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Intimacy Motivations and Pre-exposure Prophylaxis (PrEP) Adoption Intentions Among HIV-Negative Men Who Have Sex with Men (MSM) in Romantic Relationships

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

In the USA, men who have sex with men (MSM) in primary partnerships are at elevated risk for human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP), a new biomedical prevention strategy, has potential to reduce HIV transmission. This study examined predictors of PrEP adoption intentions among HIV-negative MSM in primary partnerships.

Methods

The sample included HIV-negative MSM (n = 164) who participated in an ongoing cross-sectional study with an in-person interview examining PrEP adoption intentions.

Results

Higher HIV risk perception, intimacy motivations for condomless sex, recent condomless anal sex with outside partners, education, and age were each independently associated with PrEP adoption intentions. In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions.

Conclusions

Intimacy motivations may play a central role in PrEP adoption for MSM couples. Incorporating relationship dynamics into biomedical strategies is a promising avenue for research and intervention.

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References

  1. Centers for Disease Control and Prevention. Estimated HIV incidence among adults and adolescents in the United States, 2007–2010. HIV Surveillance Supplemental Report; 2012.

  2. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2011. HIV Surveillance Report; 2013.

  3. Sullivan PS, Hamouda O, Delpech V, et al. Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005. Ann Epid. 2009; 19(6): 423-31.

    Article  Google Scholar 

  4. 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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006–2009. PloS one. 2011; 6(8): e17502.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Golub SA, Starks TJ, Payton G, Parsons JT. The critical role of intimacy in the sexual risk behaviors of gay and bisexual men. AIDS Behav. 2012; 16(3): 626-32.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Farr RH, Forssell SL, Patterson CJ. Gay, lesbian, and heterosexual adoptive parents: Couple and relationship issues. Journal of GLBT Family Studies. 2010; 6(2): 199-213.

    Article  Google Scholar 

  8. Peplau LA, Fingerhut AW. The close relationships of lesbians and gay men. Ann Rev Psychol. 2007; 58: 405-24.

    Article  Google Scholar 

  9. Adam BD, Sears A, Schellenberg EG. Accounting for unsafe sex: Interviews with men who have sex with men. J Sex Res. 2000; 37: 24-6.

    Article  Google Scholar 

  10. Suarez T, Miller J. Negotiating risks in context: A perspective on unprotected anal intercourse and barebacking among men who have sex with men—where do we go from here? Arch Sex Behav. 2001; 30(3): 287-300.

    Article  CAS  PubMed  Google Scholar 

  11. 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 Central  PubMed  Google Scholar 

  12. Newcomb ME, Ryan DT, Garofalo R, Mustanski B. The effects of sexual partnership and relationship characteristics on three sexual risk variables in young men who have sex with men. Arch Sex Behav. 2013:1–12.

  13. Malebranche DJ, Fields EL, Bryant LO, Harper SR. Masculine socialization and sexual risk behaviors among Black men who have sex with men: A qualitative exploration. Men and Masculinities. 2009; 12(1): 90-112.

    Article  Google Scholar 

  14. Rhodes T, Cusick L. Love and intimacy in relationship risk management: HIV positive people and their sexual partners. Soc Health Ill. 2000; 22(1): 1-26.

    Article  Google Scholar 

  15. Diaz R, Ayala G. Love, passion and rebellion: Ideologies of HIV risk among Latino gay men in the USA. Culture, Health, & Sexuality. 2002; 1: 277-93.

    Article  Google Scholar 

  16. Purcell DW, Mizuno Y, Smith DK, et al. Incorporating couples-based approaches into HIV prevention for gay and bisexual men: Opportunities and challenges. Arch Sex Behav. 2014; 43(1): 35-46.

    Article  PubMed  Google Scholar 

  17. Hoff CC, Chakravarty D, Beougher SC, Darbes LA, Dadasovich R, Neilands TB. Serostatus differences and agreements about sex with outside partners among gay male couples. AIDS Edu Prev. 2009; 21(1): 25-38.

    Article  Google Scholar 

  18. Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch SexBehav. 2010; 39(3): 774-87.

    Google Scholar 

  19. Hoff CC, Stall R, Paul K, et al. Differences in sexual behavior among HIV discordant and concordant gay men in primary relationships. J Acquir Immune Defic Syndr. 1997; 14(1): 72-8.

    Article  CAS  Google Scholar 

  20. Brady SS, Iantaffi A, Galos DL, Rosser BS. Open, closed, or in between: Relationship configuration and condom use among men who use the internet to seek sex with men. AIDS Behav. 2013; 17(4): 1499-514.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Goodman RN, Rietschel JC, Roy A, et al. Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke. J Rehabil Res Dev. 2014; 51(2): 213-28.

    Article  PubMed  Google Scholar 

  22. Hoff CC, Beougher SC, Chakravarty D, Darbes LA, Neilands TB. Relationship characteristics and motivations behind agreements among gay male couples: Differences by agreement type and couple serostatus. AIDS Care. 2010; 22(7): 827-35.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Eng J Med. 2010; 363: 2587-99.

    Article  CAS  Google Scholar 

  24. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Eng J Med. 2012; 367: 399-410.

    Article  CAS  Google Scholar 

  25. Thigpen MC, Kebaabetswe PM, Paxton LA, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Eng J Med. 2012; 367: 423-434.

    Article  CAS  Google Scholar 

  26. Food and Drug Administration. Truvada approved to reduce the risk of sexually transmitted HIV in people who are not infected with the virus. 2012.

  27. Centers for Disease Control and Prevention. Pre-exposure prophylaxis for the prevention of HIV infection in the United States: A clinical practice guideline. 2014.

