title: Gender moderates the relationship between impulsivity and sexual risk-taking in a cocaine-using psychiatric outpatient population.
abstract: Adults who abuse substances are at increased risk for contracting sexually transmitted infections, including HIV. Within this population, sexual risk behaviors have been associated with increased impulsivity. Studies in non-clinical populations showing gender-related differences in sexual decision-making and casual sexual partnering suggest impulsivity has a greater influence on men than women, but these differences have not been documented in substance-using patients. In a sample of 89 adults with recent cocaine use and receiving outpatient psychiatric treatment, we tested the hypothesis that gender moderates the effect of impulsivity on sexual risk-taking. Using logistic regression modeling, we tested the main and gender-moderated effects of task-related impulsivity on the probability of having a casual sexual partner and multiple sexual partners. Results confirmed a significant gender-by-impulsivity interaction; men who were more impulsive on a continuous performance task had significantly higher rates of sexual risk-taking than less impulsive men, but women's impulsivity was unrelated to these outcomes. Impulsive men were over three times as likely as less impulsive men to have a recent casual partner. Implications of these results and suggestions for future research are discussed.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA ; VA Connecticut Healthcare System, West Haven, CT 06516, USA.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Black
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA ; Connecticut Mental Health Center, New Haven, CT 06519, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McMahon
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA ; Connecticut Mental Health Center, New Haven, CT 06519, USA ; Departments of Neurobiology and Child Study Center, Yale School of Medicine, New Haven, CT 06519, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Potenza
authors.affiliation: Department of Internal Medicine, play2PREVENT Lab, Yale School of Medicine, New Haven, CT 06510, USA.
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Fiellin
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA ; VA Connecticut Healthcare System, West Haven, CT 06516, USA.
authors.forename: Marc I
authors.initials: MI
authors.lastname: Rosen
keywords: Cocaine; Gender; HIV; Impulsivity; Psychiatric; Risk