Sexual Probability Discounting: A Mechanism for Sexually Transmitted Infection Among Undergraduate Students

  • Meredith S. Berry
  • Patrick S. Johnson
  • Anahí Collado
  • Jennifer M. Loya
  • Richard Yi
  • Matthew W. Johnson
Original Paper
First Online:
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Revised:
Accepted:

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.

Keywords

Sexual health HIV/AIDS Sexually transmitted infections Condom use Sexual Probability Discounting Task 
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Notes

Acknowledgments

This research was supported in part by National Institute on Drug Abuse (NIDA) Grants R01DA032363, T32DA07209 and R01DA11692.

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 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

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

References

  1. Bontempi, J. B., Mugno, R., Bulmer, S. M., Danvers, K., & Vancour, M. L. (2009). Exploring gender differences in the relationship between HIV/STD testing and condom use among undergraduate college students. American Journal of Health Education, 40(2), 97–105.CrossRefGoogle Scholar
  2. Buhi, E. R., & Goodson, P. (2007). Predictors of adolescent sexual behavior and intention: A theory-guided systematic review. Journal of Adolescent Health, 40(1), 4–21.  https://doi.org/10.1016/j.jadohealth.2006.09.027.CrossRefPubMedGoogle Scholar
  3. Centers for Disease Control and Prevention. (2011). Control HIV/STD behavioral surveillance working group. CDC Sexual behavior questions (CSBQ). Retrieved from http://chipts.ucla.edu/wp-content/uploads/downloads/2012/01/CDC-Sexual-Behavior-Questions-_CSBQ_.pdf.
  4. Centers for Disease Control and Prevention. (2012). Trends in HIV-related risk behaviors among high school students–United States, 1991–2011. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6129a4.htm?s_cid=mm6129a4_w.
  5. Centers for Disease Control and Prevention. (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from http://www.Cdc.gov/std/stats/sti-Estimates-Fact-Sheet-Feb-2013.pdf.
  6. Centers for Disease Control and Prevention. (2014). Likely female-to-female sexual transmission of HIV. Morbidity and Mortality Weekly Report, 63, 209-210-209-210.Google Scholar
  7. Centers for Disease Control and Prevention. (2015a). Chlamydia – CDC fact sheet (detailed). Retrieved from http://www.Cdc.gov/std/chlamydia/stdfact-Chlamydia-Detailed.html.
  8. Centers for Disease Control and Prevention. (2015b). Genital herpes–CDC fact sheet. Retrieved from http://www.Cdc.gov/std/herpes/stdfact-Herpes.html.
  9. Centers for Disease Control and Prevention. (2017). HIV/AIDS basic statistics. Retrieved from https://www.cdc.gov/hiv/basics/statistics.html.
  10. Collado, A., Johnson, P. S., Loya, J. M., Johnson, M. W., & Yi, R. (2017). Discounting of condom-protected sex as a measure of high risk for sexually transmitted infection among college students. Archives of Sexual Behavior, 46(7), 2187–2195.  https://doi.org/10.1007/s10508-016-0836-x.CrossRefPubMedGoogle Scholar
  11. Crosby, R. A., Milhausen, R. R., Graham, C. A., Yarber, W. L., Sanders, S. A., Charnigo, R., & Shrier, L. A. (2014). Likelihood of condom use when sexually transmitted diseases are suspected: Results from a clinic sample. Health Education & Behavior, 41(4), 449–454.  https://doi.org/10.1177/1090198114529588.CrossRefGoogle Scholar
  12. 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
  13. de Visser, R., & Smith, A. (2001). Relationship between sexual partners influences rates and correlates of condom use. AIDS Education and Prevention, 13(5), 413–427.  https://doi.org/10.1521/aeap.13.5.413.24146.CrossRefPubMedGoogle Scholar
  14. Dick, B., Ferguson, J., & Ross, D. A. (2006). Preventing HIV/AIDS in young people. A systematic review of the evidence from developing countries. Introduction and rationale. World Health Organization Technical Report Series, 938, 1–13. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=16921915&site=ehost-live&scope=site.
  15. Douglas, K. A., Collins, J. L., Warren, C., Kann, L., Gold, R., Clayton, S., & Kolbe, L. J. (1997). Results from the 1995 National College Health Risk Behavior Survey. Journal of American College Health, 46(2), 55–67.CrossRefPubMedGoogle Scholar
