The numbers of men who have sex with men who are HIV-positive in the United States continues to rise, particularly in large urban centers such as New York City. As such, unique approaches to assessing psychosocial and sexual health and well-being of HIV-positive gay and bisexual men are crucial to developing interventions tailored to reducing sexual risk and substance use in this population. Disclosure of HIV status remains difficult for HIV-positive people due to stigma, and this difficulty is especially apparent within sexual situations. Both status disclosure and substance use have been investigated in prior research as variables that increase sexual risk (i.e. sex without condoms) among HIV-positive gay and bisexual men. During sexual encounters with non-main (i.e. new or casual) sexual partners, cognitive conflicts that result from fear of interpersonal rejection and intrapersonal shame are likely to influence the synergistic relationship between disclosure, substance use, and condom use. Building on the social psychological theory of cognitive dissonance, this investigation is based on a hypothesis that dissonance (i.e. conflict) is a negative state of arousal that motivates people to engage in behaviors to reduce that negative arousal. We hypothesize that interpersonal conflict (i.e., fear of being rejected for disclosing HIV-positive status and for using condoms) and intrapersonal conflict (i.e., higher levels of sexual shame) will interact to increase substance use and decrease both condom use and disclosure within sexual encounters. The primary goal of this study is to provide useful measurements of these constructs and examine these hypotheses to inform public health interventions aimed at reducing sexual risk and substance use. As such, the project focuses on two aims: (1) to establish reliability, validity, factor structure, and psychometric properties of three measures of intrapersonal and interpersonal conflict;and (2) to elaborate and test the relationship of interpersonal and intrapersonal conflict with HIV status disclosure, sexual risk, and substance use during sex with casual partners. The proposed project will be embedded into a larger study (R01MH87714, Parsons PI;referred to herein as the parent project), which is a longitudinal study that follows highly sexually active gay and bisexual men utilizing multiple methods to investigate their sexual risk behavior. The proposed project will add two internet-based assessments to the parent project that include both new and existing measures. We will combine these new measures with existing data to examine the psychometrics of the newly created measures and test the significance of the proposed hypotheses. The research and training plans proposed for this project are also designed to foster my development as a research scientist with a strong foundation in sexual risk, substance use, and research with HIV-positive gay and bisexual men.

Public Health Relevance

This project was designed to investigate the synergistic relationship between substance use, status disclosure, and condom use as they influence HIV transmission risk among HIV-positive gay and bisexual men. Utilizing a framework based in the validated theory of cognitive dissonance, this study will enhance our understanding of how interpersonal and intrapersonal conflicts may interact to increase or inhibit transmission risk behaviors. A better understanding of the role of cognitive conflicts in influencing risk behavior will be essential to the development of future HIV prevention efforts with HIV-positive gay and bisexual men.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Predoctoral Individual National Research Service Award (F31)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-AARR-C (22))
Program Officer
Stoff, David M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
CUNY Graduate School and University Center
Other Domestic Higher Education
New York
United States
Zip Code
Kelly, Brian C; Rendina, H Jonathon; Vuolo, Mike et al. (2015) Influences of motivational contexts on prescription drug misuse and related drug problems. J Subst Abuse Treat 48:49-55
Parsons, Jeffrey T; Rendina, H Jonathon; Grov, Christian et al. (2015) Accuracy of highly sexually active gay and bisexual men's predictions of their daily likelihood of anal sex and its relevance for intermittent event-driven HIV pre-exposure prophylaxis. J Acquir Immune Defic Syndr 68:449-55
Rendina, H Jonathon (2015) When parsimony is not enough: considering dual processes and dual levels of influence in sexual decision making. Arch Sex Behav 44:1937-47
Kelly, Brian C; Rendina, H Jonathon; Vuolo, Mike et al. (2015) A typology of prescription drug misuse: a latent class approach to differences and harms. Drug Alcohol Rev 34:211-20
Wells, Brooke E; Kelly, Brian C; Rendina, H Jonathon et al. (2015) Prescription Drug Misuse and Sexual Behavior Among Young Adults. J Sex Res 52:659-68
Ventuneac, Ana; Rendina, H Jonathon; Grov, Christian et al. (2015) An item response theory analysis of the sexual compulsivity scale and its correspondence with the hypersexual disorder screening inventory among a sample of highly sexually active gay and bisexual men. J Sex Med 12:481-93
Parsons, Jeffrey T; Rendina, H Jonathon; Moody, Raymond L et al. (2015) Syndemic production and sexual compulsivity/hypersexuality in highly sexually active gay and bisexual men: further evidence for a three group conceptualization. Arch Sex Behav 44:1903-13
Pachankis, John E; Rendina, H Jonathon; Restar, Arjee et al. (2015) A minority stress--emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men. Health Psychol 34:829-40
Golub, Sarit A; Gamarel, Kristi E; Rendina, H Jonathon (2014) Loss and growth: identity processes with distinct and complementary impacts on well-being among those living with chronic illness. Psychol Health Med 19:572-9
Grov, Christian; Rendina, H Jonathon; Breslow, Aaron S et al. (2014) Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA. Sex Transm Infect 90:26-32

Showing the most recent 10 out of 24 publications