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Belief in treatment as prevention and its relationship to HIV status and behavioral risk

Belief in treatment as prevention and its relationship to HIV status and behavioral risk
Belief in treatment as prevention and its relationship to HIV status and behavioral risk
Background:
We evaluated attitudes toward treatment as prevention (TasP) among gay, bisexual, and other men who have sex with men (GBM) in Vancouver, Canada.

Methods:
Sexually active GBM, aged ≥16 years, were recruited between 2012 and 2015 using respondent-driven sampling. At each 6-month follow-up, participants completed a computer-administered questionnaire and nursing visit. Repeated-measures latent class analysis, grouped by self-reported serostatus, identified patterns of TasP endorsement by considering TasP-related awareness, attitudes, and behavior. Binary logistic regression identified covariates of class membership. Bivariate interactions with visit number identified factors associated with longitudinal changes in class membership.

Results:
A total of 774 men provided 2590 observations. Of these, 698 enrolled in the cohort, 575 had at least 1 follow-up visit. Among these, the median follow-up time was 1.98 years (Q1–Q2: 1.49–2.49 years). Repeated-measures latent class analysis identified 3 classes: “unaware” (64.2% HIV negative/unknown vs. 29.2% of HIV positive), “skeptical” (29.7% vs. 23.1%), and “believing” (6.1% vs. 47.7%). Membership in classes representing higher TasP endorsement was associated with greater odds of condomless anal sex and having more sexual partners. Age, sexual orientation, ethnicity, substance use, and social time spent with other GBM were also associated with class membership. Longitudinally, class membership was stable among HIV-positive men but shifted toward greater TasP endorsement among HIV-negative/unknown men. For HIV-negative/unknown men, increasing endorsement was positively associated with greater education, being employed, being in a relationship, and substance use and inversely associated with recent serodiscordant condomless anal sex or sexually transmitted infection diagnosis.

Conclusions:
Over time, disparities in TasP diffusion by HIV status have lessened, although continue to persist across other key social strata.
1525-4135
8-16
Card, Kiffer G.
4bece098-5a9b-46cf-a64e-615f14acce73
Armstrong, Heather L.
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6
Cui, Zishan
2058a5ff-d3e1-4ac9-90db-0c053fa35841
Sereda, Paul
7b1e0f3a-2477-4bc7-9f65-910dee84a320
Carter, M. Allison
8c37a9c7-4e80-47b7-aed3-87468ea91f34
Montaner, Julio S. G.
8732d65e-cae2-408e-bf60-580f8298547a
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Moore, David M.
b3bb7f8f-4409-412e-959b-bcda959a8d2d
Card, Kiffer G.
4bece098-5a9b-46cf-a64e-615f14acce73
Armstrong, Heather L.
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6
Cui, Zishan
2058a5ff-d3e1-4ac9-90db-0c053fa35841
Sereda, Paul
7b1e0f3a-2477-4bc7-9f65-910dee84a320
Carter, M. Allison
8c37a9c7-4e80-47b7-aed3-87468ea91f34
Montaner, Julio S. G.
8732d65e-cae2-408e-bf60-580f8298547a
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Moore, David M.
b3bb7f8f-4409-412e-959b-bcda959a8d2d

Card, Kiffer G., Armstrong, Heather L., Lachowsky, Nathan J., Cui, Zishan, Sereda, Paul, Carter, M. Allison, Montaner, Julio S. G., Hogg, Robert S., Roth, Eric A. and Moore, David M. (2018) Belief in treatment as prevention and its relationship to HIV status and behavioral risk. JAIDS Journal of Acquired Immune Deficiency Syndromes, 77 (1), 8-16. (doi:10.1097/QAI.0000000000001557).

Record type: Article

Abstract

Background:
We evaluated attitudes toward treatment as prevention (TasP) among gay, bisexual, and other men who have sex with men (GBM) in Vancouver, Canada.

Methods:
Sexually active GBM, aged ≥16 years, were recruited between 2012 and 2015 using respondent-driven sampling. At each 6-month follow-up, participants completed a computer-administered questionnaire and nursing visit. Repeated-measures latent class analysis, grouped by self-reported serostatus, identified patterns of TasP endorsement by considering TasP-related awareness, attitudes, and behavior. Binary logistic regression identified covariates of class membership. Bivariate interactions with visit number identified factors associated with longitudinal changes in class membership.

Results:
A total of 774 men provided 2590 observations. Of these, 698 enrolled in the cohort, 575 had at least 1 follow-up visit. Among these, the median follow-up time was 1.98 years (Q1–Q2: 1.49–2.49 years). Repeated-measures latent class analysis identified 3 classes: “unaware” (64.2% HIV negative/unknown vs. 29.2% of HIV positive), “skeptical” (29.7% vs. 23.1%), and “believing” (6.1% vs. 47.7%). Membership in classes representing higher TasP endorsement was associated with greater odds of condomless anal sex and having more sexual partners. Age, sexual orientation, ethnicity, substance use, and social time spent with other GBM were also associated with class membership. Longitudinally, class membership was stable among HIV-positive men but shifted toward greater TasP endorsement among HIV-negative/unknown men. For HIV-negative/unknown men, increasing endorsement was positively associated with greater education, being employed, being in a relationship, and substance use and inversely associated with recent serodiscordant condomless anal sex or sexually transmitted infection diagnosis.

Conclusions:
Over time, disparities in TasP diffusion by HIV status have lessened, although continue to persist across other key social strata.

Full text not available from this repository.

More information

e-pub ahead of print date: 1 October 2017
Published date: 1 January 2018

Identifiers

Local EPrints ID: 429954
URI: https://eprints.soton.ac.uk/id/eprint/429954
ISSN: 1525-4135
PURE UUID: 1b774263-8c57-47cb-ba14-9b39008f083a
ORCID for Heather L. Armstrong: ORCID iD orcid.org/0000-0002-1071-8644

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Date deposited: 09 Apr 2019 16:30
Last modified: 11 May 2019 00:20

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Contributors

Author: Kiffer G. Card
Author: Nathan J. Lachowsky
Author: Zishan Cui
Author: Paul Sereda
Author: M. Allison Carter
Author: Julio S. G. Montaner
Author: Robert S. Hogg
Author: Eric A. Roth
Author: David M. Moore

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