Marseille 2007
| Abstract #143 - RESEARCH ON THE REASONS WHICH LEAD MSM TO DELIBERATELY ADOPT RISKY SEXUAL BEHAVIOURS | ||||
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Session: 18.3: Risk Perception (Parallel) on Monday @ 14.00-16.00 in CP Chaired by Elizabeth Brown, Yusef Azad Authors: Presenting Author: Mrs Maria Luisa COSMARO - LILA Milano ONLUS, Italy |
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| Additional Authors: Mr Massimo OLDRINI, Dr Pierluigi PEZZOTTA, Ms Angela OLIVERI, | ||||
| Aim: The research was conducted in 2005/2006 and was financed by Istituto Superiore di Sanit. Objectives: a) to investigate the reasons leading MSM to deliberately adopt risky sexual behaviours; b) to analyse the impact of collected data on current prevention approaches; c) to identify new sensibilisation/health education strategies specifically tailored for the life and culture of MSM. | ||||
| Method / Issue: The research included: - a qualitative survey made of 20 in-depth interviews to MSM who acknowledged they engaged in risky sexual behaviours. Sample was made of MSM 18-55 years old, 30% in a steady relationship; 33% HIV positive, 33% HIV negative; 33% did not know own HIV status - a quantitative survey through questionnaires based on most relevant items derived from analysis of qualitative survey. 322 questionnaires were completed by respondents who had engaged in sex without condom often (21%), sometimes (43%), rarely (37%). | ||||
| Results / Comments: 70% of respondents had sufficient to good information about HIV/ITS, but 77% expressed the need to receive additional information; MSM under 24 years possessed instead little information. 50% feared AIDS despite availability of HAARTs. When describing risky behaviours, the three main situations mentioned apart from "sex without condom" (38%) referred to little attention in choosing sexual partners, contact with partner's body fluids, thoughtlessness due to sexual excitation/use of drugs. When describing safe practices, 35% indicated oral sex; others mentioned sex with well known sexual partners, "safe" situations, trust in the partner. Degree of agreement on reasons for not using condoms: adoption of different precautions such as careful choice of partner, avoiding contact with sperm (46%); fear of rejection (43%); unfrequent sexual activity resulting in little chance of infection (43%); partners proposing unprotected sex are very likely HIV- (42%); condoms are unpleasant (36%); condoms ruin the excitement (35%). | ||||
| Discussion: Fear of AIDS does not prevent risky behaviours. MSM have indicated a subcategory of MSM perceived as "possibly HIV positive". Such perception seems essentially based on outward appearance/behaviours. The need to isolate or limit risk leads to identify "duty free zones" for freely expressing impulses and emotions. It appears important to reconsider prejudices and the concept of "known", key word in the decision about risktaking, since level of knowledge of sexual partners is extremely superficial. Similarly, the need of identifying safe areas brings MSM to consider oral sex as totally safe; sometimes this is the main sexual behaviour adopted and MSM want to derive from it maximum pleasure. There is evidence of a big misunderstanding: some believe that MSM proposing unprotected sex are likely to be HIV negative; HIV positive MSM instead think opposite: MSM looking for unprotected sex are certainly HIV positive. Routine HIV testing is still considered a prevention practice, as well as PPE. The research evidenced lack of consistent preventive information and need to rediscuss prejudices, categories, risky behaviours, HIV testing, HAARTs side effects. Three contexts were identified for the spread of preventive information: gay cultural associations; gay clubs/saunas, gay chat lines. | ||||
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