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Gebru NM, James TG, Ahn S, Cheong J, Berry MS, Cook RL, Leeman RF. A Behavioral Economic Examination of Sexual Behaviors in the Era of Pre-exposure Prophylaxis via Explanatory Sequential Mixed Methods. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1541-1559. [PMID: 38472604 PMCID: PMC11124550 DOI: 10.1007/s10508-024-02822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024]
Abstract
Pre-exposure prophylaxis (PrEP) use may be associated with condom use decisions. The current investigation examined sexual decision-making in the context of PrEP among young adult men who have sex with men (MSM) between 18 and 30 years old, using an explanatory sequential mixed methods design. For the quantitative aim, 99 MSM currently taking PrEP (i.e., PrEP-experienced) and 140 MSM not currently taking PrEP (i.e., PrEP-naive) completed an online survey, including the Sexual Delay Discounting Task (SDDT), which captures likelihood of condom use. For the qualitative aim, 15 people from each group were interviewed about their (1) conceptualizations of risky sex and (2) ways they manage their sexual risk. Participants were, on average, 25.69 years old (SD = 3.07) and 64% White. Results from the quantitative aim revealed, controlling for covariates, PrEP-experienced participants exhibited significantly lower likelihood of (1) using an immediately available condom and (2) waiting for a delayed condom (i.e., sexual delay discounting) compared to PrEP-naive participants. Qualitative themes explaining what young adult MSM consider to be risky sex included: (1) any sex as risky sex, (2) risky sex as "sex without a conversation," and (3) risky sex as sex with risk for physical harm. Themes on ways young adult MSM manage sexual risk were classified as proactive, reactive, and passive. Results suggest that PrEP use is related to condom use decisions. Taken together, quantitative differences in sexual delay discounting, but qualitatively similar conceptualizations and management of risky sex, suggest that the SDDT may be a useful tool in sex research to capture processes (i.e., delay discounting) underlying sexual decision-making that may be missed by traditional self-reports. Implications of results, including potentially providing (good quality) condoms with every PrEP prescription, and future research topics are discussed.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St., Box G-S121-3, Providence, RI, 02912, USA.
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA.
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA.
| | - Tyler G James
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Seungjun Ahn
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - JeeWon Cheong
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Robert L Cook
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Robert F Leeman
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Health Sciences, Northeastern University, Boston, MA, USA
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2
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Mitzel LD, Johnson MW, Vanable PA. Delay Discounting and Sexual Decision-Making: Understanding Condom Use Behavior Among U.S. College Students. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2605-2617. [PMID: 37085661 DOI: 10.1007/s10508-023-02597-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
Condoms provide protection against sexually transmitted diseases; however, condomless sex remains common among college students and intentions to use condoms do not consistently translate into condom use. This study tested which indicator of condom use intentions from a delay discounting paradigm of condom-protected sex best accounted for variance in condom use behavior. The sample consisted of 187 sexually active college students (51.9% female) who completed measures of condom use during vaginal and anal sex over the past three months and a decision-making paradigm regarding condom intentions with hypothetical sexual partners. In separate models, condom behavior was regressed on one of three indicators of condom intentions: initial intentions to use a condom, delay discounting of condom-protected sex, and overall area under the curve across all trials. Results showed that delay discounting of condom-protected sex best accounted for variance in absolute frequency of condomless sex, whereas initial intentions to use a condom best accounted for variance in relative proportion of condomless sex. Future research directions and implications for interventions are discussed.
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Affiliation(s)
- Luke D Mitzel
- Department of Psychology, Syracuse University, Syracuse, NY, USA.
- Center for Integrated Healthcare, Syracuse VA Medical Center, 620 Erie Blvd W, Syracuse, NY, 13204, USA.
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter A Vanable
- Department of Psychology, Syracuse University, Syracuse, NY, USA
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3
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Ingram KM, Collado A, Felton JW, Yi R. A Preliminary Experimental Study of Self-Objectification and Risky Sex Behavior Among a University Sample of Cisgender Women in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1643-1651. [PMID: 36757517 DOI: 10.1007/s10508-022-02510-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 06/18/2023]
Abstract
Self-objectification is associated with a number of negative mental and behavioral outcomes. Though previous research has established associations between self-objectification and risky sex, no study to date has examined whether self-objectification affects propensity to engage in risky sex. The current research employed an experimental design to examine the effect of heightened self-objectification on a laboratory analog of risky sex (n = 181). We observed that when college-attending women experienced a heightened state of self-objectification, they were more likely to engage in sex without a condom and less likely to wait to use a condom with a highly desirable partner. Given the frequency of intended and unintended objectifying messages that young women face, this increase in willingness to engage in risky sex behavior represents a consequential health concern.
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Affiliation(s)
- Katherine M Ingram
- School of Education, University of North Carolina at Chapel Hill, 100 E Cameron Ave., Chapel Hill, NC, 27514, USA.
| | - Anahi Collado
- Renée Crown Wellness Institute- University of Colorado, Boulder, CO, USA
| | - Julia W Felton
- Division of Public Health, Michigan State University, East Lansing, MI, USA
| | - Richard Yi
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
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4
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Hiadzi RA, Agyeman JA, Akrong GB. 'Baby mamas' in Urban Ghana: an exploratory qualitative study on the factors influencing serial fathering among men in Accra, Ghana. Reprod Health 2023; 20:37. [PMID: 36859283 PMCID: PMC9976522 DOI: 10.1186/s12978-023-01585-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/19/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Biological fathering, especially in patrilineal societies, was traditionally acceptable only in the context of marriage to the mother of the child. Many men were polygynous, often staying in one household with all their wives and children. However, this phenomenon has been on the decline in recent times, mainly due to Christianity, which encourages monogamy while frowning on polygyny. The Ghanaian family has for the past few years been undergoing changes due to migration, urbanization, and industrialization. With an increase in non-marital births and the dissolution of marital unions, multi-partner fertility is likely to increase. Contemporary Ghanaian perspectives on the circumstances that lead men to engage in paternal multi-partner fertility, otherwise referred to in this study as serial fathering, are scanty, hence this study examines the factors that lead to serial fathering among Ghanaian men. METHODS The study employed the qualitative method, using in-depth interviews with twenty (20) serial fathers and a focus group discussion with seven (7) women. RESULTS It was found that factors such as the attitude of women in relationships, the duolocal post-marital residential pattern, and the age at first birth are some of the reasons why some men father children with multiple partners. CONCLUSION The study concludes that both situational and personal factors account for the phenomenon of serial fathering amongst men in Prampram, Ghana, and these factors bring about distinctions in serial fathering as occurring either within or outside of marriage.
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Affiliation(s)
| | - Jemima Akweley Agyeman
- grid.8652.90000 0004 1937 1485Department of Sociology, University of Ghana, Accra, Ghana
| | - Godwin Banafo Akrong
- grid.54549.390000 0004 0369 4060School of Management and Economics, University of Electronic Science and Technology of China, Chengdu, 611731 China
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5
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Wright PJ. Pornography Consumption and Condomless Sex among Emerging U.S. Adults: Results from Six Nationally Representative Surveys. HEALTH COMMUNICATION 2022; 37:1740-1747. [PMID: 33886380 DOI: 10.1080/10410236.2021.1917745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Using six samples of unmarried U.S. residents aged 18-24 who were part of a larger biennial nationally representative survey (2008-2018), the present study examined whether pornography consumption is a risk factor for condomless sex during emerging adulthood. Condomless sex is the norm in popular, commonly consumed, pornography. Further, emerging adulthood is a time of heightened sexual experimentation and risk taking, and many emerging adults view pornography. Consistent with a sexual scripting perspective on media processes and effects, emerging adults who viewed pornography were more likely to have condomless sex than their peers who did not consume pornography. The link between pornography use and condomless sex was similar for men and women, white youth and youth of color, as well as heterosexual and LGB youth. The link was not moderated by age. Further, the link was robust even when indicators of both sexual and nonsexual sensation seeking predilections were included in analyses. These results are consistent with recent suggestions from public health experts that sex education programs need to include modules on pornography literacy.
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Affiliation(s)
- Paul J Wright
- Communication Science Unit, The Media School, Indiana University
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6
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Bibriescas N, Wainwright K, Thomas R, Lopez V, Romanowich P. Differential relationships between discount rates and health behaviors in an ethnically diverse college sample. Front Public Health 2022; 10:943499. [PMID: 36016889 PMCID: PMC9396243 DOI: 10.3389/fpubh.2022.943499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
Previous research has demonstrated associations between delay discount rate and engagement in several health behaviors. The delay discount rate is also inversely associated with social discount rates, a putative measure for sharing. However, there is little research that examines whether delay and social discount rates are differentially associated with health behavior engagement, and even less research examining the impact of ethnicity on these relationships. This study investigated whether delay and/or social discount rates predict three health behaviors varying in sociality: sexually transmitted infection (STI) testing, alcohol consumption and exercise frequency in an ethnically diverse university sample. The results showed that neither delay nor social discount rate significantly predicted alcohol consumption and exercise frequency. However, increasing social discount rates (i.e., decreased sharing) was associated with a decreased likelihood to be tested for STIs. Ethnicity significantly contributed to two models, indicating differences in STI testing and alcohol consumption across ethnicities. Ethnic differences in these health behaviors were consistent with many previous health behavior studies, suggesting a profitable way to research cultural contingencies and test the reliability of the ethnically diverse data. These findings indicate that the social discount rate is differentially associated with health behaviors with more social aspects (i.e., health behaviors related to sex) in college students.
