Skip to main content

Advertisement

SpringerLink
Log in

Compulsive Sexual Behavior and HIV/STI Risk: a Review of Current Literature

  • Sex Addiction (S Kraus, Section Editor)
  • Published:
Current Addiction Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The current literature consistently links compulsive sexual behavior (CSB) to sexual risk behaviors among diverse populations. Controversy over the conceptualization of CSB has led to challenges in formulating standardized treatment options and health promotion/prevention strategies. However, the increase in empirical research on this topic has led to a greater understanding of CSB and evidence for subtypes including the consumption of sexually explicit media (SEM) via the Internet.

Recent Findings

While the etiology of CSB is under debate, the absence of standard criteria and measures supports the heterogeneity of the condition and emphasizes the importance of other factors (e.g., developmental stage, personality characteristics, cultural background, and gender concepts) in making a comprehensive clinical assessment. Moreover, there is growing empirical support that CSB contributes to a syndemics model of HIV risk, which suggests the importance of additive and complex effects of co-occurring factors in sexual risk taking. While much scientific progress has been made on CSB in the past few years, it remains a pliable topic.

Summary

Further exploration on varying levels of CSB severity and the determination of clinically and contextually appropriate cutoff points using existing measures of CSB could provide a greater understanding of this condition, leading to more effective treatment and prevention options.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Coleman E, Horvath KJ, Miner M, Ross MW, Oakes M, Rosser BR, et al. Compulsive sexual behavior and risk for unsafe sex among internet using men who have sex with men. Arch Sex Behav. 2010;39(5):1045–53. doi:10.1007/s10508-009-9507-5.

    Article  PubMed  Google Scholar 

  2. Grov C, Parsons JT, Bimbi DS. Sexual compulsivity and sexual risk in gay and bisexual men. Arch Sex Behav. 2010;39(4):940–9. doi:10.1007/s10508-009-9483-9.

    Article  PubMed  Google Scholar 

  3. Kafka MP. Hypersexual disorder: a proposed diagnosis for DSM-V. Arch Sex Behav. 2010;39(2):377–400. doi:10.1007/s10508-009-9574-7.

    Article  PubMed  Google Scholar 

  4. Yeagley E, Hickok A, Bauermeister JA. Hypersexual behavior and HIV sex risk among young gay and bisexual men. J Sex Res. 2014;51(8):882–92. doi:10.1080/00224499.2013.818615. In a sample of young men who have sex with men (YMSM) with a past six months sexual encounter with a male partner met online, Yeagley et al. reported the prevalence of hypersexual behavior as 22%. Those who met the cutoff of ≥53 points were more likely to report more condomless anal sex partners (both receptive and insertive) in the past 2 months compared to those with scores below the cutoff. Importantly, findings also suggest that YMSM are able to minimize their risk regardless of the number of partners, but HIV risk increased if participants valued condomless receptive anal sex as an opportunity to create an emotional connection with their partner.

    Article  PubMed  Google Scholar 

  5. Derbyshire KL, Grant JE. Compulsive sexual behavior: a review of the literature. J Behav Addict. 2015;4(2):37–43. doi:10.1556/2006.4.2015.003.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cantor JM, Klein C, Lykins A, Rullo JE, Thaler L, Walling BR. A treatment-oriented typology of self-identified hypersexuality referrals. Arch Sex Behav. 2013;42(5):883–93. doi:10.1007/s10508-013-0085-1.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Moser C. Hypersexual disorder: searching for clarity. Sex Addict Compulsivity. 2013;20:48–58. doi:10.1080/10720162.2013.775631.

    Google Scholar 

  8. Karila L, Wery A, Weinstein A, Cottencin O, Petit A, Reynaud M, et al. Sexual addiction or hypersexual disorder: different terms for the same problem? A review of the literature. Curr Pharm Des. 2014;20(25):4012–20.

    Article  CAS  PubMed  Google Scholar 

  9. Griffiths MD. Internet sex addiction: a review of empirical research. Addict Res Theory. 2012;20(2):111–24.

    Article  Google Scholar 

  10. Cooper A. Sexuality and the internet: surfing into the new millennium. CyberPsychology Behav. 1998;1(2):181–7.

    Google Scholar 

  11. Kor A, Fogel Y, Reid RC, Potenza MN. Should hypersexual disorder be classified as an addiction? Sex Addict Compulsivity. 2013;20 Suppl 1–2. doi:10.1080/10720162.2013.768132.

