Relationship Factors’ Impact on Condom Use Among College Students

Research indicates that a number of college students are at risk for HIV, sexually transmitted diseases, and unplanned pregnancy as a result of their sexual behaviors. Specific behaviors placing college students at risk include having sex with multiple partners, poor communication about safer sex practices with their sexual partners and not using condoms consistently and correctly when engaging in sexual activity. The purpose of this paper is to identify potential differences in safer sex practices and factors that influence condom use among college students. A four-page, 18-item survey was developed to determine participants’ condom use and the impact of relationship status and other demographic factors on condom use. Analyses revealed that the number of lifetime vaginal sexual partners and participants’ sex influenced condom use. There were no significant differences in relationship status, duration, trust, honesty and condom use. These findings should be considered with designing interventions to increase condom use among college students.     

The condom purchase task: A hypothetical demand method for evaluating sexual health decision-making

Behavioral economic theory has proved useful for understanding the influence of delay and probability on sexual health decision-making. Demand is another principle at the intersection of microeconomics and psychology that has helped advance research relevant to health behaviors. The purpose of the present study was to develop and test a demand measure related to sexual health decision-making and the influence of sexually transmitted infection (STI) risk. Participants (N = 438) recruited using Amazon Mechanical Turk completed a commodity purchase task assessing hypothetical condom demand. Condom demand was evaluated at varied prices for use with hypothetical sexual partners that varied in STI risk. Demand was characterized by prototypic decreases in consumption with increases in cost. Higher partner STI risk was associated with greater intentions for condom-protected sex at no cost and smaller decreases in condom demand with increases in cost. Price sensitivity was also related to individual difference factors relevant to sexual health (e.g., alcohol use severity, lower STI knowledge). This study supports the utility of a condom purchase task for indexing condom valuation and capturing individual difference and contextual risk factors relevant to STI transmission. Future studies may leverage this methodology as a means to study sexual health decision-making.     

Examining memory for heterosexual college students' sexual experiences using an electronic mail diary.

To examine memory for sexual expenences, the authors asked 37 sexually active, nonmonogamous, heterosexual college students to complete an e-mail diary every day for 1 month. The diary contained questions about their sexual behaviors. Six to 12 months later, they returned for a surprise memory test, which contained questions about their sexual experiences from the diary phase. They were asked about their sexual partners, the types of sexual experiences they had, and condom use. Participants underreported the number of partners they had, but they overreported both sexual experiences and condom use. The results have implications for both sexual health educators and for people who engage in high-risk sexual behaviors.     

A longitudinal examination of risky sexual behaviors among Canadian and Italian adolescents: Considering individual, parental, and friend characteristics

In this study, two longitudinal models of early adolescent risky sexual behaviors (RSB) were compared using a pooled sample of 267 Canadian and Italian adolescents (55% females; 53% Canadians) assessed yearly from grade 8 to 10. We focused on parenting practices (monitoring, control, limit setting), adolescent problem behaviors (antisocial behaviors, substance use) and their friends' deviance (antisocial behaviors, substance use) as predictors of condom use frequency and lifetime number of sexual partners. The socialization model postulates that youths' problem behaviors and RSB are behaviors learned within the friendship network where deviancy training can occur. The selection model posits that delinquent youth tend to affiliate with each other, and that RSB is one of many behaviors that can form the basis of selection. Using structural equation modeling, this study showed that the socialization model was the most accurate to explain the emergence of RSB. A full mediation of parenting practices, passing through deviant friends and youths' problem behavior, was observed for condom use. The same process applied to number of sexual partners, but a direct effect for parenting practices was also found.     

