Department of Prevention and Community Health, George Washington University, Washington, DC.
Department of Psychology, University of Utah, Salt Lake City, UT.
Ann Behav Med. 2018 Apr 19;52(5):406-411. doi: 10.1093/abm/kax020.
Executive functioning (EF) describes a set of neurocognitive processes critical to enacting complex health behaviors. However, theoretical frameworks for understanding sexual risk behavior have generally neglected neurocognitive constructs, and beyond a few studies of individuals selected for high substance use, the literature contains virtually no research on this topic with other adults at risk for HIV infection, such as men who have sex with men (MSM).
This study tested whether EF was associated with condomless anal intercourse (CAI) among MSM.
Seventy MSM completed cognitive tests assessing EF at two time points-baseline, and approximately 30 min later after engaging in a stressful interpersonal task. Men also reported their sexual behaviors over the past 3 months, including the frequency of CAI.
Baseline EF was unrelated to CAI. However, CAI was associated with the degree to which performance improved from baseline to post-stressor administration. Compared with norms for practice effects, men who reported CAI improved less than expected from baseline to post-stressor EF performance, whereas men who reported no CAI exhibited a more normative practice effect.
MSM with histories of greater sexual risk improved less than anticipated from baseline to post-stressor on tests of EF, suggesting that they might be more cognitively depleted by the stressful interpersonal task they engaged in between administrations. It is possible that certain individuals struggle to maintain executive control in stressful interpersonal situations, a finding that could contribute to the difficulty some individuals face executing precautionary behaviors during a sexual encounter.
执行功能（EF）描述了一组对实施复杂健康行为至关重要的神经认知过程。然而，理解性风险行为的理论框架通常忽略了神经认知结构，除了少数针对高物质使用个体的研究外，文献中几乎没有关于其他感染 HIV 风险的成年人（如男男性行为者）的此类主题的研究。
本研究检验了 EF 是否与男男性行为者（MSM）中的无保护肛交（CAI）有关。
70 名 MSM 在两个时间点完成了认知测试，评估了 EF-基线，以及在进行紧张的人际任务后大约 30 分钟后。男性还报告了过去 3 个月的性行为，包括 CAI 的频率。
基线 EF 与 CAI 无关。然而，CAI 与从基线到应激后管理的表现改善程度有关。与实践效应的标准相比，报告 CAI 的男性的 EF 表现从基线到应激后改善的幅度低于预期，而报告没有 CAI 的男性则表现出更正常的实践效应。
有过更多性风险史的 MSM 在 EF 测试中从基线到应激后的改善幅度低于预期，这表明他们可能在两次测试之间进行的紧张人际任务中，认知消耗更大。某些人可能在紧张的人际情境中难以维持执行控制，这一发现可能导致一些人在性接触中难以执行预防行为。
