Abstract
Objectives
Although cocaine use has been linked to sexual HIV risk behavior for decades, the direct effects of cocaine on sexual desire and sexual decision-making are unexamined. Research suggests delay discounting (devaluation of future outcomes) and probability discounting (devaluation of uncertain outcomes) play roles in condom use decisions. This study examined the effect of cocaine administration on sexual desire, hypothetical condom use, and discounting tasks.
Methods
This double-blind, within-subjects study compared the effects of 0, 125, and 250 mg/70 kg oral cocaine HCl in 12 cocaine users. Measures included sexual desire and other subjective ratings, the Sexual Delay Discounting Task, the Sexual Probability Discounting Task, and monetary delay and probability discounting tasks.
Results
Cocaine caused dose-related increases in sexual desire and prototypical stimulant abuse-liability ratings. Relative to placebo, cocaine did not significantly alter condom use likelihood when condoms were immediately available or when sex was associated with 100% certainty of sexually transmitted infection (STI). In contrast, cocaine dose-dependently strengthened the effect of delay (sexual delay discounting) and STI uncertainty (sexual probability discounting) in decreasing condom use likelihood. Cocaine caused no significant change in monetary delay and probability discounting.
Conclusion
This is the first study showing that cocaine administration increases sexual desire. Detrimental effects of cocaine on sexual risk were only observed when safer sex required delay, or STI risk was uncertain (representative of many real-world scenarios), suggesting a critical role of discounting processes. Lack of monetary effects highlights the importance of studying clinically relevant outcomes when examining drug effects on behavioral processes.
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References
Ammons RB, Ammons CH (1962) Quick Test (QT): provisional manual. Psychol Rep 11:111–161
Baker F, Johnson MW, Bickel WK (2003) Delay discounting in current and neverbefore cigarette smokers: similarities and differences across commodity, sign, and magnitude. J Abnorm Psychol 112:382–392
Bickel WK, Pitcock JA, Yi R, Angtuaco EJ (2009) Congruence of BOLD response across intertemporal choice conditions: fictive and real money gains and losses. J Neurosci 29:8839–8846. doi:10.1523/JNEUROSCI.531908.2009
Bickel WK, Johnson MW, Koffarnus MN, MacKillop J, Murphy JG (2014) The behavioral economics of substance use disorders: reinforcement pathologies and their repair. Annu Rev Clin Psychol 10:641–677. doi:10.1146/annurevclinpsy032813153724
Booth RE, Watters JK, Chitwood DD (1993) HIV riskrelated sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack. Am J Public Health 83:1144–1148
Booth RE, Kwiatkowski CF, Chitwood DD (2000) Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack. Drug Alcohol Depend 58:219–226. doi:10.1016/S0376-8716(99)00094-0
Bux DA, Lamb RJ, Iguchi MY (1995) Cocaine use and HIV risk behavior in methadone maintenance patients. Drug Alcohol Depend 37:29–35. doi:10.1016/0376-8716(94)01058-S
Chan SK, Thornton LR, Chronister KJ, Meyer J, Wolverton M, Johnson CK, Arafat RR, Joyce PM, Switzer WM, Heneine W, Shankar A, Granade T, Owen MS, Sprinkle P, Sullivan V, Centers for Disease Control and Prevention (CDC) (2014) Likely female-to-female sexual transmission of HIV—Texas, 2012. MMWR Morb Mortal Wkly Rep 63:209–212
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Earlbaum Associates, Hillsdale, NJ
Colfax G, Vittinghoff E, Husnik MJ, McKirnan D, Buchbinder S, Koblin B, Celum C, Chesney M, Huang Y, Mayer K, Bozeman S, Judson FN, Bryant KJ, Coates TJ, EXPLORE Study Team (2004) Substance use and sexual risk: a participant- and episode-level analysis among a cohort of men who have sex with men. Am J Epidemiol 159:1002–1012
