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Starks TJ, Robles G, Dellucci TV, Cain D, D Kyre K, Outlaw AY, Lovejoy TI, Naar S, Ewing SWF. Optimizing Individual HIV Testing and Counseling for Emerging Adult Sexual Minority Men (Aged 18 to 24) in Relationships: A Pilot Randomized Controlled Trial of Adjunct Communication Components. AIDS Behav 2024:10.1007/s10461-024-04371-6. [PMID: 38801503 DOI: 10.1007/s10461-024-04371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
The majority of new HIV infections in the US occur among sexual minority men (SMM) with older adolescent and emerging adult SMM at the highest risk. Those in relationships face unique HIV prevention challenges. Existing sexual HIV transmission risk interventions for male couples often encounter implementation challenges and engaging younger SMM early in relationships may be particularly difficult. This pilot randomized controlled trial evaluated the acceptibility and feasibility of We Test HIV testing - a behavioral health intervention tailored for younger SMM in realtionships - and generated preliminary estimates of effect size. The intervention comprises two adjunct moduls - video-based communication skills training as well as communication goal setting and planning - delivered in conjunction with routine HIV testing and counseling in individual or dyadic formats. A sample of 69 SMM aged 17 to 24 were recruited online. Following baseline assessment, youth were randomized to receive either the experimental, We Test, intervention or routine HIV testing (the control condition). Follow-up assessments were completed 3 and 6 months post-baseline. Results suggested the study was feasible and the individually delivered format was acceptible. We Test HIV testing was associated with significant improvements in communication skills. In addition, youth who remained in a relationship experienced an increase in communal coping to reduce HIV infection risk and relationship power. While groups did not differ with respect to condomless anal sex with casual partners, these psycho-social constructs (communication, communal coping with HIV prevention, and relationship power) may serve as mediators of intervention effects on sexual risk reduction in a larger study.
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Affiliation(s)
- Tyrel J Starks
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA.
- Graduate Program in Health Psychology and Clinical Practice, Graduate Center, City University of New York, New York, NY, USA.
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Trey V Dellucci
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Kory D Kyre
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Angulique Y Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Travis I Lovejoy
- Division of Clinical Psychology, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Sylvie Naar
- Center for Translational Behavioral Sciences, Florida State University College of Medicine, Tallahassee, FL, USA
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Starks TJ, Kyre K, Castiblanco J, Parker JN, Kahle E, Stephenson R, Cain D. Comparing Repeated (Annual) Couples HIV Testing and Counseling to Individual HIV Testing and Counseling Among Male Couples at High Risk of HIV Infection: Protocol for a Randomized Control Trial. JMIR Res Protoc 2024; 13:e53023. [PMID: 38349737 PMCID: PMC10900088 DOI: 10.2196/53023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Couples HIV testing and counseling (CHTC) is now a standard of care prevention strategy recommended by the Centers for Disease Control and Prevention for sexual minority men (SMM) in relationships. Despite standard recommendations that couples complete CHTC every 6-12 months, no study has empirically evaluated the effects associated with CHTC retesting. OBJECTIVE This study aims to understand the benefits associated with continued dyadic engagement in the HIV prevention continuum through routine CHTC retesting, which is of particular importance for emerging-adult SMM in relationships who use drugs. METHODS Eligible couples for this CHTC retesting trial must already be enrolled in the 4Us trial, where they completed a CHTC session after their baseline survey. The purpose of the original 4Us trial was to test the efficacy of 2 intervention components for CHTC: a communication skills training video and a substance use module. Couples were eligible for the original 4Us trial if they identified as cisgender male, were in a relationship for 3 months or longer, were aged 17 years or older, and communicated in English. At least 1 partner had to be aged 17-29 years, report HIV negative or unknown serostatus, report use of at least 1 drug (cannabis, cocaine or crack, crystal methamphetamine, ketamine, gamma-hydroxybuterate [GHB], psychedelics, ecstasy, prescription medication misuse, opiates, and nitrates) use, and engage in condomless anal sex (CAS) acts with a casual partner or have a main partner who is nonmonogamous or serodiscordant. Those who complete the 4Us 12-month follow-up and remain in a relationship with the partner they participated in 4Us with are offered the opportunity to participate in this CHTC retesting trial. Those consenting are randomized to either CHTC retesting or individual HIV testing. Follow-up assessments are conducted 3 and 6 months after randomization to evaluate the effects of repeat CHTC on 2 primary outcomes: (1) CAS with a casual partner in the absence of preexposure prophylaxis (PrEP), and (2) CAS with a serodiscordant main partner who is not virally suppressed or concurrent CAS between main and casual partners in the absence of PrEP. RESULTS The CHTC retesting trial launched in January 2023, and enrollment is ongoing. As of February 2024, the study had enrolled 106 eligible participants (n=53 couples). CONCLUSIONS Findings from this CHTC retesting study will contribute to knowledge about the benefits associated with regular (repeated) CHTC testing versus routine individual HIV testing for SMM in relationships. The results of this trial will inform CHTC retesting guidance. TRIAL REGISTRATION ClinicalTrials.gov NCT05833074; htps://www.clinicaltrials.gov/study/NCT05833074. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53023.
