Response Inhibition Moderates the Association between Drug Use and Risky Sexual Behavior

Abstract

Background: HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. Objective: The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). Methods: One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Results: Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Conclusions: Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.

Keywords :

• DAST
• drug users
• cued go/no-go
• risky sex
• HIV-risk
• impulsivity
• inhibition

THE AUTHORS

Liesl A. Nydegger received her M.P.H. in 2011 and is a doctoral student at Claremont Graduate University in the School of Community and Global Health. Her current research interests include HIV prevention among vulnerable populations including adolescent and adult substance users, abuse survivors, rural South African adolescents, and other international populations. In addition, her work has focused on the development of web-based interventions and intimate partner violence prevention. She has published several peer-reviewed articles related to this research and has led several intervention and epidemiologic projects on HIV risk.

Dr. Susan L. Ames received her Ph.D. in Preventive Medicine from the Keck School of Medicine at the University of Southern California. She has conducted a variety of studies that focus on associative (habit-based) memory processes and dual process models of appetitive behaviors among adolescents and other at-risk populations. She has been influential in linking basic neurocognitive findings to cognitive assessment in addiction and contributed to methodological developments in neurocognitive assessment, including increasing understanding of neural processes underlying automatic implicit associations and control mechanisms in substance use and eating-related behaviors in adolescents and emerging adults.

Dr. Alan W. Stacy's research translates compelling but rarely applied basic research in cognitive neuroscience and memory systems for use in preventive medicine and allied areas. He was one of the first to apply basic research on memory systems and implicit (automatic) cognition to appetitive habits relevant to addiction, HIV risk behavior, and diet. He has published major reviews of this literature (e.g., Annual Review of Clinical Psychology, Stacy & Wiers, 2010; Current Directions in Psychological Science, Wiers & Stacy, 2006) that help explain why some people engage in nonoptimal, risky appetitive behavior even when they have sufficient knowledge of the risks.

Dr. Jerry L. Grenard received his Ph.D. in Preventive Medicine from the Keck School of Medicine at the University of Southern California. Although recently retired, his research examined dual cognitive processes that influence behavior related to chronic diseases such as substance use, HIV, and diabetes.

Notes

1 Supplemental analyses evaluated gender by DAST scores, gender by go/no-go false alarms, and a three-way interaction analysis evaluated gender by DAST score by go/no-go false alarms. Results of these analyses were similar to the two-way interaction models and no interactions by gender were significant.