  12. Reid RC, Kafka MP. Controversies about hypersexual disorder and the DSM-5. Curr Sex Health Rep. 2014;6:259–64. doi:10.1007/s11930-014-0031-9.

    Article  Google Scholar 

  13. Kafka MP. What happened to hypersexual disorder? Arch Sex Behav. 2014;43:1259–61.

    Article  PubMed  Google Scholar 

  14. Kingston DFP. Problematic hypersexuality: a review of conceptualization and diagnosis. Sex Addict Compulsivity. 2008;15:284–310.

    Article  Google Scholar 

  15. Kafka MP. The development and evolution of the criteria for a newly proposed diagnosis for DSM-5: hypersexual disorder. Sex Addict Compulsivity. 2013;20:19–26. doi:10.1080/10720162.2013.768127.

    Google Scholar 

  16. Kraus SW, Voon V, Potenza MN. Should compulsive sexual behavior be considered an addiction? Addiction. 2016. doi:10.1111/add.13297.

    Google Scholar 

  17. Franque F, Klein V, Briken P. Which techniques are used in psychotherapeutic interventions for nonparaphilic hypersexual behavior? Sex Med Rev. 2015;3:3–10.

    Article  Google Scholar 

  18. Miner MH, Coleman E, Center BA, Ross M, Rosser BR. The compulsive sexual behavior inventory: psychometric properties. Arch Sex Behav. 2007;36(4):579–87. doi:10.1007/s10508-006-9127-2.

    Article  PubMed  Google Scholar 

  19. Coleman E, Miner M, Ohlerking F, Raymond N. Compulsive sexual behavior inventory: a preliminary study of reliability and validity. J Sex Marital Ther. 2001;27(4):325–32. doi:10.1080/009262301317081070.

    Article  CAS  PubMed  Google Scholar 

  20. Ventuneac A, Rendina HJ, Grov C, Mustanski B, Parsons JT. An item response theory analysis of the sexual compulsivity scale and its correspondence with the hypersexual disorder screening inventory among a sample of highly sexually active gay and bisexual men. J Sex Med. 2015;12(2):481–93. doi:10.1111/jsm.12783.

    Article  PubMed  Google Scholar 

  21. Reid RC, Garos S, Fong T. Psychometric development of the hypersexual behavior consequences scale. J Behav Addict. 2012;1(3):115–22. doi:10.1556/JBA.1.2012.001.

    Article  PubMed  Google Scholar 

  22. Campbell MM, Stein DJ. Hypersexual disorder in general practice. S Afr Med J. 2014;104(6):448.

    Article  CAS  PubMed  Google Scholar 

  23. Odlaug BL, Lust K, Schreiber LR, Christenson G, Derbyshire K, Harvanko A, et al. Compulsive sexual behavior in young adults. Ann Clin Psychiatry. 2013;25(3):193–200. Odlaug et al. analyzed data from a sample of young adult students at a large public Midwestern university (N = 1837) to examine the prevalence of compulsive sexual behavior (CSB). CSB prevalence was low (2%), with those reporting CSB also experiencing more severe symptoms of depression, anxiety, stress, low self-esteem, social anxiety disorders, ADHD, compulsive buying, gambling, and kleptomania. Prevalence among this group was slightly lower than studies estimating prevalence in the general population, but results suggest that young adult college students may face different risk factors and have other comorbid conditions related to CSB.

    PubMed  Google Scholar 

  24. Rettenberger M, Klein V, Briken P. The relationship between hypersexual behavior, sexual excitation, sexual inhibition, and personality traits. Arch Sex Behav. 2015;45(1):219–33. doi:10.1007/s10508-014-0399-7. Rettenberger et al. provided support for three theories underlining hypersexual behavior using data from a large German sample (N = 1,749): the Dual Control Model (DCM; composed of sexual excitation and inhibition), dimensions of personality as assessed by the Big Five Inventory (BFI-10), and behavioral inhibition and activation (as measured by BIS/BAS).

    Article  PubMed  Google Scholar 

  25. Giordano AL, Cecil AL. Religious coping, spirituality, and hypersexual behavior among college students. Sex Addict Compulsivity. 2014;21:225–39.

    Article  Google Scholar 

  26. Dhuffar MK, Pontes HM, Griffiths MD. The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students. J Behav Addict. 2015;4(3):181–8. doi:10.1556/2006.4.2015.030.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Walton MT, Cantor JM, Lykins AD. An online assessment of personality, psychological, and sexuality trait variables associated with self-reported hypersexual behavior. Arch Sex Behav. 2015. doi:10.1007/s10508-015-0606-1.

