Delay discounting of pregnancy- and condom-protected sex among methadone-maintained women

Introduction Over 80% of pregnancies are unintended among women with opioid use disorder (OUD; Heil et al., 2011). Use of effective contraception is uncommon in this population (Terplan et al., 2015). Initiating and using effective contraception involves delays: to obtain the method from a provider, to become protected after initiating use. Interventions that include delay reductions among other elements have increased contraceptive use (Heil et al., 2016; Secura et al., 2014). Women with OUD have reported greater likelihood of engaging in unprotected sex at shorter delays to acquiring protection from sexually-transmitted infection (STI) than women without OUD (Herrmann et al., 2014). There is no current method for assessing how delays to pregnancy protection affect sexual decision-making. The present study was designed to evaluate a novel tool for measuring how delays to pregnancy protection affect self-reported likelihood to engage in protected vs. unprotected sexual intercourse