Prevalence and Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men (MSM) Who Use Mobile Geo-Social Networking Applications in Greater Tokyo
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Socio-Demographic Characteristics
3.2. Condom Use and Self-Efficacy for Practicing Safer Sex Characteristics
3.3. Correlates of Inconsistent Condom Use with Regular Male Partners
3.4. Correlates of Inconsistent Condom Use with Casual Male Partners
3.5. Correlates of Inconsistent Condom Use with Female Partners
4. Discussion
4.1. Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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n | % | ||
---|---|---|---|
Current residence | Tokyo | 883 | 53.4 |
Greater Tokyo | 553 | 33.4 | |
Another prefecture | 209 | 12.6 | |
Another country | 8 | 0.5 | |
Total | 1653 | 100 | |
Birthplace | Japan | 1593 | 96.3 |
Other | 62 | 3.7 | |
Total | 1655 | 100 | |
Age | 18–25 | 319 | 19.4 |
26–35 | 550 | 33.4 | |
36–45 | 507 | 30.8 | |
46+ | 270 | 16.4 | |
Total | 1646 | 100 | |
Gender | Male | 1641 | 99.2 |
Other | 14 | 0.8 | |
Total | 1655 | 100 | |
Marital status | No | 1582 | 95.6 |
Yes | 72 | 4.4 | |
Total | 1654 | 100 | |
Occupation | Full-time | 1133 | 68.5 |
Part-time | 185 | 11.2 | |
Student | 168 | 10.2 | |
Self-employed | 73 | 4.4 | |
Freelance | 16 | 1.0 | |
Unemployed | 69 | 4.2 | |
Other | 9 | 0.5 | |
Total | 1653 | 100 | |
Education | High school or less | 421 | 25.4 |
Two-year technical school | 274 | 16.5 | |
University | 800 | 48.3 | |
M.A. | 135 | 8.2 | |
PhD | 26 | 1.6 | |
Total | 1656 | 100 | |
Intercourse partner | Men | 1488 | 91.1 |
Men and women | 146 | 8.9 | |
Total | 1634 | 100 | |
Sexuality | Homosexual | 1408 | 85.1 |
Bisexual | 233 | 14.1 | |
Other | 14 | 0.8 | |
Total | 1655 | 100 | |
Health | Very unhealthy | 17 | 1.0 |
Unhealthy | 114 | 6.9 | |
Average | 467 | 28.2 | |
Healthy | 816 | 49.3 | |
Very healthy | 240 | 14.5 | |
Total | 1654 | 100.0 |
n | % | ||
---|---|---|---|
How often do you use a condom with a regular (penetrative and receptive anal sex) male partner? a | No anal sex with regular male partner | 246 | 14.9 |
Never | 217 | 15.5 | |
Rarely | 302 | 21.5 | |
Most of the time | 443 | 31.6 | |
Always | 442 | 31.5 | |
Total | 1404 | 100 | |
How often do you use a condom with casual (penetrative and receptive anal sex) male partners? b | No anal sex with casual male partner | 318 | 19.3 |
Never | 35 | 2.6 | |
Rarely | 197 | 14.8 | |
Most of the time | 490 | 36.8 | |
Always | 609 | 45.8 | |
Total | 1331 | 100 | |
How often do you use a condom with female (penetrative and anal sex) partners? c | No sex with female partner | 1358 | 82.6 |
Never | 29 | 10.1 | |
Rarely | 28 | 9.8 | |
