Abstract

Protection versus pleasure: reduced sensation as a deterrent for condom use among immigrant Latino MSM living in the USA

S.K. Calabrese, C.A. Reisen, M.C. Zea, P.J. Poppen, F.T. Bianchi

The George Washington University, Psychology, Washington, DC, United States

Background: Unprotected anal intercourse (UAI) is often motivated by a desire for greater physical sensation and partner intimacy relative to sex with condoms. The decision to engage in UAI commonly involves a cost-benefit analysis in which these potential gains are weighed against potential risks, which vary by HIV status, sexual role, and partner choice. We examined the impact of perceived pleasure loss related to condoms on participation in insertive and receptive UAI within this context.
Methods: 482 Dominican, Colombian, and Brazilian, immigrant MSM were surveyed regarding their attitudes and sexual practices via A-CASI. Participants rated the pleasure they derived from protected and unprotected sex in each role (insertive and receptive). Discrepancy scores were calculated as indicators of the pleasure loss associated with condom use in each role within the subsamples of participants who had previously engaged in those roles both with and without condoms [n(insertive)=297; n(receptive)=284). Separate logistic regressions were conducted for each group to evaluate perceived pleasure loss, serostatus, and relationship status in relation to UAI over the past 3 months.
Results: Analyses revealed a positive relationship between perceived pleasure loss and likelihood of UAI for both insertive and receptive roles. Additionally, participants were more likely to engage in receptive UAI if they had a main partner. Serostatus was not significantly related to UAI.
Conclusions: Findings indicate that the pleasure loss associated with condoms may be a primary deterrent for their use in either sex role among Latino MSM, regardless of serostatus. However, the main effect of partner status on receptive UAI suggests men may limit their participation in the riskier of the two roles outside of a relationship context. These results support the need to maximize the pleasure-enhancing properties of condoms and develop alternative methods of HIV prevention that do not stifle physical sensation (e.g., rectal microbicides).