The condom imperative in anal sex – one size may not fit all: A qualitative descriptive study of men who have sex with men (MSM).

Aims and objectives: To explore men who have sex with mens’ views about condom use when having anal intercourse. Background: Internationally, health promotion campaigns utilise behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated; use a condom every time for anal sex regardless of relationship status. Design: Qualitative analysis of data from a cohort of New Zealand men who have sex with men. Methods: A total of 960 useable questionnaires were completed; 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process. Results: Three themes relating to condom use in men who have sex with men were identified. These are: “Safer sex is good sex”, “Condom use is good but …” and “I use condoms sometimes”. Conclusions: The range of responses towards condom use for anal sex in MSM in our sample, reveal this as a complex public health issue, with not all MSM willing to consistently use condoms. Relevance to clinical practice: It is important that nurses do not assume that all MSM are willing to use condoms for anal sex, and should create opportunities for MSM to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help MSM to make decisions that will minimise risk of contracting infections associated with sexual activity.