Risk taking behavior in HIV-discordant male couples in the metropolitan area of Mexico City

Abstract

This research explores the meanings of sexual activity and condom use in HIVdiscordant male couples in Mexico City (couples in which only one partner is HIVpositive). For that purpose it draws on forty-four in-depth interviews with men in a current or past HIV-discordant relationship. The general motivation for this research is to explore the factors that, besides knowledge about HIV/AIDS, influence sexual behavior and unprotected sex. In populations at risk for HIV infection, information about prevention is not translated into consistent condom use (Geringer et al., 1990). Empirical studies show that people practice unsafe sex even after learning about the risk of certain sexual practices and the effectiveness of condoms to avoid any sexually transmitted disease (Davis, 2002). Doing research on the meanings that people give to sex and condoms in their everyday lives will also contribute to understanding the behavior that reduces or facilitates the transmission of HIV. Along with previous studies, the present results indicate that for all respondents, sexual interaction is an emotional and meaningful event in the context of their current relationships. All respondents framed their sexual practices with their understanding of commitment and what they expect from a relationship. Results also indicate that an important number of respondents engage in practices of unprotected sex in spite of knowing their discordance regarding HIV. For them raw sex is a way to express their commitment to the relationship, to express how much they are willing to give to each other. These men conceive of a relationship as abandoning oneself to another and sharing the same destiny. Conversely, another important number of men reported condom use on a frequent basis. These men referred to commitment as a way of maintaining each others’ wellbeing: preventing primary and secondary infection. For them a relationship is about mutual responsibility of taking care of the couple’s well being. The policy implication of these results is that health programs should enhance the idea of commitment as mutual care to reduce practices of risky sex. Conversely, health programs should eliminate the perception of commitment as mutual abandonment and sharing the same destiny.