Objectives Judgements of attractiveness have been shown to influence the character of social interactions. The present study sought to better understand the relationship between perceived attractiveness, perceived sexual health status and condom use intentions in a heterosexual male population.

Setting The study employed an electronic questionnaire to collect all data, during face-to-face sessions.

Participants 51 heterosexual, English-speaking men aged between 18 and 69 years.

Outcome measures Men were asked to rate the attractiveness of 20 women on the basis of facial photographs, to estimate the likelihood that each woman had a sexually transmitted infection (STI) and to indicate their willingness to have sex with or without a condom with each woman.

Results The more attractive a woman was judged to be on average, the more likely participants would be willing to have sex with her (p<0.0001) and the less likely they were to intend to use a condom during sex (p<0.0001). Multivariate analysis revealed that higher condom use intentions towards a particular woman were associated with lower ratings of her attractiveness (p<0.0005), higher ratings of her STI likelihood (p<0.0001), the participant being in an exclusive relationship (p=0.002), having a less satisfactory sex life (p=0.015), lower age (p=0.001), higher number of sexual partners (p=0.001), higher age at first intercourse (p=0.002), higher rates of condomless sex in the last 12 months (p<0.043) and lower confidence in their ability to assess whether or not a woman had an STI (p=0.001). The more attractive a participant judged himself to be, the more he believed that other men like him would engage in condomless sex (p=0.001) and the less likely he was to intend to use a condom himself (p=0.02).

Conclusions Male perceptions of attractiveness influence their condom use intentions; such risk biases could profitably be discussed during sex education sessions and in condom use promotion interventions.