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Abstract

Development of an effective rectal microbicide holds promise for HIV prevention. This study examined men's personal efficacy standards (i.e., preferences about product efficacy) for a future rectal microbicide and intentions to use it during anal intercourse. Three hundred eighty-five men who have sex with men, sampled in West Hollywood, completed a behavioral questionnaire, read a detailed description of a potential rectal microbicide gel, and expressed their preferences about product efficacy and intended use. On average, participants wanted a microbicide gel to be 84% effective in preventing HIV infection before they would use it as the only means of protection during anal intercourse; 53% of the men wanted the gel to be at least 95% effective. In multivariate analyses, intention to use the gel by itself was associated with higher efficacy standards for the microbicide, negative attitudes about using condoms, and a history of unprotected anal intercourse. Thirty-seven percent of the men who always used a condom during anal sex in the past year said they would be more likely to use a microbicide gel than a condom in the future; however, 85% of this subgroup wanted the gel to offer protection comparable to a condom before they would use it alone. In conclusion, an effective rectal microbicide may have a sizable public health benefit because it provides an alternative for men who dislike condoms.

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

“…Findings show significant associations of barebacking identity to serodiscordant unprotected insertive anal sex and suggest that encouraging harm-reduction strategies, in particular strategic positioning, may be an appropriate intervention technique to employ with self-identified barebacking MSM who may not respond to the prevention goal of completely eliminating unsafe sex. 12 Moreover, preceding studies have documented willingness to use rectal microbicides, 37,38 and postexposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP) [39][40][41] among HIV seronegative MSM. 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.…”