ANCHORS Alcohol & Sexual Health Study: UH3 Project

80 young adult men will complete an initial survey and receive 1 of 2 types of alcohol and sexual health education and information to encourage prevention of alcohol-related problems, HIV and other sexually transmitted infections (STIs). Participants will then take pre-exposure prophylaxis (PrEP) for HIV prevention and complete a daily 5-minute, telephone-based interactive voice response (IVR) assessment of alcohol/substance use, sexual behavior and PrEP taking for 30 days. Medication will all be active PrEP. There is no placebo control in this study. Follow-up will occur after 30-days and 6-months later.

Participants randomized to this condition will complete a web-based questionnaire and then receive personalized information regarding their alcohol use and sexual health behavior. They will complete daily, phone-based IVR monitoring for assessment purposes and receive further personalized information based on their responses.

Participants randomized to this condition will complete a web-based questionnaire and then receive educational material regarding their alcohol use and sexual health behavior. They will complete daily phone-based IVR monitoring for assessment purposes.

A daily tablet containing 245 mg of tenofovir disoproxil fumarate and 200 mg emtricitabine (Truvada; Gilead Sciences) for up to 30 days.

Daily telephone-based assessment on alcohol and other substance use, sexual health behavior and PrEP taking

Educational material to provide information, resources and techniques to enhance awareness regarding alcohol and other substance use, along with sexual health behavior.

Daily telephone-based assessment on alcohol and other substance use, sexual health behavior and PrEP taking with personalized and information based on daily IVR responses

Personalized and information on alcohol use and sexual health behavior based on responses to the web-based survey along with standardized information.

Change in self-reported number of alcoholic drinks consumed on one's peak drinking day in the past 30 days

Observation of whether or not a participant opts to fill a prescription for PrEP in the intervention period based on pharmacy documentation

Observation of prescription fills for PrEP with documentation during the follow-up period based on pharmacy documentation

Test reductions in alcohol use following the intervention as a possible mechanism underlying relationships between the intervention and adherence to PrEP

Test increase in Perceived Risk of HIV Scale score following the intervention as a possible mechanism underlying relationships between the intervention and adherence to PrEP

Test reduction in Risk Assessment Battery score following the intervention as a possible mechanism underlying relationships between the intervention and adherence to PrEP

Test increased score on the Contemplation Ladder for motivation to avoid risky sexual health behavior, to take PrEP and to reduce drinking following the intervention as a possible mechanism underlying relationships between the intervention and adherence to PrEP

Inclusion Criteria: Ability to read and write English Consumption of 5 or more drinks per drinks in a day at least once in the past 30-days Sexual intercourse with another man without condom use at least once in the past 30 days HIV seronegative at medical screening Report currently taking PrEP willingness to take PrEP Exclusion Criteria: History of clinically significant withdrawal from alcohol, defined as any one of the following: a) a lifetime history of seizures, delirium, or hallucinations during alcohol withdrawal; b) a Clinical Institute Withdrawal Assessment scale score > 8; c) a report of drinking to avoid withdrawal symptoms in the past 12 months; or d) a lifetime history of medical treatment for withdrawal. Self report injection drug use DSM-5 criteria for moderate or severe current substance use disorder besides alcohol and nicotine. Serious psychiatric symptoms Use of medications that interfere with PrEP including diuretics, nephrotoxic drugs, non-steroidal anti-inflammatory drugs, antiretroviral drugs or other drugs that may interfere with tenofovir excretion Active hepatitis B infection The following medical exclusions: serious or life-threatening conditions; inadequate biochemical, hepatic, hematologic, or pancreatic function according to laboratory testing Participant reports currently taking injectable PrEP