Intimacy a Motivator for HIV Prevention

HIV-negative gay and bisexual males in committed relationships cite intimacy as a reason to forgo using condoms. Ironically, Brown University researchers found, this was the same motivation for men to utilize pre-exposure prophylaxis (PrEP), a HIV-prevention method.

The US Public Health Service has recommended persons at high risk of getting HIV, including sexually active gay and bisexual men not using protection, to use PrEP. However, it is still unclear whether men will use PrEP, and what will drive them to stay committed to using it.

“Sex doesn’t happen in a vacuum — interpersonal and relationship context really matter,” senior author Kristi Gamarel, a psychiatry and human behavior postdoctoral researcher in the Warren Alpert Medical School of Brown University, said in a statement. “Many HIV infections are occurring between people who are in a primary relationship.”

In the cross-sectional study, published in the Annals of Behavioral Medicine, investigators interviewed 164 men who have sex with men on their likelihood of adopting PrEP.

From their interviews, the researchers deduced several reason were independently associated with adopting PrEP including higher HIV risk perception, recent condomless anal sex with outside partners, and age.”

“In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions,” the researchers wrote.

Controlling for overlap, the authors reported the strongest PrEP adoption motivations were associated with older age, lower education (to a lesser degree), and desire for intimacy.

Concluding their study, the investigators suggested clinicians implement relationship strategies to encourage high-risk candidates to undergo PrEP.

“Something that’s being supported and endorsed right now by the World Health Organization is couples voluntary testing and counseling,” Gamarel said. “That may be a way to disseminate PrEP and to allow couples to have a discussion about whether PrEP is good for their relationship and how they can support each other using PrEP.”