Association between perceived social norm and condom use among people living with HIV/AIDS in Guangzhou, China

The number of people living with HIV/AIDS (PLWHA) has been increasing in China. Previous studies have examined the association between social norms and risk behaviors among high-risk populations for HIV infection. However, little is known about social norms and condom use among people living with HIV/AIDS (PLWHA). This study sought to investigate the relationship between perceived social norms on condom use and inconsistent condom use among PLWHA. A cross-sectional survey was conducted through convenience sampling among 412 PLWHA between March and June 2013 in Guangzhou, China. Descriptive norm of condom use was measured as perception of number of friends thinking it necessary to use condoms when having sex. About three-fourths (n = 301, 73.1%) of the PLWHA were sexually active since HIV diagnosis. Among the sexually active PLWHA, the average age was 36.5 years; about two-thirds were male; the majority was Han ethnic (92.7%); 55.5% discussed condom use with their friends and the rate of inconsistent condom use in the last three sexual encounters was 29.2%. In the multivariate logistic regression, PLWHA who perceived more of their friends' approval of condom use were less likely to engage in unprotected sex than their counterparts (aOR = 0.25, p=.001). Those whose family members were aware of their HIV infection status were less likely to engage in unprotected sex than their counterparts (aOR = 0.17, p<.001). Those who lived with family members were more likely to have unprotected sex than those who lived with friends (aOR = 8.47, p=.007). The results underscore the importance of developing culturally appropriate social norm-based HIV interventions among PLWHA. Future interventions focused on changing social norms on risk behaviors in the social network of PLWHA have the potential to reduce risk behaviors and to promote condom use among PLWHA.