Interpretations of condom use and nonuse among young Norwegian gay men: a qualitative study

[Discourses about condom use and non-use among gay, bisexual men, and other men who have sex with men in two colombian cities.]

OBJECTIVE

The HIV increase cases raises concern worldwide. This phenomenon is related, among other things, to sexual practices where condom use is limited. To achieve the eradication of AIDS, international organizations have been interested in analyzing and understanding the sexual practices of certain population groups, within these men who have sex with other men. In this sense, the objective of this study was to analyze the discourses on the use and non-use of condoms held by a group of gay, bisexual and other men who have sex with men (GBHSH) men from two cities in Colombia.

METHODS

A qualitative study was carried out with data analysis through the iterative process, from the interpretation of the Information, Motivation and Behavioral Skills (IMB) model. The collection of information was carried out between 2020 and 2021 through in-depth interviews, virtually and in person, with a sample of 20 GBHSH from Colombia from the cities of Cali and Medellín.

RESULTS

In the Information component, it was identified that traditional sexual education had a negative impact and was very focused on a cisheterosexual and reproductive perspective. Regarding Motivational, it was highlighted that the majority were oriented towards not using condoms and that perceiving a low risk of contracting an STI was the main motivation for not using condoms. Regarding Behavioral Skills, it was analyzed that distrust towards the sexual partner promoted its use, but the intensification of pleasure, added to the consumption of alcohol and drugs, caused its use to decrease. It was also evidenced that the use of drugs such as PreP or PEP discouraged condom use in relationships.

CONCLUSIONS

The information on condom use revolves around cisheteronormative practices, leaving aside the care related to STIs. The motivation for not using condoms revolves around misinformation, pleasure and trust in the couple, while the motivation for condom use revolves around health care. The behavior regarding the non-use of condoms is related to the previous points, while misinformation and pleasure in non-use predominate.

Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM)

BACKGROUND

Qualitative studies on HIV prevention strategies and methods among men who have sex with men (MSM) allow identify knowledge gaps and improve preventive actions.

OBJECTIVE

To make a thematic synthesis of the scientific productions that use the qualitative methodology in the strategies and methods of HIV prevention area among MSM.

METHODS

We conducted a literature review following the guidelines of the ENTREQ protocol. The analysis included 48 empirical studies published in Portuguese, English and Spanish between 2001 and 2018 available in the Medline, Embase, Scielo, Scopus, Bireme and Web of Science databases.

RESULTS

Where an increased production in the last six years and concentration in northern countries. Seven prevention methods were part of the study, with emphasis on pre-exposure prophylaxis, testing, condoms and behavioral strategies. The main topics discussed were stigma and support and care networks.

CONCLUSION

we notice that an increasing production on prevention in the men who have sex with men segment results from the emergence of multiple preventive methods and strategies and their combined actions beyond the star role of condoms.

Love and HIV serodiscordance in gay men's accounts of life with their regular partners

This paper examines discourse on serodiscordant relationships in interviews with 16 HIV-positive and 3 HIV-negative gay men living in Scotland. Drawing on critiques concerning love, reason and HIV serostatus normativity, this paper supplies a much-needed insight into how gay men in serodiscordant relationships negotiate HIV prevention. Among other matters, some HIV-negative men were said to knowingly request risky sex with their HIV-positive partners as an expression of love. In some situations, the person without HIV claimed a normative serostatus that implied they could 'invest' more in the relationship by offering to have sexual intercourse that may expose them to HIV. Such dynamics expressed devotion on the part of the HIV-negative man, but implied obligation for the HIV-positive man. Based on these and other perspectives we argue for closer attention to gay men's subjectivity in the present circumstances of proliferating biomedical forms of HIV prevention; more thoroughly reflexive public health engagements with gay men's sexual cultures; and a research agenda for gay men that challenges HIV-serostatus normativity.

Does age affect sexual behaviour among gay men in Sydney, Melbourne and Brisbane, Australia?

Concern internationally that young gay men are at increased risk of HIV infection has not been reflected in earlier findings in Australia where younger men have not been found to be at increased likelihood to engage in unprotected anal intercourse with casual partners (UAIC). There has, however, been little attention paid to the issue of age in relation to HIV risk behaviour in Australia in recent years. In 2007, among men who completed Gay Community Periodic Survey questionnaires in Sydney, Melbourne and Brisbane, Australia, younger men were more likely to report being in relatively short-term monogamous relationships than were their older counterparts. They were also less likely to know their own or their partners' HIV serostatus. Men aged less than 25 years reported fewer recent partners and were less likely to report sex with casual male partners in the previous six months (p<0.001). Younger men were also less likely to engage in group sex. Approximately, one-quarter of the sample reported engaging in any UAIC in the previous six months during each year of the survey. Younger men were no less likely to report UAIC overall, but they were somewhat more likely to report taking the receptive position during UAIC. While age is a consideration in the assessment of risk of HIV transmission among gay men, this risk is dependent upon the context in which it occurs: Age mixing may be an important consideration in understanding HIV risk among young gay men.

'Snag bags': adapting condoms to community values in Native American communities

HIV/AIDS researchers working among Native Americans have consistently noted resistance to discussions of sexuality and the distribution of condoms. This resistance is inspired by long held values about shame and public discussions of sexuality. Also, American Indians have been reluctant to welcome public discussions of HIV/AIDS and sexuality from external entities, such as governmental agencies. As a result, Native peoples have some of the lowest documented condom use rates. However, innovations in culturally integrating condoms and safe sex messages into Native cultural ideals are proving beneficial. One such innovation is the snag bag, which incorporates popular Native sexual ideology while working within local ideals of shame to distribute condoms and safe sex materials to sexually active young people and adults. Using snag bags as an example, this research proposes that an effective approach to HIV prevention among Native peoples is not cultural sensitivity but cultural integration. That is, HIV prevention strategies must move beyond the empty promise of merely culturally-sensitizing ideas about disease cause. Instead of simply 'translating' HIV/AIDS programming into Native culture, prevention strategies must be integrated by Native peoples into their own disease theories and contemporary culture.

AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men

This study examines leading explanations for unsafe sex in light of in-depth interviews with 102 high-risk gay and bisexual men in Toronto to see how well they engage with the social circumstances and reasoning processes of men in their sexual relationships. We argue that there is an inadequate fit between some of the leading explanations and the discursive accounts provided by high risk men themselves. Their accounts focus on unsafe sex occurring as a resolution to condom and erectile difficulties, through momentary lapses and trade offs, out of personal turmoil and depression, and as a byproduct of strategies of disclosure and intuiting safety. This study examines, in particular the circumstances and rationales associated with men who identify their practices as "barebacking." We conclude with recommendations for communicating prevention messages to those most at risk based on the self-understandings of gay and bisexual men who most frequently practice unprotected sex.

Reflection and dialogue for HIV prevention among young gay men

Considerable interest has been expressed in young gay men's enhanced vulnerability to HIV-related risk. Relatively little research has, however, been conducted into the circumstances in which risk may be greatest and the strategies young gay men can use to reduce their vulnerability. This paper reports on findings from a recent exploratory in-depth study conducted in Norway. Twenty young gay men participated in repeated dialogic and reflective interviews in which situations of real and potential risk were discussed. Central among the factors enhancing vulnerability were found also to be general social codes such as configurations of 'reciprocity', as well as context-specific factors and individual biographic variables. A mode of intervention is described that seeks to empower young men more fully in sexual communication and negotiation. Such an approach has been operationalized in 'man-to-man dialogues' facilitated by members of the Norwegian Gay Health Committee.