In the era of pre-exposure prophylaxis (PrEP), the condom has lost its protective shield. This reduction in condom use is linked to the emergence of alternative prevention strategies, such as negotiated safety agreements and serosorting.
This article examines cross-sectional and longitudinal data on men engaging in homosexually active sex from two waves of interviews (1987/8 and 1991) of Project SIGMA. This study is the only non-clinical longitudinal study of male homosexual sex and HIV risk behaviors.
They are a form of protection
Gay men use condoms to protect themselves against sexually transmitted infections and diseases, including HIV. Condoms are also effective against non-HIV STIs, such as bacteria and herpes. In addition, condoms can help prevent genital warts and infections from being transmitted through anal intercourse. However, it is important to remember that condoms do not completely prevent STIs and may be ineffective against some strains of viruses like gonorrhea.
Although condom use is declining in some gay communities, it does not appear to be due to declining concerns about HIV risk. In fact, the recent availability of PrEP has shifted the perception of HIV risk and may have influenced condom use, as many people have adopted the notion that HIV is no longer an impending plague and that combining biomedical with seroadaptive strategies can offer greater safety and pleasure.
The findings from this study suggest that sexual health interventions should shift prevention messaging away from advocacy for consistent condom use and toward combination prevention. This would enable gay men to choose a variety of strategies that optimize their sexual risk while leaving space for subjectivity and agency in decision-making.
In addition, it is important to communicate the risks of STIs in a way that is culturally relevant and focuses on something teens care about, such as potential infertility. In order to do this, educators should remove barriers and get into the conversation in a way that feels authentic to teens.
They are a form of communication
Gay men often use condoms in their sex for safety, pleasure, and to communicate about risks and preferences. They also use them to avoid the stigma associated with AIDS, and they are influenced by their partners and family members’ attitudes about sex. However, these factors can be counteracted by high-quality sex education that encourages safe and healthy sexual practices.
The emergence of PrEP and other prevention options has begun to redefine traditional interpretations of sexual “risk” and safety. Men’s consistent condom use correlated with their comfort level in disclosing their HIV negative status to family members, but their willingness to use other, risk-reducing strategies was dependent on the perceived effectiveness and cost of each. Men who reported reading material dealing with homosexual issues used condoms more consistently than those who did not.
Despite the increased prevalence of PrEP and other effective methods, condoms remain a crucial component of safer sex. Barrier methods not only protect against HIV, but also STIs like gonorrhea, chlamydia, and syphilis. The current pandemic has exacerbated these challenges, as the demand for resources to treat the virus leaves little room for STI prevention. In fact, in the United States, there are only 13 states that require sex education that is medically accurate and focuses on safe sex. The rest of the country has abstinence-only sex education or none at all.
They are a form of responsibility
Gay men use condoms because they feel a sense of responsibility to protect their sexual partners against STDs. This is particularly true when they are engaging in intercourse with men. Although the number of homosexually active men infected with HIV has declined, condom use is still a critical part of reducing the risk of infection. However, some researchers have noticed a decline in condom use among gay men.
A decline in condom use has been attributed to several factors. For one, the pandemic has made it more difficult to access and purchase condoms. In addition, some people have a heightened level of embarrassment about discussing sex and feel reluctant to bring up condom use with their partners.
These findings have implications for HIV prevention efforts. For example, sex education campaigns should focus on combination prevention strategies. In addition, sexual health professionals should continue to promote abstinence as a core preventive practice.
Another factor that may have contributed to the decline in condom use is a growing sense of optimism about the AIDS epidemic. The emergence of highly active antiretroviral therapy-based biomedical interventions has transformed the perception of HIV from a death sentence to a chronic illness. This has led some people to abandon safe sex practices, including consistent condom use. This trend is particularly prevalent in states with few public health programs or those that encourage abstinence only.
They are a form of respect
For years, condom use was synonymous with HIV prevention among gay men. However, recent studies have shown that condom use is declining and condomless anal intercourse (CAI) is increasing. These findings have prompted scholars to investigate what might be driving this decline. Many researchers have speculated that three decades of condom-based sex education has led to “condom fatigue,” leading gay men to adopt inconsistent safe sex practices. Others have suggested that sex educators need to shift away from a focus on condoms and instead promote a broader concept of sexual safety.
Nonetheless, participants in this study indicated that they continued to use condoms contextually and with partners of different risk levels. They also reported using a variety of behavioural and seroadaptive strategies to optimize their sexual safety. These include negotiated safety agreements, serosorting, and viral load sorting, which can help reduce HIV transmission risk. However, these strategies are not a complete substitute for the use of barrier methods and should be used alongside a comprehensive sexual health plan.
While some participants in this study indicated that they do not like the feeling of a condom on their penis, most said that they continue to use condoms because they offer a high level of protection against infection and provide a sense of eroticism and freedom. They also reported a desire for increased sexual pleasure, and an awareness of the importance of healthy, sustainable relationships.