Most of the time | 68 | 23.8 | |
Always | 161 | 56.3 | |
Total | 286 | 100 | |
It’s difficult to talk about condom use with partners | Strongly disagree | 615 | 37.6 |
Disagree | 561 | 34.3 | |
Neutral | 325 | 19.9 | |
Agree | 106 | 6.5 | |
Strongly agree | 30 | 1.8 | |
Total | 1637 | 100 | |
I feel confident in my ability to use condoms when my partner doesn’t want to use them | Strongly disagree | 103 | 6.3 |
Disagree | 283 | 17.2 | |
Neutral | 588 | 35.7 | |
Agree | 399 | 24.3 | |
Strongly agree | 272 | 16.5 | |
Total | 1645 | 100 | |
I am able to avoid behavior that may put me at risk of HIV infection | Strongly disagree | 48 | 2.9 |
Disagree | 153 | 9.3 | |
Neutral | 554 | 33.8 | |
Agree | 614 | 37.5 | |
Strongly agree | 268 | 16.4 | |
Total | 1637 | 100 | |
I find it difficult to practice safe sex when drunk | Strongly disagree | 202 | 12.3 |
Disagree | 274 | 16.7 | |
Neutral/disagree | 451 | 27.5 | |
Agree | 556 | 33.9 | |
Strongly agree | 159 | 9.7 | |
Total | 1642 | 100.0 |
Number of Respondents (n) | % Reporting Inconsistent Condom Use with Regular Male Partner | Unadjusted Odds Ratio (95% CI) | p-Value | Adjusted Odds Ratio (95% CI) | p-Value | |
---|---|---|---|---|---|---|
Age (years) | ||||||
18-25 | 271 | 31.4 | REF | REF | ||
26–35 | 482 | 37.1 | 1.15 (0.98–1.35) | 0.078 | 1.02 (0.83–1.26) | 0.823 |
36–45 | 429 | 37.8 | 1.11 (1.00–1.23) | 0.059 | 0.96 (0.83–1.11) | 0.572 |
46+ | 217 | 42.9 | 1.14 (1.04–1.25) | 0.006 | 1.05 (0.93–1.18) | 0.469 |
Place of Birth | ||||||
Other | 58 | 27.1 | REF | |||
Japan | 1345 | 37.4 | 1.61 (0.90–2.88) | 0.112 | ||
Education | ||||||
High School or less | 360 | 43.3 | REF | REF | ||
Two-year university | 232 | 37.1 | 0.94 (0.86–1.02) | 0.130 | 0.92 (0.84–1.02) | 0.101 |
University | 682 | 35.0 | 0.71 (0.54–0.92) | 0.009 | 0.64 (0.47–0.88) | 0.005 |
Graduate degree | 130 | 29.2 | 0.54 (0.35–0.83) | 0.005 | 0.75 (0.46–1.24) | 0.270 |
Employment | ||||||
Full-time work | 968 | 38.2 | REF | REF | ||
Part-time work | 157 | 40.1 | 1.08 (0.77–1.53) | 0.653 | 0.85 (0.56–1.27) | 0.428 |
Student | 144 | 23.6 | 0.50 (0.33–0.75) | 0.001 | 0.52 (0.30–0.88) | 0.016 |
Self-employed | 82 | 36.6 | 0.93 (0.58–1.49) | 0.766 | 0.91 (0.54–1.54) | 0.729 |
Unemployed | 51 | 41.2 | 1.13 (0.64–2.00) | 0.675 | 1.18 (0.62–2.23) | 0.612 |
Current marital status | ||||||
Single | 1340 | 36.2 | REF | REF | ||
Married | 63 | 54.0 | 2.07 (1.24–3.43) | 0.005 | 2.03 (1.10–3.76) | 0.024 |
Current residence | ||||||
Central Tokyo | 765 | 37.9 | REF | |||
Greater Tokyo | 446 | 36.1 | 0.93 (0.73–1.18) | 0.534 | ||
Other prefecture | 182 | 35.7 | 0.91 (0.65–1.28) | 0.586 | ||
Intercourse partners | ||||||
Only men | 1280 | 38.0 | REF | REF | ||
