Investigating the Influence of Alcohol Use and Partner Risk Heuristics on HIV Risk Behavior among Young Men Who Have Sex with Men

项目摘要： 男男性行为青年（YMSM）酗酒和感染艾滋病毒的比例很高。高水平的 YMSM中饮酒可能导致HIV发病，因为大量饮酒可能与 无安全套肛交（CAS）的频率更高。尽管暴露前预防（PrEP）已被 有效地减少艾滋病毒感染，PrEP摄取仍然很低，许多使用PrEP的人并不是最佳的 粘附性。研究酒精使用和CAS之间的联系的研究得出了不同的结果， 可能是由于以前未调查的因素与酒精的使用相互作用，影响避孕套的使用 决策饮酒的人可能更容易产生认知偏见， 基于艾滋病毒不准确指标的特征，对性伴侣“安全”的假设 状态（即，“风险管理”）。与被认为身体健康的性伴侣一起使用避孕套的可能性较小。 有吸引力的、健康的、熟悉的或熟知的，或值得信赖的。了解合作伙伴风险管理如何相互作用 在事件水平上，酒精使用有助于艾滋病毒的危险行为，这对制定干预措施至关重要 降低YMSM中艾滋病毒感染率的方案。拟议的研究还将调查 酒精使用，合作伙伴风险管理，CAS之间的PrEP使用和非PrEP使用YMSM。拟议 研究将建立在NIMHD资助的R 01每日日记研究的基础设施上，使用YMSM，并增加 非PrEP使用HIV阴性YMSM样本，将招募他们参加每日日记研究， NIDA资助的U 01纵向队列研究。该提案将建立在申请人现有的计划， 研究艾滋病毒的危险行为，并为申请人提供博士后培训的研究领域， 她没有经验（即，酒精使用）。该提案还将为申请人提供 训练用于分析密集纵向的统计方法（即，每日日记）数据和粒度， 这是她作为一名独立科学家开始职业生涯所必需的。申请人将学习如何分析 日常乳制品数据使用多层次建模技术来测试酒精使用的人内关联， 伴侣风险行为学及其与艾滋病毒风险行为的相互作用。总而言之，拟议研究的目标是 目的：（1）研究伴侣风险行为与饮酒对性风险行为的影响;以及（2） 调查酒精使用，伴侣风险认知和PrEP中的性风险行为之间的关联- 使用和非PrEP-使用YMSM。这项研究代表了互动角色的形成性研究 在事件层面上，酒精使用和伴侣风险评估在艾滋病毒风险行为中的作用，这是重要的第一步， 制定干预措施，旨在减少问题饮酒和认知偏见的使用，例如 性伙伴风险管理是YMSM人群预防艾滋病的障碍。此外，测试这些关联， 使用PrEP和不使用PrEP的HIV阴性YMSM对于定制HIV预防至关重要 特别针对这些群体。

Project Summary: Young men who have sex with men (YMSM) have high rates of alcohol use and HIV infection. High levels of alcohol use among YMSM may contribute to HIV incidence because heavy drinking may be associated with greater frequency of condomless anal sex (CAS). Although pre-exposure prophylaxis (PrEP) has been effective at reducing HIV infection, PrEP uptake remains low, and many who use PrEP are not optimally adherent. Research examining the association between alcohol use and CAS has yielded mixed results, which may be due to previously uninvestigated factors that interact with alcohol use to influence condom use decisions. Those who consume alcohol may be more likely to engage in cognitive biases which involve assumptions about “safety” of sexual partners based on characteristics that are inaccurate indicators of HIV status (i.e., “risk heuristics”). Condom use is less likely with sexual partners who are perceived to be physically attractive, healthy, familiar or known well, or trustworthy. Understanding how partner risk heuristics interact with alcohol use to contribute to HIV risk behavior at the event level is essential to develop intervention programs to reduce HIV incidence among YMSM. The proposed study will also investigate associations among alcohol use, partner risk heuristics, and CAS among PrEP-using and non-PrEP using YMSM. The proposed study will build on the infrastructure of a NIMHD-funded R01 daily diary study of PrEP-using YMSM and add a sample of non-PrEP-using HIV-negative YMSM who will be recruited to participate in the daily diary study from a NIDA-funded U01 longitudinal cohort study. The proposal will build upon the applicant’s existing program of research on HIV risk behavior and provide the applicant with postdoctoral training in a field of research in which she does not have experience (i.e., alcohol use). The proposal will also provide the applicant with training in statistical methods for analyzing intensive longitudinal (i.e., daily diary) data and grantsmanship, which are necessary to launch her career as an independent scientist. The applicant will learn how to analyze daily dairy data using multilevel modeling techniques to test the within-persons associations of alcohol use, partner risk heuristics, and their interaction, with HIV risk behavior. In sum, the goals of the proposed study are to: (1) examine associations of partner risk heuristics and alcohol use on sexual risk behavior; and (2) investigate associations between alcohol use, partner risk heuristics, and sexual risk behavior among PrEP- using and non-PrEP-using YMSM. The proposed study represents formative research on the interactive roles of alcohol use and partner risk heuristics in HIV risk behavior at the event level, which is an important first step to develop interventions that aim to reduce both problematic drinking and the use of cognitive biases, such as partner risk heuristics, as barriers to HIV prevention among YMSM. Further, testing these associations among both PrEP-using and non-PrEP-using HIV-negative YMSM is essential in order to tailor HIV prevention interventions specifically to these groups.