Delay Discounting and Sexual Decision-Making: Understanding Condom Use Behavior among College Students

Date of Award

August 2020

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor(s)

Peter A. Vanable

Keywords

college students, condom use, delay discounting, intentions, STIs

Subject Categories

Social and Behavioral Sciences

Abstract

College students are an at-risk group for sexually transmitted infections (STIs). Condoms provide an effective means of protection against STIs, however, condomless sex remains common among college students and intentions to use condoms do not consistently translate into condom use behavior. Informed by temporal self-regulation theory, the current 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 final sample consisted of 187 sexually active college students (51.9% female) who completed measures of self-reported condom use during vaginal and anal sex over the past three months and a decision-making paradigm regarding condom use intentions with hypothetical sexual partners. Three indicators of condom use intentions were calculated: initial intentions to use a condom when one was immediately available, the way in which initial intentions changed across delay trials (e.g., preference for immediate sex without a condom vs. delayed sex with a condom), and a composite measure. Path models were specified such that condom use behavior was regressed on each indicator of condom use intentions. Results showed that variations from one’s initial intentions to use a condom in favor of immediate sex without a condom across delay trials were significantly associated with condomless sex. The isolated effect of change in initial intentions across delay trials best accounted for variance in absolute frequency of condomless sex, whereas initial intentions best accounted for variance in relative proportion of condomless sex. Future research directions and implications for interventions are discussed.

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