title: Frequent condom use with casual partners varies by sexual position among younger gay and bisexual men in New Zealand: national behavioural surveillance 2006-2011.
abstract: Background Condom promotion remains a cornerstone of HIV/STI control, but must be informed by evidence of uptake and address disparities in use. This study sought to determine the prevalence of, and demographic, behavioural and relational factors associated with, condom use during insertive and receptive anal intercourse with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand.
  
  
  
  The 2006-2011 national HIV behavioural surveillance data for YMSM aged 16-29 years was pooled. Separately for each sexual position, frequent (always/almost always) versus infrequent condom use was regressed onto explanatory variables using manual backward stepwise multivariable logistic regression analysis.
  
  
  
  Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse. YMSM who were exclusively insertive were more likely to report frequent condom use than versatile YMSM. Factors positively associated with frequent condom use, irrespective of sexual position were: in-person versus web-based recruitment, testing HIV negative versus never testing or testing HIV positive, having no recent sex with women, reporting two to five versus one male sexual partner in the past 6 months, reporting no current regular partner, but if in a regular relationship, reporting a boyfriend-type versus fuckbuddy-type partner, and frequent versus infrequent regular partner condom use. Pacific ethnicity and less formal education were negatively associated with frequent condom use only during receptive anal intercourse.
  
  
  
  The findings from this study demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM's capacity, agency and skills to negotiate condom use, especially for the receptive partner.
authors.affiliation: Division of AIDS, Faculty of Medicine, University of British Columbia, 608-1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Lachowsky
authors.affiliation: Department of Social and Community Health, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand.
authors.forename: Peter J W
authors.initials: PJ
authors.lastname: Saxton
authors.affiliation: Research Analysis and Information Unit, New Zealand AIDS Foundation, 31 Hargreaves Street, St. Mary's Bay, Auckland, 1011, New Zealand.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hughes
authors.affiliation: AIDS Epidemiology Group, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
authors.forename: Nigel P
authors.initials: NP
authors.lastname: Dickson
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, N1G 2W1, Canada.
authors.forename: Robin R
authors.initials: RR
authors.lastname: Milhausen
authors.affiliation: Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, N1G 2W1, Canada.
authors.forename: Cate E
authors.initials: CE
authors.lastname: Dewey
authors.affiliation: Department of Biomedical Science, University of Guelph, 50 Stone Road East, Guelph, N1G 2W1, Canada.
authors.forename: Alastair J S
authors.initials: AJ
authors.lastname: Summerlee
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality; D017280:Condoms; D015658:HIV Infections; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D009520:New Zealand; D012725:Sexual Behavior; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities; D055815:Young Adult