The impact of mental health problems and religiosity on African-American girls' HIV-risk

We investigated the relationship between religiosity, mental health problems, and two sexual risk behaviors-condom use and number of partners. Participants were 80 sexually active African American girls in psychiatric care and their caregivers. Results indicated differential relationships, depending on parent versus youth report. Mother's religiosity was positively related to girls' condom use and not to girls' number of partners. Controlling for other predictors in the models, mother's religiosity explained as much as 15% of the variance in girls' condom use. Whereas parent and adolescent reports of girls' depression/anxiety and rule-breaking were positively associated with number of partners, reports of aggression were associated with having fewer partners. Neither parent nor youth reports of girls' mental health problems were associated with condom use. Controlling for other predictors in the models, girls' mental health problems accounted for as much as 31% of the variance in number of partners. Findings underscore the importance of adopting an ecological framework to understand both the risk and promotive factors for sexual risk taking among troubled girls. The roles of specific aspects of psychopathology and religiosity in relation to sexual risk behavior among African American girls in psychiatric care are discussed.     

Health-protective effects of attachment among African American girls in psychiatric care

African American girls in psychiatric care are at increased risk for HIV and sexually transmitted infection (STI) through sexual risk taking. Adolescent sexual behavior often reflects peer norms and behavior. Secure attachment patterns with mothers and peers might lessen the effects of negative peer influences and reduce sexual risk taking among African American girls. This study examined the relationships among mother-daughter and peer attachment, peer norms, and sexual-risk behaviors in African American girls seeking outpatient psychiatric care. A group of 12-16-year-old African American girls (N = 262; M age = 14.45 years) reported on their attachment to their mothers and peers, peer risk-taking and dating behaviors, peer pressure, and sexual-risk behaviors (e.g., number of partners, high-risk partners, and condom use). Structural equation modeling examined whether peer attachment and peer norms mediated the relationship between mother attachment and sexual risk. Findings supported peer norms, but not peer attachment, as a mediator of mother attachment and girls' sexual-risk behaviors. Findings revealed important family and peer factors for African American girls in psychiatric care. HIV prevention programs may be strengthened by improving mother-daughter relationships, addressing the importance of peer relationships, and emphasizing how secure mother-daughter relationships can temper the impact of peer norms.     

Factors Influencing Condom Use Among African American Women: Implications for Risk Reduction Interventions

Examined factors associated with condom use in a community-based sample of 423 sexually active African American women. Measures were selected to reflect the components in prevailing models of health behavior. Condom users were higher on AIDS health priority, prevention attitudes, stage of change, behavioral intentions, reported more frequent and comfortable sexual communication with partners, perceived greater partner and peer approval for condom use, and reported that peers also used condoms. Women in exclusive relationships evidenced earlier stage of change, lower intentions to use condoms, fewer peers who engaged in preventive behaviors, perceived themselves to have lower risk, and had lower rates of condom use, higher education, and family income. Women in fluid relationships were at particularly high risk, with lower rates of condom use relative to women not in a relationship and greater sexual risk for HIV. Implications for HIV-risk reduction interventions with African American women are discussed.     

Heterosexual risk behaviors in at-risk young men from early adolescence to young adulthood: prevalence,prediction, and association with STD contraction

Health-compromising lifestyles involve stable patterns of behavior and are associated with high-risk social environments and accelerated developmental trajectories. Developmentally, antisocial behavior is associated with such lifestyles. Mediational models predicting a measure of lifetime average sexual risk behavior assessed over a 10-year period (from ages 13-14 to 22-23 years) were examined for a sample of at-risk young men. The measure included years of abstinence from intercourse as well as levels of 3 key heterosexual indicators of risk: frequency of intercourse, number of intercourse partners, and condom use. Predictors included lifetime average measures of contextual, family, and peer process variables and individual behaviors. In addition, similar models for prediction of STD contraction were assessed. A younger age of onset of intercourse was associated with higher numbers of intercourse partners after onset. As hypothesized, findings indicated mediational associations of socioeconomic status, parental monitoring, deviant-peer association, antisocial behavior, and substance use in the prediction of sexual risk behavior. Lower condom use also predicted STD contraction.     

