Cross sectional and longitudinal data on condom use among homosexually active men is presented. Data pertain to two waves of interviewing (1987/8 and 1991) from Project SIGMA, a large longitudinal study of male homosexual behaviour in the light of HIV. Aggregate changes across the time-period indicate an increase in condom use for both insertive and receptive anal intercourse, particularly with casual partners. Condom use is still much more prevalent with casual rather than regular partners. Longitudinal analysis show considerable changes at the individual level, with almost a third of men changing their practices. Half of those decreased their risk behaviours, whilst the other half increased them. Less than 1% used condoms for fellatio in the year preceding the 1991 interview, but 8.3% had used other barriers during sex, primarily for hygiene and fun reasons, rather than as disease prophylaxis. Some implications are drawn for condom promotion and HIV prevention.
PIP: Even though the uptake of condoms by homosexual and bisexual males definitely ranks as one of the most dramatic health protective behavioral changes ever recorded, HIV prevention campaigns nonetheless continue to encourage these men to use condoms during anal intercourse. Maybe 10% of gay men used condoms prior to 1980, and then primarily for reasons of hygiene, but 78% of gay and bisexual men use them for anal intercourse by 1987 and were regularly used by 50% of all men engaging in anal sex. This paper reports changes in condom use in the only non-clinic longitudinal study of gay and bisexual) men in England and Wales. 358 men were interviewed 1987/88 and 1991, and a total of 472 men in 1991. The participants were predominantly well-educated, White, and happy with their sexuality. At the aggregate level, an increase in condom use was observed over the period for both insertive and receptive anal intercourse, especially with casual partners. Longitudinal analysis shows a lot of change at the individual level, with almost a third of the men changing their practices; half of these, however, decreased their risk behaviors, while the other half increased them. Further, less than 1% used condoms for fellatio in the year preceding the 1991 interview, but 8.3% had used other barriers such as rubber gloves and dental dams during sex mainly for hygiene and fun reasons instead of for disease prevention. The authors comment on the implications of these findings for condom promotion and HIV prevention.