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Delay Discounting and HIV Sexual Risk Behavior in Men who Have Sex with Men

男男性行为者的延迟折扣和艾滋病毒性危险行为

基本信息

批准号：
9138001
负责人：
Jeb Jones
金额：
$ 4.03万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-02-17 至 2016-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9138001
关键词：
AIDS prevention Accounting Affect African American Age Alcohol or Other Drugs use Anus Behavior Therapy Behavioral Centers for Disease Control and Prevention (U.S.)Characteristics Cohort Studies Coitus Confounding Factors (Epidemiology)Cross-Sectional Studies Data Data Analyses Dependency Development Drug usage Eating Behavior Epidemic Equation Funding Goals HIV HIV Infections HIV Seropositivity HIV risk HIV/STD Health Resources Health behavior Heterosexuals Impulsivity Incidence Individual Infection Internet Intervention Lead Measures Methods Modeling National Institute of Drug Abuse Nature Obesity Participant Pathway interactions Patient Self-Report Pattern Population Preventive Intervention Prophylactic treatment Public Health Questionnaires Recording of previous events Recruitment Activity Relapse Reporting Respondent Rewards Risk Safe Sex Sampling Series Sex Behavior Sexually Transmitted Diseases Specific qualifier value Substance abuse problem Surveys Testing United States Visit base cohort condoms design discount discounting disorder prevention high risk high risk sexual behavior improved men men who have sex with men preference prospective public health relevance screening seroconversion sex sex risk sexual risk taking substance abuse treatment therapy design therapy development tool willingness

项目摘要

DESCRIPTION (provided by applicant): The HIV epidemic continues to result in approximately 2 million new infections globally each year, with approximately 50,000 infections in the United States annually. Within the United States, approximately 63% of new HIV infections occur among men who have sex with men (MSM). Although behavioral interventions have demonstrated modest efficacy in reducing self-reported sexual risk-taking, they have been less effective in reducing HIV/STI incidence. Improved behavioral HIV prevention interventions and better intervention targeting are needed. The proposed project is designed to examine the association between delay discounting (DD) and condomless anal intercourse (CAI) in MSM. DD refers to the tendency of individuals to prefer smaller, immediate consequences or rewards over larger, delayed consequences or rewards. With respect to sexual behavior, a choice to have sex without a condom when one is not available could be conceptualized as a smaller, immediately available reward compared to the choice to wait until a condom is available, which could be conceptualized as the larger, delayed reward of potential sexually transmitted disease avoidance. If DD is found to be associated with CAI, then that association could form the basis for development of new behavioral interventions designed to reduce sexual risk-taking and HIV/STI incidence. It might also be a valuable tool to identify men most in need of HIV prevention intervention. DD will be measured in two ways in the proposed study. First, monetary discounting will be measured using the Monetary Choice Questionnaire (MCQ). The MCQ presents a series of choices between small, immediately available amounts of money and larger, delayed amounts of money. A respondent's pattern of preferences is used to determine the degree to which he discounts money available at a delay. Second, sex-specific DD will be measured using the Sexual Discounting Task (SDT). In this task, respondents indicate a preference between immediate sex without a condom and sex at a specified delay with a condom. The pattern of responding is used to determine the degree to which the respondent discounts sexual activity (i.e., willingness to wait). This project has three aims. For the first two aims, an Internet-based survey will be administered to MSM to obtain demographic information, recent sexual behavior history, and monetary and sexual discounting data. Aim 1 is to assess the association between monetary DD, sexual DD, and CAI and to examine if the association is modified by age. Aim 2 is to test the hypothesis that monetary and sexual DD are associated with CAI via direct and indirect pathways using structural equation modeling. In Aim 3, participants in an ongoing, NIDA-funded cohort study of HIV-negative, young, black/African-American MSM in Atlanta, Georgia, will complete the MCQ and SDT at baseline. Aim 3 is to assess the causal association between CAI and DD using longitudinal data analysis. To the extent that DD is found to be associated with risky sexual behavior, it has the potential to be a behavioral target of HIV prevention interventions for MSM and a tool to identify men most at risk of engaging in risky sexual behavior.

描述（由申请人提供）：HIV流行继续导致全球每年约200万例新感染，美国每年约有50，000例感染。在美国，大约63%的新艾滋病毒感染发生在男男性行为者（MSM）中。尽管行为干预在减少自我报告的性冒险行为方面表现出适度的功效，但它们在减少艾滋病毒/性传播感染发病率方面效果较差。需要改进艾滋病毒行为预防干预措施，并更好地确定干预目标。本研究旨在探讨男男性接触者延迟折扣（DD）与无安全套肛交（CAI）之间的关系。DD指的是个体倾向于较小的，直接的后果或奖励，而不是较大的，延迟的后果或奖励。关于性行为，在没有安全套的情况下选择不使用安全套的性行为可以被概念化为一种较小的、立即可用的奖励，而选择等到有安全套的时候才使用安全套的性行为可以被概念化为一种较大的、延迟的潜在性传播疾病避免奖励。如果发现DD与CAI相关，那么这种关联可以形成新的行为干预措施的基础，这些干预措施旨在减少性风险-冒险行为和HIV/STI发病率。它也可能是一个有价值的工具，最需要艾滋病预防干预。在拟议的研究中，将以两种方式衡量DD。首先，货币贴现将使用货币选择问卷（MCQ）进行测量。MCQ提供了一系列选择，可以选择立即可用的小额资金，也可以选择延迟可用的大额资金。被调查者的偏好模式被用来确定他在延迟时对可用资金的折扣程度。其次，将使用性折扣任务（SDT）测量性别特异性DD。在这项任务中，受访者表示，不使用安全套的直接性行为和使用安全套的特定延迟性行为之间的偏好。回答的模式被用来确定回答者对性活动的折扣程度（即，愿意等待）。该项目有三个目标。对于前两个目标，将对MSM进行基于互联网的调查，以获得人口统计学信息、最近的性行为史以及金钱和性折扣数据。目的1是评估货币DD，性DD和CAI之间的关联，并检查该关联是否随年龄而改变。目的2是检验这一假设，即货币和性DD与CAI通过直接和间接的途径，使用结构方程模型。在目标3中，在格鲁吉亚亚特兰大市进行的一项正在进行的、由NIDA资助的HIV阴性、年轻、黑人/非洲裔美国MSM队列研究的参与者将在基线时完成MCQ和SDT。目的3是通过纵向数据分析评估CAI和DD之间的因果关系。在某种程度上，DD被发现与危险的性行为，它有可能成为艾滋病毒预防干预措施的男男性接触者的行为目标和工具，以确定男性最有风险从事危险的性行为。