Men and women | 122 | 27.0 | 0.61 (0.40–0.92) | 0.018 | 0.54 (0.34–0.88) | 0.013 |
Health | ||||||
Fair/Poor health | 498 | 39.8 | REF | |||
Healthy | 904 | 35.4 | 0.83 (0.66–1.04) | 0.106 | ||
Out to close friends | ||||||
No | 549 | 36.6 | REF | |||
Yes | 838 | 37.2 | 1.03 (0.82–1.28) | 0.815 | ||
Identify as a member of the gay community | ||||||
No | 236 | 32.6 | REF | REF | ||
Yes | 1155 | 37.7 | 1.25 (0.93–1.68) | 0.144 | 1.50 (1.07–2.10) | 0.020 |
Use gay apps for sex | ||||||
No | 511 | 31.9 | REF | REF | ||
Yes | 887 | 39.9 | 1.42 (1.13–1.78) | 0.003 | 1.15 (0.89–1.50) | 0.291 |
Use gay apps to find friends | ||||||
No | 339 | 41.9 | REF | REF | ||
Yes | 1053 | 35.3 | 0.76 (0.59–0.97) | 0.030 | 0.73 (0.54–0.97) | 0.028 |
Use gay apps to avoid being identified as gay | ||||||
No | 1268 | 36.8 | REF | |||
Yes | 115 | 40.0 | 1.15 (0.78–1.70) | 0.490 | ||
Use gay apps to find a serious relationship | ||||||
No | 631 | 40.4 | REF | REF | ||
Yes | 756 | 34.0 | 0.76 (0.61–0.95) | 0.014 | 0.85 (0.66–1.10) | 0.218 |
Ever attended a gay bar | ||||||
No | 583 | 37.2 | REF | |||
Yes | 817 | 36.8 | 0.98 (0.79–1.23) | 0.885 | ||
Participation in gay group/community or volunteer activities | ||||||
No | 1207 | 38.9 | REF | REF | ||
Yes | 194 | 25.3 | 0.53 (0.38–0.75) | 0.000 | 0.51 (0.34–0.75) | 0.001 |
Hattenba attendance | ||||||
No | 716 | 34.9 | REF | |||
Yes | 684 | 39.0 | 1.19 (0.96–1.48) | 0.111 | ||
Confident in ability to use condoms when partner doesn’t want to | ||||||
No | 839 | 49.8 | REF | REF | ||
Yes | 558 | 17.6 | 0.22 (0.17–0.28) | 0.000 | 0.31 (0.23–0.41) | 0.000 |
Able to avoid behavior that puts me at risk of HIV infection | ||||||
No | 654 | 51.4 | REF | REF | ||
Yes | 736 | 24.0 | 0.30 (0.24–0.38) | 0.000 | 0.54 (0.41–0.71) | 0.000 |
Difficult to talk about condoms with partners | ||||||
No | 1280 | 35.0 | 0.32 (0.22–0.48) | 0.000 | 0.45 (0.29–0.71) | 0.001 |
Yes | 112 | 62.5 | REF | REF | ||
Difficult to have safe sex when drunk | ||||||
No | 785 | 32.1 | REF | REF | ||
Yes | 609 | 43.7 | 0.61 (0.49–0.76) | 0.000 | 0.77 (0.60–0.99) | 0.043 |
Attend regular drinking parties | ||||||
No | 314 | 37.9 | REF | |||
Yes | 1079 | 36.7 | 0.95 (0.73–1.23) | 0.699 |
Number of Respondents (n) | % Reporting Inconsistent Condom Use with Casual Partner | Unadjusted Odds Ratio (95% CI) | p-Value | Adjusted Odds Ratio (95% CI) | p-Value | |
---|---|---|---|---|---|---|
Age (years) | ||||||
18–25 | 245 | 14.3 | REF | REF | ||
26–35 | 453 | 15.2 | 1.06 (0.85–1.32) | 0.630 | 0.97 (0.72–1.30) | 0.828 |
36–45 | 424 | 19.3 | 1.14 (0.99–1.32) | 0.071 | 1.04 (0.85–1.26) | 0.717 |
46+ | 202 | 22.8 | 1.16 (1.03–1.31) | 0.015 | 1.10 (0.93–1.30) | 0.252 |
