The fallacy of intimacy: Sexual risk behaviour and beliefs about trust and condom use among men who have sex with men in South Africa

Abstract

The objective of this study is to assess (1) whether beliefs about trust and condom use affect sexual risk behaviour, and (2) if beliefs about trust and condom use impact sexual risk behaviour directly or if this relationship is mediated by other determinants. The Information-Motivation-Behavioural Skills model was used as a framework for the mediation analysis. A diverse cohort of three hundred 18–40 year old men who have sex with men (MSM) residing in Pretoria, South Africa, were recruited and surveyed for this project. Findings indicate that men who report a high frequency of past unprotected anal intercourse are more likely to believe that it is not necessary to use condoms with a trusted or steady partner regardless of their current partnership status. This fallacy of intimacy appears to affect sexual risk behaviour through intentions and attitudes regarding safer sex practices. Based on these findings, we recommend that more attention be given in gaining a better understanding of how beliefs about trust and condom use are formed and how they can be changed among MSM in South Africa.

Keywords:

• HIV
• beliefs
• trust
• condoms
• sexual risk behaviour
• MSM
• South Africa

Acknowledgements

The study was supported by a grant from amfAR (106973; Principal Investigator: Theo Sandfort, Ph.D.) with additional support from a grant from the National Institute of Mental Health to the HIV Center for Clinical and Behavioral Studies (P30-MH43520; Principal Investigator: Anke E. Ehrhardt, Ph.D.). This research was further supported by a training grant from the National Institute of Mental Health (T32 MH19139, Behavioral Sciences Research in HIV Infection; Principal Investigator: Anke A. Ehrhardt, Ph.D.). Special acknowledgement is due to Rudi van der Walt, Marius Steenkamp and the OUT LGBT Well-Being staff for their assistance in conducting the survey.