BELIZE (2013): HIV/AIDS TRaC Study Evaluating Condom Use among MSM in Belize City. Round 3

The study aimed to monitor trends in behaviors and other key determinants of Opportunity, Ability, and Motivation (OAM) among Men who have sex with Men (MSM) in Belize. The research objectives were to identify the factors that characterize MSM who use condoms with all kinds of sex partners and to evaluate the effectiveness of condom use promotion through various interventions. The study employed a Respondent-Driven Sampling (RDS) method to select 282 MSM participants. The survey included questions about demographics, sexual behavior, use of condoms and lubricants, OAM determinants, and exposure to PSI interventions. Univariate analysis was conducted to monitor trends in 2012, controlling for socio-demographic characteristics and city. Significant determinants of consistent condom use with all clients and stable partners were identified through multivariate logistic regression, controlled by city. The main findings of the study indicate that condom use with all kinds of partners shows a regular behavior among all MSM subgroups, with a higher percentage of MSM (56.1%) using condoms compared to Trans (42.7%). However, condom use behavior decreases significantly when measured by whether it is used until the end of sex intercourse. The percentage of MSM who carried a condom when interviewed was very low in MSM and Male Sex Workers (MSW) subgroups, but increased to 39.6% in Trans. The study also found that the percentage of MSM who had an HIV test and received their results was very low, but improved in the Trans subgroup. The use of coupons on IPC activities was effective in Trans, but low in MSW and MSM subgroups. The exposure to mass media messages from PSI was more effective in Trans, while the percentage of MSM who identified correctly HIV ways of transmission was higher in MSM and MSW subgroups. The results of segmentation analysis indicate that the probability of MSM using condom consistently from beginning to the end of sex intercourse increases when they have a positive attitude towards HIV prevention practices. Conversely, the probability decreases when MSM feel able to use a condom rightly, buy condoms in boxes, agree with statements of the social norm scale of discrimination, and are circumcised. Based on the results, some programmatic recommendations were made. Firstly, efforts should be enhanced on condom use promotion through IPC activities to improve perception in MSM about the importance of using condoms consistently. Secondly, efforts should be reinforced on HIV test promotion, especially in MSW, as this subgroup shows a low use of HIV test compared to other MSM subgroups. Friendly services and practices should be improved to reduce perceptions of discrimination among MSW. The study's findings and recommendations aim to inform the development of effective interventions to promote condom use and HIV testing among MSM in Belize.