Sexual Arousal-Delay Discounting: When Condoms Delay Arousal

Been There, Done That: The Impact of the Novelty of Penile Vaginal Intercourse (PVI) and Participants' Sex on Delay and Probability Discounting of PVI

Delay and probability discounting tasks are useful for understanding aspects of decision making. The current study, which employed a mixed-model design to assess discounting of penile-vaginal intercourse (PVI), was conducted online with male and female participants recruited from Prolific (N = 300; mean age = 34.1 years). Results of the novel delay and probability discounting tasks indicated that as the delay to PVI increased, or as PVI became less certain to occur, participants were instead more likely to choose to receive oral sex, the reward initially indicated as less desirable. Having previously engaged in PVI, however, enhanced this reversal of preferences on both tasks, which suggests PVI loses some of its value when no longer novel. Males and females similarly discounted PVI on the delay discounting task, which suggests biological sex may not impact the propensity to wait for a preferred sexual behavior. On the probability discounting task, however, males were more averse to a reduced probability of PVI occurring and instead opted for receiving oral sex. The sexual behavior discounting tasks developed in the current study, and ones like it, may prove useful for identifying preferences in sexual behaviors, and ultimately enhance sexual and relationship satisfaction.

Use of preexposure prophylaxis and condom purchasing decisions

Preexposure prophylaxis (PrEP) prevents human immunodeficiency virus (HIV) but not other sexually transmitted infections (STIs). Men who have sex with men (MSM) who take PrEP tend to report reduced condom use, but little is known about the underlying mechanisms. For this study, MSM who take PrEP (i.e., PrEP experienced; n = 88) and MSM who do not (i.e., PrEP naïve; n = 113) completed an online study, including the condom purchase task (CoPT). The CoPT assesses decisions to purchase condoms across escalating prices (range: free-$55) for sex with different types of hypothetical partners: those least likely to have an STD (least STD) and those that participants most want to have sex with (most want sex with). When condoms were free, PrEP-experienced MSM had a lower rate of condom purchasing than did PrEP-naïve MSM. For both partner types, PrEP-experienced MSM reached a price break point (i.e., would not buy condoms) at a lower price than did PrEP-naïve pariticipants. For the most-want-sex-with partner at the price at which participants elected not to buy condoms, only 23% of PrEP-experienced MSM chose to abstain from sex when not purchasing condoms versus 53% among PrEP-naïve MSM. Similar patterns were observed for the least-STD partner. The results support the potential utility of the CoPT in identifying behavioral mechanisms related to condom use and PrEP.