Condom refusal and young black men: It's all about sex, maybe!
Objective: This study investigated pleasure-related correlates of recent condom refusal in young Black men attending local STD clinics. Methods: Data were collected in three US cities from clinics treating sexually transmitted diseases. Inclusion criteria were self-identified as Black/African American, male, being between 15-23 years old, and recent (past three months) use of a male condom. Of 1144 eligible young men, 697 (61.0%) enrolled in study and completed a baseline ACASI survey. Condom refusal was dichotomized to compare those who recently (past two months) refused to wear a condom to all other participants. Regression methods were used to predict the influence of condom attitudes and beliefs on this outcome. Results: Mean age was 19.6 years (SD=1.87). Nearly one of every two young men (46.8%) indicated recent refusal to use a condom when the partner has asked him to do so. Significant correlates of refusing to use a condom were: condoms change the climax or orgasm (OR=3.35, 95% confidence interval (CI) 2.02-5.55), condoms are messy (OR=2.47, 95% CI=1.58-3.83), I feel closer to my partner without a condom (OR=1.88, 95% CI=1.17-2.99), condoms make sex hurt for the girl (OR=1.78, 95% CI=1.14-2.78). There was a significant yet inverse association between condom refusal and the belief that condoms feel unnatural (OR=0.55, 95% CI=.32-.95). Conclusions: Condom beliefs and attitudes are antecedents to condom refusal behaviors of young Black males. Interventions to address pleasure-related condom attitudes and beliefs as barriers are warranted.
Diversity and culture
Public health or related education
Public health or related research
Social and behavioral sciences
Describe the sexual risk behaviors of young African American men attending an STD clinic.
Explain condom beliefs and attitudes of young African American men are antecedents to condom refusal
Discuss the need for interventions that address pleasure-related condom attitudes and beliefs of young African American men.
Keyword(s): African American, HIV Risk Behavior
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been involved on and co-principal investigator of multiple funded grants on HIV prevention. Among my scientific interests has been the development of strategies for preventing HIV and STDs in young African American men and women.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.