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TitleCondomless Anal Sex Associated With Heterogeneous Profiles Of HIV Pre-Exposure Prophylaxis Use and Sexual Activities Among Men Who Have Sex With Men: A Latent Class Analysis Using Sex Diary Data on a Mobile App
Creator黃柏僩
Huang, Po-Hsien
Yu, Yi-Fang;Wu, Huei-Jiuan;Ku, Stephane Wen-Wei;Li, Chia-Wen;Huang, Poyao;Strong, Carol
Contributor心理系
Key Wordsmobile apps; pre-exposure prophylaxis; PrEP; latent class analysis; men who have sex with men; MSM; condom; sex diaries; adherence; app; sex; diary; sexual health; HIV; Taiwan; risk; prevention
Date2021-12
Date Issued30-Jun-2022 11:09:22 (UTC+8)
SummaryBackground: New innovative technologies, such as mobile apps, have been developed to increase pre-exposure prophylaxis (PrEP) adherence and the use of log sex diaries. The contiguity of mobile apps reduces the recall bias that generally affects reported condom and PrEP use. However, none of the currently used mobile apps were designed for event-driven PrEP users, and few studies have demonstrated the potential usage of sex diary data to facilitate the understanding of the different HIV risks among heterogeneous profiles of sex diaries and PrEP use.
     Objective: We aim to discriminate the heterogeneous profiles of sex events and PrEP use and examine the risk of condomless anal sex among different types of sex events.
     Methods: We recruited 35 adult men who have sex with men from two medical centers in Taiwan since May 2020 and followed up for four months. Participants were on PrEP or willing to take PrEP. They were asked to log their sex events, PrEP use, and dosing regimens on a mobile app to improve their PrEP adherence. Latent class analysis was used to distinguish profiles of sex events and PrEP use. Indicators included correct intake of PrEP for each sex event, participants’ sexual positioning, partner’s HIV status, and age.
     Results: A total of 551 sex events were classified into three classes by latent class analysis: PrEP nonadherent flip-flopping (234/551, 42%), PrEP imperfect-adherent power bottoming (284/551, 52%), and PrEP adherent serodiscordant topping (33/551, 6%). “PrEP nonadherent flip-flopping” sex events were more likely to involve condomless anal sex than “PrEP imperfect-adherent power bottoming” (OR 1.83, 95% CI 1.03-3.25) after considering random intercepts for individuals, and this class needed to increase their PrEP adherence and use of condoms. “PrEP imperfect-adherent power bottoming” realized their own risk and packaged PrEP with condoms to protect themselves. Up to 99% (32/33) of sex events in “PrEP adherent serodiscordant topping” were protected by PrEP, but all of the sex events in this group were condomless.
     Conclusions: Using the sex diary data could advance the capacity to identify high-risk groups. HIV prevention strategy should be more flexible and combine PrEP with condom use for future HIV prevention.
RelationJournal of Medical Internet Research, 23(12), e33877
Typearticle
DOI https://doi.org/10.2196/33877
dc.contributor 心理系-
dc.creator (作者) 黃柏僩-
dc.creator (作者) Huang, Po-Hsien-
dc.creator (作者) Yu, Yi-Fang;Wu, Huei-Jiuan;Ku, Stephane Wen-Wei;Li, Chia-Wen;Huang, Poyao;Strong, Carol-
dc.date (日期) 2021-12-
dc.date.accessioned 30-Jun-2022 11:09:22 (UTC+8)-
dc.date.available 30-Jun-2022 11:09:22 (UTC+8)-
dc.date.issued (上傳時間) 30-Jun-2022 11:09:22 (UTC+8)-
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/140512-
dc.description.abstract (摘要) Background: New innovative technologies, such as mobile apps, have been developed to increase pre-exposure prophylaxis (PrEP) adherence and the use of log sex diaries. The contiguity of mobile apps reduces the recall bias that generally affects reported condom and PrEP use. However, none of the currently used mobile apps were designed for event-driven PrEP users, and few studies have demonstrated the potential usage of sex diary data to facilitate the understanding of the different HIV risks among heterogeneous profiles of sex diaries and PrEP use.
     Objective: We aim to discriminate the heterogeneous profiles of sex events and PrEP use and examine the risk of condomless anal sex among different types of sex events.
     Methods: We recruited 35 adult men who have sex with men from two medical centers in Taiwan since May 2020 and followed up for four months. Participants were on PrEP or willing to take PrEP. They were asked to log their sex events, PrEP use, and dosing regimens on a mobile app to improve their PrEP adherence. Latent class analysis was used to distinguish profiles of sex events and PrEP use. Indicators included correct intake of PrEP for each sex event, participants’ sexual positioning, partner’s HIV status, and age.
     Results: A total of 551 sex events were classified into three classes by latent class analysis: PrEP nonadherent flip-flopping (234/551, 42%), PrEP imperfect-adherent power bottoming (284/551, 52%), and PrEP adherent serodiscordant topping (33/551, 6%). “PrEP nonadherent flip-flopping” sex events were more likely to involve condomless anal sex than “PrEP imperfect-adherent power bottoming” (OR 1.83, 95% CI 1.03-3.25) after considering random intercepts for individuals, and this class needed to increase their PrEP adherence and use of condoms. “PrEP imperfect-adherent power bottoming” realized their own risk and packaged PrEP with condoms to protect themselves. Up to 99% (32/33) of sex events in “PrEP adherent serodiscordant topping” were protected by PrEP, but all of the sex events in this group were condomless.
     Conclusions: Using the sex diary data could advance the capacity to identify high-risk groups. HIV prevention strategy should be more flexible and combine PrEP with condom use for future HIV prevention.
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dc.format.extent 93 bytes-
dc.format.mimetype text/html-
dc.relation (關聯) Journal of Medical Internet Research, 23(12), e33877-
dc.subject (關鍵詞) mobile apps; pre-exposure prophylaxis; PrEP; latent class analysis; men who have sex with men; MSM; condom; sex diaries; adherence; app; sex; diary; sexual health; HIV; Taiwan; risk; prevention-
dc.title (題名) Condomless Anal Sex Associated With Heterogeneous Profiles Of HIV Pre-Exposure Prophylaxis Use and Sexual Activities Among Men Who Have Sex With Men: A Latent Class Analysis Using Sex Diary Data on a Mobile App-
dc.type (資料類型) article-
dc.identifier.doi (DOI) 10.2196/33877-
dc.doi.uri (DOI) https://doi.org/10.2196/33877-