Psychological and Cognitive Mechanisms Underlying Sexual Compulsivity and HIV Ris

性强迫症和艾滋病毒风险背后的心理和认知机制

• 批准号: 8209751
• 负责人: MICHAEL H MINER
• 金额: $ 37.24万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-11 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8209751
• 关键词: AIDS prevention; Accounting; Address; Affect; Anus; Anxiety; Arousal; Behavior; Behavior Control; Behavioral; Behavioral inhibition; Characteristics; Cognitive; Communities; Conflict (Psychology); Controlled Study; Data; Depressed mood; Development; Disease; Disinhibition; Emotional; Emotions; Equation; Future; HIV; HIV Seropositivity; Healthcare; Impairment; Impulsivity; Individual; Intervention; Knowledge; Lead; Libido; Measures; Mental Depression; Methods; Modeling; Monitor; Multiple Partners; Neighborhoods; Neurologic; Newspapers; Outcome; Participant; Patient Self-Report; Population; Prevention; Prevention approach; Process; Psychological reinforcement; Psychometrics; Public Health; Recruitment Activity; Regulation; Research; Research Project Grants; Reversal Learning; Rewards; Risk; Self Efficacy; Services; Sex Behavior; Sexual Arousal; Sexual Partners; Short-Term Memory; Sorting - Cell Movement; Source; Stimulus; Substance abuse problem; Syndrome; Training; Unsafe Sex; addiction; base; behavior change; behavior influence; case control; cognitive control; condoms; design; discounting; effective intervention; high risk sexual behavior; improved; male; men who have sex with men; negative mood; novel; psychologic; safer sex; sex risk; sexual encounter; theories; therapy development; transmission process; treatment program

DESCRIPTION (provided by applicant): Project Summary Sexual Compulsivity (SC), or high levels of sexual behavior combined with a perceived lack of control, is strongly associated with unprotected sex and other HIV sexual risk behaviors. This association has been ro- bust across populations, but particularly strong in men who have sex with men (MSM). This proposal builds on our previous research which found that SC is associated with sero-discordant unprotected anal intercourse in HIV-positive MSM even after controlling for other known correlates (e.g., condom use self-efficacy, intentions to practice safer sex, etc.). However, while the association between SC and unsafe sex has considerable em- pirical support, the manner in which SC confers this increased risk, and therefore how to best influence such processes in order to reduce risk, is as yet, unknown. SC has been conceptualized as an addictive disorder, an impulsive disorder, and as a compulsive disorder. Others have questioned the existence of SC as a defin-able disorder and attribute the increased sexual behavior to high sex drive. Common across all conceptualiza-tions are four factors: negative affect, sexual arousal, behavioral inhibition, and cognitive control. These fac- tors influence HIV risk by interfering with the ability to manage one's sexual impulses, which would lead to multiple sexual encounters, and through impairments in the ability to consider multiple reinforcement contin- gencies and to consider the long-term consequences of pleasurable behavior which interferes with condom use. This study will provide needed empirical data to clarify the characteristics of SC and how it leads to in- creased levels of HIV sexual risk behavior. Specifically, this study uses a case-control design to compare two groups of MSM, 125 MSM with SC and 125 MSM without SC. We will recruit participants from the community using Craig's list, a newspaper that targets the GLBT community, and posting flyers in neighborhoods with high concentrations of GLBT residents. We will also recruit from a treatment program that provides services for substance abuse and sexual compulsivity in GLBT individuals. Our study explores the relationship between sexual arousal and negative mood by measuring sexual arousal to erotic stimuli following the induction of two types of negative mood (depression and anxiety). We explore the influence of behavioral activation, sexual excitation, behavioral inhibition, and sexual inhibition by the use of four standardized psychometric measures, and we explore the influence of cognitive control through the use of three cognitive tasks: the Stroop task that measures conflict monitoring, the Reversal learning task that measures inhibitory control, and the Delayed dis- counting task that measures the tendency to favor either smaller immediate or larger delayed rewards. This multi-method strategy will allow us to characterize SC and to provide needed empirical data to identify, and therefore help address, the underlying mechanisms that influence unsafe sexual behavior. The findings of this study will further a nuanced approach to the development of interventions and allow for targeting the most re- source-intensive prevention efforts at those individuals most likely to spread HIV. N:\SPA Research\Grants\Miner RO1 resubmssion Jan_2011\Final Documents\Project Summary 12-30-2010.docx PUBLIC HEALTH RELEVANCE: Project Narrative Identifying the factors associated with Sexual Compulsivity (SC), which has a robust influence on unsafe sex- ual behavior, is of great importance for advancing HIV prevention and has significant Public Health Relevance. This study provides much needed empirical data which characterize SC and identifies the mechanisms in- fluencing various types of sexual behavior, including condom use, sero-sorting, and having multiple partners. The identified mechanisms allow novel interventions to be developed which target specific HIV risk behaviors and target the most resource-intensive prevention efforts at individuals most likely to spread HIV.

