Barriers to condom use among Men Living with HIV: A Qualitative study in Iran

Unprotected sexual activity is playing an increasingly important role in the currently growing incidence of HIV infection in Iran. Recognizing barriers to safe sexual practice can improve planning for condom promotion, which was the objective of the present study. This qualitative study was performed through three behavioral disease consultation clinics (HIV care clinics) in Tehran, Iran. Participants were selected among HIV-positive men patients initially by convenience sampling and narrowed-down by maximum diversity sampling in order to obtain a sample that would express various viewpoints regarding barriers to condom use. Data were collected using semi-structured individual interviews. All interviews were recorded and codes were extracted after reviewing them several times. In this study 32 participants were interviewed. Barriers to condom use were classified in four sub-themes include: Individual Beliefs (Decreased in sexual satisfaction, No need for condom use in Sero discordant couples, Failure of condom use during sexual contact, Being extra accessories), Access /Availability of Condoms (Shyness of buying condoms, No condom access at the beginning of intercourse, Expensive condoms), Personal (Wish to have children, Laziness and discomfort for condom use) and Condoms (Low quality and no Variety of condoms in Iran). Most of the participants named decreased sexual satisfaction as the most important reason for not using condoms, followed by shyness and diffidence towards buying condoms and limited access to condoms when initiating sexual intercourse. Because of the decreased sexual satisfaction and unpleasantness of condoms, 12.5% of the HIV-positive men had not used condoms on their last sexual intercourse. The most important reason mentioned by the HIV-positive patients, for not using condoms was the decrease in sexual satisfaction. Different strategies have been suggested to overcome this barrier, one of which is the educational-behavioral strategy. Another strategy could be applying a structural strategy in the community. [Homeira Fallahi, Sedigheh Sadat Tavafian, Farideh Yaghmaie, Ebrahim Hajizadeh, Ali Rastegarpour. Barriers to condom use among Men Living with HIV: A Qualitative Study in Iran. Life Sci J 2012;9(3):2593-2599] (ISSN:1097-8135). http://www.lifesciencesite.com. 376