Sociocultural Factors Affect Condom Use Among Black Men With Substance Use Disorders

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shutterstock_328029845Although HIV prevention during substance abuse treatment is ideal, existing HIV risk-reduction interventions are less effective among Black and other ethnic minority substance abusers.

Though a number of recent theories have highlighted the importance of increasing our understanding of the relationship of sociocultural factors to sexual decision-making as a step towards developing more HIV prevention interventions for ethnic minorities, few studies have examined sociocultural factors in the sexual decision-making process of Black substance abusing men.

The HIV prevention intervention Real Men Are Safe (REMAS) was evaluated in a multisite, randomized clinical trial in the NIDA Clinical Trials Network (protocol CTN-0018; the Pacific Northwest Node was the lead Node on this project).

This secondary analysis aimed to examine the relation of two specific sociocultural factors (masculinity and perceived barriers to condom use) to the self-reported sexual behaviors of Black substance abusing men with their main and casual female partners.

Analyses of the baseline data of 126 Black men entering substance abuse treatment revealed that the endorsement of both personal and social masculinity predicted more unprotected sexual occasions (USO) with casual partners. The perception that condoms decreased sexual pleasure also predicted higher USO rates with casual partners.  However, fewer partner barriers was not associated with USO among casual partners as expected. Neither the endorsement of social or personal masculinity or perceived condom barriers predicted USO with main partners.

Conclusions: These findings suggest that interventions that depict condom use as both pleasurable and congruent with Black male perceptions of masculinity may be more effective with Black substance abusing men than interventions focusing solely on health beliefs or education. Future research should continue to investigate the influence of other sociocultural factors, especially those that influence the sexual decision-making process, on sexual risk behaviors among Black men, as well as other groups.

Citation: Wilson J, et al. Do Masculinity and Perceived Condom Barriers Predict Heterosexual HIV Risk Behaviors Among Black Substance Abusing Men? Journal of Health Disparities Research and Practice 2014;7(6):54-71.

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