NDLI: Distinguishing hypothetical willingness from behavioral intentions to initiate HIV pre-exposure prophylaxis (PrEP): Findings from a large cohort of gay and bisexual men in the U.S.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rendina, H. Jonathon Whitfield, Thomas H. F. Grov, Christian Starks, Tyrel J. Parsons, Jeffrey T.
Description	Author Affiliation: Rendina HJ ( Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States); Whitfield TH ( Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, United States); Grov C ( Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, United States); Starks TJ ( Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States); Parsons JT ( Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States)
Abstract	RATIONALE: Much of the data on the acceptability of HIV Pre-Exposure Prophylaxis (PrEP) is based on willingness to take PrEP (i.e., hypothetical receptivity) rather than actual intentions (i.e., planned behavioral action) to do so. OBJECTIVE: We sought to examine differences between hypothetical willingness and behavioral intentions to begin PrEP in a national sample of gay and bisexual men (GBM) across the U.S. METHODS: We utilized data collected in 2015 to examine differences between those Unwilling (42.6% n = 375), Willing but not intending (41.4%, n = 365), and willing and Intending to take PrEP (15.9%, n = 140) in a multivariable, multinomial logistic regression. RESULTS: Men with less education had higher odds of Intending to take PrEP. Compared to men unsure about PrEP's efficacy, those who believed PrEP was at least 90% efficacious had higher odds of Intending to take PrEP. Those who saw themselves as appropriate candidates for PrEP had higher odds of Intending to take PrEP while those who saw themselves as inappropriate candidates for PrEP had lower odds of Intending to take PrEP in comparison to men unsure if they were appropriate candidates. Increased motivation for condom non-use because of perceived sexual pressure by partners was associated with higher odds of Intending to take PrEP. The groups did not differ by risk behavior nor recent STI diagnosis. CONCLUSIONS: Overall, the distinction between willingness and intentions to take PrEP was meaningful and may help explain disparities between PrEP acceptability and uptake. While much of the literature has focused on hypothetical willingness to take PrEP, these results highlight the importance of simultaneously assessing willingness and intentions when examining correspondence with uptake and developing interventions to increase PrEP uptake.
File Format	HTM / HTML
ISSN	02779536
e-ISSN	18735347
Journal	Social Science & Medicine
Volume Number	172
Language	English
Publisher	Elsevier
Publisher Date	2017-01-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	health inequalities health behavior social epidemiology healthcare policy medical sociology
Content Type	Text
Resource Type	Article
Subject	Medicine Health (social science) History and Philosophy of Science

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