Trust and condom use during last anal sex: the role of sexual caution and sexual assurances for Mexican MSM

Published: August 1, 2008

Trust and condom use during last anal sex: the role of sexual caution and sexual assurances for Mexican MSM

Background: According to CENSIDA (2007), 27% of men who have sex with men (MSM) report not using condoms with casual partners in Mexico, despite the high prevalence of HIV (13%) in this group. International studies have identified caution (feeling vulnerable) and sexual assurances (behavioral expectations) as two components of trust associated with protective sexual behaviors (Klein, Megan and Coombes 2005). We tested the applicability of these findings among Mexican MSM and applied them to the development of communication messages.

Methods: In 2007, PSI/Mexico conducted a behavioral survey with MSM aged 18-50 in five cities: Distrito Federal, Mexicali, Merida, Tapachula and Veracruz (N=890). The questionnaire addressed caution and sexual assurances, as well as socio-demographic, behavioral and attitudinal characteristics. Factor analysis was used to construct a trust index. Logistic regression was used to test the predictive nature of the trust index for condom use at last anal sex.

Results: Three items measuring caution and four items measuring sexual assurances formed a reliable index of trust (Chronbach’s alpha=0.77). Logistic regression shows that men who disagree with trust ideas have almost twice the odds of having used condoms at last sex with a man (OR=1.96; p<0.001). Other predictors of condom use were: Declaring to carry condoms all the time (OR=2.17; p<0.001), having more than 4 sexual partners in the previous year (OR=2.8; p<0.001); feeling at high risk for HIV (OR=0.44; p<0.001); agreeing with the idea of having unprotected sex if condoms are not available (OR= 2.75; p<0.001); having more than high school attendance (OR=1.66; p<0.05); and having STI in the previous year (OR=0.53; p<0.05).

Conclusions: Based on these results, PSI/Mexico has implemented motivational interviews, by which MSM are encouraged to confront their reasons for trusting and the cost of having unprotected sex with any partner. Also, Communication strategies were implemented to promote the habit of carrying condoms.

-Abstract available at link below-

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