Cocaine-dependent adults and recreational cocaine users are more likely than controls to choose immediate unsafe sex over delayed safer sex

摘要

Cocaine users have a higher incidence of risky sexual behavior and HIV infection than non-users. Our aim was to measure whether safer-sex discount rates, a measure of the likelihood of having immediate unprotected sex versus waiting to have safer sex, differed between controls and cocaine users of varying severity. Of the 162 individuals included in the primary data analyses, 69 met DSM-IV-TR criteria for cocaine dependence, 29 were recreational cocaine users who did not meet dependence, and 64 were controls. Participants completed the sexual delay discounting task, which measures one’s likelihood of using a condom when immediately available and how that likelihood decreases as a function of delay to condom availability with regard to four images chosen by the participants of hypothetical sexual partners differing in perceived desirability and likelihood of having a sexually-transmitted infection. When a condom was immediately available, stated likelihood of condom use sometimes differed between cocaine users and controls, which depended on the image condition. Even after controlling for rates of condom use when immediately available, the Cocaine Dependent and Recreational Users groups were more sensitive to delay to condom availability than controls. Safer-sex discount rates were also related to intelligence scores. The sexual discounting task identifies delay as a key variable that impacts the likelihood of using a condom among these groups and suggests that HIV-prevention efforts may be differentially effective based on an individual’s safer-sex discount rate.