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.