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Should I Convince My Partner to Go on Pre-Exposure Prophylaxis (PrEP)? The Role of Personal and Relationship Factors on PrEP-Related Social Control among Gay and Bisexual Men

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Abstract

An estimated 35–68% of new HIV infections among gay, bisexual, and other men who have sex with men (GBM) are transmitted through main partnerships. Pre-exposure prophylaxis (PrEP) is highly effective in reducing HIV seroconversion, yet PrEP uptake has been modest. PrEP-naïve GBM with HIV-negative, PrEP-naïve main partners enrolled in One Thousand Strong (n = 409), a U.S. national cohort of GBM, were asked about (1) the importance of partner PrEP use and (2) their willingness to convince their partner to initiate PrEP. On average, participants thought partner PrEP was only modestly important and were only moderately willing to try to convince their partner to initiate PrEP. Personal PrEP uptake willingness and intentions were the strongest indicators of partner PrEP outcomes. Being in a monogamish relationship arrangement (as compared to a monogamous arrangement) and the experience of intimate partner violence victimization were associated with increased willingness to persuade a partner to initiate PrEP.

Resumen

Se estima que entre un 35% y un 68% de las nuevas infecciones por VIH en varones homosexuales, bisexuales y otros hombres que mantienen relaciones sexuales con hombres (HSH) se transmite a través de la pareja principal. Aunque la Profilaxis pre-Exposición (PrEP) es altamente efectiva en la reducción de la seroconversión al VIH, el uso de la PrEP ha sido limitado. Se les preguntó a HBH naifs a la PrEP con parejas principales VIH-negativas y naifs a la PrEP reclutados para el estudio “One Thousand Strong” (n = 409), una cohorte nacional de HSH, sobre 1) la importancia de que su pareja usara PrEP y 2) su voluntad de convencer a su pareja de que empezara a usar PrEP. En promedio, los participantes consideraron que era sólo moderadamente importante que su pareja tomara PrEP, y estuvieron sólo moderadamente dispuestos a tratar de convencer a su pareja de que empezara a tomar PrEP. Voluntad e intención de uso personal de la PrEP fueron los indicadores más robustos de los resultados del uso de la PrEP en la pareja. El estar en una relación no-monógama (comparado con una relación monógama), y el tener experiencias de victimización íntima con la pareja se asociaron con una mayor voluntad de persuadir a la pareja de que comience a usar PrEP.

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Acknowledgments

One Thousand Strong study was funded by a research grant from the National Institute on Drug Abuse (R01-DA036466; J. T. Parsons & C. Grov, MPIs). H. J. Rendina was supported by a Career Development Award from the National Institute on Drug Abuse (K01-DA039030; H. J. Rendina, PI). 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 would like to acknowledge the contributions of the other members of the One Thousand Strong Study Team (Ana Ventuneac, Demetria Cain, Mark Pawson, Ruben Jimenez, Chloe Mirzayi, Brett Millar, Raymond Moody, and Thomas Whitfield) and other staff from the Center for HIV/AIDS Educational Studies and Training (Chris Hietikko, Andrew Cortopassi, Brian Salfas, Doug Keeler, Chris Murphy, Carlos Ponton, and Paula Bertone). We would also like to thank the staff at Community Marketing Inc. (David Paisley, Heather Torch, and Thomas Roth). Finally, we thank Jeffrey Schulden at NIDA, the anonymous reviewers of this manuscript, and all of our participants in the One Thousand Strong study.

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Authors and Affiliations

  1. Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, USA

    Steven A. John, Tyrel J. Starks, H. Jonathon Rendina, Christian Grov & Jeffrey T. Parsons

  2. Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Avenue, New York, NY, 10065, USA

    Tyrel J. Starks, H. Jonathon Rendina & Jeffrey T. Parsons

  3. Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA

    Tyrel J. Starks, H. Jonathon Rendina & Jeffrey T. Parsons

  4. CUNY Graduate School of Public Health and Health Policy, New York, NY, USA

    Christian Grov

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Correspondence to Jeffrey T. Parsons.

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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.

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John, S.A., Starks, T.J., Rendina, H.J. et al. Should I Convince My Partner to Go on Pre-Exposure Prophylaxis (PrEP)? The Role of Personal and Relationship Factors on PrEP-Related Social Control among Gay and Bisexual Men. AIDS Behav 22, 1239–1252 (2018). https://doi.org/10.1007/s10461-017-1835-1

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