Behavioral Economic Decision Making and Alcohol-related Sexual Risk Behavior
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The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.
KeywordsSexual risk Alcohol Behavioral economics Delay discounting Probability discounting
The authors gratefully acknowledge the following staff for their important contributions to data collection: Amanda Budziszek, Daryl Cioffi, Catherine Corno, Graham DiGuiseppi, Ayla Durst, Barbara Engler, Jeffrey Garofano, James Geckler, Jennifer Merrill, Vivian Partida, Carla Rich, Suzanne Sales, Tamara Sequeira, and Timothy Souza. This research was partially supported by NIH grants R01AA009892 (PMM), P01AA019072 (PMM), K23AA016936 (JM), and T32AA007459 (PMM). Dr. MacKillop is the holder of the Peter Boris Chair in Addictions Research, which partially supported his role.
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