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Correlates of Condom Use Intentions and Behaviors Among a Community-Based Sample of Latino Men in Los Angeles

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Abstract

HIV/AIDS has disproportionately affected Latino communities. The majority of research addressing HIV risk behaviors within this population has focused on women. However, men who have sex with women (MSW) are a population increasingly becoming infected with HIV and heterosexual contact is the primary source of HIV transmission among Latinos diagnosed with AIDS. It has been assumed that because men are likely to control condom use, relationship factors are less likely to influence safer sex behavior among men. However, because condom use is an interdependent behavior, understanding factors that predict safer sex behavior among MSW is critical. This study examined the influence of multiple factors on condom use behavior in a community-based sample of young Latino men. Data from 191 Latino men who completed baseline interviews for an intervention were analyzed to examine the association of background, intrapersonal and relationship factors with intentions to use condoms and condom use in the past three months. Findings from multivariate analyses indicated that more positive attitudes toward condoms, stronger partner condom norms and greater participation in decision-making about condom use were significantly associated with both condom use and condom use intentions. Additionally, men reporting lower expectations of negative partner reactions to condom requests were more likely to use condoms, and condom use intentions were higher among men reporting more health protective communication in the relationship. Findings suggest that interventions to prevent HIV need to include men as well as women and address the role of relationship factors and dynamics in safer sex practices.

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Acknowledgements

This research was conducted as part of the PARTNERS Project, supported by cooperative agreements #U30/CCU 915062-1-0 and #U30/CCU 615166-1-0 with the Centers for Disease Control and Prevention (CDC). Members of the PARTNERS Project include S. Marie Harvey, Principal Investigator for the Los Angeles (CA) site; Heather C. Huszti, Principal Investigator for the Oklahoma City (OK) site; and Christine Galavotti, Katina A. Pappas-DeLuca, and Joan Marie Kraft, CDC Project Officers. We extend our appreciation to the LA site field staff; without their dedication and contributions, this study would not have come to fruition.

Author information

Authors and Affiliations

  1. Department of Public Health, Oregon State University, Corvallis, OR, 97331-6406, USA

    S. Marie Harvey

Authors
  1. S. Marie Harvey
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  2. Jillian T. Henderson
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Corresponding author

Correspondence to S. Marie Harvey.

Additional information

Harvey is with the Department of Public Health, Oregon State University, Corvallis, OR, USA; Henderson is with the Bixby Center for Reproductive Health Research & Policy, University of California, San Francisco, CA, USA.

Appendix

Appendix

Items for Selected Measures

Condom Use Intentions (5-pt scale, 1 = not at all likely to 5 = extremely likely)

  1. 1.

    During the next month, you intend to try to persuade [name of partner] to use condoms every time you have sex.

  2. 2.

    You intend to get condoms during the next month.

  3. 3.

    You intend to always have condoms handy during the next month.

  4. 4.

    You intend to use condoms every time you have sex with [name of partner] during the next month.

Attitudes Toward Condoms (5-pt scale, 1 = a very bad idea to 5 = a very good idea)

  1. 1.

    How good of an idea do you think that trying to persuade [name of partner] to use condoms every time you have sex would be?

  2. 2.

    How good of an idea do you think that getting condoms during the next month would be?

  3. 3.

    How good of an idea do you think that always having condoms handy during the next month would be?

  4. 4.

    In the next month, how good of an idea do you think that you and [name of partner] using condoms every time you have sex would be?

Condom Use Self-Efficacy (5-pt scale, 1 = not at all confident to 5 = extremely confident)

  1. 1.

    How confident are you that you could suggest using a condom, even if you were afraid that [name of partner] would reject you?

  2. 2.

    How confident are you that you could suggest using a condom, even if you were unsure of how [name of partner] felt about using condoms?

  3. 3.

    How confident are you that you could suggest using a condom, even if you were afraid that [name of partner] would think that you have had sex with another [man/woman] before?

  4. 4.

    How confident are you that you could suggest using a condom, even if you were afraid that [name of partner] would think you have a sexually transmitted disease?

  5. 5.

    How confident are you that you could suggest using a condom with [name of partner], without [her/him] thinking you thought [she/he] had a sexually transmitted disease?

  6. 6.

    How confident do you feel in your ability to discuss using condoms with [name of partner]?

  7. 7.

    How confident do you feel in your ability to suggest using condoms with [name of partner]?

  8. 8.

    How confident do you feel in your ability to put a condom on [name of partner] correctly?

  9. 9.

    How confident do you feel in your ability to use a condom correctly with [name of partner]?

  10. 10.

    How confident do you feel in your ability to put a condom on without breaking the sexual mood with [name of partner]?

  11. 11.

    How confident do you feel in your ability to buy condoms without feeling embarrassed?

  12. 12.

    How confident are you that you could remember to carry a condom with you in case you need one?

  13. 13.

    How confident do you feel in your ability to use a condom with [name of partner] even after you have been drinking?

  14. 14.

    How confident do you feel in your ability to use a condom with [name of partner] even if you were high?

