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

What this Trial Is About

HIV transmission remains a major public health concern, especially among men who have sex with men (MSM). Condomless anal intercourse (CAI) is a primary way HIV spreads in this group. This research aims to better understand how heavy drinking influences sexual decisions during high arousal moments and to test a brief intervention designed to reduce sexual risk behaviors linked to alcohol use in MSM who engage in heavy drinking and CAI. Participants will be randomly assigned to one of two groups: an experimental group receiving a single motivational session to reduce heavy drinking and sexual risk behavior plus 4 weeks of supportive text messages, or an active comparator group receiving a single session of psychoeducation about heavy drinking risks, barriers to safe sex, and information about pre-exposure prophylaxis (PrEP). The study uses experience sampling method (ESM) bursts before and after the intervention to monitor alcohol use, sexual arousal, decision-making, and condomless anal intercourse over 3 weeks, with a 4-month follow-up. During the study, participants will complete surveys and ESM assessments tracking their alcohol consumption, sexual behavior, and related cognitive factors. Researchers will measure the number of times participants engage in CAI and heavy drinking episodes, as well as average drinks per week. The study includes behavioral questionnaires, monitoring through smartphone-based ESM, and follow-up data collection to evaluate how the intervention affects risky sexual behavior and alcohol use over time.

Alcohol and "Heat of the Moment" Sexual Decision Making