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Affiliation(s)
- Natashia Bibriescas
- Department of Educational Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Katherine Wainwright
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Rebecca Thomas
- Ecampus Research Unit, Oregon State University, Corvallis, OR, United States
| | - Victoria Lopez
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Paul Romanowich
- Department of Psychology, Gonzaga University, Spokane, WA, United States,*Correspondence: Paul Romanowich
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7
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Gebru NM, Kalkat M, Strickland JC, Ansell M, Leeman RF, Berry MS. Measuring Sexual Risk-Taking: A Systematic Review of the Sexual Delay Discounting Task. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2899-2920. [PMID: 35838897 PMCID: PMC9555011 DOI: 10.1007/s10508-022-02355-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
The Sexual Delay Discounting Task (SDDT; Johnson & Bruner, 2012) is a behavioral economic task that assesses sexual risk-taking by measuring likelihood of immediate and delayed condom use. The SDDT is ecologically valid and has been used to test effects of various substances on sexual risk-taking. However, considerable variety in implementation, analysis, and reporting of the SDDT may limit rigor and reproducibility of findings. The current review synthesized studies that used the SDDT to evaluate these possible variabilities systematically. A two-step search (citation-tracking and keyword-based search) was conducted to identify studies that met inclusion criteria (i.e., used the SDDT). Eighteen peer-reviewed articles met inclusion criteria. The SDDT has been implemented primarily in three populations: individuals who use cocaine, men who have sex with men, and college students. Comparable results across diverse populations support the SDDT's validity. A few studies administered substances before the SDDT. Evidence suggests that while cocaine and alcohol increased sexual risk-taking under some conditions, buspirone decreased preference for immediate condomless sex. There was also heterogeneity in the determination of data orderliness (i.e., outliers) and inconsistent reporting of task design and analysis. Considerable differences present in methodologic approaches could influence results. Reducing variation in the administration, analysis, and reporting of the SDDT will enhance rigor and reproducibility and maximize the task's tremendous potential.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA.
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
| | - Meher Kalkat
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Margaret Ansell
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Robert F Leeman
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
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8
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Bable RA, Ackerlund Brandt JA. Delay Discounting, Dating Applications, and Risky Sexual Behavior: An Exploratory Study. PSYCHOLOGICAL RECORD 2022. [DOI: 10.1007/s40732-021-00506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Johnson MW, Strickland JC, Herrmann ES, Dolan SB, Cox DJ, Berry MS. Sexual discounting: A systematic review of discounting processes and sexual behavior. Exp Clin Psychopharmacol 2021; 29:711-738. [PMID: 33001694 PMCID: PMC8977071 DOI: 10.1037/pha0000402] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral processes underlying sexual behavior are important for understanding normal human functioning and risk behavior leading to sexually transmitted infections (STIs). This systematic review examines delay and probability discounting in human sexual behavior through synthesis of 50 peer-reviewed, original research articles. Sixteen studies focusing exclusively on monetary delay discounting found small effect size positive correlations with sexual risk behaviors. Eleven studies examined delay or probability discounting of sexual behavior itself using tasks that varied duration, frequency, or quality of sex to determine value. Results show delay and uncertainty of sex causes systematic decreases in value. These studies also show consistent medium effect size relationships between sexual discounting measures and sexual health and substance use, supporting utility above and beyond monetary discounting. Twenty-three studies have modeled clinically relevant decision-making, examining effects of delay until condom availability and STI contraction probability on condom use. Observational and experimental designs found condom-use discounting is elevated in high-risk substance use populations, is sensitive to context (e.g., partner desirability), and is more robustly related to sexual risk compared with monetary discounting or condom use decisions when no delay/uncertainty was involved. Administering cocaine, alcohol, and, for some participants, methamphetamine increased condom-use discounting with minimal effect on monetary discounting or condom use when no delay/uncertainty was involved. Reviewed studies robustly support that sexual behavior is highly dependent on delay and probability discounting, and that these processes strongly contribute to sexual risk. Future research should exploit these systematic relationships to design behavioral and pharmacological approaches to decrease sexual risk behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Sean B. Dolan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David J. Cox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Meredith S. Berry
- Human Behavioral Pharmacology and Decision-Making Laboratory, Department of Health Education and Behavior, University of Florida, Gainesville, FL, United States
- Department of Psychology, University of Florida, Gainesville, FL, United States
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10
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Wongsomboon V, Cox DJ. Sexual Arousal Discounting: Devaluing Condom-Protected Sex as a Function of Reduced Arousal. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2717-2728. [PMID: 33483850 DOI: 10.1007/s10508-020-01907-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 12/05/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Sexual discounting is a growing area of research aimed at identifying factors that reduce people's reported willingness to have safe sex. One commonly reported reason for condom non-use is that a condom reduces sexual arousal. However, researchers have yet to isolate the specific role of sexual arousal using a sexual discounting framework. We extended past research by measuring how sexual arousal reduced people's willingness to have condom-protected sex ("sexual arousal discounting": SAD). College students (n = 379; 67.5% females) selected partners they most wanted and least wanted to have sex with and were randomized to one of two groups. In one group, participants rated their willingness to have sex with a condom if their own arousal decreased (from 100 to 10%) from condom use. The other group completed the same task except their partner's arousal decreased from condom use instead of their own. We observed a three-way interaction between arousal levels, most versus least desirable partners, and self versus partner groups. Participants' willingness to have condom-protected sex systematically reduced as a function of sexual arousal. This was observed more with the most (vs. least) desirable partner and in the self-arousal (vs. partner-arousal) group but only when the partner was their least desirable. Men (vs. women) displayed more arousal discounting but only with the most desirable partner. Finally, higher arousal discounting was associated with lower safe-sex self-efficacy and higher reported frequency of unprotected sex in the past 3 months. This study demonstrates how reduced sexual arousal from condom use can be measured as a factor influencing sexual risk-taking.
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Affiliation(s)
- Val Wongsomboon
- Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL, 32603, USA.
| | - David J Cox
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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11
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Harsin JD, Gelino BW, Strickland JC, Johnson MW, Berry MS, Reed DD. Behavioral economics and safe sex: Examining condom use decisions from a reinforcer pathology framework. J Exp Anal Behav 2021; 116:149-165. [PMID: 34227121 DOI: 10.1002/jeab.706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/08/2021] [Accepted: 06/06/2021] [Indexed: 12/24/2022]
Abstract
Condom use substantially reduces unwanted pregnancies and sexually transmitted infections. While condom availability is a significant public health priority, effects of condom availability constraints remain relatively under-researched. The limited research on condom availability suggests two major barriers to use: (1) effort/costs and (2) delay to access. To date, we are aware of no study that explores both demand for and discounting of condom availability; the focus of this study was to account for condom decisions using a reinforcement pathology framework. This study used a condom purchase task and the Sexual Delay Discounting Task to quantify behavioral economics of condom use. Low sexual discounting was associated with higher willingness to engage unprotected sex. Demand metrics suggest participants indicating abstinence at condom breakpoint were willing to pay nearly double for condoms relative to individuals indicating unprotected sex at breakpoint. Finally, we grouped participants into reinforcement pathology risk groups based on their discounting and demand indices; these groups significantly differed in self-reported number of sexual partners, unprotected sexual partners, and Sexual Desire scores. This study demonstrates the value of behavioral economic approaches to public health concerns, and further underscores the translational benefits of quantitative metrics to shed novel light on risky health decisions.
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Affiliation(s)
- Joshua D Harsin
- Department of Applied Behavioral Science, University of Kansas.,Cofrin Logan Center for Addiction Research and Treatment
| | - Brett W Gelino
- Department of Applied Behavioral Science, University of Kansas.,Cofrin Logan Center for Addiction Research and Treatment
| | - Justin C Strickland
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Meredith S Berry
- Department of Health Education and Behavior, University of Florida.,Department of Psychology, University of Florida
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas.,Cofrin Logan Center for Addiction Research and Treatment
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12
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Berry MS, Sweeney MM, Dolan SB, Johnson PS, Pennybaker SJ, Rosch KS, Johnson MW. Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Greater Delay Discounting of Condom-Protected Sex and Money. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:191-204. [PMID: 32328913 DOI: 10.1007/s10508-020-01698-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk of detrimental life outcomes. Recent research also indicates that ADHD is associated with sexual risk behavior, such as unprotected sex. Some risky sexual behaviors may be driven, in part, by preference for immediate rewards, referred to as delay discounting, which is prominent in etiological models of ADHD. Therefore, the present study examined the effect of delay on preference for both monetary and sexual outcomes in adults with many ADHD symptoms (both on and off medication) and with fewer ADHD symptoms. Online participants (N = 275; n = 161 males, n = 114 females) completed a monetary delay discounting task, assessing preference for smaller sooner versus larger delayed hypothetical money, and the Sexual Delay Discounting Task, assessing preference for condom use in hypothetical casual sex scenarios based on delay until condom availability. Those with greater ADHD symptoms discounted delayed monetary outcomes as well as delayed condom-protected sex (i.e., preferred sooner money rewards and immediate unprotected sex) significantly more than those with fewer symptoms; however, no effect of current medication use was found across monetary or sexual delay discounting among those with greater ADHD symptoms. This study is the first to demonstrate the relation between ADHD symptoms and reduced condom-use likelihood. Increased discounting of delayed condom-protected sex might constitute one mechanism of risky sexual behavior among individuals with ADHD symptoms. Interventions geared toward increasing condom use in situations in which condoms may otherwise be unavailable, may mitigate risky sexual behaviors and their associated harms in this population.
