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Attitudes Toward and Beliefs in the Effectiveness of Biomedical HIV Prevention Strategies Among Emerging and Young Adult Sexual Minority Men

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Abstract

Background

Pre-exposure prophylaxis (PrEP) and HIV treatment as prevention, which underlies the Undetectable = Untransmittable (U = U) campaign, are two effective biomedical approaches for HIV prevention among sexual minority men (SMM). Attitudes toward PrEP and U = U may differ between SMM emerging adults (EA: 18–24 years old) and young adults (YA: 25–29 years old) to drive differences in sexual behavior. However, to date, few studies assessed the degree to which YAs and EAs differ in their beliefs in the effectiveness of PrEP and U = U.

Method

A national sample of 80 SMM in the USA (Mage = 25.1 years; 53.7% racial/ethnic minority; 38.8% EA; 61.3% YA) participated in a 6-month mHealth intervention for PrEP adherence. Non-parametric tests assessed differences in sexual behaviors and attitudes toward the effectiveness of PrEP and U = U between EAs and YAs using baseline data.

Results

Compared to EAs, higher proportions of YAs trusted PrEP’s effectiveness and considered condom use unnecessary after taking PrEP. More YAs than EAs were willing to engage in sexual behaviors that they felt too risky before learning about U = U and were more comfortable having condomless sex with HIV-positive partners. Conversely, a greater proportion of EAs than YAs preferred to use condoms even when their partners are on anti-HIV medications.

Conclusion

Overall, YAs trusted the effectiveness of U = U and PrEP more than EAs, underscoring developmental differences in SMM’s perspectives on biomedical HIV prevention tools. Our findings underscore the importance of tailoring messages on biomedical HIV prevention options differently for EAs and YAs to optimize uptake.

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Data Availability

The data that support the findings of this study are available from the corresponding author (JM) upon reasonable request.

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Funding

This project is supported by a grant from the National Institute of Mental Health (NIMH), awarded to Drs. Keith J. Horvath and Jason V. Baker; R34MH116878.

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Authors and Affiliations

  1. San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA

    Junye Ma & Keith J. Horvath

  2. Department of Psychology, The University of North Carolina at Greensboro, 296 Eberhart Building, Greensboro, NC, 27402, USA

    Gregory E. Chase

  3. Division of Infectious Diseases, Hennepin Healthcare Research Institute, 701 Park Avenue, Minneapolis, MN, 55415, USA

    Ashley Black, Jonathan Klaphake, Kelly Garcia-Myers & Jason V. Baker

  4. Department of Medicine, University of Minnesota, 401 East River Parkway VCRC 1st Floor, Suite 131, Minneapolis, MN, 55455, USA

    Jason V. Baker

  5. Department of Psychology, College of Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA

    Junye Ma & Keith J. Horvath

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Correspondence to Junye Ma.

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Informed consent was obtained from all participants in this study. All participants provided consent to the publication of their data.

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Ma, J., Chase, G.E., Black, A. et al. Attitudes Toward and Beliefs in the Effectiveness of Biomedical HIV Prevention Strategies Among Emerging and Young Adult Sexual Minority Men. Int.J. Behav. Med. (2023). https://doi.org/10.1007/s12529-023-10244-4

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  • DOI: https://doi.org/10.1007/s12529-023-10244-4

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