Accounting for unsafe sex: Interviews with men who have sex with men

Semi-structures one-on-one interviews with 102 gay and bisexual men were conducted to examine the reasoning processes men use to exempt themselves from practicing safe sex. Qualitative analysis of the interviews revealed the following recurring themes: (a) many men who were in couple relationships avoided condom use for reasons involving intimacy or trust, or because both partners were HIV-negative; (b) unsafe sex sometimes occurred inadvertently or involuntarily; (c) negative moods and self-images were associated with unsafe sex; (d) by "intuiting" that their partner was HIV-negative, participants exempted themselves from the need for safe sex; and (e) when the boundary between safe and unsafe was unclear participants used a combination of unofficial and official guidelines to determine what is safe.