213P
Protective Factors Facilitating Consistent “Safer Sex” Practice over Decades in Men Having Sex with Men in Switzerland Confirm the Importance of Structural Prevention Approaches

Schedule:
Friday, January 16, 2015
Bissonet, Third Floor (New Orleans Marriott)
* noted as presenting author
Christoph Imhof, MA, Research fellow, University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
Olivier Favre, MSc, Head Department Health in Childern and Youth, Canton of Zug, Health Administration Canton of Zug, Zug, Switzerland
Daniel Gredig, PhD, Professor for Social Work, University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
Background and Purpose

In Switzerland, studies suggest that some 20% of MSM do not use condoms consistently when having sex with casual partners. In prevention discourses, these MSM receive most attention: studies concentrate on the identification of factors hindering condom use and interventions subsequently address the identified barriers.

However, the same studies evidence that a vast majority of MSM use condoms consistently. So in order to develop affirmative prevention interventions supporting and stabilizing the adherence to “safer sex,” it would be productive to learn more about protective factors enabling and facilitating MSM to maintain condom use practice over long periods. A qualitative study provided first insights into protective factors.

The study aimed  

a) to determine the personal HIV protection strategies adopted by MSM aged 30-44, and

b) to identify rationalities and meanings behind the corresponding strategies and behaviors.

 Methods

We conducted semi-structured, qualitative interviews with MSM aged 31 to 45 living in Switzerland. We chose the 26 participants iteratively by theoretical sampling and analysed the interview data along the principles of theoretical coding.

Results

HIV-negative participants reported a broad array of protective and risky behaviors, ranging from complying with safer sex guidelines to dispensing with protection altogether.

Some participants have been adhering to safer sex guidelines during their entire sexual biography.

Analysis suggests the existence of protective factors supporting MSM in the long-term maintenance of safer sex. They

  • could come out in a gay-affirmative social environment (family, school, peers) and experience neutral or positive responses,
  • perceived HIV infection as severe and burdensome, despite the achievement of antiretroviral treatment, and
  • had their first sexual intercourse with another man not before adolescence.

 Conclusion and Implications

Analysis showed the existence of protective factors. Future prevention interventions could aim to strengthen these factors in order to support MSM in maintaining safer sex practice: it is important—on a structural level—to support the development of a gay-affirmative social environment. Prevention should provide MSM with balanced and adequate information about the consequences of HIV infection and broach the issue of sexuality (including same-sex sexuality) at a young age.