Associations Between Relationship Power and Pre-Exposure Prophylaxis (PrEP) Use Among Men Who Have Sex With Men

  • Amy BraksmajerEmail author
  • Chen Zhang
  • James M. McMahon
Original Paper


Few studies have attempted to understand relationship-level factors impacting PrEP utilization among men who have sex with men (MSM). This study examined associations between relationship power and PrEP use among 826 MSM participating in a cross-sectional, Internet-based survey. The results of our analysis indicate that decision-making dominance was positively associated with PrEP use among MSM, but the association between relationship control/overall relationship power and PrEP use was inconclusive. Furthermore, when examining specific types of decision-making dominance, equal and greater dominance compared to one’s partner regarding types of sexual activity engaged in, as well as dominance more generally, were positively associated with PrEP use. However, the relationships between decision-making dominance related to condom use/sexual initiation and PrEP use were inconclusive. This study suggests that the promotion of egalitarian relationships—as well as other relationship-level determinants—should be an essential component of biobehavioral interventions targeting this population.


PrEP Pre-exposure prophylaxis HIV prevention Relationship power MSM 



Support for this work was provided to Dr. Braksmajer by the University of Rochester Center for AIDS Research (NIH P30AI078498). The authors would like to thank the University of Rochester Interdisciplinary Sexual Health and HIV Research Group, as well as the men who agreed to participate in the research, without whom this study would not have been possible.


Support for this work was provided to Dr. Braksmajer by the University of Rochester Center for AIDS Research (NIH P30AI078498) and the University of Rochester School of Nursing.

Compliance with Ethical Standards

Conflict of interest

Amy Braksmajer declares that she has no conflict of interest. Chen Zhang declares that she has no conflict of interest. James M. McMahon declares that he has 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. Informed consent was obtained from all individual participants included in the study.


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Copyright information

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

Authors and Affiliations

  1. 1.Department of SociologyState University of New York at GeneseoGeneseoUSA
  2. 2.School of NursingUniversity of RochesterRochesterUSA

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