# A Mixed-Methods Examination of HIV Risk in Men Who Have Sex With Men: Effects of Alcohol and Sexual Compulsivity

> **NIH NIH F31** · UNIVERSITY OF WASHINGTON · 2021 · $46,036

## Abstract

PROJECT SUMMARY
HIV is a significant public health concern in the United States, particularly among men who have sex with men
(MSM). In the past decade, MSM have accounted for approximately 70% of new HIV diagnoses, resulting in
billions of dollars in lifetime healthcare costs. Alcohol significantly contributes to HIV risk behavior among
MSM. There is a robust association between acute alcohol intoxication and condomless anal sex (CAS), as
well as failure to utilize and adhere to preventative treatments including Pre-Exposure Prophylaxis (PrEP),
Post-Exposure Prophylaxis (PEP), and adherence to antiretroviral therapy (ART). However, event-level
research provides more mixed results, indicating a variety of moderating factors. One potential moderating
factor that has not yet been investigated is sexual compulsivity (SC), which is the inability to control frequent
and intense sexual urges or impulses. SC is associated with HIV risk, alcohol use, and increased likelihood of
alcohol use before sex, suggesting those high in SC may be more susceptible to alcohol’s effects on sexual
risk. The inhibition conflict model (ICM) of alcohol myopia suggests that alcohol has the greatest impact on
sexual risk behavior in situations where a person is conflicted due to simultaneously experiencing high sexual
instigation and high sexual inhibition. Individuals high in SC have demonstrated elevated levels of both sexual
instigation and inhibition factors, potentially making them particularly vulnerable to alcohol-induced sexual risk.
The proposed research aims to investigate of the effects of alcohol use and SC, both individually and
synergistically, on HIV risk behavior in three steps. First, the proposed project would examine the potential
moderating role or SC on the relationship between alcohol use and CAS through secondary analysis of a 90-
day timeline follow-back dataset. Next, a cross-sectional survey of MSM at elevated HIV risk will evaluate the
effects of SC and alcohol use on other methods of HIV risk mitigation, including PrEP, PEP and ART use,
update, and adherence. Finally, a qualitative interview study will provide rich idiographic data on the lived
experience of those with elevated SC, alcohol use, and sexual risk behavior, as well as the interactive effects
of SC and alcohol on HIV risk. This proposal is commensurate with the candidate’s desire to develop a
research program in sexual minority health focused on HIV risk, alcohol use, and problematic sexual behavior
and supports his training goals of becoming proficient in both quantitative and qualitative methods. Through the
proposed research and training plan, the applicant will develop the skills and expertise necessary to make a
substantive contribution to the field of alcohol and HIV risk behavior as an independent clinical scientist.

## Key facts

- **NIH application ID:** 10401721
- **Project number:** 1F31AA029651-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Neil Gleason
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $46,036
- **Award type:** 1
- **Project period:** 2021-09-16 → 2025-03-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10401721

## Citation

> US National Institutes of Health, RePORTER application 10401721, A Mixed-Methods Examination of HIV Risk in Men Who Have Sex With Men: Effects of Alcohol and Sexual Compulsivity (1F31AA029651-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10401721. Licensed CC0.

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