Dual Process Interaction Model of HIV-Risk Behaviors Among Drug Offenders

Abstract

This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive functions may dampen or block effects of spontaneously activated associations. Consistent with this model, latent variable interaction analyses revealed that drug offenders scoring higher in affective decision making were relatively protected from predictive effects of spontaneous sex associations promoting risky sex. Among drug offenders with lower levels of affective decision making ability, spontaneous sexually-related associations more strongly predicted risky sex (lack of condom use and greater number of sex partners). These findings help elucidate associative and control process effects on appetitive behaviors and are important for explaining why some individuals engage in risky sex, while others are relatively protected.

Predictors of HIV-Risk Sexual Behavior

“…This finding extends previous studies that either did not examine substance use as a predictor (Holmes et al, 2005) or examined only lifetime histories of substance abuse problems (Meade et al, 2009) when investigating the relationship between previous (childhood) sexual abuse and HIV-risk sexual behavior. In addition, this finding adds to previous HIV-risk sexual behavior research among offenders that did not examine recent substance use (Ames, Grenard, & Stacy, 2013; Belenko et al, 2005; Knittel et al, 2013), and it is consistent with one study involving recently released women offenders (Scott & Dennis, 2012) where abstinence was related to decreased HIV-risk sexual behavior. The additional variance in HIV-risk sexual behavior explained by substance use in the present study underscores the importance of examining recent substance use as an independent factor when examining HIV-risk sexual behavior in relation to sexual/physical abuse histories.…”

Effects of a one-hour intervention on condom implementation intentions among drug users in Southern California

“…Drug offenses included driving under the influence, possession of small amounts of drugs, and writing illegal prescriptions. A large majority of this population are NIDUs (Ames, Grenard, & Stacy, 2012). While the intervention included some information about not sharing needles, it was not the main focus of the study and therefore not investigated.…”

Neurocognitive and psychiatric dimensions of hot, but not cool, impulsivity predict HIV sexual risk behaviors among drug users in protracted abstinence

“…Available research indicates that premorbid global cognitive function (40) and decision-making (41–44) are associated with HIV risk behavior in HIV-seropositive drug users. Research focusing on psychiatric risk factors reveal associations with externalizing psychopathology: psychopathy is as a robust predictor of sexual risk behaviors (45,46), while ADHD correlates with sexual risk behaviors independently of antisocial traits (47).…”

“…Although preliminary research has linked neurocognitive impulsivity to sexual risk behaviors among recently active drug users (41–44), no studies have examined such risk factors among drug users in protracted abstinence--a critical gap in the literature given evidence of persisting addiction-induced neuroadaptations and high risk for relapse and associated risk behaviors in protracted abstinence (53,54,55). To address these gaps, the present study examined how sexual risk behaviors were influenced by neurocognitive and psychiatric indices of “hot” and “cool” impulsivity.…”