A daily diary study examining prospective associations between minutes of daily dating app use, affect, and HIV risk among young sexual minority men

项目摘要 18-29岁的男男性行为者（YMSM）受到以下因素的影响不成比例： 艾滋病毒、性传播感染和不良心理健康。使用约会应用程序在YMSM中寻找性伴侣或浪漫伴侣， 几乎无处不在，并与艾滋病毒和性传播感染风险行为（例如，无安全套肛交; CAS）， 尽管对这种联系的研究是混合的。最近，横截面研究和轶事， 心理健康提供者建议，使用约会应用程序可能与心理健康状况较差有关， YMSM之间的自尊。反过来，精神健康与CAS和其他艾滋病毒风险行为有关 在这个人群中。少数日常日记研究将非临床情感状态（例如，焦虑， 消极的唤醒）与CAS的参与。这些研究的结果是混合的，虽然都表明一些 影响和HIV风险之间的前瞻性关联。然而，这些每日日记研究都没有检查艾滋病毒， 约会应用程序使用的背景下的风险，因为他们收集的数据之前，约会应用程序变得普遍。 因此，使用约会应用程序的情感后果可能构成了一个未充分研究的机械联系， 使用约会软件和参与艾滋病风险行为之间的关系。鉴于迄今为止还没有研究 约会应用程序的使用和YMSM之间的影响之间的关联纵向，拟议的每日日记研究的 第一个目标是研究日常约会应用程序使用和情感状态之间的潜在关联， YMSM。它的第二个目的是测试负面影响对约会应用程序之间的关联的中介作用 使用和CAS。此外，上述每日日记研究均未检查预暴露的影响 预防（PrEP;一种几乎完美的预防HIV血清转化的药物， 直接）使用影响和CAS之间的联系，因为数据是在PrEP出现之前收集的。 这构成了我们对YMSM中艾滋病毒风险的理解的一个主要差距，因为PrEP已被证明 影响他们的性风险评估和与性伴侣的情感联系。因此，为了补充 具体目标如上所述，我将进行探索性分析（例如，敏感性和适度分析） 为了更好地了解PrEP使用对约会应用程序使用的影响，负面影响和性行为， YMSM。拟议的研究将使我能够建立在我的训练，定性和基本的统计方法 通过提供密集纵向数据分析的训练（即，多级建模、中介分析， 适度分析）。这也将使我有机会在招聘，保留和 相关纵向方法。具体而言，我将利用我在以下方面可以利用的资源和基础设施： 西北大学和性与性别少数群体健康与福祉研究所招募了一名 全国青年男男性接触者样本，在城市/农村地区和种族/民族认同方面存在差异。等 培训对于我作为一名成功的独立研究人员的职业生涯至关重要。Findings from the 拟议的研究将为针对易受感染的YMSM中艾滋病毒不平等的研究和干预提供信息。

Project Summary Young men who have sex with men (YMSM) between the ages of 18-29 are disproportionately affected by HIV, STIs, and poor mental health. The use of dating apps to find sexual or romantic partners among YMSM is nearly ubiquitous and has been associated with HIV and STI risk behaviors (e.g., condomless anal sex; CAS), though research on this association has been mixed. Recently, cross-sectional research and anecdotes from mental health providers have suggested that dating app use may be associated with poorer mental health and self-esteem among YMSM. Poorer mental health, in turn, has been linked to CAS and other HIV risk behaviors in this population. A small number of daily diary studies have linked nonclinical affective states (e.g., anxiety, negative arousal) with engagement in CAS. Results of these studies are mixed, though all suggest some prospective association between affect and HIV risk. However, none of these daily diary studies examined HIV risk in the context of dating app use because they collected data before dating apps became widespread. Thus, it may be that affective consequences of dating app use constitute an understudied mechanistic link between dating app use and engagement in HIV risk behavior. Given that no research to date has examined associations between dating app use and affect among YMSM longitudinally, the proposed daily diary study’s first aim is to examine prospective associations between daily dating app use and affective states among YMSM. Its second aim is to test the mediating effect of negative affect on the association between dating app use and CAS. Additionally, none of the aforementioned daily diary studies examined the effect of pre-exposure prophylaxis (PrEP; a medication that is nearly perfect at preventing HIV seroconversion when taken as directed) use on the link between affect and CAS because data were collected prior to the advent of PrEP. This constitutes a major gap in our understanding of HIV risk among YMSM because PrEP has been shown to affect their sexual risk appraisal and emotional associations with sexual partnering. Thus, to complement the Specific Aims described above, I will conduct exploratory analyses (e.g., sensitivity and moderation analyses) to better understand the impact of PrEP use on dating app use, negative affect, and sexual behavior among YMSM. The proposed study will allow me to build upon my training in qualitative and basic statistical methods by providing training in intensive longitudinal data analysis (i.e., multilevel modeling, mediation analyses, and moderation analyses). It will also afford me the opportunity to build upon my skills in recruitment, retention, and related longitudinal methods. Specifically, I will use resources and infrastructure available to me at Northwestern University and the Institute for Sexual and Gender Minority Health and Wellbeing to recruit a nationwide sample of YMSM that is diverse in terms of urban/rural locality and racial/ethnic identity. Such training will be crucial to the launch of my career as a successful independent researcher. Findings from the proposed research will inform research and intervention against HIV inequity among vulnerable YMSM.