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Use of preexposure prophylaxis and condom purchasing decisions

Nioud Mulugeta Gebru1,2, Justin C Strickland3, Derek D Reed4

  • 1Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.

Journal of the Experimental Analysis of Behavior
|February 15, 2024
PubMed

Insights

Men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP) are less likely to purchase condoms, even for desirable partners. This suggests PrEP may influence condom use decisions, highlighting the need for integrated sexual health strategies.

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.
Keywords:
PrEPbehavioral economicsdemandsexual behaviorsyoung adults

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