Heterosexual HIV Risk: Effects of Men's Alcohol Use and Sexual Violence

说明(由申请者提供)：项目摘要：拟议研究的主要目标是探索和描述酒精消费和针对妇女的性暴力对男子危险性行为的独立和协同影响。研究表明，与受感染男性伴侣的性行为是妇女艾滋病毒传播的主要方式，性胁迫和性暴力(SCV)造成的受害历史可能会加剧妇女的艾滋病毒风险，但关于SCV行为与导致异性恋男子潜在艾滋病毒传播的危险性行为之间的联系的调查很少。此外，饮酒在SCV-HIV风险联系中的作用仍未得到研究，尽管来自不同研究的证据表明，男性饮酒与危险和暴力的性行为有关。这项研究考察了HIV风险因素、SCV相关因素和酒精相关因素之间的关系，在一个高性风险社区样本中与女性发生了性行为。本项目的调查部分从全球关联和具体事件两个层面调查这些关系。这个项目的实验部分考察了急性酒精中毒对男性对假设性行为的反应的影响，其中包括与临时女性伴侣协商避孕套。一个实验因素将在受试者之间进行调整：4级酒精条件[清醒、安慰剂、中度醉酒(0.05%)和高度醉酒(0.10%)]。依赖措施将评估参与者在整个避孕套谈判场景中的认知、情感和行为反应，包括使用胁迫或强迫获得无保护性行为的可能性。背景变量，如艾滋病毒风险因素，与SCV相关的态度和病史，以及酒精预期，对男性性行为决定的影响也将被调查。除了完善酒精在危险和暴力性行为中的作用的理论外，研究结果还对有关酒精和性暴力对异性恋艾滋病毒风险的影响的艾滋病毒预防项目有影响。该项目是制定研究计划的第一步，该计划将解决这一重要但未得到充分研究的领域。相关性：艾滋病毒/艾滋病对妇女的健康构成日益严重的威胁，她们主要面临通过受感染的男性性伴侣感染艾滋病毒的风险。经历过男性性暴力的妇女表现出更高的艾滋病毒风险因素；因此，需要更好地了解男子危险的性行为和性暴力之间的联系，以便为艾滋病毒预防工作提供信息。此外，男性酒精中毒会增加危险的性行为和性暴力；因此，了解男性饮酒对他们参与暴力和危险性行为的影响可以进一步完善艾滋病毒教育和预防计划。

DESCRIPTION (provided by applicant): Project summary: The overarching objective of the proposed research is to explore and delineate the independent and synergistic effects of alcohol consumption and sexual violence against women on men's risky sexual behavior. Research indicates that sexual activity with infected male partners is the primary mode of HIV transmission for women and that a history of victimization resulting from sexual coercion and violence (SCV) may exacerbate women's HIV risk, yet there has been little investigation of the linkages between SCV perpetration and risky sexual behavior leading to potential HIV transmission in heterosexual men. Further, the role of alcohol consumption in the SCV-HIV risk connection remains unexamined, despite evidence from separate lines of research associating men's alcohol use with both risky and violent sexual behavior. This research examines the relationships among HIV risk factors, SCV-related factors, and alcohol-related factors in a high sexual risk community sample of young men who have sex with women. The survey portion of this project investigates these relationships on both global association and event-specific levels. The experimental portion of this project examines the effects of acute alcohol intoxication on men's responses to a hypothetical sexual situation involving condom negotiation with a casual female partner. One experimental factor will be manipulated between subjects: a 4-level Alcohol Condition [Sober, Placebo, Moderate Intoxication (.05%), and High Intoxication (.10%)]. Dependent measures will assess participants' cognitive, affective, and behavioral responses throughout the condom negotiation scenario, including the likelihood of using coercion or force to gain unprotected sex. The influence of background variables, such as HIV risk factors, SCV-related attitudes and history, and alcohol expectancies, on men's sexual decisions will also be investigated. In addition to refining theories regarding alcohol's role in both risky and violent sexual behavior, findings have implications for HIV prevention programs concerning the influence of alcohol and sexual violence on heterosexual HIV risk. This project represents a first step in the development of a research program that will address this important, but understudied, area. Relevance: HIV/AIDS poses an increasingly serious health threat to women, who are primarily at risk of contracting HIV through infected male sexual partners. Women who have experienced sexual violence by men exhibit elevated HIV risk factors; thus, a better understanding of the linkages between men's risky sexual behavior and sexual violence is needed to inform HIV prevention efforts. Additionally, alcohol intoxication in men has been associated with increased risky sexual behavior and increased sexual violence; therefore, knowledge regarding the effects of men's alcohol use on their engagement in both violent and risky sexual behavior can further refine HIV education and prevention programs.