in the women’s focus group. 

One participant said she went to a religious school, where the sex education was monitored 

by a rabbi. “Sex is for procreation. There was nothing about pleasure. It was very biological. I 

only really learned about sex when I started having sex”. Another participant said sex 

education at her school “didn’t leave much of an impression… there was so much shame and 

guilt around it [sex]. But ppl are still having the sex!”. A third participant said there was “no 

messaging about pleasure, wetness or lube in communities or in sex education at school”.  

 

As the literature review outlined, condoms, as one aspect of safe sex, are a relational 

technology that affects both people who are having sex and are affected by pleasure, or lack 

thereof. Ignoring this amounts to missed opportunities to ensure effectiveness of campaigns 

for condom use and improvements in global health (Higgins and Fennell, 2013). 

 

 

4.9 Lube and Condom Failure 

Lube use was then analysed alongside results on experiences around condom failure. 

Statistically significant results showed that respondents who had used lube before 

experienced two types of condom failure more than those who had not used lube before.   

Sixty-two percent of respondents who had experienced a condom coming off during sex had 

also used lube before (p = 0,0236). The same percentage of respondents who had experienced 

a condom tearing or breaking had also used lube before (0,0132).  

It is not clear, however, if respondents had started using lube before or after having these 

experiences of condom failure but a possible reason for the correlation between more condom 

failure and the use of lube, could be that respondents had opted to use lube because they did 

not want to experience more condom failure.  

 

4.10 Pain During Sex 

The majority of the 1,782 respondents who answered the question around pain during sex 

said yes, they had experienced pain during sex (73%) and the major reason for this was that 

the sex was dry, which was selected by 48% of respondents. Another major reason was that 

the penis was too big/vagina too small (40%) followed by ‘the sex was too rough’ (35%).  



47 
 

One of the lube’s uses is to reduce ain during sex as a result of dryness. Given the now well-

established picture of dryness experienced during sex among many respondents, the data 

around respondents who said they do not use lube because they do not need it was 

interrogated further to see if they had experienced pain. This showed that a large proportion 

of respondents who said they did not need lube had also experienced dryness and pain during 

sex. Thirty-one percent of these respondents had experienced sex becoming dry for them 

unintentionally and 64% of them had also experienced pain during sex. When answering the 

question about the cause of this pain, of the 64% of the respondents who had experienced 

pain and also said they do not need lube, 39% of them selected ‘the penis was too big or the 

vagina was too small’ as one of possible several reasons for this pain. Twenty-six percent of 

them said the sex was rough and 26% of them said the sex was dry. These are experiences, 

however, that can either be remedied, or at least improved, by using lube.  

When compared by gender, the difference was stark: 90% of women respondents had 

experienced pain compared to just 44% of men (p = < 0.00001). There were substantial 

disparities in the reasons given for this pain, see Table 16: a significantly higher proportion of 

women said it was because the sex was dry/there wasn’t enough foreplay compared to men 

(50.26% versus 42.30%, p = 0,0174). A significantly higher proportion of women also 

pointed toward the penis being too big/vagina too small compared to men (43.69% versus 

28.53%, p = < 0.00001).  

 

Table 16: Response to Question 49 ‘What do you think caused this pain?’  

Respondents could select multiple reasons. 

n = 1,264 

 

 The sex 

was 

dry/there 

wasn’t 

enough 

foreplay 

The 

condom 

made it 

painful 

The penis 

was too 

big/vagina 

too small 

The 

sex 

was too 

rough 

I don’t 

know 

It was 

my 

first/my 

partner’s 

first 

time  

The position 

was 

uncomfortable 

Other 

Female 

(959) 

490 85 421 345 141 33 12 87 

50.26% 8.86% 43.69% 35.97% 14.70% 3.44% 1.25% 9.07% 

Male  132 35 87 95 54 3 9 31 



48 
 

(305) 42.30% 11.48% 28.52% 30.82% 17.70% 0.98% 2.95% 10.16% 

Total 

Responses 

per reason 

522 115 508 440 695 36 21 118 

*Percentages do not sum to 100% because respondents could select multiple answers 

 

Responses in the ‘Other’ category were interrogated because of their volume and moved to 

other categories where appropriate. Two new categories were created in the table due to how 

much these reasons were raised in the ‘Other’ category: ‘It was my first time’ and ‘the 

position was uncomfortable’. The category ‘the sex was dry’ was also amended to be ‘The 

sex was dry/there wasn’t enough foreplay’ to accommodate responses that indicated lack of 

foreplay which imply – or explicitly mention - that not enough natural lubrication was 

produced. 

A far higher proportion of women than men attributed this pain to dryness and lack of 

foreplay. This could be due to the aforementioned socialisation of men to prioritise their 

pleasure over women’s which resulted in men not being expected to consider their partner’s 

comfort as much as their partner considers her own comfort. This socialisation also teaches 

women to prioritise men’s pleasure over their own which could result in them not 

communicating their pain to their male partners. This was commented on in the women’s 

focus group where one participant said, “Men act as if sex is their thing. They don’t care 

about us”. Another said, “I’ve had painful, rushed and rough experiences with foreplay. In 

pop culture, men don’t consider women’s pleasure or comfort”. Women prioritise their 

partners’ pleasure to the detriment of their own comfort but also do so, knowingly, at the risk 

of their own safety. In light of non-use of condoms because of discomfort, research has 

shown that women’s pleasure is dependent on their partner experiencing pleasure and that 

women may decide not to use condoms in the first place knowing it will enhance men’s 

pleasure and therefore their own (Higgins & Fennell, 2013). 

As mentioned, a far higher proportion of women than men also selected the reason ‘The penis 

was too big/vagina too small’. This could be because men might be more likely to experience 

this mismatch of size as pleasure and women might be more likely to experience this as pain 



49 
 

(Braun & Kitzinger, 2001). Men could also associate large penis size with higher sexual 

status and not with a sex-related problem (Lever, Frederick, & Peplau, 2006). 

The very first point made in this section that most respondents had experienced pain during 

sex, and that many of them said this was because the sex was dry, is concerning. Despite this, 

knowledge of the remedy for dryness during sex – lube – seems to be inadequate as shown by 

three of the main reasons selected by respondents who don’t use it: not knowing where to get 

lube, not knowing what it is and wanting to start using it but they ‘don’t know enough about 

it/are scared/don’t know where to get it from’. Another finding that supports this assumption 

around inadequate education is that of the respondents who said they do not use lube because 

they do not need it 31% had experienced sex becoming dry for them unintentionally and 64% 

of them had also experienced pain during sex. Many of these respondents said this was 

because the sex was dry, was too rough or the penis was too big/vagina small yet the main 

function of lube is to make sex wetter and increase glide which would reduce friction and, 

ultimately pain, caused by these very reasons. 

 

 

4.11 Pleasure 

Respondents were asked why they have sex and the reason selected the most times, as one of 

potentially several reasons, was that it felt good (84%). The second answer selected the most 

by respondents was that ‘it brings me closer to my partner’. Other reasons selected by many 

respondents, such as ‘it