Why do homosexual men continue to practise unsafe sex? A critical review of a qualitative research paper.

Abstract

Introduction techniques usingindepthquestioning inindividual interviews andfocused group discussions are particularly suited to exploring thefactors thatinfluence behaviour. Qualitative researchers studyphenomenaand eventsintheir natural settings, often interpretingthemintermsofthesubjective meanings attached bytheindividual. Thisapproach is unique initsability toprovide a greater understanding ofthefull rangeofexperiences and attitudes. Incontrastwiththedeductive predominanceof most quantitative research, qualitative research tendsto beinductivethatis, usesempirical datatobuildup a pictureandunderstanding ofthephenomenon beingresearched. Indeedmany ofthecomputerpackages thatare now usedforthe analysis ofqualitative dataare basedon the inductive framework whichusesdatatogenerate hypotheses and buildtheories-a "grounded theory" approach. Qualitative techniques can alsoidentify issuesand concepts;clarify language and meaning;and explore perceptions, experiences,attitudes, andbehaviour. Withappropriate sampleselection, thesefactors can be investigated intermsofdifferences andsimilarities betweenindividuals, aswell asaddressingthecomplexities ofindividual experience. Itisparticularly appropriate forexploration of sensitive topics, thesuccessofwhichdepends on building rapportandgaining theconfidenceoftherespondent. Sexual health isperhaps one areawherethe complementary use ofqualitative andquantitative research methodsisbestillustrated. Qualitative research hascontributed greatly to our understanding ofsexual behaviours and lifestyles, safer sexpractice, andunderstanding process issuesinbehavioural interventions. Qualitative andquantitative research may be usedto investigate similar topics although eachwilladdress a different typeofquestion. Forexample, inrelation tosexual behaviour, a quantitative study can determine thedistributionanddeterminants ofmultiple sexual partnerships among a group ofrespondents. A qualitative approach, on theotherhand, wouldbe more appropriate to explore conceptssurrounding choice ofpartners, nuances ofbehaviours, andsociocultural factors associatedwiththeadoption ofthislifestyle. Inthis article we illustrate howtocritically reviewqualitative research findings usinga critical appraisal checklist whichcompiles a numberofkeyassessmentcriteria (seetable 1).Thesecriteria willbeapplied toan article whichexamines homosexual men'sexplanationsforengaging inunprotected analintercourse.' Eachofthefollowing sections relates tothepoints obtained inthecritical appraisal checklist.