Siegler Aaron J, Voux Alex de, Phaswana-Mafuya Nancy, Bekker Linda-Gail, Sullivan Patrick S, Baral Stefan D, Winskell Kate, Kose Zamakayise, Wirtz Andrea L, Stephenson Rob
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
J Int Assoc Provid AIDS Care. 2014 Sep-Oct;13(5):414-23. doi: 10.1177/2325957414535979. Epub 2014 Jun 16.
South African men who have sex with men (MSM) are at increased risk for HIV infection, and male condoms are fundamental to HIV prevention programs. We explored condom use experiences through in-depth interviews with 34 South African MSM from Cape Town and Port Elizabeth. For data analysis, we generated a codebook and used the constant comparison method. Condom use reinforcing elements included use of alternative sexual strategies, having a high level of self-worth that was linked to protective behaviors, and use of ready-made condom negotiation scripts. Elements inhibiting condom use included perceiving substantial declines in sexual pleasure/performance, experiences of condom failure (possibly related to petroleum-based lubricant), and being in trusted relationships. Our findings suggest nuanced HIV prevention approaches such as bolstering condom negotiation skills based on successful tactics already in use. Further research is needed to address how to mitigate perceptions and experiences that condoms negatively impact sexual pleasure and performance.
南非男男性行为者（MSM）感染艾滋病毒的风险较高，男用避孕套是艾滋病毒预防计划的基础。我们通过对来自开普敦和伊丽莎白港的34名南非男男性行为者进行深入访谈，探讨了避孕套的使用经历。在数据分析方面，我们编制了一本编码手册，并采用了持续比较法。避孕套使用的强化因素包括采用替代性性行为策略、具有与保护行为相关的高度自我价值感，以及使用现成的避孕套协商脚本。抑制避孕套使用的因素包括感觉到性快感/性表现大幅下降、避孕套失败的经历（可能与石油基润滑剂有关），以及处于信任关系中。我们的研究结果表明，需要采取细致入微的艾滋病毒预防方法，例如基于已有的成功策略加强避孕套协商技巧。需要进一步研究如何减轻人们认为避孕套会对性快感和性表现产生负面影响的观念和经历。
