{"title":"Condom use self-efficacy mediates chemsex and condom use: a moderated mediation analysis.","authors":"Edmond Pui Hang Choi, Eric Pui Fung Chow","doi":"10.1080/13548506.2025.2479260","DOIUrl":null,"url":null,"abstract":"<p><p>Among men who have sex with men (MSM), chemsex is strongly associated with condomless anal sex, contributing to the increased burden of HIV and others sexually transmitted infections (STIs) in the community. In regions with limited accessibility to HIV pre-exposure prophylaxis, condoms remain a critical method for HIV prevention. However, there is a notable lack of research examining the impact of chemsex on condom use self-efficacy. This study aimed to examine condom use self-efficacy among chemsex users and to explore its interrelationship with chemsex and condomless anal sex. Adult MSM in Hong Kong were recruited in 2021. Logistic regression analysis was employed to explore factors associated with condomless anal sex, while mediation analysis was employed to examine the relationships among chemsex, condom use self-efficacy, and condomless anal sex. The analysis included 316 MSM, 51 (16.14%) of whom engaged in chemsex in the last three months, with significantly lower condom use self-efficacy scores. Multiple logistic regression analysis indicated that chemsex engagement was significantly associated with a higher likelihood of condomless sex. Mediation analysis showed that chemsex engagement indirectly increased the likelihood of condomless anal sex through its negative impact on condom use self-efficacy, with an odds ratio of 3.52 (95% CI: 2.12-7.09). Furthermore, sexual orientation was found to moderate this indirect effect. Among gay men, the indirect effect was more pronounced (odds ratio: 3.74, 95% CI: 2.20-7.71) compared to bisexual men (odds ratio: 2.01, 95% CI: 1.18-4.12). These findings highlight the importance of targeted interventions aimed at enhancing condom use self-efficacy among MSM, particularly among those engaging in chemsex. Strengthening self-efficacy may play a critical role in promoting condom use and reducing the risk of HIV and STIs in this population.</p>","PeriodicalId":54535,"journal":{"name":"Psychology Health & Medicine","volume":" ","pages":"1-19"},"PeriodicalIF":2.3000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychology Health & Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13548506.2025.2479260","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Among men who have sex with men (MSM), chemsex is strongly associated with condomless anal sex, contributing to the increased burden of HIV and others sexually transmitted infections (STIs) in the community. In regions with limited accessibility to HIV pre-exposure prophylaxis, condoms remain a critical method for HIV prevention. However, there is a notable lack of research examining the impact of chemsex on condom use self-efficacy. This study aimed to examine condom use self-efficacy among chemsex users and to explore its interrelationship with chemsex and condomless anal sex. Adult MSM in Hong Kong were recruited in 2021. Logistic regression analysis was employed to explore factors associated with condomless anal sex, while mediation analysis was employed to examine the relationships among chemsex, condom use self-efficacy, and condomless anal sex. The analysis included 316 MSM, 51 (16.14%) of whom engaged in chemsex in the last three months, with significantly lower condom use self-efficacy scores. Multiple logistic regression analysis indicated that chemsex engagement was significantly associated with a higher likelihood of condomless sex. Mediation analysis showed that chemsex engagement indirectly increased the likelihood of condomless anal sex through its negative impact on condom use self-efficacy, with an odds ratio of 3.52 (95% CI: 2.12-7.09). Furthermore, sexual orientation was found to moderate this indirect effect. Among gay men, the indirect effect was more pronounced (odds ratio: 3.74, 95% CI: 2.20-7.71) compared to bisexual men (odds ratio: 2.01, 95% CI: 1.18-4.12). These findings highlight the importance of targeted interventions aimed at enhancing condom use self-efficacy among MSM, particularly among those engaging in chemsex. Strengthening self-efficacy may play a critical role in promoting condom use and reducing the risk of HIV and STIs in this population.
期刊介绍：
Psychology, Health & Medicine is a multidisciplinary journal highlighting human factors in health. The journal provides a peer reviewed forum to report on issues of psychology and health in practice. This key publication reaches an international audience, highlighting the variation and similarities within different settings and exploring multiple health and illness issues from theoretical, practical and management perspectives. It provides a critical forum to examine the wide range of applied health and illness issues and how they incorporate psychological knowledge, understanding, theory and intervention. The journal reflects the growing recognition of psychosocial issues as they affect health planning, medical care, disease reaction, intervention, quality of life, adjustment adaptation and management.
For many years theoretical research was very distant from applied understanding. The emerging movement in health psychology, changes in medical care provision and training, and consumer awareness of health issues all contribute to a growing need for applied research. This journal focuses on practical applications of theory, research and experience and provides a bridge between academic knowledge, illness experience, wellbeing and health care practice.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
