An Examination of Gay Couples’ Motivations to Use (or Forego) Pre-exposure Prophylaxis Expressed During Couples HIV Testing and Counseling (CHTC) Sessions

Starks, Tyrel J.; Doyle, Kendell M.; Shalhav, Ore; John, Steven A.; Parsons, Jeffrey T.

doi:10.1007/s11121-018-0892-7

Cited by 26 publications

(14 citation statements)

References 22 publications

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“…Although it has been suggested that PrEP uptake is likely to increase over time as awareness and knowledge improve among patients (Strauss et al, 2017) and providers (Petroll et al, 2017), it is likely that bisexual men will continue to be less likely to use PrEP than gay men unless it is specifically marketed to bisexual men and providers are educated about the disparities affecting this population. Relatedly, prior studies assessing PrEP (knowledge of, attitudes toward, and willingness to use) have focused on samples of "gay and bisexual men" or "MSM" (Carballo-Dieguez et al, 2017;Mimiaga et al, 2018;Parsons, John, Whitfield, Cienfuegos-Szalay, & Grov, 2018;Starks, Doyle, Shalhav, John, & Parsons, 2018), and, to date, no studies have examined unique barriers to PrEP use among bisexual men. Research on PrEP has also not been intentionally inclusive of bisexual men, nor has it focused on their potentially unique PrEP-related concerns and needs.…”

Section: The Movement Toward Biomedical Hiv Preventionmentioning

confidence: 99%

Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities

Feinstein

Dodge

2019

Arch Sex Behav

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The field of HIV/STI prevention has primarily focused on gay men (or "men who have sex with men" [MSM] as a broad category) with limited attention to bisexual men in particular. Although bisexual men are also at increased risk for HIV and other STI, they are less likely to utilize HIV/STI prevention services than gay men, and very few interventions have been developed to address their unique needs. Further, while biomedical advances are changing the field of HIV prevention, bisexual men are also less likely to use biomedical HIV prevention strategies (e.g., preexposure prophylaxis [PrEP]) than gay men. In an effort to advance research on bisexual men and their sexual health needs, the goals of this commentary are: (1) to review the empirical literature on the prevalence of HIV/STI among bisexual men, the few existing HIV/STI prevention interventions developed for bisexual men, and the use of biomedical HIV prevention among bisexual men; (2) to describe the ways in which the field of HIV/STI prevention has largely overlooked bisexual men as a population in need of targeted services; and (3) to discuss how researchers can better address the sexual health needs of bisexual men in the age of biomedical HIV prevention.

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Section: The Movement Toward Biomedical Hiv Preventionmentioning

confidence: 99%

Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities

Feinstein

Dodge

2019

Arch Sex Behav

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“…This subsequently promotes adaptive or constructive responses such as problem-solving or providing emotional support (sometimes referred to as accommodation) in response to disagreements or inconsiderate behavior (Rusbult & Van Lange, 2003 ; Rusbult et al, 1983 , 1991 ). Consistent with the overall premise of Interdependence Theory, research with SMM, specifically, has illustrated associations between dimensions of relationship functioning and a range of health outcomes, including condom use (Davidovich et al, 2006 ; Goldenberg et al, 2015 ; Mitchell & Petroll, 2013 ; Starks et al, 2014 ), HIV medication adherence (Goldenberg et al, 2013 ; Johnson et al, 2012 ), pre- and post-exposure prophylaxis to prevent HIV (Bosco et al, 2021 ; Gamarel & Golub, 2019 ; Starks et al, 2019b ), and substance use (Starks et al, 2019d ).…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, SMM who believed themselves to be at a higher risk of HIV acquisition were more likely to engage in regular testing (Stephenson et al, 2015a ). Although investigations in this area are limited, there is some evidence to suggest that SMM couples who perceive HIV transmission as a significant health threat and perceive the management of HIV transmission risk as a shared responsibility are more likely to engage in risk reduction strategies (e.g., condom use, PrEP uptake; Gamarel et al, 2014 ; Starks et al, 2019b ).…”

