Table 4. Socio-demographic, substance use, sexual risk, psychosocial, and healthcare access characteristics associated with membership in distinct classes with respect to perceived barriers to PrEP use among MSM in Tijuana, Mexico (N = 364).
| Perceived PrEP Attribute Barriers | High Level of Perceived Barriers | |||||||
|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | AOR | 95% CI | OR | 95% CI | AOR | 95% CI | |
| Socio-demographics | ||||||||
| Age (years) | 0.99 | (0.97, 1.01) | 0.99 | (0.97, 1.01)b | 1.01 | (0.99, 1.04) | 1.01 | (0.99, 1.04)b |
| ≥ High school education | 1.20 | (0.71, 2.03) | 1.15 | (0.67, 1.96)c | 0.41 | (0.17, 0.96) | 0.43 | (0.18, 1.02)c |
| Duration of residence in Tijuana (years) | 1.00 | (0.98, 1.02) | 1.00 | (0.98, 1.02)d | 0.98 | (0.95, 1.01) | 0.98 | (0.96, 1.01)d |
| Incarceration history | 0.95 | (0.55, 1.62) | 1.08 | (0.60, 1.95)e | 2.58 | (1.22, 5.47) | 2.44 | (1.04, 5.73)e |
| Employed | 1.28 | (0.74, 2.20) | 1.25 | (0.71, 2.19)f | 0.50 | (0.24, 1.03) | 0.68 | (0.30, 1.53)f |
| Psychosocial factors | ||||||||
| Social support | 1.00 | (0.99, 1.01) | 1.00 | (0.99, 1.01)g | 0.99 | (0.98, 1.00) | 0.99 | (0.98, 1.00)g |
| Outness about having sex with men | 0.95 | (0.86, 1.06) | 0.94 | (0.84, 1.05)h | 0.79 | (0.66, 0.93) | 0.84 | (0.69, 1.02)h |
| Depression (CESD-D ≥10) | 0.95 | (0.56, 1.62) | 0.94 | (0.54, 1.65)i | 1.77 | (0.86, 3.66) | 1.10 | (0.49, 2.45)i |
| Substance use | ||||||||
| Illicit drug use (≤1 month)a | 1.12 | (0.66, 1.88) | 1.09 | (0.58, 2.06)j | 2.42 | (1.13, 5.19) | 1.57 | (0.61, 4.01)j |
| Hazardous alcohol consumption (≤12 months) |
0.65 | (0.38, 1.10) | 0.62 | (0.35, 1.08)j | 0.75 | (0.37, 1.55) | 0.66 | (0.30, 1.43)j |
| Sexual Risk Behaviors (past 4 months) | ||||||||
| Any HIV-positive/status unknown partners | 0.58 | (0.34, 0.99) | 0.56 | (0.31, 1.01)k | 0.97 | (0.47, 1.99) | 0.91 | (0.40, 2.05)k |
| Any substance use before/during sex with partners |
0.75 | (0.42, 1.34) | 0.85 | (0.42, 1.74)k | 1.36 | (0.57, 1.67) | 0.76 | (0.20, 2.82)k |
| Gave/received something of value to/from partners in exchange for sex |
0.98 | (0.58, 1.67) | 0.95 | (0.53, 1.72)k | 3.02 | (1.41, 6.48) | 1.96 | (0.76, 5.04)k |
| Any CAI with partners | 0.86 | (0.49, 1.51) | 0.91 | (0.49, 1.66)l | 1.64 | (0.71, 3.81) | 1.87 | (0.54, 6.44)l |
| Healthcare Access | ||||||||
| Received care from a HCP (≤12 months) | 2.07 | (1.21, 3.53) | 2.78 | (1.41, 5.45)m | 0.72 | (0.34, 1.52) | 1.26 | (0.49, 3.23)m |
| HIV testing (≤12 months) | 1.67 | (0.99, 2.84) | 1.62 | (0.91, 2.89)m | 0.78 | (0.36, 1.68) | 1.14 | (0.48, 2.72)m |
| PrEP awareness | 1.05 | (0.54, 2.03) | 0.82 | (0.37, 1.81)n | 0.36 | (0.08, 1.57) | 0.44 | (0.03, 5.67)n |
| Perceived lifetime risk of HIV (likely/very likely) | 0.88 | (0.52, 1.48) | 0.98 | (0.52, 1.82)o | 1.10 | (0.54, 2.26) | 0.85 | (0.35, 2.03)o |
a Excluding marijuana.
b No identified confounders.
c Adjusted for age.
d Adjusted for variable in (c); additionally, adjusted for education.
e Adjusted for variables in (c) and (d); additionally, adjusted for duration of residence in Tijuana.
f Adjusted for variables in (c), (d), and (e); additionally, adjusted for incarceration history.
g Adjusted for variables in (c), (d), (e), and (f); additionally, adjusted for employment.
h Adjusted for variables in (c), (d), (e), (f), and (g); additionally, adjusted for social support.
i Adjusted for variables in (c), (d), (e), (f), (g), and (h); additionally, adjusted for outness.
j Adjusted for variables in (c), (d), (e), (f), (g), (h), and (i); additionally, adjusted for depression.
k Adjusted for variables in (c), (d), (e), (f), (g), (h), (i), and (j); additionally, adjusted for illicit drug use and hazardous alcohol consumption.
l Adjusted for variables in (c), (d), (e), (f), (g), (h), (i), (j), and (k); additionally, adjusted for HIV status of partners, substance use before/during sex with partners, and
exchange of something of value for sex with partners.
m Adjusted for variables in (c), (d), (e), (f), (g), (h), (i), (j), (k), and (l); additionally, adjusted for any CAI.
n Adjusted for variables in (c), (d), (e), (f), (g), (h), (i), (j), (k), (l), and (m); additionally, adjusted for receipt of care from a HCP and HIV testing.
o Adjusted for variables in (c), (d), (e), (f), (g), (h), (i), (j), (k), (l), (m), and (n); additionally, adjusted for PrEP awareness.
Abbreviations: CESD-D = center for epidemiologic studies depression scale; MSM = men who have sex with men; HCP = healthcare provider; CAI = condomless anal intercourse;
PrEP = pre-exposure prophylaxis.
Reference group = low level of perceived barriers.