{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:15:43Z","timestamp":1790705743796,"version":"4.1.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,12,18]],"date-time":"2026-12-18T00:00:00Z","timestamp":1797552000000},"content-version":"vor","delay-in-days":382,"URL":"http:\/\/www.sagepub.com\/licence-information-for-chorus"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100014069","name":"U.S. Military HIV Research Program","doi-asserted-by":"crossref","award":["#HT94252430004"],"award-info":[{"award-number":["#HT94252430004"]}],"id":[{"id":"10.13039\/100014069","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100014069","name":"U.S. Military HIV Research Program","doi-asserted-by":"crossref","award":["#W81XWH-18-2-0040"],"award-info":[{"award-number":["#W81XWH-18-2-0040"]}],"id":[{"id":"10.13039\/100014069","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Pre-exposure prophylaxis (PrEP) has shifted the paradigm of condom use and perceived risks for HIV and sexually transmitted infections (STIs) among men who have sex with men (MSM). We identified factors associated with inconsistent condom use and reasons for non-use among German MSM, with and without HIV, from two clinics in Germany between 2018 and 2024. Participants completed a questionnaire by computer-assisted self-interview every 6 months for up to 24 months. Multivariable robust Poisson regression models were fitted to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for the associations between factors of interest and inconsistent condom use and reasons for non-use. Inconsistent condom use was reported by 81% and 66% of 122 MSM during insertive and receptive anal sex, respectively. Inconsistent condom use was associated with (aPR [95% CI]) age &gt;30 years (insertive: 31\u201340, 1.34 [1.13, 1.59]; \u226541, 1.27 [1.02, 1.58]), living without HIV (insertive: 1.28 [1.11, 1.47]; receptive: 1.32 [1.17, 1.49]), sex under the influence of drugs (insertive: 1.20 [1.04, 1.38]; receptive: 1.16 [1.03, 1.31]), and not worrying about STIs (insertive: 1.20 [1.06, 1.36]). Living with HIV, preference for condomless sex, and partner\u2019s HIV suppression were the most frequent reasons for non-use among participants with HIV. Using PrEP, preference for condomless sex, and partner\u2019s HIV status were the most frequent reasons for non-use among participants without HIV. Novel interventions tailored to specific high-risk subgroups, adjusted to address reasons for non-use, and adapted to mitigate risk compensation among MSM using PrEP are needed.<\/jats:p>","DOI":"10.1177\/10872914251394785","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T01:07:18Z","timestamp":1763687238000},"page":"505-514","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Inconsistent Condom Use and Reasons for Non-Use in the Era of HIV Pre-Exposure Prophylaxis Among German Men Who Have Sex with Men"],"prefix":"10.1177","volume":"39","author":[{"given":"Sarah","family":"Moreland","sequence":"first","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kartavya J.","family":"Vyas","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Jessen","sequence":"additional","affiliation":[{"name":"Private Practice Jessen, 2 + Kollegen, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Esser","sequence":"additional","affiliation":[{"name":"Institute for the Research on HIV and AIDS-associated Diseases, University of Duisburg-Essen, Essen, Germany."},{"name":"HPSTD clinic, University Hospital Essen, University of Duisburg-Essen, Essen, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Duff","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Broach","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Dorsey-Spitz","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Frndak","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsedal","family":"Mebrahtu","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merlin L.","family":"Robb","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Streeck","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany."},{"name":"German Center for Infection Research, Partner Site Bonn-Cologne, Bonn, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor A.","family":"Crowell","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Bethesda, Maryland, USA."},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the RV464 Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260168"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.Es.2019.24.7.1800398"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(15)00056-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix593"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.Es.2022.27.14.2100503"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15570-6"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-4831-4"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.Es.2022.27.14.2100591"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/qad.0000000000003837"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2022.0154"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/sexes3010014"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7184.167135"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3026-8"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/qad.0000000000001832"},{"key":"e_1_3_3_16_2","volume-title":"HIV and STI prevention among men who have sex with men","author":"European Centre for Disease Prevention and Control","year":"2015","unstructured":"European Centre for Disease Prevention and Control. HIV and STI prevention among men who have sex with men. ECDC: Stockholm; 2015."},{"key":"e_1_3_3_17_2","unstructured":"International Association of Providers of AIDS Care. HIV Care Continuum \u2013 Ways HIV is Transmitted. 2024."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)00321-4"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000298"},{"issue":"4","key":"e_1_3_3_20_2","first-page":"15","article-title":"US Department of Health and Human Services\/Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021","volume":"70","year":"2021","unstructured":"US Department of Health and Human Services\/Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR, 2021; 70(4)):15\u201319.","journal-title":"MMWR"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e32833a0d3a"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1893"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-2691-z"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053369"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idnow.2022.06.002"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.3138\/cjhs.2020-0002"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/phh.0000000000001143"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.2196\/16494"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1403494812465032"},{"key":"e_1_3_3_30_2","unstructured":"Velasco E. Behavioural surveillance and HIV prevention in men who have sex with men. Reports from Australia Belgium Canada France Germany Switzerland the United Kingdom and the United States. 2007."},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.2807\/esm.11.09.00645-en"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-021-00386-4"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2022.0172"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211934"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(17)30725-9"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2023.0289"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-024-02321-x"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(21)00812-4"}],"container-title":["AIDS Patient Care and STDs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10872914251394785","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251394785","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251394785","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251394785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:08:56Z","timestamp":1777399736000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10872914251394785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/10872914251394785"],"URL":"https:\/\/doi.org\/10.1177\/10872914251394785","relation":{},"ISSN":["1087-2914","1557-7449"],"issn-type":[{"value":"1087-2914","type":"print"},{"value":"1557-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}