Sexual risk-taking mediates the association between impulsivity and acquisition of sexually transmitted infections among hazardously drinking incarcerated women

Abstract

Background: A growing literature has identified associations between impulsivity and negative behaviors such as sexual risk-taking among high-risk and/or vulnerable populations, but few studies have linked impulsivity to biological outcomes of sexual risk-taking. The main purpose of this study was to document associations among impulsivity, sexual risk-taking, and biological measures of sexually transmitted infection (STI+) in a sample of hazardously drinking incarcerated women.

Methods: Two hundred forty-five hazardously drinking incarcerated women self-reported alcohol consumption and consequences, impulsivity, and sexual behavior.

Results: Biological testing revealed a 22.9% prevalence rate for STI+. In this sample, sexual risk-taking fully mediated the association between impulsivity and likelihood of STI+. In addition, individuals reporting sexual activity with multiple partners were significantly more likely to test STI+ than those reporting sexual activity with a primary partner.

Conclusion: These results support previous research on impulsivity by demonstrating that impulsivity leads to STI+ through risky behavioral choices. These findings also extend prior work by documenting this association using biologically confirmed measures in a vulnerable female population that carries multiple risk factors and thus warrants increased research attention.

Trial registration: ClinicalTrials.gov NCT00237003.

Figure 1

Two Models Predicting the Likelihood of STI. Standardized coefficients are reported (n = 245). Although frequency of heavy alcohol use was entered into the model as an exogenous variable, it did not significantly affect the results and is thus not included in this figure.