Factors associated with nonuse of condoms in heterosexual men and women attending an HIV testing clinic in Israel

Objectives: To examine gender differences in HIV-related knowledge, perceived vulnerability, beliefs in self-control, type of sexual partnership, and their associations with nonuse of condoms. Methods: Heterosexual men and women who voluntarily attended an HIV testing clinic in Israel were asked to complete a self-report questionnaire. Scales of HIV knowledge and control and a single item for vulnerability were used. Type of sexual relationship (monogamous vs. nonmonogramous) and condom use in vaginal sex (never vs. ever) referred to the previous 6 months. Response rate was 84%; 154 men and 109 women participated. Results: Beliefs in self-control did not form a reliable scale and single items were used. No statistically significant gender differences were found in knowledge, vulnerability, or beliefs in self-control. Levels of correct HIV-related knowledge were high, but so were some misconceptions. The vast majority (87%) perceived themselves as vulnerable to HIV infection. The beliefs in self-control were moderate in some items, and low in others. In logistic regression models, different factors were significantly associated with nonuse of condoms in the two genders: the belief that their lifestyle protected them against HIV infection (OR=2.72, CI=1.06-7.03) among men, and being monogamous (OR=3.72, CI=1.28- 10.8) among women. Conclusion: Heterosexual men and women attending an HIV testing clinic need counseling to further lower misconceptions about HIV transmission and additional gender-specific counseling to address HIV- related beliefs.