RISKY SEXUAL BEHAVIOR AND PUBLIC HEALTH: ON THE USE OF BEHAVIORAL ECONOMICS TO INFORM PUBLIC HEALTH POLICY

Abstract

Risky sexual behavior represents an intransigent public health issue in the United States and exists within a complicated web of political, social, cultural, economic, racial, and geographic contexts. The Socio-Ecological Model (SEM) is a public health framework designed to situate behavior in such contexts, allowing for multi-level analysis and amelioration strategies. Condoms are an effective means of reducing sexually transmitted infections and unwanted pregnancies, but barriers to access in the form of cost and delay to acquisition may substantially impact their use. Behavioral economics provide a means of scientifically investigating these dual barriers, while utilizing research methods that lend themselves to the study of behavior that is not available for direct observation. To this end, I utilized the Condom Purchase Task and Sexual Delay Discounting Task to empirically investigate these two barriers and administered a temporal framing intervention to assess the malleability of sexual discounting and demand. I recruited participants from two STI testing clinics in Eastern Kansas, one in Lawrence and the other in Wyandotte County. Results suggested no effect of the intervention on sexual discounting and demand. When split by willingness to engage is unprotected sex and the frequency of sexual thoughts however, marked differences were observed, providing support for the use of behavioral economic research methods in informing public health policy.