Condom Usage Among Gay Couples Varies by Race

Coupled black men who have sex with men tend to use condoms more often than white MSM couples, according to research presented at the 19th International AIDS Conference in Washington. Black MSM couples tended not to discuss condom use -- unlike white MSM couples, who nonetheless were more likely to have unprotected sex. The MSM studied lived in San Francisco and New York City.

For black MSM couples, condom use was more likely regardless of HIV status. Having safe sex was an unspoken rule, so condom use was expected, these couples said.

"Research has shown that some of the fastest-growing HIV cases in the US are among men in couple relationships and among black men," said Colleen Hoff, study leader and sexuality studies professor at San Francisco State University. "However, we studied black men with black partners and found that they are practicing safe sex. This suggests that being in a relationship isn't a risk factor for black men. We need to keep searching for other factors that may explain the high incidence of HIV among this demographic."

Most white couples did not use condoms, regardless of HIV status, after talking over the risks. Interracial couples were divided on using condoms. Serodiscordant white and interracial couples took the HIV-positive partner's health into consideration when deciding whether to have protected or unprotected sex. Many associated a treatment-related low viral load with being less infectious.

"They might interpret decreased risk as no risk and hence use no protection," Hoff said. "It's a calculated risk they are taking."

Safe-sex lapses among black couples tended to be followed by discussion, HIV testing, and a return to condom use. Interracial and white couples were more likely to continue having sex without condoms.

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