Barriers to Condom use among High Risk Men who have Sex with Men in Uganda: a Qualitative Study
Musinguzi, G.; Bastiaens, H.; Matovu, J.K.B.; Nuwaha, F.; Mujisha, G.; Kiguli, J.; Arinaitwe, J.; Van Geertruyden, J.-P.; Wanyenze, R.K.
Plos one 10(7): E0132297
2015
ISSN/ISBN: 1932-6203 PMID: 26172374 DOI: 10.1371/journal.pone.0132297Document Number: 637775
Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms. However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda. The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years) MSM in 11 districts in Uganda between July and December 2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach. Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption. The findings suggest that several reasons account for lack of condom use among high-risk MSM. The findings are valuable to inform interventions needed to increase condom use among MSM.