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AIDS and Behavior
Published in: AIDS and Behavior 6/2017

01-06-2017 | Original Paper

Feasibility of an Emotion Regulation Intervention to Improve Mental Health and Reduce HIV Transmission Risk Behaviors for HIV-Positive Gay and Bisexual Men with Sexual Compulsivity

Authors: Jeffrey T. Parsons, H. Jonathon Rendina, Raymond L. Moody, Sitaji Gurung, Tyrel J. Starks, John E. Pachankis

Published in: AIDS and Behavior | Issue 6/2017

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Abstract

Gay and bisexual men (GBM) report high rates of sexual compulsivity (SC), yet no empirically based treatments exist. An intervention based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders was pilot tested in a sample of 13 HIV-positive GBM with SC. Participants completed a baseline interview, and were offered up to ten intervention sessions. Of those, 11 completed a 3-month follow-up assessment. Despite problems with session attendance (only 4 men completed all 10 sessions), improvements were observed in all psychological outcomes, including SC, depression, and anxiety. Decreases were observed in drug use and HIV risk. The Unified Protocol may be useful in improving the health of HIV-positive GBM, however challenges with session attendance must be addressed. Future work should consider if fewer sessions produce similar results, whether barriers to attending all sessions could be alleviated, and how the intervention would perform compared to treatments.
Literature
1.
Kafka MP. Hypersexual disorder: a proposed diagnosis for DSM-V. Arch Sex Behav. 2010;39(2):377–400.PubMedCrossRef
2.
Kalichman SC, Rompa D. Sexual sensation seeking and sexual compulsivity scales: validity, and predicting HIV risk behavior. J Personal Assess. 1995;65(3):586–601.CrossRef
3.
Muench F, Parsons JT. Sexual compulsivity and HIV: identification and treatment. Focus. 2004;19(6):1–5.PubMed
4.
Parsons JT, Kelly BC, Bimbi DS, Muench F, Morgenstern J. Accounting for the social triggers of sexual compulsivity. J Addict Dis. 2007;26(3):5–16.PubMedCrossRef
5.
Black DW. Compulsive sexual behavior: a review. J Psychiatr Pract. 1998;4(4):219–29.
6.
Kuzma JM, Black DW. Epidemiology, prevalence, and natural history of compulsive sexual behavior. Psychiatr Clin N Am. 2008;31(4):603–11.CrossRef
7.
Baum MD, Fishman JM. AIDS, sexual compulsivity, and gay men: a group treatment approach. In: Cadwell SA, Burnham Jr RA, editors. Therapists on the front line: psychotherapy with gay men in the age of AIDS. Washington, DC: American Psychiatric Press Inc; 1994. p. 255–74.
8.
Missildine W, Feldstein G, Punzalan JC, Parsons JT. S/he loves me, s/he loves me not: questioning heterosexist assumptions of gender differences for romantic and sexually motivated behaviors. Sex Addict Compulsivity. 2005;12(1):65–74.CrossRef
9.
Parsons JT, Rendina HJ, Ventuneac A, Moody RL, Grov C. Hypersexual, sexually compulsive, or just highly sexually active? Investigating three distinct groups of gay and bisexual men and their profiles of HIV-related sexual risk. AIDS Behav. 2015;20(2):1903–13. doi:10.​1007/​s10461-015-1029-7.
10.
Benotsch EG, Kalichman SC, Kelly JA. Sexual compulsivity and substance use in HIV seropositive men who have sex with men: prevalence and predictors of high-risk behaviors. Addict Behav. 1999;24(6):857–68.PubMedCrossRef
11.
Shuper PA, Joharchi N, Rehm J. Personality as a predictor of unprotected sexual behavior among people living with HIV/AIDS: a systematic review. AIDS Behav. 2014;18(2):398–410.PubMedCrossRef
12.
Kalichman SC, Greenberg J, Abel GG. HIV-seropositive men who engage in high risk sexual behavior: psychological characteristics and implications for prevention. AIDS Care. 1997;9(4):441–540.PubMedCrossRef
13.
O’Leary A, Wolitski RJ, Remien RH, et al. Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men. AIDS. 2005;19:S67–75.PubMedCrossRef
14.
Reece M. Sexual compulsivity and HIV serostatus disclosure among men who have sex with men. Sex Addict Compulsivity. 2003;10:1–11.CrossRef
15.
Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing psychosocial correlates of condomless anal sex in HIV-diagnosed and HIV-nondiagnosed men who have sex with men: a series of meta-analyses of studies from 1993–2013. LGBT Health. 2015;2(3):200–20.PubMedCrossRef
