Applying the Information-Motivation-Behavioral Skills Model to Understand PrEP Intentions and Use Among Men Who Have Sex with Men

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2018 Dec 17

PMID 30554396

Citations 45

Authors

Jennifer L Walsh

Affiliations

Soon will be listed here.

Abstract

Research is needed to determine targets for interventions to increase pre-exposure prophylaxis (PrEP) uptake. The Information-Motivation-Behavioral Skills (IMB) model has not been tested for PrEP use among men who have sex with men (MSM). Men and transgender women and men were surveyed at a community event in the Midwest in 2016 (N = 476, 60% White, M = 35). New measures assessed PrEP knowledge, attitudes, stigma, descriptive and subjective norms, and intentions, and participants reported on PrEP use. We tested the IMB model for a subsample of HIV-negative MSM and transgender individuals (N = 357) using structural equation modeling. Only 12% of participants used PrEP. New measures performed well and were reliable (αs = 0.83-0.94). Structural models generally supported the IMB model: knowledge, stigma, and self-efficacy were directly associated with use, and attitudes, stigma, and descriptive norms had indirect effects on use via self-efficacy. The IMB model may be useful when developing PrEP interventions for MSM.

Citing Articles

Delineating the dyadic coping process in HIV serodiscordant male couples: a dyadic daily diary study using the common fate model.

Hou J, Fu R, Jiang T, Yu N Qual Life Res. 2025; .

PMID: 39899139 DOI: 10.1007/s11136-025-03903-4.

Cross-sectional study measuring the level and relationship of awareness, attitude and willingness to use HIV pre-exposure prophylaxis in Davao City, Philippines.

Gabucan V BMJ Open. 2025; 15(1):e091977.

PMID: 39832991 PMC: 11749391. DOI: 10.1136/bmjopen-2024-091977.

Intentions to Use PrEP Among a National Sample of Transgender and Gender-Expansive Youth and Emerging Adults: Examining Gender Minority Stress, Substance Use, and Gender Affirmation.

Cluesman S, Gwadz M, Cleland C AIDS Behav. 2025; .

PMID: 39821058 DOI: 10.1007/s10461-025-04613-1.

Sexual and Gender Minority Adolescents' Preferences for HIV Pre-Exposure Prophylaxis Social Marketing Campaigns: Qualitative Preimplementation Study.

Macapagal K, Zapata J, Ma J, Gordon J, Owens C, Valadez-Tapia S JMIR Form Res. 2025; 9:e60398.

PMID: 39819751 PMC: 11809614. DOI: 10.2196/60398.

Associations Between PrEP Stigma, PrEP Confidence, and PrEP Adherence: Conditional Indirect Effects of Anticipated HIV Stigma.

Yigit I, Budhwani H, Rainer C, Claude K, Muessig K, Hightow-Weidman L J Acquir Immune Defic Syndr. 2024; 97(2):99-106.

PMID: 39250643 PMC: 11573708. DOI: 10.1097/QAI.0000000000003474.

References

Thigpen M, Kebaabetswe P, Paxton L, Smith D, Rose C, Segolodi T . Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012; 367(5):423-34. DOI: 10.1056/NEJMoa1110711. View

Donnell D, Baeten J, Bumpus N, Brantley J, Bangsberg D, Haberer J . HIV protective efficacy and correlates of tenofovir blood concentrations in a clinical trial of PrEP for HIV prevention. J Acquir Immune Defic Syndr. 2014; 66(3):340-8. PMC: 4059553. DOI: 10.1097/QAI.0000000000000172. View

Donenberg G, Schwartz R, Emerson E, Wilson H, Bryant F, Coleman G . Applying a cognitive-behavioral model of HIV risk to youths in psychiatric care. AIDS Educ Prev. 2005; 17(3):200-16. PMC: 1237132. DOI: 10.1521/aeap.17.4.200.66532. View

Laufer F, OConnell D, Feldman I, Zucker H . Vital Signs: Increased Medicaid Prescriptions for Preexposure Prophylaxis Against HIV infection--New York, 2012-2015. MMWR Morb Mortal Wkly Rep. 2015; 64(46):1296-301. DOI: 10.15585/mmwr.mm6446a5. View

