Determinants of condom use among African Americans who smoke crack cocaine

This paper presents findings from an elicitation study that focused on the sexual risks and condom use behaviour of African American crack smokers. Of interest were the attitudes, beliefs, and barriers that affect the adoption and maintenance of condoms as an HIV prophylactic. Thick descriptive data were collected from 64 heterosexual African Americans who smoke crack cocaine. Data were content analysed for descriptions of condom use attitudes, normative beliefs, and barriers or facilitators of condom use. Participants described few positive condom use outcome expectations, while detailing several negative expectations. Normative beliefs were found to be weakly related to condom use with casual partners. However, descriptions of sexual relationships with intimate partners indicated that the normative expectations of the partner strongly influenced condom use. Participants described few contextual barriers to condom use, although situational barriers, including crack addiction, were identified.