Background: Health concerns regarding casual sexual encounters during travel have been recognized for some time. The perception that female travellers' motivations are more romantic rather than sexual when entering a relationship with local men may exclude them from receiving appropriate travel health advice. This may pose even greater health risks, not only to themselves but also to their local partners.
Method: This paper presents 11 Western female tourists' perceptions of their relationships with local men in Cuzco/Peru, based on in-depth interviews, observations, and informal discussions.
Results: Relationships with local men were often triggered by their physical appearance. Other themes identified were: methods and location of first contact, benefits for the local men, safe sex/condom use, and travel health advice received.
Conclusions: The findings support calls for more emphasis on sexual health in travel health education. Three aspects should be included: 1) an awareness that unfamiliar environment can cause 'out of character' behaviour, 2) an emphasis on not only to use but to not stop using condoms, and 3) the need to acquire negotiation skills.