HIV Prevention Method Preferences Within Sexual Partnerships Reported by HIV-Negative MSM and TW in Tijuana, Mexico

  • H. A. PinesEmail author
  • R. Patrick
  • D. M. Smith
  • A. Harvey-Vera
  • J. S. Blumenthal
  • G. Rangel
  • S. J. Semple
  • T. L. Patterson
Original Paper


To assess the potential for decreased condom use as pre-exposure prophylaxis (PrEP) is scaled-up in Latin America, we examined HIV prevention method preferences (neither PrEP nor condoms, condoms only, PrEP only, or PrEP with condoms) within 1302 sexual partnerships reported by 397 HIV-negative men who have sex with men (MSM) and transgender women (TW) in Tijuana, Mexico. Using PrEP with condoms (56%) was preferred to using condoms only (24%), using PrEP only (17%), and using neither PrEP nor condoms (3%). Compared to using condoms only, using PrEP only was preferred within primary (adjusted odds ratio [AOR] = 4.13, 95% confidence interval [CI] 1.92, 8.90) and condomless sex practicing (AOR = 6.97, 95% CI 3.92, 12.40) partnerships, suggesting PrEP use may not displace condom use among MSM and TW in Tijuana and other similar settings.


Pre-exposure prophylaxis HIV prevention method preferences Men who have sex with men Transgender women Mexico 



The authors thank the study participants and staff without whom this study would not have been possible.


This work was supported by grants from the National Institute on Drug Abuse: K01DA040543 (HAP), R01DA037811 (TLP), and T32DA023356 (RP).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.CrossRefGoogle Scholar
  2. 2.
    Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global epidemiology of HIV infection and related syndemics affecting transgender people. J Acquir Immune Defic Syndr. 2016;72(Suppl 3):S210–9.CrossRefGoogle Scholar
  3. 3.
    World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach, 2nd edn. 2016. Accessed 2 Feb 2018.
  4. 4.
    Blumenthal J, Haubrich RH. Will risk compensation accompany pre-exposure prophylaxis for HIV? Virtual Mentor. 2014;16(11):909–15.CrossRefGoogle Scholar
  5. 5.
    Fonner VA, Dalglish SL, Kennedy CE, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30(12):1973–83.CrossRefGoogle Scholar
  6. 6.
    Traeger MW, Schroeder SE, Wright EJ, 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.CrossRefGoogle Scholar
  7. 7.
    Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000–2006: a systematic review. PLoS Med. 2007;4(12):e339.CrossRefGoogle Scholar
  8. 8.
    Baral SD, Poteat T, Stromdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):214–22.CrossRefGoogle Scholar
  9. 9.
    Hoagland B, De Boni RB, Moreira RI, et al. Awareness and willingness to use pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women in Brazil. AIDS Behav. 2017;21(5):1278–87.CrossRefGoogle Scholar
  10. 10.
    Peinado J, Lama JR, Galea JT, et al. Acceptability of oral versus rectal HIV preexposure prophylaxis among men who have sex with men and transgender women in Peru. J Int Assoc Provid AIDS Care. 2013;12(4):278–83.CrossRefGoogle Scholar
  11. 11.
    Galea JT, Kinsler JJ, Salazar X, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. Int J STD AIDS. 2011;22(5):256–62.CrossRefGoogle Scholar
  12. 12.
    Colfax G, Vittinghoff E, Husnik MJ, et al. Substance use and sexual risk: a participant- and episode-level analysis among a cohort of men who have sex with men. Am J Epidemiol. 2004;159(10):1002–12.CrossRefGoogle Scholar
  13. 13.
    Hensel DJ, Rosenberger JG, Novak DS, Reece M. Sexual event-level characteristics of condom use during anal intercourse among HIV-negative men who have sex with men. Sex Transm Dis. 2012;39(7):550–5.CrossRefGoogle Scholar
  14. 14.
    Mansergh G, Shouse RL, Marks G, et al. Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sex Transm Infect. 2006;82(2):131–4.CrossRefGoogle Scholar
  15. 15.
    Mustanski B, Newcomb ME, Clerkin EM. Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychol. 2011;30(5):597–605.CrossRefGoogle Scholar
  16. 16.
    Rosenberger JG, Reece M, Schick V, et al. Condom use during most recent anal intercourse event among a US sample of men who have sex with men. J Sex Med. 2012;9(4):1037–47.CrossRefGoogle Scholar
  17. 17.
    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.CrossRefGoogle Scholar
  18. 18.
    Underhill K. Intimacy, condom use, and pre-exposure prophylaxis (PReP) acceptability among men who have sex with men (MSM) in primary partnerships: a comment on Gamarel and Golub. Ann Behav Med. 2015;49(2):151–3.CrossRefGoogle Scholar
  19. 19.
    Pitpitan EV, Goodman-Meza D, Burgos JL, et al. Prevalence and correlates of HIV among men who have sex with men in Tijuana, Mexico. J Int AIDS Soc. 2015;18:19304.CrossRefGoogle Scholar
  20. 20.
    Salas-Espinoza KJ, Menchaca-Diaz R, Patterson TL, et al. HIV prevalence and risk behaviors in male to female (MTF) transgender persons in Tijuana, Mexico. AIDS Behav. 2017;21(12):3271–8.CrossRefGoogle Scholar
  21. 21.
    Heckathorn DD. Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44(2):174–99.CrossRefGoogle Scholar
  22. 22.
    Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV Knowledge Questionnaire. AIDS Educ Prev. 2002;14(2):172–82.CrossRefGoogle Scholar
  23. 23.
    Doherty IA, Padian NS, Marlow C, Aral SO. Determinants and consequences of sexual networks as they affect the spread of sexually transmitted infections. J Infect Dis. 2005;191(Suppl 1):S42–54.CrossRefGoogle Scholar
  24. 24.
    Carey MP, Carey KB, Maisto SA, Gordon CM, Weinhardt LS. Assessing sexual risk behaviour with the timeline followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients. Int J STD AIDS. 2001;12(6):365–75.CrossRefGoogle Scholar
  25. 25.
    Kauth MR, St Lawrence JS, Kelly JA. Reliability of retrospective assessments of sexual HIV risk behavior: a comparison of biweekly, three-month, and twelve-month self-reports. AIDS Educ Prev. 1991;3(3):207–14.Google Scholar
  26. 26.
    Schroder KE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med. 2003;26(2):104–23.CrossRefGoogle Scholar
  27. 27.
    Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.CrossRefGoogle Scholar
  28. 28.
    Goodreau SM, Carnegie NB, Vittinghoff E, et al. What drives the US and Peruvian HIV epidemics in men who have sex with men (MSM)? PLoS ONE. 2012;7(11):e50522.CrossRefGoogle Scholar
  29. 29.
    Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.CrossRefGoogle Scholar
  30. 30.
    Smith DK, Herbst JH, Rose CE. Estimating HIV protective effects of method adherence with combinations of preexposure prophylaxis and condom use among African American men who have sex with men. Sex Transm Dis. 2015;42(2):88–92.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Infectious Diseases and Global Public Health, Department of MedicineUniversity of California, San DiegoLa JollaUSA
  2. 2.Comisión de Salud Fronteriza México-Estados Unidos-El Colegio de la Frontera NorteTijuanaMexico
  3. 3.Department of PsychiatryUniversity of California, San DiegoLa JollaUSA

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