Abstract
Despite advancements in HIV prevention such as pre-exposure prophylaxis (PrEP), Latino sexual minority men (LSMM) have elevated HIV incidence and limited PrEP engagement. LSMM are also disproportionately affected by adverse childhood experiences (ACEs), which may be associated with health behaviors, such as condomless anal sex (CAS) in the absence of PrEP. This paper explores the potential role of PrEP self-efficacy as a moderator of the adverse effects of ACEs on sexual behaviors. Survey data from 279 LSMM living in South Florida were analyzed using linear regression models, and interaction effects were further probed using simple slope analysis. The results revealed that PrEP self-efficacy was a significant moderator that influences the direction and strength of the relationships between ACEs and PrEP-less CAS.For those 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 suggest that PrEP self-efficacy in LSMM is a potential resilience factor that can buffer the impact of ACEs on PrEP-less CAS. Integrating PrEP self-efficacy development into HIV prevention initiatives and interventions may lead to a reduction in behaviors that can lead to HIV acquisition among populations experiencing high HIV incidence and also endorse a history of ACEs.