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'You shouldn't trust what i tell you in a survey': a mixed methods study on contradictions regarding condom use between statements from hiv positive men who have sex with men in quantitative surveys versus in-depth qualitative interviews

Author: 
Roberto Garcia, Denise G. Ramos and Mariliza H. da Silva
Subject Area: 
Health Sciences
Abstract: 

Background: Previous studies demonstrate that the incidence of HIV infection has increased among men who have sex with men. And yet, quantitative surveys fail to demonstrate a corresponding change in their behavior. Aims: To conduct a mixed methods study about condom use among HIV positive individuals, comparing reports provided through a quantitative survey and a qualitative interview. Methods: We collected quantitative data from 178 HIV positive participants, 81 of them also undergoing a qualitative interview. Results: A total of 73 (41%) individuals in our overall sample reported to always use condoms during sex in the quantitative survey (n = 178), while in our qualitative interview sub-sample only 14 (17.3%) individuals did not report behaviors that contradicted the constant use of condoms (n = 81), the decrease in percentage being attributed to contradictions. A large percentage of these individuals providing contradictory statements reported making use of illicit drugs during sex. We also found a number of qualitative emerging concepts indicating that contradictory statements were made in the context of fictitious scenarios where condoms were not used, situations where trust was questioned, simply not being willing to use condoms without any apparent rationale, darkrooms, and situations where patients willingly engaged in extreme sexual behaviors. Conclusions: Given the discrepancy between what individuals report in quantitative surveys and what they subsequently report during qualitative interviews, clinical and policy guidelines should be cautious in interpreting surveys without a parallel, qualitative component.

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