(PS1-88) Exploring the Role of Prep Self-efficacy in Moderating the Relationship Between Adverse Childhood Experiences and Condomless Anal Sex Among Latino Sexual Minority Men

Despite advancements in HIV prevention treatments such as pre-exposure prophylaxis (PrEP), Latino sexual minority men (LSMM) continue to experience elevated HIV incidence and barriers to PrEP engagement. Furthermore, LSMM are disproportionately affected by adverse childhood experiences (ACEs), which can potentially influence behaviors associated with risk of HIV acquisition, such as sex without the use of prevention tools. Self-efficacy, which is typically associated with self-protective health behaviors, may moderate the effects of factors that impede PrEP use, such as ACEs. The current study examined whether PrEP self-efficacy as a moderator mitigated the adverse effects of ACEs on condomless/PrEP-less condomless anal sex, a behavior associated with HIV acquisition. We analyzed self-reported psychosocial assessment data from 279 LSMM in South Florida using sequential linear regression models. Our aim was to understand the main effects of ACEs and PrEP self-efficacy on PrEP-less CAS, as well as the moderation effect of PrEP self-efficacy. Interaction effects were further explored using simple slope analysis. Our findings indicate that PrEP self-efficacy significantly influences the direction and strength of the relationships between ACEs and PrEP-less CAS. For individuals with lower PrEP self-efficacy, ACEs were associated with an increase in PrEP-less CAS (b = 3.91, p < .001), and for those with higher PrEP self-efficacy, ACEs were associated with a moderate decrease in PrEP-less CAS (b = -1.24, p = .004). The results underscore the potential resilience offered by PrEP self-efficacy among LSMM, acting as a buffer against the impact of ACEs on engaging in PrEP-less CAS. This study suggests that integrating PrEP self-efficacy development into HIV prevention initiatives and interventions could prove instrumental in preventing behaviors that heighten the risk of HIV acquisition among populations experiencing high HIV incidence and that also have a history of ACEs.