Correlates and predictors of HIV risk among inner-city African American female teenagers

OBJECTIVE DESIGN: For human immunodeficiency virus (HIV)-related prevention initiatives to be most effective, they should be broad-based and incorporate multiple domains of influence. This study tested how several ecodevelopmental domains influenced HIV-risk related attitudes and behaviors in a community sample of African American female teens (N = 242). MAIN OUTCOME MEASURES: Outcome measures were number of partners, frequency of intercourse, number of pregnancies, abstinence/condom use, HIV/AIDS-related attitudes and behaviors, and HIV testing. RESULTS: Structural Equation Modeling revealed many direct paths from ecodvelopmental domains to risky sexual behaviors. The findings include having more partners was associated with parental alcohol-related problems, more drug use, and a younger age at first intercourse. More frequent intercourse was associated with less cultural pride and more drug use. More pregnancies were related to a younger age at first intercourse and parental alcohol problems. HIV testing was associated with having experienced sexual abuse, an older age at first intercourse, and stronger self-efficacy. CONCLUSIONS: Prevention programs that focus on risk reduction could expand their focus beyond sexual behavior to include a broad-range of psychosocial domains that are associated with HIV-risk. The effectiveness of prevention programs should be monitored carefully for appropriateness in different ethnic groups.     

保护动机对农村流动人口性病艾滋病高危性行为的预测

农村流动人口已经成为我国性病艾滋病预防干预的重点人群。为了探讨流动人口所存在的性病艾滋病高危性行为,以及保护动机（Protection Motivation）对性病艾滋病高危性行为的预测作用,研究选取2201名从农村到北京打工已有3个月的流动人口为被试,采用问卷调查的形式,要求其报自己报告初始性行为发生的时间、性伙伴的数量、商业性行为、性伙伴的性行为、安全套的使用,对我国性病艾滋病严重程度的评估,以及所拥有的性病艾滋病症状知识和传播知识。对904名已发生性行为的流动人口的统计分析发现：（1）农村流动人口存在较多的高危性行为,男性流动人口的高危性行为明显多于女性流动人口;（2）保护动机理论对农村流动人口的性病艾滋病高危性行为具有明显的预测作用,其中的外在奖励、内在奖励、反应效能和反应代价与农村流动人口的性病艾滋病高危性行为的关系更为密切。研究揭示,保护动机理论可以作为我国今后开展农村流动人口性病艾滋病高危性行为预防干预工作的一个基础     

Adult attachment and sexual behavior

The relations between adult attachment processes and sexuality were examined in a community sample of 792 young adults (327 men and 465 women) from the Niagara region of Canada. Participants completed questionnaires that included Simpson’s (1990) measure of adult attachment, self‐reported physical attractiveness, erotophilia, and a variety of sexual behavior measures (e.g., number of sexual partners, age of first sexual experience, frequency of sexual behaviors in the past year, whether an affair had occurred in the past year, and consistent condom usage). The sexuality measures were factor analyzed to extract common factors. The results were modest, but a number of significant relationships between sexuality and attachment were observed. For example, people scoring higher on a secure attachment index perceived themselves as more physically attractive, whereas people scoring higher on an anxious attachment index perceived themselves as less physically attractive, had an early first intercourse (and more lifetime partners), more infidelity, and took more sexual precautions (e.g., condom usage). The results were generally stronger in women, with most of the attachment/sexuality associations in the full sample being driven by the results in women. Implications for understanding sexual variability, including high‐risk sexual behavior, are discussed.     

Knowledge,beliefs, peer norms,and past behaviors as correlates of risky sexual behaviors among college students

Abstract

HIV/AIDS knowledge, age at onset of sexual activity, perceptions of personal risk and peer norms were explored as correlates for risky sexual behaviors among college students. Ninety-nine male and 185 female college students completed a 66-item questionnaire. A majority reported being sexually active with most in mutually monogamous relationships or not currently in a sexual relationship. Multiple regression correlation analyses showed knowledge about HIV/AIDS to be very high but that this knowledge did not independently relate to the extent of risky behaviors. Perceptions of risk were positively related to number of partners and single-time partners but not condom usage. In contrast to previous studies, perceived peer norms did not independently relate to behaviors. Instead, age at first intercourse was found to have substantial overlap with current perceptions, attitudes, and likelihood for engaging in risky behaviors. The necessity for including previous behaviors in analyses of the impact of attitudes and perceived norms on behavioral intentions is discussed.     

