Risky sexual behaviors among men in residential treatment for substance misuse: The role of compulsive sexual behavior
Abstract
Compulsive sexual behaviors (CSB; i.e., a pattern of excessive and difficult to control sexual behaviors and fantasies) and risky sexual behaviors (e.g., unprotected sex, increased number of sexual partners, exchange of sex for drugs or money) are prevalent among those in treatment for substance misuse. CSB positively associated with risky sexual behaviors among high-risk populations such as men who have sex with men and persons living with sexually transmitted infections; however, this relationship has yet to be examined among men in treatment for substance misuse. Given the high prevalence of risky sexual behaviors among substance misusing populations, we examined if CSB were positively related to risky sexual behaviors among adult men in residential substance misuse treatment (N = 266), while statistically controlling for research supported correlates of risky sexual behavior including impulsivity, sensation seeking, affective instability, substance use, and age. CSB was positively associated with risky sexual behavior and accounted for a significant amount of the variance in the model predicting risky sexual behaviors. Our findings suggest that, among substance misuse patients, CSB may be a risk factor for risky sexual behaviors.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
There has been no integrative review of the dual systems notion applied to sexual addiction.
“Although there are occasional references to the relevance of dual systems models to sexual addiction (Garner et al., 2020;Reid et al., 2015), there has so far been no integrative review of the topic.”
From A motivation model of sex addiction – Relevance to the controversy over the concept (2022) · cites this paper as Garner et al., 2020
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
SAUNDERS, J. B., AASLAND, O. G., BABOR, T. F., DE LA FUENTE, J. R., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb02093.x · Cited by 13,482 · see citing works
Individual differences in reasoning: Implications for the rationality debate?
Stanovich, K. E., & West, R. F. (2000) · Behavioral and Brain Sciences · doi:10.1017/s0140525x00003435 · Cited by 4,255 · see citing works
Normal personality assessment in clinical practice: the NEO personality inventory
Costa, P. T., & McCrae, R. R. (1992) · Psychological Assessment · doi:10.1037/1040-3590.4.1.5 · Cited by 3,414 · see citing works
Impulse and Self-Control From a Dual-Systems Perspective
Hofmann, W., Friese, M., & Strack, F. (2009) · Perspectives on Psychological Science · doi:10.1111/j.1745-6924.2009.01116.x · Cited by 1,487 · see citing works
Sexually Transmitted Infections Among US Women and Men
Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C. B., Su, J. R., Xu, F., & Weinstock, H. (2013) · Sexually Transmitted Diseases · doi:10.1097/olq.0b013e318286bb53 · Cited by 1,255 · see citing works
Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007) · Psychological Assessment · doi:10.1037/1040-3590.19.1.107 · Cited by 1,193 · see citing works
Hypersexual disorder: A proposed diagnosis for DSM-V
Kafka, M. P. (2010) · Archives of Sexual Behavior · doi:10.1007/s10508-009-9574-7 · Cited by 1,095 · see citing works
Wiers, R. W., Bartholow, B. D., van den Wildenberg, E., Thush, C., Engels, R. C. M. E., Sher, K. J., Grenard, J., Ames, S. L., & Stacy, A. W. (2007) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2006.09.021 · Cited by 734 · see citing works
Estimated HIV incidence and prevalence in the United States 2010–2015
Linley, L., Johnson, A. S., Song, R., Wu, B., Hu, S., Singh, S., Siddiqi, A.-E.-A., Green, T. A., Hall, H. I., Hernandez, A. L., et al. (2018) · Cited by 698 · see citing works
Implicit cognition and addiction: a tool for explaining paradoxical behavior
Stacy, A. W., & Wiers, R. W. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131444 · Cited by 607 · see citing works
Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model
Bancroft, J., & Vukadinovic, Z. (2004) · The Journal of Sex Research · doi:10.1080/00224490409552230 · Cited by 482 · see citing works
Rehm, J., Shield, K. D., Joharchi, N., & Shuper, P. A. (2012) · Addiction · doi:10.1111/j.1360-0443.2011.03621.x · Cited by 344 · see citing works
Parsons, J. T., Grov, C., & Golub, S. A. (2012) · American Journal of Public Health · doi:10.2105/ajph.2011.300284 · Cited by 335 · see citing works
AIDS Research and Human Retroviruses
Liebert, M. A. (2005) · Cited by 320 · see citing works
Psychometric development of the Problematic Pornography Use Scale
Kor, A., Zilcha‐Mano, S., Fogel, Y. A., Mikulincer, M., Reid, R. C., & Potenza, M. N. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2014.01.027 · Cited by 286 · see citing works
Epidemiology, Prevalence, and Natural History of Compulsive Sexual Behavior
Kuzma, J. M., & Black, D. W. (2008) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2008.06.005 · Cited by 276 · see citing works
The Sexual Compulsivity Scale: Further Development and Use With HIV-Positive Persons
Kalichman, S. C., & Rompa, D. (2001) · Journal of Personality Assessment · doi:10.1207/s15327752jpa7603_02 · Cited by 261 · see citing works
Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review.
