A Multi-methods Examination of Sexual Partnerships and Condom Use among Low Income Heterosexual African-American Men

Background: This study used both qualitative and quantitative methods to study the sexual partnerships, risk behaviors, and condom use perceptions of low-income heterosexually active African-American men.

Methods: The setting is a large, publicly funded STD clinic in a major metropolitan city. The research used both a quantitative survey (N = 159) and qualitative focus groups (N = 18).

Results: The quantitative survey results indicated that most men (71%) had a main partner and many (42%) also had additional sex partners. Median number of female sex partners (past year) was 4. The qualitative data also supported a norm of multiple, concurrent sexual partners, and men elucidated the different types of sexual partners that existed beyond their main partner (e.g., friend, jump off, one night stand). 13% of men reported sex with other men in the past year. The quantitative study found protected sex to be infrequent, particularly with main partners. Despite some positive attributes of condoms, qualitative discussions revealed numerous barriers to condom use in the context of main and casual sexual partnerships. Differences in these barriers as well as in approaches to condom negotiation in main versus casual partnerships were found.

Conclusions: Low income, heterosexual African-American men visiting this STD clinic were found to engage in numerous unprotected sexual risk behaviors with multiple partners. Interventions that are responsive to the unique cultural context of this population are urgently needed.