  16. Du, W., Green, L., & Myerson, J. (2002). Cross-cultural comparisons of discounting delayed and probabilistic rewards. Psychological Record, 52(4), 479–492.  https://doi.org/10.1007/BF03395199.CrossRefGoogle Scholar
  17. Fehr, S., Vidourek, R., & King, K. (2015). Intra- and interpersonal barriers to condom use among college students: A review of the literature. Sexuality and Culture, 19(1), 103–121.  https://doi.org/10.1007/s12119-014-9249-y.CrossRefGoogle Scholar
  18. Galizio, M. (1979). Contingency-shaped and rule-governed behavior: Instructional control of human loss avoidance. Journal of the Experimental Analysis of Behavior, 31(1), 53–70.  https://doi.org/10.1901/jeab.1979.31-53.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Green, L., & Myerson, J. (2004). A discounting framework for choice with delayed and probabilistic rewards. Psychological Bulletin, 130(5), 769–792.  https://doi.org/10.1037/0033-2909.130.5.769.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Green, L., Myerson, J., & Ostaszewski, P. (1999). Discounting of delayed rewards across the life span: Age differences in individual discounting functions. Behavioural Processes, 46(1), 89–96.  https://doi.org/10.1016/S0376-6357(99)00021-2.CrossRefPubMedGoogle Scholar
  21. Haque, M. R., & Soonthorndhada, A. (2009). Risk perception and condom-use among Thai youths: Findings from Kanchanaburi demographic surveillance system site in Thailand. Journal of Health, Population & Nutrition, 27(6), 772–783. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=49119034&site=ehost-live&scope=site.
  22. Herrmann, E., Johnson, P., & Johnson, M. (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. Holt, D. D., Green, L., & Myerson, J. (2003). Is discounting impulsive? Evidence from temporal and probability discounting in gambling and non-gambling college students. Behavioural Processes, 64(3), 355–367.  https://doi.org/10.1016/S0376-6357(03)00141-4.CrossRefPubMedGoogle Scholar
  24. Holt, D. D., Newquist, M. H., Smits, R. R., & Tiry, A. M. (2014). Discounting of food, sex, and money. Psychonomic Bulletin & Review, 21(3), 794–802.  https://doi.org/10.3758/s13423-013-0557-2.CrossRefGoogle Scholar
  25. Jarmolowicz, D. P., Bickel, W. K., & Gatchalian, K. M. (2013). Alcohol-dependent individuals discount sex at higher rates than controls. Drug and Alcohol Dependence, 131(3), 320–323.  https://doi.org/10.1016/j.drugalcdep.2012.12.014.CrossRefPubMedPubMedCentralGoogle 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., & Bruner, N. R. (2013). Test-retest reliability and gender differences in the sexual discounting task among cocaine-dependent individuals. Experimental and Clinical Psychopharmacology, 21(4), 277–286.  https://doi.org/10.1037/a0033071.CrossRefPubMedGoogle Scholar
  29. Johnson, P. S., Herrmann, E. S., & Johnson, M. W. (2015a). Opportunity costs of reward delays and the discounting of hypothetical money and cigarettes. Journal of the Experimental Analysis of Behavior, 103(1), 87–107.  https://doi.org/10.1002/jeab.110.CrossRefPubMedGoogle Scholar
  30. Johnson, M. W., Johnson, P. S., Herrmann, E. S., & Sweeney, M. M. (2015b). Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls. PLoS ONE, 10(5), 1–21.  https://doi.org/10.1371/journal.pone.0128641.Google Scholar
  31. Kirby, D. B., Laris, B. A., & Rolleri, L. A. (2007). Sex and HIV education programs: Their impact on sexual behaviors of young people throughout the world. Journal of Adolescent Health, 40(3), 206–217.  https://doi.org/10.1016/j.jadohealth.2006.11.143.CrossRefPubMedGoogle Scholar
  32. Ku, L. C., Sonenstein, F. L., & Pleck, J. H. (1992). The association of AIDS education and sex education with sexual behavior and condom use among teenage men. Family Planning Perspectives, 24(3), 100–106.CrossRefPubMedGoogle Scholar
  33. Lammers, J., van Wijnbergen, S. J., & Willebrands, D. (2013). Condom use, risk perception, and HIV knowledge: A comparison across sexes in Nigeria. HIV/AIDS, 5, 283–293.  https://doi.org/10.2147/hiv.s31687.PubMedPubMedCentralGoogle Scholar
  34. Lawyer, S. R. (2008). Probability and delay discounting of erotic stimuli. Behavioural Processes, 79(1), 36–42.  https://doi.org/10.1016/j.beproc.2008.04.009.CrossRefPubMedGoogle Scholar
  35. 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
