Are prior sexual risk behaviors associated with adherence to COVID-19 preventative behaviors among young Black men?

Abstract

Background Behavioral clustering is a phenomenon in which several risk or protective behaviors co-occur in an individual. We sought to determine if prior sexual risk behaviors among young Black men who have sex with women (MSW) could predict subsequent non-adherence to COVID-19 prevention behaviors. Methods Young Black MSW aged 15-24 previously enrolled in a community-based Chlamydia trachomatis (Ct) screening program were enrolled in a sub-study between May-June 2020 and asked about adherence to four COVID-19 recommended non-pharmaceutical prevention behaviors (hand washing, mask wearing, social distancing, and following stay at home orders). Data from the original study was used to elicit the follow pre-pandemic behaviors including: having multiple sex partners, inconsistent condom use, prior STI testing behaviors and substance use. Wilcoxon rank sum tests were used to assess the association between historic risk behaviors and COVID-19 behavior score. Results There were 109 men included in the analysis, with a mean age of 20.5 years (S.D. 2.0). Inconsistent condom use, multiple sex partners, and prior HIV/STI testing status were not associated with fewer COVID-19 preventive behaviors but men who used any non-prescription drugs (p = 0.001) or marijuana only (p = 0.028) had a lower median COVID-19 preventative score compared to those who did not engage in those activities. Conclusion While none of the sexual risk behavior variables were associated, self-reported non-prescription drug and marijuana use were both significant predictors of lower adherence to COVID-19 preventative behaviors among young Black men. Young men who use drugs may need additional support to promote COVID-19 preventative behavior uptake.