Condom use and non-use among transgender women in Colombia: a qualitative analysis based on the IMB model

Moncayo Quevedo, Jorge Eduardo; Pérez-Arizabaleta, María Del Mar; Reyes Sevillano, Wilmar Hernán

doi:10.11606/s1518-8787.2022056004145

Brasil

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Original Article • Rev. Saúde Pública 56 • 2022 • https://doi.org/10.11606/s1518-8787.2022056004145 linkcopy

Condom use and non-use among transgender women in Colombia: a qualitative analysis based on the IMB model

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE Review the reasons for condom use and non-use among transgender women in Colombia based on the information, motivation and behavioral skills (IMB) model.

METHOD Qualitative study in which an iterative process analysis was carried out. A focal group participated in person, and in-depth interviews were conducted virtually.

RESULTS First study carried out in Colombia on condom use among transgender women under the IMB model. The information component finds that traditional sexual education does not have a positive impact. Regarding motivational aspects, the importance of family support and follow-up and community-based organizations to motivate sexual health care and condom use is highlighted. Regarding behavioral skills, it was found that distrust towards sexual partners and the acquisition of condoms promote their use.

CONCLUSIONS It is important to create spaces for sexual education delivered by and for the LGBTIQ population, followed by the medical knowledge of health centers, to have positive impacts on the sexual health of transgender women; studies with sexual partners of transgender women are encouraged in order to know the reasons why they request the non-use of condoms.

Women; Transgender Persons; Unsafe Sex; Sexual and Gender Minorities, psychology; Qualitative Research

Variable	n (%)
Age (in years)
20–24	2 (6.1)
25–29	6 (18.2)
30–34	3 (9.1)
35–39	5 (15.2)
40–44	5 (15.2)
45–49	3 (9.1)
≥ 50	9 (27.3)
Marital status
Married	2 (6.1)
Polyamorous	1 (3.0)
Survivor	1 (3.0)
Unmarried	4 (12.1)
Single	24 (72.7)
Widowed	1 (3.0)
Race/Ethnicity
African	8 (24.2)
Black	1 (3.0)
White	3 (9.1)
Indigenous	2 (6.1)
Mestiza	13 (39.4)
Mulatto	1 (3.0)
Trigueña	5 (15.2)
Occupation
Alternate (stylist by day and sex worker by night)	4 (12.1)
Truck driver	1 (3.0)
Human rights advocate	7 (21.2)
Nurse	1 (3.0)
Stylist	7 (21.2)
Gardener	1 (3.0)
Webcam model	6 (18.2)
Various jobs	2 (6.1)
Sex worker	4 (12.1)
Monthly income (USD)
0–50	8 (24.2)
51–100	4 (12.1)
100–180	3 (9.1)
181–260	4 (12.1)
261–385	6 (18.2)
385–515	2 (6.1)
≥ 516	6 (18.2)
Socioeconomic stratum
1	8 (24.2)
2	8 (24.2)
3	15 (45.5)
5	2 (6.1)
Highest level of education attained
Complete undergraduate degree	5 (15.2)
Incomplete undergraduate degree	5 (15.2)
Complete technician or vocational	7 (21.2)
Complete high school	9 (27.3)
Incomplete high school	4 (12.1)
Complete primary school	1 (3.0)
Incomplete primary school	1 (3.0)
None	1 (3.0)

Theoretical component	Primary code	Secondary code	Exemplary quote
Information	Knowledge about condoms	Pregnancy prevention	The first time I heard about condoms was in school, and they related it to pregnancy prevention. At first my parents told me to use a condom so I wouldn’t get someone pregnant.
	Knowledge about condoms	STI prevention	When I started talking about HIV, I learned that it was a way to prevent HIV. I know that condoms protect against many diseases.
	Lack of knowledge	Lack of information	When I was young I didn’t know about condoms, I didn’t protect myself for a long time because I didn’t think it was necessary. When I began to have experience in sexual relations I learned about it. I had the habit of using double condoms and not using condoms. They have the idea that there is a risk in penetration but there is no risk in oral sex, so they protect themselves for penetration, but they do not protect themselves for oral sex.
Motivation	Personal motivational experiences	Self-care	One has to take care of the self, and value themselves as a human being, as a person. Over time I realized that I have to take care of my body, so I protect myself when I have sex. I always use it because I think it is a total danger not to use it, how scary to get a disease and damage your life, imagine the Aids, that you have to live with that, with constant treatments, how scary.
Motivation	Social motivational experiences	Acceptance by the blood and social family	When a trans girl counts on the support of her family, it greatly influences one’s desire to take care of one’s own health and that of others. In the community-based organization I go to (Santamaría Fundación) they motivate me to take care of my health, to use condoms and to make my partner respect me in my sexual practices. I am very careful in my sexual practices because I am afraid that my family will see me sick, and I will have to deal with an illness.
Behavior	Use	Mistrust of the sexual partner	I go with the client and at once I take out my condom and I uncover it and if the man has a problem because of the condom, I tell him that I am sorry but there is no service. If a man tells me that he pays me more for being without a condom, I already know that this is something dangerous and I refuse to have sex with him.
	Use	Acquisition	I use it when I they are available. I can claim them at health centers and also at foundations. There are many organizations or foundations that give them away.
	Non-use	Characteristics of condoms	Condoms are too tight. Sometimes condoms cause allergies.
		Client’s conditions in sex work	There are trans women who are in need and it’s their turn, so they agree to sex without a condom when they are offered extra money. Nobody shoots porn with a condom anymore. One tries to put the condom on the toy, but if it appears a little bit the client makes them take it off.
		Relations with the sexual partner	The only thing that would influence the use of condoms is if the person is my steady partner for a long time, then it could be eliminated, but otherwise no. Men always say that they don’t feel with a condom. They get angry when you ask for it, and say it’s because they lose sensation. Besides, if you ask for it, they start distrusting you, saying that you are unfaithful.
Behavior	Non-use	Acquisition	There are very expensive condoms; people with limited economic resources cannot buy them because they have other needs. I was ashamed to go to a pharmacy to buy condoms.
		Disinhibition: attraction	When you like a man, the last thing you think about is using a condom. If you like the person, you can do anything in bed, even without a condom.
		Disinhibition: arousal	At the moment of arousal when you forget to use a condom, it doesn’t matter, you don’t even realize it.
		Disinhibition: consumption of psychoactive substances and alcohol	When I’m drunk I lose my mind, become irresponsible; everyone is irresponsible after being drunk. Alcohol makes us do many things, with a glass of alcohol you don’t care if it’s with or without a condom.
		Oral sex	Oral sex with a condom is horrible. I’m more flexible when it comes to oral sex. I do it without a condom.

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro

[TFN1] STI: sexually transmitted infections; HIV: human immunodeficiency virus.