Advertisement

Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior

  • Hunter HahnEmail author
  • Samuel Kalnitsky
  • Nathaniel Haines
  • Sneha Thamotharan
  • Theodore P. Beauchaine
  • Woo-Young Ahn
Original Paper

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.

Keywords

HIV risk behavior Delay discounting Sexual discounting Impulsivity Sensation seeking 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Aral, S. O., & Leichliter, J. S. (2010). Non-monogamy: Risk factor for STI transmission and acquisition and determinant of STI spread in populations. Sexually Transmitted Infections, 86(Suppl. 3), iii29–iii36.  https://doi.org/10.1136/sti.2010.044149.CrossRefPubMedGoogle Scholar
  2. Beauchaine, T. P., Ben-David, I., & Sela, A. (2017). Attention-deficit/hyperactivity disorder, delay discounting, and risky financial behaviors: A preliminary analysis of self-report data. PLoS ONE.  https://doi.org/10.1371/journal.pone.0176933.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bickel, W. K., Odum, A. L., & Madden, G. J. (1999). Impulsivity and cigarette smoking: Delay discounting in current, never, and ex-smokers. Psychopharmacology, 146(4), 447–454.  https://doi.org/10.1007/PL00005490.CrossRefPubMedGoogle Scholar
  4. Boneau, C. A. (1960). The effects of violations of assumptions underlying the t test. Psychological Bulletin, 57(1), 49–64.CrossRefGoogle Scholar
  5. Borchers, H. W. (2017). pracma: Practical numerical math functions R package version 2.0.7. Retrieved November 14, 2017, from https://CRAN.R-project.org/package=pracma.
  6. Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk. Perspectives on Psychological Science, 6(1), 3–5.  https://doi.org/10.1177/1745691610393980.CrossRefPubMedGoogle Scholar
  7. CDC. (2017a). HIV among gay and bisexual men. Retrieved November 14, 2017, from https://www.cdc.gov/hiv/group/msm/index.html.
  8. CDC. (2017b). HIV among transgender people. Retrieved August 31, 2016, from https://www.cdc.gov/hiv/group/gender/transgender/index.html.
  9. Charnigo, R., Noar, S. M., Garnett, C., Crosby, R., Palmgreen, P., & Zimmerman, R. S. (2013). Sensation seeking and impulsivity: Combined associations with risky sexual behavior in a large sample of young adults. Journal of Sex Research, 50(5), 480–488.  https://doi.org/10.1080/00224499.2011.652264.CrossRefPubMedGoogle Scholar
  10. Chesson, H. W., Leichliter, J. S., Zimet, G. D., Rosenthal, S. L., Bernstein, D. I., & Fife, K. H. (2006). Discount rates and risky sexual behaviors among teenagers and young adults. Journal of Risk and Uncertainty, 32(3), 217–230.  https://doi.org/10.1007/s11166-006-9520-1.CrossRefGoogle Scholar
  11. Dariotis, J. K., & Johnson, M. W. (2015). Sexual discounting among high-risk youth ages 18–24: Implications for sexual and substance use risk behaviors. Experimental and Clinical Psychopharmacology, 23(1), 49–58.  https://doi.org/10.1037/a0038399.CrossRefPubMedGoogle Scholar
  12. de Leeuw, J. R. (2015). jsPsych: A JavaScript library for creating behavioral experiments in a web browser. Behavior Research Methods, 47(1), 1–12.  https://doi.org/10.3758/s13428-014-0458-y.CrossRefPubMedGoogle Scholar
  13. Donohew, L., Zimmerman, R., Cupp, P. S., Novak, S., Colon, S., & Abell, R. (2000). Sensation seeking, impulsive decision-making, and risky sex: Implications for risk-taking and design of interventions. Personality and Individual Differences, 28(6), 1079–1091.  https://doi.org/10.1016/S0191-8869(99)00158-0.CrossRefGoogle Scholar
  14. Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160.  https://doi.org/10.3758/BRM.41.4.1149.CrossRefPubMedGoogle Scholar
  15. Gerrard, M., Gibbons, F. X., & Bushman, B. J. (1996). Relation between perceived vulnerability to HIV and precautionary sexual behavior. Psychological Bulletin, 119(3), 390–409.CrossRefGoogle Scholar
  16. Glick, S. N., Morris, M., Foxman, B., & Aral, S. O. (2012). A comparison of sexual behavior patterns among men who have sex with men and heterosexual men and women. Journal of Acquired Immune Deficiency Syndromes, 60(1), 83–90.  https://doi.org/10.1097/QAI.0b013e318247925e.CrossRefPubMedGoogle Scholar
  17. Green, K. E., & Feinstein, B. A. (2012). Substance use in lesbian, gay, and bisexual populations: An update on empirical research and implications for treatment. Psychology of Addictive Behaviors, 26(2), 265–278.  https://doi.org/10.1037/a0025424.CrossRefPubMedGoogle Scholar
  18. Halpern-Felsher, B. L., Millstein, S. G., & Ellen, J. M. (1996). Relationship of alcohol use and risky sexual behavior: A review and analysis of findings. Journal of Adolescent Health, 19(5), 331–336.  https://doi.org/10.1016/S1054-139X(96)00024-9.CrossRefPubMedGoogle Scholar
