Resisting the 'Condom Every Time for Anal Sex' Health Education Message

Objective: Ensuring men who have sex with men (MSM) adopt and maintain condom use for anal sex is a challenging health education goal. In order to inform the development of social marketing practices to encourage safe-sex practices, the views of MSM about a key HIV health education message ("using a condom every time for anal sex") were sought. Design: Individual and paired interviews were conducted face-to-face and online, with a total of 22 MSM who identified as low users of condoms. Transcripts of interviews were analysed thematically. Setting: Online and various locations in Auckland, New Zealand. Results: Two main themes were identified in relation to the men's views of the condom every time message: (a) awareness and appropriateness of the message; and (b) resistance to the message. The men interviewed reported a contradictory view with respect to the condom every time message. While it is viewed as an appropriate message for MSM as a group, for some individual men, particularly those in relationships, the message has little resonance. One solution offered was for the sexual practices of such men to be recognized and for appropriate and more relevant health education messages to be developed. Conclusion: Addressing the gulf between professional and (some) lay understandings of what is appropriate for messages that seek to encourage men to adopt and to maintain condom use, and therefore reduce the chances of HIV infection, remains a significant challenge for health promotion agencies.