“The Provider”: The Effects of Economic Inequalities on Self-Efficacy and Sexual Decision Making among MSM

Casey D. Hall, Emory University
Karen L. Andes, Emory University

Self-efficacy has been a model to understand condom negotiations among men who have sex (MSM); however it focuses primarily on individual characteristics and few studies have examined effects of relationship dynamics such as inequalities on self-efficacy. We conducted a 10-week longitudinal qualitative study with MSM examining relationship perceptions and sexual risk-taking. During a baseline in-depth interview (IDI), participants built a retrospective sexual history timeline. Participants completed three follow-up relationship diaries, which were discussed in a debrief IDI. Verbatim transcripts were analyzed as life-stories and thematically coded. Preliminary results suggest that male same-sex relationships often fall along a spectrum of financial imbalance which sometimes mirror traditional heterosexual relationships or transactional sex. This spectrum is defined by financial support by one partner to another which appears to be related to a sense of control and conflict. Results may be used to inform the self-efficacy model to better address sexual decision-making in MSM relationships.