1. Information, Motivation, and Self-Efficacy Among Men Who Have Sex With Men and Transgender Women in the State of Maharashtra, India
- Author
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Wilkerson, J Michael, Rhoton, Jayson Michael, Li, Dennis, Rawat, Shruta Amit, Patankar, Pallav, Rosser, BR Simon, and Ekstrand, Maria
- Subjects
Public Health ,Health Sciences ,Sexually Transmitted Infections ,HIV/AIDS ,Sexual and Gender Minorities (SGM/LGBT*) ,Behavioral and Social Science ,Infectious Diseases ,Prevention ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,Condoms ,Cross-Sectional Studies ,Female ,HIV Infections ,Homosexuality ,Male ,Humans ,India ,Male ,Middle Aged ,Motivation ,Self Efficacy ,Sexual Behavior ,Transgender Persons ,behavior change ,gay men ,HIV prevention ,Internet-based survey ,structural equation modeling ,Medical and Health Sciences ,Education ,Psychology and Cognitive Sciences ,Public health ,Applied and developmental psychology - Abstract
BackgroundIndia's National AIDS Control Programme calls for, among other things, targeted behavioral interventions that address determinants contributing to new infections among men who have sex with men (MSM) and hijras (transgender women).AimTo determine if the information-motivation-behavioral skills model was transferable to an Indian context.MethodsWe recruited 442 MSM and 7 hijras into an online cross-sectional study that asked questions about condom use knowledge, motivation, self-efficacy, and sexual behavior. Structural equation modeling was used to test the overall information-motivation-behavioral skills structure.ResultsCondom use and HIV risk knowledge did not significantly predict condom use self-efficacy or having condomless anal sex with more than one male partner in the past 3 months, and knowledge was not significantly correlated with attitudes toward barebacking. Despite this, the final structural model explained 14.4% of the variance in condom use self-efficacy and 20.0% of the variance in risky sexual behavior. Overall fit of the model was good: χ2(201, N = 447) = 445.002, p < .0001, root mean square error of approximation = .052, 90% CI [.046, .059], comparative fit index = .989, Tucker-Lewis Index = .987.ConclusionThe public health response to India's HIV epidemic is currently different than in the West due to differences in medication access and public health infrastructure. As Indian MSM and hijras learn more about the effectiveness of viral suppression and hopefully have greater access to preexposure prophylaxis, researchers should monitor for changing attitudes toward condoms and be prepared to collaborate with the public health infrastructure in order to develop interventions that reinforce positive attitudes toward condom use.
- Published
- 2019