Use of preexposure prophylaxis and condom purchasing decisions

Area of Science:

• Public Health
• Behavioral Science
• Infectious Disease Prevention

Background:

• Pre-exposure prophylaxis (PrEP) is effective in preventing HIV but not other sexually transmitted infections (STIs).
• MSM using PrEP report decreased condom use, but the behavioral mechanisms are not well understood.
• Understanding these mechanisms is crucial for comprehensive STI prevention strategies.

Purpose of the Study:

• To investigate the behavioral mechanisms underlying reduced condom use among MSM using PrEP.
• To compare condom purchasing decisions between PrEP-experienced and PrEP-naïve MSM.
• To assess the utility of the Condom Purchase Task (CoPT) in evaluating these behaviors.

Main Methods:

• An online study involving PrEP-experienced (n=88) and PrEP-naïve (n=113) MSM.
• Participants completed the Condom Purchase Task (CoPT) assessing condom purchasing decisions at varying price points.
• Hypothetical partners included 'least STD' and 'most want sex with' scenarios.

Main Results:

• PrEP-experienced MSM purchased fewer condoms than PrEP-naïve MSM, even when free.
• PrEP-experienced MSM reached a price point of non-purchase at lower costs for both partner types.
• When unwilling to purchase condoms, PrEP-experienced MSM were less likely to abstain from sex compared to PrEP-naïve MSM.

Conclusions:

• The Condom Purchase Task (CoPT) can identify behavioral mechanisms related to condom use and PrEP.
• PrEP use is associated with altered decision-making regarding condom procurement.
• Integrated strategies addressing both PrEP uptake and consistent condom use are essential for MSM sexual health.