Correlations Between Community-Level HIV Preexposure Prophylaxis Coverage and Individual-Level Sexual Behaviors among US Men Who Have Sex with Men

Background HIV preexposure prophylaxis (PrEP) has been associated with changes in sexual behavior after PrEP initiation. However, behavioral differences may also emerge among PrEP non-users in communities with high PrEP coverage. Methods We used demographic, behavioral, and sexual network data from ARTnet, a cross-sectional study of US men who have sex with men conducted during 2017-2019. Multivariable regression models with a Bayesian modeling framework in which individuals were nested within their residential geographic areas were used to estimate associations between area-level PrEP coverage and five sexual behavior outcomes (number of total, main, and casual male partners [network degree]; count of one-time partnerships; and consistent condom use in one-time partnerships), controlling for individual PrEP use. Findings PrEP coverage ranged from 10.3% (Philadelphia) to 38.9% (San Francisco). Total degree was highest in Miami (1.35) and lowest in Denver (0.78), while the count of one-time partners was highest in San Francisco (11.7/year) and lowest in Detroit (1.5/year). Adjusting for individual PrEP use and demographics, community PrEP coverage was associated with higher total degree (adjusted incidence rate ratio [aIRR]=1.73; 95% CrI, 0.92-3.44), casual degree (aIRR=2.05; 95% CrI, 0.90-5.07), and count of one-time partnerships (aIRR=1.90; 95% CrI, 0.46-8.54). Without adjustment for individual PrEP use, these associations were amplified. There were weaker associations with main degree (aIRR=1.21; 95% CrI, 0.48-3.20) and consistent condom use in one-time partnerships (aIRR=1.68; 95% CrI, 0.86-3.35). Interpretation Most of the associations between community PrEP coverage and sexual behavior were explained by individual PrEP use. However, there were residual associations after controlling for individual PrEP use, suggesting that PrEP coverage may partially drive community-level changes in sexual behavior.

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African-American Adolescents Residing in High-risk Urban Environments Do Use Condoms: Correlates and Predictors of Condom Use Among Adolescents in Public Housing Developments

PEDIATRICS ◽

10.1542/peds.98.2.269 ◽

1996 ◽

Vol 98 (2) ◽

pp. 269-278 ◽

Cited By ~ 2

Author(s):

Ralph J. DiClemente ◽

Mark Lodico ◽

Olga A. Grinstead ◽

Gary Harper ◽

Richard L. Rickman ◽

...

Keyword(s):

African American ◽

High Risk ◽

Condom Use ◽

Public Housing ◽

San Francisco ◽

African American Adolescents ◽

Consistent Condom ◽

Consistent Condom Use ◽

Housing Developments

Objective. African-American adolescents living in high-risk inner-city environments have been disproportionately affected by the epidemics of human immunodeficiency virus (HIV) and other sexually transmitted diseases. Understanding the factors that influence the use of condoms by adolescents is critical for developing effective behavioral interventions. The present study examined the demographic, psychosocial, and behavioral correlates of condom use among African-American adolescents residing in public housing developements in an HIV epicenter (San Francisco) and prospectively evaluated the stability of these significant cross-sectional variables to predict consistent condom use. Design. A prospective study. Setting. Two public housing developments in San Francisco. Participants. African-American adolescents and young adults between 12 and 21 years of age were recruited though street outreach and completed a theoretically derived research interview assessing HIV-related knowledge, attitudes, and behaviors. After a 6-month period, adolescents completed a follow-up interview similar to the baseline measure. Among adolescents reporting sexual activity in the 6 months before completing the baseline interview (n = 116), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on consistent condom use. Results. Adolescents who had high assertive self-efficacy to demand condom use (adjusted odds ratio [OR], 11), perceived peer norms as supporting condom use (OR, 4.2), had greater impulse control (OR, 3.7), were male (OR, 4.7), and were younger (OR, 2.9) were more likely to report consistent condom use. Frequency of sexual intercourse was inversely related to condom use; adolescents with higher numbers of sexual episodes were less likely to use condoms consistently. Prospective analyses identified the baseline level of condom use as the best predictor of condom use at the 6-month followup Adolescents who were consistent condom users at baseline were 7.4 times as likely to be consistent condom users during the follow-up period. Of those adolescents changing their frequency of condom use during the follow-up interval, significantly more engaged in risky behavior; 33.3% changed from consistent to inconsistent condom use, whereas 20.6% changed from inconsistent to consistent use (OR, 1.6). Conclusions. The findings suggest that HIV prevention programs need to be implemented early, before high-risk behaviors are established and may be more difficult to modify.

