title: Barriers to Condom Use among High Risk Men Who Have Sex with Men in Uganda: A Qualitative Study.
abstract: BACKGROUND
  Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms. However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda.
  
  
  METHODS
  The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years) MSM in 11 districts in Uganda between July and December 2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach.
  
  
  RESULTS
  Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption.
  
  
  CONCLUSIONS
  The findings suggest that several reasons account for lack of condom use among high-risk MSM. The findings are valuable to inform interventions needed to increase condom use among MSM.
authors.affiliation: Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda; International Health, University of Antwerp, Antwerp, Belgium.
authors.forename: Geofrey
authors.initials: G
authors.lastname: Musinguzi
authors.affiliation: Primary and Interdisciplinary Care University of Antwerp, Antwerp, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: Bastiaens
authors.affiliation: Community Health and Behavior Sciences Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Joseph K B
authors.initials: JK
authors.lastname: Matovu
authors.affiliation: Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Nuwaha
authors.affiliation: MARPS Network, Kampala, Uganda.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Mujisha
authors.affiliation: Community Health and Behavior Sciences Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Juliet
authors.initials: J
authors.lastname: Kiguli
authors.affiliation: Ministry of Health, Kampala, Uganda.
authors.forename: Jim
authors.initials: J
authors.lastname: Arinaitwe
authors.affiliation: International Health, University of Antwerp, Antwerp, Belgium.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Van Geertruyden
authors.affiliation: Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Rhoda K
authors.initials: RK
authors.lastname: Wanyenze
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D017280:Condoms / Q000706:statistics & numerical data*; D005106:Exploratory Behavior; D005239:Fear; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D063509:Homophobia; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D017008:Negotiating; D010146:Pain; D012306:Risk; D021841:Safe Sex; D012725:Sexual Behavior / Q000523:psychology; D014454:Uganda; D055815:Young Adult