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Understanding Consistent Condom Use Among Homeless Men Who Have Sex with Women and Engage in Multiple Sexual Partnerships: A Path Analysis

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Abstract

Consistent condom use is the main strategy aimed at preventing individuals from acquiring HIV through sexual intercourse. The mechanism of consistent condom use among a high-risk homeless subpopulation—homeless men who have sex with women and also engage in multiple sexual partnerships—remains unclear. This study identified 182 homeless men who engaged in multiple sexual partnerships from a representative sample of homeless men, who self-identified as heterosexual, using meal line services in Downtown Los Angeles’ Skid Row area. Information such as participants’ condom use psychosocial correlates, sexual risk behaviors, and social network characteristics were collected. Results suggested that condom efficacy is a potential intervening mechanism through which condom attitudes (β = −0.199; p = 0.005) and depression (β = −0.156; p = 0.029) are associated with an individual’s consistent condom use. Having more network members with whom participants talked about HIV prevention (β = 0.051; p = 0.006) was also found to be associated with an individual’s consistent condom use. HIV prevention programs should focus on increasing their condom efficacy to help reduce HIV risks among this vulnerable homeless subpopulation.

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Notes

  1. Although in all three hypotheses, both direct and indirect paths from the major independent variables (e.g., condom attitudes, social network characteristics, and individual mental health status) to consistent condom use are proposed, paths modeled in the final path analysis were based on bivariate analysis results.

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Acknowledgments

This research was supported by Grant R01HD059307 from the National Institute of Child Health and Human Development (S. Wenzel, PI). We thank Drs. Joan Tucker, Daniela Golinelli, David Kennedy, and Ryan Brown of the RAND Corporation for their participation in the design and data collection for this study.

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  1. School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA, 90089, USA

    Hsun-Ta Hsu, Suzanne Wenzel, Eric Rice, Tamika D. Gilreath & Seth Kurzban

  2. Department of Preventive Medicine, University of Southern California, 1441 Eastlake Avenue, USC/Norris Comprehensive Cancer Center, NOR-4435, Los Angeles, CA, 90089-9175, USA

    Jennifer Unger

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  1. Hsun-Ta Hsu
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Hsu, HT., Wenzel, S., Rice, E. et al. Understanding Consistent Condom Use Among Homeless Men Who Have Sex with Women and Engage in Multiple Sexual Partnerships: A Path Analysis. AIDS Behav 19, 1676–1688 (2015). https://doi.org/10.1007/s10461-015-1051-9

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