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

Abstract

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.

Sexual Roles, Risk Sexual Behaviours, and HIV Prevalence among Men who Have Sex with Men Seeking HIV Testing in Changsha, China

“…Condom use may protect against HIV infection, but we observed a low level of condom use during anal sex in this sample and inconsistent condom use in the last 6 months among MSM, similar to the study by Zhou Qian, et al [ 55 ]; only 4.20% MSM used condoms during oral sex in the last 6 months, lower than a study conducted in Chengdu, China [ 56 ]. Inconsistent condom use is a common problem among MSM in many countries, especially in the low-income and middle-income countries [ 57 - 61 ].…”

Motivations for Sexual Behavior and Intentions to Use Condoms: Development of the Regulatory Focus in Sexuality Scale

“…In the sexual and health behavior domain, there is abundant empirical evidence showing the influence of social norms and social pressure regarding safe sex practices in general (e.g., Albarracín et al, 2005), as well as in intentions to use or actual use of condoms (e.g., Albarracín, Kumkale, & Johnson, 2004). For example, individuals who perceive greater social pressure to use condoms show greater avoidance of risky sexual practices, than those who do not perceive such pressure (Hart, Peterson, & Community Intervention Trial for Youth Study Team, 2004;Miner, Peterson, Welles, Jacoby, & Rosser, 2009;Zhou et al, 2017).…”

“…perceived social norms of condom use and actual condom use in high-risk populations, such as female sex workers (Chen, Li, Zhou, Wen, & Wu, 2013), and drug users (Latkin, Forman, Knowlton, & Sherman, 2003). Much less is known, however, about how social norms influence condom use intentions in the general population, and if these findings are replicated cross-culturally (for an exception see, Zhou et al, 2017). Furthermore, to our knowledge, the interaction between social norms and regulatory focus has never been extended to examine sexual behavior (for an exception on marketing research, see Melnyk, Herpen, Fischer, & Trijp, 2013).…”

Motivations for Sexual Behavior and Intentions to Use Condoms: Development of the Regulatory Focus in Sexuality (RFS) Scale

“…In the sexual and health behavior domain, there is abundant empirical evidence showing the influence of social norms and social pressure regarding safe sex practices in general (e.g., Albarracín et al, 2005), as well as in intentions to use or actual use of condoms (e.g., Albarracín, Kumkale, & Johnson, 2004). For example, individuals who perceive greater REGULATORY FOCUS IN SEXUALITY 8 social pressure to use condoms show greater avoidance of risky sexual practices, than those who do not perceive such pressure (Hart, Peterson, & Community Intervention Trial for Youth Study Team, 2004;Miner, Peterson, Welles, Jacoby, & Rosser, 2009;Zhou et al, 2017).…”