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Introduction: Past research shows that HIV self‐testing (HIVST) can increase testing and facilitate more HIV diagnoses relative to clinic testing. However, in the United States, the use of HIVSTs is limited due to concerns that those who use HIVST could be less likely to be linked to care. Methods: From January 2019 to April 2022, we recruited 811 men who have sex with men (MSM) in the United States who tested infrequently using an online marketing campaign and randomized them 1:1:1 to receive one of the following every 3 months for a year: (1) text message reminders to get tested at a local clinic (control); (2) mailed HIVST kits with access to a free helpline (standard HIVST); and (3) mailed HIVST kits with counselling provided within 24 hours of opening a kit (eTest). Quarterly follow‐up surveys assessed HIV testing, sexually transmitted infection (STI) testing, pre‐exposure prophylaxis (PrEP) use and sexual risk behaviour. Findings: Eight participants were diagnosed with HIV, and all but one were through HIVST. Participants in either HIVST condition, standard or eTest, had significantly higher odds of any testing (OR = 7.9, 95% CI = 4.9−12.9 and OR = 6.6, 95% CI = 4.2−10.5) and repeat testing (>1 test; OR = 8.5, 95% CI = 5.7−12.6; OR = 8.9, 95% CI = 6.1−13.4) over 12 months relative to the control group. Rates of STI testing and PrEP uptake did not differ across study condition, but those in the eTest condition reported 27% fewer sexual risk events across the study period relative to other groups. Conclusions: HIVST vastly increased testing, encouraged more regular testing among MSM, and identified nearly all new cases, suggesting that HIVST could diagnose HIV acquisition earlier. Providing timely follow‐up counselling after HIVST did not increase rates of STI testing or PrEP use, but some evidence suggested that counselling may have reduced sexual risk behaviour. To encourage more optimal testing, programmes should incorporate HIVST and ship kits directly to recipients at regular intervals. [ABSTRACT FROM AUTHOR]

Anxiety disorders are a significant cause of disability globally, yet only one in ten sufferers receives adequate quality treatment. Exposure-based therapies are effective in reducing symptoms associated with a number of anxiety disorders. However, few therapists use exposure techniques to treat these conditions, even when they are adequately trained in them, often because of concerns about provoking distress, drop out, logistical barriers, and other concerns. Virtual reality exposure therapy (VRET) can address many of these concerns, and a large body of research decisively shows that VRET is as efficacious for treating these conditions as in vivo exposures. Yet, use of VRET remains low. In this article, we discuss several factors we believe are contributing to low VRET adoption among therapists and raise potential solutions to address them. We consider steps that VR experience developers and researchers might take, such as leading studies of VRET's real-world effectiveness and treatment optimization trials and continuing to improve the fit of platforms with clinicians' workflows. We also discuss steps to address therapist reservations using aligned implementation strategies, as well as barriers for clinics, and the roles that professional organizations and payers could have in improving care by encouraging adoption of VRET. [ABSTRACT FROM AUTHOR]

Objective: This study examined associations between drinking motivation, alcohol use, and sexual hookups among college students. Participants: Participants (n = 755 Midwest college student drinkers; 61% female) ranged in age from 18 to 24. Methods: Participants completed online measures of alcohol involvement (use and motives) and sexual activity. Results: Alcohol use was positively linked to sexual hookups. Social and enhancement motives were positively and indirectly associated with sexual hookups via alcohol use. Drinking to cope had a direct association with sexual hookups. Social drinking was more strongly associated with hookups in men than in women, but both groups exhibited a positive association. Conclusions: This study is the first to highlight the relationships between distinct drinking motives and sexual risk behavior. The results indicate that specific motives may increase risk of sexual hookups both indirectly via alcohol use, as well as directly, at least among those that drink to cope with negative mood.

A range of research has recognized the benefits of optimism in a variety of health-related outcomes. Pessimism has received less attention but may be a distinct concept that is uniquely related to certain health behaviors, including drug use. The present study examined relationships between optimism and pessimism and alcohol use trajectories of adolescents using latent growth modeling. Results suggest that optimism was negatively associated with alcohol use at age 14, but pessimism was negatively associated with alcohol use at that age for boys. Findings illustrate the importance of perceptions about the future to patterns of alcohol use at younger ages. (Contains 1 figure.)

