Barriers to condom use: Results for men and women enrolled in HIV risk reduction trials in outpatient drug treatment

ABSTRACT

HIV transmission often occurs through heterosexual high-risk sex. Even in the era of HIV combination prevention, promoting condom use and understanding barriers to consistent condom use remain priorities, especially among substance-dependent individuals. Men and women (N = 729) in outpatient drug treatment participated in a five-session gender-specific risk reduction group or one-session HIV Education group. Condom barriers (Motivation, Partner-related, Access/Availability, Sexual experience) were assessed at baseline and 6-month follow-up. Completing either intervention was associated with fewer motivation and partner-related barriers. Among women, reductions in motivation and sexual experience barriers were associated with less sexual risk with primary partners. Condom barriers are important to gender-specific HIV prevention; given limited resources, brief interventions maximizing active components are needed.

KEYWORDS:

• attitudes
• condoms
• gender differences
• HIV/AIDS
• substance use disorders

Acknowledgments

The authors wish to thank Paul Crits-Christoph, Ph.D., University of Pennsylvania and Robert Gallop, Ph. D., West Chester University, for their assistance in combining the datasets from the women’s and men’s CTN protocols. The authors acknowledge the support of the clinical and administrative staff at participating treatment programs, the work of the local research teams, and the generous commitment of time from research participants.

In memory of Dr. Donald Calsyn who passed away February 3, 2013, during the preparation of this manuscript.