An Event-Level Analysis of Condom Use During Anal Intercourse Among Self-Reported Human Immunodeficiency Virus-Negative Gay and Bisexual Men in a Treatment as Prevention Environment.

摘要: BACKGROUND We sought to identify factors associated with condom use during anal intercourse among self-identified human immunodeficiency virus-negative gay, bisexual, and other men who have sex (GBM) in Vancouver, Canada following "treatment as prevention" (TasP) scale-up 2010. METHODS Sexually active GBM were recruited using respondent-driven sampling from 2012 2014. analyzed participants' most recent sexual encounter up their last 5 partners within the past 6 months. In addition individual- event-level explanatory factors, we assessed potential associations TasP awareness, TasP-related prevention practice (viral load sorting), attitudes (human virus treatment optimism). Accounting for clustering at chain-level participant-level, versus nonuse determined a multivariable generalized linear mixed model built backward selection AIC minimization. RESULTS Of 513 participants, 436 (85%) reported total of 1196 events 56% use. The proportion condom-protected decreased monthly over study period (odds ratio [OR], 0.95 per month, 95% confidence interval [CI], 0.92-0.98). practices significantly lower odds univariate level, but no longer significant multivariate level. model, partner methamphetamine (adjusted OR [aOR], 0.18; CI, 0.06-0.58), frequency that (aOR, 0.97 act; 0.95-0.98) time since first months; 0.95-0.99) use, whereas participant alcohol 1.41; 1.01-1.98) planned future 1.56; 1.08-2.27) greater Event-level receptive-only 2.10; 1.38-3.20) or insertive-only 2.53; 1.64-3.90) positions compared reporting both positions. CONCLUSIONS not salient predictors GBM's Health promotion must consider between condomless substance relational factors.