Population Council Research that makes a difference

XVIII International AIDS Conference (AIDS 2010)
18–23 July 2010

Abstract

"Conspiracy beliefs about HIV, attitudes toward condoms and treatment, and HIV-related preventive behaviors among men who have sex with men in Tshwane (Pretoria), South Africa"
Waimar Tun, Scott Kellerman, Senkhu Maime, Zukiswa Fipaza, Meredith Sheehy, Lung Vu, and Dawie Nel

Background
South Africans have received messages about HIV origin, treatment, and prevention that contradict evidence-based information and may negatively impact HIV preventive behaviors.

Methods
A cross-sectional survey was conducted with 339 men who have sex with men (MSM) recruited through respondent-driven sampling in Tshwane. Eligibility criteria included being18 years old or older and having sex with another man in the last six months. Face-to-face interviews assessed HIV knowledge, attitudes toward condoms and HIV treatment, HIV-related conspiracy beliefs (i.e., people are being experimented on with new HIV treatments; HIV is man-made), and HIV testing and sexual history.

Results
Two-thirds of the MSM sample were younger than 26 years old, 91 percent were black, 86 percent were single, one-third had more than 12 years' schooling, and 74 percent self-identified as homosexual. Eighty-five percent reported a male sex partner in the past two months, of whom 50 percent reported two or more male sex partners, and 27 percent reported unprotected anal intercourse (UAI). Three-fourths had ever tested for HIV. Over 90 percent had correct knowledge about HIV transmission. However, 19 percent subscribed to at least 3 of 12 conspiracy beliefs, and 11 percent reported being less careful about HIV because of better HIV treatments. MSM who had never tested for HIV were more likely to report being less careful about HIV because of better treatments (AOR: 3.7; 95% CI: 1.6–8.4) and slightly more likely to subscribe to conspiracy beliefs (AOR: 1.8; 95% CI: 0.9–3.7). MSM who reported UAI were more likely to hold negative condom attitudes (AOR: 2.1; 95% CI: 1.1–3.8), be engaged in sex work (AOR: 2.7; 95% CI: 1.2–6.2), and slightly more likely to mistrust government condoms (AOR: 1.8; 95% CI: 1.0–3.3).

Conclusions
Negative condom attitudes, mistrust in government condoms, and misunderstanding about HIV treatment can be barriers to condom use and HIV testing among South African MSM. Media campaigns and peer education may improve HIV-related norms and attitudes.

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