Executive Functioning, Substance Use, and Sexual Risk Taking in Gay Men

Several associations between substance use and risk taking have been clearly established in psychological and behavioral research. Among them is the trend for sexual risk taking in individuals who misuse substances, including alcohol and drugs. The negative health consequences of both substance use and sexually risky behavior are significant. For gay and bisexual men, the risk of sexually transmitted diseases and HIV are especially high. One theory for uninhibited sexual activity is the alcohol myopia theory, which suggests that alcohol intoxication creates a short-range outlook relying on immediate stimulation. In other words, intoxicated individuals don’t always look at a person’s morals or personality when considering sex. Instead, they look for instant gratification.

Some experts believe that drug and alcohol misuse and addiction impair executive functioning (EF), resulting in higher rates of impulsivity and skewed reward motivation processes. In an effort to determine if EF contributes to sexual risk taking, Sarit A. Golub of the Department of Psychology at Hunter College of the City University of New York led a study examining the EF of 104 bisexual and gay men, all of whom had a history of substance misuse and were HIV negative. Golub conducted neurological and psychological tests on the participants and evaluated their levels of substance use and sexual activity in the 30 days preceding the interview.

She discovered three unique classifications of EF. They included poor performing, indicated by impairment in some, but not all tasks, low performing, indicated by impairment across all tasks, and high performing as evidenced by successful performance on all tasks. Although all three classes had the same levels of substance misuse, substance dependency was highest among the low performing group. These individuals also reported the highest levels of sexual risk taking. In contrast, the poor performing group, which only exhibited EF deficits on the Iowa Gambling Task, had the lowest levels of risky sexual behavior. The results from the high-performing group suggested that the link between substance misuse and sexually risky behavior was episodic and not chronic. Golub added, “These findings underscore the importance of identifying different EF subtypes—rather than simply examining specific EF tasks individuals—in the development of interventions to reduce risk behavior among substance users.”

Golub, S. A., Starks, T. J., Kowalczyk, W. J., Thompson, L. I., Parsons, J. T. (2012). Profiles of executive functioning: Associations with substance dependence and risky sexual behavior. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029034

Related articles:
Identifying and Treating Addiction and Substance Abuse Problems
Adolescent Drinking Increases Risk for Sexually Transmitted Diseases

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  • Rupert J

    Rupert J

    July 18th, 2012 at 12:23 AM

    So do these ppl take these risks due to the effefcts of alcohol and drugs or is it an inherent character in those tht are also prone to alcohol n drug misuse? effect of or co-occuring phenomenon?

  • Al


    July 18th, 2012 at 4:10 AM

    Lesson to be learned: just don’t drink and use drugs if you find yourself anywhere near at risk for making poor decisions regarding unsafe sex!

  • LibC


    July 19th, 2012 at 5:41 PM

    At least it seems that the connections are not something that continue to happen even when there is little substance abuse.
    We all make mistakes and poor decisions from time to time. You have to know when and where to draw the line, and it seems that there are many who still do.

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