Modeling The Erosion of Safe Sex Practices

As starting hypothesis, we argue that the erosion of safe sex practices for people having frequent change of sexual partner might be explained in terms of two mechanisms: instrumental conditioning through “reward” (greater sexual pleasure) following unprotected sex and misperception of the risk to become infected by HIV due to low infectivity of HIV and long delays (long latency and incubation period). A causal-loop diagram is developed and discussed. However, the formulation of a stockand-flow model requires a detailed discussion of the modern theory of instrumental conditioning (the behavioral regulation approach). Surprisingly, the behavioral regulation approach suggests as actual mechanism responsible for erosion of safe sex practices the return to the “behavioral bliss point” (zero condom use) due to a gradually declining perception of risk. Such misperception of risk impacts on the instrumental contingency (acceptance of safe sex). We propose counteracting policies in accordance with the behavioral regulation theory of instrumental conditioning mediated by risk perception. We also discuss the relation of this paper to a parallel paper on erosion of information security and safety (i.e. organizational accidents).