Information-Motivation-Behavioral Skills model of consistent condom use among transgender women in Shenyang, China

Huwen Wang,Yue Shi,Qiuming Shen,Yong Cai,Lhakpa Tsamlag,Rui She,Zixin Wang,Shuxian Zhang,Tiecheng Ma,Ying Wang,Joseph T F Lau,Ruijie Chang

doi:10.1186/s12889-020-08494-y

Huwen Wang, Yue Shi + Show 10 more

Open Access

https://doi.org/10.1186/s12889-020-08494-y

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Abstract

BackgroundThe Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, but not yet among transgender women (TGW). None effective interventions has been carried out among TGW so far to control their high prevalence of unprotected anal intercourse. The intent of the current study is to examine the application of the IMB model to clarifying the association between condom use correlates and condom use frequency among TGW in China.MethodsUsing snowball sampling, we recruited 198 self-identified TGW in Shenyang, China from April 2017 to July 2017. Participants were required to complete a questionnaire assessing their background characteristics and IMB model constructs. Structural equation modeling (SEM) was conducted to demonstrate the utility of the IMB model.ResultsThe consistent condom use (CCU) rate was 47.0%. Results of SEM indicated that HIV-preventive motivation (comprising condom use attitude and subjective norms; β = 0.823, P < 0.001) and behavioral skills (including condom use skills and self-efficacy; β = 0.979, P = 0.004) were related to more frequent condom use, whereas HIV knowledge was unrelated to condom use (β = 0.052, P = 0.540).ConclusionsThe low CCU rate suggested that TGW in China were at high risk of HIV infection and transmission and a key intervention population. HIV-preventive interventions for this population should focus on enhancing motivation and strengthening behavioral skills to increase condom use frequency and reduce HIV infection.

Highlights

The Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, but not yet among transgender women (TGW)
Background characteristics of subjects A total of 198 TGW completed the questionnaire (Table 1). They had an average age of 33.5 years
Half the subjects (47.0%) reported consistent condom use (CCU); the CCU rates with regular sexual partners, casual sexual partners, and transactional sexual partners were 26.3, 28.8, and 59.1%, respectively

Summary

Introduction

The Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, but not yet among transgender women (TGW). Transgender women (TGW) are those whose gender identity (woman) is different from their birth-assigned sex (male) [1]. A meta-analysis by the World Health Organization of five cohort studies [14] assessed condom effectiveness among MSM and transgender people in developed countries and found that the relative effect on HIV transmission of condom use was a relative risk of 0.36 (95% CI: 0.20–0.67) and that consistent condom use (CCU) reduced HIV transmission by 64% (95% CI: 32–80%)

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