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BMC Public Health. 2017 Aug 7;17(1):641. doi: 10.1186/s12889-017-4662-4.

Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men.

Li H1,2,3, Xue L4, Tucker JD5,6, Wei C7, Durvasula M8, Hu W4, Kang D9, Liao M9, Tang W5,6,10, Ma W11.

Author information

1
Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China. hcli@alumni.cuhk.net.
2
UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. hcli@alumni.cuhk.net.
3
SESH Global, Guangzhou, China. hcli@alumni.cuhk.net.
4
Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China.
5
UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
6
SESH Global, Guangzhou, China.
7
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
8
Department of Economics, Duke University, Durham, NC, USA.
9
Shandong Provincial Center for Disease Control and Prevention, Jinan, China.
10
Guangdong Provincial Center for Skin Diseases and STI Control, Guangzhou, China.
11
Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China. weima@sdu.edu.cn.

Abstract

BACKGROUND:

Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM), a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association.

METHODS:

A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services), condom use peer norms, condom use self-efficacy, and frequency of condom use.

RESULTS:

The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036). HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy.

CONCLUSION:

The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use.

KEYWORDS:

Community engagement; HIV; Men who have sex with men; Path model; Peer norm; Self-efficacy

PMID:
28784172
PMCID:
PMC5545844
DOI:
10.1186/s12889-017-4662-4
[Indexed for MEDLINE]
Free PMC Article

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