Place of Birth | ||||||
Japan | 1273 | 17.8 | REF | REF | ||
Other | 57 | 8.8 | 2.30 (0.91–5.82) | 0.079 | 0.76 (0.25–2.27) | 0.625 |
Education | ||||||
High School or less | 323 | 29.1 | REF | REF | ||
Two-year university | 224 | 15.6 | 0.82 (0.74–0.91) | 0.000 | 0.80 (0.70–0.91) | 0.001 |
University | 652 | 14.1 | 0.40 (0.29–0.55) | 0.000 | 0.35 (0.23–0.52) | 0.000 |
Graduate degree | 132 | 8.3 | 0.22 (0.11–0.43) | 0.000 | 0.32 (0.15–0.67) | 0.002 |
Employment | ||||||
Full-time work | 919 | 16.9 | REF | REF | ||
Part-time work | 146 | 24.0 | 1.56 (1.03–2.37) | 0.037 | 1.05 (0.62–1.77) | 0.856 |
Student | 135 | 10.4 | 0.57 (0.32–1.02) | 0.059 | 0.80 (0.36–1.74) | 0.565 |
Self-employed | 76 | 14.5 | 0.84 (0.43–1.62) | 0.597 | 0.80 (0.37–1.75) | 0.582 |
Unemployed | 53 | 32.1 | 2.33 (1.28–4.26) | 0.006 | 1.83 (0.86–3.89) | 0.118 |
Current marital status | ||||||
Single | 1264 | 17.4 | REF | |||
Married | 66 | 18.2 | 1.05 (0.56–2.00) | 0.871 | ||
Current residence | ||||||
Central Tokyo | 732 | 19.7 | REF | REF | ||
Greater Tokyo | 430 | 15.3 | 0.74 (0.54–1.02) | 0.062 | 0.62 (0.43–0.90) | 0.011 |
Other prefecture | 158 | 13.3 | 0.62 (0.38–1.02) | 0.061 | 0.57 (0.31–1.03) | 0.064 |
Intercourse partners | ||||||
Only men | 1212 | 17.8 | REF | |||
Both men and women | 118 | 13.6 | 0.72 (0.42–1.26) | 0.246 | ||
Health | ||||||
Fair/poor health | 472 | 15.1 | REF | REF | ||
Healthy | 857 | 21.6 | 0.64 (0.48–0.86) | 0.003 | 0.89 (0.63–1.25) | 0.491 |
Out to close friends | ||||||
No | 519 | 17.7 | REF | |||
Yes | 794 | 17.6 | 0.99 (0.74–1.33) | 0.965 | ||
Identify as a member of the gay community | ||||||
No | 217 | 18.4 | REF | |||
Yes | 1101 | 17.3 | 0.92 (0.63–1.35) | 0.677 | ||
Use gay apps for sex | ||||||
No | 414 | 10.6 | REF | REF | ||
Yes | 911 | 20.5 | 2.17 (1.53–3.09) | 0.000 | 2.01 (1.33–3.03) | 0.001 |
Use gay apps to find friends | ||||||
No | 340 | 21.8 | REF | REF | ||
Yes | 980 | 16.0 | 0.69 (0.50–0.93) | 0.017 | 0.63 (0.44–0.91) | 0.013 |
Use gay apps to avoid being identified as gay | ||||||
No | 1202 | 17.6 | REF | |||
Yes | 108 | 18.5 | 1.07 (0.64–1.77) | 0.801 | ||
Use gay apps to find a serious relationship | ||||||
No | 587 | 19.5 | REF | REF | ||
Yes | 498 | 15.7 | 0.76 (0.58–1.02) | 0.064 | 0.95 (0.67–1.34) | 0.756 |
Ever attended a gay bar | ||||||
No | 530 | 17.5 | REF | |||
Yes | 797 | 17.3 | 0.98 (0.74–1.31) | 0.913 | ||
Participation in gay group/community or volunteer activities | ||||||
No | 1139 | 18.3 | REF | REF | ||
Yes | 190 | 12.1 | 0.62 (0.39–0.98) | 0.040 | 0.65 (0.37–1.12) | 0.117 |
Hattenba attendance | ||||||
No | 619 | 13.6 | REF | REF | ||
Yes | 707 | 20.7 | 1.66 (1.24–2.22) | 0.001 | 1.10 (0.77–1.58) | 0.588 |
