Intention to Behavior: Using the Integrative Model of Behavioral Prediction to Understand Actual Control of PrEP Uptake
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ORIGINAL PAPER
Intention to Behavior: Using the Integrative Model of Behavioral Prediction to Understand Actual Control of PrEP Uptake Among Gay Men Minhao Dai1 · Nancy Grant Harrington2 Received: 30 November 2019 / Revised: 14 July 2020 / Accepted: 16 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract PrEP is an effective daily prevention medicine used to reduce risks of HIV infections. Previous research has pointed out the intention–behavior gap on PrEP uptake among gay men. The current study built on research examining how the integrative model of behavioral prediction (IMBP) factors influences PrEP uptake among gay men to explore how actual control variables, namely skills and environmental constraints, moderated the intention–behavior relationship. We used results from formative interviews to construct a survey and collected data from 420 gay men. Results showed several factors that were associated with PrEP uptake among gay men. Specifically, the lack of access to an LGBTQ-friendly healthcare provider(s) and lack of English fluency had significant main effects on PrEP uptake behavior, while lack of access to a healthcare provider and lack of healthcare system knowledge were significant moderators of the intention–behavior relationship. This study advances our understanding of the IMBP and offers practical implications for PrEP promotion. Limitations and suggestions for future studies are discussed. Keywords PrEP uptake · Integrative Model of Behavioral Prediction · Environmental constraints · Sexual orientation
Introduction Gay men are disproportionally affected by sexually transmitted diseases (STDs). Recent data indicate that they account for 86% of all reported cases of primary and secondary syphilis, 82% of all male HIV infection cases, and 37.8% of antimicrobialresistant gonorrhea infection cases (Centers for Diseases Control and Prevention [CDC], 2017), although this population makes up only an estimated 4.5% of the male population in the U.S. (Newport, 2018). STD prevention for this group, therefore, is paramount. Adding to the STD prevention arsenal, the Food and Drug Administration in 2012 approved pre-exposure prophylaxis (PrEP), an antiretroviral treatment pre-exposure prophylaxis medication, for use in HIV prevention. Building on the previous literature that explored the influence of attitudes, * Minhao Dai [email protected] 1
School of Communication and Media, Kennesaw State University, 402 Bartow Ave., MD 2207, Kennesaw, GA 30144, USA
Department of Communication, University of Kentucky, Lexington, KY, USA
2
norms, and perceived behavioral control on PrEP uptake intention and behavior, this manuscript examines the role of actual control variables (i.e., skills and environmental constraints) that moderate PrEP uptake intention and behavior. PrEP is the combination of tenofovir and emtricitabine, and the medication interferes with HIV’s ability to copy itself in the human body after a person has been exposed to the human immunodeficiency virus. T
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