Condom use philosophy and behaviors among young men who have sex with men: Variations among HIV pre-exposure prophylaxis users and nonusers.

View Abstract

BACKGROUND

In the United States, sexually transmitted infections, particularly HIV, occur at disproportionally high rates among young men who have sex with men (YMSM). Oral pre-exposure prophylaxis (PrEP) is a highly effective in reducing HIV acquisition. Reduction of condom use has been noted among adult populations of MSM using PrEP. However, less is known about PrEP and condom use among YMSM.

PURPOSE

Our objective was to understand condom attitudes/beliefs and behaviors among YMSM in the context of PrEP use and nonuse.

METHODOLOGICAL ORIENTATION

We conducted qualitative interviews between May and November, 2017 in Boston, MA. All YMSM were HIV-negative by self-report. We purposively sampled youth who used PrEP and those who did not use PrEP. Data were analyzed using content analysis.

SAMPLE

The sample consisted of 31 YMSM aged 17-24 years (mean = 21.5 years).

CONCLUSIONS

Young men who have sex with men provided rich descriptions of their condom-use philosophies and behaviors. Three themes emerged: 1) Different condom philosophies between youth who used PrEP and youth who do not, 2) Inconsistent or absent condom use by PrEP users, and 3) Similar condom behaviors regardless of PrEP use with certain partner types, if low self-efficacy was reported, and when sex occurred during periods of substance use and/or intoxication.

IMPLICATIONS FOR PRACTICE

This study provides understanding of YMSM condom decision-making process in the context of PrEP use or nonuse. Findings are useful to inform development and testing of individually tailored interventions for YMSM based on their personal condom-use philosophies and behaviors to improve risk reduction decision making, use of condoms, and PrEP.

Investigators
Abbreviation
J Am Assoc Nurse Pract
Publication Date
2020-04-08
Pubmed ID
32282565
Medium
Print-Electronic
Full Title
Condom use philosophy and behaviors among young men who have sex with men: Variations among HIV pre-exposure prophylaxis users and nonusers.
Authors
Fontenot HB, Krakower D, White BP, Marquez SM, Dormitzer J, Psaros C, OʼCleirigh C, Mayer KH