Determinants of condom use with occasional partners among MSM in Ukraine
METHODS: Case-control study with 866 participants was nested in a cross-sectional survey among MSM conducted in 2007. Controls were those who used a condom during the most recent sexual contact with an occasional partner, and cases – those who did not. Independent variables included socio-demographic characteristics, other risky behaviors, HIV knowledge and sources of information. Bivariate analysis used chi-square test and multivariate – binary logistic regression.
RESULTS: Better knowledge and use of harm reduction services (HRS) was associated with safer behaviors. Those respondents, who were unaware whether HIV testing was available to them, had a greater risk of unprotected sex: OR = 2.344 (95%CI 1.09-5.00) as well as those who were unclear about the quality of condoms they get from HRS. Among those not covered by HRS, older MSM and those who have multiple commercial partners are at higher risk of unprotected sex. Among those attending HRS, a major barrier to use condoms is their perception as diminishing sensitivity: OR=4.143 (95%CI 1.305-13.152). The dose-dependent association was found with frequency of alcohol consumption – unsafe sexual contacts were more likely in daily alcohol users compared to those who used alcohol on a monthly basis: OR=2.264 (95%CI 1.041-4.923).
DISCUSSION: Low CUWOP is typical for those MSMs who practice other risky behaviors including frequent alcohol use, contacts with multiple commercial sex partners and non-use of HRS which include provision of information, condoms and testing. Thus HIV prevention depends not only on the fact whether preventive services are provided but whether they are used by the target group.
KEY WORDS: MSM, risky behavior, information, HIV/AIDS, condom use, occasional sexual partners, risk factors, harm reduction services.
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