Prevalence and Correlates of Condom Use Resistance Among Men Who Have Sex with Men Reporting Recent Heavy Alcohol Use and Condomless Sex

Condom use resistance (CUR) involves use of coercive and non-coercive tactics to persuade a sexual partner who wants to use a condom to forgo use. Given that limited research has explored use of CUR tactics among men who have sex with men (MSM), the present study sought to estimate the prevalence and correlates of CUR among MSM. Participants (N = 261 MSM reporting recent heavy alcohol use and condomless anal sex) completed measures assessing CUR tactics and correlates (i.e., sexual frequency and risk, sexual sensation seeking, compulsive sexual behavior, alcohol use) as well as measures especially relevant to MSM (i.e., internalized homonegativity, concerns about HIV and sexually transmitted infection [STI] risk, sexual position preference). Results indicated a majority of participants reported any lifetime use of non-coercive (76.8%) and coercive (54.3%) CUR tactics. Frequency of CUR tactic use was significantly associated with increased sexual sensation seeking, compulsive sexual behavior, casual sex frequency, condomless anal sex frequency, and decreased STI concern, but showed limited association with internalized homonegativity, HIV concern, sexual position preference, and alcohol use. Results suggest that prevalence and correlates of CUR among MSM may be similar to men who have sex with women, but this comparison should be made cautiously given the unique dynamics of male-male sexual encounters (e.g., topping vs. bottoming).