Fifty Ways to Leave Your Rubber: How Men in Mombasa Rationalize Unsafe Sex

Sarah C. Thomsen, Family Health International
Michael Stalker, Family Health International
Cathy Toroitich-Ruto, Family Health International
Ndugga Baker Maggwa, Family Health International
Peter Mwarogo, Family Health International

Background: In Kenya, 50-70% of female sex workers (SWs) are HIV+, but they are often at the mercy of their male partners when it comes to using condoms. More research is needed to look at men’s attitudes towards condoms, and to identify ways to increase condom use among men who frequent sex workers. Methods: Over 100 men were contacted through participant observations and in-depth interviews in locations where commercial sexual transactions are initiated regarding their attitudes towards male condoms. Results: We documented fifty excuses, which can be grouped into five different reasons for non-use: perceived costs, perceived benefits, perceived efficacy of condoms, self-efficacy, and locus of control. Conclusions: Some reasons that men dislike condoms are difficult to affect directly, others are due to gaps in knowledge and myths. This qualitative data will help design targeted interventions that increase the likelihood of initiated and sustained behavior change.