Ramos Stephen D, Stamp Bryce F, Powers Kimberly A, Hightow-Weidman Lisa, Storholm Erik D, Soberano Zachary R, Stocks Jacob B, Rosso Matthew T, Horvath Keith J
Department of Psychology, College of Social and Behavioral Sciences, California State University, San Bernardino, 5500 University Parkway, SBS-527, San Bernardino, USA.
Department of Psychology, College of Sciences, San Diego State University, San Diego, USA.
AIDS Behav. 2025 May 29. doi: 10.1007/s10461-025-04753-4.
The disproportionate HIV burden among young sexual minority men (YSMM) necessitates the study of neurodevelopmental decisional factors impacting transmission-relevant behaviors. We investigated the impact of behavioral regulation on condomless anal sex among YSMM, considering PrEP use, partnership type, and substance use as potential effect measure modifiers. YSMM (n = 120) completed an online baseline survey assessing behavioral regulation, PrEP use, and sociodemographics, and digital daily surveys on sexual behaviors, substance use, and partner type over eight weeks. We used modified Poisson regression, controlling for age, race, ethnicity, and education, to examine the relationship between behavioral regulation index (BRI) scores and condom use during anal sex. We used interaction terms to assess effect measure modification by substance use before or during sex and partnership type, stratified by PrEP use status. Difficulties in behavioral regulation (higher scores) increased the probability of condomless sex while using substances, but this association was not present in the absence of substance use. Behavioral regulation difficulties also contributed to a higher probability of condomless sex with main partners among PrEP non-users. Higher BRI scores were linked to condomless sex in particular contexts (i.e., sex with substances or main partners). These findings highlight the complex relationships between behavioral regulation and sexual behavior in the context of biomedical HIV prevention options and relationship dynamics for YSMM.
年轻性少数男性（YSMM）中不成比例的艾滋病毒负担使得有必要研究影响与传播相关行为的神经发育决策因素。我们调查了行为调节对YSMM中无保护肛交的影响，将使用暴露前预防（PrEP）、性伴侣类型和物质使用作为潜在的效应测量修饰因素。120名YSMM完成了一项在线基线调查，评估行为调节、PrEP使用和社会人口统计学特征，并在八周内对性行为、物质使用和伴侣类型进行数字每日调查。我们使用修正的泊松回归，控制年龄、种族、民族和教育程度，来研究行为调节指数（BRI）得分与肛交时使用避孕套之间的关系。我们使用交互项来评估性行为前或性行为期间物质使用和伴侣类型对效应测量的修饰作用，并按PrEP使用状态进行分层。行为调节困难（得分较高）会增加在使用物质时无保护性行为的可能性，但在不使用物质的情况下不存在这种关联。行为调节困难也导致PrEP未使用者与主要伴侣发生无保护性行为的可能性更高。较高的BRI得分与特定情况下的无保护性行为有关（即与使用物质的人或主要伴侣发生性行为）。这些发现突出了在生物医学艾滋病毒预防选择和YSMM的关系动态背景下，行为调节与性行为之间的复杂关系。