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Affiliation(s)
- Meredith S Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Mary M Sweeney
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
| | - Sean B Dolan
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
- Department of Psychology, California State University, Chico, Chico, CA, USA
| | - Steven J Pennybaker
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
| | - Keri S Rosch
- Center for Neurodevelopmental and Imaging Research and Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA.
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13
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Brogan KM, Rapp JT, Niedfeld AM, Thompson KR, Burkhart BR. Using Arousal Suppression Exercises to Decrease Inappropriate Sexual Arousal in Detained Adolescent Males: Three Clinical Demonstrations. Behav Anal Pract 2020; 13:348-359. [PMID: 32647598 DOI: 10.1007/s40617-020-00408-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Reyes, Vollmer, and Hall (2011) found that 2 arousal suppression strategies, 1 of which involved counting backward from 100 to 0, decreased sexual arousal for 2 male sex offenders with intellectual disabilities. In the current clinical study, we taught 3 adolescent males who had been adjudicated for illegal sexual behavior to self-report arousal when they were presented with sexually arousing visual stimuli. Based on the procedures in the Reyes et al. (2011) study, we taught participants to count backward from 100 to 0 when they verbally reported a criterion level of sexual arousal in the presence of visual media. Subsequently, we gradually faded therapists' instructions for 2 participants until they independently used the arousal suppression exercise. Results showed that each participant's self-reported sexual arousal decreased upon implementation of treatment relative to baseline. Decreased sexual arousal continued even under conditions of faded therapist instructions for 2 participants. The relative merits of using self-report measures are discussed.
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Affiliation(s)
- Kristen M Brogan
- Department of Psychology, Auburn University, 226 Thach Hall, Auburn, AL 36849-5214 USA
| | - John T Rapp
- Department of Psychology, Auburn University, 226 Thach Hall, Auburn, AL 36849-5214 USA
| | - Amanda M Niedfeld
- Department of Psychology, Auburn University, 226 Thach Hall, Auburn, AL 36849-5214 USA
| | - Kelli R Thompson
- Department of Psychology, Auburn University, 226 Thach Hall, Auburn, AL 36849-5214 USA
| | - Barry R Burkhart
- Department of Psychology, Auburn University, 226 Thach Hall, Auburn, AL 36849-5214 USA
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Dolan SB, Johnson PS, Johnson MW. The Hotel Room Purchase Task: Effects of Gender and Partner Desirability on Demand for Hypothetical Sex in Individuals with Disordered Cocaine Use and Controls. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1251-1262. [PMID: 31989411 PMCID: PMC8977073 DOI: 10.1007/s10508-020-01634-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 05/03/2023]
Abstract
Hypothetical purchase tasks allow for rapid assessment of behavioral economic demand for numerous commodities and are useful in evaluating reinforcer pathologies, such as substance and behavioral addiction. Currently, there is not a task for evaluating demand for sex without requiring implicit engagement in sex work. The current study used a novel purchase task with hotel rooms for sex as the hypothetical commodity to assess demand for sex in individuals with disordered cocaine use, a population that frequently engages in risky sexual behavior. Adults meeting criteria for cocaine abuse or dependence (13 males, ten females) and noncocaine-using controls (eight males, three females) chose hypothetical sexual partners from a series of photographs and endorsed two partners with whom they would most and least like to have sex. Participants then completed the hotel purchase task for both partners, wherein they reported how many nights at a hotel room, at prices from $10 to $1280 per night, they would purchase in a year. Demand intensity was significantly greater and demand elasticity was significantly lower for the most preferred relative to the less preferred partner. Males demonstrated significantly greater intensity and lesser elasticity for sex than females. Demand metrics did not differ between the cocaine and control group. This task may serve as a useful measure of demand for sex without requiring implicit hypothetical engagement in sex work. Future studies exploring the relation between task performance and other characteristics such as sexual dysfunction, in addition to acute substance administration effects, may further determine the task's clinical utility.
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Affiliation(s)
- Sean B Dolan
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Suite 3026, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Department of Psychology, California State University, Chico, Chico, CA, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Suite 3026, Baltimore, MD, 21224, USA.
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15
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Sweeney MM, Berry MS, Johnson PS, Herrmann ES, Meredith SE, Johnson MW. Demographic and sexual risk predictors of delay discounting of condom-protected sex. Psychol Health 2020; 35:366-386. [PMID: 31311321 PMCID: PMC6962567 DOI: 10.1080/08870446.2019.1631306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/10/2019] [Indexed: 10/26/2022]
Abstract
Objective: Sexual delay discounting describes the decreased likelihood of condom-protected sex if a condom is not immediately available, which can be quantitatively summarised using the Sexual Delay Discounting Task (SDDT). The present studies determined the extent to which condom use likelihood as assessed by the SDDT is associated with self-reported sexual risk behaviours and demographics in two online samples of adults. Design: Study 1 (n = 767) assessed demographics, sexual risk behaviour, and delay discounting, and examined relations between these variables using correlation and regression. Study 2 (n = 267) examined whether real-world instances of unprotected sex because a condom was not immediately available predicted greater sexual discounting. Main outcome measures: Sexual delay discounting, condom use. Results: Both studies observed significant positive relations between sexual delay discounting and self-reported sexual risk behaviours, and found that males tended to show greater sexual discounting. In Study 2, 46% of the sample self-reported having unprotected sex because a condom was not immediately available, and these individuals showed significantly greater sexual delay discounting. Conclusion: These results extend prior findings by demonstrating that delay is a critical variable underlying real-life sexual risk behaviour among non-clinical samples. The SDDT is an ecologically valid measure of these processes.
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Affiliation(s)
- Mary M. Sweeney
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Meredith S. Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Patrick S. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Evan S. Herrmann
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Steven E. Meredith
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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16
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Leeman RF, Rowland BHP, Gebru NM, Potenza MN. Relationships among impulsive, addictive and sexual tendencies and behaviours: a systematic review of experimental and prospective studies in humans. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180129. [PMID: 30966924 DOI: 10.1098/rstb.2018.0129] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Impulsivity's relationships to addictive and sexual behaviours raise questions regarding the extent impulsivity may constitute a vulnerability factor for subsequent addictive and sexual behaviours and/or results from each of these. Here, we systematically reviewed empirical support for impulsivity as a precipitating factor or a consequence of addictive or sexual behaviours. We restricted ourselves to recent, human studies with assessments over time, including at least one measure of impulsivity, addictive and sexual behaviours, yielding a review including 29 published reports from 28 studies. Findings point to generalized, self-reported impulsivity as a predictor of addictive and sexual behaviours at a wide range of severity, with elements of both impulsivity and compulsivity to these acts. Alcohol consumption often increases impulsive behaviour, including inclinations towards impulsive and potentially compulsive sexual acts. Research using the Sexual Delay Discounting Task has yielded findings linking impulsivity, addictive and sexual behaviour and as such is a valuable research tool that should be used more extensively. The present review identified gaps to be addressed in further research that concurrently examines facets of impulsivity, addictive and sexual behaviours, especially because criteria for compulsive sexual behaviour disorder have been included in the eleventh edition of the International Classification of Diseases. This article is part of the theme issue 'Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications'.
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Affiliation(s)
- Robert F Leeman
- 1 Department of Health Education and Behavior, College of Health and Human Performance and the Center for Addiction Research and Education, University of Florida , Gainesville, FL 32611 , USA.,2 Department of Psychiatry, Yale School of Medicine , New Haven, CT 06510 , USA
| | - Bonnie H P Rowland
- 1 Department of Health Education and Behavior, College of Health and Human Performance and the Center for Addiction Research and Education, University of Florida , Gainesville, FL 32611 , USA
| | - Nioud Mulugeta Gebru
- 1 Department of Health Education and Behavior, College of Health and Human Performance and the Center for Addiction Research and Education, University of Florida , Gainesville, FL 32611 , USA
| | - Marc N Potenza
- 2 Department of Psychiatry, Yale School of Medicine , New Haven, CT 06510 , USA.,3 Child Study Center and the Department of Neuroscience, Yale School of Medicine , New Haven, CT 06510 , USA.,4 Connecticut Council on Problem Gambling , Wethersfield, CT 06109 , USA.,5 Connecticut Mental Health Center , New Haven, CT 06519 , USA
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17
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Grady E, Hayward RD, Edhayan E. Associations of Alcohol and Drug Misuse with Hospital Outcomes in Traumatic Injury Patients. Subst Use Misuse 2020; 55:622-627. [PMID: 31747848 DOI: 10.1080/10826084.2019.1691598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Traumatic injury is one of the most common causes of mortality worldwide. Previous research suggests that alcohol and drug misuse can increase the risk of experiencing these injuries. Method: Data on all hospital admissions due to traumatic injury in the Detroit metropolitan area between 2006 and 2014 were obtained from the Michigan State Inpatient Database. Patients with no recorded substance misuse comorbidity were compared with those who had (a) alcohol misuse comorbidity only, (b) drug misuse comorbidity only, and (c) both alcohol and drug misuse comorbidities. Outcomes examined included in-hospital mortality, length of stay, and total cost of care. Results: Generalized linear modeling was used to examine the relationship between substance misuse comorbidities and each of the three outcomes. Lower mortality was related to drug and drug/alcohol misuse. Longer length of stay was related to alcohol, drug, and alcohol/drug misuse. Total costs were higher for patients with comorbid alcohol misuse, but lower for those with comorbid drug misuse. These patterns of results were not changed after controlling for differences in background demographics and injury characteristics. Discussion: Alcohol and drug misuse were highly prevalent in trauma patients, in comparison to estimate for the US population as a whole. The relationship between substance misuse comorbidity and outcomes among trauma patient is not straightforward. Substance misuse of all types was related to longer hospitalization, but its association with cost and mortality was mixed. Assessment of substance misuse background at intake may help optimize care for trauma patients.
