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 性强迫症 (SC)，或高水平的性行为与感知缺乏控制相结合，与无保护的性行为和其他艾滋病毒性危险行为密切相关。这种关联在不同人群中都很牢固，但在男男性行为者 (MSM) 中尤其强烈。该提案建立在我们之前的研究基础上，该研究发现，即使在控制了其他已知的相关因素（例如，安全套使用自我效能、实施安全性行为的意图等）之后，SC 仍与 HIV 阳性 MSM 中血清不一致的无保护肛交有关。 。然而，虽然性行为与不安全性行为之间的关联有相当多的经验支持，但性行为如何增加风险，以及如何最好地影响此类过程以降低风险，目前尚不清楚。 SC 被概念化为一种成瘾性障碍、一种冲动性障碍和一种强迫性障碍。其他人质疑 SC 作为一种可定义的疾病的存在，并将性行为的增加归因于高性欲。所有概念化的共同点有四个因素：负面情绪、性唤起、行为抑制和认知控制。这些因素通过干扰控制性冲动的能力（这将导致多次性接触）以及考虑多重强化意外事件和考虑愉悦行为的长期后果的能力受损来影响艾滋病毒风险。这会干扰安全套的使用。这项研究将提供所需的经验数据，以阐明 SC 的特征以及它如何导致 HIV 性危险行为水平增加。具体来说，本研究采用病例对照设计来比较两组 MSM，即 125 MSM 接受 SC 和 125 MSM 不接受 SC。我们将使用《克雷格名单》（一份针对 GLBT 社区的报纸）从社区招募参与者，并在 GLBT 居民高度集中的社区张贴传单。我们还将从一个为 GLBT 个体提供药物滥用和性强迫症服务的治疗计划中招募人员。我们的研究通过测量诱发两种负面情绪（抑郁和焦虑）后对性刺激的性唤起来探讨性唤起和负面情绪之间的关系。我们通过使用四种标准化心理测量来探索行为激活、性兴奋、行为抑制和性抑制的影响，并通过使用三种认知任务来探索认知控制的影响：测量冲突监控的斯特鲁普任务，逆转学习任务测量抑制控制，延迟贴现任务测量倾向于较小的即时奖励或较大的延迟奖励的倾向。这种多方法策略将使我们能够描述 SC 的特征，并提供所需的经验数据来识别，从而帮助解决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细致入微的方法来制定干预措施，并允许针对最有可能传播艾滋病毒的个人开展资源最密集的预防工作。 N:\SPA Research\Grants\Miner RO1 resubmssion Jan_2011\Final Documents\Project Summary 12-30-2010.docx 公共卫生相关性：项目叙述 确定与性强迫症 (SC) 相关的因素对不安全性行为有很大影响，对于推进艾滋病毒预防非常重要，并且具有重大的公共卫生相关性。这项研究提供了急需的经验数据，这些数据描述了 SC 的特征，并确定了影响各种类型性行为的机制，包括安全套的使用、血清分类和拥有多个性伴侣。已确定的机制允许开发新的干预措施，针对特定的艾滋病毒风险行为，并针对最有可能传播艾滋病毒的个人进行资源最密集的预防工作。