![[ Visit Client Website ]](images/banner.gif)
Learning Objective 1: The learner will be able to articulate reasons for using and not using condoms among MSM
Learning Objective 2: The learner will be able to discuss cultural processes to decision-making related to condom use among MSM
Methods: Trained community interviewers, conducted in-depth interviews Hindi or Marathi 20 self-identified MSM. Audio-recorded interviews were transcribed verbatim and translated to English. Three initial transcripts were read to develop a coding list which was used to code the remaining interviews. An intensive 2-day meeting resulted in a final concept map with themes and connected sub-themes.
Results: Knowledge about risk prevention through condom use was high. However, cultural patterns of decision-making regarding the use of condoms (sex partner from ‘good’ family; looks clean; introduced by a family member) dominated reasons for using or not using condoms. Primary sub-themes were abuse, violence, and sex work (forced sex with clients; emotional disempowerment) and beliefs about safe sex and partners (using herbs for prevention; withdrawal before ejaculation). Challenges to conducting community-based research in an international setting in different languages are myriad and lessons learned will also be presented (sustaining solid partnerships, extensive process evaluations and feasibility testing, and training processes to build capacity in the research setting.
Conclusion: Successful behavior change interventions must be built on foundations that leverage existing cultural norms to optimize effectiveness, rather than be drawn from heterosexual and Western cultural perspectives. In India, in many areas, nurses are the only healthcare providers, dispensing both community health interventions and acute medical care. Information on factors associated with safe sex behaviors, when confirmed in through quantitative studies as we anticipate, will be integral to building a community-centered nursing prevention intervention.