Are Prior Sexual Risk Behaviors Associated With Adherence to COVID-19 Preventative Behaviors Among Young Black Men?

Behavioral clustering is a phenomenon in which several risk or protective behaviors co-occur in an individual. We sought to determine if prior sexual risk behaviors among young Black men who have sex with women could predict subsequent nonadherence to COVID-19 prevention behaviors.

Young Black men who have sex with women aged 15 to 24 years previously enrolled in a community-based Chlamydia trachomatis (Ct) screening program were enrolled in a substudy between May and June 2020 and asked about adherence to 4 COVID-19 recommended nonpharmaceutical prevention behaviors (handwashing, mask wearing, social distancing, and following stay at home orders). Data from the original study were used to elicit the follow prepandemic behaviors including having multiple sex partners, inconsistent condom use, prior sexually transmitted infection testing behaviors, and substance use. Wilcoxon rank sum tests were used to assess the association between historic risk behaviors and COVID-19 behavior score.

There were 109 men included in the analysis, with a mean (SD) age of 20.5 (2.0) years. Inconsistent condom use, multiple sex partners, and prior HIV/sexually transmitted infection testing status were not associated with fewer COVID-19 preventive behaviors, but men who used any nonprescription drugs ( P = 0.001) or marijuana only ( P = 0.028) had a lower median COVID-19 preventative score compared with those who did not engage in those activities.

Although none of the sexual risk behavior variables were associated, self-reported nonprescription drug and marijuana use were both significant predictors of lower adherence to COVID-19 preventative behaviors among young Black men. Young men who use drugs may need additional support to promote COVID-19 preventative behavior uptake.