Condom use intentions mediate the relationships between psychosocial constructs and HIV sexual risk behavior in young Black men who have sex with men

Seul Ki Choi, Sara LeGrand, Willa Dong, Kathryn Elizabeth Muessig, Lisa B Hightow-Weidman

Research output: Contribution to journalArticle

Abstract

HIV prevention interventions that reduce sexual risk behaviors among young Black men who have sex with men (YBMSM), the most severely affected population in the United States, are critical for reducing disparities in HIV infection. However, there are few theory-based sexual risk reduction interventions designed specifically for YBMSM. This study tested the applicability of the Integrated Behavioral Model (IBM), which theorizes that behavioral intentions mediate the relationship between psychosocial constructs and health behavior on condomless anal intercourse (CAI) among YBMSM. To test key constructs of the IBM, analyses were conducted with baseline data from the HealthMpowerment (HMP) randomized controlled trial. Logistic regression was used to examine the relationships between condom use self-efficacy, norms, attitudes, intentions, and environmental constraints, and CAI. Mediation analysis was conducted to determine if condom use intentions mediated the relationship between psychosocial constructs (i.e., condom use self-efficacy, norms, and attitudes) and CAI. Overall 55.7% reported one or more acts of CAI with a male partner in the past 3 months. Those who reported CAI in the 3 months prior to the baseline survey reported lower self-efficacy for condom use, lower condom use norms, more negative attitudes toward condom use, and lower condom use intentions at baseline than those who reported no CAI. In mediation analysis, the relationships between CAI and self-efficacy for condom use (estimated indirect effect = −0.004 (SE = 0.002)), condom use norms (−0.002 (SE = 0.001)) and attitudes toward condom use (−0.005 (SE = 0.002)) were mediated by condom use intentions. This study applied the IBM to sexual risk behavior among a sample of YBMSM. Results indicate that the relationships between condom use self-efficacy, norms, and attitudes, and CAI were mediated by condom use intentions. Future theory-informed interventions should focus on increasing self-efficacy for condom use, condom use norms, attitudes toward condom use, and condom use intentions to reduce CAI among YBMSM.

LanguageEnglish (US)
Pages53-60
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume31
Issue number1
DOIs
StatePublished - Jan 2 2019

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Condoms
Risk-Taking
risk behavior
Sexual Behavior
HIV
self-efficacy
Self Efficacy
mediation
health behavior
logistics
Health Behavior
regression
Risk Reduction Behavior

Keywords

  • HIV sexual risk behavior
  • Integrated Behavioral Model (IBM)
  • condom use intentions
  • condomless anal intercourse
  • young Black men who have sex with men

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Condom use intentions mediate the relationships between psychosocial constructs and HIV sexual risk behavior in young Black men who have sex with men",
abstract = "HIV prevention interventions that reduce sexual risk behaviors among young Black men who have sex with men (YBMSM), the most severely affected population in the United States, are critical for reducing disparities in HIV infection. However, there are few theory-based sexual risk reduction interventions designed specifically for YBMSM. This study tested the applicability of the Integrated Behavioral Model (IBM), which theorizes that behavioral intentions mediate the relationship between psychosocial constructs and health behavior on condomless anal intercourse (CAI) among YBMSM. To test key constructs of the IBM, analyses were conducted with baseline data from the HealthMpowerment (HMP) randomized controlled trial. Logistic regression was used to examine the relationships between condom use self-efficacy, norms, attitudes, intentions, and environmental constraints, and CAI. Mediation analysis was conducted to determine if condom use intentions mediated the relationship between psychosocial constructs (i.e., condom use self-efficacy, norms, and attitudes) and CAI. Overall 55.7{\%} reported one or more acts of CAI with a male partner in the past 3 months. Those who reported CAI in the 3 months prior to the baseline survey reported lower self-efficacy for condom use, lower condom use norms, more negative attitudes toward condom use, and lower condom use intentions at baseline than those who reported no CAI. In mediation analysis, the relationships between CAI and self-efficacy for condom use (estimated indirect effect = −0.004 (SE = 0.002)), condom use norms (−0.002 (SE = 0.001)) and attitudes toward condom use (−0.005 (SE = 0.002)) were mediated by condom use intentions. This study applied the IBM to sexual risk behavior among a sample of YBMSM. Results indicate that the relationships between condom use self-efficacy, norms, and attitudes, and CAI were mediated by condom use intentions. Future theory-informed interventions should focus on increasing self-efficacy for condom use, condom use norms, attitudes toward condom use, and condom use intentions to reduce CAI among YBMSM.",
keywords = "HIV sexual risk behavior, Integrated Behavioral Model (IBM), condom use intentions, condomless anal intercourse, young Black men who have sex with men",
author = "Choi, {Seul Ki} and Sara LeGrand and Willa Dong and Muessig, {Kathryn Elizabeth} and Hightow-Weidman, {Lisa B}",
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AU - Hightow-Weidman, Lisa B

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