Li Haochu, Xue Li, Tucker Joseph D, Wei Chongyi, Durvasula Maya, Hu Wenqi, Kang Dianming, Liao Meizhen, Tang Weiming, Ma Wei
Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China.
UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
BMC Public Health. 2017 Aug 7;17(1):641. doi: 10.1186/s12889-017-4662-4.
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.
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.
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.
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.
社区参与策略常常被纳入旨在促进男男性行为者（MSM）使用避孕套的公共卫生干预措施中，MSM是预防艾滋病毒的关键人群。然而，避孕套使用的同伴规范和自我效能在社区参与与避孕套使用之间的关联中所起的作用尚不清楚。本研究探讨了同伴规范和自我效能在这种关联中可能的中介作用。
2015年在中国男男性行为者中开展了一项全国性横断面在线调查。纳入标准包括生物学上为男性、年龄大于16岁、一生中至少有过一次与男性肛交、在过去三个月中有过无保护肛交或阴道性交。使用Mplus 6.11进行验证性因素分析和路径建模分析，以检验艾滋病毒/性健康社区参与（如加入与艾滋病毒和性健康服务相关的社交媒体和社区活动）、避孕套使用同伴规范、避孕套使用自我效能和避孕套使用频率之间的结构关系。
研究发现，艾滋病毒/性健康社区参与、避孕套使用同伴规范、避孕套使用自我效能和避孕套使用频率相互关联。获得了一个良好的数据模型，拟合指数为：CFI = 0.988，TLI = 0.987，RMSEA = 0.032，90% CI（0.028，0.036）。艾滋病毒/性健康社区参与与避孕套使用频率相关，这直接由避孕套使用同伴规范介导，并通过自我效能间接介导。
该研究表明，避孕套使用同伴规范和自我效能可能是社区参与与避孕套使用之间途径的中介因素，并表明基于同伴的干预措施对改善避孕套使用的重要性。
