Beliefs that Condoms Reduce Sexual Pleasure—Gender Differences in Correlates Among Heterosexual HIV-Positive Injection Drug Users (IDUs)

Abstract

Studies consistently find that negative condom beliefs or attitudes are significantly associated with less condom use in various populations, including HIVpositive injection drug users (IDUs). As part of efforts to reduce sexual risk among HIV-positive IDUs, one of the goals of HIV interventions should be the promotion of positive condom beliefs. In this paper we sought to identify the correlates of negative condom beliefs and examined whether such correlates varied by gender, using a subsample (those with an opposite-sex main partner; n=348) of baseline data collected as part of a randomized controlled study of HIV-positive IDUs. In multivariate analyses, we found more significant correlates for women than for men. With men, perception that their sex partner is not supportive of condom use (negative partner norm) was the only significant correlate (Beta= j 0.30; pG0.01; R 2 =0.18). Among women, negative partner norm (Beta= j 0.18; pG0.05); having less knowledge about HIV, STD, and hepatitis (Beta=j0.16; pG0.05); lower self-efficacy for using a condom (Beta= j 0.40; pG0.01); and more episodes of partner violence (Beta=0.15; pG0.05) were significantly associated with negative condom beliefs (R 2 =0.36). These findings suggest important gender-specific factors to consider in interventions that seek to promote positive condom beliefs among HIV-positive IDUs.

Differences between Men and Women in Condom Use, Attitudes, and Skills in Substance Abuse Treatment Seekers

“…Related to access, women and men did not differ on items about whether they can get condoms, but men were more likely to be religiously opposed to using condoms. It is not surprising that negative effects of condoms on sexual experience were reported more by men than women; this is consistent with other studies reporting men’s concerns about condoms 15,26 . It is also consistent that men reported more condom barriers overall, while women perceived a more positive balance between advantages and disadvantages of condom use 27 .…”

“…In a sample of HIV positive injection drug users (IDU) 26 , men were more likely than women to endorse the beliefs that, with condoms, sex doesn’t feel as good or as natural. Among rural heterosexual African American stimulant users 27 , women reported more advantages to condom use on a decisional balance measure.…”

Sexual health prevention for incarcerated women: eroticising safe sex during re-entry to the community

“…Participants described fear of physical or sexual violence reprisal on requests for male condom use, and fear of partner loss particularly when faced with uncertainty in regard to housing, social or economic support. Studies with at-risk populations of women show similar results, suggesting that negative condom attitudes are associated with poor self-efficacy, risk for partner violence22 and increased socioeconomic vulnerability 23 24. Negative attributions may be related to gender inequality and circumstances that make it difficult to refuse sex 25 26…”

Barriers to condom use: Results for men and women enrolled in HIV risk reduction trials in outpatient drug treatment

“…In a sample of 348 HIV-positive injection drug users, men had more negative condom beliefs related to sexual pleasure compared to women; negative beliefs were associated with lower self-efficacy (i.e., one's belief that s/he can control his/her own condom use) to use condoms among both men and women (Mizuno, Purcell, Latka, Metsch, Gomez, & Latkin, 2007). Among women and men participating in randomized clinical trials of comparable risk reduction interventions (using the dataset from the current study), men endorsed more barriers to condom use than women, especially those related to the effect on sexual experience (Calsyn et al, 2013).…”