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Affiliation(s)
- Tyrel J Starks
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of CUNY, New York, NY, United States
| | - Kory Kyre
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Juan Castiblanco
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Jayelin N Parker
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Erin Kahle
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Rob Stephenson
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
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Wolfs K, Bos AE, Mevissen FE, Alberts H, van Lankveld JJ. Ego depletion and implicit and explicit determinants of condom use intentions: an experimental study among young men. OPEN RESEARCH EUROPE 2023; 3:11. [PMID: 37645512 PMCID: PMC10445834 DOI: 10.12688/openreseurope.15433.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The Reflective Impulsive Model of Strack and Deutsch (2004) is a dual-process model and could be a dynamic theoretical framework of sexual risk behavior that is able to predict condom use under different circumstances. If we apply the Reflective Impulsive Model to sexual risk behavior, implicit attitudes regarding sexual risk behavior should have a stronger impact on behavior when working memory capacity is low. Explicit attitudes have a strong impact on intentions, which diminishes as participants have less working memory capacity. METHODS In this study, we induced a state of ego depletion to examine the impact of low working memory capacity on implicit and explicit attitudes and condom use intentions. Young, male participants ( N = 66) were randomly assigned to either an ego depletion condition (difficult calculus task) or a placebo condition (easy calculus task). At baseline, a questionnaire measuring explicit attitudes and intentions to use a condom, and an Implicit Association Test measuring implicit attitudes towards condoms were administered. After the ego calculus task, participants once more completed the questionnaire and Implicit Association Test. RESULTS We found no evidence that ego depletion had an effect on intentions to use a condom in young men. Explicit attitudes predicted intentions to use a condom, regardless of participants' state. We found no relationship between implicit condom attitudes and intentions to use a condom, neither in the ego depletion nor in the placebo condition. CONCLUSIONS The implications of this null finding are discussed.
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Affiliation(s)
- Kenny Wolfs
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Arjan E.R. Bos
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Fraukje E.F. Mevissen
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Hugo Alberts
- Positivepsychology.com, Maastricht, The Netherlands
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Abu-Ba’are GR, Shamrock OW, Apreku A, Agbemedu GRK, Zigah EY, Ezechi OC, Nelson LE, Torpey K. Awareness and Willingness to use Condoms and Preexposure Prophylaxis among Gay, Bisexual, and Other Cisgendered Men who Have sex with men in Slum Communities in Ghana. BSGH-004. J Int Assoc Provid AIDS Care 2023; 22:23259582231209649. [PMID: 37933162 PMCID: PMC10631318 DOI: 10.1177/23259582231209649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 11/08/2023] Open
Abstract
Introduction: Research has begun to examine human immunodeficiency virus (HIV) prevention strategies within the Ghanaian context. Still, little is known about specific populations such as gay, bisexual, and other cisgender men who have sex with men (GBMSM) living in slum communities. We studied HIV prevention strategies such as condoms and preexposure prophylaxis (PrEP) in slum communities and the awareness and willingness to use these choices among GBMSM. This qualitative study examines HIV prevention strategies, specifically examining PrEP and condom use behaviors among GBMSM in Ghana. Methods: We conducted in-depth face-to-face interviews among 12 GBMSM from slums in Accra and Kumasi cities in Ghana. Data were analyzed through a summative content analysis with multiple reviewers to develop codes. Data were collected from participants in January 2022. Results: We found the fear and perceived risk of infection were motivators for consistent condom use, especially during anal sex. GBMSM living with HIV receiving antiretroviral therapy were more inclined to use condoms. We found motivations for using PrEP were influenced by the type of sexual activity and a history of negative HIV status. Also, the barriers to PrEP for GBMSM included limited access to healthcare facilities and the distance to these facilities. Conclusions: To improve condom and PrEP access and uptake, we recommend addressing structural barriers by increasing the number of health facilities and implementing targeted interventions to address the lack of information on HIV awareness and prevention. Involving peer educators may also effectively promote HIV prevention strategies, especially in communities with limited access to healthcare such as slums. Overcoming these access constraints could significantly enhance awareness and prevention of HIV, leading to improved health outcomes for GBMSM living in slum communities.
