Behavioral intention to perform risk compensation behaviors after receiving HPV vaccination among men who have sex with men in China

Figures & data

Table 1. Background characteristics of the participants (N = 624).

	N	%
Socio-demographics
Age group
18–30	372	59.6
31–40	179	28.7
>40	73	11.7
Current marital status
Currently single	510	81.7
Cohabited/married with men	111	17.8
Cohabited/married with women	3	0.5
Education level
Secondary or below	93	14.9
University or above	531	85.1
Current employment status
Full-time	492	78.8
Part-time/unemployment/retired/students	132	21.2
Personal monthly income (HKD)
<10,000	101	16.2
10,000–19,999	207	33.2
20,000–39,999	223	35.7
≥40,000	90	14.4
Refuse to disclose	3	0.5
Sexual orientation
Homosexual	556	89.1
Bisexual	66	10.6
Heterosexual	1	0.2
Refuse to disclose	1	0.2
HIV/STD-related service utilization in the last six months
HIV testing
No	278	44.6
Yes	346	55.4
Other HIV/STDs prevention services^1 in the past six months
No	324	51.9
Yes	300	48.1
Sexual behaviors in the last six months
Had had anal intercourse with regular male sex partners (RP)
No	122	19.6
Yes	502	80.4
Had had anal intercourse with non-regular male sex partners (NRP)
No	303	48.6
Yes	321	51.4
Condomless anal intercourse (CAI) with either RP or NRP
No	404	64.7
Yes	220	35.3
Use of sexual potency drugs before/during anal intercourse with men
No	583	93.4
Yes	41	6.6
Use of illicit drugs before/during anal intercourse with men (Chemsex)
No	585	93.3
Yes	39	6.3
History of HIV/STD infection
Self-reported HIV status
Negative	552	88.5
Positive	26	4.2
Refuse to disclose	12	1.9
Had never tested for HIV antibody	34	5.4
History of other STD infection
No	503	80.6
Yes	121	19.4

¹Including condom distribution, education on partners, leaflets of HIV/AIDS information, and seminars.

Table 2. Perceptions related to pre-intention phase of HAPA (N = 624).

	%	Mean (SD)
Behavioral intention to reduce frequency of condom use with various partners after receiving HPV vaccination
How high is your chance of reducing frequency of condom use with regular male sex partners (RP) during anal intercourse after receiving HPV vaccination?
No (Very low/low/moderate)	93.1
Yes (High/very high)	6.9
How high is your chance of reducing frequency of condom use with non-regular male sex partners (NRP) during anal intercourse after receiving HPV vaccination?
No (Very low/low/moderate)	96.0
Yes (High/very high)	4.0
Behavioral intention to reduce frequency of condom use with any type of male sex partners (either RP or NRP) after receiving HPV vaccination
No	92.0
Yes	8.0
Risk perception (% somewhat lower/much lower)
Perceived change in risk of contracting HIV after receiving HPV vaccination	35.7
Perceived change in risk of contracting other STDs after receiving HPV vaccination	51.4
Risk Perception Scale ^1		4.9(1.5)
Positive outcome expectancy of CAI with men after receiving HPV vaccination (% agree/strongly agree)
Will increase intimacy between you and your male sex partner	25.8
Will increase trust between you and your male sex partner	32.7
Positive Outcome Expectancy Scale ^2		5.7 (2.4)
Negative outcome expectancy of CAI with men after receiving HPV vaccination (%agree/strongly agree)
You will contract HIV	52.4
You will contract other STDs	49.2
You will feel worried	53.4
You will feel guilty	41.2
Negative Outcome Expectancy Scale ^3		13.8 (4.1)
Perceived self-efficacy of consistent condom use with sex partners after receiving HPV vaccination under different conditions (%somewhat confident/very confident)
You are confident to use condom consistently even when you are sexually aroused	68.6
You are confident to use condom consistently even when your sex partner is not willing to use it	61.7
Perceived Self-efficacy Scale ^4		7.7 (2.3)
Behavioral intention to take up HPV vaccination
How high is your chance of taking up three-dose HPV vaccination at market rate within the next year (after being briefed about the efficacy of HPV vaccination)?
No (Very low/low/moderate)	71.6
Yes (High/very high)	28.4

¹ Risk Perception Scale: two items, Cronbach’s alpha: 0.702.

² Positive Outcome Expectancy Scale: two items, Cronbach’s alpha: 0.791.