Confident in ability to use condoms when my partner doesn’t want to | ||||||
No | 817 | 24.8 | REF | REF | ||
Yes | 506 | 5.1 | 0.16 (0.11–0.25) | 0.000 | 0.38 (0.23–0.61) | 0.000 |
Able to avoid behavior that puts me at risk of HIV infection | ||||||
No | 643 | 31.3 | REF | REF | ||
Yes | 673 | 4.3 | .010 (0.07–0.15) | 0.000 | 0.18 (0.11–0.28) | 0.000 |
Difficult to talk about condoms with partners | ||||||
Yes | 110 | 33.6 | REF | REF | ||
No | 1207 | 16.1 | 0.38 (0.25–0.58) | 0.000 | 0.54 (0.33–0.88) | 0.014 |
Difficult to have safe sex when drunk | ||||||
No | 744 | 13.0 | REF | REF | ||
Yes | 577 | 23.2 | 0.50 (0.37 - 0.66) | 0.000 | 0.74 (0.53–1.05) | 0.091 |
Attend regular drinking parties | ||||||
No | 296 | 20.9 | REF | REF | ||
Yes | 1024 | 16.5 | 0.75 (0.54–1.03) | 0.077 | 1.05 (0.71–1.56) | 0.814 |
Number of respondents (n) | % Reporting Inconsistent Condom Use with Female Partner | Unadjusted Odds Ratio (95% CI) | p-Value | Adjusted Odds Ratio (95% CI) | p-Value | |
---|---|---|---|---|---|---|
Age (years) | ||||||
18–25 | 73 | 13.7 | REF | REF | ||
26–35 | 111 | 10.8 | 0.89 (0.57–1.39) | 0.602 | 0.65 (0.38–1.11) | 0.113 |
36–45 | 67 | 35.8 | 1.54 (1.16–2.03) | 0.002 | 1.19 (0.84–1.68) | 0.328 |
46+ | 33 | 33.3 | 1.34 (1.05–1.72) | 0.019 | 1.00 (0.72–1.39) | 0.986 |
Place of Birth | ||||||
Japan | 276 | 20.3 | 2.29 (0.28–18.46) | 0.436 | ||
Other | 10 | 10.0 | REF | |||
Education | ||||||
High School or less | 75 | 29.3 | REF | REF | ||
Two-year university | 47 | 12.8 | 0.77 (0.60–0.99) | 0.039 | 0.75 (0.57–0.99) | 0.046 |
University | 132 | 18.2 | 0.54 (0.28–1.04) | 0.066 | 0.51 (0.23–1.13) | 0.096 |
Graduate degree | 32 | 15.6 | 0.45 (0.15–1.31) | 0.141 | 0.73 (0.20–2.63) | 0.633 |
Employment | ||||||
Full-time work | 214 | 22.0 | REF | REF | ||
Part-time work | 18 | 22.2 | 1.02 (0.32–3.23) | 0.980 | 1.02 (0.27–3.88) | 0.971 |
Student | 37 | 5.4 | 0.20 (0.05–0.88) | 0.032 | 0.21 (0.04–1.09) | 0.063 |
Self-employed | 15 | 20.0 | 0.89 (0.24–3.28) | 0.859 | 1.57 (0.37–6.61) | 0.540 |
Unemployed | 2 | 50.0 | 3.46 (0.21–57.89) | 0.373 | 1.99 (0.06–64.1) | 0.699 |
Current marital status | ||||||
Single | 244 | 15.6 | REF | REF | ||
Married | 41 | 46.3 | 4.68 (2.31–9.47) | 0.000 | 2.70 (1.09–6.69) | 0.032 |
Current residence | ||||||
Central Tokyo | 131 | 21.4 | REF | |||
Greater Tokyo | 116 | 15.5 | 0.68 (0.35–1.30) | 0.240 | ||
Other prefecture | 39 | 28.2 | 1.45 (0.64–3.26) | 0.375 | ||
Health | ||||||
Healthy | 195 | 21.0 | 1.23 (0.65–2.34) | 0.524 | ||
Fair/Poor health | 90 | 17.8 | REF | |||
Out to close friends | ||||||
No | 155 | 17.4 | REF | |||
Yes | 129 | 22.5 | 1.38 (0.77–2.47) | 0.287 | ||