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Condom Use and Related Factors among Rural and Urban Men Who Have Sex With Men in Western China: Based on Information-Motivation-Behavioral Skills Model

American Journal of Men s Health ◽

10.1177/1557988319899799 ◽

2020 ◽

Vol 14 (1) ◽

pp. 155798831989979 ◽

Cited By ~ 2

Author(s):

Ling Hu ◽

Yetao Luo ◽

Xiaoni Zhong ◽

Rongrong Lu ◽

Yang Wang ◽

...

Keyword(s):

Condom Use ◽

Service Providers ◽

Western China ◽

Consistent Condom ◽

Consistent Condom Use ◽

Related Factors ◽

Behavioral Skills ◽

Urban Men ◽

Rural And Urban ◽

Sex With Men

This study aimed to determine the differences in condom use and related factors among rural–urban men who have sex with men (MSM) in Western China. A cross-sectional survey was conducted in Chongqing, Sichuan, and Guangxi, which recruited MSM by non-probability sampling. Data were collected through an anonymous, standardized, and self-reported questionnaire guided by an information–motivation–behavioral skills model. Structural equation model was applied to analyze the related factors. Out of the 1141 MSM included in this analysis, 856 (75%) and 285 (25%) were from urban and rural areas, respectively. The median age was 27 years for both groups. Self-reported consistent condom use for anal sex in the past 6 months was 57.58%. The rate of consistent condom use was lower in rural MSM than in urban MSM (50.88% vs. 59.81%, p = .008). Behavioral skills, HIV/AIDS intervention services, and response costs had direct positive and negative influences on condom use, respectively. By contrast, motivation and information exhibited indirect influence. All the factors were mediated by behavioral skills in rural and urban MSM, except for the information that had no effect among urban MSM but had an indirect effect among rural MSM. These findings suggest that service providers should pay attention to substantial rural–urban differences and design different AIDS prevention and intervention strategies targeting rural and urban MSM.

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What happens after HIV self-testing? Results from a longitudinal cohort of Chinese men who have sex with men

BMC Infectious Diseases ◽

10.1186/s12879-019-4455-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Weiming Tang ◽

Wenting Huang ◽

Haidong Lu ◽

Bolin Cao ◽

Dan Wu ◽

...

Keyword(s):

Hiv Prevention ◽

Condom Use ◽

Hiv Testing ◽

Consistent Condom ◽

Consistent Condom Use ◽

Longitudinal Cohort ◽

Prevention Services ◽

Self Testing ◽

Hiv Test ◽

Sex With Men

Abstract Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.

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Assessing consistent condom use among migrant men who have sex with men in Shanghai, China: validation of an information–motivation–behavioural skills model

BMC Infectious Diseases ◽

10.1186/s12879-019-4090-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Ying Wang ◽

Mengmeng Jia ◽

Dong Yuan ◽

Ajuan Liang ◽

Zhiruo Zhang ◽

...

Keyword(s):

Condom Use ◽

Consistent Condom ◽

Consistent Condom Use ◽

Sex With Men

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Prevalence of Condom Use and Its Related Factors Among Men Who Have Sex With Men in Thailand

Ramathibodi Medical Journal ◽

10.33165/rmj.2019.42.4.207154 ◽

2019 ◽

Vol 42 (4) ◽

pp. 49-59

Author(s):

Sirinan Prakot ◽

Sasisopin Kiertiburanakul ◽

Poolsuk Janepanish Visudtibhan

Keyword(s):

Condom Use ◽

Behavioral Control ◽

Rank Correlation ◽

Subjective Norms ◽

Consistent Condom ◽

Perceived Behavioral Control ◽

Online Questionnaire ◽

Consistent Condom Use ◽

Related Factors ◽

Sex With Men

Background: The new challenge of human immunodeficiency virus (HIV) prevention exists in men who have sex with men (MSM) and becomes the key population accounting for the vast majority of new HIV infections worldwide. Consistent condom use has been proved to be effective to prevent HIV transmission. Promoting the use of condom is needed; however, knowledge on what factors relevant to the performance of this behavior among MSM in Thailand is limited. Objectives: To examine the prevalence rate of condom use among MSM in Thailand, and to identify related factors of its use. Methods: Participants were recruited using convenience sampling with inclusion criteria. The data were collected using an online questionnaire and then analyzed using chi-square test and Spearman rank correlation. Results: A total of 153 data sets from participants were included in the analysis. The average age was 27.4 ± 5.8 years. The HIV positivity was 6.5%, and consistent condom use was 55.6%. The correlational analysis showed that age (P = .03), intention, attitude, subjective norms, and perceived behavioral control (P < .01) were significantly correlated with consistent condom use. Conclusions: The interventions proposed to promote consistent condom use among MSM should focus on increasing intention, attitude, subjective norms, and/or perceived behavioral control, especially among young MSM in Thailand.

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