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Affiliation(s)
- Gamji Rabiu Abu-Ba’are
- School of Nursing, University of Rochester, Rochester, USA
- Behavioral, Sexual and Global Health Lab, School of Nursing, University of Rochester, Rochester, USA
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, University of Ghana, Accra, Ghana
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Osman Wumpini Shamrock
- School of Nursing, University of Rochester, Rochester, USA
- Behavioral, Sexual and Global Health Lab, School of Nursing, University of Rochester, Rochester, USA
| | - Amos Apreku
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | | | | | | | - LaRon E. Nelson
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, University of Ghana, Accra, Ghana
- School of Nursing, Yale University, New Haven, Connecticut, USA
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
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Marcantonio TL, O’Neil AM, Jozkowski KN. Sexual consent cues among sexual minority men in the United States. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1936141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tiffany L. Marcantonio
- University of Arkansas, Department of Health, Human Performance, and Recreation
- Kinsey Institute for Research in Sex, Gender, and Reproduction
| | | | - Kristen N. Jozkowski
- Kinsey Institute for Research in Sex, Gender, and Reproduction
- Indiana University, Department of Applied Health Sciences
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Starks TJ, I Lovejoy T, Sauermilch D, Robles G, Stratton MJ, Cain D, Naar S, Ewing SWF. Developmental Barriers to Couples' HIV Testing and Counseling Among Adolescent Sexual Minority Males: A Dyadic Socio-ecological Perspective. AIDS Behav 2021; 25:787-797. [PMID: 32944842 DOI: 10.1007/s10461-020-03044-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
Couples HIV Testing and Counseling (CHTC) is now a standard of care for partnered sexual minority men. While adolescent sexual minority men (ASMM; ages 15-19) face disproportionate HIV risk, the emergent nature of relationships and communication skills may present challenges to accessing and engaging in CHTC. This study utilized qualitative data from 28 ASMM recruited in 4 urban centers in the USA during the formative stage of Adolescent Trials Network study ATN-156. Participants were cis-male, HIV-negative, and in a relationship with a similarly-aged cis-male partner. Thematic analysis indicated low and high levels of commitment were barriers to CHTC. Concerns about caregiver attitudes towards HIV testing were salient. Adolescents' perception of structural barriers highlighted reliance on caregiver resources, which limited access to sexual health services. Prevention programming must address structural barriers to access encountered by adolescents. ASMM in relationships may benefit from programming that includes options for individual and dyadic participation.
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Affiliation(s)
- Tyrel J Starks
- Hunter College of the City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA.
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY, USA.
| | - Travis I Lovejoy
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | | | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Mark J Stratton
- Hunter College of the City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Demetria Cain
- Hunter College of the City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Sylvie Naar
- Florida State University, Tallahassee, FL, USA
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Sternin S, McKie RM, Winberg C, Travers RN, Humphreys TP, Reissing ED. Sexual consent: Exploring the perceptions of heterosexual and non-heterosexual men. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1879911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | | | - Robb N. Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Canada
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8
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John SA, López-Rios J, Starks TJ, Rendina HJ, Grov C. Willingness to Distribute HIV Self-Testing Kits to Recent Sex Partners Among HIV-Negative Gay and Bisexual Men and an Examination of Free-Response Data from Young Men Participating in the Nationwide Cohort. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2081-2089. [PMID: 32495242 PMCID: PMC7366497 DOI: 10.1007/s10508-020-01752-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
Sexual minority men (SMM)-and young SMM in particular-are disproportionately affected by HIV. Secondary distribution of HIV self-testing (HIVST) kits-wherein patients deliver kits to partners-is a novel strategy to increase HIV testing access. Using quantitative data, we assessed willingness to distribute HIVST kits to recent sex partners among a U.S. national sample of HIV-negative SMM (n = 786). A thematic analysis was then conducted to identify barriers and facilitators of kit distribution to partners among young SMM (M age = 25.75 years; range: 20-29; n = 165). Overall, 93.5% of SMM (and 97.0% of young SMM) were willing to deliver HIVST kits to recent sex partners. Among young SMM, main barriers and facilitators included concerns about their partners' reaction, availability and cost, protection beliefs for others, HIV stigma and perceived infidelity, packaging and support, communication skill needs, inability to contact partners, requests for anonymity, and dyadic self-testing with their partners. The findings highlight the need for supportive intervention strategies such as informational content for HIVST, using motivational interviewing when providing the testing kits to index clients and providing skills-based training through role-playing exercises. Secondary distribution of HIVST kits through index patients is a potentially acceptable approach that could be used to expand access to HIV testing and aid in efforts to end the HIV epidemic in the U.S.
