Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior
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.
KeywordsHIV risk behavior Delay discounting Sexual discounting Impulsivity Sensation seeking
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
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 was obtained from all individual participants included in the study.
- 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.
- CDC. (2017a). HIV among gay and bisexual men. Retrieved November 14, 2017, from https://www.cdc.gov/hiv/group/msm/index.html.
- CDC. (2017b). HIV among transgender people. Retrieved August 31, 2016, from https://www.cdc.gov/hiv/group/gender/transgender/index.html.
- 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
- 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
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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/10.1037/0012-16220.127.116.11.CrossRefPubMedPubMedCentralGoogle Scholar
- 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/10.1037/0278-618.104.22.1685.CrossRefPubMedGoogle Scholar
- 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
- 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
- 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
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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
- 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
- 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
- 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
- Morey, L. C. (1991). Personality assessment inventory (PAI). Odessa, FL: Psychological Assessment Resources.Google Scholar
- 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
- 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
- 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.CrossRefGoogle Scholar
- 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
- R Development Core Team. (2018). R: A language and environment for statistical computing. https://www.R-project.org/. Accessed 5 Jan 2018.
- 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
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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
- 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