Abstract
Condoms provide protection against sexually transmitted diseases; however, condomless sex remains common among college students and intentions to use condoms do not consistently translate into condom use. This study tested which indicator of condom use intentions from a delay discounting paradigm of condom-protected sex best accounted for variance in condom use behavior. The sample consisted of 187 sexually active college students (51.9% female) who completed measures of condom use during vaginal and anal sex over the past three months and a decision-making paradigm regarding condom intentions with hypothetical sexual partners. In separate models, condom behavior was regressed on one of three indicators of condom intentions: initial intentions to use a condom, delay discounting of condom-protected sex, and overall area under the curve across all trials. Results showed that delay discounting of condom-protected sex best accounted for variance in absolute frequency of condomless sex, whereas initial intentions to use a condom best accounted for variance in relative proportion of condomless sex. Future research directions and implications for interventions are discussed.
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References
Abraham, C. S., Sheeran, P., Abrams, D., & Spears, R. (1996). Health beliefs and teenage condom use: A prospective study. Psychology and Health, 11(5), 641–655. https://doi.org/10.1080/08870449608404994
Abraham, C. S., Sheeran, P., Norman, P., Conner, M., de Vrles, N., & Otten, W. (1999). When good intentions are not enough: Modeling postdecisional cognitive correlates of condom use. Journal of Applied Social Psychology, 29(12), 2591–2612.
Agocha, V. B., & Cooper, M. L. (1999). Risk perceptions and safer-sex intentions: Does a partner’s physical attractiveness undermine the use of risk-relevant information? Personality and Social Psychology Bulletin, 25(6), 746–759.
Ainslie, G. (1975). Specious reward: A behavioral theory of impulsiveness and impulse control. Psychological Bulletin, 82(4), 463–496.
Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22, 453–474.
Akaike, H. (1974). A new look at the statistical model identification. IEEE Transactions on Automatic Control, 19(6), 716–723.
Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127(1), 142–161.
Basen-Engquist, K. (1992). Psychosocial predictors of “safer sex” behaviors in young adults. AIDS Education and Prevention, 4(2), 120–134.
Bickel, W. K., & Marsch, L. A. (2001). Toward a behavioral economic understanding of drug dependence: Delay discounting processes. Addiction, 96(1), 73–86. https://doi.org/10.1080/09652140020016978
Celio, M. A., MacKillop, J., Caswell, A. J., Mastroleo, N. R., Kahler, C. W., Barnett, N. P., Colby, S. M., Operario, D., & Monti, P. M. (2016). Interactive relationships between sex-related alcohol expectancies and delay discounting on risky sex. Alcoholism Clinical and Experimental Research, 40(3), 638–646. https://doi.org/10.1111/acer.12988
Centers for Disease Control and Prevention. (2019). Sexually Transmitted Disease Surveillance 2018. U.S. Department of Health and Human Services. https://doi.org/10.15620/cdc.79370
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
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
Eleftheriou, A., Bullock, S., Graham, C. A., Stone, N., & Ingham, R. (2016). Does attractiveness influence condom use intentions in heterosexual men? An experimental study. BMJ Open, 6(6), e010883. https://doi.org/10.1136/bmjopen-2015-010883
Fishbein, M. (1980). A theory of reasoned action: Some applications and implications. Nebraska Symposium on Motivation, 27, 65–116.
Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention and behavior: An introduction to theory and research. Addison-Wesley.
Francis, D. B., Noar, S. M., Widman, L., Willoughby, J. F., Sanchez, D. M., & Garrett, K. P. (2016). Perceptions of a campus-wide condom distribution programme: An exploratory study. Health Education Journal, 75(8), 998–1011. https://doi.org/10.1177/0017896916648994
Hahn, H., Kalnitsky, S., Haines, N., Thamotharan, S., Beauchaine, T. P., & Ahn, W. Y. (2019). Delay discounting of protected sex: Relationship type and sexual orientation influence sexual risk behavior. Archives of Sexual Behavior, 48(7), 2089–2102. https://doi.org/10.1007/s10508-019-1450-5
Hall, P. A., & Fong, G. T. (2013). Temporal self-regulation theory: Integrating biological, psychological, and ecological determinants of health behavior performance. In P. A. Hall (Ed), Social Neuroscience and Public Health (pp 35–53). Springer. https://doi.org/10.1007/978-1-4614-6852-3_3
Hall, P. A., & Fong, G. T. (2007). Temporal self-regulation theory: A model for individual health behavior. Health Psychology Review, 1(1), 6–52. https://doi.org/10.1080/17437190701492437
Hennessy, M., Fishbein, M., Curtis, B., & Barrett, D. W. (2007). Evaluating the risk and attractiveness of romantic partners when confronted with contradictory cues. AIDS and Behavior, 11(3), 479–490. https://doi.org/10.1007/s10461-006-9156-9
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
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
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
Johnson, M. W., Herrmann, E. S., Sweeney, M. M., LeComte, R. S., & Johnson, P. S. (2017). 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(4), 599–612. https://doi.org/10.1007/s00213-016-4493-5
Johnson, M. W., Strickland, J. C., Herrmann, E. S., Dolan, S. B., Cox, D. J., & Berry, M. S. (2021). Sexual discounting: A systematic review of discounting processes and sexual behavior. Experimental and Clinical Psychopharmacology, 29(6), 711–738. https://doi.org/10.1037/pha0000402
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
Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). Guilford Press.
