Cognitive-emotional mechanisms of alcohol intoxication-involved HIV-risk behavior among men who have sex with men (MSM).

Alcohol use is a key risk factor for HIV infection among men who have sex with men (MSM), primarily because it interferes with condom use. However, little is known about the cognitive-emotional mechanisms through which alcohol influences decisions to use condoms with high-risk partners among MSM. In this study, we tested whether alcohol-related deficits in inhibitory control and attention bias toward sexual cues (vs. condoms and neutral cues) accounted for increases in condomless anal sex (CAS) intentions after drinking among MSM. Heavy-drinking, high-risk MSM (N = 83) were randomly assigned to receive (a) alcohol, (b) placebo, or (c) control beverages before behavioral tasks assessing inhibitory control and attention bias, and a video-based sexual risk scenario that assessed several aspects of sexual decision making. Results showed that inhibitory control and attention bias to sexual cues did not mediate associations between intoxication and CAS intentions. Inhibitory control deficits also did not moderate the indirect effects of intoxication on CAS intentions through attention bias. Three-way interactions between alcohol/placebo condition, inhibitory control, and attention bias were also not significant. Together, these findings provide little evidence that these two processes play a significant role in alcohol-involved HIV risk, at least as assessed by the specific tasks used in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).