Protection versus pleasure: reduced sensation as a deterrent for condom use among immigrant Latino MSM
living in the USA
S.K. Calabrese, C.A. Reisen, M.C. Zea, P.J. Poppen, F.T. Bianchi
The George Washington University, Psychology, Washington, DC, United States
Background: Unprotected anal intercourse (UAI) is often motivated by a
desire for greater physical sensation and partner intimacy relative to sex with
condoms. The decision to engage in
UAI commonly involves a cost-benefit analysis in which these potential gains
are weighed against potential risks, which vary by HIV status, sexual role, and
partner choice. We examined the impact of perceived pleasure loss related to
condoms on participation in insertive and receptive UAI within this context.
Methods: 482 Dominican, Colombian, and Brazilian, immigrant MSM were
surveyed regarding their attitudes and sexual practices via A-CASI.
Participants rated the pleasure they derived from protected and unprotected sex
in each role (insertive and receptive). Discrepancy scores were calculated as
indicators of the pleasure loss associated with condom use in each role within
the subsamples of participants who had previously engaged in those
roles both with and without condoms [n(insertive)=297; n(receptive)=284). Separate
logistic regressions were conducted for each group to evaluate perceived
pleasure loss, serostatus, and relationship status in relation to UAI over the
past 3 months.
Results: Analyses revealed a positive relationship between perceived
pleasure loss and likelihood of UAI for both insertive and receptive
roles. Additionally, participants
were more likely to engage in receptive UAI if they had a main partner. Serostatus was not significantly
related to UAI.
Conclusions: Findings indicate that the pleasure loss associated with
condoms may be a primary deterrent for their use in either sex role among
Latino MSM, regardless of serostatus.
However, the main effect of partner status on receptive UAI suggests men
may limit their participation in the riskier of the two roles outside of a relationship
context. These results support the
need to maximize the pleasure-enhancing properties of condoms and develop
alternative methods of HIV prevention that do not stifle physical sensation
(e.g., rectal microbicides).
Back to the Programme-at-a-Glance