BEHAVIORAL RISK-REDUCTION STRATEGIES TO PREVENT HIV-INFECTION AMONG HOMOSEXUAL MEN - A GROUNDED THEORY APPROACH

To be able to design effective health education interventions for homo sexual men, it is necessary to understand determinants of safe and uns afe sex from the perspective of those involved. In this qualitative st udy, therefore, an open approach was taken to allow for this perspecti ve, Interviews were conducted with 50 randomly selected HIV-antibody n egative participants in the Amsterdam Cohort Study. Detailed questions were asked about sexual interactions and behaviors with steady and no nsteady partners. Whether or not homosexual men consciously protected themselves from HIV infection and which strategy they adopted was foun d to depend on three major factors: 1) motivation and intention, 2) si gnificance of anal sex, and 3) risk perception within specific relatio nships. From a theoretical perspective results indicate that, next to the centrality of individual motivation as postulated in both the Theo ry of Reasoned Action and the Theory of Planned Behavior, symbolic mea ning inherent in sexual acts, as well as type of relationship are impo rtant determinants of protective sexual behaviors that have to be take n into account to understand adequately why homosexual men engage in s afe or unsafe sex. Some strategies employed by homosexual men carry un certainties that continue to put them at increased risk for HIV infect ion. Health education interventions can be designed to address these i ssues.