Crepaz, N., & Marks, G. N. (2001) · Health Psychology · doi:10.1037//0278-6133.20.4.291 · Cited by 255 · see citing works
Carnes, P., Green, B., & Carnes, S. (2010) · Sexual Addiction & Compulsivity · doi:10.1080/10720161003604087 · Cited by 244 · see citing works
Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review.
Crepaz, N., & Marks, G. N. (2001) · Health Psychology · doi:10.1037/0278-6133.20.4.291 · Cited by 207 · see citing works
Kalichman, S. C., & Cain, D. N. (2004) · The Journal of Sex Research · doi:10.1080/00224490409552231 · Cited by 182 · see citing works
Stuart, G. L., Moore, T. M., Kahler, C. W., & Ramsey, S. E. (2003) · Substance Abuse · doi:10.1080/08897070309511539 · Cited by 182 · see citing works
Self-citationSexual Compulsivity Among Gay/Bisexual Male Escorts Who Advertise on the Internet
T. Parsons, D. B. (2001) · Sexual Addiction & Compulsivity · doi:10.1080/10720160127562 · Cited by 178 · see citing works
Davis, K. C., Hendershot, C. S., George, W. H., Norris, J., & Heiman, J. R. (2007) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2007.68.843 · Cited by 148 · see citing works
Coleman, E. (1987) · Journal of Chemical Dependency Treatment · doi:10.1300/j034v01n01_11 · Cited by 126 · see citing works
Stuart, G. L., Moore, T. M., Ramsey, S. E., & Kahler, C. W. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.46 · Cited by 125 · see citing works
Self-citationTull, M. T., Weiss, N. H., Adams, C. E., & Gratz, K. L. (2012) · Addictive Behaviors · doi:10.1016/j.addbeh.2012.05.001 · Cited by 121 · see citing works
BRYANT, K. J. (2006) · Substance Use & Misuse · doi:10.1080/10826080600846250 · Cited by 116 · see citing works
Deckman, T., & DeWall, C. N. (2011) · Personality and Individual Differences · doi:10.1016/j.paid.2011.06.004 · Cited by 104 · see citing works
Compulsive Sexual Behavior and Risk for Unsafe Sex Among Internet Using Men Who Have Sex with Men
Men’s INTernet Sex (MINTS-II) Team, Coleman, E., Horvath, K. J., Miner, M., Ross, M. W., Oakes, M., & Rosser, B. R. S. (2010) · Archives of Sexual Behavior · doi:10.1007/s10508-009-9507-5 · Cited by 95 · see citing works
G. Benotsch, S. C. K. (2001) · Sexual Addiction & Compulsivity · doi:10.1080/10720160127561 · Cited by 95 · see citing works
Hypersexuality in college students: The role of psychopathy
Kastner, R. M., & Sellbom, M. (2012) · Personality and Individual Differences · doi:10.1016/j.paid.2012.05.005 · Cited by 91 · see citing works
ASSESSMENT AND TREATMENT OF ADDICTIVE SEXUAL DISORDERS: RELEVANCE FOR CHEMICAL DEPENDENCY RELAPSE
Schneider, J. P., & Irons, R. R. (2001) · Substance Use & Misuse · doi:10.1081/ja-100108428 · Cited by 84 · see citing works
Derefinko, K. J., Peters, J. R., Eisenlohr-Moul, T. A., Walsh, E. C., Adams, Z. W., & Lynam, D. R. (2014) · Archives of Sexual Behavior · doi:10.1007/s10508-014-0327-x · Cited by 83 · see citing works
Sexual Compulsivity in a Sample of HIV-Positive Methamphetamine-using Gay and Bisexual Men
Semple, S. J., Zians, J., Grant, I., & Patterson, T. L. (2006) · AIDS and Behavior · doi:10.1007/s10461-006-9127-1 · Cited by 82 · see citing works
Brem, M. J., Shorey, R. C., Anderson, S. T., & Stuart, G. L. (2017) · Mindfulness · doi:10.1007/s12671-017-0723-0 · Cited by 77 · see citing works
Self-citationCompulsive sexual behavior: prefrontal and limbic volume and interactions
Schmidt, C., Morris, L. S., Kvamme, T. L., Hall, P., Birchard, T., & Voon, V. (2017) · Human Brain Mapping · doi:10.1002/hbm.23447 · Cited by 69 · see citing works