16.
Semple SJ, Zians J, Grant I, Patterson TL. Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men. AIDS Behav. 2006;10(5):587–98.PubMedCrossRef
17.
Rendina HJ, Gamarel KE, Pachankis JE, Ventuneac A, Grov C, Parsons JT. Extending the minority stress model to incorporate HIV-positive gay and bisexual men’s experiences: a longitudinal examination of mental health and sexual risk behavior. Ann Behav Med. 2016. doi:10.​1007/​s12160-016-9822-8.
18.
Rendina HJ, Golub SA, Grov C, Parsons JT. Stigma and sexual compulsivity in a community-based sample of HIV-positive gay and bisexual men. AIDS Behav. 2012;16(3):741–50.PubMedCrossRef
19.
Johnson AS, Hall HI, Hu X, Lansky A, Holtgrave DR, Mermin J. Trends in diagnoses of HIV infection in the United States, 2002–2011. JAMA. 2014;312(4):432–4.PubMedCrossRef
20.
Cochran SD, Sullivan JG, Mays VM. Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. J Consult Clin Psychol. 2003;71(1):53–61.PubMedPubMedCentralCrossRef
21.
Lee JH, Gamarel KE, Kahler CW, et al. Co-occurring psychiatric and drug use disorders among sexual minority men with lifetime alcohol use disorders. Drug Alcohol Depend. 2015;151:167–72.PubMedPubMedCentralCrossRef
22.
Dyer TP, Shoptaw S, Guadamuz TE, et al. Application of syndemic theory to black men who have sex with men in the Multicenter AIDS Cohort Study. J Urban Health. 2012;89(4):697–708.PubMedPubMedCentralCrossRef
23.
Mustanski B, Garofalo R, Herrick A, Donenberg G. Psychosocial health problems increase risk for HIV among urban young men who have sex with men: preliminary evidence of a syndemic in need of attention. Ann Behav Med. 2007;34(1):37–45.PubMedPubMedCentralCrossRef
24.
Stall R, Mills TC, Williamson J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.PubMedPubMedCentralCrossRef
25.
Parsons JT, Grov C, Golub SA. Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: further evidence of a syndemic. Am J Public Health. 2012;102(1):156–62.PubMedPubMedCentralCrossRef
26.
Parsons JT, Rendina HJ, Moody RL, Ventuneac A, Grov C. Syndemic production and sexual compulsivity/hypersexuality in highly sexually active gay and bisexual men: further evidence for a three group conceptualization. Arch Sex Behav. 2015;44(7):1903–13.PubMedPubMedCentralCrossRef
27.
28.
Singer MC. AIDS and the health crisis of the US urban poor: the perspective of critical medical anthropology. Soc Sci Med. 1994;39(7):931–48.PubMedCrossRef
29.
Singer MC, Erickson PI, Badiane L, et al. Syndemics, sex and the city: understanding sexually transmitted diseases in social and cultural context. Soc Sci Med. 2006;63(8):2010–21.PubMedCrossRef
30.
Carrico AW, Pollack LM, Stall RD, et al. Psychological processes and stimulant use among men who have sex with men. Drug Alcohol Depend. 2012;123(1):79–83.PubMedCrossRef
31.
Herrick AL, Lim SH, Plankey MW, et al. Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach. Am J Public Health. 2013;103(1):79–85.PubMedPubMedCentralCrossRef
32.
Raymond NC, Coleman E, Miner MH. Psychiatric comorbidity and compulsive/impulsive traits in compulsive sexual behavior. Compr Psychiatry. 2003;44:370–80.PubMedCrossRef
33.
Black DW, Kehrberg LLD, Flumerfelt DL, Schlosser SS. Characteristics of 36 subjects reporting compulsive sexual behavior. Am J Psychiatry. 1997;154(2):243–9.PubMedCrossRef
34.
Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674.PubMedPubMedCentralCrossRef
35.
36.
Hatzenbuehler ML, O’Cleirigh C, Mayer KH, Mimiaga MJ, Safren SA. Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men. Ann Behav Med. 2011;42(2):227–34.PubMedPubMedCentralCrossRef
37.
Pachankis JE, Rendina HJ, Restar A, Ventuneac A, Grov C, Parsons JT. A minority stress—emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men. Health Psychol. 2015;34(8):829–40.PubMedCrossRef
38.
Pachankis JE, Rendina HJ, Ventuneac A, Grov C, Parsons JT. The role of maladaptive cognitions in hypersexuality among highly sexually active gay and bisexual men. Arch Sex Behav. 2014;43(4):669–83.PubMedPubMedCentralCrossRef
39.
Cooper M, Lebo RA. Assessment and treatment of sexual compulsivity: a multi-modal perspective. J Soc Work Pract Addict. 2001;1(2):61–74.CrossRef
40.
Krueger RB, Kaplan MS. The paraphilic and hypersexual disorders: an overview. J Psychiatr Pract. 2001;7(6):391–403.PubMedCrossRef
