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Risk Perception and Decision-Making

What is the role of risk perception in health behavior?

Many theories of health behavior and behavior change focus on the role of risk perception, arguing that individuals rationally evaluate the risks and benefits of a given choice before deciding on a course of action. In contrast, our research contends that : 1) risk perception is only one small influence on decision-making processes; 2) "objective" or epidemiological assessments of risk do not accurately reflect the perceptions of individuals in their daily lives; and 3) understanding the psychology of risk and the meaning of what is considered risky behavior in the lives of the people with whom we work is critical to crafting effective interventions and supporting health and wellness. 

Projects

Project IMPrOVE: Understanding Implementation of HIV Prevention Navigation in STD Clinics (R01MH106380-02S1; Golub, PI)

Project IMPrOVE is a partnership between HART and the New York City Department of Health and Mental Hygiene (DOHMH) to evaluate a new model of STD clinic-based PrEP navigation and implementation. We want to understand how this new intervention works -- Which patients does it help most and why? Which components of the program are most or least effective? How can program elements be modified to best serve highest priority patients? We are collecting data from patients who accept and refuse navigation services and following them over time. We are also using the Proctor Implementation Science Framework (Proctor et al., 2013) to operationalize program components, monitor fidelity, and better understand optimal outcomes.

READY: Preparing for Implementation of Sustained Release Antivirals for HIV Prevention (R01MH105268 ; Golub, PI)

Long-acting injectable (LAI) formulations of anti-retroviral medications are currently being studied for use in HIV prevention. Such LAI products have many advantages, but may also face challenges -- How acceptable will these product be? Which patients will be most (and least) interested in them? How should patient education materials be developed and what guidelines should providers be given to assist them in delivery of these new products? This project takes a multi-modal approach to identifying relevant healthcare system delivery factors, provider dynamics, and patient preferences that might inform optimal delivery of long-acting ARV formulations for HIV prevention (LAI PrEP), and develops specific recommendations for provider education, clinical guidance, and strategies for optimizing delivery of LAI PrEP to highest priority populations. We are partnering with the Health Outreach to Teen (HOTT) program at Callen-Lorde Community Health Center and the Hetrick Martin Institute (HMI) to answer these research questions. 

Findings

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Select Publications

Golub, S.A., Thompson, L., & Kowalczyk, W. (2016). Affective differences in Iowa Gambling Task performance associated with sexual risk taking and substance use among HIV-positive and HIV-negative men who have sex with men. Journal of Clinical and Experimental Neuropsychology, 38(2), 141-157.

Golub, S. A., & Gamarel, K. E. (2016). Psychometric evaluation of the Condom Barriers and Motivations Scale (CBMS). Journal of Behavioral Medicine, 1-12.

Golub, S.A. (2014). Tensions between the epidemiology and psychology of HIV risk: Implications for Pre-exposure Prophylaxis. AIDS and Behavior, 18(9):1686-1693.  

Golub, S.A., Starks, T.J., Payton, G., & Parsons, J.T. (2012). The critical role of intimacy in the sexual risk behaviors of gay and bisexual men. AIDS and Behavior, 16(3), 626-632.