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Alcohol and "Heat of the Moment" Sexual Decision Making among MSM: Identifying Mechanisms of Sexual Risk and Promoting Behavior Change Through Brief Intervention

Award Number: R01AA030461
ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2022
PERIOD OF PERFORMANCE END DATE: 05/31/2027

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Alcohol and "Heat of the Moment" Sexual Decision Making among MSM: Identifying Mechanisms of Sexual Risk and Promoting Behavior Change Through Brief Intervention - PROJECT SUMMARY/ABSTRACT This application is in response to two objectives of RFA-AA-21-016: HIV Prevention and Alcohol to translate basic behavioral science findings about alcohol’s effects on sexual decision-making to 1). Test an intervention designed to address sexual decision-making in the “heat-of-the-moment” (i.e., when intoxicated and sexually aroused), and 2). Extend laboratory research to test cognitive and motivational within-person mechanisms underlying alcohol and arousal effects on sexual decision-making in the natural environment. The application is informed by our previous alcohol challenge laboratory research on factors contributing to condomless intercourse (CI) among MSM. This research showed that intoxication was associated with heightened sexual arousal and increased CI intentions. Consistent with dual process theories, intoxication and arousal were associated with a shift in decision-making process characterized by an increased role of sexual reward motivation relative to condom use motivation and a corresponding decrease in the role of executive functioning. This pattern suggests that prevention interventions may be effective in reducing CI by targeting strategies that enhance condom use motivation and reduce the reliance on effortful / controlled processing in the “heat-of-the-moment.” We piloted an intervention that integrates motivational interviewing, personalized cognitive counseling, and text messaging that decreased alcohol consumption and CI in MSM. The intervention is designed, in part, to foster increased condom-related planning and increase the use of implementation scripts to foster use of condoms in the “heat-of-the-moment.” In AIM 1, we extend the pilot work on the intervention to a larger sample and an intensive longitudinal design comprised of 3-weeks of experience sampling method (ESM) pre- and post- intervention to test the intervention’s mechanisms of action. Specifically, we hypothesize that: A. the intervention will be associated with reduced alcohol intoxication and CI, and B. the intervention will reduce within-person associations of intoxication and arousal with CI, and C. intoxication and condom-related planning will mediate associations between intervention condition and CI at 4-month follow-up. Of particular importance is hypothesis B, which tests whether the intervention affects sexual decision-making in the “heat-of-the-moment” when compelling cues are prominent. Aim 2 extends to the natural environment our laboratory research to test dual-process theory derived mechanisms linking intoxication, arousal, and CI. Here, we test if sexual delay discounting and working memory mediate, within-person, associations of intoxication and arousal with CI and if changes in these effects underlie the intervention effects during the 3-week post-intervention period. The proposed study will advance understanding of within-person processes affecting sexual decision-making in the “heat-of-the-moment” when drive for immediate gratification peaks, test the effectiveness of a brief intervention, and identify the intervention’s effects on both within-person processes proximal to CI as well as between-person mechanisms of behavior change.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $564,826 )
2026	2026	TRUSTEES OF BOSTON UNIVERSITY	1 SILBER WAY	BOSTON	MA	02215	SUFFOLK	USA	Alcohol Research Programs	000	5	6/1/2026	NON-COMPETING CONTINUATION	$564,826
														Subtotal = $564,826

Issue Date FY: 2025 ( Subtotal = $697,478 )
2025	2025	TRUSTEES OF BOSTON UNIVERSITY	1 SILBER WAY	BOSTON	MA	02215	SUFFOLK	USA	Alcohol Research Programs	000	4	9/3/2025	NON-COMPETING CONTINUATION	$697,478
														Subtotal = $697,478

Issue Date FY: 2024 ( Subtotal = $691,154 )
2024	2024	TRUSTEES OF BOSTON UNIVERSITY	1 SILBER WAY	BOSTON	MA	02215	SUFFOLK	USA	Alcohol Research Programs	000	3	6/25/2024	NON-COMPETING CONTINUATION	$691,154
														Subtotal = $691,154

Issue Date FY: 2023 ( Subtotal = $672,680 )
2023	2023	TRUSTEES OF BOSTON UNIVERSITY	1 SILBER WAY	BOSTON	MA	02215	SUFFOLK	USA	Alcohol Research Programs	000	2	5/4/2023	NON-COMPETING CONTINUATION	$672,680
														Subtotal = $672,680

Issue Date FY: 2022 ( Subtotal = $730,912 )
2022	2022	TRUSTEES OF BOSTON UNIVERSITY	1 SILBER WAY	BOSTON	MA	02215	SUFFOLK	USA	Alcohol Research Programs	000	1	8/15/2022	NEW	$730,912
														Subtotal = $730,912

Grand Total All Awards = $3,357,050

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Alcohol and "Heat of the Moment" Sexual Decision Making among MSM: Identifying Mechanisms of Sexual Risk and Promoting Behavior Change Through Brief Intervention

Award Number: R01AA030461

ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2022

PERIOD OF PERFORMANCE END DATE: 05/31/2027

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