The Development and Validation of a Model Explaining Sexual Behavior Among College Students Implications for AIDS Communication Campaigns

College students' risky sexual behavior places them at relatively higher than average risk for HIV infection. This study examines various explanations for college students' risky behavior, and proposes and tests a model of factors influencing college students' sexual behavior. A LISREL estimation of the model shows that the model fits the data. The results also show that (1) sensation-seeking predispositions and the sexual motive for a pleasurable relationship are indirectly or directly related to all measures of sexual behavior (i.e., number of partners, incidence of unprotected sex, and percentage of condom use); (2) sexual motives driven by concern for health have only an indirect effect on percentage of condom use; and (3) optimistic bias, personal relevance, perceptions about partners, and images of condoms are related to sensation seeking, sexual motives, and sexual behavior. In addition, interpersonal influence from sexual partners appears to both facilitate and inhibit safer sexual behavior. Suggestions are provided regarding campaigns designed for AIDS prevention among college students.     

Influence of Profession as Risk of STIs in Intimate Partner Relationship in South Asian Countries

Mixing of sexual partners as part of the profession of female sex workers (FSWs) can be a risk in intimate partner relationship, which is primarily based on love and affection. Sexual relation with one partner provides emotional and psychological support. However, when it is a web of partners, it often results in unprotected sex, consequently creating a pathway for disease and increasing the vulnerability of FSWs to sexually transmitted infections (STIs). This paper analyses the subtleties of sexual behavior of FSWs and their vulnerability toward STIs in intimate partner relationship in South Asian countries. The basic data used in this paper have been taken from 3 countries, 1271 FSWs from Bangladesh, 1404 FSWs from Nepal, and 7399 FSWs from India. The data were collected through modified time location cluster sampling as a part of mapping and size estimation of most-at-risk populations (MARPs) in Nepal and key affected populations (KAPs) in Bangladesh during the period of 2010–2016. The data for India are taken from the integrated behavioral and biological assessment (IBBA), which assesses the prevalence of high risk population in India. The findings reveal that the majority of the FSWs were married, which reveals dynamics of sexual activity placing them at higher risk of STIs. About half of the FSWs had more than 15 coituses in the last 30 days in Nepal, which is a high risk factor. Unprotected sex is reported high across all three countries irrespective of all background characteristics. Condom use during intercourse in Bangladesh is less likely in older FSWs and more likely among educated FSWs who had coital frequency of 7 or more in the last 30 days. Interestingly, unmarried FSWs in Nepal are less likely to use condom in their last sex as against India where FSWs are more likely to use condom in their last sex. The prevalence of STI among uneducated FSWs is found higher in Bangladesh as compared to Nepal and India. The socio-demographic background characteristics showed a significant association with unprotected sex, coital frequency and prevalence of STI across all three countries.     

Are Transgender Persons at Higher Risk for HIV Than Other Sexual Minorities? A Comparison of HIV Prevalence and Risks

SUMMARY

Recent studies have shown that transgender people are at high risk for HIV. Few studies, however, have directly compared the HIV risks and sexual health of transgender persons with that of other sexual minority populations. This study used baseline data of intervention studies targeting transgender persons, men who have sex with men, and women who have sex with women and men to compare their HIV risk behavior and sexual health. No significant differences were found between transgender persons and nontransgender men or women in consistent condom use or attitudes toward condom use. Transgender persons were less likely to have multiple partners and more likely to be monogamous than men who have sex with men; no differences were found between transgender persons and the women in this respect. When combining data on condom use, monogamy, and multiple partners, transgender persons did not differ from either nontransgender group in their overall risk for HIV. Transgender persons were less likely than the men or the women to have been tested for HIV. With regard to HIV prevalence, 17% of the men compared to only one transgender person and none of the women reported being HIV-positive. Transgender persons were also less likely than men who have sex with men to use drugs; no differences were found in the use of alcohol. However, with regard to mental health, transgender persons were more likely than the men to have experienced depression and more likely than men or women to have considered or attempted suicide. Finally, transgender persons reported the lowest levels of support from family and peers. Thus, in our sample, transgender persons appear to be at lower risk for HIV but at higher risk for mental health concerns than men who have sex with men. Remarkably few differences were found between transgender persons and women who have sex with women and men-a finding which might reflect the impact of social stigma on sexual health and have implications for the design of future HIV/STI prevention efforts.     

