Association for Behavior Analysis International

Discounting, a behavioral measure of impulsive choice, is associated with a variety of social health phenomena (e.g., substance abuse), but relatively little empirical attention has been focused on the examination of discounting in relation to sexual decisions and outcomes. In spite of the clear relevance of discounting to sexual decisions that lead to long-term poor health outcomes (e.g., sexually transmitted infections), only2 studies to date have been published specifically examining discounting of sexual outcomes (Lawyer, et al., 2008, 2010). This symposium comprises3 research studies that significantly extend the nascent focus on discounting for sexual outcomes. David Jarmalowicz, et al. will present data examining the cross-commodity discounting of sexual and monetary outcomes in cocaine addicts that speak to the commodity-specific discounting rates in this sample. Frederick Schoepflin and Steven R. Lawyer will examine the impact of exposure to sexual cues in the laboratory on discounting for sexual versus monetary outcomes. Matthew Johnson will examine how discounting for sexual and monetary outcomes is related to real-world sexual risk behavior in cocaine addicts. This symposium highlights the importance of translational research for bridging basic laboratory-behavioral research and real-world social health phenomena. Dr. Derek Reed, a respected discounting researcher, will serve as discussant.

Choice procedures examining the discounting of delayed reinforcers provide insight into individuals' valuation of various commodities. For example, cocaine users discount cocaine more rapidly than money (e.g., Bickel et al., 2011). Because cocaine users also engage in risky sexual behaviors, they may also disproportionately discount delayed sexual encounters. Although such between-commodity comparisons highlight the relative rates of discounting for each commodity, little is known about the mechanisms driving these differing discounting rates. For instance, are drug reinforcers rapidly discounted because they quickly loose their value, or are immediate drugs disproportionately valuable? This study of 25 treatment-seeking cocaine addicts analyzed delay discounting of2 commodities (equated amounts of sex and money); specifically between sex now vs. sex later (S-S), money now vs. money later (M-M), sex now vs. money later (S-M), and money now vs. sex later (M-S). Changes in the delayed commodity resulted in large and significant changes in discounting rates, whereas changes in the immediate commodity resulted in small nonsignificant changes. These findings suggest that cocaine addicts not only discount sexual encounters more rapidly than money, but also that this differential discounting may occur because sexual encounters are rapidly devalued.

Cocaine dependence is associated with high rates of sexual risk behavior and HIV infection; however, little is known regarding responsible behavioral mechanisms. Cocaine-dependent individuals (N = 62) completed the Sexual Discounting Task assessing decisions between immediate unprotected sex and delayed sex with a condom across4 hypothetical partners: most (and least) likely to have a sexually transmitted infection (STI), and most (and least) sexually desirable. Participants also completed a real rewards money delay-discounting task, and the HIV Risk-Taking Behavior Scale (HRBS), which included a subscale of self-reported sexual risk behavior. Sexual discounting (preference for immediate unprotected sex) was significantly greater when making responses for partners judged least (compared to most) likely to have an STI, and for partners judged most (compared to least) desirable. Greater self-reported sexual risk behavior on the HRBS was significantly associated with greater sexual discounting in3 of the4 sexual discounting partner conditions (with the exception being the most desirable partner condition). However, sexual risk was not significantly correlated with money discounting, suggesting domain specificity. Results suggest that delay discounting may be a behavioral mechanism accounting for the high rates of sexual risk and HIV acquisition in cocaine dependence.