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

项目总结： 男男性行为者(YMSM)有很高的饮酒率和艾滋病毒感染率。高水平的 青年男性接触者饮酒可能会增加HIV的发病率，因为大量饮酒可能与 更频繁的无套肛交(CAS)。尽管暴露前预防(PrEP)一直是 在减少艾滋病毒感染方面，PrEP的接受率仍然很低，许多使用PrEP的人并不是最好的 追随者。研究酒精使用和CAS之间的联系产生了好坏参半的结果， 可能是由于以前未被调查的因素与酒精使用相互作用而影响避孕套的使用 决定。那些饮酒的人可能更有可能陷入认知偏见，这种偏见包括 基于不准确的艾滋病毒指示物的特征对性伴侣“安全”的假设 状态(即“风险启发式”)。对被认为是身体健康的性伴侣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。了解合作伙伴风险启发式如何交互 在事件层面上使用酒精导致艾滋病毒危险行为对于制定干预措施是必不可少的 减少青年男性接触者中艾滋病毒发病率的计划。拟议的研究还将调查 在使用PrEP和使用YMSM的非PrEP之间，酒精使用、伴侣风险启发式和CAS。建议数 这项研究将建立在NIMHD资助的R01使用YMSM的PrEP每日日记研究的基础上，并添加一个 将被招募参加每日日记研究的非PrEP-HIV阴性YMSM样本 NIDA资助的U01纵向队列研究。该提案将建立在申请人现有计划的基础上 研究艾滋病毒危险行为，并为申请人提供博士后培训领域的研究 她没有经验(也就是饮酒)。该提案还将为申请人提供 接受统计方法方面的培训，以分析密集的纵向(即每日日记)数据和能力， 这是她作为一名独立科学家开始职业生涯所必需的。申请者将学习如何分析 使用多级建模技术测试人内饮酒关联的每日乳制品数据， 伴侣风险启发式，以及他们与艾滋病毒风险行为的互动。总而言之，拟议研究的目标是 为了：(1)检验伴侣风险启发式和饮酒与性危险行为之间的关系；以及(2) 在PrEP中调查酒精使用、伴侣风险启发式和性风险行为之间的关联 使用和不使用PrEP-使用YMSM。建议的研究代表了对互动角色的形成性研究 在事件层面上研究酗酒和伴侣风险启发式的艾滋病毒风险行为，这是重要的第一步 制定旨在减少问题饮酒和认知偏见使用的干预措施，例如 性伴侣风险启发式，作为青年男性接触者中艾滋病毒预防的障碍。进一步地，测试这些关联在 无论是使用PrEP还是不使用PrEP的HIV阴性YMSM都是必不可少的，以适应HIV预防 专门针对这些群体的干预措施。

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.