Driving force of condomless sex after online intervention among Chinese men who have sex with men

• Published in: BMC public health Vol. 19; no. 1; p. 978
• Main Authors: Huang, Wenting, Wu, Dan, Pan, Stephen W, Li, Katherine, Ong, Jason J, Fu, Hongyun, Liu, Chuncheng, Mao, Jessica, Tucker, Joseph D, Tang, Weiming
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22.07.2019; BioMed Central; BMC
• Subjects: Adult; Behavior; China - epidemiology; Condom use; Condoms; Condoms - statistics & numerical data; Education, Distance; Health aspects; Health promotion; Health Promotion - methods; HIV; HIV Infections - epidemiology; Homosexuality, Male - psychology; Homosexuality, Male - statistics & numerical data; Humans; Information management; Internet videos; Intervention (Psychology); Male; Methods; MSM; MSM (Men who have sex with men); Risk-Taking; Sex tourism; Sexual behavior; Sexual intercourse; Surveys and Questionnaires; Tourism; Unsafe Sex - psychology; Videotape Recording; China; HIV; Condom use; MSM
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-019-7307-y

Condom use remains consistently low among Chinese men who have sex with men (MSM). This study aims to identify factors associated with condom use after online video intervention. This is a secondary data analysis of data collected from an online non-inferiority trial comparing the effectiveness of two condom use promotion video interventions among Chinese MSM. Participants from the two groups were combined since the effectiveness of two video interventions were shown to be non-inferior. Univariable and multivariable logistic regression were used to identify factors associated with condomless sex after the intervention during the follow-up interval. Overall, 1173 participants were recruited at baseline and 791 (67.4%) completed the three-month follow-up survey. 57.3% (453/791) of the participants reported condomless sex after intervention in the three-month follow-up interval. MSM who have had sex under the influence of alcohol in the last 3 months (Odds Ratio(OR) = 1.90; 95% CI: 1.22, 2.97; Adjusted OR(AOR) = 1.79; 95% CI: 1.13, 2.83) and ever have had sex tourism (OR = 2.75; 95% CI: 1.34, 5.63; AOR = 2.40; 95% CI: 1.15, 5.07) at baseline were more likely to have condomless sex after intervention in the three-month follow-up period. MSM who had a higher level of community engagement in sexual health (OR = 0.54; 95% CI: 0.35, 0.82; AOR = 0.49; 95% CI: 0.32, 0.75 with substantial engagement) and who viewed additional condom promotion videos during the follow-up period by themselves (OR = 0.67; 95% CI = 0.50, 0.89; AOR = 0.67; 95% CI: 0.50, 0.91). were less likely to have condomless sex during the follow-up period. The intervention appeared to be effective among MSM who reported viewing additional condom promotion videos by themselves and more community engagement after the intervention. In MSM who reported risky sexual behaviors at baseline, the intervention appeared less effective. Tailored intervention videos that target particular subgroups, active in-person community engagement, and optimized intervention frequency should be considered in future sexual health interventions.