Skip to main content

Advertisement

SpringerLink
Log in

PrEP Use and PrEP Use Disclosure are Associated with Condom Use During Sex: A Multilevel Analysis of Latino MSM Egocentric Sexual Networks

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Pre-exposure prophylaxis (PrEP) is integral to HIV prevention; however, the influence of PrEP use and PrEP use disclosure on condom use is unclear among Latinx men who have sex with men (LMSM). This study explored associations of LMSM PrEP use and use disclosure on consistent dyadic condom use in the past 6 months. Participants were 130 HIV-negative PrEP and non-PrEP using LMSM ages 20–39 years. Two-level logistic regression models assessing individual- and dyadic-level predictors on condom use were fitted using R. Participants reported a mean of four sexual partners (n = 507 dyads). Participants who reported using PrEP or having more sexual partners were more likely to use condoms; however, participants who reported disclosing PrEP use were less likely to use condoms. Future longitudinal studies should characterize approaches to increase informed personal health choices and conversations about PrEP, condom use, and other HIV risk-reduction strategies using network methodologies.

Resumen

La pastilla PrEP es un nuevo método profiláctico para prevenir el contagio del VIH. Aun no se ha determinado la manera en que el consumo de PrEP y las conversaciones sobre el uso de PrEP puedan influenciar en el uso de condones entre los hombres Latinos que tienen relaciones sexuales con otros hombres (HLSH). Este estudio exploró las asociaciones entre el uso y la divulgación del uso de PrEP con el uso de condones durante las relaciones sexuales que los HLSH tuvieron en los últimos 6 meses. En este estudio participaron un total 130 HLSH que eran VIH-negativos usuarios. Los participantes podían ser usuarios o no usuarios de PrEP, pero todos debían tener entre 20 y 39 años. Estimamos modelos de regresión logística de dos niveles, utilizando el programa R, para identificar factores individuales y diádicos asociados con el uso de condones. Los participantes reportaron un promedio de cuatro parejas sexuales (n = 507 diadas). Encontramos que los participantes que reportaron usar PrEP o tenían un promedio mayor de parejas sexuales tenían una mayor probabilidad de haber usando condones. Sin embargo, la probabilidad de haber usados condones se redujo en los participantes que comunicaron a sus parejas sexuales que usaban PrEP. Es necesario implementar otros estudios longitudinales para entender como diseñar estrategias basadas en redes sociales que promuevan conversaciones sobre PrEP y el uso de condones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Diagnoses of HIV infection among adults and adolescents in metropolitan statistical areas—United States and Puerto Rico, 2017. HIV Surveill Suppl Rep. 2019;24.

  2. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2010–2016. HIV Surveill Suppl Rep. 2019;24(1):1–89.

    Google Scholar 

  3. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2014–2018. HIV Surveill Suppl Rep. 2020;25(1):1–77.

    Google Scholar 

  4. Hess KL, Hu X, Lansky A, Mermin J, Hall HI. Lifetime risk of a diagnosis of HIV infection in the United States. Ann Epidemiol. 2017;27(4):238–43.

    Article  PubMed  PubMed Central  Google Scholar 

  5. HIV/AIDS Section, Division of Disease Control and Health Protection, Florida Department of Health. HIV Epidemiology Area 11a. Tallahasee, FL: Florida Department of Health; 2018.

  6. Zea MC, Reisen CA, Poppen PJ, Bianchi FT. Unprotected anal intercourse among immigrant Latino MSM: the role of characteristics of the person and the sexual encounter. AIDS Behav. 2009;13(4):700–15.

    Article  PubMed  Google Scholar 

  7. Poppen PJ, Reisen CA, Zea MC, Bianchi FT, Echeverry JJ. Predictors of unprotected anal intercourse among HIV-positive Latino gay and bisexual men. AIDS Behav. 2004;8(4):379–89.

    Article  PubMed  Google Scholar 

  8. Poppen PJ, Reisen CA, Zea MC, Bianchi FT, Echeverry JJ. Serostatus disclosure, seroconcordance, partner relationship, and unprotected anal intercourse among HIV-positive Latino men who have sex with men. AIDS Educ Prev. 2005;17(3):227–37.