Mustanski B, Donenberg G, Emerson E . I can use a condom, i just don't: the importance of motivation to prevent HIV in adolescent seeking psychiatric care. AIDS Behav. 2006; 10(6):753-62. DOI: 10.1007/s10461-006-9098-2. View

Oldenburg C, Mitty J, Biello K, Closson E, Safren S, Mayer K . Differences in Attitudes About HIV Pre-Exposure Prophylaxis Use Among Stimulant Versus Alcohol Using Men Who Have Sex with Men. AIDS Behav. 2015; 20(7):1451-60. PMC: 4833721. DOI: 10.1007/s10461-015-1226-4. View

McCormack S, Dunn D, Desai M, Dolling D, Gafos M, Gilson R . Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2015; 387(10013):53-60. PMC: 4700047. DOI: 10.1016/S0140-6736(15)00056-2. View

Smith D, Toledo L, Smith D, Adams M, Rothenberg R . Attitudes and program preferences of African-American urban young adults about pre-exposure prophylaxis (PrEP). AIDS Educ Prev. 2012; 24(5):408-21. DOI: 10.1521/aeap.2012.24.5.408. View

OLeary A, Jemmott L, Jemmott J . Mediation analysis of an effective sexual risk-reduction intervention for women: the importance of self-efficacy. Health Psychol. 2008; 27(2S):S180-4. DOI: 10.1037/0278-6133.27.2(Suppl.).S180. View

10.

Hoots B, Finlayson T, Nerlander L, Paz-Bailey G . Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men-20 US Cities, 2014. Clin Infect Dis. 2016; 63(5):672-7. PMC: 5009903. DOI: 10.1093/cid/ciw367. View

11.

Smith D, Van Handel M, Wolitski R, Stryker J, Hall H, Prejean J . Vital Signs: Estimated Percentages and Numbers of Adults with Indications for Preexposure Prophylaxis to Prevent HIV Acquisition--United States, 2015. MMWR Morb Mortal Wkly Rep. 2015; 64(46):1291-5. DOI: 10.15585/mmwr.mm6446a4. View

12.

Barclay T, Hinkin C, Castellon S, Mason K, Reinhard M, Marion S . Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychol. 2007; 26(1):40-9. PMC: 2863998. DOI: 10.1037/0278-6133.26.1.40. View

13.

Goedel W, Halkitis P, Greene R, Duncan D . Correlates of Awareness of and Willingness to Use Pre-exposure Prophylaxis (PrEP) in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in New York City. AIDS Behav. 2016; 20(7):1435-42. DOI: 10.1007/s10461-016-1353-6. View

14.

Eaton L, Driffin D, Smith H, Conway-Washington C, White D, Cherry C . Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event. Sex Health. 2014; 11(3):244-51. PMC: 4331017. DOI: 10.1071/SH14022. View

15.

Chan P, Mena L, Patel R, Oldenburg C, Beauchamps L, Perez-Brumer A . Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities. J Int AIDS Soc. 2016; 19(1):20903. PMC: 4908080. DOI: 10.7448/IAS.19.1.20903. View

16.

Grant R, Lama J, Anderson P, McMahan V, Liu A, Vargas L . Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363(27):2587-99. PMC: 3079639. DOI: 10.1056/NEJMoa1011205. View

17.

Bauer D . A more general model for testing measurement invariance and differential item functioning. Psychol Methods. 2016; 22(3):507-526. PMC: 5140785. DOI: 10.1037/met0000077. View

18.

Fisher J, Fisher W . Changing AIDS-risk behavior. Psychol Bull. 1992; 111(3):455-74. DOI: 10.1037/0033-2909.111.3.455. View

19.

Robertson A, Stein J, Baird-Thomas C . Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the Information-Motivation-Behavior Skills (IMB) model. J Adolesc Health. 2006; 38(1):18-25. DOI: 10.1016/j.jadohealth.2004.08.013. View

20.

Biello K, Oldenburg C, Mitty J, Closson E, Mayer K, Safren S . The "Safe Sex" Conundrum: Anticipated Stigma From Sexual Partners as a Barrier to PrEP Use Among Substance Using MSM Engaging in Transactional Sex. AIDS Behav. 2016; 21(1):300-306. PMC: 5624223. DOI: 10.1007/s10461-016-1466-y. View