  19. Hatzenbuehler, M. L., Corbin, W. R., & Fromme, K. (2008a). Trajectories and determinants of alcohol use among LGB young adults and their heterosexual peers: Results from a prospective study. Developmental Psychology, 44(1), 81–90.  https://doi.org/10.1037/0012-1649.44.1.81.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Hatzenbuehler, M. L., Nolen-Hoeksema, S., & Erickson, S. J. (2008b). Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men. Health Psychology, 27(4), 455–462.  https://doi.org/10.1037/0278-6133.27.4.455.CrossRefPubMedGoogle Scholar
  21. Hayaki, J., Anderson, B., & Stein, M. (2006). Sexual risk behaviors among substance users: Relationship to impulsivity. Psychology of Addictive Behaviors, 20(3), 328–332.  https://doi.org/10.1037/0893-164X.20.3.328.CrossRefPubMedGoogle Scholar
  22. Herrmann, E. S., Johnson, P. S., & Johnson, M. W. (2015). Examining delay discounting of condom-protected sex among men who have sex with men using crowdsourcing technology. AIDS and Behavior, 19(9), 1655–1665.  https://doi.org/10.1007/s10461-015-1107-x.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Hirshfield, S., Remien, R. H., Humberstone, M., Walavalkar, I., & Chiasson, M. A. (2004). Substance use and high-risk sex among men who have sex with men: A national online study in the USA. AIDS Care, 16(8), 1036–1047.  https://doi.org/10.1080/09540120412331292525.CrossRefPubMedGoogle Scholar
  24. Holloway, I. W., Pulsipher, C. A., Gibbs, J., Barman-Adhikari, A., & Rice, E. (2015). Network influences on the sexual risk behaviors of gay, bisexual and other men who have sex with men using geosocial networking applications. AIDS and Behavior, 19(S2), 112–122.  https://doi.org/10.1007/s10461-014-0989-3.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Hughes, T. L., & Eliason, M. (2002). Substance use and abuse in lesbian, gay, bisexual and transgender populations. Journal of Primary Prevention, 22(3), 263–298.  https://doi.org/10.1023/A:1013669705086.CrossRefGoogle Scholar
  26. Johnson, M. W., & Bickel, W. K. (2008). An algorithm for identifying nonsystematic delay-discounting data. Experimental and Clinical Psychopharmacology, 16(3), 264–274.  https://doi.org/10.1037/1064-1297.16.3.264.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Johnson, M. W., & Bruner, N. R. (2012). The sexual discounting task: HIV risk behavior and the discounting of delayed sexual rewards in cocaine dependence. Drug and Alcohol Dependence, 123(1–3), 15–21.  https://doi.org/10.1016/j.drugalcdep.2011.09.032.CrossRefPubMedGoogle Scholar
  28. Johnson, M. W., Johnson, P. S., Herrmann, E. S., & Sweeney, M. M. (2015). Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls. PLoS ONE, 10(5), e0128641.  https://doi.org/10.1371/journal.pone.0128641.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Jones, J., Guest, J. L., Sullivan, P. S., Sales, J. M., Jenness, S. M., & Kramer, M. R. (2018). The association between monetary and sexual delay discounting and risky sexual behavior in an online sample of men who have sex with men. AIDS Care, 30(7), 844–852.  https://doi.org/10.1080/09540121.2018.1427851.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Jones, J., & Sullivan, P. S. (2014). Impulsivity as a risk factor for HIV transmission in men who have sex with men: A delay discounting approach. Journal of Homosexuality, 62(5), 588–603.  https://doi.org/10.1080/00918369.2014.987568.CrossRefGoogle Scholar
  31. Jones, J., & Sullivan, P. S. (2016). Age-dependent effects in the association between monetary delay discounting and risky sexual behavior. SpringerPlus, 5(1), 852.  https://doi.org/10.1186/s40064-016-2570-1.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Kalichman, S. C., Johnson, J. R., Adair, V., Rompa, D., Multhauf, K., & Kelly, J. A. (1994). Sexual sensation seeking: Scale development and predicting AIDS-risk behavior among homosexually active men. Journal of Personality Assessment, 62(3), 385–397.  https://doi.org/10.1207/s15327752jpa6203_1.CrossRefPubMedGoogle Scholar
  33. Kapadia, F., Latka, M. H., Hudson, S. M., & Golub, E. T. (2007). Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities. Drug and Alcohol Dependence, 91, S56–S63.  https://doi.org/10.1016/j.drugalcdep.2007.01.004.CrossRefPubMedGoogle Scholar
  34. Kollins, S. H. (2003). Delay discounting is associated with substance use in college students. Addictive Behaviors, 28(6), 1167–1173.  https://doi.org/10.1016/S0306-4603(02)00220-4.CrossRefPubMedGoogle Scholar
  35. Kort, D. N., Samsa, G. P., & McKellar, M. S. (2017). Sexual orientation differences in HIV testing motivation among college men. Journal of American College Health, 65(3), 223–227.  https://doi.org/10.1080/07448481.2016.1277429.CrossRefPubMedGoogle Scholar
