Perceptions of condom use among African American men who have sex with men

The objectives of this study were to describe what African American men perceive as the risks of different sexual acts when not using condoms, the social and situational barriers to using condoms, the attitudes towards condom use of other men they know, and the strategies needed to promote condom use. In semi-structured interviews, participants were asked questions regarding their perceptions of the risks of HIV infection from various sexual activities, barriers to condom use, condom attitudes of people in their social and sexual networks, and strategies necessary to promote condom use. Analyses indicated that African American men who sex with men (MSM) most often mentioned sex without a condom as risky sexual behaviour, specifically anal sex. The most frequently perceived barrier to safer sex practice was 'sex on the Spur of the moment'. Respondents also perceived several salient attitudes towards condom use held by the African American MSM they knew. In particular, respondents were divided in their perception of social support for condom use among their friends and acquaintances. Also, they perceived that men in their social and sexual networks held less favourable attitudes towards condom use in committed relationships. Findings are discussed in relation to various interpersonal (e.g., relationship issues) and contextual (e.g., social support and social networks) factors that may influence HIV sexual risk behaviours among African American MSM.