The effectiveness of the intervention model based on cognitive behavioral therapy in reducing risky sexual behaviors among MSM.

METHODS: Based on CBT theory and the Internet, we established an intervention model targeting high-risk sexual behavior patterns in MSM. We then conducted a randomized controlled trial (n = 50) to assess the impact of the CBT-based intervention on high-risk sexual behaviors and gut microbiota changes in this population. RESULTS: Prior to the implementation of the intervention, 44% of the participants engaged in high-risk behaviors despite having better cognitive levels. However, preliminary findings from post-intervention investigations indicate that intervention measures based on CBT demonstrate greater efficacy compared to traditional methods. After intervention with CBT, the incidence of unprotected anal intercourse in the intervention group was significantly reduced compared to the control group (p = 0.016). Some bacterial taxa (e.g., Bifidobacterium longum and Prevotella) showed potential associations with behavioral changes following CBT; however, these microbiome-related findings are exploratory and hypothesis-generating, not conclusive. CONCLUSION: The high-risk sexual behaviors of MSM increase health risks. However, the method of intervention through the CBT courses can effectively correct the deviation between the cognition and practice. In this process, changes in gut microbiota were observed to be potentially associated with behavioral changes, but these associations are preliminary and warrant further investigation in confirmatory studies.