HIV risks among money boys in China: Applicability of theory of planned behavior in intended condom use

Background/Objectives: Money boys (MBs) are male sex workers who sell sex to men who have sex with men (MSM). The objectives of this study were (1) to investigate the levels of risk behaviors among MBs and (2) to examine whether the Theory of Planned Behavior (TPB) was applicable in intended condom use. Methods: This study was conducted in two cites (Shenzhen and Shanghai) in 2009. In each city, ten MB-congregated clubs located at different geographic districts were selected. Results: In total, 122 MBs were recruited, 60 from shanghai and 62 from Shenzhen. The number of male sex clients reported by MBs was 10 in the past 2 months. Seventy-eight percent of MBs reported having used condoms for every anal sex act and 24% for every oral sex act. About one third reported having had female sexual partners in the past 2 months, half (53%) of whom used condoms for every sex act. A path analytical model was developed to assess the possible mechanism through which intention to condom use were predicted by the three TPB constructs: attitudes towards condom use, subjective norms, and perceived behavioral control (PBC). The results of modeling documented the mediation effect of PBC. Specifically, PBC mediated the association between attitudes and intention to use condoms, and the association between subjective norms and the intention. Conclusion: The findings demonstrate that the theory of planned behavior is applicable in intended condom use among Chinese MBs and HIV interventions should take the medication effect of PBC into consideration.