Contextual Factors Surrounding Extradyadic High-Risk Sexual Decision-Making in Men: A Case-Oriented Perspective

Individuals who engage in high-risk sexual behavior (HRSB) have an increased risk of being exposed to HIV/AIDS and other devastating sexually transmitted diseases, as well as an increased risk of experiencing various other potentially dangerous mental and physical repercussions (Birthrong & Latzman, 2014; World Health Organization, 2002). Men aged 20-24 years consistently have the highest rate of chlamydia and gonorrhea among all age groups in the United States (CDC, 2012). A total of 1,422,976 individuals were reported to have contracted chlamydia in 2012 alone, a 41% increase from 2002 (CDC, 2012). The increased prevalence of STIs in the male population is related to decrease contraceptive use and an increased tendency to be under chemical influence while engaging in sexual acts (Atkins, Yi, Baucom, & Christensen, 2005). Consequently, identifying a functional theoretical understanding of the context, decision-making, and management of HRSB is elemental in order to develop empirically valid prevention strategies that will decrease the likelihood of individuals contracting preventable sexually-transmitted infections. Therefore, the purpose of the current study is to provide a basis for theorizing about sexual-decision making, as well as laying the groundwork for developing effective prevention strategies for reducing incidents of HRSB. Previous research defines high-risk sexual behavior as a low regularity of condom use while engaging in sexual acts (Birthrong & Latzman, 2014; Caballero-Hoyos & Gil, 2005; Villasenor-Sierra, Millan-Guerrero, Trujillo-Hernandez, & Monarrez-Espino, 2013). Essentially, HRSB is defined as behaviors that have relatively high propensities to lead to sexually transmitted diseases (Birthrong & Latzman, 2014; Caballero-Hoyos et al., 2013; Gil, 2005). Additionally, engaging in sexual acts with 3 or more sexual partners in a 12-month time span is considered HRSB (Caballero-Hoyos et al., 2013). The use of drugs and alcohol while performing sexual acts has also been linked to HRSB (Caballero-Hoyos et al., 2013; Cook & Clark, 2005). For the purposes of our research, HRSB was defined by the participants themselves; that is to say, we invited individuals to participate in our study who were actively practicing sexual encounters with unfamiliar individuals while in a primary relationship and who defined their own behavior as high-risk. Decision-Making Models of High Risk Sexual Behavior Many models have been developed to explain the decision-making process of (HRSB). Juhasz and Sonnenshein-Schneider (1980) proposed a model for sexual decision-making with three distinct factors (socialization influences, factors germane to the situation, and cognitive factors). In discussing the cognitive factors of sexual decision-making, Juhasz and Sonnenshein-Schneider (1980) focused on the sexual education that individuals have concerning the consequences of engaging in risky sexual behavior and how this information is received. When important sexual education is withheld from an individual, through educational limitations of the nature of sexual behavior, or if an individual does not have the analytic power to comprehend and internalize the information as it is given, there are many misconceptions about the consequences of engaging in HRSB (Juhasz & Sonnenshein-Schneider, 1980). Juhasz and Sonnenshein-Schneider (1980) also proposed that socialization influences mediate how an individual responds to the factors germane to the situation while in accordance to the sexual ideologies of the people around them. While this model is theoretically sound, it has not been empirically validated and focuses exclusively on adolescent sexual decision-making processes. Consequently, empirically validated sexual decision-making models that focus on adult populations are necessary. In this vein, Lock and Vincent (1995) use the Interaction Model of Client Health Behavior to provide evidence that variables such as age, social and family influence, sexual beliefs, peer influence, attitudes toward sex, and how committed one is to their partner are found affects one's decision-making process in engaging in sexual behavior. …