Substance Use Disorders in Hypersexual Adults
Reid, R. C., & Meyer, M. D. (2016) · Current Addiction Reports · doi:10.1007/s40429-016-0124-9 · Cited by 66 · see citing works
Macapagal, K., Janssen, E., Fridberg, D. J., Finn, P., & Heiman, J. (2010) · Archives of Sexual Behavior · doi:10.1007/s10508-010-9676-2 · Cited by 63 · see citing works
The Psychobiology of Sexual Addiction
Ragan, P., & Martin, P. R. (2000) · Sexual Addiction & Compulsivity The Journal of Treatment and Prevention · doi:10.1080/10720160008400216 · Cited by 55 · see citing works
Shuper, P. A., Joharchi, N., & Rehm, J. T. (2013) · AIDS and Behavior · doi:10.1007/s10461-013-0554-5 · Cited by 43 · see citing works
Storholm, E. D., Satre, D. D., Kapadia, F., & Halkitis, P. N. (2016) · Archives of Sexual Behavior · doi:10.1007/s10508-015-0566-5 · Cited by 43 · see citing works
Hypersexual Behavior and HIV Sex Risk among Young Gay and Bisexual Men
Yeagley, E. E., Hickok, A., & Bauermeister, J. A. (2013) · The Journal of Sex Research · doi:10.1080/00224499.2013.818615 · Cited by 41 · see citing works
Approach bias for erotic stimuli in heterosexual male college students who use pornography
Sklenarik, S., Potenza, M. N., Gola, M., Kor, A., Kraus, S. W., & Astur, R. S. (2019) · Journal of Behavioral Addictions · doi:10.1556/2006.8.2019.31 · Cited by 41 · see citing works
Compulsive Sexual Behavior and its Relationship to Risky Sexual Behavior
Miner, M. H., & Coleman, E. (2013) · Sexual Addiction & Compulsivity The Journal of Treatment and Prevention · doi:10.1080/10720162.2013.768133 · Cited by 39 · see citing works
Semple, S. J., Strathdee, S. A., Zians, J., & Patterson, T. L. (2011) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2011.587390 · Cited by 38 · see citing works
Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2085 · Cited by 38 · see citing works
Self-citationHypersexuality among a Substance Use Disorder Population
Stavro, K., Rizkallah, E., Dinh-Williams, L., Chiasson, J.-P., & Potvin, S. (2013) · Sexual Addiction & Compulsivity · doi:10.1080/10720162.2013.787379 · Cited by 36 · see citing works
Magyar, M. S., Edens, J. F., Lilienfeld, S. O., Douglas, K. S., Poythress, N. G., & Skeem, J. L. (2011) · Psychological Assessment · doi:10.1037/a0025359 · Cited by 31 · see citing works
HIV Risk Reduction in the National Institute on Drug Abuse Cocaine Collaborative Treatment Study
WOODY, G. E., Gallop, R., Luborsky, L. B., BLAINE, J. D., Frank, A. F., Salloum, I. M., Gastfriend, D. R., & Crits-Christoph, P. F. (2003) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200305010-00012 · Cited by 30 · see citing works
Cavazos‐Rehg, P. A., Spitznagel, E. L., Schootman, M., Strickland, J. R., Afful, S. E., Cottler, L. B., & Bierut, L. J. (2009) · AIDS Patient Care and STDs · doi:10.1089/apc.2008.0272 · Cited by 30 · see citing works
Shorey, R. C., Elmquist, J., Gawrysiak, M. J., Anderson, S., & Stuart, G. L. (2016) · Mindfulness · doi:10.1007/s12671-016-0525-9 · Cited by 30 · see citing works
Self-citationWilson, M. J., & Vassileva, J. (2016) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2015.1121269 · Cited by 27 · see citing works
Reynolds, E., Magidson, J., Bornovalova, M., Gwadz, M. A., Ewart, C. K., Daughters, S., & Lejuez, C. (2010) · Psychology of Addictive Behaviors · doi:10.1037/a0018929 · Cited by 26 · see citing works
