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Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model

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Abstract

This study on determinants of sexual protection behavior among HIV-positive gay men used the empirically tested information-motivation-behavioral skills (IMB) model. HIV-specific variables were added to the model to determine factors decisive for condom use with steady and casual partners. Data were collected using an anonymous, standardized self-administered questionnaire. Study participants were recruited at HIV outpatient clinics associated with the Eurosupport Study Group and the Swiss HIV Cohort Study. To identify factors associated with condom use, backward elimination regression analyses were performed. Overall, 838 HIV-infected gay men from 14 European countries were included in this analysis. About 53% of them reported at least one sexual contact with a steady partner; 62.5% had sex with a casual partner during the last 6 months. Forty-three percent always used condoms with steady partners and 44% with casual partners. High self-efficacy and subjective norms in favor of condom-use were associated with increased condom use with casual and steady partners, whereas feeling depressed was associated with decreased condom use with casual partners. Condoms were used less often with HIV-positive partners. Self-efficacy as an important behavioral skill to perform protection behavior was influenced by lower perceived vulnerability, higher subjective norms, and more positive safer sex attitudes. The IMB-model constructs appeared to be valid; however, not all the model predictors could be determined as hypothesized. Besides the original IMB constructs, HIV-specific variables, including sexual partners’ serostatus and mental health, explained condom use. Such factors should be considered in clinical interventions to promote “positive prevention.”

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Acknowledgments

We are grateful to all study participants for contributing to this study and to the investigators at the participating centers: Austria: Birgit Mumelter (University of Innsbruck), Gabriele Schmied (European Centre, Vienna); Belgium: Ruth Borms (Sensoa, Antwerp); Czech Republic: Ivo Prochazka (University of Prague); Germany: Johannes Bogner (Ludwig Maximilians University, Munich), Werner Becker and Ramona Volkert (Private Practice, Munich), Andreas Niedermeier (University Clinic for Dermatology, Munich), Martin Karwat (Private Practice, Munich); Greece: Nikos Dedes (Synthesis, Athens); Hungary: Peter Csépe (Semmelweis University, Budapest); Italy: Gloriana Bartoli and Carlo Giaquinto (University of Padua, Padua); Caterina Uberti-Foppa and Giulia Galotta (HSR Ospedale, Milan); Latvia: Anda Vaisla (Latvian Family Planning Association, Riga); Poland: Michal Pozdal and Zbigniew Izdebski (University of Zielona Góra); Portugal: Luis Caldeira (Hospital Santa Maria, Lisbon) and Sónia Ferreira Dias (Institute of Hygiene and Tropical Medicine, Lisbon) for contributions to the manuscript; Spain: Victoria Gordillo (University Complutense of Madrid); UK: Ed Wilkins and Cinthia Murphy (Pennine Acute Hospitals NHS Trust, Manchester). Our thanks also go to the Swiss National Science Foundation and the Swiss HIV Cohort Study for funding, support and co-operation. EUROSUPPORT V received funding from the European Commission, SANCO/Public Health, grant agreement nr. 2004314. The Commission is not responsible for any use that may be made of the information contained in this publication.

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Correspondence to Christiana Nöstlinger.

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Nöstlinger, C., Nideröst, S., Platteau, T. et al. Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model. Arch Sex Behav 40, 817–827 (2011). https://doi.org/10.1007/s10508-010-9682-4

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