| Autoren: |
Moreland S; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Vyas KJ; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Jessen H; Private Practice Jessen2 + Kollegen, Berlin, Germany., Esser S; Institute for the Research on HIV and AIDS-associated Diseases, University of Duisburg-Essen, Essen, Germany.; HPSTD clinic, University Hospital Essen, University of Duisburg-Essen, Essen, Germany., Duff E; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Broach E; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Dorsey-Spitz J; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Frndak S; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Mebrahtu T; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Robb ML; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA., Streeck H; Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany.; German Center for Infection Research, Partner Site Bonn-Cologne, Bonn, Germany., Crowell TA; U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA.; Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA. |
| Abstract: |
Pre-exposure prophylaxis (PrEP) has shifted the paradigm of condom use and perceived risks for HIV and sexually transmitted infections (STIs) among men who have sex with men (MSM). We identified factors associated with inconsistent condom use and reasons for non-use among German MSM, with and without HIV, from two clinics in Germany between 2018 and 2024. Participants completed a questionnaire by computer-assisted self-interview every 6 months for up to 24 months. Multivariable robust Poisson regression models were fitted to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for the associations between factors of interest and inconsistent condom use and reasons for non-use. Inconsistent condom use was reported by 81% and 66% of 122 MSM during insertive and receptive anal sex, respectively. Inconsistent condom use was associated with (aPR [95% CI]) age >30 years (insertive: 31-40, 1.34 [1.13, 1.59]; ≥41, 1.27 [1.02, 1.58]), living without HIV (insertive: 1.28 [1.11, 1.47]; receptive: 1.32 [1.17, 1.49]), sex under the influence of drugs (insertive: 1.20 [1.04, 1.38]; receptive: 1.16 [1.03, 1.31]), and not worrying about STIs (insertive: 1.20 [1.06, 1.36]). Living with HIV, preference for condomless sex, and partner's HIV suppression were the most frequent reasons for non-use among participants with HIV. Using PrEP, preference for condomless sex, and partner's HIV status were the most frequent reasons for non-use among participants without HIV. Novel interventions tailored to specific high-risk subgroups, adjusted to address reasons for non-use, and adapted to mitigate risk compensation among MSM using PrEP are needed. |
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