UVM Theses and Dissertations
Format:
Print
Author:
Herrmann, Evan
Dept./Program:
Psychology
Year:
2013
Degree:
PhD
Abstract:
Women are at increased risk for sexually transmitted HIV infection compared to men. Opioid-maintained (OM) women are at even greater risk because they are more likely to engage in risky sexual behaviors (e.g., having multiple partners, trading sex for drugs/money) without using condoms. The overarching aim of this study was to examine sexual decision making in a large sample of women, including both non-drug-using and OM women. The three specific aims of the study were to: 1) characterize delay discounting of condom-protected sex among women (N = 60) using the novel Sexual Discounting Task (SDT; Johnson & Bruner, 2012), 2) compare sexual discounting between OM women (N=27) and non-drug-using controls (n =33), and 3) examine relationships between sexual discounting and variables associated with HIV infection among OM women. Women chose hypothetical sexual partners from a series of photographs.
Next, participants identifiedwhich partners they: 1) most wanted to have sex with (MOST SEX), 2) least wanted to have sex with (LEAST SEX) 3) thought were least likely to have an STI (LEAST STI), and 4) thought were most likely to have an STI (MOST STI). Then, women indicated the likelihood of 1) having sex with or without an immediately available condom (0-delay trial), and 2) having sex immediately without a condom vs. waiting various delays to have sex with a condom (delay trials) for each of the four hypothetical partners they selected. Women reported they were more likely to have unprotected sex with the LEAST STI partner vs. the MOST STI partner (94% vs. 75%, p<.001) on 0-delay trials. Repeated-measures ANOVA indicated robust delay discounting of condom-protected sex within all four conditions (ps <.001).
Discounting data were orderly and well-fit by hyperboloid functions for all four partner conditions (median R²s>.95), with greater impulsivity in the more desirable partner conditions (MOST SEX and LEAST STI) vs. their less desirable counterparts (LEAST SEX and MOST STI). Higher scores on the Barratt ImpulsIveness Scale (BIS-11) were associated with greater impulsivity in the MOST SEX, LEAST SEX, and LEAST STI partner conditions. Regression analyses demonstrated that women with multiple sex partners and who used condoms inconsistantly were more likely to have unprotected sex in MOST SEX and LEAST STI partner conditions. Repeated-measures ANOVA revealed that OM women discounted the value of condom-protected sex more steeply than non-drug-using women for MOST SEX and LEAST STI partner conditions and that OM women discounted money more steeply and had higher BIS-11 scores than non-drug-using women, all indicative of greater impulsivity among OM women.
Regression analyses demonstrated that history of injection cocaine use predicted steeper discounting of condom-protected sex among OM women. Taken together, these results suggest that women discount the value of condom-protected sex as a function of delay in the same orderly and hyperbolic manner as they discount other rewards. Likewise, the steeper discounting rates observed among OM women are consistent with findings from studies comparing delay discounting of money between drug users and non-users. Furthemore, relationships between sexual discounting and injection cocaine use, a variable associated with HIV infection among OM women. The results of the present study suggest that the SDT may be measuring decision-making processes that underlie real-world risky sexual behavior. Further investigation of these relationships is warranted.
Next, participants identifiedwhich partners they: 1) most wanted to have sex with (MOST SEX), 2) least wanted to have sex with (LEAST SEX) 3) thought were least likely to have an STI (LEAST STI), and 4) thought were most likely to have an STI (MOST STI). Then, women indicated the likelihood of 1) having sex with or without an immediately available condom (0-delay trial), and 2) having sex immediately without a condom vs. waiting various delays to have sex with a condom (delay trials) for each of the four hypothetical partners they selected. Women reported they were more likely to have unprotected sex with the LEAST STI partner vs. the MOST STI partner (94% vs. 75%, p<.001) on 0-delay trials. Repeated-measures ANOVA indicated robust delay discounting of condom-protected sex within all four conditions (ps <.001).
Discounting data were orderly and well-fit by hyperboloid functions for all four partner conditions (median R²s>.95), with greater impulsivity in the more desirable partner conditions (MOST SEX and LEAST STI) vs. their less desirable counterparts (LEAST SEX and MOST STI). Higher scores on the Barratt ImpulsIveness Scale (BIS-11) were associated with greater impulsivity in the MOST SEX, LEAST SEX, and LEAST STI partner conditions. Regression analyses demonstrated that women with multiple sex partners and who used condoms inconsistantly were more likely to have unprotected sex in MOST SEX and LEAST STI partner conditions. Repeated-measures ANOVA revealed that OM women discounted the value of condom-protected sex more steeply than non-drug-using women for MOST SEX and LEAST STI partner conditions and that OM women discounted money more steeply and had higher BIS-11 scores than non-drug-using women, all indicative of greater impulsivity among OM women.
Regression analyses demonstrated that history of injection cocaine use predicted steeper discounting of condom-protected sex among OM women. Taken together, these results suggest that women discount the value of condom-protected sex as a function of delay in the same orderly and hyperbolic manner as they discount other rewards. Likewise, the steeper discounting rates observed among OM women are consistent with findings from studies comparing delay discounting of money between drug users and non-users. Furthemore, relationships between sexual discounting and injection cocaine use, a variable associated with HIV infection among OM women. The results of the present study suggest that the SDT may be measuring decision-making processes that underlie real-world risky sexual behavior. Further investigation of these relationships is warranted.