External validity of analogue sexual risk laboratory data

Causal Effects of Alcohol Consumption on Condom Negotiation Skills of Women with Varying Sexual Assault Histories

Sexual assault victimization experience and alcohol consumption are well-documented HIV risk factors for women who have sex with men (WSM). Nonetheless, behavioral mechanisms of the synergistic effects of these factors on women's increased HIV risk are not well delineated. This study is the first to examine the interactive effects of sexual assault history and acute intoxication on women's condom negotiation behavior during a face-to-face role-play with a male actor. Participants were female, single, social drinkers, ages 21 to 35, recruited from the community. Women were categorized as having experienced past sexual assault victimization or not based on their questionnaire responses, then were randomly assigned to consume either no alcohol or alcohol (0.08 target BAC) and engaged in a role-play with a male actor that included condom use negotiation. Participants' verbal, paraverbal, and nonverbal behavior was video recorded and coded by independent raters. As hypothesized, sexual assault history interacted with alcohol condition to significantly influence participants' assertive condom negotiation behavior. These results further our scientific understanding of how intoxication may exacerbate the relationship between sexual assault history and HIV risk, and can inform prevention programs tailored to the unique needs of WSM who have a history of sexual assault victimization and are social drinkers.

Effects of Alcohol Intoxication on Sexual Decision-Making among Men Who Have Sex with Men (MSM): Alcohol's Influences on Self-Control Processes

This experiment tested mechanisms linking alcohol intoxication and analogue determinants of condomless anal intercourse (CAI) in a sample of 257 men who have sex with men (MSM). The two mechanisms tested were implicit approach biases toward CAI stimuli and executive working memory. Participants were randomized to 3 conditions (water control, placebo, or alcohol) and following beverage administration completed a working memory task, an Approach Avoidance Task of sexual vs. condom stimuli, and two video role-play vignettes of high-risk sexual scenarios. Sexual arousal and CAI intentions were assessed by self-report, and behavioral skills and risk exposure were derived from participants' role-play behavior. Estimation of four path models showed that the hypothesized mechanisms were supported for the CAI intention outcome, but the findings for the skills and risk exposure outcome were mixed. Implications for development and enhancement of HIV prevention interventions were discussed.