"The Main Concern is HIV, Everything Else is Fixable": Indifference Toward Sexually Transmitted Infections in the Era of Biomedical HIV Prevention.

Elissa L Sarno, Kathryn Macapagal, Michael E Newcomb
Author Information
  1. Elissa L Sarno: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. elissa.sarno@northwestern.edu. ORCID
  2. Kathryn Macapagal: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
  3. Michael E Newcomb: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Abstract

With the advent of biomedical HIV prevention, attitudes toward and cultural norms around condom use and sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (MSM) are changing. Participants of 2GETHER, a randomized controlled trial of a relationship education and HIV prevention program for male couples, have acknowledged that having condomless anal sex put them at increased risk for STIs. Nonetheless, facilitators of the program have increasingly observed that participants were indifferent toward STIs and unmotivated to engage in preventative behaviors, particularly if they used pre-exposure prophylaxis. Participants' reasons for their lack of motivation to take precautions against STIs are reviewed. Implications of these attitudes for public health interventions to reduce rates of STIs among MSM, including frequent screening and treatment of STIs and potential messaging around condom use, are discussed.

Keywords

References

  1. MMWR Morb Mortal Wkly Rep. 2019 Apr 12;68(14):321-325 [PMID: 30973847]
  2. Perspect Public Health. 2015 Nov;135(6):299-308 [PMID: 26253643]
  3. J Acquir Immune Defic Syndr. 2018 Apr 1;77(4):358-364 [PMID: 29210834]
  4. Int Public Health J. 2012 Oct-Dec;4(4):419-434 [PMID: 30147844]
  5. Sex Transm Infect. 2018 Sep;94(6):457-462 [PMID: 29487172]
  6. AIDS Care. 2016 Sep;28(9):1154-8 [PMID: 26915281]
  7. N Engl J Med. 2015 Dec 3;373(23):2237-46 [PMID: 26624850]
  8. Health Educ Q. 1984 Spring;11(1):1-47 [PMID: 6392204]
  9. JMIR Res Protoc. 2020 Jan 27;9(1):e15883 [PMID: 32012111]
  10. AIDS Behav. 2020 May;24(5):1376-1388 [PMID: 31768688]
  11. N Engl J Med. 2010 Dec 30;363(27):2587-99 [PMID: 21091279]
  12. JAMA. 2019 Feb 5;321(5):451-452 [PMID: 30629090]
  13. Am J Mens Health. 2019 Jan-Feb;13(1):1557988319827396 [PMID: 30819060]
  14. AIDS Behav. 2014 Sep;18(9):1712-21 [PMID: 24965676]
  15. Clin Infect Dis. 2018 Aug 16;67(5):676-686 [PMID: 29509889]
  16. Sex Health. 2019 Feb;16(1):18-24 [PMID: 30517838]
  17. Cult Health Sex. 2018 Jun;20(6):658-672 [PMID: 28872441]
  18. Lancet. 2016 Jan 2;387(10013):53-60 [PMID: 26364263]
  19. Arch Sex Behav. 2014 Jan;43(1):61-72 [PMID: 24217953]
  20. Prev Sci. 2017 Aug;18(6):737-747 [PMID: 28578516]
  21. AIDS Behav. 2020 May;24(5):1334-1341 [PMID: 31489520]
  22. JAMA. 2019 Apr 9;321(14):1380-1390 [PMID: 30964528]
  23. Health Psychol. 2014 Oct;33(10):1251-60 [PMID: 23977877]

Grants

  1. F32AA028194/NIAAA NIH HHS
  2. F32 AA028194/NIAAA NIH HHS
  3. R01AA024065/NIAAA NIH HHS
  4. DP2DA042417/NIDA NIH HHS
  5. DP2 DA042417/NIDA NIH HHS
  6. R01 AA024065/NIAAA NIH HHS

MeSH Term

HIV Infections
Homosexuality, Male
Humans
Male
Pre-Exposure Prophylaxis
Sexual Behavior
Sexual and Gender Minorities
Sexually Transmitted Diseases

Word Cloud

Created with Highcharts 10.0.0STIsHIVmensexMSMpreventionattitudestowardaroundcondomusetransmittedinfectionsamongprogramprophylaxisSexuallyadventbiomedicalculturalnormssexuallygaybisexualchangingParticipants2GETHERrandomizedcontrolledtrialrelationshipeducationmalecouplesacknowledgedcondomlessanalputincreasedriskNonethelessfacilitatorsincreasinglyobservedparticipantsindifferentunmotivatedengagepreventativebehaviorsparticularlyusedpre-exposureParticipants'reasonslackmotivationtakeprecautionsreviewedImplicationspublichealthinterventionsreduceratesincludingfrequentscreeningtreatmentpotentialmessagingdiscussed"TheMainConcernEverythingElseFixable":IndifferenceTowardTransmittedInfectionsEraBiomedicalPreventionMenPre-exposurePrEP

Similar Articles

Cited By (6)