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Kalwicz DA, Rao S, Modrakovic DX, Zea MC, Dovidio JF, Eaton LA, Holt M, MacGibbon J, Zaheer MA, Garner A, Calabrese SK. The Implications of PrEP Use, Condom Use, and Partner Viral Load Status for Openness to Serodifferent Partnering Among US Sexual Minority Men (SMM). AIDS Behav 2024; 28:524-534. [PMID: 38329558 PMCID: PMC10999131 DOI: 10.1007/s10461-023-04241-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 02/09/2024]
Abstract
PrEP has been reported to facilitate openness to serodifferent sexual partnerships among sexual minority men (SMM). However, other aspects of a sexual scenario likely come into play, including whether or not condoms are used and whether or not the partner living with HIV has an undetectable viral load. This online survey study evaluated the association between PrEP status and openness to serodifferent partnering, as well as the effects of various sexual scenario variables (condom use and partner's viral load) among 268 HIV-negative SMM in the US. Each participant reported their PrEP status and rated their openness to serodifferent partnering in four sexual scenarios, which varied by condom use (with/without) and partner viral load status (detectable/undetectable). Analyses of covariance (ANCOVAs) were conducted to assess differences in openness to serodifferent partnering by PrEP status in each scenario, adjusting for background characteristics. A two-way repeated measures ANCOVA and a three-way mixed factorial ANCOVA, including PrEP status as a between-subjects variable, were also performed to assess the effects of condom use and partner viral load status on openness. Across all scenarios, current PrEP users expressed significantly greater openness to serodifferent partnering compared to participants who had never used PrEP. Current PrEP users were also more likely than former PrEP users to consider partnering with someone with an undetectable viral load without using condoms. Both PrEP users and PrEP-inexperienced individuals had greater openness to serodifferent partnering with a partner having an undetectable (vs. detectable) viral load, which was magnified by condom use among the latter.
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Affiliation(s)
- David A Kalwicz
- Department of Psychological and Brain Sciences, George Washington University, 2013 H Street NW, Washington, DC, 20006, USA.
| | - Sharanya Rao
- Department of Psychological and Brain Sciences, George Washington University, 2013 H Street NW, Washington, DC, 20006, USA
| | - Djordje X Modrakovic
- Department of Psychological and Brain Sciences, George Washington University, 2013 H Street NW, Washington, DC, 20006, USA
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, George Washington University, 2013 H Street NW, Washington, DC, 20006, USA
| | - John F Dovidio
- Department of Psychology, Yale University, New Haven, CT, USA
- Social and Behavioral Sciences Department, Yale University, New Haven, CT, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Myra A Zaheer
- Department of Psychological and Brain Sciences, George Washington University, 2013 H Street NW, Washington, DC, 20006, USA
- School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Alex Garner
- Hornet Gay Social Network, Los Angeles, CA, USA
| | - Sarah K Calabrese
- Department of Psychological and Brain Sciences, George Washington University, 2013 H Street NW, Washington, DC, 20006, USA
- Department of Prevention and Community Health, George Washington University, Washington, DC, USA
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McKetchnie SM, White B, Fontenot H, Dormitzer J, Psaros C, Fitch C, O'Cleirigh C, Mayer KH, Krakower DS. Perspectives of Young Men Who Have Sex with Men on PrEP Adherence and Peer Navigation: A Qualitative Study. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2037-2049. [PMID: 36940046 PMCID: PMC10330054 DOI: 10.1007/s10508-023-02579-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
HIV incidence is disproportionately high among young cisgender men who have sex with men (YMSM), but YMSM are less likely than adults to use HIV pre-exposure prophylaxis (PrEP). Among YMSM living with HIV, peer navigation programs have been effective in linkage to care and increasing medication adherence; such programs may aid HIV-uninfected YMSM in overcoming barriers to engagement in PrEP care. We conducted 32 semi-structured qualitative interviews at a community health center in Massachusetts, USA, specializing in sexual and gender minority health with four sub-groups of YMSM who: (1) had never discussed PrEP with a medical provider, (2) had discussed PrEP with a medical provider but declined a prescription, (3) were prescribed PrEP and have sub-optimal adherence (taking fewer than 4 pills per week), and (4) were prescribed PrEP and were optimally adherent. Domains addressed in the interviews included knowledge of PrEP and HIV prevention, barriers and facilitators to PrEP adherence, and attitudes toward peer navigation for PrEP. Interviews were transcribed and coded using thematic analysis methodology. Multiple themes emerged from the interviews, including finding that perceived costs, anticipated stigma, sexual activity, and relationship status influence PrEP uptake and adherence; establishing pill-taking routines is an important adherence facilitator; and peer navigators could offer benefits for PrEP adherence.
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Affiliation(s)
- Samantha M McKetchnie
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02214, USA.
- School of Social Work, Boston College, Newton, MA, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Bradley White
- Department of Nursing, MGH Institute of Health Professionals, Boston, MA, USA
| | - Holly Fontenot
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | | | - Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02214, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Calvin Fitch
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02214, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Conall O'Cleirigh
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02214, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Douglas S Krakower
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA
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