An empirical test of the Information-Motivation-Behavioral Skills model of willingness and intention to use HIV pre-exposure prophylaxis among adolescent men who have sex with men.

BACKGROUND

Adolescent men who have sex with men (AMSM) are disproportionately affected by HIV, yet uptake of HIV pre-exposure prophylaxis (PrEP) among AMSM is low. Theory-based research is needed to increase PrEP adoption for HIV prevention among AMSM.

PURPOSE: Using the Information-Motivation-Behavioral Skills (IMB) model, we aimed to (1) examine information, motivation, and behavioral skills as determinants of willingness and intention to use PrEP and (2) determine whether these relationships were moderated by depressive symptoms and substance use.

METHODS

A secondary analysis was performed using cross-sectional baseline data from 1,364 AMSM ages 13-18 who participated in the SMART eHealth HIV prevention intervention between 2018 and 2020. Structural equation modeling and multigroup analysis were used to investigate the aims.

RESULTS

Information and social motivation were indirectly associated with PrEP willingness and intention through behavioral skills. Personal motivation was directly associated with PrEP willingness and intention. Depressive symptoms and substance use were not moderators.

CONCLUSIONS

AMSM who were more informed about and socially motivated to take PrEP had stronger PrEP-related behavioral skills, and in turn were more likely to be willing and have an intention to use PrEP. AMSM who were more personally motivated to use PrEP were more likely to be willing and have an intention to use PrEP. Results suggest that the IMB model may remain robust in the presence of depression and substance use. These findings support the use of the IMB model in interventions designed to promote PrEP uptake among AMSM.

CLINICAL TRIALS REGISTRATION NUMBER: NCT03511131.