Brooke E. Wells - US grants

[unreadable] DESCRIPTION (provided by applicant): The proposed F31 represents a first step in a research trajectory focused on the complex relationships between gender, sexuality and substance use/abuse. Specifically, this project is designed to examine women's use of alcohol prior to sexual activity to discern the motivations for use and the negative consequences of this combination, especially for HIV and other sexual risks. The proposed project will utilize a mixed-method design in a sample of young adult women (ages 18-29) who frequent NYC clubs to appropriately address the following specific aims: Aim #1: To examine individual predictors of and factors associated with the use of alcohol prior to sexual activity; Aim #2: To examine the various consequences (unprotected sex, non-consensual sex, negative psychological impacts) of the combination of alcohol and sex; Aim #3: To explicate the moderating role of context in the relationship between alcohol consumption and sexual behavior, especially risky sexual behavior; Aim #4: To understand the role of gendered sexual norms in the relationship between alcohol consumption and sexual behavior; Aim #5: To examine the role of associating alcohol with sex in determining overall drinking patterns, especially problem drinking behaviors. To address these aims, this project will utilize both qualitative and quantitative data from 100 young women (ages 18-29). Specifically, the current project measures several psychological, psychosocial, and demographic variables, as well as detailed narratives relating women's most recent experiences of sexual activity while sober and while under the influence of alcohol, including information about the context in which the behavior occurred and the sexual risk involved in the situation. Qualitative, quantitative, and mixedmethod analyses will be used to answer the research questions that follow from these specific aims. This study will begin to fill key gaps in both the HIV prevention and alcohol use/abuse literatures in explicating the factors that influence sexual risk as well as sexual factors that may precipitate alcohol abuse among women, an often neglected group in both literatures. Critical knowledge generated about the social, individual, and contextual risk factors for sexual risk and alcohol abuse among women will inform future research and set the stage for future prevention and intervention efforts. [unreadable] [unreadable] [unreadable]

DESCRIPTION (provided by applicant): The proposed investigation seeks to examine the role of sexual conflict about condom use in the association between substance use and HIV risk behavior among young men who have sex with men (YMSM) in New York City (NYC), as sexual conflict is thought to be a major mechanism of the association between substance use and HIV risk behavior. We will undertake quantitative and qualitative secondary data analyses and conduct a pilot project of the proposed expressive writing intervention, guided by the following three aims: (1) Test the proposed model and explore the extent to which the mechanisms of expressive writing's effects are relevant to sexual conflict and its association with HIV risk behavior among YMSM; (2) Utilize the evidence gathered in Specific Aim 1 to develop the writing instructions and protocol for the expressive writing pilot study (Aim 3); and (3) Conduct a feasibility and acceptability pilot of the writing instructions and project protocols among substance using YMSM. To achieve these aims, the first phase of the project involves secondary data analyses of data from three existing studies (two of which were NIDA-funded studies). These analyses will determine the role of the known mechanisms of expressive writing's effects in sexual conflict about condom use and the effects of conflict on HIV risk behavior and substance use. The second phase of the project involves utilizing the findings of these analyses to develop an expressive writing intervention. Finally, in the third phase of the project, we will conduct a feasibility and acceptability pilot project with 20 HIV-, substance usin, and sexually risky YMSM (18-29 years old). For the pilot project, we will utilize venue-based sampling to recruit a diverse sample of YMSM, who will complete a baseline assessment, three sessions of expressive writing, and a follow-up assessment one month after the writing sessions end. Assessments will include measures of sexual conflict, substance use, sexual risk, and feedback on the writing sessions as well as analyses of retention and intervention acceptability. Pilot data will be analyzed and results will inform the revision of the proposed model and the development of a larger-scale expressive writing intervention designed to intervene upon sexual conflict about condom use. PUBLIC HEALTH RELEVANCE: The findings of this study will facilitate a more nuanced understanding of the mechanisms underlying the association between substance use and HIV risk, which will, in turn, inform prevention and intervention efforts. Specifically, the findings wll inform preventions, interventions, and treatments designed to decrease substance use (and the negative effects of substance use), decrease HIV risk behavior, and to disrupt the association between substance use and HIV risk behavior. Further, this study will develop a highly portable, affordable, and easy- to-implement intervention modality that could be used across a variety of settings.