Amsterdam 2015
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| Abstract #2238 - Why do I do what I do? Motivational determinants of risk taking | ||||
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Session: 18.5: Why do I do what I do? Motivational determinants of risk taking (Symposium) on Wednesday @ 14.30-16.00 in C202 Chaired by Maria Koulentianou, Joseph Lau Authors: Presenting Author: Dr Philippe CG Adam - UNSW AUSTRALIA, Australia |
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| Additional Authors: | ||||
| Aim: Biomedical prevention is an important tool for HIV-prevention among MSM. While the popularity of biomedical prevention can be explained by growing evidence on its efficacy, there were longstanding concerns regarding MSM’s motivation to use condoms consistently. In this context, biomedical prevention was seen as a possible alternative to problems faced by behavioural prevention. This study conducted in France revisits the notion of condom use demotivation and empirically assesses the associations between demotivation, beliefs around treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP) and sexual risk-taking among two groups of MSM that are priority populations for HIV prevention: men who find partners in commercial sex venues and those who hook-up online using internet sites or phone apps. | ||||
| Method / Issue: An online study conducted between June and July 2012 recruited 1164 MSM living in France. Participants’ mean age was 37.3 years, 92.4 identified as gay and 19.3% were HIV positive. Most participants (92.2%) reported to meet sex partners online 53.5% met partners in commercial sex venues. The survey included measures of condom use demotivation (4-item scale) and beliefs about TasP and PrEP (9-item scale). Participants reported whether they engaged in unprotected anal sex with casual partners (UAIC) in the past 6 months. Analyses consisted of assessing the prevalence of UAIC, identifying its correlates, including demotivation, and exploring the contribution of condom use demotivation to UAIC in the two target groups. | ||||
| Results / Comments: Over a third of participants (35.7%) reported UAIC in the past 6 months, which was significantly associated with being HIV positive, having more than 10 partners in the past 6 months, visiting commercial sex venues, dating/hooking-up online and being demotivated towards using condoms. The contribution of demotivation to UAIC differed however between groups of MSM. Compared to other men, those who hooked-up online did not differ in levels of demotivation. Also, no significant association was found between demotivation and UAIC among men who hooked-up online. In contrast, men who frequented commercial sex venues were found to be more demotivated towards condom use than other MSM, reflecting higher HIV optimism. While the association between UAIC and being demotivated was significant among patrons of commercial sex venues, demotivation only partially explained UAIC among these men. | ||||
| Discussion: Findings suggest that the widely held belief that MSM generally engage in UAIC because they are demotivated to using condoms needs reconsideration. While higher levels of demotivation were found among patrons of commercial sex venues, demotivation only partially explained sexual risk-taking in this group. Data also show little evidence that UAIC among men who hook-up online can be explained by demotivation regarding using condom. Men who hook-up online were not found to be particularly demotivated and UAIC was not associated with demotivation in this group. In addition to new motivational strategies, behavioural prevention should reflect on and address the specific needs of MSM who may take risk without being particularly demotivated towards condom use. Interventions to increase behaviour planning and self-regulation could support MSM who hook-up online to act on their continued motivation to use condoms. | ||||
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