Dandy KL, Gatch MB (2009) The effects of chronic cocaine exposure on impulsivity in rats. Behav Pharmacol 20:400–405. doi:10.1097/FBP.0b013e328330ad89
Dariotis JK, Johnson MW (2015) Sexual discounting among high-risk youth ages 18-24: implications for sexual and substance use risk behaviors. Exp Clin Psychopharmacol 23:49–58. doi:10.1037/a0038399
Darke S, Hall W, Heather N, Ward J, Wodak A (1991) The reliability and validity of a scale to measure HIV risk-taking behavior among intravenous drug users. AIDS 5:181–185
Dunn, KE, Barrett, FS, Herrmann, ES, Plebani, JG, Sigmon, SC, & Johnson, MW (2016) Behavioral Risk Assessment for Infectious Diseases (BRAID): self-report instrument to assess injection and noninjection risk behaviors in substance users. Drug Alcohol Depend
Edlin BR, Irwin KL, Faruque S, McCoy CB, Word C, Serrano Y, Inciardi JA, Bowser BP, Schilling RF, Holmberg SD (1994) Intersecting epidemics—crack cocaine use and HIV infection among inner-city young adults. Multicenter Crack Cocaine and HIV Infection Study Team. N Engl J Med 331:1422–1427. doi:10.1056/NEJM199411243312106
Edwards JM, Halpern CT, Wechsberg WM (2006) Correlates of exchanging sex for drugs or money among women who use crack cocaine. AIDS Educ Prev 18:420–429. doi:10.1521/aeap.2006.18.5.420
George WH, Davis KC, Norris J, Heiman JR, Stoner SA, Schacht RL, Hendershot CS, Kajumulo KF (2009) Indirect effects of acute alcohol intoxication on sexual risk-taking: the roles of subjective and physiological sexual arousal. Arch Sex Behav 38:498–513. doi:10.1007/s10508-008-9346-9
Green RM, Lawyer SR (2014) Steeper delay and probability discounting of potentially real versus hypothetical cigarettes (but not money) among smokers. Behav Process 108:50–56. doi:10.1016/j.beproc.2014.09.008
Grella CE, Anglin MD, Wugalter SE (1995) Cocaine and crack use and HIV risk behaviors among high-risk methadone maintenance clients. Drug Alcohol Depend 37:15–21. doi:10.1016/0376-8716(94)01059-T
Haberny KA, Walsh SL, Ginn DH, Wilkins JN, Garner JE, Setoda D, Bigelow GE (1995) Absence of acute cocaine interactions with the MAO-B inhibitor selegiline. Drug Alcohol Depend 39:55–62. doi:10.1016/0376-8716(95)01137-N
Hall HI, An Q, Tang T, Song R, Chen M, Green T, Kang J, Centers for Disease Control and Prevention (CDC) (2015) Prevalence of diagnosed and undiagnosed HIV infection—United States, 2008-2012. MMWR Morb Mortal Wkly Rep 64:657–662
Heil SH, Sigmon SC, Mongeon JA, Higgins ST (2005) Characterizing and improving HIV/AIDS knowledge among cocaine-dependent outpatients. Exp Clin Psychopharmacol 13:238–243. doi:10.1037/1064-1297.13.3.238
Heil SH, Johnson MW, Higgins ST, Bickel WK (2006) Delay discounting in currently using and currently abstinent cocaine-dependent outpatients and non-drug-using matched controls. Addict Behav 31:1290–1294. doi:10.1016/j.addbeh.2005.09.005
Herrmann ES, Heil SH, Sigmon SC, Dunn KE, Washio Y, Higgins ST (2013) Characterizing and improving HIV/AIDS knowledge among cocaine-dependent outpatients using modified materials. Drug Alcohol Depend 127:220–225. doi:10.1016/j.drugalcdep.2012.07.006
Herrmann ES, Hand DJ, Johnson MW, Badger GJ, Heil SH (2014) Examining delay discounting of condom-protected sex among opioid-dependent women and non-drug-using control women. Drug Alcohol Depend 144:53–60. doi:10.1016/j.drugalcdep.2014.07.026
Herrmann ES, Johnson PS, Johnson MW (2015) Examining delay discounting of condom-protected sex among men who have sex with men using crowdsourcing technology. AIDS Behav 19:1655–1665. doi:10.1007/s104610151107x
Hoffman JA, Klein H, Eber M, Crosby H (2000) Frequency and intensity of crack use as predictors of women's involvement in HIV-related sexual risk behaviors. Drug Alcohol Depend 58:227–236. doi:10.1016/S0376-8716(99)00095-2
Hoyle RH, Kenny, D (1999) Sample size, reliability, and tests of statistical mediation. In: Hoyle RH (ed), Statistical strategies for small sample research. Sage, Thousand Oaks, CA, pp 195–222.
