ArticleBMC public health2026
Socio-structural and individual determinants of HIV/STI prevention behaviors in Chile: a national cross-sectional analysis.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite ongoing prevention efforts, rates of consistent condom use and testing for human immunodeficiency virus (HIV)/sexually transmitted infections (STI) remain low in Chile. Understanding how individual and socio-structural behavioral determinants influence these prevention behaviors is essential to developing effective interventions.
methodsWe analyzed nationally representative data from the ENSSEX 2022–2023 survey (n = 20,392), mapping 44 behavioral indicators to the COM-B model and the Theoretical Domains Framework. Multivariable logistic regression models assessed associations between behavioral determinants and two key outcomes: consistent condom use and HIV/STI testing, adjusted by sex and other covariates.
resultsConsistent condom use was reported by 15.5% of respondents, and HIV/STI testing by 23.1%. Injunctive norms favoring condom use were strongly associated with consistent condom use (aOR = 1.89), while access to sexual health services (aOR = 2.07) and PrEP awareness (aOR = 1.67) were strongly associated with HIV/STI testing. General knowledge about HIV was not independently associated with either behavior after adjustment.
conclusionsIn this cross-sectional study of a nationally representative sample of Chilean adults, socio-structural factors—particularly injunctive norms and access to sexual health services—showed stronger and more consistent associations with condom use and HIV/STI testing than did knowledge-related factors after multivariable adjustment. These findings highlight the need for comprehensive, culturally tailored, multi-component interventions that integrate structural, normative, and motivational elements to enhance HIV/STI prevention in Chile and similar settings.
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