O10.6 A longitudinal analysis of men who have sex with men’s condom use and attitudes during HIV antiretroviral prevention scale-up
Why this work is in the frame
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Bibliographic record
Abstract
<h3>Background</h3> Within British Columbia, men who have sex with men (MSM) comprise an increasing proportion of new HIV diagnoses (60% in 2016). We sought to identify temporal trends in condom-use and condom-related attitudes among MSM, especially in relation to antiretroviral-based prevention scale-up. <h3>Methods</h3> A prospective biobehavioural cohort of sexually-active MSM in Metro Vancouver were recruited using respondent-driven sampling (RDS). Every six months, participants self-completed questionnaires. We analyzed temporal trends (6-month periods) in condomless sex (binary outcome) and condom-related attitudes (continuous outcomes) using 3-level generalized linear mixed model (visit; participant; RDS chain). Statistical interactions were tested between time and antiretroviral treatment/pre-exposure prophylaxis (PrEP) use. <h3>Results</h3> Between 03/2015–02/2018, 520 participants (32.1% HIV-positive) completed 1861 study visits. Over time, reporting any condomless anal sex with an unknown/opposite status partner increased for HIV-negative men (OR=1.20, 95%CI:1.03–1.40) and decreased for HIV-positive men (OR=0.83, 95%CI:0.73–0.94). Correct Condom Use Self-Efficacy scale scores decreased among HIV-positive men (B=-0.296, p<0.001) but remained unchanged among HIV-negative men (p=0.167). Overall, Condom Barriers Experience subscale scores decreased, indicating more problems over time (B=-0.236, p<0.001). Other individual items indicated that fewer men reported they ‘can always get condoms’ (B=-0.023, p=0.003), ‘always have condoms when I have sex’ (B=-0.028, p=0.006), and ‘can always ask sexual partners to use condoms’ (B=-0.027, p=0.002). Over time, the ability to ‘say no’ to condomless sex increased among HIV-negative men using PrEP (B=0.172, p=0.023), but decreased among HIV-negative men not using PrEP (B=-0.049, p=0.001) (interaction, p=0.004). <h3>Conclusion</h3> MSM reported changing condom experiences over time, including decreased condom access, availability, and norms. HIV-positive men had less condomless sex with serodiscordant partners and reported more difficulties using condoms over time. PrEP-using men reported greater agency to decline condomless sex; the opposite was true for other HIV-negative men. Innovations in individual and community-level condom promotion and interventions are needed, especially for HIV-negative men not using PrEP. <h3>Disclosure</h3> No significant relationships.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it