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Assessing Motivation for Condom Use Among MSM: Effort Discounting as a Novel Measure of Sexual Risk
Peter Luehring-Jones1, Tibor P Palfai2, Jeffrey S Simons3
1Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, 2nd Floor, Boston, MA, 02215, USA. pluehrin@bu.edu.
AIDS and Behavior
|February 19, 2026
Summary
A new sexual effort discounting task accurately measures motivation for condom use in men who have sex with men (MSM). This tool helps understand how motivation impacts sexual decision-making and condom use in real-time.
Area of Science:
- Psychology
- Public Health
- Behavioral Science
Background:
- Motivation for condom use among men who have sex with men (MSM) is influenced by individual traits and situational factors.
- Previous assessments relied on cross-sectional, self-report measures, limiting real-time understanding of condom use motivation.
Purpose of the Study:
- To develop and validate a novel sexual effort discounting task for assessing individual differences in condom use motivation among MSM.
- To measure the effort MSM would exert to obtain a condom before anal intercourse with a partner of unknown HIV and STI status.
Main Methods:
- A pilot study with 55 MSM who engage in risky sexual behavior administered the sexual effort discounting task repeatedly within an ecological momentary assessment (EMA) framework.
- The task's reliability and validity were assessed through longitudinal associations with daily condom use motivation, self-reported sexual behaviors, condom use cognitions, and a related Sexual Delay Discounting Task.
Main Results:
- The sexual effort discounting task demonstrated good reliability across repeated administrations.
- Validity was supported by significant longitudinal associations with daily condom use motivation and correlations with sexual behavior and cognitions.
- Positive associations were found with a newly developed EMA version of the Sexual Delay Discounting Task.
Conclusions:
- The novel sexual effort discounting task offers a valuable tool for assessing individual differences in condom use motivation among MSM.
- This method allows for a deeper understanding of how varying motivation levels influence sexual decision-making and the impact of contextual variables on motivation in research designs.
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