AIDS and Behavior

, Volume 20, Issue 8, pp 1667–1674 | Cite as

Outcome Expectancy and Sexual Compulsivity Among Men Who Have Sex with Men Living with HIV

  • Monique J. BrownEmail author
  • Julianne M. Serovich
  • Judy A. Kimberly
Original Paper


Sexual compulsivity is operationalized by engaging in repetitive sexual acts, having multiple sexual partners and/or the excessive use of pornography. Outcome expectancy refers to the beliefs about the consequences of engaging in a given behavior. Research examining the relationship between outcome expectancy and sexual compulsivity is limited. The aim of this study was to assess the association between outcome expectancy and sexual compulsivity among men who have sex with men (MSM) living with HIV. Data were obtained from 338 MSM. Simple and multiple linear regression models were used to assess the association between outcome expectancy and sexual compulsivity. After adjusting for age, race/ethnicity, income, education, and employment status, for every one point increase in outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices, there was, on average, an approximate one point decrease in sexual compulsivity score. Prevention and intervention programs geared towards reducing sexual compulsivity among MSM should focus on increasing outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices.


Sexual compulsivity Outcome expectancy HIV disclosure Condom use MSM 


Las características de la compulsividad sexual incluyen actos sexuales repetitivos, múltiples parejas sexuales y el uso excesivo de la pornografía. El resultado esperado se refiere a las creencias sobre las consecuencias de envolverse en un comportamiento específico. Los estudios que examinan la relación entre el resultado esperado y la compulsividad sexual son limitados. El objetivo de esta investigación fue evaluar la asociación entre el resultado esperado y la compulsividad sexual entre los hombres que tienen sexo con hombres (HSH) viviendo con VIH. Los datos fueron obtenidos de 338 HSH. La asociación entre el resultado esperado y la compulsividad sexual fue evaluada con un análisis de regresión lineal sencilla y múltiple. Después de ajustar por la edad, la raza/etnicidad, el ingreso, la educación, y el estado de empleo, por cada punto de incremento en los resultados esperados en el área del uso del condón, divulgación de tener el VIH y negociación de prácticas sexuales seguras, hubo aproximadamente un punto de reducción en la puntación de la compulsividad sexual. Los programas de prevención e intervención para reducir la compulsividad sexual entre HSH deberían enfocarse en el aumento de los resultados esperados relacionados con el uso de condones, la divulgación de tener el VIH, y la negociación de las prácticas sexuales seguras.



This study was supported by funding from the National Institute of Mental Health (R01MH082639) to the second author. We would like to thank the men who participated in this study and Ms. Ercilia Calcano for edits made to the Spanish version of the abstract.


