MSM Risk Taking 1
Negative Affective Reactions to an HIV Prevention Intervention:
Impact on Subsequent Sexual Risk Taking Among Young MSM
Since its apex in 1992, AIDS diagnoses have decreased and stabilized at about 40,000
new cases annually (CDC, 2006). Nevertheless, HIV, the virus that causes AIDS, continues to
pose a severe health threat to men who have sex with men (MSM) (CDC, 2004). Although only
5% to 7% of adult males in the United States are MSM, this group accounted for approximately
70% of all estimated HIV infections in 2004 (CDC, 2004). Among those 18 to 30, younger
MSM engage in more risky sexual behaviors (MacKellar, et al., 2005; Xia, Osmond, Tholandi,
Pollack, Zhou, Ruiz, and Catania, 2006). Yet, as Reyna and Farley (2006) note in a major recent
review of adolescent decision-making, existing HIV prevention interventions that focus on
promoting more deliberate decision-making may be insufficient given that effective decision-
making is often based on non-rational “gist” and “emotional” reactions within the context of risk.
Unfortunately, younger MSM typically lack the experience within contexts of risk needed to
develop appropriate “gist” and “emotional” reactions that would prevent risky choices.
Thus, existing HIV preventions may be less effective with younger MSM (Reyna &
Farley, 2006). In the current work, we consider how an interactive video (IAV) may
“contextualize risk,” providing a virtual environment that facilitates the learning of risk cues and
anticipatory negative emotions that might then reduce unprotected anal intercourse (UAI) in real
life. Specifically, we examine whether the negative emotions generated in an interactive sexual
scenario predict reductions in subsequent risky sexual behavior.
Below, we first consider the decision-making styles our interventions should take into
account for younger MSM and then discuss an intervention, Socially Optimized Learning in
Virtual Environments (SOLVE), which aims to facilitate the learning of anticipatory emotions that
might reduce UAI for young MSM.