Regier Paul S, Teitelman Anne M, Jagannathan Kanchana, Monge Zachary A, McCondochie Calumina, Elkind Jaclynn, Childress Anna Rose
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
School of Nursing, University of Pennsylvania, Philadelphia, PA, United States.
Front Behav Neurosci. 2020 Jan 10;13:279. doi: 10.3389/fnbeh.2019.00279. eCollection 2019.
Young adult women in the United States have high rates of sexually transmitted infections, increasing the risk of human immunodeficiency virus (HIV). The underlying neurobiology of behaviors that increase the probability of contracting sexually-transmitted diseases (STIs) and HIV is just beginning to be explored. The current study assessed the link between sexual risk and the brain and behavioral response to sexual cues in emerging adult women. Our hypothesis was that women with more activity in reward/motivational circuitry would report higher sexual risk behaviors and would evidence higher positive affective bias to visual sexual stimuli. Women ( = 52; age = 18-24 years) who had protected sex 100% of the time ( = 17) vs. those who did not ( = 35), in the past 3 months, were compared on their brain response to 500 ms evocative (sex, aversive, food) vs. neutral cues in a blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) fast event-related design. Based on existing literature, an anatomical "cue-reactive" mask was used to constrain the analyses. Self-reported sexual activity and the affective bias scores to sexual cues were examined as correlates with the brain response to cues. In contrast to our initial hypothesis, the higher sexual risk (Unprotected) group had significantly activation in mesolimbic brain regions and lower (less positive) affective bias scores to sexual cues compared to the lower risk (Protected) group. As predicted, the brain response was positively correlated with sexual bias. Follow-up analyses showed an effect of partner "risk" (e.g., more vs. less knowledge of partner's STIs/HIV status). This evidence suggests that women who have protected sex may view sexual-related stimuli more positively, reflected by a neural response in reward/motivational regions and more positive sexual bias scores. In contrast, young women at increased risk for STIs/HIV may feel more negatively about sexual-related stimuli, evidenced by a lower mesolimbic response and a less positive affective bias to sexual cues. These data may help identify young women who are at greatest risk for acquiring STIs and/or HIV, which carries added importance with the availability of new medications that can prevent HIV.
美国年轻成年女性的性传播感染率很高，这增加了感染人类免疫缺陷病毒（HIV）的风险。增加感染性传播疾病（STIs）和HIV可能性的行为背后的神经生物学机制才刚刚开始被探索。当前的研究评估了成年女性中性风险与大脑以及对性暗示的行为反应之间的联系。我们的假设是，奖赏/动机回路活动较多的女性会报告更高的性风险行为，并且对视觉性刺激会表现出更高的积极情感偏向。将在过去3个月中100%采取了安全性行为的女性（n = 17）与未采取安全性行为的女性（n = 35）进行比较，比较她们在血氧水平依赖（BOLD）功能磁共振成像（fMRI）快速事件相关设计中对500毫秒唤起性（性、厌恶、食物）与中性暗示的大脑反应。基于现有文献，使用了一个解剖学上的“线索反应性”掩码来限制分析。自我报告的性活动以及对性暗示的情感偏向分数被作为与大脑对暗示的反应的相关性进行检验。与我们最初的假设相反，与低风险（采取了安全性行为）组相比，高性风险（未采取安全性行为）组在中脑边缘脑区的激活明显减少，并且对性暗示的情感偏向分数更低（更不积极）。正如所预测的，大脑反应与性偏向呈正相关。后续分析显示了伴侣“风险”的影响（例如，对伴侣性传播感染/艾滋病毒状况了解较多与较少）。这一证据表明，采取了安全性行为的女性可能会更积极地看待与性相关的刺激，这通过奖赏/动机区域的神经反应和更积极的性偏向分数得以体现。相比之下，性传播感染/艾滋病毒风险增加的年轻女性可能对与性相关的刺激感觉更消极，这通过中脑边缘反应较低以及对性暗示的积极情感偏向较低得以证明。这些数据可能有助于识别感染性传播感染和/或艾滋病毒风险最高的年轻女性，鉴于有可预防艾滋病毒的新药物，这一点尤为重要。
