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| Behavioral and Neuroeconomic Approaches to Reducing the Spread of Sexually Transmitted Infections |
| Sunday, May 28, 2017 |
| 3:00 PM–3:50 PM |
| Hyatt Regency, Centennial Ballroom B/C |
| Area: EAB/BPN; Domain: Translational |
| Chair: Maggie Sweeney (Johns Hopkins University School of Medicine) |
| Abstract: Research in this symposium uses behavior analytic and neuroeconomic tools to understand and ameliorate the spread of sexually transmitted infections. This symposium spans domains of basic and applied research. The experimental laboratory studies (i.e., Sweeney, Koffarnus) examine environmental contributors to and neural correlates of sexual risk decisions, but also test the relationships of these decisions to clinically relevant risk behavior outside of the laboratory. Sweeney will present data that identify biological and environmental determinants of sexual delay discounting (i.e., the expected decrease in condom use likelihood when a condom is delayed), and also suggest that decreased likelihood of condom use as captured by the Sexual Delay Discounting Task corresponds to instances of self-reported sexual risk behaviors. Koffarnus will present a series of experiments describing sexual delay discounting in stimulant users, and present preliminary neuroimaging data that examine the neural correlates of sexual risk decision making in stimulant users. Finally, Rodewald will present a behavior analytic approach to increase knowledge in HIV positive individuals about the personal and public health benefits of adherence to antiretroviral medications, which decrease the amount of HIV in the body and consequently reduce the likelihood of spreading HIV to others. |
| Instruction Level: Intermediate |
| Keyword(s): addiction, computer-based training, delay discounting, HIV risk |
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| Using Crowdsourcing Technology to Examine the Relationship Between Sexual Delay Discounting and Sexual Risk Behavior |
| (Basic Research) |
| MAGGIE SWEENEY (Johns Hopkins University School of Medicine), Meredith Steele Berry (Johns Hopkins University School of Medicine), Patrick S. Johnson (Johns Hopkins University School of Medicine), Evan Herrmann (Johns Hopkins University School of Medicine), Matthew W. Johnson (Johns Hopkins University School of Medicine) |
| Abstract: The Sexual Delay Discounting Task examines potential decrease in hypothetical condom use likelihood when condom-protected sex is delayed. Using Amazon Mechanical Turk, we evaluated the relation between task performance and self-reported sexual risk behavior in two nationwide adult samples. In Study 1 (n = 767), sexual delay discounting was significantly correlated with increased sexual risk behaviors (e.g., unprotected sex), and showed stronger correlations with sexual risk relative to money discounting. Multivariate regression analyses suggested males show both greater sexual discounting and increased self-reported risk behavior relative to females. Study 2 (n = 267) assessed the relation between self-reported discounting-like sexual risk behavior and sexual delay discounting. Forty-six percent of the sample reported having had sex without a condom when they normally would have, but did not because a condom was not immediately available. Individuals reporting this showed significantly greater discounting on the Sexual Delay Discounting Task relative to those who did not, including when controlling for biological sex, but did not show significantly lower likelihood of condom use when there was no delay. Overall, these data suggest that delay contributes to real-life sexual risk behaviors, and that the Sexual Delay Discounting Task appropriately captures this phenomenon. |
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HIV Sexual Risk Decision-Making in Stimulant Addiction |
| (Basic Research) |
| MIKHAIL KOFFARNUS (Virginia Tech Carilion Research Institute), Matthew W. Johnson (Johns Hopkins University School of Medicine), Warren K. Bickel (Virginia Tech Carilion Research Institute and Department of Psychology, Virginia Tech), Stephen LaConte (Virginia Tech Carilion Research Institute) |
| Abstract: Illicit stimulant abuse and addiction remain significant problems. Of major health concern with stimulant use is the increased rate of sexual HIV-risk behavior in this group and a corresponding increased rate of HIV infection. The sexual delay discounting task is a measure of HIV risk that is analogous to a monetary delay discounting task, but assesses how the decision to engage in hypothetical risky sex changes as a function of the delay to condom availability, thereby obtaining a safer-sex discount rate. I will review recent studies of ours using the sexual delay discounting task in stimulant users. I will also present preliminary results from an ongoing neuroimaging study comparing neural correlates of sexual risk decision making in stimulant users. Our studies have shown that that cocaine-dependent participants discount safer sex at a much higher rate than controls. Across dependence groups, males also discount safer sex at a higher rate than do females, underscoring the importance of gender in understanding risky sexual behavior and condom use. Preliminary neuroimaging results reveal greater activation of areas of the left frontal and temporal cortex during sexual risk decisions when the hypothetical sexual partner is rated more sexually desirable. |
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Evaluation of a Computer-Based Training Course on Antiretroviral Medication for People Living With HIV |
| (Applied Research) |
| ANDREW RODEWALD (Center for Learning and Health, Johns Hopkins University School of Medicine), Carol-Ann Getty (Johns Hopkins University School of Medicine), Brian R. Katz (Johns Hopkins University School of Medicine), August F. Holtyn (Johns Hopkins University School of Medicine), Brantley Jarvis (Johns Hopkins University School of Medicine), Shrinidhi Subramaniam (Johns Hopkins University School of Medicine), Kenneth Silverman (Johns Hopkins University School of Medicine) |
| Abstract: Daily adherence to antiretroviral medications by people living with HIV can reduce the amount of HIV in the body (viral load) and sustain good health, but many people living with HIV do not maintain adherence to antiretroviral medications. Participants completed a computer-based training course on HIV and the benefits of daily adherence to antiretroviral medication. The course was delivered in ATTAIN, a program that allows for easy course development, repeated and random presentation of questions, delivery of immediate feedback for responses, and provision of monetary incentives for performance. A multiple-baseline across sections of the course was used to evaluate the effectiveness of the course in teaching participants the course content. Participants (N=54) took three tests that tested the material presented in the first (Modules 1-7), second (Modules 8-14) and third (Modules 15-19) sections of the course. All tests were administered before training began and then again after each participant completed each section of the course. Preliminary results (see Figure 1) show that performance on the test of each section of the course increased following completion of training on the corresponding course section. The results show that the course taught participants about HIV and the potential health benefits of ART adherence. |
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