³ Negative Outcome Expectancy Scale: four items, Cronbach’s alpha: 0.872.

⁴ Self-efficacy Scale: two items, Cronbach’s alpha: 0.825.

Table 3. Associations between background variables and behavioral intention to reduce condom use with either RP or NRP after receiving the HPV vaccination.

	Row%	ORu (95% CI)	p Values
Socio-demographics
Age group
18–30	7.8	1.0
31–40	7.8	1.00 (0.52, 1.95)	0.992
>40	9.6	1.25 (0.53, 2.98)	0.608
Current marital status
Currently single	7.8	1.0
Cohabited/married with men	9.1	1.18 (0.57, 2.43)	0.659
Cohabited/married with women	0.0	N.A.	N.A.
Education level
Secondary or below	14.0	1.0
University or above	7.0	0.46 (0.24, 0.91)	0.024
Current employment status
Full-time	6.9	1.0
Part-time/unemployment/retired/students	12.1	1.86 (0.99, 3.48)	0.053
Personal monthly income (HKD)
<10,000	9.9	1.0
10,000–19,999	8.7	0.87 (0.39, 1.95)	0.730
20,000–39,999	8.1	0.80 (0.36, 1.80)	0.588
≥40,000	3.3	0.31 (0.08, 1.18)	0.086
Refuse to disclose	33.3	4.55 (0.38, 54.75)	0.233
Sexual orientation
Homosexual	7.8	1.0
Bisexual	9.1	1.16 (0.48, 2.85)	0.740
Heterosexual	0.0	N.A.	N.A.
Refuse to disclose	0.0	N.A.	N.A.
HIV/STD-related service utilization in the last six months
HIV testing
No	8.6	1.0
Yes	7.5	0.86 (0.48, 1.53)	0.609
Other HIV/STD prevention services^1 in the past six months
No	7.7	1.0
Yes	8.3	1.09 (0.61, 1.94)	0.777
Sexual behaviors in the last six months
Had had anal intercourse with regular male sex partners (RP)
No	9.0	1.0
Yes	7.8	0.85 (0.42, 1.72)	0.649
Had had anal intercourse with non-regular male sex partners (NRP)
No	6.6	1.0
Yes	9.3	1.46 (0.81, 2.63)	0.209
Condomless anal intercourse (CAI) with either RP or NRP
No	6.2	1.0
Yes	21.6	2.77 (1.54, 4.99)	0.001
Use of illicit drugs before/during anal intercourse with men (Chemsex)
No	7.7	1.0
Yes	12.8	1.77 (0.66, 4.13)	0.259
History of HIV/STD infection
Self-reported HIV status
Negative	7.8	1.0
Positive	11.5	1.54 (0.45, 5.35)	0.493
Refuse to disclose	16.7	2.37 (0.50, 11.15)	0.276
Had never tested for HIV antibody	5.9	0.74 (0.17, 3.19)	0.686
History of other STD infection
No	8.9	1.0
Yes	4.4	0.44 (0.17, 1.13)	0.088

ORu: univariate odds ratios; CI: confidence interval; N.A.: not applicable.

Row%, ORu, and 95% CI were bold for variables with p < 0.05 in univariate logistic regression analysis.

Table 4. Factors associated with behavioral intention to reduce condom use with either RP or NRP after receiving the HPV vaccination.

	ORu (95% CI)	p Values	AOR (95% CI)	p Values
Perceptions related to condom use based on the pre-intentional phase of HAPA
Risk Perception Scale	1.13 (0.93, 1.39)	0.222	–	–
Positive Outcome Expectancy Scale	1.34 (1.17, 1.53)	<0.001	1.29 (1.12, 1.48)	<0.001
Negative Outcome Expectancy Scale	0.98 (0.92, 1.05)	0.596	–	–
Perceived Self-efficacy Scale	0.78 (0.69, 0.87)	<0.001	0.83 (0.70, 0.92)	0.001
Behavioral intention to take up HPV vaccination
How high is your chance of taking up three-dose HPV vaccination at market rate within the next year (after being briefed about the efficacy of HPV vaccination)?
No (Very low/low)	1.0
Yes (Moderate/high/very high)	1.33 (0.72, 2.46)	0.358	–	–

ORu: univariate odds ratios; AOR: adjusted odds ratios, odds ratios adjusted for significant background variables listed in Table 3; CI: confidence interval; – : not considered in the models.

ORu, AOR, and 95% CI were bold for variables with p < 0.05 in logistic regression analysis.