    Article  PubMed  Google Scholar 

  9. Lo SC, Reisen CA, Poppen PJ, Bianchi FT, Zea MC. Cultural beliefs, partner characteristics, communication, and sexual risk among Latino MSM. AIDS Behav. 2011;15(3):613–20.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dolezal C, Carballo-Diéguez A, Nieves-Rosa L, Dı́az F. Substance use and sexual risk behavior: understanding their association among four ethnic groups of Latino men who have sex with men. J Subst Abuse. 2000;11(4):323–36.

    Article  PubMed  Google Scholar 

  11. Pines HA, Gorbach PM, Weiss RE, Reback CJ, Landovitz RJ, Mutchler MG, et al. Individual-level, partnership-level, and sexual event-level predictors of condom use during receptive anal intercourse among HIV-negative men who have sex with men in Los Angeles. AIDS Behav. 2016;20(6):1315–26.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jarama SL, Kennamer JD, Poppen PJ, Hendricks M, Bradford J. Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men. AIDS Behav. 2005;9(4):513–23.

    Article  PubMed  Google Scholar 

  13. Halkitis PN, Kapadia F, Siconolfi DE, Moeller RW, Figueroa RP, Barton SC, et al. Individual, psychosocial, and social correlates of unprotected anal intercourse in a new generation of young men who have sex with men in New York City. Am J Public Health. 2013;103(5):889–95.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mayfield W. The development of an internalized homonegativity inventory for gay men. J Homosex. 2001;41(2):53–76.

    Article  CAS  PubMed  Google Scholar 

  15. Lin Y-J, Israel T. A computer-based intervention to reduce internalized heterosexism in men. J Couns Psychol. 2012;59(3):458.

    Article  PubMed  Google Scholar 

  16. Reisner SL, O’Cleirigh C, Hendriksen ES, McLain J, Ebin J, Lew K, et al. “40 & Forward”: preliminary evaluation of a group intervention to improve mental health outcomes and address HIV sexual risk behaviors among older gay and bisexual men. J Gay Lesbian Soc Serv. 2011;23(4):523–45.

    Article  Google Scholar 

  17. Cahill S, Valadéz R, Ibarrola S. Community-based HIV prevention interventions that combat anti-gay stigma for men who have sex with men and for transgender women. J Public Health Policy. 2013;34(1):69–81.

    Article  PubMed  Google Scholar 

  18. De Santis JP, Gattamorta KA, Valdes B, Sanchez M, Provencio-Vasquez E. The relationship of Hispanic cultural factors and sexual behaviors of Hispanic men who have sex with men. Sex Cult. 2019;23(1):292–309.

    Article  Google Scholar 

  19. Cauce AM, Domenech-Rodriguez M. Latino families: myths and realities. In: Latino children and families in the United States: current research and future directions. Westport, CT: Praeger Publishers; 2002. p. 3–25.

    Google Scholar 

  20. Hogben M, Aral SO. Risk compensation in the age of biomedical prevention. Focus (San Francisco, Calif). 2010;24(4):5–7.

    Google Scholar 

  21. Eaton LA, Kalichman SC. Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies. Curr HIV/AIDS Rep. 2007;4(4):165–72.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Cassell MM, Halperin DT, Shelton JD, Stanton D. Risk compensation: the Achilles’ heel of innovations in HIV prevention? BMJ. 2006;332(7541):605–7.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Montaño MA, Dombrowski JC, Dasgupta S, Golden MR, Duerr A, Manhart LE, et al. Changes in sexual behavior and STI diagnoses among MSM initiating PrEP in a clinic setting. AIDS Behav. 2019;23(2):548–55.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Newcomb ME, Moran K, Feinstein BA, Forscher E, Mustanski B. Pre-exposure prophylaxis (PrEP) use and condomless anal sex: evidence of risk compensation in a cohort of young men who have sex with men. J Acquir Immune Defic Syndr. 2018;77(4):358–64.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Golub SA, Kowalczyk W, Weinberger CL, Parsons JT. Preexposure prophylaxis and predicted condom use among high-risk men who have sex with men. J Acquir Immune Defic Syndr. 2010;54(5):548–55.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Chen Y-H, Guigayoma J, McFarland W, Snowden JM, Raymond HF. Increases in pre-exposure prophylaxis use and decreases in condom use: behavioral patterns among HIV-negative san Francisco men who have sex with men, 2004–2017. AIDS Behav. 2019;23(7):1841–5.

