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Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men

Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men
Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men
McKirnan’s Cognitive Escape Theory (1996) is often characterized by the hypothesis that drugs are used during sex by gay, bisexual, and other men who have sex with men (gbMSM) to relieve internal cognitive conflict over safe-sex norms and sexual desire. We examined how McKirnan’s Cognitive Escape Scale (CES) is related to other widely used constructs relevant to sexualized substance use with hopes of better situating the theory within the evolving landscape of HIV-prevention. Associations between CES and trait anxiety, depression, treatment optimism, sexual altruism, sexual sensation seeking, and self-perceived risk for HIV transmission/acquisition were tested. Mediation analyses tested whether associated psychological measures mediated the effect of CES on the proportion of events in which participants reported co-occurrent substance use and condomless anal sex. Results indicated that CES is associated with higher sexual sensation seeking, treatment optimism, trait anxiety, and perceived likelihood of HIV transmission/ acquisition. Mediation analyses suggest that CES is related to but operates independently of treatment optimism, sensation seeking, and trait anxiety. Nevertheless, the intersection of HIV- related worries and substance use expectancies are clearly more nuanced than is widely reported is discussions on cognitive escape
Chemsex, Cognitive escape, Condom use, Gay and bisexual men, Substance use
0954-0121
1489-1497
Card, Kiffer G.
4bece098-5a9b-46cf-a64e-615f14acce73
Armstrong, Heather
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Wang, Lu
22f5289e-46aa-418f-bdf7-95b76c40d4ee
Bacani, Nicanor
87b35d3e-a58f-4cb5-bcc9-05afc090b95e
Moore, David M.
b3bb7f8f-4409-412e-959b-bcda959a8d2d
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6
Card, Kiffer G.
4bece098-5a9b-46cf-a64e-615f14acce73
Armstrong, Heather
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Wang, Lu
22f5289e-46aa-418f-bdf7-95b76c40d4ee
Bacani, Nicanor
87b35d3e-a58f-4cb5-bcc9-05afc090b95e
Moore, David M.
b3bb7f8f-4409-412e-959b-bcda959a8d2d
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6

Card, Kiffer G., Armstrong, Heather, Wang, Lu, Bacani, Nicanor, Moore, David M., Roth, Eric A., Hogg, Robert S. and Lachowsky, Nathan J. (2019) Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men. AIDS Care, 32 (12), 1489-1497. (doi:10.1080/09540121.2019.1705961).

Record type: Article

Abstract

McKirnan’s Cognitive Escape Theory (1996) is often characterized by the hypothesis that drugs are used during sex by gay, bisexual, and other men who have sex with men (gbMSM) to relieve internal cognitive conflict over safe-sex norms and sexual desire. We examined how McKirnan’s Cognitive Escape Scale (CES) is related to other widely used constructs relevant to sexualized substance use with hopes of better situating the theory within the evolving landscape of HIV-prevention. Associations between CES and trait anxiety, depression, treatment optimism, sexual altruism, sexual sensation seeking, and self-perceived risk for HIV transmission/acquisition were tested. Mediation analyses tested whether associated psychological measures mediated the effect of CES on the proportion of events in which participants reported co-occurrent substance use and condomless anal sex. Results indicated that CES is associated with higher sexual sensation seeking, treatment optimism, trait anxiety, and perceived likelihood of HIV transmission/ acquisition. Mediation analyses suggest that CES is related to but operates independently of treatment optimism, sensation seeking, and trait anxiety. Nevertheless, the intersection of HIV- related worries and substance use expectancies are clearly more nuanced than is widely reported is discussions on cognitive escape

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Accepted/In Press date: 21 November 2019
Published date: 18 December 2019
Additional Information: Funding Information: Momentum is funded through the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes for Health Research (MOP-107544, FDN-143342, PJT-153139). KGC is supported by a Student Research Development Award from the International Academy of Sex Research, a Canadian HIV Trials Network / Canadian Foundation for AIDS Research Postdoctoral Fellowship award, a Michael Smith Foundation for Health Research Trainee award, and a Canadian Institutes of Health Research Health Systems Impact Fellowship award. NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DMM and NJL are supported by Scholar Awards from the Michael Smith Foundation for Health Research (#5209, #16863). HLA is supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (Grant # MFE-152443). KGC is supported by a Canadian HIV Trials Network / Canadian Foundation for AIDS Research Postdoctoral Fellowship award, a Michael Smith Foundation for Health Research Trainee award, a Canadian Institutes of Health Research Health Systems Impact Fellowship award, and a International Academy for Sex Research Student Research Development Award. The authors would like to thank the Momentum Health Study participants, office staff and community advisory board, as well as our community partner agencies, Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC. Publisher Copyright: © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Keywords: Chemsex, Cognitive escape, Condom use, Gay and bisexual men, Substance use
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Identifiers

Local EPrints ID: 437554
URI: http://eprints.soton.ac.uk/id/eprint/437554
DOI: doi:10.1080/09540121.2019.1705961
ISSN: 0954-0121
PURE UUID: 105e0fdb-d2b5-4b08-a621-b92835740212
ORCID for Heather Armstrong: ORCID iD orcid.org/0000-0002-1071-8644

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Date deposited: 05 Feb 2020 17:31
Last modified: 31 Aug 2022 04:01

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Contributors

Author: Kiffer G. Card
Author: Heather Armstrong ORCID iD
Author: Lu Wang
Author: Nicanor Bacani
Author: David M. Moore
Author: Eric A. Roth
Author: Robert S. Hogg
Author: Nathan J. Lachowsky

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