    PubMed  Google Scholar 

  28. Parsons JT, Rendina HJ, Ventuneac A, Cook KF, Grov C, Mustanski B. A psychometric investigation of the hypersexual disorder screening inventory among highly sexually active gay and bisexual men: an item response theory analysis. J Sex Med. 2013;10(12):3088–101. doi:10.1111/jsm.12117.

    Article  PubMed  Google Scholar 

  29. Storholm ED, Satre DD, Kapadia F, Halkitis PN. Depression, compulsive sexual behavior, and sexual risk-taking among urban young gay and bisexual men: the P18 cohort study. Arch Sex Behav. 2015. doi:10.1007/s10508-015-0566-5. Storholm et al. analyzed data from a longitudinal study of young men who have sex with men (YMSM) in New York City to examine relationships between compulsive sexual behavior (CSB), depression (BDI-II), and condomless anal sex (CAS). This study observed a dynamic interaction between depression and CSB that predicted greater sexual risk.

    PubMed  Google Scholar 

  30. Dhuffar MK, Griffiths MD. Understanding the role of shame and its consequences in female hypersexual behaviours: a pilot study. J Behav Addict. 2014;3(4):231–7. doi:10.1556/JBA.3.2014.4.4.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Klein V, Rettenberger M, Briken P. Self-reported indicators of hypersexuality and its correlates in a female online sample. J Sex Med. 2014;11(8):1974–81. doi:10.1111/jsm.12602. In an online sample of women (N = 988), Klein et al. reported prevalence of hypersexuality at 3.1%, with higher scores on the Hypersexual Behavior Inventory (HBI) associated with higher masturbation frequency, number of sexual partners, and frequency of pornography use. Women who scored above an HBI cutoff of ≥53 (range: 19 to 95) were more likely to identify as single, bisexual, and to report higher rates of sexual encounters under the influence of drugs and alcohol.

    Article  PubMed  Google Scholar 

  32. Smith PH, Potenza MN, Mazure CM, McKee SA, Park CL, Hoff RA. Compulsive sexual behavior among male military veterans: prevalence and associated clinical factors. J Behav Addict. 2014;3(4):214–22. doi:10.1556/JBA.3.2014.4.2.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Stavro K, Rizkallah E, Dinh-Williams L, Chiasson J-P, Potvin S. Hypersexuality among a substance use disorder population. Sex Addict Compulsivity. 2013;20:210–6. doi:10.1080/10720162.2013.787379.

    Google Scholar 

  34. Womack SD, Hook JN, Ramos M, Davis DE, Penberthy JK. Measuring hypersexual behavior. Sex Addict Compulsivity. 2013;20:65–78. doi:10.1080/10720162.2013.768126.

    Google Scholar 

  35. Scanavino MT, Ventuneac A, Rendina HJ, Abdo CH, Tavares H, Amaral ML, et al. Sexual compulsivity scale, compulsive sexual behavior inventory, and hypersexual disorder screening inventory: translation, adaptation, and validation for use in Brazil. Arch Sex Behav. 2014;45(1):207–17.

    Article  Google Scholar 

  36. Reid RC. Personal perspectives on hypersexual disorder. Sex Addict Compulsivity. 2013;20 suppl 4–18. doi:10.1080/10720162.2013.772876.

  37. Miner MH, Coleman E. Compulsive sexual behavior and its relationship to risky sexual behavior. Sex Addict Compulsivity. 2013;20:127–38. doi:10.1080/10720162.2013.768133.

    Google Scholar 

  38. Kafka MP. DSM-IV Axis I psychopathology in males with non-paraphilic hypersexual disorder. Curr Addict Rep. 2015;2:202–6.

    Article  Google Scholar 

  39. Starks TJ, Grov C, Parsons JT. Sexual compulsivity and interpersonal functioning: sexual relationship quality and sexual health in gay relationships. Health Psychol. 2013;32(10):1047–56. doi:10.1037/a0030648.

    Article  PubMed  Google Scholar 

  40. Reid RC, Garos S, Carpenter BN. Reliability, validity, and psychometric development of the hypersexual behavior inventory in an outpatient sample of men. Sex Addict Compulsivity. 2011;18:30–51.

    Article  Google Scholar 

  41. Carvalho J, Stulhofer A, Vieira AL, Jurin T. Hypersexuality and high sexual desire: exploring the structure of problematic sexuality. J Sex Med. 2015;12(6):1356–67. doi:10.1111/jsm.12865.

