Abstract
BackgroundSocial norms and self-efficacy play important roles in promoting consistent condom use among men who have sex with men (MSM). Few studies have investigated the association between social norms, self-efficacy and consistent condom use with different kinds of male partners among MSM. We conducted an online survey of MSM to evaluate this in China.MethodsA cross-sectional online survey was conducted in 2015. Participants completed a validated questionnaire covering socio-demographic information, consistent condom use, condom use social norms and self-efficacy. Eligible participants were 16 or older, born biologically as a male, engaged in anal sex with a man at least once during their lifetime, engaged in condomless anal or vaginal sex in the last three months. In this study, we further restricted to people who had sex with male partners in the last three months. Participants were classified into three groups: engaged in sex only with regular partners, engaged in sex only with casual partners and engaged in sex with both regular partners and casual partners.ResultsParticipants were recruited from 32 provinces in China. Among 1057 participants, 451(42.7%), 217(20.5%), and 389(36.8%) engaged in sex with regular partners only, casual partners only and both types in the last three months, respectively. Men engaged in sex only with regular partners in the last three months had a higher condom use self-efficacy than with other two types of partners (P < 0.01). Both social norms (regular partners: adjusted OR:1.59, 95% CI: 0.97–2.60; casual partners: adjusted OR: 1.58, 95% CI: 1.19–2.09; both types: adjusted OR: 1.48, 95% CI: 1.13–1.95) and self-efficacy (regular partners: adjusted OR: 2.88, 95% CI: 1.59–5.22; casual partners: adjusted OR: 2.35, 95% CI: 1.69–3.26; both types: adjusted OR: 2.45, 95% CI: 1.81–3.32) were positively associated with consistent condom use. No interaction effect was detected between condom social norms and self-efficacy on consistent condom use among Chinese MSM (p > 0.05).ConclusionsBoth social norms and self-efficacy were positively correlated with consistent condom use with any types of partners among Chinese MSM. Tailored interventions that aimed to improve social norms and self-efficacy has the potential to improve overall condom use among Chinese MSM.Trial registrationClinicalTrials.gov: NCT02516930. August 6, 2015.
Highlights
Social norms and self-efficacy play important roles in promoting consistent condom use among men who have sex with men (MSM)
Men engaged in sex only with casual partners (19.8%, 36/182) had a higher rate of consistent condom use than only with regular partners (13.5%, 61/451) or both types (13.2%, 40/264) (Table 1)
Men engaged in sex only with regular partners had a higher median score of condom use self-efficacy than with other two different types of partners (P < 0.01)
Summary
Social norms and self-efficacy play important roles in promoting consistent condom use among men who have sex with men (MSM). Few studies have investigated the association between social norms, self-efficacy and consistent condom use with different kinds of male partners among MSM. Promoting consistent condom use is an important strategy for HIV/STIs control among men who have sex with men (MSM) [1]. Previous studies have documented several reasons for the limited condom use among Chinese MSM, which including but not limited to low HIV risk perception, and low condom use social norms and self-efficacy [8, 9]. Altering condom use social norms and self-efficacy are considered to be two vital methods for promoting condom use [8, 9]
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