In the United States, sexually transmitted infections (STIs) are a major public health concern. There are an estimated 19
million new cases annually which costs the U.S. health care system $16.4
billion each year [1
]. Adolescents and young adults are the most common groups to become infected and bear over half of all reported cases [1
]. More concerning is the physical and psychological effects of these infections. Although most infections, even if untreated, will have no physical sequelae, those that do can lead to disorders such as pelvic inflammatory disease, sterility, and cancer [2
]. The psychological effects are just as devastating. Having an STI is predictive of having higher levels of psychological distress [3
] and emotional responses such as fear, denial, confusion, sadness, and anger [4
]. These emotions can also inhibit disclosure of viral STIs (Herpes and Human Papillomavirus) to new sexual partners [5
]. STIs are contracted through a sexual risk behaviors, and much is known about these behaviors.
STIs are transmitted through a cluster of sexual risk behaviors (i.e., early age of intercourse, multiple sexual partners, having penetrative intercourse without a condom) and multiple correlates of these behaviors are known [6
]. Many studies have examined correlates and reasons for sexual risk behaviors in adolescents and young adults. Behaviors such as alcohol and drug use, carrying a weapon, and recent fighting incidents are all associated with increased sexual activity [8
] and early initiation of intercourse and multiple sexual partners [7
]. Perceptions such as that one's peers engage in sexual risk behaviors [9
] and that one is not susceptible to STIs [10
] or a lowered perceived likelihood of getting an STI [7
] are positively associated with sexual risk behaviors. Once an individual has acquired an STI, there is a greater likelihood for subsequent infections [7
]; therefore, safer sexual behaviors, such as condom use, are paramount. Reasons why condoms are not used have been explored, and emotion is one factor. In descriptive work, participants reported being “swept away” or having sexual desire as a reason for not having safer sex [11
]. The likelihood or propensity of being overcome with emotions in different situations can be attributed to one's temperament [13
]. Temperament has been cited as a predictor of other health risk behaviors such delinquency, substance use, and smoking [14
]; therefore, it stands to reason that it would be linked to sexual risk behaviors as well.
Temperament is defined as individual differences in reactivity (i.e., arousal and affect) and self-regulation(i.e., attention) [16
]. These differences are influenced by heredity, maturation, and experience [17
]. There is also evidence of the interaction of environment or context with temperament in determining behavior. When there is a “goodness of fit” with the environment or context, then there is optimal functioning of the organism [18
]. In other words, when the environmental demands are in concordance with the individual's capacities by temperamental traits, the individual is more likely to have successful behavioral outcomes. Therefore, in regards to sexual risk behaviors, it is not only important to study temperament, but also the contribution of temperament and environment to sexual risk behaviors.
Temperament intuitively makes sense in which to examine sexual risk behaviors because the major traits of it center on emotional reactivity (i.e., arousal and affect) and self-regulation of that reactivity (i.e., attention) [20
], components which are involved in sexual response. Although temperament has been studied in relation to sexual risk behaviors, only specific traits of arousal and affect primarily have been studied. Sensation seeking [21
] and negative mood [23
] are related to higher sexual risk intentions (i.e., choosing risky partners, intentions not to use condoms). Novelty-seeking, harm-avoidance, reward-dependence, and avoidant coping styles are related to actual behaviors of unprotected sex [25
]. Gulletteand Lyons studied sexual sensation seeking and compulsivity in relation to HIV risk behaviors and found that although men scored higher than women on sexual sensation seeking, there were no gender differences in regards to sexual risk behaviors [6
]. They also found that sexual sensation seeking in conjunction with other variables (age, alcohol problems, and sexual compulsivity) predicted sexual risk behaviors. Self-regulation components of temperament, conversely, have been associated with safer sexual behaviors such as positive perceptions of sexual abstinence [26
] and fewer sexual partners [27
]. No studies to date have examined all temperament components (arousal, affect, and self-regulation)within one study or examined the interaction of temperament with an environmental or contextual component.
The context of a sexual encounter is made up of situational or emotional factors which influence decisions at the critical moment of deciding to engage in safer- or risky-sexual behaviors [28
]. Situational factors include place and partner. Aspects of the place that influence the likelihood of a sexual encounter are amount of privacy [28
], cozy appearance, and general comfort [28
]. Partner characteristics include attractiveness of the partner [28
], familiarity [12
] and the pressure to satisfy a partner [30
]. Emotional factors can also influence the context of a sexual encounter. Individuals often report a range of emotions in sexual encounters from love to apathy [29
]. It is important to note that emotions differ from mood, or the affective component of temperament in that emotions are brief and temporary experiences; whereas, temperament serves to modulate an individual's reactivity to the emotions experienced [31
]. Sexual risk behaviors have been found to differ depending upon the sexual context [28
]. How context interacts with temperament and affects sexual risk behaviors is unknown.
The purpose of this study was to examine all components of temperament (arousal, affect, and attention) as a predictor of sexual risk intentions in two different sexual contexts (safer and risky) and its relationship to actual sexual risk behaviors. Since temperament was different for gender in previous study [6
], its association with temperament, context, and sexual risk intentions and behaviors was also examined here. It was hypothesized that sexual risk intentions would be different by context and temperament. No hypothesized directions were made since this was a first examination of temperament and context.