Sexual Compulsivity in HIV-Positive Men and Women: Prevalence, Predictors, and Consequences of High-Risk Behaviors

Abstract

Most HIV-positive individuals do not engage in sexual behavior that places their partners at risk for contracting HIV. However, a small minority continues to engage in unprotected sexual activity with HIV-negative partners or partners of unknown HIV status. One factor that may play a role in high-risk sexual activity is sexual compulsivity or sexual addiction. The present study investigated the role of sexual compulsivity as a contributing factor to high-risk sexual behavior in a sample of HIV-positive men and women ( N = 294). Participants completed measur es assessing sexual compulsivity, sexual behavior, substance use, and mental health variables. Men and women scoring high in sexual compulsivity ( n = 49) reported engaging in unprotected anal and vaginal intercourse with HIV-negative partners or partners of unknown HIV status more frequently than participants scoring low in sexual compulsivity ( n = 243). Mathematical modeling of sexual risk behavior indicated that four times as many new HIV infections could be expected among the HIV-negative sex partners of sexually compulsive participants as among the partners of noncompulsives. Individuals scoring high in sexual compulsivity were more likely to report cocaine use, and scored higher on measures of psychopathology than individuals low in sexual compulsivity. The results suggest a need to integrate HIV risk reduction services, mental health treatment, and substance use treatment for sexually compulsive persons living with HIV.