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Affiliation(s)
- Edmund Grady
- Department of Surgery, Ascension St. John Hospital, Detroit, Michigan, USA
| | - R David Hayward
- Department of Surgery, Ascension St. John Hospital, Detroit, Michigan, USA
| | - Elango Edhayan
- Department of Surgery, Ascension St. John Hospital, Detroit, Michigan, USA
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19
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Hahn H, Kalnitsky S, Haines N, Thamotharan S, Beauchaine TP, Ahn WY. Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2089-2102. [PMID: 31414329 DOI: 10.1007/s10508-019-1450-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 05/06/2023]
Abstract
Sexual discounting, which describes delay discounting of later protected sex vs. immediate unprotected sex (e.g., sex now without a condom vs. waiting an hour to have sex with a condom), is consistently linked to sexual risk behavior. Estimates suggest that over two-thirds of HIV transmissions occur between individuals in committed relationships, but current sexual discounting tasks examine sexual discounting only with hypothetical strangers, leaving a gap in our understanding of sexual discounting with committed sexual partners. We used the Sexual Discounting Task (SDT) to compare discounting rates between men who have sex with men (MSM; n = 99) and heterosexual men (n = 144) and tested a new SDT condition evaluating sexual discounting with main partners. MSM in committed relationships discounted protected sex with their main partner at higher rates than heterosexual men, and discounting rates correlated with self-report measures of condom use, impulsivity/sensation seeking, and substance use. These findings suggest that sexual discounting is a critical factor potentially related to increased HIV transmission between MSM in committed relationships and may be an important target for intervention and prevention.
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Affiliation(s)
- Hunter Hahn
- Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA.
| | - Samuel Kalnitsky
- Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA
| | - Nathaniel Haines
- Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA
| | - Sneha Thamotharan
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Child and Adolescent Psychiatry, Rhode Island Hospital, Providence, RI, USA
| | | | - Woo-Young Ahn
- Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA
- Department of Psychology, Seoul National University, Seoul, Korea
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20
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Jones J, Guest JL, Sullivan PS, Kramer MR, Jenness SM, Sales JM. Concordance between monetary and sexual delay discounting in men who have sex with men. Sex Health 2019; 15:214-222. [PMID: 29212590 DOI: 10.1071/sh17111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/15/2017] [Indexed: 11/23/2022]
Abstract
Background Delay discounting has been found to be associated with numerous health-related outcomes, including risky sexual behaviour. To date, it is unclear whether delay discounting measured in different domains is associated within individuals. The goal of this study was to assess the concordance of monetary and sexual delay discounting in men who have sex with men. METHODS Participants completed an online survey, including the Monetary Choice Questionnaire and the Sexual Discounting Task. Linear regression models were used to assess the association between monetary and sexual discount rates. RESULTS Sexual discount rates did not predict monetary discount rates. There was a substantial amount of clustering of sexual discount rates, requiring sexual discounting data to be categorised. CONCLUSIONS Monetary and sexual delay discounting are distinct processes that are not necessarily associated within individuals, and monetary delay discounting is not an appropriate proxy measure for sexual impulsivity. Data from the Sexual Discounting Task are typically rank-transformed for analysis. These data suggest that this might be an invalid method of analysis. Future studies should investigate the distribution of their data to determine if it is appropriate to analyse sexual discounting data as a continuous measure.
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Affiliation(s)
- Jeb Jones
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Jodie L Guest
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Patrick S Sullivan
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Michael R Kramer
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Samuel M Jenness
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Jessica M Sales
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road, Atlanta, GA 30322
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21
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Ssewamala FM, Sensoy Bahar O, Tozan Y, Nabunya P, Mayo-Wilson LJ, Kiyingi J, Kagaayi J, Bellamy S, McKay MM, Witte SS. A combination intervention addressing sexual risk-taking behaviors among vulnerable women in Uganda: study protocol for a cluster randomized clinical trial. BMC Womens Health 2019; 19:111. [PMID: 31419968 PMCID: PMC6697981 DOI: 10.1186/s12905-019-0807-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/31/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has the highest number of people living with HIV/AIDS, with Nigeria, South Africa, and Uganda accounting for 48% of new infections. A systematic review of the HIV burden among women engaged in sex work (WESW) in 50 low- and middle-income countries found that they had increased odds of HIV infection relative to the general female population. Social structural factors, such as the sex work environment, violence, stigma, cultural issues, and criminalization of sex work are critical in shaping sexually transmitted infection (STI)/HIV risks among WESW and their clients in Uganda. Poverty is the most commonly cited reason for involvement in sex work in SSA. Against this backdrop, this study protocol describes a randomized controlled trial (RCT) that tests the impact of adding economic empowerment to traditional HIV risk reduction (HIVRR) to reduce new incidence of STIs and HIV among WESW in Rakai and the greater Masaka regions in Uganda. METHODS This three-arm RCT will evaluate the efficacy of adding savings, financial literacy and vocational training/mentorship to traditional HIVRR on reducing new incidence of STI infections among 990 WESW across 33 hotspots. The three arms (n = 330 each) are: 1) Control group: only HIVRR versus 2) Treatment group 1: HIVRR plus Savings plus Financial Literacy (HIVRR + S + FL); and 3) Treatment group 2: HIVRR plus S plus FL plus Vocational Skills Training and Mentorship (V) (HIVRR + S + FL + V). Data will be collected at baseline (pre-test), 6, 12, 18 and 24-months post-intervention initiation. This study will use an embedded experimental mixed methods design where qualitative data will be collected post-intervention across all conditions to explore participant experiences. DISCUSSION When WESW have access to more capital and/or alternative forms of employment and start earning formal income outside of sex work, they may be better able to improve their skills and employability for professional advancement, thereby reducing their STI/HIV risk. The study findings may advance our understanding of how best to implement gender-specific HIV prevention globally, engaging women across the HIV treatment cascade. Further, results will provide evidence for the intervention's efficacy to reduce STIs and inform implementation sustainability, including costs and cost-effectiveness. TRIAL REGISTRATION ClinicalTrials.gov , ID: NCT03583541 .
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Affiliation(s)
- Fred M Ssewamala
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Yesim Tozan
- College of Global Public Health, New York University, New York City, NY, USA
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | | | - Joshua Kiyingi
- International Center for Child Health and Development, Masaka, Uganda
| | | | | | - Mary M McKay
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Susan S Witte
- Columbia University School of Social Work, New York City, NY, USA
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22
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Health behaviors, outcomes and their relationships among young men aged 18-24 years in a rural area of north India: A cross-sectional study. PLoS One 2019; 14:e0220285. [PMID: 31348808 PMCID: PMC6662032 DOI: 10.1371/journal.pone.0220285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 07/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background There is limited information related to health behaviors and their related
factors among young men in rural setting of India. This study was conducted
to investigate multiple health risk behaviors and outcomes among young men
aged 18–24 years in rural India. Methods This was a community-based cross-sectional survey conducted in the Ballabgarh
block of Faridabad district, Haryana, India. Information regarding
socio-demographic details, substance use, injury & violence, mental
health and sexual behaviors were collected using a semi-structured interview
schedule. Age adjusted prevalence estimates of behaviors and outcomes are
computed along with 95% Confidence Intervals. Mediation analysis was carried
out to examine relationships between socio-demographic variables, select
behaviors and outcomes reported in the study. Results A total of 836 young men participated in the study, with mean (SD) age of
20.6 (1.9) years. The age-adjusted prevalence (with 95% Confidence Interval)
for ever use of tobacco, alcohol, and other substances was 34.2% (33.9,
34.5), 23.4% (23.2, 23.6), and 4.5% (4.4, 4.5), respectively. Loneliness and
suicidal thoughts were reported by 237 and 35 youth men with age adjusted
prevalence as 28.6%, 95% CI: 28.4–28.8 and 4.3%, 95% CI: 4.23–4.31,
respectively. A total of 330 young men met serious injury in past one year
(prevalence 39.3%, 95%CI: 39.01–39.67). Almost one-third of men (prevalence
30.6%, 95%CI: 30.34–30.85) had engaged in pre-marital sexual intercourse.