  36. Lansky, A., Thomas, J. C., & Earp, J. A. (1998). Partner-specific sexual behaviors among persons with both main and other partners. Family Planning Perspectives, 30(2), 93.  https://doi.org/10.2307/2991666.CrossRefPubMedGoogle Scholar
  37. Lawyer, S. R., & Mahoney, C. T. (2017). Delay discounting and probability discounting, but not response inhibition, are associated with sexual risk taking in adults. Journal of Sex Research, 55(7), 863–870.  https://doi.org/10.1080/00224499.2017.1350627.CrossRefPubMedGoogle Scholar
  38. Lawyer, S. R., & Schoepflin, F. J. (2013). Predicting domain-specific outcomes using delay and probability discounting for sexual versus monetary outcomes. Behavioural Processes, 96, 71–78.  https://doi.org/10.1016/j.beproc.2013.03.001.CrossRefPubMedGoogle Scholar
  39. Lescano, C. M., Vazquez, E. A., Brown, L. K., & Litvin, E. B. (2006). Condom use with “casual” and ‘main’ partners: What’s in a name? Journal of Adolescent Health, 39(3), 443.e1–443.e7.  https://doi.org/10.1016/j.jadohealth.2006.01.003.CrossRefGoogle Scholar
  40. Mahoney, C. T., & Lawyer, S. R. (2018). Domain-specific relationships in sexual measures of impulsive behavior. Archives of Sexual Behavior, 47(6), 1591–1599.  https://doi.org/10.1007/s10508-018-1210-y.CrossRefPubMedGoogle Scholar
  41. Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., et al. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103(4), 546–556.  https://doi.org/10.1111/j.1360-0443.2008.02149.x.CrossRefPubMedPubMedCentralGoogle Scholar
  42. McCabe, S. E., Bostwick, W. B., Hughes, T. L., West, B. T., & Boyd, C. J. (2011). The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 100(10), 1946–1952.  https://doi.org/10.2105/AJPH.2009.163147.CrossRefGoogle Scholar
  43. McKerchar, T., & Renda, C. (2012). Delay and probability discounting in humans: An overview. Psychological Record, 62, 817–834.CrossRefGoogle Scholar
  44. Mehrotra, P., Noar, S. M., Zimmerman, R. S., & Palmgreen, P. (2009). Demographic and personality factors as predictors of HIV/STD partner-specific risk perceptions: Implications for interventions. AIDS Education and Prevention, 21(1), 39–54.  https://doi.org/10.1521/aeap.2009.21.1.39.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697.  https://doi.org/10.1037/0033-2909.129.5.674.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Misovich, S. J., Fisher, J. D., & Fisher, W. A. (1997). Close relationships and elevated HIV risk behavior: Evidence and possible underlying psychological processes. Review of General Psychology, 1(1), 72–107.  https://doi.org/10.1037/1089-2680.1.1.72.CrossRefGoogle Scholar
  47. Morey, L. C. (1991). Personality assessment inventory (PAI). Odessa, FL: Psychological Assessment Resources.Google Scholar
  48. Morris, S. B., & DeShon, R. P. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods, 7(1), 105–125.CrossRefGoogle Scholar
  49. Mustanski, B. S., Newcomb, M. E., Du Bois, S. N., Garcia, S. C., & Grov, C. (2011). HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. Journal of Sex Research, 48(2–3), 218–253.  https://doi.org/10.1080/00224499.2011.558645.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Parsons, J. T., Lelutiu-Weinberger, C., & Botsko, M. (2013). Predictors of day-level sexual risk for young gay and bisexual men. AIDS and Behavior, 17, 1465–1477.  https://doi.org/10.1007/s10461-012-0206-1.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Pathela, P., Braunstein, S. L., Schillinger, J. A., Shepard, C., Sweeney, M., & Blank, S. (2011). Men who have sex with men have a 140-fold higher risk for newly diagnosed HIV and syphilis compared with heterosexual men in New York City. Journal of Acquired Immune Deficiency Syndromes, 58(4), 408–416.  https://doi.org/10.1097/QAI.0b013e318230e1ca.CrossRefPubMedGoogle Scholar
  52. Patterson, T. L. (2005). Methamphetamine-using HIV-positive men who have sex with men: Correlates of polydrug use. Journal of Urban Health, 82(1), i120–i126.  https://doi.org/10.1093/jurban/jti031.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51(6), 768–774.  https://doi.org/10.1002/1097-4679(199511)51:6<768::aid-jclp2270510607>3.0.co;2-1.CrossRefPubMedGoogle Scholar
  54. Paz-Bailey, G., Mendoza, M. C. B., Finlayson, T., Wejnert, C., Le, B., Rose, C., et al. (2016). Trends in condom use among MSM in the United States: The role of antiretroviral therapy and seroadaptive strategies. AIDS, 30(12), 1985–1990.  https://doi.org/10.1097/QAD.0000000000001139.CrossRefPubMedPubMedCentralGoogle Scholar
  55. R Development Core Team. (2018). R: A language and environment for statistical computing. https://www.R-project.org/. Accessed 5 Jan 2018.