Rates of HIV and other sexually transmitted infections (STIs) are high among sexual minority men (SMM). A large body of research has explored determinants of HIV/STI risk behavior, but few studies have explored emotional consequences of these events. Understanding the valence, timing, and strength of emotional reactions to sexual risk could inform use of specific behavior change techniques in interventions (such as anticipated regret) and identify new opportunities for intervention, including just-in-time interventions. We analyzed data from an ecological momentary assessment (EMA) study of 100 HIV-negative/unknown-status SMM to understand patterns of positive affect, negative affect, shame, and stress in the 24 hours after sex. Mixed-effects models showed that the probability of negative affect was higher in the hours following condomless anal sex (CAS) with high-risk partners during which SMM reported being under the influence of alcohol or drugs (A/D involved CAS), versus all other types of sex events (OR = 0.92, SE = 0.03, p =.017). The probability of shame was also higher after A/D-involved CAS, versus other sex events (OR = 1.14, SE = 0.07, p =.035). Findings suggest that the hours following A/D-involved CAS events may be an opportune time to intervene to help SMM avoid similarly aversive experiences in the future. [ABSTRACT FROM AUTHOR]

In recent years, the rapid growth of technology has been accompanied by advances in research methodology that can lend unique insights into many critical questions about how processes involved in [...]

Objective: The current study tested the associations between a dual-systems model of self-control and alcohol use and problem severity. Method: The sample consisted of 491 college students (77.0% women) from a rural state university. Participants completed a series of online surveys that assessed aspects of self-control, alcohol consumption, and alcohol-related problems. Results: A confirmatory factor analysis model indicated two moderately correlated factors of poor control and good self-control. Poor control was positively associated with both alcohol use and problem severity. Good self-control had a negative association with problem severity. Good self-control moderated the association between poor control and alcohol use as well as between poor control and problem severity. The association between poor control and alcohol use was stronger at low levels of good self-control, whereas at high levels of good self-control, the effect of poor control was weaker and not significant. The interaction predicting problem severity was different: There was a negative association between good self-control and problem severity at low levels of poor control, and this effect diminished as poor control increased. Conclusions: The results suggest that multidimensional models of self-control may be useful in understanding problematic alcohol use and may be beneficial for prevention and intervention efforts. (J. Stud. Alcohol Drugs, 72, 678-684, 2011), SELF-REGULATION OF BEHAVIOR is central to understanding alcohol use and problems (Hull and Slone, 2004; Wills et al., 2002). Some theorists propose that self-control comprises a single-order factor structure, with [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2009.12.026 Byline: Jeffrey S. Simons (a), Stephen A. Maisto (b), Tyler B. Wray (a) Keywords: Risky sex; Alcohol; Marijuana; Impulsivity; Affect Abstract: Use of alcohol and marijuana among college students is common and use of these substances may increase the likelihood of risky sexual behavior. The present study found significant associations between risky sexual behavior and both mean BAC per drinking day and marijuana use intensity. However, hypothesized interactions between marijuana use and BAC were not supported. In addition, positive and negative urgency and premeditation were each significantly associated with the likelihood of risky sex. Substance use and facets of impulsivity and self-control exhibited direct associations with risky sexual behavior but hypothesized moderation effects were not supported. Associations between urgency and risky sexual behavior varied as a function of gender and trait positive affect. Author Affiliation: (a) Department of Psychology, The University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069, United States (b) Department of Psychology and Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244, USA

Background: HIV pre-exposure prophylaxis (PrEP) has considerable potential for reducing incidence among high-risk groups, such as gay, bisexual, and other men who have sex with men (GBM). However, PrEP's effectiveness is closely linked with consistent use, and a variety of individual-level barriers, including alcohol use, could impede optimal uptake and use. Web-based interventions can encourage medication adherence, HIV prevention behaviors, and responsible drinking and may help support PrEP care, particularly in resource-limited settings. Objective: We previously developed a web application called Game Plan that was designed to encourage heavy drinking GBM to use HIV prevention methods and reduce their alcohol use and was inspired by brief motivational interventions. This paper aims to describe the web-based content we designed for integration into Game Plan to help encourage PrEP uptake and consistent use among GBM. In this paper, we also aim to describe this content and its rationale. Methods: Similar to the original site, these components were developed iteratively, guided by a thorough user-centered design process involving consultation with subject-matter experts, usability interviews and surveys, and user experience surveys. Results: In addition to Game Plan's pre-existing content, the additional PrEP components provide specific, personal, and digestible feedback to users about their level of risk for HIV without PrEP and illustrate how much consistent PrEP use could reduce it; personal feedback about their risk for common sexually transmitted infections to address low-risk perceptions; content challenging common beliefs and misconceptions about PrEP to reduce stigma; content confronting familiar PrEP and alcohol beliefs; and a change planning module that allows users to select specific goals for starting and strategies for consistent PrEP use. Users can opt into a weekly 2-way SMS text messaging program that provides similar feedback over a 12-week period after using Game Plan and follows up on the goals they set. Conclusions: Research preliminarily testing the efficacy of these components in improving PrEP outcomes, including uptake, adherence, sexually transmitted infection rates, and alcohol use, is currently ongoing. If supported, these components could provide a scalable tool that can be used in resource-limited settings in which face-to-face intervention is difficult. [ABSTRACT FROM AUTHOR]