Current substance use was found to be significant mediator for associations
with socio-demographic variables studied for dependent variables viz.
pre-marital sexual intercourse and serious injury. Conclusion High prevalence of various risk behaviors and outcomes was found in young men
aged 18–24 years in our rural setting. It is imperative that multi-component
health intervention package be rolled out to address these.
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Mayo-Wilson LJ, Glass NE, Ssewamala FM, Linnemayr S, Coleman J, Timbo F, Johnson MW, Davoust M, Labrique A, Yenokyan G, Dodge B, Latkin C. Microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices in economically-vulnerable African-American young adults (EMERGE): protocol for a feasibility randomized clinical trial. Trials 2019; 20:439. [PMID: 31315685 PMCID: PMC6637550 DOI: 10.1186/s13063-019-3529-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/15/2019] [Indexed: 01/08/2023] Open
Abstract
Background Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages (“nudges”) that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. Methods/design In total, 40 young adults who are African-American, aged 18–24, live in Baltimore City, have experienced at least one episode of homelessness in the last 12 months, are unemployed or underemployed (fewer than 10 h per week), are not enrolled in school, own a cell phone with text messaging, and report at least one episode of unprotected or unsafe sex in the prior 12 months will be recruited from two community-based organizations providing residential supportive services to urban youth. Participants will undergo a 3-week run-in period and thereafter be randomly assigned to one of two groups with active interventions for 20 weeks. The first group (“comparison”) will receive text messages with information on job openings. The second group (“experimental”) will receive text messages with information on job openings plus information on HIV prevention and business educational sessions, a mentored apprenticeship, and a start-up grant, and business and HIV prevention text messages based on principles from behavioral economics. The two primary outcomes relate to the feasibility of conducting a larger trial. Secondary outcomes relate to employment, sexual risk behaviors, and HIV preventive practices. All participants will be assessed using an in-person questionnaire at pre-intervention (prior to randomization) and at 3 weeks post-intervention. To obtain repeated, longitudinal measures, participants will be assessed weekly using text message surveys from pre-intervention up to 3 weeks post-intervention. Discussion This study will be one of the first U.S.-based feasibility randomized clinical trials of an HIV prevention microenterprise intervention for economically-vulnerable African-American young adults. The findings will inform whether and how to conduct a larger efficacy trial for HIV risk reduction in this population. Trial registration ClinicalTrials.gov, NCT03766165. Registered on 4 December 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3529-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Larissa Jennings Mayo-Wilson
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA. .,Department of Applied Health Science, Indiana University School of Public Health, 1025 E. 7th Street, Bloomington, IN, USA.
| | - Nancy E Glass
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD, USA
| | - Fred M Ssewamala
- Washington University in St. Louis, The Brown School, Goldfarb, One Brookings, Drive, St. Louis, MO, USA
| | | | - Jessica Coleman
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Fatmata Timbo
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, USA
| | - Melissa Davoust
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Alain Labrique
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Gayane Yenokyan
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA
| | - Brian Dodge
- Department of Applied Health Science, Indiana University School of Public Health, 1025 E. 7th Street, Bloomington, IN, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Hampton House 737, Baltimore, MD, USA
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24
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Berry MS, Johnson PS, Collado A, Loya JM, Yi R, Johnson MW. Sexual Probability Discounting: A Mechanism for Sexually Transmitted Infection Among Undergraduate Students. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:495-505. [PMID: 29582269 PMCID: PMC6365211 DOI: 10.1007/s10508-018-1155-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 01/02/2018] [Accepted: 01/15/2018] [Indexed: 05/03/2023]
Abstract
Lack of condom use among youth is a major contributor to the spread of sexually transmitted infections (STIs) including HIV/AIDS, which has lifelong deleterious health consequences. College students (N = 262) completed the Sexual Probability Discounting Task in which participants reported their likelihood of condom use under various probabilities of contracting an STI. Each participant completed the task in regard to different STIs including HIV/AIDS and different partners. Results showed that the likelihood of condom-protected sex generally decreased as HIV/AIDS and other STI contraction became less probable. Moreover, condom-protected sex likelihood was related to STI type (e.g., decreased condom-protected sex in chlamydia relative to HIV/AIDS condition) and partner desirability (decreased condom-protected sex with more desirable partners). Results are the first to show that compared to other STIs, HIV/AIDS had the most influence on condom-protected sex. Results showed probability discounting contributed to lack of condom-protected sex and offers a novel framework for examining determinants of within-subject variability in condom use.
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Affiliation(s)
- Meredith S. Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Patrick S. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anahí Collado
- Department of Psychology, University of Maryland, College Park, MD
| | - Jennifer M. Loya
- Department of Psychology, University of Maryland, College Park, MD
| | - Richard Yi
- Department of Psychology, University of Maryland, College Park, MD
| | - Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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25
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Espinoza L, Richardson JL, Ferguson K, Chou CP, Baezconde-Garbanati L, Stacy AW. Adolescent Substance Use and Sensation-Seeking on Sexual Behaviors Among Young Adults from Continuation High Schools. Subst Use Misuse 2019; 54:373-383. [PMID: 30654684 PMCID: PMC6438727 DOI: 10.1080/10826084.2018.1496453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. OBJECTIVE To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. METHODS Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. RESULTS Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. Conclusions/Importance: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.
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Affiliation(s)
- Lilia Espinoza
- a Department of Public Health , California State University Fullerton , Fullerton , California , USA
| | - Jean L Richardson
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Kristin Ferguson
- c School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Chih-Ping Chou
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Lourdes Baezconde-Garbanati
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Alan W Stacy
- d School of Community & Global Health , Claremont Graduate University , Claremont , California , USA
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Black SR, Seager I, Meers MR, Arnold LE, Birmaher B, Findling RL, Horwitz SM, Youngstrom EA, Fristad MA. Associations between Parental Psychopathology and Sexual Behavior in an Outpatient Psychiatric Sample. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 49:50-59. [PMID: 30376641 DOI: 10.1080/15374416.2018.1514614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Early age of sexual debut is associated with an increase in negative outcomes, including higher incidence of nonconsensual sexual experiences, higher rates of sexually transmitted infections, and risky sexual practices. Little research has examined the role of parental psychopathology as a predictor of adolescent sexual activity, however. The current study aims to close this gap by examining the relationship between parental psychopathology and sexual activity in a longitudinal sample of youth. Participants were 685 adolescents from the Longitudinal Assessment of Manic Symptoms study, the majority of whom were male (67%) and White (65%). Analyses considering likelihood of sexual initiation included the full sample, whereas analyses considering predictors of the age of sexual debut included the 162 participants who reported ever having sexual intercourse (62% male, 51% White) via the Youth Risk Behavior Surveillance-High School version. Cox regression analyses suggested that maternal generalized anxiety disorder predicted decreased likelihood of initiating sex during the 8-year follow-up period, whereas paternal conduct disorder predicted increased likelihood of initiating sex. Multivariate linear regressions also showed that maternal conduct disorder predicted earlier age of sexual debut among those who had initiated, whereas paternal antisocial personality disorder predicted later age of sexual debut. These associations were observed in both male and female adolescents. Furthermore, these effects were largely not explained by the established relationship between youth psychopathology and sexual behavior. Results have implications for interventions aimed at decreasing sexual risk taking in vulnerable youth.
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Affiliation(s)
- Sarah R Black
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center
| | - Ilana Seager
- Department of Psychology, The Ohio State University
| | - Molly R Meers
- Department of Psychology, Nationwide Children's Hospital
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh Medical Center
| | - Robert L Findling
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Sarah M Horwitz
- Department of Child and Adolescent Psychiatry, New York University School of Medicine
| | - Eric A Youngstrom
- Departments of Psychology and Neuroscience and Psychiatry, University of North Carolina at Chapel Hill
| | - Mary A Fristad
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center.,Department of Psychology, The Ohio State University.,Department of Nutrition, The Ohio State University
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Mahoney CT, Lawyer SR. Domain-Specific Relationships in Sexual Measures of Impulsive Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1591-1599. [PMID: 29696554 DOI: 10.1007/s10508-018-1210-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 02/23/2018] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
Impulsivity is an important construct for understanding sexual behaviors, but behavioral and self-report measures of impulsivity often are not correlated. One possible explanation for this is that there is little shared variance in the measures because behavioral measures index impulsivity by asking questions about monetary preferences, while self-report measures index impulsivity by asking about a broad range of real-world outcomes (including those of a sexual nature) largely unrelated to money-related preferences. Undergraduate students (total N = 105; female n = 77, male n = 28) completed laboratory measures-delay discounting (DD) and probability discounting (PD)-for two different outcomes-money and sexual activity. Participants also completed the Delaying Gratification Inventory (DGI), which measures difficulty with delaying gratification (i.e., impulsivity) across different domains, including money and physical pleasures. Findings indicated that DD and PD for money were not related to any of the DGI subscales. However, DD for sexual activity was significantly related to the DGI Physical Pleasures subscale, but not other subscales. These findings suggest that the relationship between behavioral and self-report measures of impulsive choice may be stronger when both are measuring domain-specific rather than domain-general behavioral patterns, but further research is warranted.