描述（由申请人提供）：项目摘要性强迫性（SC），或高水平的性行为与缺乏控制的性行为相结合，与未受保护的性行为和其他HIV性风险行为密切相关。这种协会一直在人群中占上风，但在与男性发生性关系的男性中尤其强大（MSM）。这项提案基于我们先前的研究，该研究发现SC与HIV阳性MSM中的血清中未受保护的肛门性交有关，即使在控制了其他已知相关性（例如，避孕套使用自我效能感，实践更安全的性别等）。但是，尽管SC与不安全性别之间的关联具有相当大的支持，但SC赋予这种增加的风险的方式，因此如何最大程度地影响此类过程以降低风险，但尚不清楚。 SC已被概念化为成瘾性疾病，一种冲动性疾病和强迫症。其他人则质疑SC的存在是一种可定义的疾病，并将增加的性行为归因于高性欲驱动力。在所有概念上的常见是四个因素：负面影响，性唤醒，行为抑制和认知控制。这些方面通过干扰管理一个人的性冲动的能力来影响艾滋病毒的风险，这将导致多次性交，并通过考虑考虑多种强化继续进行的能力，并考虑干扰避孕套使用的愉悦行为的长期后果。这项研究将提供所需的经验数据，以阐明SC的特征及其如何导致艾滋病毒性风险行为水平。具体而言，本研究使用病例对照设计来比较两组MSM，125 MSM的SC和125 MSM，而无需SC。我们将使用克雷格（Craig）名单（针对GLBT社区的报纸）招募社区的参与者，并在GLBT居民浓度高的社区中发布传单。我们还将从一个治疗计划中招募，该计划为GLBT个人提供滥用药物和性强迫的服务。我们的研究通过在诱导两种类型的负面情绪（抑郁和焦虑）后测量对色情刺激的性唤醒来探讨性唤醒和负面情绪之间的关系。我们通过使用四种标准的心理测量指标来探索行为激活，性激发，行为抑制和性抑制的影响，我们通过使用三个认知任务来探索认知控制的影响：测量冲突监控的Streoop任务，衡量较大的延迟控制任务或计算延迟任务的逆转学习任务的差异，并降低了较小的延迟任务。这种多方法策略将使我们能够表征SC并提供所需的经验数据，以识别影响不安全性行为的潜在机制。这项研究的结果将进一步采取一些细微的方法来开发干预措施，并允许针对最有可能传播艾滋病毒的人的最密集的预防努力。 N：\ spa Research \ Grants \ Miner RO1 Resubmssion Jan_2011 \ Final Documents \ Project Summary 12-30-2010.docx 公共卫生相关性：识别与性强迫（SC）相关的因素的项目叙述对不安全的性行为行为产生了强大的影响，对预防艾滋病毒的预防并且具有很大的公共卫生相关性至关重要。这项研究提供了急需的经验数据，这些数据表征了SC​​并确定具有各种性行为的机制，包括使用避孕套，血清排序和有多个伴侣。确定的机制允许开发出针对特定艾滋病毒风险行为的新颖干预措施，并针对最有可能传播艾滋病毒的个体的最重要的预防措施。