This abstract was presented orally at the 11th Annual Canadian Conference on HIV/AIDS Research in Winnipeg in April 2002, and will be presented as a poster at the XIV International AIDS Conference to be held in Barcelona, Spain, in July 2002.

Beliefs about "cum," condoms and intimacy among young gay men (YGM) in the context of rising HIV incidence in Vancouver

Chris Buchner, Arn J. Schilder, Mary Lou Miller, Steve Martindale, Martin T. Schechter, Michael V. O'Shaughnessy, Robert S. Hogg, Patricia Spittal

The Vanguard Project, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC.

BACKGROUND:

The American CDC has expanded prevention efforts to target HIV-positive individuals. In Canada, such prevention efforts are rare. Furthermore, there has been little research on the sexuality and sexual practices of HIV-positive young gay men (YGM).

OBJECTIVES:

To better understand the cultural beliefs and meanings regarding semen (known as "cum"), condom use and intimacy among HIV+ YGM. The meaning of these concepts in the context of YGM's sexual culture and why some YGM remain vulnerable to risks of HIV and STDs must be better understood in order to reduce transmission.

METHOD:

Participants were recruited from the Vanguard Project. Data collected through 104 in-depth interviews with 26 HIV-positive and HIV-negative YGM were managed through NU*DIST software. Themes investigated included family history, experiences with physical and sexual violence, intimate/affective relationships and HIV-related vulnerabilities.

RESULTS:

For many YGM, cultural beliefs regarding the significance of "cum" are related to intimacy; those who had seroconverted reported more consistently positive and intimate associations with "cum" and its sexual exchange. For these men, condoms were seen as a barrier to intimacy and "real" sex. Within consensual sero-concordant sexuality, HIV-positive gay men often did not consider or conceptualize the need for sexual protection. For these men, condoms had negative cultural connotations often experienced as barriers to the exchange of "cum," which signified a level of desired and unexplored intimate acceptance. HIV-negative participants more often reported distasteful or negative associations with "cum" than their HIV-positive counterparts. For HIV-positive men, significant associations of "cum" with infection seemed limited to recalling their beliefs before infection.

CONCLUSIONS:

The desire for intimacy by YGM is powerful and will often challenge the rational risks associated with HIV transmission and STD infections. It is crucial that the gay cultural significance of condoms and "cum" be understood and addressed in any interventions.