Power, communication and condom use: patterns of HIV-relevant sexual risk management in heterosexual relationships

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Abstract
Combining relationship-based theories with quantitative methods is a relatively new approach in HIV prevention research. In this paper--focusing on relationship power, communication on HIV protection measures and condom use--clusters are identified which contribute to the understanding of HIV-relevant sexual risk management in heterosexual contacts. Data on 508 heterosexual contacts were collected in the German-speaking part of Switzerland using computer-assisted telephone interviews. Condom use is practised regularly among young and middle-aged couples but not among older couples. Cluster analyses show that in sexual contacts with equal or female power, communication appears to be decisive as to whether a condom is used. Male relationship power, however, is accompanied by relatively frequent condom use, regardless of whether the couple communicated about HIV protection measures. Implications for HIV prevention research and strategies, with an emphasis on aspects of relationship, gender and age, are suggested.