Applying the Information-Motivation-Behavioral Skills Model to Understand PrEP Intentions and Use Among Men Who Have Sex with Men

Abstract

Research is needed to determine targets for interventions to increase pre-exposure prophylaxis (PrEP) uptake. The Information-Motivation-Behavioral Skills (IMB) model has not been tested for PrEP use among men who have sex with men (MSM). Men and transgender women and men were surveyed at a community event in the Midwest in 2016 (N = 476, 60% White, Mage = 35). New measures assessed PrEP knowledge, attitudes, stigma, descriptive and subjective norms, and intentions, and participants reported on PrEP use. We tested the IMB model for a subsample of HIV-negative MSM and transgender individuals (N = 357) using structural equation modeling. Only 12% of participants used PrEP. New measures performed well and were reliable (αs = 0.83-0.94). Structural models generally supported the IMB model: knowledge, stigma, and self-efficacy were directly associated with use, and attitudes, stigma, and descriptive norms had indirect effects on use via self-efficacy. The IMB model may be useful when developing PrEP interventions for MSM.

Keywords: HIV prevention; Information–motivation–behavioral skills model; Men who have sex with men; Pre-exposure prophylaxis.

Conflict of interest statement

Conflict of Interest: Jennifer L. Walsh declares that she has no conflict of interest.

Figures

Figure 1.

The information-motivation-behavioral skills (IMB) model for PrEP use for HIV-negative men and transgender women and men who have sex with men (N = 357). The structural equation model fit the data well, Χ2(249) = 308.57, RMSEA = .03, CFI = .96, TLI = .96 (average over 100 imputations). Unstandardized linear and probit regression coefficients are reported for continuous and categorical outcomes respectively.

Figure 2.

The information-motivation-behavioral skills (IMB) model for PrEP intentions for HIV-negative men and transgender women and men who have sex with men and who are not currently using PrEP (N = 310). The structural equation model had an acceptable fit, Χ2(267) = 417.37, RMSEA = .04, CFI = .95, TLI = .94 (average over 100 imputations). Unstandardized linear regression coefficients are reported.