Predictors of condom use at last sex in backrooms among men who have sex with men: implications for HIV prevention programs, Mexico, 2007
Background: Backrooms, frequently found in clubs frequented by men who have sex with men (MSM) in Mexico, are a space for immediate, often anonymous and potentially risky sexual encounters. We compare characteristics of men who used a condom at last sexual intercourse in a backroom with those who did not use a condom. Factors explored include attitudes toward sexuality, perceptions of homophobia, condom availability and condom use.
Methods: We recruited 894 men ages 18-50 years in clubs in five Mexican cities: Mexico City, Merida, Mexicali, Veracruz and Tapachula and administered a face to face survey that used a time-location sampling strategy. We used logistic regression analysis to identify variables significantly associated (p<0.05) with condom use at last sex in a backroom.
Results: Of 894 men recruited, 345 (39%) reported having had sex in a backroom and were included in the analysis. Respondents who agreed that men feel proud about having several sexual partners (n=229, 66%), and that MSM hide their attraction to other men to avoid discrimination (n=263, 76%), were less likely to have used condoms in their last sexual intercourse in a backroom (OR=0.532, p<0.05; and OR=0.472, p<0.05, respectively) compared to those who disagreed with these ideas. Respondents who lived in province (n=158, 46%) were less likely to use a condom than those from Mexico City (OR =0.11, p<0.001). Men who showed condoms at the time of interview (n=113, 33%) were more likely to report condom use at last sex in a backroom compared to those who were not carrying condoms (OR=2.86, p<0.05).
Conclusions: Our findings suggest that prevention programs should focus on encouraging MSM to carry condoms with them at all times. Providing access to condoms in clubs with backrooms is essential for those who don’t carry condoms, especially in province. Findings also suggest the implementation of communication campaigns to decrease homophobia.
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