Section: Introductionmentioning

confidence: 99%

Partners’ Consensus About Joint Effort and COVID-19 Prevention Among Sexual Minority Men

et al. 2021

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The current study examined the relevance of relationship functioning to partners’ agreement or consensus about joint effort surrounding COVID-19 prevention. Interdependence theory has been widely used to understand how relationship partners influence health behavior, including how sexual minority male (SMM) couples regulate HIV risk. Couples with better relationship functioning tend to be more successful at negotiating joint (shared) goals and subsequently accomplishing them. The study recruited 134 cis-male, SARS-CoV-2 negative adults in relationships with cis-male partners from phone-based social networking applications. Participants completed an online survey assessing relationship functioning (Perceived Relationship Components Questionnaire), COVID-19 prevention behaviors, and risk perceptions. Partners’ consensus around joint COVID-19 prevention effort was assessed using an adapted version of the Preferences for Sexual Health Outcomes scale. Path analyses indicated that consensus for joint prevention effort predicted social distancing ( B = 0.23; p = .001) and the number of other COVID-19 prevention behaviors engaged in ( B = 0.17; p = .003) above and beyond perceived risk and relationship functioning. Relationship satisfaction predicted higher levels of consensus for joint COVID-19 prevention effort ( B = 0.40; p = .029). Findings suggest that the theoretical foundations of successful HIV prevention interventions that utilize joint goal formation may generalize to the prediction of COVID-19 prevention behavior and may be leveraged to mitigate the risk of SARS-CoV-2 infection among SMM in relationships. Interventions that overlook the potential for dyadic regulation of health behavior may miss opportunities to capitalize on shared coping resources and fail to address relational barriers to prevention.

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“…Further underscoring this importance, the CDC PrEP guidelines make specific recommendation to prescribe PrEP to MSM and all people in serodifferent relationships [2]. Previous research has also shown that serodifferent relationship status may be a primary driver for patients to seek PrEP to mitigate the risk of HIV transmission to the HIV-negative partner [28]. Patients in serodifferent relationships have expressed interest in PrEP as a method for protection from HIV and to decrease anxiety about HIV transmission during sex [29].…”

Section: Introductionmentioning

confidence: 99%

Assumptions about patients seeking PrEP: Exploring the effects of patient and sexual partner race and gender identity and the moderating role of implicit racism

et al. 2022

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Introduction Daily pre-exposure prophylaxis (PrEP) for HIV-prevention is an essential component of national plans to end the HIV epidemic. Despite its well-documented safety and effectiveness, PrEP prescription has not met the public health need. Significant disparities between White and Black people exist with respect to PrEP prescription, as do disparities between men and women. One factor contributing to these disparities is clinicians’ assumptions about patients seeking PrEP. Methods The present study sought to investigate medical students’ assumptions about patients seeking PrEP (anticipated increased condomless sex, extra-relational sex, and adherence to PrEP), and assumed HIV risk when presenting with their sexual partner. We systematically varied the race (Black or White) and gender (man or woman) of a fictional patient and their sexual partner. All were in serodifferent relationships including men who have sex with men (MSM), women (MSW), and women who have sex with men (WSM). Participants also completed an implicit association test measuring implicit racism against Black people. We evaluated the moderation effects of patient and partner race on assumptions as well as the moderated moderation effects of implicit racism. Results A total of 1,472 students participated. For MSM patients, having a Black partner was associated with higher assumed patient non-adherence to PrEP compared to a White partner, however a White partner was associated with higher assumed HIV risk. For MSW patients, a White male patient was viewed as being more likely to engage in more extra-relational sex compared to a Black male patient. For WSM patients, White women were assumed to be more likely to have condomless and extra-relational sex, be nonadherent to PrEP, and were at higher HIV risk. Overall, implicit racism was not related to negative assumptions about Black patients as compared to White patients based on patient/partner race. Discussion Medical education about PrEP for HIV prevention must ensure future health professionals understand the full range of patients who are at risk for HIV, as well as how implicit racial biases may affect assumptions about patients in serodifferent couples seeking PrEP for HIV prevention. As gatekeepers for PrEP prescription, clinicians’ assumptions about patients seeking PrEP represent a barrier to access. Consistent with prior research, we identified minimal effects of race and implicit racism in an experimental setting.

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An Examination of Gay Couples’ Motivations to Use (or Forego) Pre-exposure Prophylaxis Expressed During Couples HIV Testing and Counseling (CHTC) Sessions

Cited by 26 publications

References 22 publications

Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities

Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities

Partners’ Consensus About Joint Effort and COVID-19 Prevention Among Sexual Minority Men

Assumptions about patients seeking PrEP: Exploring the effects of patient and sexual partner race and gender identity and the moderating role of implicit racism

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