Mazur, J. E. (1987). An adjusting procedure for studying delayed reinforcement. In M. L. Commons, J. E. Mazur, J. A. Nevin, & H. Rachlin (Eds.), Quantitative analysis of behavior: The effects of delay and of intervening events on reinforcement value (Vol. 5, pp. 55–73). Lawrence Erlbaum Associates, Inc.
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user's guide (Eighth ed.). Muthén & Muthén. https://www.statmodel.com/
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
O’Sullivan, L. F., Udell, W., Montrose, V. A., Antoniello, P., & Hoffman, S. (2010). A cognitive analysis of college students’ explanations for engaging in unprotected sexual intercourse. Archives of Sexual Behavior, 39(5), 1121–1131. https://doi.org/10.1007/s10508-009-9493-7
Qualtrics. (2018–2020). Qualtrics. In (Version last accessed March, 2020) [software]. https://www.qualtrics.com/
Quinn, P. D., & Fromme, K. (2010). Self-regulation as a protective factor against risky drinking and sexual behavior. Psychology of Addictive Behaviors, 24(3), 376–385. https://doi.org/10.1037/a0018547
Quisenberry, A. J., Eddy, C. R., Patterson, D. L., Franck, C. T., & Bickel, W. K. (2015). Regret expression and social learning increases delay to sexual gratification. PLoS ONE, 10(8), e0135977. https://doi.org/10.1371/journal.pone.0135977
Rachlin, H. (1992). Diminishing marginal value as delay discounting. Journal of the Experimental Analysis of Behavior, 57(3), 407–415. https://doi.org/10.1901/jeab.1992.57-407
Sclove, S. L. (1987). Application of model-selection criteria to some problems in multivariate-analysis. Psychometrika, 52(3), 333–343.
Shacham, E., Nelson, E. J., Schulte, L., Bloomfield, M., & Murphy, R. (2016). Condom deserts: Geographical disparities in condom availability and their relationship with rates of sexually transmitted infections. Sexually Transmitted Infections, 92(3), 194–199. https://doi.org/10.1136/sextrans-2015-052144
Sheeran, P. (2002). Intention–behavior relations: A conceptual and empirical review. European Review of Social Psychology, 12(1), 1–36.
Sheeran, P., Abraham, C., & Orbell, S. (1999). Psychosocial correlates of heterosexual condom use: A meta-analysis. Psychological Bulletin, 125(1), 90–132.
Simons, J. S., Simons, R. M., Maisto, S. A., Hahn, A. M., & Walters, K. J. (2018). Daily associations between alcohol and sexual behavior in young adults. Experimental and Clinical Psychopharmacology, 26(1), 36–48. https://doi.org/10.1037/pha0000163
Sweeney, M. M., Berry, M. S., Johnson, P. S., Herrmann, E. S., Meredith, S. E., & Johnson, M. W. (2020). Demographic and sexual risk predictors of delay discounting of condom-protected sex. Psychology and Health, 35(3), 366–386. https://doi.org/10.1080/08870446.2019.1631306
Turchik, J. A., & Garske, J. P. (2009). Measurement of sexual risk taking among college students. Archives of Sexual Behavior, 38(6), 936–948. https://doi.org/10.1007/s10508-008-9388-z
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
Acknowledgements
This research was supported in part by the Syracuse University Department of Psychology research funds. This article is the final manuscript from Luke Mitzel’s dissertation project conducted at Syracuse University. The full dissertation is available through ProQuest Dissertations & Theses database. Since completing this work at Syracuse University, Luke Mitzel has taken a position at the Center for Integrated Healthcare. The views expressed in this article are the views of the authors and do not necessarily reflect the views of any of the authors’ affiliated institutions.
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This research was supported in part by the Syracuse University Department of Psychology research funds.
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Mitzel, L.D., Johnson, M.W. & Vanable, P.A. Delay Discounting and Sexual Decision-Making: Understanding Condom Use Behavior Among U.S. College Students. Arch Sex Behav 52, 2605–2617 (2023). https://doi.org/10.1007/s10508-023-02597-4
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DOI: https://doi.org/10.1007/s10508-023-02597-4