  28. White JM, Mimiaga MJ, Krakower DS, Mayer KH. Evolution of Massachusetts physician attitudes, knowledge, and experience regarding the use of antiretrovirals for HIV prevention. AIDS Patient Care ST. 2012; 26(7): 395-405.

    Google Scholar 

  29. Tripathi A, Ogbuanu C, Monger M, Gibson JJ, Duffus WA. Preexposure prophylaxis for HIV infection: Healthcare providers’ knowledge, perception, and willingness to adopt future implementation in the southern US. South Med J. 2012; 105(4): 199-206.

    Article  PubMed  Google Scholar 

  30. Khawcharoenporn T, Kendrick S, Smith K. HIV risk perception and preexposure prophylaxis interest among a heterosexual population visiting a sexually transmitted infection clinic. AIDS Patient Care ST. 2012; 26(4): 222-33.

    Google Scholar 

  31. Krakower DS, Mimiaga MJ, Rosenberger JG, et al. Limited Awareness and Low Immediate Uptake of Pre-Exposure Prophylaxis among Men Who Have Sex with Men Using an Internet Social Networking Site. PloS one. 2012; 7(3): e33119.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger C. From Efficacy to Effectiveness: Facilitators and Barriers to PrEP Acceptability and Motivations for Adherence Among MSM and Transgender Women in New York City. AIDS Patient Care ST. 2013; 27(4): 248-54.

    Article  Google Scholar 

  33. Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Pre-exposure antiretroviral prophylaxis (PrEP) attitudes in high risk Boston area MSM: Limited knowledge and experience, but potential for increased utilization after education. J Acquir Immune Defic Syndr. 2009; 50(1): 77.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Brooks RA, Kaplan RL, Lieber E, Landovitz RJ, Lee S, Leibowitz AA. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care. 2011; 23(9): 1136-45.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Brooks RA, Landovitz RJ, Kaplan RL, Lieber E, Lee S, Barkley TW. Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: A mixed methods study. AIDS Patient Care ST. 2012; 26(2): 87-94.

    Article  Google Scholar 

  36. Mimiaga MJ, Closson EF, Kothary V, Mitty JA. Sexual partnerships and considerations for HIV antiretroviral pre-exposure prophylaxis utilization among high-risk substance using men who have sex with men. Arch Sex Behav. 2013:1–8.

  37. 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: 365-75.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Lewis MA, McBride CM, Pollak KI, Puleo E, Butterfield RM, Emmons KM. Understanding health behavior change among couples: An interdependence and communal coping approach. Soc Sci Med. 2006; 62(6): 1369-80.

    Article  PubMed  Google Scholar 

  39. New York City Department of Health and Mental Hygiene. Pediatric/Adolescent HIV/AIDS Surveillance in New York City: Annual Report, December 2009. 2010.

  40. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Conger RD, Conger KJ, Martin MJ. Socioeconomic status, family processes, and individual development. J Marriage Fam. 2010; 72(3): 685-704.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Maisel NC, Karney BR. Socioeconomic status moderates associations among stressful events, mental health, and relationship satisfaction. J Fam Psychol. 2012; 26(4): 654.

    Article  PubMed  Google Scholar 

  43. Kalichman SC, Grebler T. Stress and poverty predictors of treatment adherence among people with low-literacy living with HIV/AIDS. Psychosom Med. 2010; 72(8): 810-6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  44. Gardner EM, McLees MP, Steiner JF, del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011; 52(6): 793-800.

    Article  PubMed Central  PubMed  Google Scholar 

  45. WHO. Guidance on couples HIV testing and counseling including antiretroviral therapy for treatment and prevention in serodiscordant couples: Recommendations for a public health approach. 2012.

  46. Stephenson R, Sullivan PS, Salazar LF, Gratzer B, Allen S, Seelbach E. Attitudes towards couples-based HIV testing among MSM in three US cities. AIDS Behav. 2011; 15(1): 80-7.

    Article  Google Scholar 

  47. Wagenaar BH, Christiansen-Lindquist L, Khosropour C, et al. Willingness of US men who have sex with men (MSM) to participate in couples HIV voluntary counseling and testing (CVCT). PloS one. 2012; 7(8): e42953.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. Bolger N, Davis A, Rafaeli E. Diary methods: Capturing life as it is lived. Ann Rev Psychol. 2003; 54(1): 579-616.

    Article  Google Scholar 

  49. Bolger N, Laurenceau JP. Intensive longitudinal methods: An introduction to diary and experience sampling research. New York, NY: Guilford Press; 2013.

    Google Scholar 

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Acknowledgments

This project was funded by grant R01MH095565 from the National Institute of Mental Health (S.A. Golub, PI). The authors gratefully acknowledge the hardwork of Anthony Surace, Kailip Boonrai, Inna Saboshchuk, and Dr. Corina Lelutiu-Weinberger. We also thank Dr. Jeffrey Parsons and the staff at the Center for HIV Educational Studies and Training. We are grateful to the participants who gave their time and energy to this study and to Dr. Willo Pequegnat for her support.

Conflict of Interest

Drs. Kristi Gamarel and Sarit Golub declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Authors and Affiliations

  1. Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Avenue, New York, NY, 10065, USA

    Kristi E. Gamarel PhD & Sarit A. Golub PhD

  2. Doctoral Program in Psychology, The Graduate Center of the City University of New York (CUNY), New York, NY, USA

    Kristi E. Gamarel PhD & Sarit A. Golub PhD

Authors
  1. Kristi E. Gamarel PhD
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  2. Sarit A. Golub PhD
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Correspondence to Sarit A. Golub PhD.

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Gamarel, K.E., Golub, S.A. 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. 49, 177–186 (2015). https://doi.org/10.1007/s12160-014-9646-3

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  • DOI: https://doi.org/10.1007/s12160-014-9646-3

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