  36. Lawyer, S. R., Williams, S. A., Prihodova, T., Rollins, J. D., & Lester, A. C. (2010). Probability and delay discounting of hypothetical sexual outcomes. Behavioural Processes, 84(3), 687–692.  https://doi.org/10.1016/j.beproc.2010.04.002.CrossRefPubMedGoogle Scholar
  37. Madden, G. J., Petry, N. M., & Johnson, P. S. (2009). Pathological gamblers discount probabilistic rewards less steeply than matched controls. Experimental and Clinical Psychopharmacology, 17(5), 283–290.  https://doi.org/10.1037/a0016806.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Maharaj, P., & Cleland, J. (2005). Risk perception and condom use among married or cohabiting couples in KwaZulu-Natal, South Africa. International Family Planning Perspectives, 31(1), 24–29.CrossRefPubMedGoogle Scholar
  39. Myerson, J., Green, L., & Warusawitharana, M. (2001). Area under the curve as a measure of discounting. Journal of the Experimental Analysis of Behavior, 76(2), 235–243.  https://doi.org/10.1901/jeab.2001.76-235.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Orr, D. P., & Langefeld, C. D. (1993). Factors associated with condom use by sexually active male adolescents at risk for sexually transmitted disease. Pediatrics, 91(5), 873–879.PubMedGoogle Scholar
  41. Owusu-Edusei, K., Jr., Chesson, H. W., Gift, T. L., Tao, G., Mahajan, R., Ocfemia, M. C. B., & Kent, C. K. (2013). The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sexually Transmitted Diseases, 40(3), 197–201.  https://doi.org/10.1097/OLQ.0b013e318285c6d2.CrossRefPubMedGoogle Scholar
  42. Poltavski, D. V., & Weatherly, J. N. (2013). Delay and probability discounting of multiple commodities in smokers and never-smokers using multiple-choice tasks. Behavioural Pharmacology, 24(8), 659–667.  https://doi.org/10.1097/FBP.0000000000000010.CrossRefPubMedGoogle Scholar
  43. Prata, N., Morris, L., Mazive, E., Vahidnia, F., & Stehr, M. (2006). Relationship between HIV risk perception and condom use: Evidence from a population-based survey in Mozambique. International Family Planning Perspectives, 32(4), 192–200.CrossRefPubMedGoogle Scholar
  44. Rachlin, H., Raineri, A., & Cross, D. (1991). Subjective probability and delay. Journal of the Experimental Analysis of Behavior, 55(2), 233–244.  https://doi.org/10.1901/jeab.1991.55-233.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Rimsza, M. E. (2005). Sexually transmitted infections: New guidelines for an old problem on the college campus. Pediatric Clinics of North America, 52(1), 217–228.CrossRefPubMedGoogle Scholar
  46. Rosengard, C., Clarke, J. G., DaSilva, K., Hebert, M., Rose, J., & Stein, M. D. (2005). Correlates of partner-specific condom use intentions among incarcerated women in Rhode Island. Perspectives on Sexual & Reproductive Health, 37(1), 32–38.CrossRefGoogle Scholar
  47. Stanger-Hall, K., & Hall, D. W. (2011). Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the U.S. PLoS ONE, 6(10), 1–11.  https://doi.org/10.1371/journal.pone.0024658.CrossRefGoogle Scholar
  48. van Empelen, P., Schaalma, H. P., Kok, G., & Jansen, M. W. J. (2001). Predicting condom use with casual and steady sex partners among drug users. Health Education Research, 16(3), 293–305.  https://doi.org/10.1093/her/16.3.293.CrossRefPubMedGoogle Scholar
  49. Widman, L., Noar, S. M., Choukas-Bradley, S., & Francis, D. B. (2014). Adolescent sexual health communication and condom use: A meta-analysis. Health Psychology, 33(10), 1113–1124.  https://doi.org/10.1037/hea0000112.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Wongsomboon, V., & Robles, E. (2017). Devaluation of safe sex by delay or uncertainty: A within-subjects study of mechanisms underlying sexual risk behavior. Archives of Sexual Behavior, 46(7), 2131–2144.  https://doi.org/10.1007/s10508-016-0788-1.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Meredith S. Berry
    • 1
  • Patrick S. Johnson
    • 1
    • 3
  • Anahí Collado
    • 2
    • 4
  • Jennifer M. Loya
    • 2
    • 5
  • Richard Yi
    • 2
    • 6
  • Matthew W. Johnson
    • 1
  1. 1.Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of PsychologyUniversity of MarylandCollege ParkUSA
  3. 3.Department of PsychologyCalifornia State UniversityChicoUSA
  4. 4.Alvord, Baker and Associates, LLCRockvilleUSA
  5. 5.Department of PsychologyGeorge Mason UniversityFairfaxUSA
  6. 6.Department of Health Education and BehaviorUniversity of FloridaGainesvilleUSA

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