  15. 15.

    How confident do you feel in your ability to use a condom with [name of partner] even if you were sexually excited?

Partner-Specific Perceived Vulnerability (5-pt scale, 1 = not at all likely to 5 = extremely likely)

  1. 1.

    How likely is it that you could get HIV from having sex with [name of partner] without using a condom?

  2. 2.

    How likely is it that you could get a sexually transmitted disease other than HIV from having sex with [name of partner] without using a condom?

HIV Information Heuristics (5-pt scale, 1 = definitely false to 5 = definitely true)

  1. 1.

    If you love and trust someone, you don't have to worry about getting HIV from them.

  2. 2.

    You can tell whether someone has HIV by the way they look.

  3. 3.

    Only people who are homosexual or who use drugs really have to worry about getting HIV.

  4. 4.

    If you know a person very well, you don't have to use condoms to protect against getting HIV from them.

  5. 5.

    You don't have to use a condom for HIV protection if you are in a relationship with just one person, even if that person had sex without a condom with other people before.

  6. 6.

    If a person is not a drug user, you don't need to worry about getting HIV from them.

  7. 7.

    It's more important to use condoms in one-night stands and flings than in real relationships.

  8. 8.

    If you know a person's sexual history and lifestyle before you have sex with them, you do not need to use condoms.

Duration of Relationship (number of months)

  1. 1.

    How long have you been in a sexual relationship with [name of partner]?

Perceived Partner Norms (5-pt scale, 1 = not important to 5 = extremely important)

  1. 1.

    How important is it to [name of partner] that you get condoms during the next month?

  2. 2.

    How important is it to [name of partner] that you always have condoms handy during the next month?

  3. 3.

    How important is it to [name of partner] that you and [she/he] use condoms every time you have sex in the next month?

Commitment (5-pt scale, 1 = not at all like your relationship; to 5 = extremely like your relationship)

  1. 1.

    Even when [name of partner] is hard to deal with, you remain committed to your relationship.

  2. 2.

    Because of your commitment to [name of partner], you would not let other people come between you.

  3. 3.

    You have faith that your relationship with [name of partner] will continue.

  4. 4.

    You view your relationship with [name of partner] as permanent.

  5. 5.

    You can't imagine ending your relationship with [name of partner].

Decision-Making about Condom Use (5-pt scale, 1 = not at all to 5 = a great deal)

  1. 1.

    How much do you take part in deciding whether or not to use a condom with [name of partner]?

Health-Protective Sexual Communication (0 = no, 1 = yes)

  1. 1.

    Have you ever talked with [name of partner] about how he felt using condoms?

  2. 2.

    Have you ever talked with [name of partner] about whether you have ever been tested for HIV, the virus that causes AIDS?

  3. 3.

    Have you ever talked with [name of partner] about whether you ever had some type of sexually transmitted disease like herpes, chlamydia, syphilis, or gonorrhea?

  4. 4.

    Have you ever talked with [name of partner] about whether you ever injected (or shot) drugs like heroin, cocaine, steroids, or speed?

  5. 5.

    Have you ever talked with [name of partner] about whether you ever had sex with other women?

  6. 6.

    Have you ever talked with [name of partner] about whether you have ever been in prison?

  7. 7.

    Have you ever talked with [name of partner] about whether or not you have ever had sex with someone else besides him?

  8. 8.

    Have you ever talked with [name of partner] about whether or not he has ever had sex with someone else besides you?

  9. 9.

    Have you ever talked with [name of partner] about whether he has ever been tested for HIV, the virus that causes AIDS?

  10. 10.

    Have you ever talked with [name of partner] about whether he has ever had some type of sexually transmitted disease like herpes, chlamydia, syphilis, or gonorrhea?

  11. 11.

    Have you ever talked with [name of partner] about whether he ever injected (or shot) drugs like heroin, cocaine, steroids or speed?

  12. 12.

    Have you ever talked with [name of partner] about whether he ever had sex with other men?

  13. 13.

    Have you ever talked with [name of partner] about whether he has ever been in prison?

  14. 14.

    Have you ever talked with [name of partner] about what type of birth control you would like to use?

  15. 15.

    Have you ever talked with [name of partner] about whether you both will have sex only with each other and no one else?

Outcome Expectations for Suggesting Condom Use (5-pt scale, 1 = not at all likely to 5 = extremely likely)

  1. 1.

    How likely is it that [name of partner] would get mad at you if you said you had to use a condom?

  2. 2.

    How likely is it that [name of partner] would think you were having sex with another person if you said you had to use a condom?

  3. 3.

    How likely is it that [name of partner] wouldn't like it if you had a condom with you?

  4. 4.

    How likely is it that [name of partner] would feel like you were saying you don't trust him if you said you had to use a condom?

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Harvey, S.M., Henderson, J.T. Correlates of Condom Use Intentions and Behaviors Among a Community-Based Sample of Latino Men in Los Angeles. JURH 83, 558–574 (2006). https://doi.org/10.1007/s11524-006-9064-3

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