Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men

Abstract

This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men’s subjectivities – their perceptions of and preferences for specific brands, types, and flavours of condoms and lubricants – influenced engagement with such safer sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer sex supplies, health services, and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context.

Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.

“…Trans-women sex workers coped with inadequate access to lubricants by using substitutes such as lotions, margarine, avocado, egg white or yoghurt. The use of eggs, lotions, margarine as a lubricant among transgender persons is documented (39,48). However, these may have health effects to the users.…”

Seizing opportunities for intervention: Changing HIV-related knowledge among men who have sex with men and transgender women attending trusted community centers in Nigeria

“…In sub-Saharan Africa, access to condom-compatible lubricants is impeded by both stigmatization and resource constraints [28,29]. These factors contribute to frequent utilization of alternative sexual lubricants such as saliva, soap, butter, yogurt, and cooking oils [30]. In our study, water-based lubricants were freely available to study participants in conjunction with education about their use which may potentially account for the knowledge gains observed in this domain.…”

“It’s worse with fellow patients… they judge you as evil”: Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda.

“…In order to cope with limited access to lubricants, transwomen sex workers used substitutes such as lotions, margarine, avocado, egg white or yoghurt. The use of eggs, lotions, margarine as a lubricant among transgender persons is documented (32,38).…”