Decision-making about condom use and nonuse among gay men in Mexico: Meanings, signs and the performance of identity

Although in Mexico condom use is the central HIV/STI prevention strategy promoted among men who have sex with men (MSM) includes gay men, a recent on-line survey among MSM in Mexico found that 50% knew someone who practiced barebacking and 14% reported having practiced it themselves, while surveys indicate that 50-80% of Mexican MSM report “always” using condoms in last sexual intercourse. Therefore, this study's objective was to explore the meanings and representations involved in decision-making by young MSM about condom use during anal penetration. Free-lists, pile-sorts, face-to-face focus groups and on-line individual interviews were carried out with a convenience sample of young gay men. Free-lists and pile-sorts were registered in writing, focus groups were taped and transcribed and on-line interviews were saved as text. Qualitative analyses using cultural consensus theory and the constant comparative method were carried out with Anthropac and NVIVO software. The elements of decision-making about condom use constitute signs used to convey meaning to self and others. Use and nonuse of condoms are involved in the performative construction of identities. Therefore, the decision to use or not to use condoms during anal sex is rarely if ever simply a means to an end (protection or physical pleasure) but is also a vehicle of communication within the performance of gay identities. This research seeks to elucidate the meanings of these behaviors and thereby inform harm-reduction and protective strategies that are better adapted to Mexican gay men's realities and more apt to meet their sexual health needs.