    Article  PubMed  Google Scholar 

  42. de Tubino Scanavino M, Ventuneac A, Abdo CHN, Tavares H, do Amaral MLSA, Messina B, et al. Compulsive sexual behavior and psychopathology among treatment-seeking men in São Paulo, Brazil. Psychiat Res. 2013;209:518–24.

  43. Weinstein A, Katz L, Eberhardt H, Cohen K, Lejoyeux M. Sexual compulsion—relationship with sex, attachment and sexual orientation. J Behav Addict. 2015;4(1):22–6. doi:10.1556/JBA.4.2015.1.6.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Reid RC, Berlin HA, Kingston DA. Sexual impulsivity in hypersexual men. Curr Behav Neurosci Rep. 2015;2:1–8. doi:10.1007/s40473-015-0034-5.

    Article  Google Scholar 

  45. Carpenter RW, Trull TJ. Components of emotion dysregulation in borderline personality disorder: a review. Curr Psychiatry Rep. 2013;15(1):335. doi:10.1007/s11920-012-0335-2.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Derbyshire KL, Grant JE. Neurocognitive findings in compulsive sexual behavior: a preliminary study. J Behav Addict. 2015;4(2):35–6. doi:10.1556/2006.4.2015.004.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Pinto J, Carvalho J, Nobre PJ. The relationship between the FFM personality traits, state psychopathology, and sexual compulsivity in a sample of male college students. J Sex Med. 2013;10(7):1773–82. doi:10.1111/jsm.12185.

    Article  PubMed  Google Scholar 

  48. Egan V, Parmar R. Dirty habits? Online pornography use, personality, obsessionality, and compulsivity. J Sex Marital Ther. 2013;39(5):394–409. doi:10.1080/0092623X.2012.710182.

    Article  PubMed  Google Scholar 

  49. Jylha P, Isometsa E. The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depress Anxiety. 2006;23(5):281–9. doi:10.1002/da.20167.

    Article  PubMed  Google Scholar 

  50. Reid RC, Bramen JE, Anderson A, Cohen MS. Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients. J Clin Psychol. 2014;70(4):313–21. doi:10.1002/jclp.22027.

    Article  PubMed  Google Scholar 

  51. Reid RC, Temko J, Moghaddam JF, Fong TW. Shame, rumination, and self-compassion in men assessed for hypersexual disorder. J Psychiatr Pract. 2014;20(4):260–8. doi:10.1097/01.pra.0000452562.98286.c5.

    Article  PubMed  Google Scholar 

  52. Grubbs JB, Hook J, Griffin BJ, Davis DE. Evaluating outcome research for hypersexual behavior. Curr Addict Rep. 2015;2:207–13.

    Article  Google Scholar 

  53. Parsons JT, Rendina HJ, Moody RL, Ventuneac A, Grov C. Syndemic production and sexual compulsivity/hypersexuality in highly sexually active gay and bisexual men: further evidence for a three group conceptualization. Arch Sex Behav. 2015;44(7):1903–13. doi:10.1007/s10508-015-0574-5. Parsons et al. recruited a sample of highly sexually active (i.e., reporting more than nine partners in the last 90 days) men who have sex with men (MSM) in New York City (N = 368) to examine differences in scores on the Sexual Compulsivity Scale (SCS), the Hypersexual Disorder Screening Inventory (HDSI), syndemic factors, and HIV risk. The authors found that men who scored high for both SCS and HDSI were more likely to be HIV-positive and had higher proportions of serodiscordant condomless anal sex acts, compared to men who scored high for SC only and men who did not score high on SC nor HDSI. The results support the rationale for differential classification based on both SCS and HDSI and is the first investigation in recent years to operationalize differences in risks between both measures.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Parsons JT, Grov C, Golub SA. Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: further evidence of a syndemic. Am J Public Health. 2012;102(1):156–62. doi:10.2105/AJPH.2011.300284.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Parsons JT, Rendina HJ, Ventuneac A, Moody RL, Grov C. Hypersexual, sexually compulsive, or just highly sexually active? Investigating three distinct groups of gay and bisexual men and their profiles of HIV-related sexual risk. AIDS Behav. 2015. doi:10.1007/s10461-015-1029-7.

    Google Scholar 

  56. Bancroft J, Graham CA, Janssen E, Sanders SA. The dual control model: current status and future directions. J Sex Res. 2009;46(2–3):121–42. doi:10.1080/00224490902747222.

    Article  PubMed  Google Scholar 

  57. Muise A, Milhausen RR, Cole SL, Graham C. Sexual compulsivity in heterosexual married adults: the role of sexual excitation and sexual inhibition in individuals not considered “high-risk”. Sex Addict Compulsivity. 2013;20:192–209. doi:10.1080/10720162.2013.786661.

