Condom use during most recent anal intercourse event among a U.S. sample of men who have sex with men.

Introduction: Recent nationally representative data documenting event-level condom use have included samples that are predominantly heterosexual, resulting in limited information on rates of condom use for penile-anal intercourse (PAI) among men who have sex with men (MSM).
Aim: This study sought to document the demographic and event-specific situational factors associated with condom use during most recent PAI among MSM.
Methods: Data were collected via an Internet survey from 14,750 MSM (ages 18-87 years) from 50 U.S. states and the District of Columbia.
Main Outcome Measures: Measures included items related to sociodemographics, recent sexual behavior history, event characteristics, condom use, and items associated with ejaculation during the event.
Results: Participants' median age was 39.0 years; race/ethnicities included white (83.2%), Latino (7.2%), and African American (3.9%), and most men (85.3%) identified as homosexual. Age (P ≤ 0.001), race/ethnicity (P ≤ 0.001), partner status (P ≤ 0.001), and location of sexual event (P ≤ 0.001) were all significantly related to the likelihood of condom use during men's most recent PAI with another man. In total, only 2.5% of the entire sample reported that ejaculation occurred in their own or their sexual partner's anus without a condom during most recent PAI.
Conclusions: This study provides a large-scale assessment of condom use during the most recent PAI among MSM in the United States. Findings from this study highlight diversity in condom use behaviors and demonstrate varying degrees of potential risk for human immunodeficiency virus and other sexually transmitted infections. Future prevention efforts should consider contextual components of condom use, including partner type, location of the sexual event, and semen exposure, to more accurately develop individualized risk reduction strategies.
(© 2012 International Society for Sexual Medicine.)