  56. Rasmussen, E. B., Lawyer, S. R., & Reilly, W. (2010). Percent body fat is related to delay and probability discounting for food in humans. Behavioural Processes, 83(1), 23–30.  https://doi.org/10.1016/j.beproc.2009.09.001.CrossRefPubMedGoogle Scholar
  57. Samji, H., Cescon, A., Hogg, R. S., Modur, S. P., Althoff, K. N., Buchacz, K., et al. (2013). Closing the gap: Increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS ONE, 8(12), e81355.  https://doi.org/10.1371/journal.pone.0081355.CrossRefPubMedPubMedCentralGoogle Scholar
  58. Saunders, J. B., Aasland, O. G., Babor, T. F., Delafuente, J. R., & Grant, M. (1993). Development of the Alcohol-Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88(6), 791–804.  https://doi.org/10.1111/j.1360-0443.1993.tb02093.x.CrossRefPubMedGoogle Scholar
  59. Semple, S. J., Zians, J., Grant, I., & Patterson, T. L. (2006). Methamphetamine use, impulsivity, and sexual risk behavior among HIV-positive men who have sex with men. Journal of Addictive Diseases, 25(4), 105–114.  https://doi.org/10.1300/J069v25n04_10.CrossRefPubMedGoogle Scholar
  60. Shapiro, D. N., Chandler, J., & Mueller, P. A. (2013). Using mechanical turk to study clinical populations. Clinical Psychological Science, 1(2), 213–220.  https://doi.org/10.1177/2167702612469015.CrossRefGoogle Scholar
  61. Sheeran, P., & Taylor, S. (1999). Predicting intentions to use condoms: A meta-analysis and comparison of the theories of reasoned action and planned behavior. Journal of Applied Social Psychology, 29(8), 1624–1675.  https://doi.org/10.1111/j.1559-1816.1999.tb02045.x.CrossRefGoogle Scholar
  62. Skinner, H. A. (1982). The drug abuse screening test. Addictive Behaviors, 7(4), 363–371.  https://doi.org/10.1016/0306-4603(82)90005-3.CrossRefPubMedGoogle Scholar
  63. Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23(9), 1153–1162.  https://doi.org/10.1097/QAD.0b013e32832baa34.CrossRefPubMedGoogle Scholar
  64. Thamotharan, S., Hahn, H., & Fields, S. (2017). Drug use status in youth: The role of gender and delay discounting. Substance Use and Misuse, 103(3), 1–10.  https://doi.org/10.1080/10826084.2017.1280831.CrossRefGoogle Scholar
  65. Weller, S. C., & Beaty, K. D. (2002). Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database of Systematic Reviews.  https://doi.org/10.1002/14651858.cd003255.CrossRefPubMedGoogle Scholar
  66. Woody, G. E., VanEtten-Lee, M. L., McKirnan, D., Donnell, D., Metzger, D., Seage, G., III, et al. (2001). Substance use among men who have sex with men: Comparison with a national household survey. Journal of Acquired Immune Deficiency Syndromes, 27(1), 86–90.  https://doi.org/10.1097/00042560-200105010-00015.CrossRefPubMedGoogle Scholar
  67. Yudko, E., Lozhkina, O., & Fouts, A. (2007). A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. Journal of Substance Abuse Treatment, 32(2), 189–198.  https://doi.org/10.1016/j.jsat.2006.08.002.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyThe Ohio State UniversityColumbusUSA
  2. 2.Department of Psychiatry and Human BehaviorThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Department of Child and Adolescent PsychiatryRhode Island HospitalProvidenceUSA
  4. 4.Department of PsychologySeoul National UniversitySeoulKorea

Personalised recommendations