Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA.
Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA.
Arch Sex Behav. 2019 Jan;48(1):383-395. doi: 10.1007/s10508-018-1258-8. Epub 2018 Aug 20.
Numerous factors have been shown to increase sexual risk-taking-especially among gay and bisexual men (GBM), who remain disproportionately affected by HIV and STIs. We present three lines of evidence that highlight the need to consider a previously under-explored situational factor in sexual risk-taking: tiredness. While tiredness has been shown, in sleep science literature, to impair cognition, emotional functioning, and decision-making in a wide range of behaviors, it has yet to be considered in-depth as a risk factor in sexual behavior. Counter to the common-sense assumption that being tired should impede the performance of active, effortful behaviors such as sex, we propose that tiredness may actually increase sexual risk-taking. Analyzing data from an online survey of 1113 HIV-negative GBM, we found that sex with casual partners most commonly occurred at night, especially among younger GBM and those with an evening chronotype, and that sex without condoms more often occurred at or later than one's usual time of feeling tired (as was reported by 44.2% of men) than did sex with condoms (reported by 36.6%). We also found that tiredness can increase sexual desire in many GBM (endorsed by 29.9%), and increases the likelihood of engaging in receptive positioning in anal sex (endorsed by almost 40% of men with a versatile sexual positioning identity). These findings highlight the importance of considering tiredness as a situational risk factor in sexual health-especially among younger GBM-and of counting sex among the behaviors that can be adversely impacted by poor or overdue sleep.
许多因素已被证明会增加性行为风险——尤其是在男同性恋和双性恋者（GBM）中，他们仍然不成比例地受到 HIV 和性传播感染的影响。我们提出了三条证据线，强调需要考虑性行为风险中一个以前未充分探索的情境因素：疲劳。虽然在睡眠科学文献中已经表明，疲劳会损害认知、情绪功能和广泛行为中的决策能力，但它尚未被深入考虑为性行为的风险因素。与疲劳应该妨碍性行为等主动、费力行为的常识假设相反，我们提出疲劳实际上可能会增加性行为风险。通过分析对 1113 名 HIV 阴性 GBM 的在线调查数据，我们发现与随意伴侣的性行为最常发生在晚上，尤其是在年轻的 GBM 和那些夜间型的人中，而且无保护措施的性行为更常发生在他们感到疲劳的时间或之后（44.2%的男性报告），而不是有保护措施的性行为（36.6%的男性报告）。我们还发现，疲劳会增加许多 GBM 的性欲望（29.9%的男性表示认同），并增加在肛交中接受性体位的可能性（近 40%的具有多种性体位身份的男性表示认同）。这些发现强调了将疲劳视为性行为健康中的情境风险因素的重要性——尤其是在年轻的 GBM 中——并将性行为视为可能受到睡眠不佳或睡眠不足影响的行为之一。