Hudziak JJ, Helzer JE, Wetzel MW, Kessel KB, McGee B, Janca A, Przybeck T (1993) The use of the DSM-III-R checklist for initial diagnostic assessments. Compr Psychiatry 34:375–383
Jaffe JH, Cascella NG, Kumor KM, Sherer MA (1989) Cocaine-induced cocaine craving. Psychopharmacology 97:59–64
Joe GW, Simpson DD (1995) HIV risks, gender, and cocaine use among opiate users. Drug Alcohol Depend 37:23–28. doi:10.1016/0376-8716(94)01030-O
Johnson MW (2012) An efficient operant choice procedure for assessing delay discounting in humans: initial validation in cocaine-dependent and control individuals. Exp Clin Psychopharmacol 20:191–204. doi:10.1037/a0027088
Johnson MW, Bickel WK (2002) Within-subject comparison of real and hypothetical money rewards in delay discounting. J Exp Anal Behav 77:129–146. doi:10.1901/jeab.2002.77-129
Johnson MW, Bickel WK (2008) An algorithm for identifying nonsystematic delay-discounting data. Exp Clin Psychopharmacol 16:264–274. doi:10.1037/1064-1297.16.3.264
Johnson MW, Bruner NR (2012) The sexual discounting task: HIV risk behavior and the discounting of delayed sexual rewards in cocaine dependence. Drug Alcohol Depend 123:15–21. doi:10.1016/j.drugalcdep.2011.09.032
Johnson MW, Bruner NR (2013) Test-retest reliability and gender differences in the sexual discounting task among cocaine-dependent individuals. Exp Clin Psychopharmacol 21:277–286. doi:10.1037/a0033071
Johnson MW, Griffiths RR (2013) Comparative abuse liability of GHB and ethanol in humans. Exp Clin Psychopharmacol 21:112–123. doi:10.1037/a0031692
Johnson MW, Bickel WK, Baker F (2007) Moderate drug use and delay discounting: a comparison of heavy, light, and never smokers. Exp Clin Psychopharmacol 15:187–194. doi:10.1037/1064–1297.15.2.187
Johnson MW, Strain EC, Griffiths RR (2010) Effects of oral caffeine pretreatment on response to intravenous nicotine and cocaine. Exp Clin Psychopharmacol 18:305–315. doi:10.1037/a0020509
Johnson MW, Bruner NR, Johnson PS (2015a) Cocaine dependent individuals discount future rewards more than future losses for both cocaine and monetary outcomes. Addict Behav 40:132–136. doi:10.1016/j.addbeh.2014.08.011
Johnson MW, Johnson PS, Herrmann ES, Sweeney MM (2015b) Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls. PLoS One 10:e0128641. doi:10.1371/journal.pone.0128641
Johnson PS, Sweeney MM, Herrmann ES, Johnson MW (2016) Alcohol increases delay and probability discounting of condom-protected sex: a novel vector for alcohol-related HIV transmission. Alcohol Clin Exp Res 40:1339–1350. doi:10.1111/acer.13079
Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E, Howes MJ, Jin R, Secnik K, Spencer T, Ustun TB, Walters EE (2005) The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 35:245–256
Koffarnus MN, Woods JH (2013) Individual differences in discount rate are associated with demand for self-administered cocaine, but not sucrose. Addict Biol 18:8–18. doi:10.1111/j.1369-1600.2011.00361.x
Lagorio CH, Madden GJ (2005) Delay discounting of real and hypothetical rewards III: steady-state assessments, forced-choice trials, and all real rewards. Behav Process 69:173–187. doi:10.1016/j.beproc.2005.02.003
Lawyer SR, Schoepflin FJ (2013) Predicting domain-specific outcomes using delay and probability discounting for sexual versus monetary outcomes. Behav Process 96:71–78. doi:10.1016/j.beproc.2013.03.001
