The ABCs of HIV prevention in men: associations with HIV risk and protective behaviors
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To elucidate associations between beliefs in abstinence, fidelity, and condom use (the "ABCs" of preventing HIV and other sexually transmitted infections) and associated self-reported risk behaviors among Kenyan men. We assessed associations of beliefs in the ABCs with sociodemographic characteristics and sexual risk behaviors in a respondent-driven sample of 500 men in Nairobi. Younger age, single marital status, and higher education were associated with beliefs in abstinence and condom use as "best" prevention methods; and older age and marriage were associated with belief in fidelity. Many of these and other associations persisted in multivariate models. Men citing abstinence or fidelity belief less often reported sex with a female sex worker (FSW) ever or recent concurrent partnerships less often. Belief in fidelity was negatively associated with reported use of condoms ever. Belief in condom use to prevent HIV was most common among those having recent concurrent partnerships. Beliefs in abstinence, fidelity ("being faithful"), or condom use were associated, in plausible directions, with life stages and other demographic factors and with corresponding risk and preventive behaviors. Context-specific and selective educational promotion of individual ABC components rather than comprehensive education from an early age in a wide repertoire of prevention strategies ignores the evolution of sexual behaviors and the relative utility of different approaches throughout the life course.