Michael Miner, PhD, will be the principal investigator on a new $1 million grant from the National Institutes of Mental Health (NIMH) to study sexual compulsivity. Over the next three years Miner in collaboration with the Kinsey Institute and his team of co-investigators will be working to gather the empirical data needed to clarify the characteristics of sexual compulsivity and how it leads to increased levels of HIV sexual risk behavior. The findings of this study will further a nuanced approach to the development of interventions and allow for targeting the most resource- intensive prevention efforts at those individuals most likely to spread HIV.
Miner said, "This grant provides an exciting opportunity to test the assumptions that have driven our treatment interventions for decades. Further, our timing could not be better, given the recent definition of addiction put forth by the Academy of Addiction Medicine which we can empirically investigate using our methodology."
Sexual compulsivity, or high levels of sexual behavior combined with a perceived lack of control, is strongly associated with unprotected sex and other HIV sexual risk behaviors. This association has been robust across populations, but particularly strong in men who have sex with men (MSM). Miner's new project builds on previous research conducted at PHS which found that sexual compulsivity is associated with sero-discordant unprotected anal intercourse in HIV-positive MSM even after controlling for other known correlates (e.g., condom use self-efficacy, intentions to practice safer sex, etc.). However, while the association between sexual compulsivity and unsafe sex has considerable empirical support, the manner in which sexual compulsivity confers this increased risk, and therefore how to best influence such processes in order to reduce risk, is as yet, unknown.
Sexual compulsivity has been conceptualized as an addictive disorder, an impulsive disorder, and as a compulsive disorder. Others have questioned the existence of sexual compulsivity as a definable disorder and attribute the increased sexual behavior to high sex drive. Common across all conceptualizations are four factors: negative affect, sexual arousal, behavioral inhibition, and cognitive control. These factors influence HIV risk by interfering with the ability to manage one's sexual impulses, which would lead to multiple sexual encounters, and through impairments in the ability to consider multiple reinforcement contingencies and to consider the long-term consequences of pleasurable behavior which interferes with condom use. This study will provide needed empirical data to clarify the characteristics of SC and how it leads to increased levels of HIV sexual risk behavior.
A multi-method strategy will allow the research team to characterize sexual compulsivity and to provide needed empirical data to identify, and therefore help address, the underlying mechanisms that influence unsafe sexual behavior.
The research team includes co-investigators Angus MacDonald, III, PhD (U of M Department of Psychology), Rebecca Swinburne Romine, PhD, Nancy Raymond, MD, Erick Janssen, PhD (Kinsey Institute).
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