The purpose of this study was to examine the effects of alcohol intoxication and its interaction with contextual or situation (partner familiarity) and individual differences variables (effortful control, urgency, and whether taking pre-exposure prophylaxis (PrEP) medication) on sexual behaviors in men who have sex with men (MSM), a subgroup for whom HIV continues to be a major public health problem in the U.S. The participants were 236 men recruited from two northeastern U.S. cities and aged 21–50 years, M = 27.8). These men participated in a 6-week (two 3-week sampling bursts) experience sampling method (ESM) study. The ESM data were collected via use of software installed on the participant’s own or study-provided mobile phone. Individual differences variables were measured by participants’ completing questionnaires measuring effortful control and urgency, and the participant’s self-report of whether he was currently taking PrEP. The ESM data pertained to sexual behavior as well as situation variables of familiarity of relevant sexual partners and number of standard alcohol drinks consumed. The results generally were consistent with hypotheses, as alcohol intoxication showed a curvilinear relation to the occurrence of condomless anal intercourse. Furthermore, the likelihood of occurrence of condomless anal sex increased with increased familiarity of the sexual partner. Similarly, taking PrEP increased the likelihood of occurrence of condomless anal sex. At the same time, alcohol’s effects were moderated by all three individual differences variables as expected, but the prediction that partner familiarity would moderate alcohol’s effects on the occurrence of condomless sex was not supported. Clinical implications of the findings center on the application of the data to HIV prevention programs toward inclusion of more empirically supported, nuanced information on the relation between acute alcohol intoxication and sexual behavior. Directions for further research address the need for additional testing and refinement of a person × situation approach to alcohol and sexual behavior. Furthermore, it is argued that it is important to refine further the concept of sexual risk in the context of taking PrEP and to conduct more detailed, multivariate studies of the relation between taking PrEP and patterns of sexual behavior.

本研究的目的是检查酒精中毒及其与情境或情境（伴侣熟悉程度）和个体差异变量（努力控制、紧迫感以及是否服用暴露前预防 (PrEP) 药物）对性行为的影响男男性行为者 (MSM)，艾滋病毒仍然是美国主要公共卫生问题的一个亚群 参与者是从美国东北部两个城市招募的 236 名男性，年龄在 21-50 岁之间，M = 27.8）。这些人参加了为期 6 周（两次 3 周抽样突发）的经验抽样方法 (ESM) 研究。ESM 数据是通过使用安装在参与者自己或研究提供的手机上的软件收集的。个体差异变量是通过参与者完成的测量努力控制和紧迫感的问卷，以及参与者关于他目前是否正在服用 PrEP 的自我报告来衡量的。ESM 数据与性行为以及相关性伴侣的熟悉程度和消费的标准酒精饮料数量有关。结果总体上与假设一致，因为酒精中毒与无安全套肛交的发生呈曲线关系。此外，发生无套肛交的可能性随着性伴侣的熟悉度增加而增加。同样，服用 PrEP 会增加发生无套肛交的可能性。同时，正如预期的那样，酒精的影响受到所有三个个体差异变量的调节，但不支持伴侣熟悉度会调节酒精对无安全套性行为发生的影响的预测。研究结果的临床意义集中在将数据应用于 HIV 预防计划，以纳入更多经验支持的、关于急性酒精中毒与性行为之间关系的细微信息。进一步研究的方向解决了对酒精和性行为的人×情境方法进行额外测试和改进的需要。此外，