    Google Scholar 

  58. Spenhoff M, Kruger TH, Hartmann U, Kobs J. Hypersexual behavior in an online sample of males: associations with personal distress and functional impairment. J Sex Med. 2013;10(12):2996–3005. doi:10.1111/jsm.12160.

    Article  PubMed  Google Scholar 

  59. Riemersma J, Sytsma M. A new generation of sexual addiction. Sex Addict Compulsivity. 2013;20:306–22. doi:10.1080/10720162.2013.843067.

    Article  Google Scholar 

  60. Noor SW, Simon Rosser BR, Erickson DJ. A brief scale to measure problematic sexually explicit media consumption: psychometric properties of the compulsive pornography consumption (CPC) scale among men who have sex with men. Sex Addict Compulsivity. 2014;21(3):240–61. doi:10.1080/10720162.2014.938849.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Downing Jr MJ, Antebi N, Schrimshaw EW. Compulsive use of Internet-based sexually explicit media: adaptation and validation of the compulsive internet use scale (CIUS). Addict Behav. 2014;39(6):1126–30. doi:10.1016/j.addbeh.2014.03.007.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Grubbs JB, Volk F, Exline JJ, Pargament KI. Internet pornography use: perceived addiction, psychological distress, and the validation of a brief measure. J Sex Marital Ther. 2015;41(1):83–106. doi:10.1080/0092623X.2013.842192.

    Article  PubMed  Google Scholar 

  63. Dhuffar MK, Griffiths MD. A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Curr Addict Rep. 2015;2:163–74.

    Article  Google Scholar 

  64. Laier C, Pawlikowski M, Pekal J, Schulte FP, Brand M. Cybersex addiction: experienced sexual arousal when watching pornography and not real-life sexual contacts makes the difference. J Behav Addict. 2013;2(2):100–7. doi:10.1556/JBA.2.2013.002.

    Article  PubMed  Google Scholar 

  65. Voon V, Mole TB, Banca P, Porter L, Morris L, Mitchell S, et al. Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours. PLoS ONE. 2014;9(7):e102419. doi:10.1371/journal.pone.0102419.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Rosser BR, Noor SW, Iantaffi A. Normal, problematic and compulsive consumption of sexually explicit media: clinical findings using the compulsive pornography consumption (CPC) scale among men who have sex with men. Sex Addict Compulsivity. 2014;21(4):276–304. doi:10.1080/10720162.2014.959145. Rosser et al. recruited a convenience sample of 1,165 men who have sex with men (MSM) online to assess problematic sexually explicit media (SEM) consumption. Findings suggest distinct characteristics in those reporting extreme or clinically relevant CPC and that those with extreme levels of CPC are more focused solely on CPC over other sexual behavior.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Schiebener J, Laier C, Brand M. Getting stuck with pornography? Overuse or neglect of cybersex cues in a multitasking situation is related to symptoms of cybersex addiction. J Behav Addict. 2015;4(1):14–21. doi:10.1556/JBA.4.2015.1.5.

  68. Nelson KM, Pantalone DW, Gamarel KE, Simoni JM. A new measure of the perceived influence of sexually explicit online media on the sexual behaviors of men who have sex with men. J Sex Res. 2015:1–13. doi:10.1080/00224499.2015.1066744.

  69. Reid RC. How should severity be determined for the DSM-5 proposed classification of hypersexual disorder? J Behav Addict. 2015;4(4):221–5. doi:10.1556/2006.4.2015.041.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY, 10013, USA

    Irene S. Yoon, Steven T. Houang, Sabina Hirshfield & Martin J. Downing Jr.

Authors
  1. Irene S. Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven T. Houang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabina Hirshfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin J. Downing Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin J. Downing Jr..

Ethics declarations

Conflict of Interest

Irene S. Yoon, Steven T. Houang, Dr. Sabina Hirshfield, and Dr. Martin J. Downing, Jr declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors. The study conducted by Downing, Antebi, and Schrimshaw (2014) received approval from the Columbia University Institutional Review Board for human subjects participation.

Additional information

This article is part of the Topical Collection on Sex Addiction

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoon, I.S., Houang, S.T., Hirshfield, S. et al. Compulsive Sexual Behavior and HIV/STI Risk: a Review of Current Literature. Curr Addict Rep 3, 387–399 (2016). https://doi.org/10.1007/s40429-016-0121-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40429-016-0121-z

Keywords

Search

Navigation