Sexual behaviour in injecting drug users

A survey of the self-reported sexual behaviors of 1239 intravenous drug users recruited off the streets in Sydney, Australia, highlighted the impact of both sexual orientation and gender on the risk of human immunodeficiency virus (HIV) infection in this population. The sample included 908 men (mean age, 27.9 years) and 331 women (mean age, 26.3 years), the majority of whom were unemployed or receiving social security benefits. Among male respondents, 50 were homosexual, 117 were bisexual, and 719 were heterosexual; for females these numbers were 10, 95, and 220, respectively. Oral and vaginal sex were the most commonly reported practices among heterosexuals, while homosexuals primarily reported manual stimulation and oro-genital contact. The regular sexual partners of male intravenous drug users tended not to be addicts, while female drug users were primarily involved with male partners who also abused drugs. Among male respondents, condom use was highest among homosexuals, followed by bisexuals, and lowest among heterosexuals; there were no significant differences by sexual orientation in female respondents' condom use. Overall, condoms were most likely to be utilized in anal sex and least likely in the case of oral sex. Condom use was about 5% lower when a regular as opposed to casual sexual partner was involved. Most of the 64 HIV-positive respondents were homosexuals, suggesting that sexual orientation rather than drug abuse was the primary risk factor. Given the finding that there is substantial variation in condom use among subgroups of intravenous drug abusers, it is recommended that HIV prevention programs adopt a diversified rather than uniform approach.     

Comparison of Marine and College Women's HIV/AIDS-Relevant Sexual Behaviors1

This study compares the heterosexual risk behaviors, perceptions of vulnerability to HIV/AIDS, and predictors of condom use of two groups of women with very different sexual and contraceptive histories and habits–college women and women in Marine Corps recruit training. The Marines' s]exual behaviors put them at greater risk of contracting HIV than the college students; that is, Marines reported more frequent intercourse with more partners, used condoms less frequently, and had less knowledge about HIV/AIDS transmission. Consistent with these differences, college students displayed a larger illusion of unique invulnerability than did the Marines. In general, the women who had more sexual partners and more frequent sexual intercourse were less likely to report regularly using condoms. In addition, the data provide support for Weinstein and Nicholich's (1993) recent suggestion that the relation between risk perception and risk behavior is different for different groups of people.     

Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex

The present study tested the proposition that an intervention to reduce alcohol use among college students will also reduce their risky sexual behavior. In a randomized controlled trial, 154 heavy-drinking, predominantly White, heterosexual college students at behavioral risk for infection with HIV and other sexually transmitted diseases were assigned to receive no intervention or a two-session, in-person, motivational interviewing-based intervention focused on (a) reducing alcohol risk behavior, (b) reducing HIV risk behavior, or (c) reducing both alcohol and HIV risk behavior. Three-month retrospective assessments of alcohol use and sexual behavior were conducted at intake and at 3-, 6-, 9-, 12-, and 15-month follow-up appointments. During follow-up, participants who received the single-focus alcohol risk-reduction intervention drank less frequently and consumed fewer drinks per drinking day as compared with no-intervention control participants, but did not differ from control participants in their frequency of intercourse without a condom or number of sexual partners. Participants who received the single-focus HIV risk-reduction intervention evidenced fewer unprotected sex events during follow-up, as compared with control participants. The number of sexual partners reported during follow-up did not differ by condition. Effects of the interventions did not vary significantly over time and were not moderated by participant gender. Results suggest that intervening to reduce alcohol use may not reduce risky sexual behavior among nonminority college students, but that a brief motivational intervention targeting HIV risk behavior may have utility for reducing the frequency of unprotected sex in this population.