Changes in condom use among homosexual men in San Francisco
Catania, J.A.; Coates, T.J.; Stall, R.; Bye, L.; Kegeles, S.M.; Capell, F.; Henne, J.; McKusick, L.; Morin, S.; Turner, H.
Health Psychology Official Journal of the Division of Health Psychology American Psychological Association 10(3): 190-199
1991
ISSN/ISBN: 0278-6133 PMID: 1879391 DOI: 10.1037/0278-6133.10.3.190Document Number: 316217
2 research studies of changes in condom use among homosexual males in San Francisco for the period 1984-88 are discussed. The 1st study examined attrition and cohort bias effects on self-reported condom use in a longitudinal cohort and multiple sample investigation. An initial baseline sample of 500 self-identified gay men was sampled and interviewed by telephone as the longitudinal cohort, with 3 cross-sectional samples later surveyed for comparison. The frequency of receptive or insertive anal intercourse with and without condoms with primary and secondary sex partners was queried for the 30-day period prior to the survey in both studies. This 1st study found a 4-fold increase in condom use over the period 1984-87 to be neither effected by repeated assessments of the longitudinal cohort, nor respondent attrition. As determinants of condom use in this population for the period 1984-88, the 2nd study examined the influence of formal and informal social support for sex behavior change, being in a mutually monogamous sexual relationships, knowing the primary partner's HIV-antibody status, knowing one's antibody status, and the expected consequences of condom use on one's self-worth, sexual pleasure, health, and perceptions of one's sex partner. Research was based on AIDS Behavioral Research Project data obtained through recruitment in bathhouses and gay bars. 529 predominantly white, while collar, college-educated men of mean age 39 years remained in the study through 1988. While condom use increased by almost 4-fold, these men have been slower to change condom use behavior than respondents in the 1st study. Informal support and knowing one's HIV status are strong predictors of condom use 1 year later. Men always using condoms were found to have more social support from informal sources, more positive expectations of condoms, positive interpersonal and personal consequences, and were more likely to be HIV-positive than occasional or non-users. Programs best suited to effect condom use changes will focus on social support, sexual pleasure, self-worth, and relationship issues. Attention should also be placed upon the erotic/pleasure dimension of using condoms, changing community norms, and factors influencing HIV-negative people to take precautions against HIV infection. Methodological limitations are discussed regarding result reliability and validity, with further research encouraged.