Deneke, E., Knepper, C., Green, B. A., & Carnes, P. J. (2015) · Sexual Addiction & Compulsivity · doi:10.1080/10720162.2014.979382 · Cited by 23 · see citing works
Bornovalova, M. A., Daughters, S. B., & Lejuez, C. W. (2010) · Behavior Modification · doi:10.1177/0145445510364414 · Cited by 11 · see citing works
Effect of Continuing Care for Cocaine Dependence on HIV Sex-Risk Behaviors
Wimberly, A. S., Ivey, M. A., Rennert, L., & McKay, J. R. (2016) · AIDS and Behavior · doi:10.1007/s10461-016-1434-6 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A motivation model of sex addiction – Relevance to the controversy over the concept
Toates, F. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104872 · Cited by 25 · see citing works
“Some sexually-addicted people run high risks in pursuing sex (Ban-croft et al., 2003; Garner et al., 2020; Kafka, 2010; Miner and Coleman, 2013), described as searching for “ hits of adrenalin ” (Schwartz and Brasted, 1985, p.103).”
BackgroundGaudet, É., Teumeni, F. N., Popova, N., Coulombe, S., Demetrovics, Z., & Bőthe, B. (2025) · Current Addiction Reports · doi:10.1007/s40429-025-00637-8 · Cited by 10 · see citing works
Basting, E. J., Barrett, M. E., Garner, A. R., Florimbio, A. R., Sullivan, J. A., Medenblik, A. M., & Stuart, G. L. (2023) · Archives of Sexual Behavior · doi:10.1007/s10508-023-02580-z · Cited by 9 · see citing works
Self-citationBasting, E. J., Medenblik, A. M., Eberwein, J. D., Garner, A. R., Shorey, R. C., & Stuart, G. L. (2024) · Journal of Traumatic Stress · doi:10.1002/jts.23079 · Cited by 8 · see citing works
Self-citationGarner, A. R., Brem, M. J., Shorey, R. C., Hamlin, J. S., & Stuart, G. L. (2022) · Computers in Human Behavior · doi:10.1016/j.chb.2022.107385 · Cited by 7 · see citing works
Self-citationHow are pornography and sexual sensation seeking related?
Esplin, C. R., Hatch, H. D., Hatch, S., Braithwaite, S. R., & Deichman, C. L. (2021) · Sexual & Relationship Therapy · doi:10.1080/14681994.2021.1937977 · Cited by 7 · see citing works
Ibáñez‐Tomás, E., Ballester‐Arnal, R., Elipe‐Miravet, M., & Gasch‐Gallén, À. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03858-4 · Cited by 3 · see citing works
Saleem, M., & Rizvi, T. (2024) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2024.09.001 · Cited by 2 · see citing works
Ibáñez‐Tomás, E., & Gasch‐Gallén, À. (2024) · Sexes · doi:10.3390/sexes5020007
Gleason, N., Wang, S. S., Smith, L., Rahm-Knigge, R. L., Coleman, E., & George, W. H. (2026) · Sexual Health & Compulsivity · doi:10.1080/26929953.2026.2673332
- Authors
- Garner, A. R., Shorey, R. C., Anderson, S., & Stuart, G. L.
- Affiliations
- University of Tennessee at Knoxville (US)
- University of Wisconsin–Milwaukee (US)
- Cornerstone of Recovery, Louisville, USA
- Corresponding author
- Garner, Alisa R.
- Venue
- Sexual Addiction & Compulsivity
- Publisher
- Informa UK Limited
- Published
- 2020-04-02
- Volume
- 27
- Issue
- 1-2
- Pages
- 135-148
- ISSN
- 1072-0162 (ISSN-L)
- 1532-5318
- OpenAlex
- W3016077073
- Cited by
- 10
- References
- 57
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sexual Addiction & Compulsivity The Journal of Treatment and Prevention (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- compulsive sexual behavior, sexual risk behavior, addiction treatment, residential treatment, men, unprotected sex, sexual partners, sex work, impulsivity, sensation seeking, neuroticism, risk factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
