AIDS and Behavior

, Volume 22, Issue 7, pp 2284–2295 | Cite as

Do Diary Studies Cause Behavior Change? An Examination of Reactivity in Sexual Risk and Substance Use in Young Men Who Have Sex with Men

  • Michael E. Newcomb
  • Gregory Swann
  • David Mohr
  • Brian Mustanski
Original Paper


Behavioral diaries are frequently used for observing sexual and substance use behaviors, but participating in diary studies may cause behavior change. This study examined change in sexual and substance use behaviors among young men who have sex with men (YMSM) in a two-month diary study compared to control. An analytic sample of 324 YMSM was randomized to receive daily diaries, weekly diaries, or no diaries (control) for 2 months. Half of the diary participants were randomized to receive automated weekly feedback. Between-subjects analyses found no evidence of change in sexual or substance use behaviors from baseline to 2-month follow-up when comparing the diary conditions to control. Within-persons growth mixture models of all diary data showed significant decreases in condomless anal sex (CAS) and illicit drug use. Weekly automated feedback had no effect on behavior change. Findings provide evidence of change in CAS and illicit drug use amongst diary participants.


HIV/AIDS Young men who have sex with men Behavioral diaries Self-monitoring Substance use 



This project was funded by a Grant from the National Institute on Drug Abuse (R03DA035704; PI: Newcomb). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse.


This study was funded by the National Institute on Drug Abuse (R03DA035704).

Compliance with Ethical Standards

Conflict of interest

The authors have no known conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all participants included in the study.


