Unhealthy alcohol use is common among MSM taking PrEP. The majority of drug use reported was marijuana and poppers, and drug use other than these was uncommon among our cohort. Read more!
Alcohol use is a key risk factor for HIV infection among MSM, in part because intoxication may interfere with the use of prevention methods like condoms. However, few studies have examined whether this is due to alcohol's pharmacological or expectancy effects. These findings suggest that alcohol's expectancy effects may play a role in sexual decision-making.
Gay and bi men are often inundated with HIV information, potentially to the point of fatigue. This may lead to avoidance of HIV related thoughts. However, these findings suggest that those who tend to avoid HIV-related thoughts may be at increased risk for HIV and alcohol-related problems. Read more about this, here.
In this publication, we report the results of our eTest pilot study. All participants who were mailed home-based HIV tests reported testing for HIV at least once over the course of the 7 month study, compared to 72% of those reminded it might be time to get tested at a clinic. Those who were called immediately following the completion of their home-based test were more likely to receive risk reduction counseling, prevention supplies (e.g., condoms and lube), and PrEP referrals during the study period. No effects were seen regarding PrEP uptake or STI testing. Stay tuned for results from our larger eTest study, beginning recruitment in 2018!
The first app of it’s kind, geared toward gay and bisexual men during the time of HIV testing, was developed. This fully-functional app, called “Game Plan”, provides: 1) specific and personal feedback to users about their level of risk, (2) exercises to help prompt users to reflect on whether their current behavior aligns with other important life goals and values, and for those open to change, (3) exercises to help users understand factors that contribute to risk, and (4) a change planning module.
Using a timeline followback (TLFB) to assess health behaviors such as alcohol and drug use, sexual behavior, and medication adherence has been around for decades. So how accurate is it? Comparing online monthly recall TLFB to daily dairy collection we see that timeline collection is valid for overall engagement in these health behaviors, but underreporting still occurs.
We studied associations between discrimination and alcohol outcomes. We can report that more discrimination events can lead to more alcohol problems. This is true among HIV + and HIV - gay/bi men. Additionally, reporting more discrimination experiences was associated with drinking more frequently for sexual reasons among both groups.
Staying true to our lab, we’ve gathered data on HIV testing habits among men who have sex with men (MSM) in the Northeastern Unites States. We found that racial/ethnic minority MSM, those with a college degree and those who engaged in more recent HIV-risky behavior had higher odds of having tested in the last 12 months. Conversely, the odds of having tested in the last 12 months were lower among those who reported drinking alcohol heavily, when compared with more moderate drinkers, highlighting yet another potential impact of alcohol on HIV outcomes.
We've known for awhile that computers can help counsel patients to make better decisions about their health. But, most of the systems built for this purpose so far require users to interact with the "counselor" using a "point-and-click" interface. That is, patients enter their responses to the computer's prompts by clicking, pressing, typing, and so on. Obviously, most typical counseling interactions with a person simply allow patients to speak naturally about their experiences, and this may be a more potent way of interacting that leads to better outcomes. In a small study, we tested whether a computer counseling system that used a natural speech interface helped heavy-drinking college students reduce their alcohol use and alcohol-related problems, when compared with a "point-and-click" interface. Find out more about our results here!
We're very excited to share our first publication from the eTEST project! In this paper, we report results from some qualitative research we conducted to help inform the development of eTEST. We showed that using a smartphone together with an internet-of-things (IoT) device to provide counseling and linkage to care after testing for HIV at home is feasible and could be a welcomed resource that helps those at-risk get tested more often, while also giving them the support they need.
Some might say, "No, duh!" But, we conducted one of the first studies to explore whether specific levels of drinking on a given day increased the odds of engaging in behavior that can transmit HIV in gay/bi men who are living with HIV. In this paper, published in the journal AIDS & Behavior, we showed that drinking more than 5 drinks on a given day increased the odds of engaging in sex that could transmit HIV that same day more than two-fold, and having more than 12 drinks increased those odds over 6-fold. These findings are in stark contrast to similar studies of straight men and women, which don't show such pronounced increases.
In our ongoing effort to understand exactly why alcohol and drug use increases the risk for sexually-transmitted infections like HIV, a paper we published in the journal Psychology of Addictive Behaviors showed that some gay/bi men may drink specifically to feel less inhibited about meeting romantic partners, and that these men may end up drinking more heavily than others. This tendency could also be one factor that increases risk for STIs and HIV in these men, but more carefully-designed studies are needed to explore this.
In a recent special issue of Alcohol Research: Current Reviews, a peer-reviewed publication that reviews the latest in alcohol research and is published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), we were invited to review the latest available scientific research on using mobile devices to study behavior, and its potential to improve health. The special issue focused on mobile health (mHealth) research, so we fit right in! Pretty cool!
Not exactly ground-breaking, but a necessary part of science! We're always trying to sort out the best way to study behaviors, especially because it's pretty tricky when people may be embarrassed about them or have a tough time remembering them. In this paper, we showed that one useful approach to collecting data about sensitive behaviors is to ask participants to recount them, day-by-day.
It's been widely accepted that drinking heavily increases the risk for sexually-transmitted infections, in part because it's assumed that intoxication leads to making riskier decisions about sex. But, in a paper we recently published in Drug and Alcohol Dependence, we showed that there is little evidence that heavy drinking specifically increases risky decisions about sex, but this is specific to straight men and women who drink a lot.
In this review we published in the journal Translational Behavioral Medicine, we explored the scientific evidence for using computers and other electronic devices to help people take their HIV medications regularly and on time. Good news, even simple tools can be helpful! Imagine the potential that more sophisticated programs might have!
Gay and bisexual men suffer from alcohol-related problems just like everyone else, but often experience more severe health-related consequences due to these problems than others. In this review we published in Drug and Alcohol Reviews, we suggest that more research is needed to explore how well common treatments for alcohol use disorders work in gay/bi men.
In a paper we recently published in the journal Archives of Sexual Behavior, we showed that one way alcohol intoxication may lead to riskier choices about sex is that sex-related cues may command more of your attention than when you're sober. This could make sex seem more impelling, even at the expense of its consequences.