(P35) Can prior sexual risk behaviors predict adherence to COVID-19 preventative behaviors among young Black men?

Background: Behavioral clustering is a phenomenon in which several risk or protective behaviors co-occur in an individual. Behavioral clustering has been found in adolescents and young adults, across a range of behaviors (e.g., bullying, substance use). We sought to determine if prior sexual risk behaviors among young Black men who have sex with women (MSW) were associated with non-adherence to COVID-19 prevention behaviors.



Methods: Young Black MSW aged 15-26 previously enrolled in a community-based Chlamydia trachomatis (Ct) screening program were enrolled in a sub-study between May-June 2020 and asked about adherence to four early COVID-19 recommended prevention behaviors (hand washing, mask wearing, social distancing, and following stay at home orders). Participants rated their adherence to each behavior as “all of the time”, “most of the time”, “some of the time”, “none of the time”, and “refuse to answer”. Responses were coded as 3, 2, 1, 0, and missing, from which a COVID-19 preventative behavior score was created by summing those values. Data from the original study was used to elicit the follow pre-pandemic behaviors: having multiple partners, inconsistent condom use, prior HIV testing, prior Ct or gonorrhea (GC) testing, testing positive for Ct/GC during the study, binge drinking, or drug use. Wilcoxon rank sum tests were used to assess the association between historic risk behaviors and COVID-19 behavior score.



Results: Of the 111 men included in the analysis, the mean age was 20.5 (S.D. 2.0), with 19.1% previously testing positive for Ct or GC during the parent study. Those who used non-prescription drugs (p=0.001), or marijuana (p=0.028) had a lower median COVID-19 preventative score compared to those who did not engage in those activities. Prior positive Ct/GC test at enrollment in the parent study, inconsistent condom use, Ct/GC testing prior to study enrollment, prior HIV testing, having multiple partners, and binge drinking were not associated with COVID-19 preventative score.



Conclusion: Self-reported non-prescription drug and marijuana use was a significant predictor of lower adherence to COVID-19 preventative behaviors among young Black men. Young people who use drugs may need additional support to promote COVID-19 preventative behavior uptake.