Using Behavioral Measures to Assess Change in HIV Sexual Risk-Taking Following Pre-Exposure Prophylaxis (PrEP) Uptake in Heavy Drinking Young Men Who Have Sex With Men

使用行为测量来评估与男性发生性行为的酗酒年轻男性在接触前预防 (PrEP) 后艾滋病毒性风险行为的变化

• 批准号: 10241301
• 负责人: Nioud Mulugeta Gebru
• 金额: $ 4.2万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-16 至 2022-07-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10241301
• 关键词: AIDS prevention; Address; Adherence; Age; Alcohol consumption; Alcohols; Area; Attention; Attitude; Behavior; Behavior Therapy; Clinical; Control Groups; Cross-Sectional Studies; Data; Data Analyses; Financial compensation; Funding; Future; HIV; HIV Infections; Heavy Drinking; Incidence; Individual; Intervention; Intervention Studies; Literature; Measures; Methodology; Methods; National Institute on Alcohol Abuse and Alcoholism; Outcome; Outcome Measure; Patient Self-Report; Pharmaceutical Preparations; Physicians; Prospective Studies; Psychological reinforcement; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Rewards; Risk; Risk Factors; Role; Sexual Partners; Sexually Transmitted Diseases; Standardization; Study Subject; Substance administration; Targeted Research; Testing; Time; TimeLine; Training; Unsafe Sex; Work; alcohol demand; alcohol misuse; base; behavior change; behavior measurement; behavioral economics; career; clinical outcome measures; clinically relevant; comparison group; condoms; control trial; design; discounting; experience; follow-up; heavy drinking young adult; innovation; medication compliance; men who have sex with men; movie; novel; open label; pill; pre-exposure prophylaxis; prevent; prospective; randomized trial; reduced alcohol use; reinforcer; response; sexual risk behavior; sexual risk taking; substance user; treatment adherence; treatment comparison; uptake; young adult; young men who have sex with men

Project Summary/Abstract HIV incidence rates are disproportionately high among young adult (ages 18-30) men who have sex with men (MSM), in part due to overlapping risk-factors, such as high rates of alcohol use. Pre-exposure prophylaxis (PrEP) is an efficacious HIV prevention drug, but has little utility without strong adherence. The potential for risk compensation – an increase in sexual risk-taking (e.g., more condomless sex) as PrEP users believe their risk for HIV is reduced – is another considerable concern with PrEP, because PrEP does not protect against other sexually transmitted infections (STIs). Substantial evidence indicates that alcohol facilities the spread of HIV by increasing sexual risk-taking and reducing medication adherence, exacerbating both critical concerns with PrEP – increased sexual risk-taking and reduced PrEP adherence. However, alcohol has received little attention in the PrEP and risk compensation literature, with only two studies reporting on alcohol use. Further, research on PrEP and risk compensation is replete with methodological limitations, including an exclu- sive reliance on retrospective self-reports and largely consists of cross-sectional studies. Research examining PrEP and risk compensation is inconclusive, in part due to these limitations. There is an urgent need to address this as a quarter of physicians report unwillingness to prescribe PrEP due to risk compensation concerns. Thus, the proposed study will address these gaps and limitations by determining the effects of PrEP and alcohol use on sexual risk-taking by using novel behavioral measures before and after PrEP uptake. The proposed project will use the Sexual Delay Discounting Task (SDDT) pre- and post-PrEP uptake to examine changes in HIV sexual risk-taking and determine associations with alcohol use, demand and reinforcement. The SDDT is a novel measure of sexual risk-taking that minimizes retrospective self-report, is reliable and valid, yet underutilized. The SDDT assesses impact of partner STI/HIV status and condom availability on likelihood of condom use, and has shown stronger relations to clinical outcomes, compared to self-report and other discount- ing measures. Despite this promising supporting evidence, the SDDT has not been used as an outcome measure in intervention studies. This study will establish validity of the SDDT as an outcome measure for future studies, providing a novel target for research testing interventions to reduce alcohol use and sexual risk-taking. The proposed F31 will enhance a NIAAA-funded randomized control trial (UH2/UH3AA026214, Leeman) testing a mobile intervention to reduce alcohol misuse and enhance PrEP adherence. Heavy drinking young adult MSM (N = 80) will receive open-label PrEP for 30 days, with a follow-up at 6-months. A no treatment control group (no PrEP; no intervention; N = 40) will be added for the F31 to complete study measures following the same timeline. This F31 will enable the applicant to work with a highly-skilled, experienced training team to develop proficiencies in: (1) randomized controlled trial and experimental methods; (2) application of behavioral economics; and (3) longitudinal data analysis to prepare for a career as independent investigator in alcohol/HIV research.

