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Data from MSM who participated in a biobehavioural survey in Zimbabwe were used. Secondary statistical data analysis methods were used to determine prevalences and drivers of CAI. This is the first large biobehavioural survey that generated valuable information useful for analysing condomless anal sex among MSM in Zimbabwe.
What this study adds: This study adds to the body of knowledge on factors affecting use of condom during anal sex among MSM in Zimbabwe. The global HIV epidemic among men who have sex with men MSM continues to be a significant public health concern worldwide, given the disproportionate burden of infection this group faces. The primary drivers of CAI can be grouped into socio-behavioural, accessibility, and perceptual dimensions.
Socio-behavioural drivers of CAI were perhaps the most multifaceted. Alcohol use, for example, which can impair judgement and decision-making, emerged as a significant factor. The influence of peer pressure or social norms, often leading to unpreparedness or embarrassment regarding procurement of condoms, is another crucial socio-behavioural factor.
Furthermore, perceptions related to trust, where regular or attractive partners were less likely to use condoms, indicate that relationship dynamics also play a role in determining condom use. MSM might decide not to use condoms when having sex with a regular sexual partner due to the mutual trust that friends would not put them at risk. Likewise, condom unavailability could be a key determinant, which might be due to a lack of adequate distribution or logistical issues in specific areas, highlighting the need for improving access to condoms among this population.