Lawyer SR, Schoepflin F, Green R, Jenks C (2011) Discounting of hypothetical and potentially real outcomes in nicotine-dependent and nondependent samples. Exp Clin Psychopharmacol 19:263–274. doi:10.1037/a0024141
Logue AW, Tobin H, Chelonis JJ, Wang RY, Geary N, Schachter S (1992) Cocaine decreases self-control in rats: a preliminary report. Psychopharmacology 109:245–247
Madden GJ, Begotka AM, Raiff BR, Kastern LL (2003) Delay discounting of real and hypothetical rewards. Exp Clin Psychopharmacol 11:139–145
Madden GJ, Raiff BR, Lagorio CH, Begotka AM, Mueller AM, Hehli DJ, Wegener AA (2004) Delay discounting of potentially real and hypothetical rewards: II. Between- and within-subject comparisons. Exp Clin Psychopharmacol 12:251–261. doi:10.1037/1064-1297.12.4.251
Malow RM, West JA, Corrigan SA, Pena JM, Cunningham SC (1994) Outcome of psychoeducation for HIV risk reduction. AIDS Educ Prev 6:113–125
Matusiewicz AK, Carter AE, Landes RD, Yi R (2013) Statistical equivalence and test-retest reliability of delay and probability discounting using real and hypothetical rewards. Behav Process 100:116–122. doi:10.1016/j.beproc.2013.07.019
McCoy CB, Lai S, Metsch LR, Messiah SE, Zhao W (2004) Injection drug use and crack cocaine smoking: independent and dual risk behaviors for HIV infection. Ann Epidemiol 14:535–542. doi:10.1016/j.annepidem.2003.10.001
Mendez IA, Simon NW, Hart N, Mitchell MR, Nation JR, Wellman PJ, Setlow B (2010) Self-administered cocaine causes long-lasting increases in impulsive choice in a delay discounting task. Behav Neurosci 124:470–477. doi:10.1037/a0020458
Morris SB, DeShon RP (2002) Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychol Methods 7:105–125
Myerson J, Green L, Warusawitharana M (2001) Area under the curve as a measure of discounting. J Exp Anal Behav 76:235–243. doi:10.1901/jeab.2001.76-235
Nann-Vernotica E, Donny EC, Bigelow GE, Walsh SL (2001) Repeated administration of the D1/5 antagonist ecopipam fails to attenuate the subjective effects of cocaine. Psychopharmacology 155:338–347
O'Brien CP (2011) Drug addiction; Goodman & Gilman’s pharmacologic basis for therapeutics. In: Brunton LL, Chabner BA, Knollman BC (eds) Goodman & Gilman’s pharmacologic basis for therapeutics. McGraw-Hill, New York
Perry JL, Larson EB, German JP, Madden GJ, Carroll ME (2005) Impulsivity (delay discounting) as a predictor of acquisition of IV cocaine self-administration in female rats. Psychopharmacology 178:193–201. doi:10.1007/s00213-004-1994-4
Perry JL, Nelson SE, Carroll ME (2008) Impulsive choice as a predictor of acquisition of IV cocaine self- administration and reinstatement of cocaine-seeking behavior in male and female rats. Exp Clin Psychopharmacol 16:165–177. doi:10.1037/1064-1297.16.2.165
Prendergast ML, Urada D, Podus D (2001) Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs. J Consult Clin Psychol 69:389–405
Rachlin H, Raineri A, Cross D (1991) Subjective probability and delay. J Exp Anal Behav 55:233–244. doi:10.1901/jeab.1991.55-233
Rasmussen EB, Lawyer SR, Reilly W (2010) Percent body fat is related to delay and probability discounting for food in humans. Behav Process 83:23–30. doi:10.1016/j.beproc.2009.09.001
