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Pilot Randomized Trial of an Expressive Writing Intervention to Reduce Sexual HIV-Transmission Risk and Substance Use Among Emerging Adult Gay and Bisexual Men

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Abstract

This pilot randomized controlled trial evaluated the feasibility, acceptability, and preliminary efficacy of expressive writing to reduce HIV-related sexual risk taking and symptoms of drug dependence among emerging adult gay and bisexual men (EAGBM) through linguistic mechanisms involving use of words associated with cognitive processing (e.g., think, cause), positive emotion (e.g., love, nice), and negative emotion (e.g., hurt, shame). Between 2014 and 2015, EAGBM (n = 78; aged 18–29) completed a baseline survey and were randomized to complete three 15-min expressive writing or equivalent control-group writing sessions and follow-up assessments 2 months post-baseline. EAGBM in the expressive writing condition utilized significantly more positive emotion, negative emotion, and cognitive processing words. Path model results indicated the intervention condition resulted in significant reductions in symptoms of drug dependence and frequency of condomless anal sex (CAS) through paths mediated by positive emotion words, and significant increases in CAS through a path mediated by negative emotion words.

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Acknowledgements

The authors acknowledge the contributions of other members of the team, especially Evie Arroyo, Andrew Cortopassi, Sarit Golub, Ruben Jimenez, Douglas Keeler, Chloe Mirzayi, John Pachankis, Jamie Pennebaker, Jon Rendina, Erika Robel, Brian Salfas, and Martez Smith. We thank Kelly Sisson for editorial assistance. We also thank Richard Jenkins for his support of the project, as well as research staff, recruiters, interns, and the participants who volunteered their time.

Funding

This study was supported by a grant from the National Institute on Drug Abuse (R03 DA033868, Brooke E. Wells, P.I.).

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Authors and Affiliations

  1. Center for Human Sexuality Studies, Widener University, One University Place, Chester, PA, 19013, USA

    Brooke E. Wells

  2. Interdisciplinary Sexuality Research Collaborative, Widener University, Chester, PA, USA

    Brooke E. Wells

  3. Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA

    Steven Samrock & Tyrel J. Starks

  4. Department of Sociology, Purdue University, West Lafayette, IN, USA

    Mark Pawson

  5. Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY, USA

    Tyrel J. Starks

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  1. Brooke E. Wells
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  4. Tyrel J. Starks
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Contributions

BW, MP, and TS contributed to the study conception and design and were engaged in data collection. TS performed data analyses. The first draft of the manuscript was written by SS, BW, and TS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Brooke E. Wells.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

The study was approved by the CUNY University Integrated Institutional Review Board (CUNY-UI IRB), and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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All participants provided informed consent prior to engaging in any study activities.

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Wells, B.E., Samrock, S., Pawson, M. et al. Pilot Randomized Trial of an Expressive Writing Intervention to Reduce Sexual HIV-Transmission Risk and Substance Use Among Emerging Adult Gay and Bisexual Men. AIDS Behav 26, 584–595 (2022). https://doi.org/10.1007/s10461-021-03413-7

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