View article

Young men who have sex with men (YMSM) are at increased risk for HIV. With interventions insufficiently efficacious, researchers are exploring theoretical mediators (eg, does change in self-efficacy actually change behavior?). Neuroscience approaches suggest additional mediators such as enhancing YMSM’s consideration of future consequences (CFC). A virtual game intervention, SOLVE (Socially Optimized Learning in Virtual Environments), explored the possibility that change in self-efficacy and CFC would mediate sexually risky behavior change. Data analyzed were from 579 HIV-negative, self-identified MSMs, aged from 18 to 24, who had condomless anal intercourse (CAI) in the past 90 days, randomly assigned to SOLVE or the wait-listed control, who returned at 6-months. Using regression, we found CFC and self-efficacy mediated the link between condition and reduction in risky sex over 6 months. Within the game condition, the involvement to risk reduction link was similarly mediated by self-efficacy and CFC. Implications of these findings are discussed.