项目摘要/摘要 与男性发生性关系的年轻人（18-30岁）的年轻人（18-30岁）的艾滋病毒发病率率不成比例 （MSM），部分是由于风险因素重叠，例如高饮酒率。暴露前预防 （PREP）是一种有效的艾滋病毒预防药物，但没有强大依从性的效用。风险的潜力 补偿 - 性冒险的增加（例如，更无避孕套的性行为），因为用户认为他们的风险 因为艾滋病毒的减少 - 是PREP的另一个考虑因素，因为PREP不能保护其他 性传播感染（STIS）。大量证据表明，酒精设施由 增加性冒险并降低药物依从性，加剧这两个关键问题 - 增加性冒险和降低的预科。但是，酒精几乎没有关注 准备和风险补偿文献，只有两项有关饮酒的研究。 此外，对准备和风险补偿的研究被方法论上的局限性取代，包括排除 关于回顾性自我报告的退休，在很大程度上由横断面研究组成。研究检查 准备和风险补偿是尚无定论的，部分原因是这些限制。迫切需要解决 这是四分之一的医生报告说，由于风险补偿的问题，不愿意准备准备。那， 拟议的研究将通过确定准备和酒精的影响来解决这些差距和局限性 在预备前后，通过使用新型的行为措施进行性冒险。 拟议的项目将使用性延迟折现任务（SDDT）预先摄取和考试后的摄入 艾滋病毒性冒险的变化并确定与酒精使用，需求和增强的关联。这 SDDT是对性冒险的一种新颖的衡量，可最大程度地减少回顾性自我报告，可靠且有效，但 未充分利用。 SDDT评估伴侣性传播感染/艾滋病毒状况和避孕套的影响对可能性的可能性 使用避孕套，并且与自我报告和其他折扣相比，与临床结果显示了密切的关系 - 措施。尽管有保证的支持证据，但SDDT尚未用作结果措施 在干预研究中。这项研究将确定SDDT作为未来研究的结果度量的有效性， 为研究测试干预措施提供了新的目标，以减少酒精使用和性冒险。 拟议的F31将增强NIAAA资助的随机对照试验（UH2/UH3AA026214，Leeman）测试 一项移动干预措施，以减少滥用酒精并增强预科依从性。大量饮用的年轻成人MSM （n = 80）将接受30天的开放标签准备，并在6个月内进行随访。没有治疗对照组（否 准备；没有干预； F31将添加n = 40），以完成同一时间表之后的研究措施。 该F31将使申请人能够与高技能，经验丰富的培训团队合作，以发展能力 在：（1）随机对照试验和实验方法； （2）行为经济学的应用； （3） 纵向数据分析为作为酒精/艾滋病毒研究的独立研究者的职业做准备。

项目成果

Measuring Sexual Risk-Taking: A Systematic Review of the Sexual Delay Discounting Task.

• DOI: 10.1007/s10508-022-02355-y
• 发表时间: 2022-08
• 期刊: ARCHIVES OF SEXUAL BEHAVIOR
• 影响因子: 3.8
• 作者: Gebru, Nioud Mulugeta;Kalkat, Meher;Strickland, Justin C.;Ansell, Margaret;Leeman, Robert F.;Berry, Meredith S.
• 通讯作者: Berry, Meredith S.

Relationships among Substance Use, Sociodemographics, Pre-Exposure Prophylaxis (PrEP) Awareness and Related Attitudes among Young Adult Men Who Have Sex with Men.

• DOI: 10.1080/10826084.2022.2040030
• 发表时间: 2022
• 期刊: SUBSTANCE USE & MISUSE
• 影响因子: 2
• 作者: Gebru, Nioud Mulugeta;Benvenuti, Maria Costanza;Rowland, Bonnie H. P.;Kalkat, Meher;Chauca, Patricia G.;Leeman, Robert F.
• 通讯作者: Leeman, Robert F.

Are Drinking Cognitions Associated with Marijuana and Concurrent Alcohol and Marijuana Use among Adolescents and Young Adults?

• DOI: 10.26828/cannabis/2022.01.006
• 发表时间: 2022-02-22
• 期刊: Cannabis (Albuquerque, N.M.)
• 作者: Pritschmann, Ricarda K;Gebru, Nioud Mulugeta;Litt, Dana M;Zhou, Zhengyang;Lewis, Melissa A
• 通讯作者: Lewis, Melissa A