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NEGOTIATING SAFETY OR SLIPPING
OUT OF CONDOMS? PROCESSES WHEREBY GAY MALE COUPLES STOP PRACTISING PROTECTED
SEX
Barry
D Adam1, Winston Husbands2, James Murray2,
and John Maxwell2
1University of Windsor, Windsor, Ontario; 2AIDS Committee
of Toronto, Toronto, Ontario
Objectives:
This research reports on differences between male couples who practise unprotected
sex through "negotiating safety" and couples who drop condom use without
knowing their serostatus.
Methods: Qualitative interviews with gay men in couples in
metro Toronto (N=59) with a small Windsor comparative group (N=5).
Results: The narratives of men in couples who report episodic
or no condom use, and who have not "negotiated safety" fall into several
modalities: (a) men who rely on a romance or monogamy script consistent with
widespread heterosexual models of relationships. It is noteworthy that this
script appears especially strong among men of South Asian, Latin American, and
Caribbean background in this sample. (b) Men who report erectile difficulties
with condom use struggle to find solutions (such as delayed application) or
abandon condoms altogether. Older men are overrepresented in this group. (c)
An emergent form of neoliberal moral reasoning, consistent with prevailing ideologies
of the larger society, provides legitimacy for unprotected sex, especially among
certain urban networks of HIV-positive men.
Conclusion: Despite the "rational man"premises of
health-belief theories, the narratives of men at risk show a set of countervailing
concerns and cultural scripts that make them more vulnerable to HIV transmission.
Effective HIV prevention requires addressing these concerns and scripts rather
than simply appealing to presumed "self-interest" or "reason".