As the mechanisms of the associations between substance use and risky sex remain unclear, this study investigates the interactive roles of conflicts about casual sex and condom use and expectancies of the sexual effects of substances in those associations among gay men. Conflict interacted with expectancies to predict sexual behavior under the influence; low casual sex conflict coupled with high expectancies predicted the highest number of casual partners, and high condom use conflict and high expectancies predicted the highest number of unprotected sex acts. Results have implications for intervention efforts that aim to improve sexual decision-making and reduce sexual expectancies.
AbbeyAMcAuslanPRossLT. (1999) Alcohol expectancies regarding sex, aggression, and sexual vulnerability: Reliability and validity assessment. Psychology of Addictive Behaviors13(3): 174–182.
2.
AdamPCTevaIde WitJB (2008) Balancing risk and pleasure: Sexual self-control as a moderator of the influence of sexual desires on sexual risk-taking in men who have sex with men. Sexually Transmitted Infections84(6): 463–467.
3.
AlvyLMMcKirnanDJManserghG. (2011) Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS and Behavior15(6): 1171–1179.
4.
BaliunasDRehmJIrvingH. (2010) Alcohol consumption and risk of incident human immunodeficiency virus infection: A meta-analysis. International Journal of Public Health55(3): 159–166.
5.
BimbiDSNaninJEParsonsJT. (2006) Assessing gay and bisexual men’s outcome expectancies for sexual risk under the influence of alcohol and drugs. Substance Use & Misuse41(5): 643–652.
6.
BirdJDVoisinDR (2011) A conceptual model of HIV disclosure in casual sexual encounters among men who have sex with men. Journal of Health Psychology16(2): 365–373.
7.
BrownJLVanablePA (2007) Alcohol use, partner type, and risky sexual behavior among college students: Findings from an event-level study. Addictive Behaviors32(12): 2940–2952.
8.
BrownSAChristiansenBAGoldmanMS (1987) The Alcohol Expectancy Questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol48(5): 483–491.
9.
CaffrayCMSchneiderSL (2000) Why do they do it? Affective motivators in adolescents’ decisions to participate in risk behavior. Cognition & Emotion14(4): 543–576.
10.
CooperML (2002) Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol. Supplement 14: 101–117.
11.
CooperMLOrcuttHK (1997) Drinking and sexual experience on first dates among adolescents. Journal of Abnormal Psychology106: 191–202.
12.
CoxeSWestSGAikenLS (2009) The analysis of count data: A gentle introduction to Poisson regression and its alternatives. Journal of Personality Assessment91(2): 121–136.
13.
DasEde WitJBVetR. (2008) ‘Feeling’ risk and seeing solutions: Predicting vaccination intention against hepatitis B infection among men who have sex with men. Journal of Health Psychology13(6): 728–732.
14.
DermenKHCooperML (1994a) Sex-related alcohol expectancies among adolescents: I. Scale development. Psychology of Addictive Behavior8(3): 152–160.
15.
DermenKHCooperML (1994b) Sex-related alcohol expectancies among adolescents: II. Prediction of drinking in social and sexual situations. Psychology of Addictive Behavior8(3): 161–168.
16.
DermenKHCooperML (2000) Inhibition conflict and alcohol expectancy as moderators of alcohol’s relationship to condom use. Experimental and Clinical Psychopharmacology8(2): 198–206.
17.
DolezalCCarballo-DieguezANieves-RosaL. (2000) Substance use and sexual risk behavior: Understanding their association among four ethnic groups of Latino men who have sex with men. Journal of Substance Abuse11(4): 323–336.
18.
DraycottSDabbsA (1998) Cognitive dissonance 2: A theoretical grounding of motivational interviewing. The British Journal of Clinical Psychology37(3): 355–364.
19.
FestingerL (1957) A Theory of Cognitive Dissonance. Stanford, CA: Stanford University Press.
20.
GeorgeWHNorrisJ (1991) Alcohol, disinhibition, sexual arousal, and deviant sexual behavior. Alcohol Health and Research World15: 133–138.
21.
GeorgeWHStonerSA (2000) Understanding acute alcohol effects on sexual behavior. Annual Review of Sex Research11: 92–124.
22.
GibbieTMMijchAHayM (2012) High levels of psychological distress in MSM are independent of HIV status. Journal of Health Psychology17(5): 653–663.
23.
GrovCBimbiDSNaninJE. (2006a) Exploring racial and ethnic differences in recreational drug use among gay and bisexual men in New York City and Los Angeles. Journal of Drug Education36(2): 105–123.
24.
GrovCBimbiDSParsonsJT. (2006b) Layer upon layer: The coming out process as it relates to generations, race and gender. Journal of Sex Research43: 115–121.
25.
GrovCParsonsJTBimbiDS (2008) In the shadows of a prevention campaign: Sexual risk in the absence of crystal methamphetamine. AIDS Education and Prevention20(1): 42–55.
26.
HalkitisPNKutnickAHSlaterS (2005) The social realities of adherence to protease inhibitor regimens: Substance use, health care and psychological states. Journal of Health Psychology10(4): 545–558.
27.
HalkitisPNSolomonTMMoellerRW. (2009) Methamphetamine use among gay, bisexual and non-identified men-who-have-sex-with-men: An analysis of daily patterns. Journal of Health Psychology14(2): 222–231.
28.
Harmon-JonesE (2000) Cognitive dissonance and experienced negative affect: Evidence that dissonance increases experienced negative affect even in the absence of aversive consequences. Personality & Social Psychology Bulletin26(12): 1490–1501.
29.
HaskingPLyversMCarlopioC (2011) The relationship between coping strategies, alcohol expectancies, drinking motives and drinking behaviour. Addictive Behaviors36(5): 479–487.
