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Mediation Analysis of Peer Norms, Self-Efficacy, and Condom Use Among Chinese Men Who Have Sex with Men: A Parallel Process Latent Growth Curve Model


The objective of this study was to examine direct and indirect relationships among peer norms, self-efficacy, and condom use among Chinese men who have sex with men (MSM). A longitudinal study determined the effectiveness of a condom use video promotion among Chinese MSM in 2015. In this analysis, 804 Chinese MSM were recruited at baseline and then followed at 3 weeks and 3 months after the intervention. Parallel process latent growth curve modeling (LGM) with multiple indicators and bootstrapping was conducted using Mplus 7.4. The LGM model fit indexes were good with RMSEA = 0.046, 90% CI (0.044, 0.048), CFI = 0.956, TLI = 0.955. Our results showed that the initial measure of peer norms affected the initial measure of condom use indirectly through the initial measure of self-efficacy (αβ = 0.414, 95% CI 0.260–0.759). The rate of change in peer norms over time also significantly affected the rate of change in condom use through the rate of change in self-efficacy (αβ = 0.101, 95% CI 0.014–0.262). Self-efficacy mediated the association between peer norms and condom use, indicating a strong potential of causal relationship between peer norms and self-efficacy among Chinese MSM.

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This work was supported by the National Institutes of Health (National Institute of Allergy and Infectious Diseases 1R01AI114310); UNC-South China STD Research Training Centre (Fogarty International Centre 1D43TW009532 to JT); UNC Center for AIDS Research (National Institute of Allergy and Infectious Diseases 5P30AI050410); the UNC Chapel Hill, Johns Hopkins University, Morehead School of Medicine and Tulane University (UJMT) Fogarty Fellowship (FIC R25TW0093); and American Psychological Association’s Cyber Mentors Program (National Institute of Mental Health R25-MH083635). The listed grant funders played no role in any step of this study. We appreciate the men who participated in this study. We also thank Dr. Chongyi Wei for providing oversight for data collection and development of this article. The content of the article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

HL contributed to the conception and design of the study and drafted the paper. JT provided oversight for data collection, and WM, DK, ML, WT, and BJ assisted in the data collection. HL and GM searched the literature. HL ESK, and JW analyzed the data. All authors revised the manuscript and approved the final version to be published.

Correspondence to Haochu Li.

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This study was reviewed and approved by institutional review boards at the Guangdong Provincial Center for Skin Diseases and STI Control, University of North Carolina at Chapel Hill, and University of California San Francisco.

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Li, H., Tucker, J.D., Ma, W. et al. Mediation Analysis of Peer Norms, Self-Efficacy, and Condom Use Among Chinese Men Who Have Sex with Men: A Parallel Process Latent Growth Curve Model. Arch Sex Behav 49, 287–297 (2020).

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  • Peer norms
  • Self-efficacy
  • Condom use
  • Structural equation modeling
  • Chinese MSM