Drug Choice, Impulsivity, and Risky Sexual Behavior

描述(由申请者提供)：危险性行为(RSB)是全球艾滋病毒的主要原因。证据表明，药物使用与参与RSB有关，这种关系因所选药物的不同而不同。事实上，一些研究人员已经证明，与使用可卡因/可卡因的海洛因吸毒者相比，吸食可卡因/可卡因的海洛因使用者中RSB的发生率要高得多。这些研究被解释为表明，使用可卡因/可卡因是RSB的一个风险因素。然而，一个限制是，也使用强效/可卡因的海洛因使用者使用两种药物，而不使用强效/可卡因的海洛因使用者仅使用一种药物。因此，在这些研究中，更多的可卡因/可卡因的使用也可以被概念化为另一种药物的总体相加效应，而不一定是可卡因/可卡因的特定效应。事实上，对药物选择作用的真正检验需要独立的群体(例如，依赖可卡因/可卡因但不依赖海洛因的人与依赖海洛因但不依赖可卡因/可卡因的人与依赖可卡因/可卡因和海洛因的人)更清楚地隔离由此产生的差异。作为这一研究的第二个局限，很少有研究提供一个明确发展的理论框架来解释为什么RSB水平的增加与可卡因/可卡因的使用有关。目前的应用程序将比较以下三组开始住宅吸毒治疗的个人的RSB水平：a)100名依赖可卡因/可卡因且每月使用海洛因不超过一次的个人(涵盖治疗前6个月)；以及b)100名依赖海洛因且每月使用不超过一次强效/可卡因的个人(涵盖治疗前6个月)；以及c)100名同时依赖可卡因/可卡因和海洛因的个人(涵盖治疗前6个月)。此外，目前的研究将包括对来自社会行动理论的变量和冲动性在该结构的几个领域(例如，延迟折扣、行为抑制、冲动性冒险)的理论驱动组合的调节和中介作用的检验，以开始开发一个更大的框架来理解药物选择和RSB。这些结果将为今后的纵向研究进一步评估因果关系问题奠定基础，并将通过更好地了解RSB的风险因素，开始提供关于预防艾滋病毒感染的有用信息。

DESCRIPTION (provided by applicant): Risky sexual behavior (RSB) is the leading cause of HIV worldwide. Evidence suggests that drug use is related to engagement in RSB, with this relationship differing across drug of choice. Indeed, several researchers have documented that RSB is significantly more frequent in heroin users who use crack/cocaine compared to heroin users who do use crack/cocaine. These studies have been interpreted to suggest that crack/cocaine use is a risk-factor for RSB. One limitation, however, is that heroin users also using crack/cocaine are using two drugs whereas heroin users not using crack/cocaine are using only one drug. Thus, greater levels of crack/cocaine use in these studies also could be conceptualized as the additive effects of another drug in general, and not necessarily the specific effects of crack/cocaine. Indeed, a true test of the role of drug choice requires independent groups (e.g., individuals dependent on crack/cocaine and not heroin vs. individuals dependent on heroin and not crack/cocaine vs. individuals dependent on both crack/cocaine and heroin) to more clearly isolate resulting differences. As a second limitation of this line of research, few studies have provided a clearly developed theoretical framework to explain why increased levels of RSB are related to crack/cocaine use. The current application will compare level of RSB across the following three groups of individuals beginning residential drug use treatment: a) 100 individuals dependent on crack/cocaine and using heroin no more than once monthly (covering a period 6 months prior to treatment); and b) 100 individuals dependent on heroin and using crack/cocaine no more than once monthly (covering a period 6 months prior to treatment); and c) 100 individuals dependent on both crack/cocaine and heroin (covering a period 6 months prior to treatment). Further, the current study will include an examination of the moderating and mediating effects of theory-driven combinations of variables taken from Social Action Theory and impulsivity across several domains of this construct (e.g., delay discounting, behavioral inhibition, impulsive risk taking) to begin to develop a larger framework to understand drug choice and RSB. The results will set the stage for future longitudinal research further assessing issues of causality and will begin to provide useful information regarding the prevention of HIV infection through better understanding risk factors for RSB.