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Passaro RC, Chávez-Gomez S, Castañeda-Huaripata A, Gonzales-Saavedra W, Beymer MR, Segura ER, Nanclares F, Dilley J, Cabello R, Clark JL. Personalized Cognitive Counseling Reduces Drinking Expectancy Among Men Who Have Sex with Men and Transgender Women in Lima, Peru: A Pilot Randomized Controlled Trial. AIDS Behav 2020; 24:3205-3214. [PMID: 32418164 PMCID: PMC8112108 DOI: 10.1007/s10461-020-02882-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Personalized cognitive counseling (PCC) is an evidence-based intervention designed to modify HIV-related risk behavior. We assessed the impact of PCC on sexual behavior, drinking expectancy, and incidence of sexually transmitted infections (STIs) in a 6-month randomized controlled trial among 153 HIV-uninfected men who have sex with men (MSM) and transgender women (TW) in Peru. Study retention was ≥ 90%, with three HIV infections (3 Control) and 19 cases of GC/CT (10 Control, 9 PCC) at 6 months. There was a decline in condomless receptive anal intercourse in the Control (0.74, 95% CI 0.60-0.91; p < 0.01) and PCC arms (0.72, 0.55-0.94; p = 0.02) at 6-month follow-up. There was a decrease in drinking expectancy at 6 months among participants endorsing alcohol use in the PCC arm (0.89, 0.83-0.96; p < 0.01), versus no change in the Control arm (0.98, 0.92-1.04; p = 0.54). PCC was efficacious in reducing drinking expectancy and HIV risk among MSM and TW in Peru.
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Affiliation(s)
- R Colby Passaro
- Department of Emergency Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA.
- South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
- Division of Infectious Diseases, Department of Medicine, UCLA SAPHIR Program C/O UCLA, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.
| | | | | | | | - Matthew R Beymer
- Department of Community Health Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Eddy R Segura
- South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Francisco Nanclares
- Alliance Health Project, University of California San Francisco, San Francisco, CA, USA
| | - James Dilley
- Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | | | - Jesse L Clark
- South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Mullens AB, Fein EC, Young RM, Dunne MP, Norton G, Daken K. Stimulant expectancy questionnaire for men who have sex with men: A measure of substance-related beliefs. Health Promot J Austr 2019; 31:309-319. [PMID: 31225931 DOI: 10.1002/hpja.271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/22/2018] [Accepted: 06/09/2019] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED Stimulant use has been identified as a key risk factor for sexual behaviours leading to HIV transmission. Substance-related expectancies are associated with substance use and postsubstance use thoughts, feelings and behaviours. Expectancies held by specific cultural subgroups have rarely been investigated, particularly regarding a range of commonly used stimulants. METHOD The Stimulant Expectancy Questionnaire for Men who have Sex with Men (SEQ-MSM) was initially generated through consumer panel and interviews regarding the most commonly used stimulants among MSM in Australia (methamphetamine, amphetamines and ecstasy), with initial administration among 98 MSM to facilitate item reduction. A community sample of 427 MSM was used to validate the SEQ-MSM, with exploratory factor analysis (EFA; n = 202) and confirmatory factor analysis (CFA; n = 225). RESULTS EFA revealed three distinct substance reinforcement domains ('Enhanced sexual experience', 'Sexual communication and negotiation' and 'Cognitive impairment'). The scale was associated with stimulant consumption patterns (including greater expectancies regarding sexual enhancement among methamphetamine users), and the factor structure, comprising a final form of the MSM-SEQ, was confirmed through CFA. CONCLUSIONS The SEQ-MSM represents a reliable measure of outcome expectancies related to the range of commonly used stimulants among Australian MSM. Development of applied validation studies with the SEQ-MSM is a key next step in advancing health promotion, clinical interventions and research efforts to reduce harm (eg, HIV transmission) associated with stimulant use (particularly methamphetamine) among MSM. SO WHAT?: Objectives: This research maps expectancies specific among gay and men who have sex with men (MSM), and relationships between expectancies and stimulant use patterns and behaviours postuse - including sexual activity (eg, condomless anal sex).