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Affiliation(s)
- Colin T Mahoney
- Department of Psychology, Idaho State University, 921 S. 8th Ave, Stop 8112, Pocatello, ID, 83209, USA.
| | - Steven R Lawyer
- Department of Psychology, Idaho State University, 921 S. 8th Ave, Stop 8112, Pocatello, ID, 83209, USA
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28
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Sosa-Rubí SG, Salinas-Rodríguez A, Montoya-Rodríguez AA, Galárraga O. The Relationship Between Psychological Temporal Perspective and HIV/STI Risk Behaviors Among Male Sex Workers in Mexico City. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1551-1563. [PMID: 29380090 PMCID: PMC5955784 DOI: 10.1007/s10508-017-1123-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 05/17/2023]
Abstract
Men who have sex with men (MSM) face a disproportionate burden of HIV incidence and HIV prevalence, particularly young men who have sex with men. The aim of this article was to analyze the relation between a psychological temporal perspective and HIV/sexually transmitted infection (STI) risk behaviors among male sex workers (MSWs), a potentially highly present-oriented group of MSM. A total sample of 326 MSWs were included and responded to a validated psychological scale: the Zimbardo's Time Perspective Inventory; they also reported how frequently they engaged in protective behaviors against HIV and other STI risks behaviors, including condom use with casual and regular partners, as well as prior HIV testing. We adjusted structural equation models to analyze the relation between a psychological temporal perspective and HIV/STI risk behaviors. We found that orientation toward the past was correlated with decreased condom use with casual partners (β = - 0.18; CI95% - 0.23, - 0.12). Future orientation was not associated with condom use with casual partners. Regarding condom use with regular partners, past and present orientation were related to lower likelihood of condom use (β = - 0.23; CI95% - 0.29, - 0.17; β = - 0.11; CI95% - 0.19, - 0.02), whereas future orientation increased the likelihood of condom use with regular partners (β = 0.40; CI95% 0.31, 0.50). Time orientation (past, present, or future) did not predict the probability of having an HIV test. The design of HIV/STI prevention programs among vulnerable populations, such as MSM and MSWs, should consider specific time-frame mechanisms that can importantly affect sexual risk behavior decisions.
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Affiliation(s)
- Sandra G Sosa-Rubí
- National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Aarón Salinas-Rodríguez
- National Institute of Public Health, Avenida Universidad No. 655, Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | | | - Omar Galárraga
- Brown University School of Public Health, Providence, RI, USA
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29
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Lemley SM, Jarmolowicz DP, Parkhurst D, Celio MA. The Effects of Condom Availability on College Women's Sexual Discounting. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:551-563. [PMID: 28913688 DOI: 10.1007/s10508-017-1040-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 06/28/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women's sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.
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Affiliation(s)
- Shea M Lemley
- Department of Applied Behavioral Science, University of Kansas, 4041 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA.
| | - David P Jarmolowicz
- Department of Applied Behavioral Science and Problem Gambling Research and Education Support System, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Daniel Parkhurst
- Department of Applied Behavioral Science, University of Kansas, 4050 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Mark A Celio
- Department of Behavioral and Social Sciences, Brown University, Box G-121-5, 121 S. Main Street, Providence, RI, 02915, USA
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30
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Collado A, Johnson PS, Loya JM, Johnson MW, Yi R. Discounting of Condom-Protected Sex as a Measure of High Risk for Sexually Transmitted Infection Among College Students. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2187-2195. [PMID: 27699562 PMCID: PMC5893305 DOI: 10.1007/s10508-016-0836-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 08/02/2016] [Accepted: 08/09/2016] [Indexed: 05/03/2023]
Abstract
The study examined sexual delay discounting, or the devaluation of condom-protected sex in the face of delay, as a risk factor for sexually transmitted infection (STI) among college students. Participants (143 females, 117 males) completed the sexual delay discounting task (Johnson & Bruner, 2012) and questionnaires of risky sexual behavior, risk perception, and knowledge. Participants exhibited steeper sexual delay discounting (above and beyond general likelihood of having unprotected sex) when partners were viewed as more desirable or less likely to have a STI, with males demonstrating greater sexual delay discounting than females across most conditions. Importantly, greater self-reported risky sexual behaviors were associated with higher rates of sexual delay discounting, but not with likelihood of using a condom in the absence of delay. These results provide support for considering sexual delay discounting, with particular emphasis on potential delays to condom use, as a risk factor for STI among college students.
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Affiliation(s)
- Anahí Collado
- Alvord, Baker, and Associates, LLC, 3200 Tower Oaks Blvd, Suite 200, Rockville, MD, 20852, USA.
| | - Patrick S Johnson
- Psychology Department, California State University-Chico, Chico, CA, USA
| | - Jennifer M Loya
- Psychology Department, George Mason University, Fairfax, VA, USA
| | - Matthew W Johnson
- School of Medicine, Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Richard Yi
- Psychology Department, University of Maryland- College Park, College Park, MD, USA
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31
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Wongsomboon V, Robles E. Devaluation of Safe Sex by Delay or Uncertainty: A Within-Subjects Study of Mechanisms Underlying Sexual Risk Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2131-2144. [PMID: 27473071 DOI: 10.1007/s10508-016-0788-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 05/26/2016] [Accepted: 06/03/2016] [Indexed: 05/06/2023]
Abstract
The value of safe sex may be discounted based on contextual factors associated with an opportunity for sex. College students in a within-subjects study selected hypothetical sexual partners from a set of pictures and classified them based on attractiveness and estimated chance of having an sexually transmitted infection (STI). In the Sexual Delay Discounting (SDD) task, participants rated their likelihood (0-100 %) of waiting for some period of time (e.g., 3 h) to have protected sex with their selected partners, when they could have immediate sex without protection. In the Sexual Probability Discounting (SPD) task, participants rated their likelihood of having protected sex if the opportunity was uncertain (e.g., 50 %), when they could have unprotected sex for sure (100 %). All participants included in the final analyses were aware of and had a positive attitude towards protection against STIs as they were likely to have immediate (or certain) protected sex. Results from 432 delay data in the SDD task and 488 probability data in the SPD task showed that participants' preference for safe sex systematically decreased as the delay to and odds against having safe sex increased. However, this preference was altered by the participants' perception of their partner's attractiveness and STI risk.
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Affiliation(s)
- Val Wongsomboon
- School of Social and Behavioral Sciences, Arizona State University, 4701 W. Thunderbird Road, Glendale, AZ, 85306, USA.
| | - Elias Robles
- School of Social and Behavioral Sciences, Arizona State University, 4701 W. Thunderbird Road, Glendale, AZ, 85306, USA
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32
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Behavioral Economic Predictors of Alcohol and Sexual Risk Behavior in College Drinkers. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/s40732-017-0239-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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33
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Ballester-Arnal R, Ruiz-Palomino E, Gil-Llario MD. Structural Equation Modeling Test of an Integrated Model of Spanish Youth's Condom Use. AIDS Behav 2017; 21:1407-1416. [PMID: 27217037 DOI: 10.1007/s10461-016-1430-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Heterosexual transmission represents 26 % of newly diagnosed infection in Spanish youth. Behavioral change models have emphasized the influence of multiple variables to predict condom use behavior. The aim of this study is to examine how those variables are organized and which theory explains the condom use behavior better. A sample of 424 young heterosexuals (M age = 20.62; SD = 2.16) filled out a battery of self-report questionnaires for assessing AIDS-related variables, personality traits and clinical variables (general, sexuality-related and health-related). A structural model was specified that included perceived pleasure and condom use self-efficacy as predictive variables. Depression and sexual compulsivity indirectly influence behavior. The final model accounted for 65.9 % of the variance in behavior. These results highlight the importance of cognitive and emotional variables as predictors of behavior (ex. expectations of pleasure and self-efficacy beliefs). This is important information for designing effective psychological interventions.
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34
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Johnson MW, Herrmann ES, Sweeney MM, LeComte RS, Johnson PS. Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV. Psychopharmacology (Berl) 2017; 234:599-612. [PMID: 27921140 PMCID: PMC5343757 DOI: 10.1007/s00213-016-4493-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 11/21/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Although cocaine use has been linked to sexual HIV risk behavior for decades, the direct effects of cocaine on sexual desire and sexual decision-making are unexamined. Research suggests delay discounting (devaluation of future outcomes) and probability discounting (devaluation of uncertain outcomes) play roles in condom use decisions. This study examined the effect of cocaine administration on sexual desire, hypothetical condom use, and discounting tasks. METHODS This double-blind, within-subjects study compared the effects of 0, 125, and 250 mg/70 kg oral cocaine HCl in 12 cocaine users. Measures included sexual desire and other subjective ratings, the Sexual Delay Discounting Task, the Sexual Probability Discounting Task, and monetary delay and probability discounting tasks. RESULTS Cocaine caused dose-related increases in sexual desire and prototypical stimulant abuse-liability ratings. Relative to placebo, cocaine did not significantly alter condom use likelihood when condoms were immediately available or when sex was associated with 100% certainty of sexually transmitted infection (STI). In contrast, cocaine dose-dependently strengthened the effect of delay (sexual delay discounting) and STI uncertainty (sexual probability discounting) in decreasing condom use likelihood. Cocaine caused no significant change in monetary delay and probability discounting. CONCLUSION This is the first study showing that cocaine administration increases sexual desire. Detrimental effects of cocaine on sexual risk were only observed when safer sex required delay, or STI risk was uncertain (representative of many real-world scenarios), suggesting a critical role of discounting processes. Lack of monetary effects highlights the importance of studying clinically relevant outcomes when examining drug effects on behavioral processes.