    Article  PubMed  Google Scholar 

  27. Holt M, Lea T, Mao L, Kolstee J, Zablotska I, Duck T, et al. Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013–17. Lancet HIV. 2018;5(8):e448–56.

    Article  PubMed  Google Scholar 

  28. Traeger MW, Schroeder SE, Wright EJ, Hellard ME, Cornelisse VJ, Doyle JS, et al. Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis. Clin Infect Dis. 2018;67(5):676–86.

    Article  PubMed  Google Scholar 

  29. Hoff CC, Chakravarty D, Bircher AE, Campbell CK, Grisham K, Neilands TB, et al. Attitudes towards PrEP and anticipated condom use among concordant HIV-negative and HIV-discordant male couples. AIDS Patient Care STDs. 2015;29(7):408–17.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Marcus JL, Katz KA, Krakower DS, Calabrese SK. Risk compensation and clinical decision making—the case of HIV preexposure prophylaxis. N Engl J Med. 2019;380(6):510–2.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Brooks RA, Landrian A, Nieto O, Fehrenbacher A. Experiences of anticipated and enacted pre-exposure prophylaxis (PrEP) stigma among Latino MSM in Los Angeles. AIDS Behav. 2019;23(7):1964–73.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hooks CN, Gross AM. Racialized sexual risk perceptions of pre-exposure prophylaxis in men who have sex with men. Sex Cult. 2020;24:1738–55.

    Article  Google Scholar 

  33. Andrew BJ, Mullan BA, de Wit JBF, Monds LA, Todd J, Kothe EJ. Does the theory of planned behaviour explain condom use behaviour among men who have sex with men? A meta-analytic review of the literature. AIDS Behav. 2016;20(12):2834–44.

    Article  PubMed  Google Scholar 

  34. Ewart CK. Social action theory for a public health psychology. Am Psychol. 1991;46(9):931.

    Article  CAS  PubMed  Google Scholar 

  35. Rhodes SD, McCoy TP. Condom use among immigrant Latino sexual minorities: multilevel analysis after respondent-driven sampling. AIDS Educ Prev. 2015;27(1):27–43.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kanamori M, Fallon S, Shrader C, Gonzalez V, Doblecki-Lewis S, Moreno Y, Safren S, Inestroza N, Prado G. Sexual networks and social determinants of health to increase prep uptake: how Latino MSM’s sexual network configurations can facilitate PrEP uptake [Oral presentation]. In: Biomedical Prevention Summit, Dec 3–4, 2019; Houston, TX.

  37. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 update: a clinical practice guideline. In: US Public Health Service, editor. Atlanta, GA: Centers for Disease Control and Prevention. 2018.

  38. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inf. 2019;95:103208.

    Article  Google Scholar 

  39. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42(2):377–81.

    Article  Google Scholar 

  40. Knight G, Gonzales N, Saenz D, Bonds D, Germán M, Deardorf J, et al. The Mexican American cultural values scales for adolescents and adults. J Early Adolesc. 2010;30(3):444–81.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Corona R, Rodríguez VM, McDonald SE, Velazquez E, Rodríguez A, Fuentes VE. Associations between cultural stressors, cultural values, and Latina/o college students’ mental health. J Youth Adolesc. 2017;46(1):63–77.

    Article  PubMed  Google Scholar 

  42. Rosseel Y. lavaan: an R package for structural equation modeling. J Stat Softw. 2012;48(2):36.

    Article  Google Scholar 

  43. R Core Team. R: a language and environment for statistical computing. In: Computing RFfS, editor. Vienna, Austria 2019.

