title: The condom imperative in anal sex - one size may not fit all: a qualitative descriptive study of men who have sex with men.
abstract: OBJECTIVE
  To explore men who have sex with men's views about condom use when having anal intercourse.
  
  
  BACKGROUND
  Internationally, health promotion campaigns use behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated that 'use a condom every time for anal sex regardless of relationship status'.
  
  
  METHODS
  Qualitative analysis of data from a cohort of New Zealand men who have sex with men.
  
  
  METHODS
  A total of 960 useable questionnaires were completed: 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process.
  
  
  RESULTS
  Three themes relating to condom use in men who have sex with men were identified. These are as follows: 'Safer sex is good sex', 'Condom use is good but …' and 'I use condoms sometimes'.
  
  
  CONCLUSIONS
  The range of responses towards condom use for anal sex in men who have sex with men in our sample reveal this as a complex public health issue, with not all men who have sex with men willing to consistently use condoms.
  
  
  CONCLUSIONS
  It is important that nurses do not assume that all men who have sex with men are willing to use condoms for anal sex, and should create opportunities for men who have sex with men to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help men who have sex with men to make decisions that will minimise risk of contracting infections associated with sexual activity.
authors.affiliation: Department of Nursing, AUT University, Auckland, New Zealand.
authors.forename: Stephen
authors.initials: S
authors.lastname: Neville
authors.affiliation: SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand.
authors.forename: Jeffery
authors.identifier: http://orcid.org/0000-0003-3052-5249
authors.initials: J
authors.lastname: Adams
authors.affiliation: School of Health & Social Care, London South Bank University, London, UK.
authors.forename: Calvin
authors.initials: C
authors.lastname: Moorley
authors.affiliation: Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.
authors.forename: Debra
authors.identifier: http://orcid.org/0000-0001-5252-5325
authors.initials: D
authors.lastname: Jackson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D006293:Health Promotion; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009520:New Zealand; D036301:Qualitative Research; D021841:Safe Sex; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: 
  HIV
  ; anal sex; condom use; men who have sex with men; qualitative survey; sexual health