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BMC Public Health. 2019 Jan 28;19(1):120. doi: 10.1186/s12889-019-6452-7.

"Condoms are … like public transit. It's something you want everyone else to take": Perceptions and use of condoms among HIV negative gay men in Vancouver, Canada in the era of biomedical and seroadaptive prevention.

Author information

1
Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
2
Department of History, Simon Fraser University, Burnaby, BC, Canada.
3
School of Public Health & Social Policy, University of Victoria, room B202, HSD Building, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada.
4
YouthCO HIV & Hep C Society, Vancouver, BC, Canada.
5
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
6
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
7
Department of Anthropology, University of Victoria, Victoria, BC, Canada.
8
Centre for Addictions Research of British Columbia, Victoria, BC, Canada.
9
Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada. nlachowsky@uvic.ca.
10
School of Public Health & Social Policy, University of Victoria, room B202, HSD Building, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada. nlachowsky@uvic.ca.

Abstract

BACKGROUND:

The emergence of biomedical and seroadaptive HIV prevention strategies has coincided with a decline in condom use among gay men.

METHODS:

We undertook a social ecological analysis of condom use and perceptions using nineteen semi-structured interviews with HIV negative gay men in Vancouver, Canada who used HAART-based prevention strategies.

RESULTS:

Contributors to inconsistent condom use were found at various levels of the social ecological model. Ongoing concern regarding HIV transmission and belief in the proven efficacy of condoms motivated contextual use. When condoms were not used, participants utilized seroadaptive and biomedical prevention strategies to mitigate risk.

CONCLUSIONS:

These findings indicate that notions of "safety" and "risk" based on consistent condom use are eroding as other modes of prevention gain visibility. Community-based and public health interventions will need to shift prevention messaging from advocacy for universal condom use toward combination prevention in order to meet gay men's current prevention needs. Interventions should advance gay men's communication and self-advocacy skills in order to optimize these strategies.

KEYWORDS:

Combination prevention; Condoms; Gay and bisexual men; HAART; HIV prevention; Seroadaptive strategies; Social ecological model

PMID:
30691426
PMCID:
PMC6350294
DOI:
10.1186/s12889-019-6452-7
[Indexed for MEDLINE]
Free PMC Article

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