Rendina HJ, Moody RL, Ventuneac A, Grov C, Parsons JT (2015) Aggregate and event-level associations between substance use and sexual behavior among gay and bisexual men: comparing retrospective and prospective data. Drug Alcohol Depend 154:199–207. doi:10.1016/j.drugalcdep.2015.06.045
Roesch MR, Calu DJ, Schoenbaum G (2007) Dopamine neurons encode the better option in rats deciding between differently delayed or sized rewards. Nat Neurosci 10:1615–1624. doi:10.1038/nn2013
Schiff S, Amodio P, Testa G, Nardi M, Montagnese S, Caregaro L, di Pellegrino G, Sellitto M (2015) Impulsivity toward food reward is related to BMI: evidence from intertemporal choice in obese and normal-weight individuals. Brain Cogn. doi:10.1016/j.bandc.2015.10.001
Semaan S, Des Jarlais DC, Sogolow E, Johnson WD, Hedges LV, Ramirez G, Flores SA, Norman L, Sweat MD, Needle R (2002) A meta-analysis of the effect of HIV prevention interventions on the sex behaviors of drug users in the United States. J Acquir Immune Defic Syndr 30 Suppl 1:S73–S93
Setlow B, Mendez IA, Mitchell MR, Simon NW (2009) Effects of chronic administration of drugs of abuse on impulsive choice (delay discounting) in animal models. Behav Pharmacol 20:380–389. doi:10.1097/FBP.0b013e3283305eb4
Simon NW, Mendez IA, Setlow B (2007) Cocaine exposure causes long-term increases in impulsive choice. Behav Neurosci 121:543–549. doi:10.1037/0735-7044.121.3.543
Smith BJ, Jones HE, Griffiths RR (2001) Physiological, subjective and reinforcing effects of oral and intravenous cocaine in humans. Psychopharmacology 156:435–444
Sobel BF, Sigmon SC, Griffiths RR (2004) Transdermal nicotine maintenance attenuates the subjective and reinforcing effects of intravenous nicotine, but not cocaine or caffeine, in cigarette-smoking stimulant abusers. Neuropsychopharmacology 29:991–1003. doi:10.1038/sj.npp.1300415
Strathdee SA, Sherman SG (2003) The role of sexual transmission of HIV infection among injection and non-injection drug users. J Urban Health 80:iii7–ii14
Sussner BD, Smelson DA, Rodrigues S, Kline A, Losonczy M, Ziedonis D (2006) The validity and reliability of a brief measure of cocaine craving. Drug Alcohol Depend 83:233–237. doi:10.1016/j.drugalcdep.2005.11.022
Volkow ND, Wang GJ, Fowler JS, Telang F, Jayne M, Wong C (2007) Stimulant-induced enhanced sexual desire as a potential contributing factor in HIV transmission. Am J Psychiatry 164:157–160. doi:10.1176/appi.ajp.164.1.157
Winhusen TM, Somoza EC, Lewis DF, Kropp F, Theobald J, Elkashef A (2014) An evaluation of substance abuse treatment and HIV education on safe sex practices in cocaine dependent individuals. ISRN Addict 2014:912863. doi:10.1155/2014/912863
Yi R, Johnson MW, Bickel WK (2005) Relationship between cooperation in an iterated prisoner’s dilemma game and the discounting of hypothetical outcomes. Learn Behav 33:324–336
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This work was supported by the National Institute on Drug Abuse (NIDA) through R01DA032363, R01DA035277, and T32DA007209. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors declare that they have no conflict of interest.
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Johnson, M.W., Herrmann, E.S., Sweeney, M.M. et al. Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV. Psychopharmacology 234, 599–612 (2017). https://doi.org/10.1007/s00213-016-4493-5
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DOI: https://doi.org/10.1007/s00213-016-4493-5