A mixed method analysis of differential reasons for condom use and non-use among gay, bisexual, and other men who have sex with men

被引:1
作者
Lachowsky, Nathan J. [1 ,2 ]
Brennan, David J. [1 ]
Berlin, Graham W. [2 ,3 ]
Souleymanov, Rusty [1 ,4 ]
Georgievski, Georgi [1 ,5 ]
Kesler, Maya [1 ]
机构
[1] Univ Toronto, Factor Inwentash Fac Social Work, Toronto, ON, Canada
[2] Univ Victoria, Sch Publ Hlth & Social Policy, 3800 Finnerty Rd, Victoria, BC V8W 2Y2, Canada
[3] Ryerson Univ, Dept Psychol, Toronto, ON, Canada
[4] Univ Manitoba, Fac Social Work, Winnipeg, MB, Canada
[5] Sinai Hlth, Bridgepoint Act Healthcare, Toronto, ON, Canada
关键词
Condom use; health promotion; HIV; AIDS; men who have sex with men; sexually transmitted infections; HIV PREVENTION; PREEXPOSURE PROPHYLAXIS; YOUNG MEN; SOCIAL ANXIETY; RISK-FACTOR; INTERNET; INTERCOURSE; MSM; ACCEPTABILITY; BEHAVIOR;
D O I
10.3138/cjhs.2020-0002
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
We sought to examine how condom use was differentially reasoned by gay, bisexual and other men who have sex with other men (GBM) in Ontario, Canada. Data were derived from a community-based study of GBM who completed an anonymous online questionnaire in 2014. Participants qualitatively described reasons a condom was used or not at their most recent anal sex event. Qualitative responses were thematically coded non-exclusively and associations with event-level and individual-level factors were determined quantitatively using manual backward stepwise multivariable logistic regression. Among 1,830 participants, 1,460 (79.8%) reported a recent anal sex event, during which 884 (60.6%) used condoms. Reasons for condom use included protection/safety (82.4%), norms (30.5%), and combination prevention (6.2%). Reasons for non-use were intentional (43.1%), trust (27.6%), unintentional (25.7%), and other strategies (19.6%). Event-level substance use was associated with all non-use reasons: e.g., more likely to be unintentional, less likely to be trust. Condom non-use with online-met partners was associated with more intentional and unintentional reasons and less trust reasons. Non-white and bisexual GBM were less likely to explain condom use as a norm. Participant-partner HIV status was an important predictor across most condom use and non-use reasons: e.g., sero-different partnerships were more likely to reason condom use as combination prevention and condom non-use as trust, unknown status partnerships were more likely to reason non-use as unintentional. Condom use among GBM is a multi-faceted practice, especially with increasing antiretroviral-based HIV prevention. Future interventions must adapt to changing GBM (sub-)cultures with targeted, differentiated, culturally-appropriate, and sustained interventions.
引用
收藏
页码:65 / 77
页数:13
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