Identify as a member of the LGBT community | ||||||
No | 76 | 21.1 | REF | |||
Yes | 210 | 19.5 | 0.91 (0.48–1.74) | 0.775 | ||
Use gay apps for sex | ||||||
No | 119 | 20.2 | REF | |||
Yes | 165 | 19.4 | 0.95 (0.53–1.72) | 0.871 | ||
Use gay apps to find friends | ||||||
No | 77 | 28.6 | REF | REF | ||
Yes | 204 | 16.7 | 0.50 (0.27–0.93) | 0.028 | 0.68 (0.33–1.37) | 0.276 |
Use gay apps to avoid being identified as gay | ||||||
No | 239 | 20.5 | REF | |||
Yes | 41 | 17.1 | 0.80 (0.33–1.91) | 0.613 | ||
Use gay apps to find a serious relationship | ||||||
No | 163 | 22.7 | REF | |||
Yes | 119 | 16.0 | 0.65 (0.35–1.19) | 0.163 | ||
Ever attended a gay bar | ||||||
No | 179 | 17.9 | REF | |||
Yes | 105 | 22.9 | 1.36 (0.75–2.47) | 0.310 | ||
Participation in gay group/community or volunteer activities | ||||||
No | 265 | 19.6 | REF | |||
Yes | 20 | 20.0 | 1.02 (0.33–3.19) | 0.967 | ||
Hattenba attendance | ||||||
No | 169 | 15.4 | REF | |||
Yes | 115 | 26.1 | 1.94 (1.08–3.50) | 0.280 | ||
Confident in ability to use condoms when my partner doesn’t want to | ||||||
No | 151 | 26.5 | REF | REF | ||
Yes | 135 | 12.6 | 0.40 (0.21–0.75) | 0.004 | 0.51 (0.23–1.11) | 0.090 |
Able to avoid behavior that puts me at risk of HIV infection | ||||||
No | 116 | 29.3 | REF | REF | ||
Yes | 169 | 13.6 | 0.38 (0.21–0.69) | 0.001 | 0.53 (0.25–1.13) | 0.101 |
Difficult to talk about condoms with partners | ||||||
Yes | 19 | 31.6 | REF | |||
No | 265 | 19.2 | 0.52 (0.19–1.42) | 0.202 | ||
Difficult to have safe sex when drunk | ||||||
No | 174 | 19.0 | REF | |||
Yes | 111 | 21.6 | 0.85 (0.47–1.53) | 0.585 | ||
Attend regular drinking parties | ||||||
No | 60 | 25.0 | REF | |||
Yes | 224 | 18.8 | 0.69 (0.35–1.36) | 0.285 |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hill, A.O.; Bavinton, B.R.; Armstrong, G. Prevalence and Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men (MSM) Who Use Mobile Geo-Social Networking Applications in Greater Tokyo. Int. J. Environ. Res. Public Health 2018, 15, 2815. https://doi.org/10.3390/ijerph15122815
Hill AO, Bavinton BR, Armstrong G. Prevalence and Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men (MSM) Who Use Mobile Geo-Social Networking Applications in Greater Tokyo. International Journal of Environmental Research and Public Health. 2018; 15(12):2815. https://doi.org/10.3390/ijerph15122815
Chicago/Turabian StyleHill, Adam O, Benjamin R Bavinton, and Gregory Armstrong. 2018. "Prevalence and Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men (MSM) Who Use Mobile Geo-Social Networking Applications in Greater Tokyo" International Journal of Environmental Research and Public Health 15, no. 12: 2815. https://doi.org/10.3390/ijerph15122815