  1. 1.
    CDC. HIV surveillance—men who have sex with men (MSM). Atlanta: Division of HIV/AIDS Prevention; National Center for HIV/AIDS, Viral Hepatitis, Sexual Transmitted Diseases and Tuberculosis Prevention; Centers for Disease Control and Prevention; 2016.Google Scholar
  2. 2.
    Newcomb ME, Birkett M, Corliss HL, Mustanski B. Sexual orientation, gender, and racial differences in illicit drug use in a sample of US high school students. Am J Public Health. 2014;104:304–10.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Talley AE, Hughes TL, Aranda F, Birkett M, Marshal MP. Exploring alcohol-use behaviors among heterosexual and sexual minority adolescents: intersections with sex, age, and race/ethnicity. Am J Public Health. 2014;104:295–303.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Drumright LN, Patterson TL, Strathdee SA. Club drugs as causal risk factors for HIV acquisition among men who have sex with men: a review. Subst Use Misuse. 2006;41:1551–601.CrossRefPubMedGoogle Scholar
  5. 5.
    Vosburgh HW, Mansergh G, Sullivan PS, Purcell DW. A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS Behav. 2012;16:1394–410.CrossRefPubMedGoogle Scholar
  6. 6.
    Bolger N, Davis A, Rafaeli E. Diary methods: capturing life as it is lived. Annu Rev Psychol. 2003;54:579–616.CrossRefPubMedGoogle Scholar
  7. 7.
    Gillmore MR, Leigh BC, et al. Does “high = high risk”? An event-based analysis of the relationship between substance use and unprotected sex among gay and bisexual men. AIDS Behav. 2002;6:361–70.CrossRefGoogle Scholar
  8. 8.
    Horvath KJ, Beadnell B, Bowen AM. A daily web diary of the sexual experiences of men who have sex with men: comparisons with a retrospective recall survey. AIDS Behav. 2007;11:537–48.CrossRefPubMedGoogle Scholar
  9. 9.
    Mustanski B. Moderating effects of age on the alcohol and sexual risk taking association: an online daily diary study of men who have sex with men. AIDS Behav. 2008;12:118–26.CrossRefPubMedGoogle Scholar
  10. 10.
    Newcomb ME. Moderating effect of age on the association between alcohol use and sexual risk in MSM: evidence for elevated risk among younger MSM. AIDS Behav. 2013;17:1746–54.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Pachankis JE, Hatzenbuehler ML, Starks TJ. The influence of structural stigma and rejection sensitivity on young sexual minority men’s daily tobacco and alcohol use. Soc Sci Med. 2014;103:67–75.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Gillmore MR, Leigh BC, Hoppe MJ, Morrison DM. Comparison of daily and retrospective reports of vaginal sex in heterosexual men and women. J Sex Res. 2010;47:279–84.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Leigh BC, Morrison DM, Hoppe MJ, Beadnell B, Gillmore MR. Retrospective assessment of the association between drinking and condom use. J Stud Alcohol Drugs. 2008;69:773–6.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Glick SN, Winer RL, Golden MR. Web-based sex diaries and young adult men who have sex with men: assessing feasibility, reactivity, and data agreement. Arch Sex Behav. 2013;42:1327–35.CrossRefPubMedGoogle Scholar
  16. 16.
    Hensel DJ, Rosenberger JG, Novak DS, Reece M. Sexual event-level characteristics of condom use during anal intercourse among HIV-negative men who have sex with men. Sex Transm Dis. 2012;39:550–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Newcomb ME, Mustanski B. Diaries for observation or intervention of health behaviors: factors that predict reactivity in a sexual diary study of men who have sex with men. Ann Behav Med. 2014;47:325–34.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Stalgaitis C, Glick SN. The use of web-based diaries in sexual risk behaviour research: a systematic review. Sex Transm Infect. 2014;90:374–81.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Mustanski B, Starks T, Newcomb ME. Methods for the design and analysis of relationship and partner effects on sexual health. Arch Sex Behav. 2014;43:21–33.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Clar C, Barnard K, Cummins E, et al. Self-monitoring of blood glucose in type 2 diabetes: systematic review. Health Technol Assess. 2010;14:1–140.CrossRefGoogle Scholar
  21. 21.
    Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Self-monitoring and other non-pharmacological interventions to improve the management of hypertension in primary care: a systematic review. Br J Gen Pract. 2010;60:e476–88.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111:92–102.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Pew Research Center. U.S. smartphone use in 2015. Washington, DC: Pew Research Center; 2015.Google Scholar
  24. 24.
    Krebs P, Duncan DT. Health app use among US mobile phone owners: a national survey. JMIR Mhealth Uhealth. 2015;3:e101.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47:1102–14.CrossRefPubMedGoogle Scholar
  26. 26.
    Bandura A. Social cognitive theory of self-regulation. Organ Behav Hum Decis Process. 1991;50:248–87.CrossRefGoogle Scholar
  27. 27.
    Newcomb ME, Swann G, Estabrook R, et al. Patterns and predictors of compliance in a prospective diary study of substance use and sexual behavior in a sample of young men who have sex with men. Assessment. 2016. Scholar
  28. 28.
    Mustanski B. Ethical and regulatory issues with conducting sexuality research with LGBT adolescents: a call to action for a scientifically informed approach. Arch Sex Behav. 2011;40:673–86.CrossRefPubMedGoogle Scholar
  29. 29.
    Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction. 1993;88:791–804.CrossRefPubMedGoogle Scholar
  30. 30.
    Adamson SJ, Kay-Lambkin FJ, Baker AL, et al. An improved brief measure of cannabis misuse: the Cannabis Use Disorders Identification Test-Revised (CUDIT-R). Drug Alcohol Depend. 2010;110:137–43.CrossRefPubMedGoogle Scholar
  31. 31.
    Greenfield TK. Ways of measuring drinking patterns and the difference they make: experience with graduated frequencies. J Subst Abuse. 2000;12:33–49.CrossRefPubMedGoogle Scholar
  32. 32.
    Lei H, Nahum-Shani I, Lynch K, Oslin D, Murphy SA. A “SMART” design for building individualized treatment sequences. Annu Rev Clin Psychol. 2012;8:21–48.CrossRefPubMedGoogle Scholar
  33. 33.
    Murphy SA. An experimental design for the development of adaptive treatment strategies. Stat Med. 2005;24:1455–81.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Michael E. Newcomb
    • 1
    • 2
  • Gregory Swann
    • 1
    • 2
  • David Mohr
    • 3
  • Brian Mustanski
    • 1
    • 2
  1. 1.Institute for Sexual and Gender Minority Health and WellbeingNorthwestern UniversityChicagoUSA
  2. 2.Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Department of Preventive Medicine, Center for Behavioral Intervention TechnologiesNorthwestern UniversityChicagoUSA

Personalised recommendations