Cognitive Influences on Sexual Risk and Risk Appraisals in Men Who Have Sex with Men
Cognitive Influences on Sexual Risk and Risk Appraisals in Men Who Have Sex with Men
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DOI：
10.1037/hea0000010
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发表时间：
2014-07-01
影响因子：
4.2
通讯作者：
Mustanski, Brian
中科院分区：
文献类型：
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作者：
Newcomb, Michael E.;Mustanski, Brian
每年新增艾滋病毒感染者中，男男性行为者 (MSM) 占一半以上。先前的研究已将信息、动机和行为技能（IMB）模型中的认知变量与性风险行为联系起来，但认知还可能影响对性接触的风险评估，从而加剧性风险。本研究的目的是利用前瞻性事件水平数据来检验认知变量对 MSM 性风险的直接影响，以及这些变量对无保护肛交 (UAI) 与这些遭遇的风险评估之间关联的调节作用。 143 名不同种族的 MSM 参加了一项为期 3 个月的性行为在线日记研究。每周，参与者报告最多三次性接触中每次发生的具体性行为，包括性行为类型、安全套的使用以及在性接触期间感知的感染艾滋病毒的风险。所有分析均采用分层线性模型进行。安全套使用自我效能是唯一与 UAI 直接相关的认知变量。然而，艾滋病毒知识和安全套使用的社会规范都有助于风险评估的准确性。相反，那些非常积极地变得/保持更安全的 MSM 淡化了与他们无保护的性接触相关的风险。认知变量在直接和通过风险评估间接影响 MSM 的性风险方面发挥着重要作用。在艾滋病毒预防干预措施中解决这些认知过程可能有助于提高安全套使用的可能性和风险评估的准确性。
Men who have sex with men (MSM) account for more than half of new HIV infections each year. Previous research has linked cognitive variables from the Information, Motivational and Behavioral Skills (IMB) Model to sexual risk behavior, but cognitions may additionally influence risk appraisals of sexual encounters and subsequently potentiate sexual risk. The aim of this study was to use prospective event-level data to examine the direct influence of cognitive variables on sexual risk in MSM, as well as the moderating effects of these variables on the association between unprotected anal intercourse (UAI) and risk appraisals of these encounters. One hundred forty-three ethnically diverse MSM were enrolled in a 3-month online diary study of sexual behavior. Each week participants reported on specific sexual behaviors that occurred during each of up to three sexual encounters, including type of sexual behavior, condom use, and perceived risk for acquiring HIV during the encounter. All analyses were conducted with Hierarchical Linear Modeling. Condom use self-efficacy was the only cognitive variable that was directly associated with UAI. However, both HIV knowledge and social norms of condom use contributed to accuracy of risk appraisals. Conversely, MSM who were highly motivated to become/stay safer downplayed the risk associated with their unprotected sexual encounters. Cognitive variables play an important role in influencing sexual risk in MSM both directly and indirectly via risk appraisals. Addressing these cognitive processes in HIV prevention interventions may help to increase the likelihood of condom use and the accuracy of risk appraisals.