CONTEXT: Most research on heterosexual transmission of HIV and other sexually transmitted diseases (STDs) has focused on women. However, heterosexual transmission of STDs cannot be prevented without a better understanding of men's, as well as women's, sexual beliefs and behaviors. METHODS: Heterosexually active men's beliefs about four methods of STD prevention--abstinence, mutual monogamy, use of male condoms and use of female condoms--were elicited through open-ended interviews. A survey based on these responses was administered to a random sample of 486 heterosexually active men, and scores were calculated to examine their beliefs about each behavior. Additional analyses explored how these beliefs were related to men's characteristics and to their actual behavior. RESULTS: The men held both positive and negative beliefs about the outcomes of using each method and thought that their partners, close friends, health care providers, family members and, to some extent, friends at church had opinions about whether they should use each method. Multiple regression analyses showed that the men's beliefs were related to their marital status and, to some extent, their race or ethnicity and education. Beliefs about the outcomes of practicing abstinence, practicing mutual monogamy and using male condoms with steady partners were significantly related to these behaviors; beliefs about whether they had support for practicing monogamy or using male condoms with steady partners were significant predictors of doing so. CONCLUSIONS: Encouraging safer-sex practices among heterosexually active men will require addressing their beliefs and perceived norms about alternative methods of preventing STDs.
CONTEXT: Most research on heterosexual transmission of HIV and other sexually transmitted diseases (STDs) has focused on women. However, heterosexual transmission of STDs cannot be prevented without a better understanding of men's, as well as women's, sexual beliefs and behaviors. METHODS: Heterosexually active men's beliefs about four methods of STD prevention--abstinence, mutual monogamy, use of male condoms and use of female condoms--were elicited through open-ended interviews. A survey based on these responses was administered to a random sample of 486 heterosexually active men, and scores were calculated to examine their beliefs about each behavior. Additional analyses explored how these beliefs were related to men's characteristics and to their actual behavior. RESULTS: The men held both positive and negative beliefs about the outcomes of using each method and thought that their partners, close friends, health care providers, family members and, to some extent, friends at church had opinions about whether they should use each method. Multiple regression analyses showed that the men's beliefs were related to their marital status and, to some extent, their race or ethnicity and education. Beliefs about the outcomes of practicing abstinence, practicing mutual monogamy and using male condoms with steady partners were significantly related to these behaviors; beliefs about whether they had support for practicing monogamy or using male condoms with steady partners were significant predictors of doing so. CONCLUSIONS: Encouraging safer-sex practices among heterosexually active men will require addressing their beliefs and perceived norms about alternative methods of preventing STDs.