Thoughts Associated with Unprotected Anal Intercourse Among Men at High Risk in San Francisco 1997-1999

Abstract

Men who had high-risk sex with men in the previous year ( N = 124) were asked to recall their thought processes at the time they last had unprotected anal sex with a man who was HIV-positive or of unknown serostatus. Self-justifications for non-condom use were examined individually and in internally validated scales. The most common single self-justification was I want to have unprotected sex because it feels good , endorsed by 76%. Other common thoughts included the notion that it is only human to slip up occasionally (59%) and the resolution to withdraw before ejaculation (59%). For scaled items, the most strongly endorsed themes were: (1) that condoms reduce sexual pleasure (any of 6 items endorsed at least slightly by 90%); (2) fatalism or leaving it to chance (11 items, 81%); and (3) loss of control (9 items, 77%). The thoughts and themes identified may be useful in planning individual and community prevention messages.