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An Integrated Theoretical Approach to Substance Use and Risky Sexual Behavior Among Men Who Have Sex with Men

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Abstract

Research demonstrates a consistent association between substance use and sexual risk, particularly among men who have sex with men (MSM). The present study builds upon two existing theories (Cognitive Escape Theory and Expectancy Theory) to examine the synergistic role of sexual conflict (surrounding unsafe sex) and expectancies in sexual behavior among 135 MSM. Two conflicts were examined: (1) The conflict between motivation to practice safer sex and temptation for unprotected sex; and (2) The conflict between motivation to practice safer sex and perceived benefits of unprotected sex. Factorial ANOVAs (2 × 2; high versus low expectancies and conflict versus no conflict) revealed a significant interaction between conflict and expectancies—individuals who reported high levels of conflict were more sensitive to the effect of expectancies than were those experiencing low levels of sexual conflict. Results demonstrate the synergistic effects of conflict and expectancies and highlight the importance of integrating existing theories to more fully consider the intrapsychic operation and experience of sexual conflicts.

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Acknowledgments

The Young Men’s Health Project was supported by a grant from the National Institute on Drug Abuse (NIDA) (R01-DA020366, Jeffrey T. Parsons, Principal Investigator). Brooke E. Wells was supported, in part, as a postdoctoral fellow in the Behavioral Sciences training in Drug Abuse Research program sponsored by Public Health Solutions and the National Development and Research Institutes, Inc., with funding from the NIDA (T32 DA07233). The authors acknowledge the contributions of the Young Men’s Health Project team—Michael Adams, Virginia Andersen, Anthony Bamonte, Jessica Colon, Erica Friedman, Armando Fuentes, Christian Grov, Chris Hietikko, Catherine Holder, Eda Inan, Juline Koken, Dasha Kouznetsova, Mark Pawson, Jonathan Rendina, Kevin Robin, Anthony Surace, Julia Tomassilli, Jaye Walker, Corina Weinberger, and the CHEST recruitment team. We also gratefully acknowledge members of the CHEST Stat Brunch for their assistance with conceptualization and statistical analyses, and Richard Jenkins for his support of the project.

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Authors and Affiliations

  1. The Center for HIV/AIDS Educational Studies and Training, New York, NY, USA

    Brooke E. Wells, Sarit A. Golub & Jeffrey T. Parsons

  2. Social-Personality Psychology Program, The Graduate Center of the City University of New York, New York, NY, USA

    Sarit A. Golub & Jeffrey T. Parsons

  3. Department of Psychology, Hunter College of the City University of New York, 695 Park Avenue, New York, NY, 10065, USA

    Sarit A. Golub & Jeffrey T. Parsons

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  1. Brooke E. Wells
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  2. Sarit A. Golub
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  3. Jeffrey T. Parsons
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Correspondence to Jeffrey T. Parsons.

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Wells, B.E., Golub, S.A. & Parsons, J.T. An Integrated Theoretical Approach to Substance Use and Risky Sexual Behavior Among Men Who Have Sex with Men. AIDS Behav 15, 509–520 (2011). https://doi.org/10.1007/s10461-010-9767-z

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