AIDS and Behavior

, Volume 23, Issue 2, pp 534–543 | Cite as

Pre-exposure Prophylaxis Among Men Who have Sex with Men: Dual Motivational Model of Intention to Use Pre-exposure Prophylaxis

  • Yerina S. RanjitEmail author
  • Alex Dubov
  • Maxim Polonsky
  • Liana Fraenkel
  • Adedotun Ogunbajo
  • Kenneth Mayer
  • Frederick L. Altice
Original Paper


Men who have sex with men (MSM) account for most new HIV infections in the United States. Despite representing a fraction of the population, MSM make up an estimated 65% of new infections. To address this epidemic, pre-exposure prophylaxis (PrEP) is recommended to supplement condom use. Despite its effectiveness, PrEP uptake among MSM is low. Few studies have employed theoretical approaches to understand PrEP use intention. Incorporating factors like safe sex fatigue, expectation of better sexual experiences, and perceived risk are proposed in this dual motivational path model of PrEP use intention. This model hypothesized that PrEP use intention is influenced by two key pathways: (1) protection motivation pathway, and (2) sexual expectancy pathway. Data were collected using social networking applications from 402 MSM. The model was tested using structural equation modeling. We elaborate the complex decision-making process proposed by this novel theoretical model and discuss its practical implications.


Men who have sex with men (MSM) Pre-exposure prophylaxis (PrEP) Dual motivational model Safe sex fatigue, perceived risk 



Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health, under Award Number AR060231-06 (Fraenkel). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors do not have any conflicts of interest related to the content of this manuscript.

Compliance with Ethical Standards

Conflict of interest

Yerina S. Ranjit, Alex Dubov, Maxim Polonksy, Liana Fraenkel, Adedotun Ogunbajo, Kenneth Mayer, and Frederick L. Altice declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yerina S. Ranjit
    • 1
    Email author
  • Alex Dubov
    • 2
  • Maxim Polonsky
    • 3
  • Liana Fraenkel
    • 4
  • Adedotun Ogunbajo
    • 5
  • Kenneth Mayer
    • 6
  • Frederick L. Altice
    • 1
  1. 1.AIDS Program, Department of Internal MedicineYale UniversityNew HavenUSA
  2. 2.Loma Linda University School of Public HealthLoma LindaUSA
  3. 3.Quinnipiac University School of BusinessHamdenUSA
  4. 4.Section of RheumatologyYale University School of MedicineNew HavenUSA
  5. 5.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  6. 6.Department of Global Health and PopulationHarvard T.H. Chan, School of Public HealthBostonUSA

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