Objective: We sought to examine highly sexually active gay and bisexual men’s accuracy in predicting their sexual behavior for the purposes of informing future research on intermittent, event-driven HIV Pre-Exposure Prophylaxis (PrEP).
Design: For 30 days, 92 HIV-negative men completed a daily survey about their sexual behavior (n = 1,688 days of data) and indicated their likelihood of having anal sex with a casual male partner the following day.
Method: We utilized multilevel modeling to analyze the association between self-reported likelihood of and subsequent engagement in anal sex.
Results: We found a linear association between men’s reported likelihood of anal sex with casual partners and the actual probability of engaging in sex, though men overestimated the likelihood of sex. Overall, we found that men were better at predicting when they would not have sex than when they would, particularly if any likelihood value greater than 0% was treated as indicative that sex might occur. We found no evidence that men’s accuracy of prediction was affected by whether it was a weekend or whether they were using substances, though both did increase the probability of sex.
Discussion: These results suggested that, were men taking event-driven intermittent PrEP, 14% of doses could have been safely skipped with a minimal rate of false negatives using guidelines of taking a dose unless there was no chance (i.e., 0% likelihood) of sex on the following day. This would result in a savings of over $1,300 per year in medication costs per participant.