title: Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men.
abstract: This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men's subjectivities - their perceptions of and preferences for specific brands, types and flavours of condoms and lubricants - influenced engagement with such safer-sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer-sex supplies, health services and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context.
authors.affiliation: a HIV Center for Clinical and Behavioral Studies, Department of Psychiatry , Columbia University and New York State Psychiatric Institute , New York , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Lee
authors.affiliation: a HIV Center for Clinical and Behavioral Studies, Department of Psychiatry , Columbia University and New York State Psychiatric Institute , New York , USA.
authors.forename: Theo
authors.initials: T
authors.lastname: Sandfort
authors.affiliation: a HIV Center for Clinical and Behavioral Studies, Department of Psychiatry , Columbia University and New York State Psychiatric Institute , New York , USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Collier
authors.affiliation: b Center for AIDS Prevention Studies , University of California San Francisco , California , USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Lane
authors.affiliation: c Faculty of Humanities , University of Pretoria , Pretoria , South Africa.
authors.forename: Vasu
authors.initials: V
authors.lastname: Reddy
mesh_terms: D000328:Adult; D044383:Black People; D017280:Condoms / Q000706:statistics & numerical data*; D018451:Homosexuality, Male; D006801:Humans; D007407:Interviews as Topic; D054327:Lubricants; D008297:Male; D036301:Qualitative Research; D021841:Safe Sex; D012725:Sexual Behavior; D012747:Sexual Partners; D013019:South Africa
chemical_list: D054327:Lubricants
keywords: Men who have sex with men; South Africa; condoms; lubricants; sexual experiences