Background: Use of male condoms can reduce the risk of transmission of STDs, including HIV. However, high numbers of men who have sex with men (MSM) continue to report not using condoms or using them inconsistently. This analysis looked at factors associated with condom use among MSM at four Community-based Organizations (CBOs) funded by the Centers for Disease Control and Prevention for HIV prevention programs.
Methods: Data were collected from 2012-2014 through an evaluation of an HIV prevention intervention delivered by CBOs in Hawaii, Massachusetts, New York, and Oregon. Data from 832 MSM who reported anal sex with male partners in the past three months were analyzed. Participants self-reported all data. Condom use was defined as always, sometimes, or never using condoms. Multinomial logistic regression models were used to assess the relationship of condom use with behavioral risk factors and recent STD diagnoses.
Results: Of participants, 22.1% always used condoms, 47.5% used condoms sometimes, and 30.1% never used condoms. In multivariable models, less frequent condom use was reported by injection drug users (IDU) [OR, 0.45; 95%CI (0.21, 0.95)], participants whose partners were IDU [OR, 0.39; 95% CI (0.16, 0.96)], and those reporting anal sex with a male while drunk or high [OR, 0.53; 95% CI (0.32, 0.86)]. More frequent condom use was reported by participants with more male sex partners [OR, 1.10; 95% CI (1.05, 1.15)]. No significant associations were observed between condom use and STD diagnoses.
Conclusions: Given that nearly 80% of MSM were not using condoms consistently, condom use should be promoted among all MSM. Specific groups of MSM on which to further focus condom promotion include IDU, partners of IDUs, those reporting sex while drunk or high, and those with fewer male sex partners.