Amsterdam 2015
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| Abstract #2121 - Poster 2 | ||||
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Session: 59.18: Poster 2 (Poster) on Tuesday in Chaired by Authors: Presenting Author: Prof. Dr. Daniel Gredig - University of Applied Sciences and Arts Northwestern Switzerland, Switzerland |
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| Additional Authors: | ||||
| Aim: In Costa Rica, the number of newly diagnosed HIV infections per year is slightly growing and shows the pattern of a concentrated epidemic: 79.4% of persons diagnosed with HIV in the years 2002–2012 were men, including a large proportion of MSM. This corresponds with the fact that globally MSM are disproportionally affected by HIV. Although studies have assessed MSM condom use in Costa Rica, the concrete and locality-specific dynamics underlying this HIV protective behaviour has not been investigated. Against this background, this project aimed to establish the predictors of condom use by MSM aged 18–24 in Costa Rica when having anal sex with casual partners. The theoretical framework was drawn from an extended version of the Information-Motivation-Behavioural Skills (IMB) Model developed in Europe. Besides the socio-cognitive variables comprised by the original IMB Model, this extended version includes the personal HIV protection strategy adopted, as well as cultural, social, and economic resources. The extended model also considers inhibitors of condom use related to the sex partner or to the situation in which sex was engaged in. | ||||
| Method / Issue: A convenience sample of MSM aged 18–24 living in Costa Rica was gathered. Participants were addressed by flyers, social media, specific dating websites, NGOs, key persons in the scene, and peers. Data were collected using standardized personal interviews and analysed using descriptive statistics. The IMB model was tested by means of structural equation modelling using the scale-free least square method. | ||||
| Results / Comments: The sample of 238 MSM aged 18–24 included 221 men self-identified as homosexual/gay, 15 as bisexual, and 2 as heterosexual. 134 reported having had sex with casual partners in the last six months. Of the 119 respondents who had anal sex, 13.4% reported using a condom each time, 23.5% most times, and 15.1% often. In contrast, 32.8% reported using a condom a few times, 8.4% almost never, and 6.7% never. Analysis showed that the constructs Information, Motivation, and Behavioural skills (IMB) predicted condom use. Considering the single variables in these constructs, the perceived severity of an HIV infection was the strongest and direct predictor of condom use whereas behavioural skills and knowledge had small effects. A further strong predictor is the personal HIV protection strategy (intention to have “safer sex”). Determining inhibitors were not having the condom to hand during the sex act, trusting one’s partner, and a sex partner rejecting condom use. Behavioural skills were predicted by knowledge, stereotypical health beliefs, attitudes, subjective norms, perceived severability, and perceived vulnerability. In turn, these socio-cognitive variables, the personal protection strategy, and the inhibitors were determined by economic, cultural, and social resources. | ||||
| Discussion: The HIV protective behaviour of young MSM in Costa Rica turned out to be inconsistent. The extended IMB model proved capable of explaining condom use. In particular the influence of cultural, economic, and social resources was confirmed. Prevention offers for young MSM in Costa Rica should consider the impact of these resources. | ||||
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