Alcohol and "Heat of the Moment" Sexual Decision Making among MSM: Identifying Mechanisms of Sexual Risk and Promoting Behavior Change Through Brief Intervention

酒精与 MSM 中“一时冲动”的性决策：识别性风险机制并通过简短干预促进行为改变

• 批准号: 10541644
• 负责人: STEPHEN A MAISTO
• 金额: $ 73.09万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10541644
• 关键词: AIDS prevention; Address; Adult; Affect; Alcohol consumption; Alcoholic Intoxication; Alcohols; Arousal; Basic Behavioral Science; Behavior; Behavior Therapy; Behavioral; Behavioral Mechanisms; Cognitive; Counseling; Cues; Data; Decision Making; Desire for food; Development; Effectiveness; Environment; Exhibits; Fostering; Goals; HIV; HIV diagnosis; Heavy Drinking; Human immunodeficiency virus test; Incidence; Informal Social Control; Intervention; Intoxication; Laboratory Finding; Laboratory Research; Link; Measures; Mediating; Mediator of activation protein; Methods; Motivation; Pattern; Persons; Prevention; Prevention approach; Process; Public Health; Randomized; Research; Rewards; Risk; Risk Factors; Risk Reduction; Role; Route; Sampling; Self-control as a personality trait; Sex Behavior; Sexual Arousal; Short-Term Memory; Testing; Text Messaging; Translating; Treatment Efficacy; United States; Work; alcohol effect; base; behavior change; binge drinking; brief intervention; cognitive capacity; cognitive testing; condomless anal sex; condoms; design; discounting; effectiveness testing; executive function; experience; experimental study; follow-up; group intervention; improved; insight; intervention effect; laboratory experiment; longitudinal design; male; men who have sex with men; modifiable risk; motivational enhancement therapy; post intervention; preventive intervention; psychologic; response; sexual role; theories; therapy design; transmission process

PROJECT SUMMARY/ABSTRACT This application is in response to two objectives of RFA-AA-21-016: HIV Prevention and Alcohol to translate basic behavioral science findings about alcohol’s effects on sexual decision-making to 1). Test an intervention designed to address sexual decision-making in the “heat-of-the-moment” (i.e., when intoxicated and sexually aroused), and 2). Extend laboratory research to test cognitive and motivational within-person mechanisms underlying alcohol and arousal effects on sexual decision-making in the natural environment. The application is informed by our previous alcohol challenge laboratory research on factors contributing to CAI among MSM. This research showed that intoxication was associated with heightened sexual arousal and increased CAI intentions. Consistent with dual process theories, intoxication and arousal were associated with a shift in decision-making process characterized by an increased role of sexual reward motivation relative to condom use motivation and a corresponding decrease in the role of executive functioning. This pattern suggests that prevention interventions may be effective in reducing CAI by targeting strategies that enhance condom use motivation and reduce the reliance on effortful / controlled processing in the “heat-of-the-moment.” We piloted an intervention that integrates motivational interviewing, personalized cognitive counseling, and text messaging that decreased alcohol consumption and CAI in MSM. The intervention is designed, in part, to foster increased condom-related planning and increase the use of implementation scripts to foster use of condoms in the “heat- of-the-moment.” In AIM 1, we extend the pilot work on the intervention to a larger sample and an intensive longitudinal design comprised of 3-weeks of experience sampling method (ESM) pre- and post- intervention to test the intervention’s mechanisms of action. Specifically, we hypothesize that A. the intervention will be associated with reduced alcohol intoxication and CAI, B. the intervention will reduce within-person associations of intoxication and arousal with CAI, and C. intoxication and condom-related planning will mediate associations between intervention condition and CAI at 4-month follow-up. Of particular importance is hypothesis B, which tests whether the intervention affects sexual decision-making in the “heat-of-the-moment” when compelling cues are prominent. Aim 2 extends to the natural environment our laboratory research to test dual-process theory derived mechanisms linking intoxication, arousal, and CAI. Here, we test if sexual delay discounting and working memory mediate, within-person, associations of intoxication and arousal with CAI and if changes in these effects underlie the intervention effects during the 3-week post-intervention period. The proposed study will advance understanding of within-person processes affecting sexual decision-making in the “heat-of-the- moment” when drive for immediate gratification peaks, test the effectiveness of a brief intervention, and identify the intervention’s effects on both within-person processes proximal to CAI as well as between-person mechanisms of behavior change.

项目摘要/摘要 此应用是响应RFA-AA-21-016的两个目标：预防HIV和酒精以翻译 关于酒精对性决策的影响至1）的基本行为科学发现。测试干预措施 旨在解决“瞬间”中的性决策（即，陶醉和性行为时 唤醒）和2）。扩展实验室研究以测试认知和动机内部机制 酒精和唤醒对自然环境中的性决策的影响。该应用程序是 我们以前的酒精挑战实验室研究对MSM中CAI的因素进行了研究。 这项研究表明，中毒与性唤醒的增强有关 意图。与双重过程理论一致，中毒和唤醒与转变有关 决策过程的特征是性奖励动机的作用增加 使用动机和执行功能的作用相应减少。这种模式表明 预防干预措施可能通过针对增强使用安全套使用的策略而有效地减少CAI 动机并减少“瞬间”中精力 /受控处理的缓解。我们驾驶 整合动机访谈，个性化认知咨询和文本消息的干预措施 减少了饮酒和MSM的CAI。干预的设计部分是为了增加 与避孕套相关的计划并增加了实施脚本的使用来促进“热热”中使用避孕套 在AIM 1中，我们将干预方面的试点工作扩展到更大的样本和密集的 纵向设计完成了3周的经验抽样方法（ESM），干预前后 测试干预的作用机制。具体来说，我们假设A.干预将是 与降低酒精中毒和CAI相关的B.干预将减少人身关联 与CAI的中毒和唤醒，C。陶醉和与避孕套相关的计划将调解关联 在4个月随访中的干预条件和CAI之间。假设b，特别重要的是 测试干预措施是否会在引人注目的“时刻”中影响性决策 提示是突出的。 AIM 2扩展到自然环境我们的实验室研究以测试双重过程 理论得出的机制将中毒，唤醒和CAI连接起来。在这里，我们测试性延迟是否在折扣和 工作记忆介导，人身内，中毒和唤醒的关联与CAI以及是否发生变化 这些影响是干预后3周的干预效应。拟议的研究 将提高对影响性决策的人内部过程的理解 时刻”当驱动即时满足达到峰值时，请测试简短干预的有效性，并确定 干预对靠近CAI的个人内部过程的影响以及人之间的影响 行为改变的机制。