Knowledge and acceptability of alternative HIV prevention bio-medical products among MSM who bareback

Nodin, Nuno; Carballo‐Diéguez, Alex; Ventuneac, Ana; Balán, Iván C.; Remien, Robert H.

doi:10.1080/09540120701449096

Cited by 69 publications

(79 citation statements)

References 34 publications

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“…Recent research has begun to explore the acceptability of alternative HIV biomedical products (microbicides, vaccines, PEP, and PrEP) with MSM who engage in unsafe sex. 42 Extending this research to MSM who selfidentify as barebackers may yield important insight to increase the utilization and acceptability of biomedical products to prevent HIV infection among this subset of at-risk MSM who sometimes or always do not use condoms.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Identifying as a Barebacker among High-Risk New England HIV Seronegative Men Who Have Sex with Men

et al. 2008

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Studies have found that between 14% and 46% of US men who have sex with men (MSM) consistently report "barebacking" behavior (i.e., intentional unprotected anal intercourse) with other men. This is of public health significance because MSM continue to constitute more than 50% of new HIV infections in the USA. Men who self-identify as barebackers may represent a different and unique subset of MSM with distinct HIV prevention needs. In 2007, 227 HIV seronegative MSM recruited through modified respondent-driven sampling completed an intervieweradministered survey which assessed barebacker identity (i.e., personally identifying with the barebacker scene), demographics, sexual risk behaviors, psychosocial variables, and drug/alcohol use. Bivariate and multivariable logistic regression procedures were used to examine predictors of barebacker identity in relation to HIV risk behavior. Overall, 31% of participants identified as a barebacker. In bivariate analyses, lower education (OR=1.76; 95% CI=0.99-3.13; pG0.05), a current drinking problem (OR=2.34, 95% CI=1.29-4.23; pG0.01), higher levels of HIV treatment optimism (OR=1.06; 95% CI= 1.01-1.12; pG0.05), meeting sexual partners at private sex parties (OR=2.47; 95% CI=1.28-4.74; pG0.01) or at bars/cubs (OR=1.97; 95% CI=1.10-3.52; pG0.05), and engaging in serodiscordant unprotected insertive anal sex (OR=3.42; 95% CI=1.27-9.21; pG0.01) significantly predicted barebacker identification compared to those with no barebacker identification. In a multivariable model, barebackers were more likely to screen in for alcohol abuse (adjusted OR=2.16; 95% CI=1.09-4.27; pG0.05) and engage in serodiscordant unprotected insertive anal sex (adjusted OR=3.17; 95% CI=1.09-9.20; pG0.05) compared to their non-barebacker counterparts. No significant differences were found in serodiscordant unprotected receptive anal sex between barebackers and nonbarebackers. These findings suggest that barebacker identity is related to intentional HIV sexual risk taking and alcohol abuse. Furthermore, strategic positioning (i.e., engaging in insertive rather than receptive sex) might be associated with barebacker identification and may indicate a harm-reduction strategy being used among some HIV-uninfected MSM to reduce their risk of becoming infected. Additional research is warranted to understand the social identity of barebacking among MSM in order to develop more nuanced prevention strategies.

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Section: Discussionmentioning

confidence: 99%

Predictors of Identifying as a Barebacker among High-Risk New England HIV Seronegative Men Who Have Sex with Men

et al. 2008

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“…A modified grounded theory approach was employed to identify themes that might explain PrEP adoption intentions among HIV-negative GBM in serodiscordant relationships. 13,14 An extensive list of codes and their definitions was derived from the interview guide, interviewer field notes, and multiple readings of the transcripts. The coding team, consisting of the first author (R.A.B.)…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies focused on PrEP knowledge and offlabel use of antiretroviral medications as PrEP and attitudes and potential use of PrEP among MSM. [9][10][11][12][13] Despite these studies, a gap exists in knowledge regarding acceptability and potential adoption of PrEP among HIV-negative gay and bisexual men (GBM) in serodiscordant relationships, a specific target population for PrEP.…”

mentioning

confidence: 99%

Sexual Risk Behaviors and Acceptability of HIV Pre-Exposure Prophylaxis Among HIV-Negative Gay and Bisexual Men in Serodiscordant Relationships: A Mixed Methods Study

Brooks

Landovitz

Kaplan

et al. 2012

AIDS Patient Care and STDs

168

151

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The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation.

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“…One qualitative study conducted in New York City included questions about PrEP and other biomedical prevention methods for a subset of 72 participants in a web-based study (Nodin, Carballo-Dieguez, Ventuneac, Balan, & Remien, 2008) of MSM Internet users who reported barebacking (intentional condomless anal intercourse). MSM of any HIV status were included, 39% of respondents were under the age of 30 years, 21% were African American, and 28% were Hispanic.…”

Section: Introductionmentioning

confidence: 99%

Attitudes and Program Preferences of African-American Urban Young Adults About Pre-Exposure Prophylaxis (PrEP)

Smith

Toledo²,

Smith³

et al. 2012

AIDS Education and Prevention

172

154

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Knowledge and acceptability of alternative HIV prevention bio-medical products among MSM who bareback

Cited by 69 publications

References 34 publications

Predictors of Identifying as a Barebacker among High-Risk New England HIV Seronegative Men Who Have Sex with Men

Predictors of Identifying as a Barebacker among High-Risk New England HIV Seronegative Men Who Have Sex with Men

Sexual Risk Behaviors and Acceptability of HIV Pre-Exposure Prophylaxis Among HIV-Negative Gay and Bisexual Men in Serodiscordant Relationships: A Mixed Methods Study

Attitudes and Program Preferences of African-American Urban Young Adults About Pre-Exposure Prophylaxis (PrEP)

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