  44. Pines HA, Gorbach PM, Weiss RE, Shoptaw S, Landovitz RJ, Javanbakht M, et al. Sexual risk trajectories among MSM in the United States: implications for pre-exposure prophylaxis delivery. J Acquir Immune Defic Syndr. 2014;65(5):579.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Eaton LA, Kalichman SC, Price D, Finneran S, Allen A, Maksut J. Stigma and conspiracy beliefs related to pre-exposure prophylaxis (PrEP) and interest in using PrEP among black and white men and transgender women who have sex with men. AIDS Behav. 2017;21(5):1236–46.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Mustanski B, Ryan DT, Hayford C, Phillips G, Newcomb ME, Smith JD. Geographic and individual associations with PrEP Stigma: Results From the RADAR cohort of diverse young men who have sex with men and transgender women. AIDS Behav. 2018;22(9):3044–56.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Dubov A, Galbo P, Altice FL, Fraenkel L. Stigma and shame experiences by MSM who take PrEP for HIV prevention: a qualitative study. AJMH. 2018;12(6):1843–54.

    PubMed  Google Scholar 

  48. Johnson EH, Jackson LA, Hinkle Y, Gilbert D, Hoopwood T, Lollis CM, et al. What is the significance of black-white differences in risky sexual behavior? J Natl Med Assoc. 1994;86(10):745–59.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Stephenson R, White D, Darbes L, Hoff C, Sullivan P. HIV testing behaviors and perceptions of risk of HIV infection among MSM with main partners. AIDS Behav. 2015;19(3):553–60.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Pérez A, Santamaria EK, Operario D. A systematic review of behavioral interventions to reduce condomless sex and increase HIV testing for Latino MSM. J Immigr Minor Health. 2018;20(5):1261–76.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Algarin AB, Shrader CH, Bhatt C, Hackworth BT, Cook RL, Ibañez GE. The pre-exposure prophylaxis (PrEP) continuum of care and correlates to initiation among HIV-negative men recruited at Miami Gay Pride 2018. J Urban Health. 2019;96(6):835–44.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We acknowledge the men who participated in this study; our community partner Latinos Salud and their team members Christian Oliver, Jeremy Johnston, Cooper Wade, and Omar Valdez; and our mentors.

Funding

Research reported in this publication was supported by the National Institute on Drug Abuse (Awards #K99DA041494 PI: Kanamori, R00DA041494 PI: Kanamori), National Institute of Allergy and Infectious Diseases (Award 350 #P30AI050409 Sub-award PI: Kanamori), National Institute of Mental Health (Award #P30MH116867 Sub-award PI: Kanamori), and National Institute of Minority Health Disparities (Award # F31MD015988 PI: Shrader). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, the National Institute of Minority Health Disparities, or the National Institutes of Health.

Author information

Authors and Affiliations

  1. Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA

    Cho-Hee Shrader, Juan Arroyo-Flores & Mariano Kanamori

  2. Department of Sociology, University of South Florida, 4202 East Fowler Ave CPR 107, Tampa, FL, 33630, USA

    John Skvoretz

  3. Latinos Salud, 2330 Wilton Dr, Wilton Manors, FL, 33305, USA

    Stephen Fallon & Victor Gonzalez

  4. Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd, Room 463, Coral Gables, FL, 33146, USA

    Steven Safren

  5. Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA

    Angel Algarin

  6. Division of Epidemiology, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33136, USA

    Ariana Johnson

  7. Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street #853, Miami, FL, 33136, USA

    Susanne Doblecki-Lewis

Authors
  1. Cho-Hee Shrader
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan Arroyo-Flores
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Skvoretz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephen Fallon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Victor Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Steven Safren
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Angel Algarin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ariana Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Susanne Doblecki-Lewis
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mariano Kanamori
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cho-Hee Shrader.

Ethics declarations

Conflict of interest

Dr. Doblecki-Lewis reports investigator-initiated research support from Gilead Sciences. The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.

Ethical Approval

The present study was approved by the Institutional Review Board of University of Miami (IRB #20180284). All study team members, including our community-based partners, received Human Subjects Research training prior to study commencement. Participants received a $50 gift card as compensation for their time.

Informed Consent

Written consent in either English or Spanish (based on participant preference) was provided and obtained from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shrader, CH., Arroyo-Flores, J., Skvoretz, J. et al. PrEP Use and PrEP Use Disclosure are Associated with Condom Use During Sex: A Multilevel Analysis of Latino MSM Egocentric Sexual Networks. AIDS Behav 25, 1636–1645 (2021). https://doi.org/10.1007/s10461-020-03080-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-020-03080-0

Keywords

Search

Navigation