The primary aim of this proposal is to develop and test the efficacy of a cognitive behavioral treatment (CBT) for the co-occurrence of alcohol use disorders (AUD) and sexual-risk taking behaviors among men-who-have-sex-with men (MSM). This proposal will build on empirical research demonstrating the effectiveness of current CBT for AUD and HIV prevention, and recommended strategies to improve CBT by providing more individualized and broad focused interventions. Cognitive Behavioral Risk Reduction Treatment (CBRRT) will address motivational factors, teach skills to cope with proximal risk antecedents, and teach skills to cope with underlying problems that serve to maintain AUD and sexual-risk taking behaviors. Three types of underlying problems will be addressed: sensation seeking, gay identity issues, and psychological distress. A secondary aim of this proposal is to examine moderators and mediators of CBRRT. Specifically, the proposal will test whether MSM with higher levels of underlying problems or higher levels of baseline risky behaviors will differentially benefit from CBRRT. In addition, the proposal will test whether changes in CBT mediators (e.g., self-efficacy) or underlying problems mediate the effects of CBRRT on outcomes. In order to accomplish these aims, a randomized clinical trial will be conducted. Two hundred and forty seronegative MSM seeking treatment for AUD and sexual risk-taking behaviors will be recruited into the study and assessed. Subjects will be randomly assigned to two intervention conditions: CBRRT or a control treatment consisting of alcohol skills treatment. Each treatment will consist of 12 weekly individual psychotherapy sessions. Observation and ratings of treatment sessions (via videotape) and weekly supervision will be used to monitor and document treatment delivery. Subjects will be assessed at baseline, end of treatment, and at three, six and 12 months following treatment. Biological and collateral verification of self-reported alcohol and drug use will be conducted. The primary outcomes measured will be: the number of unprotected anal intercourse acts with a partner of positive or unknown HIV status and the number of drinks per possible drinking day.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA011745-05
Application #
6509277
Study Section
Special Emphasis Panel (ZAA1-AA (05))
Program Officer
Freeman, Robert
Project Start
1998-09-28
Project End
2004-12-31
Budget Start
2002-07-01
Budget End
2004-12-31
Support Year
5
Fiscal Year
2002
Total Cost
$351,253
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Psychiatry
Type
Schools of Medicine
DUNS #
114400633
City
New York
State
NY
Country
United States
Zip Code
10029
Kuerbis, Alexis; Mereish, Ethan H; Hayes, Marie et al. (2017) Testing Cross-Sectional and Prospective Mediators of Internalized Heterosexism on Heavy Drinking, Alcohol Problems, and Psychological Distress Among Heavy Drinking Men Who Have Sex With Men. J Stud Alcohol Drugs 78:113-123
Heidinger, Bram; Gorgens, Kim; Morgenstern, Jon (2015) The effects of sexual sensation seeking and alcohol use on risky sexual behavior among men who have sex with men. AIDS Behav 19:431-9
Kuerbis, Alexis; Morgenstern, Jon; Hail, Lisa (2012) Predictors of moderated drinking in a primarily alcohol-dependent sample of men who have sex with men. Psychol Addict Behav 26:484-95
Morgenstern, Jon; Irwin, Thomas W; Wainberg, Milton L et al. (2007) A randomized controlled trial of goal choice interventions for alcohol use disorders among men who have sex with men. J Consult Clin Psychol 75:72-84
Irwin, Thomas W; Morgenstern, Jon; Parsons, Jeffrey T et al. (2006) Alcohol and sexual HIV risk behavior among problem drinking men who have sex with men: An event level analysis of timeline followback data. AIDS Behav 10:299-307