Interpersonal and intrapersonal conflict and their association with substance use

描述(申请人提供)：在美国，与艾滋病毒阳性男性发生性关系的男性人数继续上升，特别是在纽约等大城市中心。因此，评估艾滋病毒阳性男同性恋者和双性恋者的心理社会和性健康及幸福感的独特方法，对于制定旨在减少这一人群的性风险和药物使用的干预措施至关重要。由于耻辱，艾滋病毒阳性者仍然很难披露艾滋病毒状况，这一困难在性情况下尤其明显。在以前的研究中，身份披露和物质使用都被作为增加艾滋病毒阳性男同性恋者和双性恋者的性行为风险(即不使用避孕套的性行为)的变量进行调查。在与非主要(即新的或随意的)性伴侣的性接触中，由于害怕人际拒绝和个人内部羞耻感而产生的认知冲突可能会影响披露、物质使用和避孕套使用之间的协同关系。这项研究建立在认知不和谐的社会心理学理论的基础上，基于这样一个假设，即不和谐(即冲突)是一种消极的唤醒状态，它会激励人们采取行为来减少这种消极的唤醒。我们假设，人际冲突(即害怕因透露艾滋病毒阳性状态和使用避孕套而被拒绝)和内部冲突(即更高程度的性羞耻感)将 相互作用，增加物质使用，减少避孕套的使用和性行为中的暴露。这项研究的主要目标是提供对这些结构的有用测量，并检查这些假设，以便为旨在减少性风险和物质使用的公共卫生干预提供信息。因此，本研究集中于两个目标：(1)建立三个测量工具的信度、效度、因素结构和心理测量学特性 人际冲突和人际冲突；以及(2)阐述和测试人际冲突和人际冲突与艾滋病毒状况披露、性风险以及在与临时伴侣发生性行为时使用药物的关系。建议的项目将被嵌入到一项更大的研究中(R01MH87714，Parsons Pi；这里称为父母项目)，这是一项纵向研究，跟踪研究高度性行为活跃的同性恋和双性恋男子，利用多种方法调查他们的性风险行为。拟议的项目将在母项目中增加两个基于互联网的评估，包括新的和现有的措施。我们将把这些新的测量方法与现有的数据结合起来，以检验新创建的测量方法的心理测量学，并检验提出的假设的意义。为这个项目提出的研究和培训计划也是为了促进我作为一名研究科学家的发展，我在性风险、药物使用以及对艾滋病毒阳性的同性恋和双性恋男性的研究方面拥有坚实的基础。

DESCRIPTION (provided by applicant): The numbers of men who have sex with men who are HIV-positive in the United States continues to rise, particularly in large urban centers such as New York City. As such, unique approaches to assessing psychosocial and sexual health and well-being of HIV-positive gay and bisexual men are crucial to developing interventions tailored to reducing sexual risk and substance use in this population. Disclosure of HIV status remains difficult for HIV-positive people due to stigma, and this difficulty is especially apparent within sexual situations. Both status disclosure and substance use have been investigated in prior research as variables that increase sexual risk (i.e. sex without condoms) among HIV-positive gay and bisexual men. During sexual encounters with non-main (i.e. new or casual) sexual partners, cognitive conflicts that result from fear of interpersonal rejection and intrapersonal shame are likely to influence the synergistic relationship between disclosure, substance use, and condom use. Building on the social psychological theory of cognitive dissonance, this investigation is based on a hypothesis that dissonance (i.e. conflict) is a negative state of arousal that motivates people to engage in behaviors to reduce that negative arousal. We hypothesize that interpersonal conflict (i.e., fear of being rejected for disclosing HIV-positive status and for using condoms) and intrapersonal conflict (i.e., higher levels of sexual shame) will interact to increase substance use and decrease both condom use and disclosure within sexual encounters. The primary goal of this study is to provide useful measurements of these constructs and examine these hypotheses to inform public health interventions aimed at reducing sexual risk and substance use. As such, the project focuses on two aims: (1) to establish reliability, validity, factor structure, and psychometric properties of three measures of intrapersonal and interpersonal conflict; and (2) to elaborate and test the relationship of interpersonal and intrapersonal conflict with HIV status disclosure, sexual risk, and substance use during sex with casual partners. The proposed project will be embedded into a larger study (R01MH87714, Parsons PI; referred to herein as the parent project), which is a longitudinal study that follows highly sexually active gay and bisexual men utilizing multiple methods to investigate their sexual risk behavior. The proposed project will add two internet-based assessments to the parent project that include both new and existing measures. We will combine these new measures with existing data to examine the psychometrics of the newly created measures and test the significance of the proposed hypotheses. The research and training plans proposed for this project are also designed to foster my development as a research scientist with a strong foundation in sexual risk, substance use, and research with HIV-positive gay and bisexual men.