Examining Intrapersonal and Social Environment Factors Associated with Condom Use and HIV Testing Among Young Adult MSM Living in Beirut, Lebanon

Men who have sex with men (MSM) are disproportionately affected by HIV, particularly in urban Middle Eastern areas like Beirut, Lebanon. Understanding factors influencing HIV prevention, such as condom use and HIV testing is crucial. This study used the Information-Motivation-Behavioral Skills (IMB) Model determinants and explored social environment factors to assess their associations with condomless sex and HIV testing. Model fit was also examined to compare our IMB model alone versus an extended model incorporating social environment factors. A sample of 164 MSM (ages 18-29) in Beirut was analyzed using IMB determinants (e.g., HIV knowledge, motivation, condom use self-efficacy) and social environment determinants (e.g., safer sex peer norms, network engagement in HIV testing and risk discussions). Bivariate associations and multivariate regressions were conducted, and model fit was assessed using likelihood ratio testing. Findings showed that our IMB model alone better predicted condomless anal sex, whereas neither model adequately fit HIV testing outcomes. Within our IMB model, higher HIV knowledge was associated with increased odds of condomless sex, while greater condom use self-efficacy was linked to reduced odds. These results suggest that condom use and HIV testing are influenced by different factors. Interventions should not only increase HIV knowledge but also enhance self-efficacy to reduce condomless sex.