41.
Kaplan MS, Krueger RB. Diagnosis, assessment, and treatment of hypersexuality. J Sex Res. 2010;47(2–3):181–98.PubMedCrossRef
42.
McConaghy N, Armstrong MS, Blaszczynski A. Expectancy, covert sensitization and imaginal desensitization in compulsive sexuality. Acta Psychiatr Scand. 1985;72(2):176–87.PubMedCrossRef
43.
Sbraga TP, O’Donohue WT. The sex addiction workbook: proven strategies to help you regain control of your life. Oakland: New Harbinger Publications; 2004.
44.
Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behav Ther. 2004;35(2):205–30.CrossRef
45.
Goldfried MR. Toward the delineation of therapeutic change principles. Am Psychol. 1980;35(11):991–9.PubMedCrossRef
46.
Ellard KK, Fairholme CP, Boisseau CL, Farchione TJ, Barlow DH. Unified protocol for the transdiagnostic treatment of emotional disorders: protocol development and initial outcome data. Cogn Behav Pract. 2010;17(1):88–101.CrossRef
47.
Pachankis JE, Hatzenbuehler ML, Rendina HJ, Safren SA, Parsons JT. LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: a randomized controlled trial of a transdiagnostic minority stress approach. J Consult Clin Psychol. 2015;83(5):875–89. doi:10.​1037/​ccp0000037.
48.
Grov C, Parsons JT, Bimbi DS. Sexual compulsivity and sexual risk in gay and bisexual men. Arch Sex Behav. 2010;39(4):940–9.PubMedCrossRef
49.
Forney JC, Miller RL, The City Project Study T. Risk and protective factors related to HIV-risk behavior: a comparison between HIV-positive and HIV-negative young men who have sex with men. AIDS Care. 2012;24(5):544–52.PubMedCrossRef
50.
van Kesteren NMC, Hospers HJ, Kok G. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Couns. 2007;65(1):5–20.PubMedCrossRef
51.
Pantalone DW, Bimbi DS, Holder CA, Golub SA, Parsons JT. Consistency and change in club drug use by sexual minority men in New York City, 2002 to 2007. Am J Public Health. 2010;100(10):1892–5.PubMedPubMedCentralCrossRef
52.
Rhodes SD, Hergenrather KC, Yee LJ, Knipper E, Wilkin AM, Omli MR. Characteristics of a sample of men who have sex with men, recruited from gay bars and Internet chat rooms, who report methamphetamine use. AIDS Patient Care STDS. 2007;21(8):575–83.PubMedCrossRef
53.
Yu G, Wall MM, Chiasson MA, Hirshfield S. Complex drug use patterns and associated HIV transmission risk behaviors in an internet sample of U.S. men who have sex with men. Arch Sex Behav. 2014;44(2):421–8.PubMedPubMedCentralCrossRef
54.
Grov C, Bux D, Parsons JT, Morgenstern J. Recruiting hard-to-reach drug-using men who have sex with men into an intervention study: lessons learned and implications for applied research. Subst Use Misuse. 2009;44(13):1855–71.PubMedPubMedCentralCrossRef
55.
56.
Vial AC, Starks TJ, Parsons JT. Relative efficiency of field and online strategies in the recruitment of HIV-positive men who have sex with men. AIDS Educ Prev. 2015;27(2):103–11.PubMedPubMedCentralCrossRef
57.
Parsons JT, Vial AC, Starks TJ, Golub SA. Recruiting drug using men who have sex with men in behavioral intervention trials: a comparison of internet and field-based strategies. AIDS Behav. 2013;17(2):688–99.PubMedPubMedCentralCrossRef
58.
Kalichman SC, Rompa D. The sexual compulsivity scale: further development and use with HIV-positive persons. J Personal Assess. 2001;76:379–95.CrossRef
59.
Grov C, Golub SA, Mustanski B, Parsons JT. Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men. Psychol Addict Behav. 2010;24(3):487.PubMedCrossRef
60.
Barlow DH, Farchione TJ, Fairholme CP, et al. Unified protocol for transdiagnostic treatment of emotional disorders: therapist guide. New York: Oxford University Press; 2011.
61.
Gratz K, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess. 2004;26(1):41–54.CrossRef
62.
63.
Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State worry questionnaire. Behav Res Ther. 1990;28(6):487–95.PubMedCrossRef
64.
Bentley KH, Gallagher MW, Carl JR, Barlow DH. Development and validation of the Overall Depression Severity and Impairment Scale. Psychol Assess. 2014;26(3):815–30.PubMedCrossRef
65.
Norman SB, Hami Cissell S, Means-Christensen AJ, Stein MB. Development and validation of an overall anxiety severity and impairment scale (OASIS). Depress Anxiety. 2006;23(4):245–9.PubMedCrossRef
66.
Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–11.PubMedCrossRef
67.
Allensworth-Davies D, Cheng DM, Smith PC, Samet JH, Saitz R. The short inventory of problems—modified for drug use (SIP-DU): validity in a primary care sample. Am J Addict. 2012;21(3):257–62.PubMedPubMedCentralCrossRef
68.
Sobell LC, Sobell MB. Timeline follow-back: a technique for assessing self-reported ethanol consumption. In: Allen J, Litten RZ, editors. Measuring alcohol consumption: psychosocial and biological methods. Totowa, NJ: Humana Press; 1992. p. 41–72.CrossRef
69.
Fals-Stewart W, O’Farrell TJ, Freitas TT, McFarlin SK, Rutigliano P. The timeline followback reports of psychoactive substance use by drug-abusing patients: psychometric properties. J Consult Clin Psychol. 2000;68(1):134–44.PubMedCrossRef
70.
Carey MP, Carey KB, Maisto SA, Gordon CM, Weinhardt LS. Assessing sexual risk behaviour with the timeline followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients. Int J STD AIDS. 2001;12(6):365–75.PubMedPubMedCentralCrossRef
71.
Velasquez MM, von Sternberg K, Johnson DH, Green C, Carbonari JP, Parsons JT. Reducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: a randomized clinical trial. J Consult Clin Psychol. 2009;77(4):657.PubMedPubMedCentralCrossRef
72.
Parsons JT, Kowalczyk WJ, Botsko M, Tomassilli J, Golub SA. Aggregate versus day level association between methamphetamine use and HIV medication non-adherence among gay and bisexual men. AIDS Behav. 2013;17(4):1478–87.PubMedPubMedCentralCrossRef
73.
Grov C, Rendina HJ, Ventuneac A, Parsons JT. Brief report: partners met via sex parties present significantly greater odds for condomless anal sex among MSM: an event-level analysis of venues where male partners are met. JAIDS. 2014;67(5):564–8.PubMedPubMedCentral
74.
Rendina HJ, Moody RL, Ventuneac A, Grov C, Parsons JT. Aggregate and event-level associations between substance use and sexual behavior among gay and bisexual men: comparing retrospective and prospective data. Drug Alcohol Depend. 2015;154:199–207.PubMedPubMedCentralCrossRef
75.
Grov C, Rendina HJ, Moody RL, Ventuneac A, Parsons JT. HIV serosorting, status disclosure, and strategic positioning among highly sexually active gay and bisexual men. AIDS Patient Care STDS. 2015;29(10):559–68.PubMedPubMedCentralCrossRef
76.
Rosenthal R. Meta-analytic procedures for social research, vol. 6. Newbury Park: SAGE Publications, Incorporated; 1991.CrossRef
77.
Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863.PubMedPubMedCentralCrossRef
78.
79.
Safren SA, Perry N, Blashill A, O’Cleirigh C, Ribaudo H, Mayer K. The cost and intensity of behavioral interventions to promote HIV self-care for high-risk HIV-positive MSM compared to the cost and intensity of standard HIV treatment. Arch Sex Behav. 2015;44:1833–41.PubMedPubMedCentralCrossRef
80.
Crepaz N, Lyles CM, Wolitski RJ, et al. Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS. 2006;20(2):143–57.PubMedCrossRef
81.
The Healthy Living Project Team. Effects of a behavioral intervention to reduce risk of transmission among people living with HIV: the Healthy Living Project Randomized Controlled Study. JAIDS. 2007;44(2):213–21.
82.
Parsons JT, Golub SA, Rosof E, Holder C. Motivational interviewing and cognitive-behavioral intervention to improve HIV medication adherence among hazardous drinkers: a randomized controlled trial. JAIDS. 2007;46(4):443.PubMedPubMedCentral
83.
Safren SA, O’Cleirigh C, Tan JY, et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals. Health Psychol. 2009;28(1):1–10.PubMedPubMedCentralCrossRef
84.
Safren SA, O’Cleirigh CM, Bullis JR, Otto MW, Stein MD, Pollack MH. Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users: a randomized controlled trial. J Consult Clin Psychol. 2012;80(3):404–15.PubMedPubMedCentralCrossRef
Metadata
Title
Feasibility of an Emotion Regulation Intervention to Improve Mental Health and Reduce HIV Transmission Risk Behaviors for HIV-Positive Gay and Bisexual Men with Sexual Compulsivity
Authors
Jeffrey T. Parsons
H. Jonathon Rendina
Raymond L. Moody
Sitaji Gurung
Tyrel J. Starks
John E. Pachankis
Publication date
01-06-2017
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2017
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-016-1533-4

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