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Affiliation(s)
- Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA.
| | - Evan S Herrmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
- Columbia College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - Mary M Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Robert S LeComte
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
- Department of Psychology, California State University, Chico, CA, USA
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35
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Strickland JC, Bolin BL, Romanelli MR, Rush CR, Stoops WW. Effects of acute buspirone administration on inhibitory control and sexual discounting in cocaine users. Hum Psychopharmacol 2017; 32. [PMID: 28120485 DOI: 10.1002/hup.2567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 10/12/2016] [Accepted: 11/25/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Cocaine users display deficits in inhibitory control and make impulsive choices that may increase risky behavior. Buspirone is an anxiolytic that activates dopaminergic and serotonergic systems and improves impulsive choice (i.e., reduces sexual risk-taking intent) in cocaine users when administered chronically. We evaluated the effects of acutely administered buspirone on inhibitory control and impulsive choice. METHODS Eleven subjects with a recent history of cocaine use completed this within-subject, placebo-controlled study. Subjects performed two cued go/no-go and a sexual risk delay-discounting task following oral administration of buspirone (10 and 30 mg), triazolam (0.375 mg; positive control), and placebo (negative control). Physiological and psychomotor performance and subject-rated data were also collected. RESULTS Buspirone failed to change inhibitory control or impulsive choice; however, slower reaction times were observed at the highest dose tested. Buspirone did not produce subject-rated drug effects but dose-dependently decreased diastolic blood pressure. Triazolam impaired psychomotor performance and increased ratings of positive subject-rated effects (e.g., Like Drug). CONCLUSIONS These findings indicate that acutely administered buspirone has little impact on behavioral measures of inhibitory control and impulsive sexual decision-making. Considering previous findings with chronic dosing, these findings highlight that the behavioral effects of buspirone differ as a function of dosing conditions.
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Affiliation(s)
| | - B Levi Bolin
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | | | - Craig R Rush
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA.,Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.,Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - William W Stoops
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA.,Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.,Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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36
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Richardson GB, Dariotis JK, Lai MHC. From Environment to Mating Competition and Super-K in a Predominantly Urban Sample of Young Adults. EVOLUTIONARY PSYCHOLOGY 2017; 15:1474704916670165. [PMID: 28152622 PMCID: PMC6349591 DOI: 10.1177/1474704916670165] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/26/2016] [Indexed: 11/24/2022] Open
Abstract
Recent research suggests human life history strategy (LHS) may be subsumed by multiple dimensions, including mating competition and Super-K, rather than one. In this study, we test whether a two-dimensional structure best fit data from a predominantly urban sample of young adults ages 18-24. We also test whether latent life history dimensions are associated with environmental harshness and unpredictability as predicted by life history theory. Results provide evidence that a two-dimensional model best fit the data. Furthermore, a moderate inverse residual correlation between mating competition and Super-K was found, consistent with a life history trade-off. Our findings suggest that parental socioeconomic status may enhance investment in mating competition, that harshness might persist into young adulthood as an important correlate of LHS, and that unpredictability may not have significant effects in young adulthood. These findings further support the contention that human LHS is multidimensional and environmental effects on LHS are more complex than previously suggested. The model presented provides a parsimonious explanation of an array of human behaviors and traits and can be used to inform public health initiatives, particularly with respect to the potential impact of environmental interventions.
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Affiliation(s)
- George B. Richardson
- School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Jacinda K. Dariotis
- School of Education, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH, USA
- College of Education, Criminal Justice, and Human Services, Evaluation Services Center, University of Cincinnati, Cincinnati, OH, USA
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark H. C. Lai
- School of Education, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH, USA
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37
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L’impulsivité sexuelle et les comportements sexuels problématiques chez les adultes : vers des mesures comportementales spécifiques et innovatrices. SEXOLOGIES 2016. [DOI: 10.1016/j.sexol.2015.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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38
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Carrier Emond F, Nolet K, Cyr G, Rouleau JL, Gagnon J. Sexual impulsivity and problematic sexual behaviors in adults: Towards innovative domain-specific behavioral measures. SEXOLOGIES 2016. [DOI: 10.1016/j.sexol.2015.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Koffarnus MN, Johnson MW, Thompson-Lake DGY, Wesley MJ, Lohrenz T, Montague PR, Bickel WK. Cocaine-dependent adults and recreational cocaine users are more likely than controls to choose immediate unsafe sex over delayed safer sex. Exp Clin Psychopharmacol 2016; 24:297-304. [PMID: 27454677 PMCID: PMC5017011 DOI: 10.1037/pha0000080] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cocaine users have a higher incidence of risky sexual behavior and HIV infection than nonusers. Our aim was to measure whether safer sex discount rates-a measure of the likelihood of having immediate unprotected sex versus waiting to have safer sex-differed between controls and cocaine users of varying severity. Of the 162 individuals included in the primary data analyses, 69 met the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria for cocaine dependence, 29 were recreational cocaine users who did not meet the dependence criteria, and 64 were controls. Participants completed the Sexual Discounting Task, which measures a person's likelihood of using a condom when one is immediately available and how that likelihood decreases as a function of delay to condom availability with regard to 4 images chosen by the participants of hypothetical sexual partners differing in perceived desirability and likelihood of having a sexually transmitted infection. When a condom was immediately available, the stated likelihood of condom use sometimes differed between cocaine users and controls, which depended on the image condition. Even after controlling for rates of condom use when one is immediately available, the cocaine-dependent and recreational users groups were more sensitive to delay to condom availability than controls. Safer sex discount rates were also related to intelligence scores. The Sexual Discounting Task identifies delay as a key variable that impacts the likelihood of using a condom among these groups and suggests that HIV prevention efforts may be differentially effective based on an individual's safer sex discount rate. (PsycINFO Database Record
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Affiliation(s)
- Mikhail N. Koffarnus
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Daisy G. Y. Thompson-Lake
- Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michael J. Wesley
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - Terry Lohrenz
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - P. Read Montague
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - Warren K. Bickel
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
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Age-dependent effects in the association between monetary delay discounting and risky sexual behavior. SPRINGERPLUS 2016; 5:852. [PMID: 27386301 PMCID: PMC4919197 DOI: 10.1186/s40064-016-2570-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/14/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Monetary delay discounting is a measure of impulsivity associated with substance use and abuse, problem gambling, and other health-related outcomes. More recently, delay discounting has been shown to be associated with risky sexual behavior. We analyzed survey data from men who have sex with men who completed a monetary discounting task and reported sexual behaviors in the previous 12 months. FINDINGS Monetary delay discounting was associated with condomless anal intercourse among young (18-24 years), but not older, men who have sex with men. CONCLUSIONS Monetary delay discounting may identify young men at increased risk of engaging in HIV risk behaviors.
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41
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Johnson PS, Sweeney MM, Herrmann ES, Johnson MW. Alcohol Increases Delay and Probability Discounting of Condom-Protected Sex: A Novel Vector for Alcohol-Related HIV Transmission. Alcohol Clin Exp Res 2016; 40:1339-50. [PMID: 27129419 PMCID: PMC4968206 DOI: 10.1111/acer.13079] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/28/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol use, especially at binge levels, is associated with sexual HIV risk behavior, but the mechanisms through which alcohol increases sexual risk taking are not well-examined. Delay discounting, that is, devaluation of future consequences as a function of delay to their occurrence, has been implicated in a variety of problem behaviors, including risky sexual behavior. Probability discounting is studied with a similar framework as delay discounting, but is a distinct process in which a consequence is devalued because it is uncertain or probabilistic. METHODS Twenty-three, nondependent alcohol users (13 male, 10 female; mean age = 25.3 years old) orally consumed alcohol (1 g/kg) or placebo in 2 separate experimental sessions. During sessions, participants completed tasks examining delay and probability discounting of hypothetical condom-protected sex (Sexual Delay Discounting Task, Sexual Probability Discounting Task) and of hypothetical and real money. RESULTS Alcohol decreased the likelihood that participants would wait to have condom-protected sex versus having immediate, unprotected sex. Alcohol also decreased the likelihood that participants would use an immediately available condom given a specified level of sexually transmitted infection (STI) risk. Alcohol did not affect delay discounting of money, but it did increase participants' preferences for larger, probabilistic monetary rewards over smaller, certain rewards. CONCLUSIONS Acute, binge-level alcohol intoxication may increase sexual HIV risk by decreasing willingness to delay sex in order to acquire a condom in situations where one is not immediately available, and by decreasing sensitivity to perceived risk of STI contraction. These findings suggest that delay and probability discounting are critical, but heretofore unrecognized, processes that may mediate the relations between alcohol use and HIV risk.