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Affiliation(s)
- Steven A John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Javier López-Rios
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, The CUNY Institute for Implementation Science in Population Health, 55 West 125th Street, New York, NY, 10027, USA
| | - Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, The CUNY Institute for Implementation Science in Population Health, 55 West 125th Street, New York, NY, 10027, USA.
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Skakoon-Sparling S, Cramer KM. Are We Blinded by Desire? Relationship Motivation and Sexual Risk-Taking Intentions during Condom Negotiation. JOURNAL OF SEX RESEARCH 2020; 57:545-558. [PMID: 30884967 DOI: 10.1080/00224499.2019.1579888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Effective condom negotiation skills support better sexual health for both men and women. The current study explored relationship motivation (motivation to establish and maintain long-term romantic relationships), gender, and sexual orientation as factors influencing the condom negotiation process. Participants (177 heterosexual women, 157 heterosexual men, and 106 men who have sex with men) read a vignette describing an encounter with a hypothetical new sexual/romantic partner and responded to embedded items and scales. Stronger relationship motivation predicted increased willingness to have condomless sex among women who perceived greater familiarity with the hypothetical partner. Gender and sexual orientation predicted different preferences for condom insistence strategies. The findings suggest that there are a number of conditions that make it more difficult to recognize risk during a sexual encounter and demonstrate how the process of condom negotiation can be impacted by gender, sexual orientation, and relationship motivation.
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A Pilot Randomized Trial of Intervention Components Addressing Drug Use in Couples HIV Testing and Counseling (CHTC) with Male Couples. AIDS Behav 2019; 23:2407-2420. [PMID: 30887190 DOI: 10.1007/s10461-019-02455-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Men who have sex with men (MSM) experience high rates of substance use and HIV infection. Main partners are the source of many (35-68%) of these new HIV infections. This study developed and examined the efficacy of two adjunct components to couples HIV testing and counseling (CHTC)-communication training (CT) videos and a substance use module (SUM)-to reduce drug use and sexual HIV transmission risk in MSM couples. Participants included 70 male couples randomized into one of four conditions: CHTC, CHTC + CT videos, CHTC + SUM, and CHTC + CT videos + SUM. Participants completed a survey pre-intervention and 1-, 3-, and 6-months later. Completion of the SUM in the absence of CT videos was associated with significant immediate decreases in drug use and related problems; however, at 3- and 6-month follow ups, the SUM was only associated with reductions in drug use and related problems among men who also viewed the CT videos. There were no between-condition differences in sexual behavior. CHTC may serve as a vehicle for the delivery of brief substance use intervention for MSM couples.ClinicalTrails.gov NCT # 03125915.
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Starks TJ, Millar BM, Doyle KM, Bertone P, Ohadi J, Parsons JT. Motivational interviewing with couples: A theoretical framework for clinical practice illustrated in substance use and HIV prevention intervention with gay male couples. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2018; 5:490-502. [PMID: 30581887 PMCID: PMC6300150 DOI: 10.1037/sgd0000297] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Epidemiological data indicate the need to address substance use and sexual HIV transmission risk among gay and bisexual men in relationships. While brief Motivational Interviewing (MI) delivered to the individual has shown efficacy in reducing sexual HIV risk with casual partners and substance use, the application of MI with couples has received less attention. Most studies of MI with couples have conceptualized the "spouse" or partner as an adjunct participant in the treatment of an identified client. We propose a theoretical framework for conducting MI with a couple, which approaches the couple as the identified client, and may be adopted when either one or both partners engage in the target behavior. We then discuss similarities between MI-processes conceptualized with our proposed framework and those that are salient in existing couples therapies. We utilize case examples from brief MI sessions targeting substance use and sexual HIV risk in gay male couples to illustrate three phenomena unique to the implementation of MI with couples: 1) interpersonal ambivalence; 2) the role of dyadic functioning in tolerating and resolving interpersonal ambivalence; and 3) joint goal formation as a prerequisite to the planning phase of MI. Connecting these phenomena with the transformation of motivation and accommodation processes outlined in Couples Interdependence Theory, this paper suggests that brief MI may be a promising modality for substance use and HIV risk reduction interventions with couples generally and gay couples specifically.
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Affiliation(s)
- Tyrel J. Starks
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave, New York, NY 10065, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, 365 5th Ave, New York, NY 10034, USA
| | - Brett M. Millar
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Kendell M. Doyle
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Paula Bertone
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Jonathan Ohadi
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave, New York, NY 10065, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, 365 5th Ave, New York, NY 10034, USA
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