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与男男性行为者的性冒险行为相关的认知和情绪因素。

Cognitive and Emotional Factors Associated with Sexual Risk-Taking Behaviors Among Young Men Who Have Sex with Men.

机构信息

Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.

Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.

出版信息

Arch Sex Behav. 2019 May;48(4):1127-1136. doi: 10.1007/s10508-018-1310-8. Epub 2019 Jan 3.

Abstract

Young men who have sex with men (YMSM) between the ages of 13 and 24 account for a disproportionate number of new HIV infections in the U.S. Recognizing the unique developmental circumstances that YMSM face and building on the dual-process model, it is important to consider the role of cognitive and emotional factors as well as self-efficacy to negotiate safer sex when understanding experiences of sexual risk-taking among YMSM. This article used structural equation modeling to examine how the decisional balance to use condoms (a cognitive factor) and limerence (an emotional factor) are both directly and indirectly associated with sexual risk-taking behaviors (the number of insertive and receptive condomless anal intercourse partners), with indirect effects occurring via limited self-efficacy to negotiate safer sex. Data were from a cross-sectional online survey of YMSM (aged 18-24) in the U.S. who did not report being in a romantic relationship. Analysis included a sample of 1084 single YMSM who had never tested positive for HIV and who had engaged in anal intercourse in the previous 2 months. Results indicated that the decisional balance to use condoms was both directly and indirectly associated with reduced sexual risk-taking behaviors. Limerence was not directly associated with sexual risk-taking behaviors; however, it was indirectly associated with sexual risk-taking behavior through limited self-efficacy to negotiate safer sex. These findings highlight the importance of considering both cognitive and emotional factors, as well as self-efficacy to use condoms, in the development and implementation of HIV prevention interventions for YMSM.

摘要

年龄在 13 至 24 岁之间的男男性行为者(MSM)占美国新感染艾滋病毒人数的很大比例。认识到 MSM 面临的独特发展情况,并基于双重过程模型,考虑认知和情感因素以及协商安全性行为的自我效能对于理解 MSM 的性风险行为体验非常重要。本文使用结构方程模型来检验避孕套使用决策平衡(认知因素)和爱慕(情感因素)如何直接和间接与性风险行为(插入和接受无保护肛交的性伴侣数量)相关,间接影响通过协商安全性行为的自我效能有限发生。数据来自美国一项横断面在线调查,对象为年龄在 18 至 24 岁之间、未报告处于恋爱关系中的 MSM。分析包括了从未检测出 HIV 阳性且在过去 2 个月内进行过肛交的 1084 名单身 MSM。结果表明,使用避孕套的决策平衡与降低性风险行为直接相关。爱慕与性风险行为没有直接关联;但是,它通过协商安全性行为的自我效能有限与性风险行为间接相关。这些发现强调了在为 MSM 制定和实施 HIV 预防干预措施时,考虑认知和情感因素以及使用避孕套的自我效能的重要性。

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