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Affiliation(s)
- Patrick S Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary M Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan S Herrmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Meredith SE, Sweeney MM, Johnson PS, Johnson MW, Griffiths RR. Weekly Energy Drink Use Is Positively Associated with Delay Discounting and Risk Behavior in a Nationwide Sample of Young Adults. JOURNAL OF CAFFEINE RESEARCH 2016; 6:10-19. [PMID: 26989563 PMCID: PMC4779981 DOI: 10.1089/jcr.2015.0024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Energy drink use is associated with increased risk behavior among adolescents and college students. This study examined this relationship in a nationwide sample of young adults and also examined relations between energy drink use and delay discounting. Methods: Participants were 874 U.S. adults 18-28 years of age with past 30-day consumption of caffeine and alcohol. Participants completed an online survey of energy drink use, drug use, sexual activity, alcohol misuse (alcohol use disorders identification test [AUDIT]), sensation seeking (four-item Brief Sensation Seeking Scale [BSSS-4]), and delay discounting of monetary rewards and condom use. Results: Over one-third of participants (n = 303) reported consuming energy drinks at least once per week. Weekly energy drink users were more likely than less-than-weekly energy drink users to report a recent history of risk behaviors, including cigarette smoking (56% vs. 28%, p < 0.0001), illicit stimulant use (22% vs. 6%, p < 0.0001), and unprotected sex (63% vs. 45%, p < 0.0001). Covariate-adjusted analyses found that weekly energy drink users did not have significantly higher BSSS-4 scores (3.5 vs. 3.1, p = 0.098), but they had higher mean AUDIT scores (8.0 vs. 4.8, p < 0.0001), and they more steeply discounted delayed monetary rewards. Although weekly energy drink users did not show steeper discounting of delayed condom use, they showed a lower likelihood of using a condom when one was immediately available. Conclusions: This study extends findings that energy drink use is associated with risk behavior, and it is the first study to show that energy drink use is associated with monetary delay discounting.
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Affiliation(s)
- Steven E. Meredith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Mary M. Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patrick S. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Roland R. Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Appelhans BM, French SA, Pagoto SL, Sherwood NE. Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies. Appetite 2015; 96:268-279. [PMID: 26431681 DOI: 10.1016/j.appet.2015.09.035] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 08/26/2015] [Accepted: 09/28/2015] [Indexed: 12/31/2022]
Abstract
Weight loss outcomes in lifestyle interventions for obesity are primarily a function of sustained adherence to a reduced-energy diet, and most lapses in diet adherence are precipitated by temptation from palatable food. The high nonresponse and relapse rates of lifestyle interventions suggest that current temptation management approaches may be insufficient for most participants. In this conceptual review, we discuss three neurobehavioral processes (attentional bias, temporal discounting, and the cold-hot empathy gap) that emerge during temptation and contribute to lapses in diet adherence. Characterizing the neurobehavioral profile of temptation highlights an important distinction between temptation resistance strategies aimed at overcoming temptation while it is experienced, and temptation prevention strategies that seek to avoid or minimize exposure to tempting stimuli. Many temptation resistance and temptation prevention strategies heavily rely on executive functions mediated by prefrontal systems that are prone to disruption by common occurrences such as stress, insufficient sleep, and even exposure to tempting stimuli. In contrast, commitment strategies are a set of devices that enable individuals to manage temptation by constraining their future choices, without placing heavy demands on executive functions. These concepts are synthesized in a conceptual model that categorizes temptation management approaches based on their intended effects on reward processing and degree of reliance on executive functions. We conclude by discussing the implications of our model for strengthening temptation management approaches in future lifestyle interventions, tailoring these approaches based on key individual difference variables, and suggesting high-priority topics for future research.
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Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren St, Suite 470, Chicago, IL 60612, USA; Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson Blvd Suite 400, Chicago, IL 60612, USA.
| | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Nancy E Sherwood
- HealthPartners Institute for Education and Research, 8170 33rd Ave S, Mail Stop 23301A, Bloomington, MN 55425, USA.
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Kervick AA, Hogan MJ, O'Hora D, Sarma KM. Testing a structural model of young driver willingness to uptake Smartphone Driver Support Systems. ACCIDENT; ANALYSIS AND PREVENTION 2015; 83:171-181. [PMID: 26277411 DOI: 10.1016/j.aap.2015.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/10/2015] [Accepted: 07/22/2015] [Indexed: 06/04/2023]
Abstract
There is growing interest in the potential value of using phone applications that can monitor driver behaviour (Smartphone Driver Support Systems, 'SDSSs') in mitigating risky driving by young people. However, their value in this regard will only be realised if young people are willing to use this technology. This paper reports the findings of a study in which a novel structural model of willingness to use SDSSs was tested. Grounded in the driver monitoring and Technology Acceptance (TA) research literature, the model incorporates the perceived risks and gains associated with potential SDSS usage and additional social cognitive factors, including perceived usability and social influences. A total of 333 smartphone users, aged 18-24, with full Irish driving licenses completed an online questionnaire examining willingness or Behavioural Intention (BI) to uptake a SDSS. Following exploratory and confirmatory factor analyses, structural equation modelling indicated that perceived gains and social influence factors had significant direct effects on BI. Perceived risks and social influence also had significant indirect effects on BI, as mediated by perceived gains. Overall, this model accounted for 72.5% of the variance in willingness to uptake SDSSs. Multi-group structural models highlighted invariance of effects across gender, high and low risk drivers, and those likely or unlikely to adopt novel phone app technologies. These findings have implications for our understanding of the willingness of young drivers to adopt and use SDSSs, and highlight potential factors that could be targeted in behavioural change interventions seeking to improve usage rates.
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Affiliation(s)
- Aoife A Kervick
- School of Psychology, National University of Ireland, Galway, Ireland.
| | - Michael J Hogan
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Denis O'Hora
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Kiran M Sarma
- School of Psychology, National University of Ireland, Galway, Ireland
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Fields SA, Ramos A, Reynolds BA. Delay discounting and health risk behaviors: the potential role of stress. Curr Opin Psychol 2015. [DOI: 10.1016/j.copsyc.2015.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Schuelter-Trevisol F, Almeida da Silva M, Claudino D, Gonçalves E Silva HC, Mendes Marcon CE. Hiv And Sexually Transmitted Infections Among Youths: A Brazilian Perception. Am J Public Health 2015; 105:e5. [PMID: 26378855 DOI: 10.2105/ajph.2015.302854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Fabiana Schuelter-Trevisol
- All of the authors are with the Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil. Fabiana Schuelter-Trevisol is also with the Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão
| | - Maricele Almeida da Silva
- All of the authors are with the Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil. Fabiana Schuelter-Trevisol is also with the Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão
| | - Dikson Claudino
- All of the authors are with the Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil. Fabiana Schuelter-Trevisol is also with the Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão
| | - Helena Caetano Gonçalves E Silva
- All of the authors are with the Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil. Fabiana Schuelter-Trevisol is also with the Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão
| | - Chaiana Esmeraldino Mendes Marcon
- All of the authors are with the Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Tubarão, Santa Catarina, Brazil. Fabiana Schuelter-Trevisol is also with the Clinical Research Center, Hospital Nossa Senhora da Conceição, Tubarão
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Jarmolowicz DP, Lemley SM, Asmussen L, Reed DD. Mr. right versus Mr. right now: A discounting-based approach to promiscuity. Behav Processes 2015; 115:117-22. [DOI: 10.1016/j.beproc.2015.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
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Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls. PLoS One 2015; 10:e0128641. [PMID: 26017273 PMCID: PMC4445907 DOI: 10.1371/journal.pone.0128641] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 04/29/2015] [Indexed: 12/11/2022] Open
Abstract
Individuals with cocaine use disorders are disproportionately affected by HIV/AIDS, partly due to higher rates of unprotected sex. Recent research suggests delay discounting of condom use is a factor in sexual HIV risk. Delay discounting is a behavioral economic concept describing how delaying an event reduces that event’s value or impact on behavior. Probability discounting is a related concept describing how the uncertainty of an event decreases its impact on behavior. Individuals with cocaine use disorders (n = 23) and matched non-cocaine-using controls (n = 24) were compared in decision-making tasks involving hypothetical outcomes: delay discounting of condom-protected sex (Sexual Delay Discounting Task), delay discounting of money, the effect of sexually transmitted infection (STI) risk on likelihood of condom use (Sexual Probability Discounting Task), and probability discounting of money. The Cocaine group discounted delayed condom-protected sex (i.e., were more likely to have unprotected sex vs. wait for a condom) significantly more than controls in two of four Sexual Delay Discounting Task partner conditions. The Cocaine group also discounted delayed money (i.e., preferred smaller immediate amounts over larger delayed amounts) significantly more than controls. In the Sexual Probability Discounting Task, both groups showed sensitivity to STI risk, however the groups did not differ. The Cocaine group did not consistently discount probabilistic money more or less than controls. Steeper discounting of delayed, but not probabilistic, sexual outcomes may contribute to greater rates of sexual HIV risk among individuals with cocaine use disorders. Probability discounting of sexual outcomes may contribute to risk of unprotected sex in both groups. Correlations showed sexual and monetary results were unrelated, for both delay and probability discounting. The results highlight the importance of studying specific behavioral processes (e.g., delay and probability discounting) with respect to specific outcomes (e.g., monetary and sexual) to understand decision making in problematic behavior.
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