  1. 1.
    Quadland MC. Compulsive sexual behavior: definition of a problem and an approach to treatment. J Sex Marital Ther. 1985;11:121–32.CrossRefPubMedGoogle Scholar
  2. 2.
    Black DW. The epidemiology and phenomenology of compulsive sexual behavior. CNS Spectr. 2000;5:26–72.PubMedGoogle Scholar
  3. 3.
    Parsons JT, Kelly BC, Bimbi DS, Muench F, Morgenstern J. Accounting for the social triggers of sexual compulsivity. J Addict Dis. 2007;26:5–16.CrossRefPubMedGoogle Scholar
  4. 4.
    Anthony DT, Hollander E. Sexual compulsions. In: Hollander E, editor. Obsessive-compulsive-related disorders. Washington: American Psychiatric Press; 1992. p. 139–50.Google Scholar
  5. 5.
    Kafka MP. Paraphilia-related disorders: common, neglected, and misunderstood. Harv Rev Psychiatry. 1994;2:39–40 (discussion 41–42).CrossRefPubMedGoogle Scholar
  6. 6.
    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;102:156–62.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Jerome RC, Woods WJ, Moskowitz JT, Carrico AW. The Psychological context of sexual compulsivity among men who have sex with men. AIDS Behav. 2015. doi: 10.1007/s10461-015-1083-1.Google Scholar
  8. 8.
    Benotsch EG, Kalichman SC, Kelly JA. Sexual compulsivity and substance use in HIV-seropositive men who have sex with men: prevalence and predictors of high-risk behaviors. Addict Behav. 1999;24:857–68.CrossRefPubMedGoogle Scholar
  9. 9.
    Woolf-King SE, Rice TM, Truong HM, Woods WJ, Jerome RC, Carrico AW. Substance use and HIV risk behavior among men who have sex with men: the role of sexual compulsivity. J Urban Health. 2013;90:948–52.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Reece M. Sexual compulsivity and HIV serostatus disclosure among men who have sex with men. Sex Addict Compulsivity. 2003;10:1–11.CrossRefGoogle Scholar
  11. 11.
    Semple SJ, Zians J, Grant I, Patterson TL. Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men. AIDS Behav. 2006;10:587–98.CrossRefPubMedGoogle Scholar
  12. 12.
    Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall Inc; 1986.Google Scholar
  13. 13.
    Williams DM. Outcome expectancy and self-efficacy: theoretical implications of an unresolved contradiction. Pers Soc Psychol Rev. 2010;14:417–25.CrossRefPubMedGoogle Scholar
  14. 14.
    Bandura A. Social Learning Theory. Englewood Cliffs: Prentice Hall; 1977.Google Scholar
  15. 15.
    Sherman SG, Celentano DA, Mcgrath JW, et al. The reliability and validity of the Modified Condom Outcome Expectancy Scale (MCOES) among an international sample of HIV-negative partners of people living with HIV/AIDS. AIDS Care. 2003;15:359–66.CrossRefPubMedGoogle Scholar
  16. 16.
    Kalichman S, Tannenbaum L, Nachimson D. Personality and cognitive factors influencing substance use and sexual risk for HIV infection among gay and bisexual men. Psychol Addict Behav. 1998;12:262–71.CrossRefGoogle Scholar
  17. 17.
    Hittner J. Alcohol-related outcome expectancies: construct overview and implications for primary and secondary prevention. J Prim Prev. 1997;17:297–314.CrossRefGoogle Scholar
  18. 18.
    Kobau R, DiIorio C. Epilepsy self-management: a comparison of self-efficacy and outcome expectancy for medication adherence and lifestyle behaviors among people with epilepsy. Epilepsy Behav. 2003;4:217–25.CrossRefPubMedGoogle Scholar
  19. 19.
    Stewart JE, Strack S, Graves P. Development of oral hygiene self-efficacy and outcome expectancy questionnaires. Community Dent Oral Epidemiol. 1997;25:337–42.CrossRefPubMedGoogle Scholar
  20. 20.
    Benotsch EG, Kalichman SC, Pinkerton SD. Sexual compulsivity in HIV-positive men and women: prevalence, predictors, and consequences of high-risk behaviors. Sex Addict Compulsivity. 2001;8:83–99.CrossRefGoogle Scholar
  21. 21.
    Dodge B, Reece M, Cole SL, Sandfort TG. Sexual compulsivity among heterosexual college students. J Sex Res. 2004;41:343–50.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Grov C, Parsons JT, Bimbi DS. Sexual compulsivity and sexual risk in gay and bisexual men. Arch Sex Behav. 2010;39:940–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Ajzen I. From intentions to actions: A theory of planned behavior. In: Kuhl J, Beckman J, editors. Action-control: from cognition to behavior. Heidelberg: Springer; 1985. p. 11–39.CrossRefGoogle Scholar
  24. 24.
    Des Jarlais DC, Paone D, Milliken J, et al. Audio-computer interviewing to measure risk behaviour for HIV among injecting drug users: a quasi-randomised trial. Lancet. 1999;353:1657–61.CrossRefPubMedGoogle Scholar
  25. 25.
    Perlis TE, Des Jarlais DC, Friedman SR, Arasteh K, Turner CF. Audio-computerized self-interviewing versus face-to-face interviewing for research data collection at drug abuse treatment programs. Addiction. 2004;99:885–96.CrossRefPubMedGoogle Scholar
  26. 26.
    Semple SJ, Patterson TL, Grant I. HIV-positive gay and bisexual men: predictors of unsafe sex. AIDS Care. 2003;15:3–15.CrossRefPubMedGoogle Scholar
  27. 27.
    Coleman E, Miner M, Ohlerking F, Raymond N. Compulsive sexual behavior inventory: a preliminary study of reliability and validity. J Sex Marital Ther. 2001;27:325–32.CrossRefPubMedGoogle Scholar
  28. 28.
    Kalichman SC, Johnson JR, Adair V, Rompa D, Multhauf K, Kelly JA. Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men. J Pers Assess. 1994;62:385–97.CrossRefPubMedGoogle Scholar
  29. 29.
    Williams R. Measurement Error 1: Consequences of Measurement Error [Online]. Available at: Accessed 17 Dec 2015.

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Monique J. Brown
    • 1
    Email author
  • Julianne M. Serovich
    • 1
  • Judy A. Kimberly
    • 1
  1. 1.College of Behavioral and Community SciencesUniversity of South FloridaTampaUSA

Personalised recommendations