George William H, Blayney Jessica A, Stappenbeck Cynthia A, Davis Kelly Cue
Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195-1525, USA.
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
AIDS Behav. 2021 Dec;25(Suppl 3):347-364. doi: 10.1007/s10461-021-03351-4. Epub 2021 Jul 9.
HIV/AIDS remains a significant health threat and alcohol is a robust contributing factor. After 25 years of alcohol challenge studies investigating alcohol-related behavioral risk (ARBR), much has been learned delineating how drinking influences sexual transmission. We examine this research and consider its relevance for interventions in the era of antiretrovirals. We consider prototypic alcohol challenge methods, illustrative findings, and prevention/intervention implications, noting three perspectives: (a) scale up/extend existing interventions, including identifying under-targeted risk groups and intersecting with PrEP/PEP interventions; (b) modify existing interventions by cultivating psychoeducational content related to alcohol expectancies, alcohol myopia, sexual arousal, risk perception, sexual abdication, and condom use resistance; and (c) innovate new interventions through Science of Behavior Change approaches and repurposing ARBR paradigms. Finally, we suggest research directions concluding that until HIV incidence diminishes significantly, psychosocial interventions addressing the nexus of alcohol use, sexual transmission, and adherence to biomedical protocols will be an important priority.
艾滋病毒/艾滋病仍然是一个重大的健康威胁，而酒精是一个重要的促成因素。在对与酒精相关的行为风险（ARBR）进行了25年的酒精激发研究之后，人们对饮酒如何影响性传播有了很多了解。我们审视这项研究，并考虑其在抗逆转录病毒时代对干预措施的相关性。我们考虑了典型的酒精激发方法、说明性研究结果以及预防/干预意义，注意到三个观点：（a）扩大/扩展现有干预措施，包括识别未得到充分关注的风险群体并与暴露前预防（PrEP）/暴露后预防（PEP）干预措施相结合；（b）通过培养与酒精预期、酒精近视、性唤起、风险认知、性放弃和避孕套使用抵抗相关的心理教育内容来修改现有干预措施；（c）通过行为改变科学方法和重新利用ARBR范式来创新新的干预措施。最后，我们提出研究方向，得出结论：在艾滋病毒发病率显著下降之前，针对酒精使用、性传播和对生物医学方案的依从性之间联系的心理社会干预措施将是一个重要的优先事项。
