Condom use substantially reduces unwanted pregnancies and sexually transmitted infections. While condom availability is a significant public health priority, effects of condom availability constraints remain relatively under-researched. The limited research on condom availability suggests two major barriers to use: (1) effort/costs and (2) delay to access. To date, we are aware of no study that explores both demand for and discounting of condom availability; the focus of this study was to account for condom decisions using a reinforcement pathology framework. This study used a condom purchase task and the Sexual Delay Discounting Task to quantify behavioral economics of condom use. Low sexual discounting was associated with higher willingness to engage unprotected sex. Demand metrics suggest participants indicating abstinence at condom breakpoint were willing to pay nearly double for condoms relative to individuals indicating unprotected sex at breakpoint. Finally, we grouped participants into reinforcement pathology risk groups based on their discounting and demand indices; these groups significantly differed in self-reported number of sexual partners, unprotected sexual partners, and Sexual Desire scores. This study demonstrates the value of behavioral economic approaches to public health concerns, and further underscores the translational benefits of quantitative metrics to shed novel light on risky health decisions.

中文翻译：

---

行为经济学和安全性行为：从强化病理学框架检查安全套使用决策

安全套的使用大大减少了意外怀孕和性传播感染。虽然安全套的可用性是一个重要的公共卫生优先事项，但安全套可用性限制的影响仍然相对缺乏研究。对安全套可用性的有限研究表明使用有两个主要障碍：(1) 努力/成本和 (2) 延迟获得。迄今为止，据我们所知，还没有一项研究同时探讨了安全套供应的需求和打折情况；这项研究的重点是使用强化病理学框架来解释安全套的决定。本研究使用安全套购买任务和性延迟贴现任务来量化安全套使用的行为经济学。低性折扣与更高的参与无保护性行为的意愿相关。需求指标表明，与在断点处表示无保护性行为的个人相比，表示在安全套断点处禁欲的参与者愿意为安全套支付近一倍的费用。最后，我们根据参与者的贴现率和需求指数将参与者分为强化病理风险组；这些群体在自我报告的性伴侣数量、未受保护的性伴侣数量和性欲得分方面存在显着差异。这项研究证明了行为经济学方法对公共卫生问题的价值，并进一步强调了定量指标的转化优势，以阐明风险健康决策的新亮点。我们根据他们的贴现和需求指数将参与者分组为强化病理学风险组；这些群体在自我报告的性伴侣数量、未受保护的性伴侣数量和性欲得分方面存在显着差异。这项研究证明了行为经济学方法对公共卫生问题的价值，并进一步强调了定量指标的转化优势，以阐明风险健康决策的新亮点。我们根据他们的贴现和需求指数将参与者分组为强化病理学风险组；这些群体在自我报告的性伴侣数量、未受保护的性伴侣数量和性欲得分方面存在显着差异。这项研究证明了行为经济学方法对公共卫生问题的价值，并进一步强调了定量指标的转化优势，以阐明风险健康决策的新亮点。