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Affiliation(s)
- Amy B Mullens
- School of Psychology & Counselling, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia.,School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Erich C Fein
- School of Psychology & Counselling, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Michael P Dunne
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Graham Norton
- Haemophilia Foundation Queensland, Fortitude Valley, QLD, Australia
| | - Kirstie Daken
- School of Psychology & Counselling, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
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Illicit drug use and its association with sexual risk behaviour among MSM: more questions than answers? Curr Opin Infect Dis 2016; 29:58-63. [PMID: 26694620 DOI: 10.1097/qco.0000000000000234] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Illicit drug use before or during sex - known as sexualized drug use (colloquially 'chemsex' or 'party and play') - has evolved as novel psychoactive substances have entered the market in many parts of the world. Here, we review key conceptual issues in associations between illicit drug use and sexual risk-behaviour in MSM. RECENT FINDINGS Although many studies have confirmed that MSM use drugs with greater prevalence than the general population, evidence is of variable quality and a sampling frame is difficult to establish. Moreover, psychosocial hypotheses linking drug use and sexual risk, including cognitive escape and sensation seeking, are unsatisfactory and generally ignore strategic use of drugs for sexual aims. Person-level associations between drug use history and both sexual risk behaviour and HIV infection tend to be consistent around the world, but evidence comparing encounters within subjects is generally unclear and out of date. SUMMARY There is a need for interventions for harm reduction targeted at MSM that account specifically for the social and cultural contexts of sexualized drug use. Expanded attention to surveillance of emerging drug use trends can help clinicians in sexual health and infectious diseases best anticipate the needs of their service users.
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Starks TJ, Millar BM, Tuck AN, Wells BE. The role of sexual expectancies of substance use as a mediator between adult attachment and drug use among gay and bisexual men. Drug Alcohol Depend 2015; 153:187-93. [PMID: 26051159 PMCID: PMC4520231 DOI: 10.1016/j.drugalcdep.2015.05.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/22/2015] [Accepted: 05/14/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND Research exploring substance use in gay and bisexual men has increasingly paid attention to interpersonal dynamics and relational concerns associated with the use of substances. The current study explored the role of adult attachment style on drug use as well as the potential mediating role of sexual expectancies of substance use among gay and bisexual men. METHODS Online survey data were gathered from 122 gay and bisexual men across the U.S., with a mean age of 33 years. All participants were HIV-negative and identified their relationship status as single. Survey measures included attachment style, sexual expectancies of substance use, and recent drug use. RESULTS While neither anxious or avoidant attachment were directly associated with the odds of recent drug use, they were positively associated with sexual expectancies of substance use (β=0.27, p<0.01, and β=0.21, p<0.05) which, in turn, were positively associated with the odds of drug use (expB=1.09, p<0.01). Bootstrapping tests of indirect effects revealed a significant indirect relationship between anxious attachment and drug use through sexual expectancies of substance use (β=0.11, p<0.05), but not for avoidant attachment. CONCLUSIONS This study highlights the importance of interpersonal expectancies as motivators for drug use among gay and bisexual men. Sexual expectancies of substance use were associated with drug use and anxious adult attachment was associated indirectly with drug use through these sexual expectancies.
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Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave, New York, NY 10065, USA,Health Psychology and Clinical Science doctoral program, Graduate Center, CUNY, 365 5th Ave, New York, NY 10034, USA,Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th St, 9th Floor, New York, NY 10018, USA
| | - Brett M. Millar
- Health Psychology and Clinical Science doctoral program, Graduate Center, CUNY, 365 5th Ave, New York, NY 10034, USA,Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th St, 9th Floor, New York, NY 10018, USA
| | - Andrew N. Tuck
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th St, 9th Floor, New York, NY 10018, USA
| | - Brooke E. Wells
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave, New York, NY 10065, USA,Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th St, 9th Floor, New York, NY 10018, USA,Basic and Applied Social Psychology doctoral program, Graduate Center, CUNY, 365 5th Ave, New York, NY 10034, USA,Doctorate in Public Health program, Graduate Center, CUNY, 365 5th Ave, New York, NY 10034, USA
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