30.
HeathJLanoyeAMaistoSA (2012) The role of alcohol and substance use in risky sexual behavior among older men who have sex with men: A review and critique of the current literature. AIDS and Behavior16(3): 578–589.
31.
KoblinBAHusnikMJColfaxG. (2006) Risk factors for HIV infection among men who have sex with men. AIDS20(5): 731–739.
32.
LangARSearlesJLauermanR. (1980) Expectancy, alcohol, and sex guilt as determinants of interest in and reaction to sexual stimuli. Journal of Abnormal Psychology89(5): 644–653.
33.
Lau-BarracoCDunnME (2008) Evaluation of a single-session expectancy challenge intervention to reduce alcohol use among college students. Psychology of Addictive Behaviors22(2): 168–175.
34.
LippkeSZiegelmannJP (2006) Understanding and modeling health behavior: The multi-stage model of health behavior change. Journal of Health Psychology11(1): 37–50.
35.
LoewensteinGLernerJS (2003) The role of affect in decision making. In: DavidsonRJSchererKRGoldsmithHH (eds) Handbook of Affective Sciences. New York: Oxford University Press, pp. 619–642.
36.
McKirnanDJPetersonPL (1990) Cognitive restraint and binging in drugs and unsafe sex. Paper presented at the May American Psychiatric Association Annual Meeting: New York
37.
McKirnanDJOstrowDGHopeB (1996) Sex, drugs and escape: A psychological model of HIV-risk sexual behaviours. AIDS Care8(6): 655–669.
38.
McKirnanDJVanablePAOstrowDG. (2001) Expectancies of sexual “escape” and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse13(1–2): 137–154.
39.
MaistoSAPalfaiTVanablePA. (2012) The effects of alcohol and sexual arousal on determinants of sexual risk in men who have sex with men. Archives of Sexual Behavior41(9): 971–986.
40.
MillerKWWilderLBStillmanFA. (1997) The feasibility of a street-intercept survey method in an African-American community. American Journal of Public Health87: 655–658.
41.
MillerWRRollnickS (2002) Motivational Interviewing: Preparing People for Change. New York: Guilford Press.
42.
MorrisABAlberyIP (2001) Alcohol consumption and HIV risk behaviours: Integrating the theories of alcohol myopia and outcome-expectancies. Addiction Research & Theory9(1): 73–86.
43.
MullensABYoungRMDunneMP. (2011) The Drinking Expectancy Questionnaire for men who have sex with men (DEQ-MSM): A measure of substance-related beliefs. Drug and Alcohol Review30(4): 372–380.
44.
PatrickMEMaggsJL (2009) Does drinking lead to sex? Daily alcohol-sex behaviors and expectancies among college students. Psychology of Addictive Behavior23(3): 472–481.
45.
ShoptawSRebackCJ (2007) Methamphetamine use and infectious disease-related behaviors in men who have sex with men: Implications for interventions. Addiction102(Suppl. 1): 130–135.
46.
SiegelKSchrimshawEW (2000) Coping with negative emotions: The cognitive strategies of HIV-infected gay/bisexual men. Journal of Health Psychology5(4): 517–530.
47.
StallRPurcellDW (2000) Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS and Behavior4(2): 181–192.
48.
SteeleCMJosephsRA (1990) Alcohol myopia: Its prized and dangerous effects. The American Psychologist45(8): 921–933.
49.
SticeERohdePShawH. (2011) An effectiveness trial of a selected dissonance-based eating disorder prevention program for female high school students: Long-term effects. Journal of Consulting and Clinical Psychology79(4): 500–508.
50.
StoneJFernandezNC (2008) To practice what we preach: The use of hypocrisy and cognitive dissonance to motivate behavior change. Social and Personality Psychology Compass2(2): 1024–1051.
51.
StonerSAGeorgeWHPetersLM. (2007) Liquid courage: Alcohol fosters risky sexual decision-making in individuals with sexual fears. AIDS and Behavior11(2): 227–237.
52.
StueveAO’DonnellLDuranR. (2002) Being high and taking sexual risks: Findings from a multisite survey of urban young men who have sex with men. AIDS Education and Prevention14(6): 482–495.
53.
SullivanPSSalazarLBuchbinderS. (2009) Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS23(9): 1153–1162.
54.
TryonWWMisurellJR (2008) Dissonance induction and reduction: A possible principle and connectionist mechanism for why therapies are effective. Clinical Psychology Review28(8): 1297–1309.
55.
VanablePAMcKirnanDJBuchbinderSP. (2004) Alcohol use and high-risk sexual behavior among men who have sex with men: The effects of consumption level and partner type. Health Psychology23(5): 525–532.
56.
WellsBEGolubSAParsonsJT (2011) An integrated theoretical approach to substance use and risky sexual behavior among men who have sex with men. AIDS and Behavior15(3): 509–520.
57.
WhiteHRFlemingCBCatalanoRF. (2009) Prospective associations among alcohol use-related sexual enhancement expectancies, sex after alcohol use, and casual sex. Psychology of Addictive Behaviors23(4): 702–707.
58.
WiersRWKummelingRH (2004) An experimental test of an alcohol expectancy challenge in mixed gender groups of young heavy drinkers. Addictive Behaviors29(1): 215–220.
59.
WilsonGTLawsonDM (1976) Expectancies, alcohol, and sexual arousal in male social drinkers. Journal of Abnormal Psychology85(6): 587–594.
60.
YiHShidloASandfortT (2011) Assessing maladaptive responses to the stress of being at risk of HIV infection among HIV-negative gay men in New York City. Journal of Sex Research48(1): 62–73.
