Ambivalence and Unprotected Sex: Failure to Predict Sexual Activity and Decreased Condom Use1

Using a prospective design, we assessed whether ambivalence toward sexual activity is associated with decreased condom use. Undergraduates predicted whether they would have intercourse and use condoms in the next week. A week later, they reported their sexual and contraceptive behavior. Among 65 individuals who had intercourse and planned to use condoms, ambivalence toward sexual activity was negatively associated with condom use. Moreover, whether intercourse was planned mediated the relationship between ambivalence and condom use, such that ambivalence was negatively associated with accuracy in planning sex, and unplanned sex was less likely to be protected. Individuals who are ambivalent about sex may intend to use condoms, but fail to do so because they cannot predict when they will have intercourse.     

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.     

A six-month follow-up of adolescents' sexual risk-taking,HIV/AIDS knowledge,and attitudes to condoms

A follow-up study was conducted to investigate change in sexual behaviour, knowledge about HIV/AIDS transmission, and attitudes to condoms over a 6-month period in a sample of late-adolescent students. The study also obtained subjective reports of HIV/AIDS-relevant change. Overall there was a decrease in sexual risk-taking behaviour with casual partners but no change occurred in sexual behaviour with regular partners, knowledge about HIV/AIDS, attitude towards condoms, or intention to use a condom on next sexual encounter. Examination of individual data revealed that, for some adolescents where behavioural change had occurred, this was in the direction of less safe sex. There were few self-reports of change in sexual behaviour, intention to take precautions against HIV/AIDS, or concern about HIV/AIDS over the preceding 6 months. Subjective reports of behaviour change did not correspond with reports of actual behaviour. Low rates of behaviour change are attributed to the failure of adolescents to personalize the threat of AIDS and to their trust in the safety of sex with a regular partner as well as to the lack of relevance of HIV/AIDS education campaigns to this group.     

Effects of question format and collection mode on the accuracy of retrospective surveys of health risk behavior: a comparison with daily sexual activity diaries.

OBJECTIVE: To use prospective diaries to assess the effects of alternative survey question formats and data collection modes on the accuracy of retrospective self-reports of sexual behavior for the same time period. DESIGN: Over a 3-month period, 493 adults completed and returned by mail daily diaries of their sexual activities. Participants then returned to complete a retrospective survey of their sexual activities during the same 3-month time period. Participants were randomized to 1 of 6 retrospective experimental survey conditions that represented the combinations of 2 question formats (in aggregate and by partner) and 3 collection modes (paper questionnaire, computer-assisted self-interview [CASI], and audio-enhanced CASI). MAIN OUTCOME MEASURES: Frequencies of sexual activities and condom use reported in surveys were compared with what participants had recorded in their prospective daily diaries. RESULTS: Relative to activity recorded in daily diaries, participants more often underreported than overreported (61% vs. 28%, p < .05) sexual behavior in retrospective surveys. Greater survey-to-diary consistency in reported behavior was achieved with by-partner question format (p < .032) and CASI collection modes (p < .05) used in surveys. However, median rates of error in survey-to-diary comparisons of reported behavior were as high as 40%. CONCLUSION: Even after refinements in survey question format and use of CASI techniques, there remained substantial error in participants' retrospective reports of sexual practices. These error rates may be comparable to, or even larger than, the expected effect size of some intervention studies. Further research is needed to improve the accuracy of sexual behavior reports.     

Cognitive,Behavioral, and Personality Correlates of HIV-Positive Persons' Unsafe Sexual Behavior1

This study examined sexually risky behaviors of HIV-positive men and women within the framework of social cognitive theory. Condom use was found to be associated with high self-efficacy, positive influeces from social models, and specific condom use expectancies. As risky sexual behavior may be the manifestation of a more general pattern of risk taking that emerges from personality dispositions such as impulsiveness or psychoticism, this possibility was explored with discriminant analyses. Self-reported impulsivity, substance abuse, promiscuity, and deception served as markers of the presumed disposition. While these variables did not reliably distinguish between consistent and inconsistent condom users, they did enhance significantly the classification of individuals who, during the past 6 months, had been sexually abstinent, monogamous, or nonmonogamous. Those who reported more sex partners scored higher on impulsivity, disclosed more involvement with illegal drugs, and showed greater willingness to mislead potential partners about their sexual history than monogamous or sexually abstinent persons with HIV.     

Acculturation-related variables, sexual initiation, and subsequent sexual behavior among Puerto Rican, Mexican, and Cuban youth.

The relationship among acculturation-related variables, past sexual activity, and subsequent sexual behavior was examined for a sample of Latino youth in the United States over a 12-month period. A subsample from the National Longitudinal Study of Adolescent Health database was analyzed by means of a prospective design. History of sexual intercourse predicted subsequent sexual behavior over the ensuing 12 months. The acculturation-related variables were related to whether an adolescent reported being sexually active at Wave 1 but in a complex fashion. Among recent immigrants, youth from English-speaking homes were less likely to be sexually active than those from Spanish-speaking homes. The opposite was observed for youth who were born in the United States or who had resided in the United States most of their lives.     

Using the Internet to find offline sex partners.

We aimed to expand upon the demographic characteristics and gender differences among those who have met someone on the Internet who they later met offline and had sex with as well as any relationship with cybersex, sexually transmitted infections, and online sexual problems. We analyzed data collected through an online questionnaire in 2002 in Sweden including a total population of 1836 respondents of which 1458 used the Internet for sexual purposes. Of those, 35% men and 40% women reported to have met offline sex partners online. The majority reported an occurrence of one to two times, whereas 10% reported six or more times. The analysis suggested women aged 34-49 and 50-65 years, homo- and bisexual men, and singles more likely to have this experience. They were also more likely to have engaged in cybersex. No relationships were found with sexually transmitted infections or online sexual problems. The results suggest that using the Internet to find sex partners may be less hazardous for the general Internet users than pointed out by prior research about this behavior often focusing on specific sub groups of Internet users.     

Classifying a Person as a Sexual Partner: The Impact of Contextual Factors

This study assessed the influence of five factors on respondents' judgments of whether two hypothetical actors, Tom and Lucy, would consider each other to be "sexual partners." The factors were: respondent's gender, actor's gender, type of act (vaginal, anal, or oral intercourse), frequency of act (once, several times), and actors' dating status (not dating, dated once, dated for three months). 223 undergraduates (mean age 22.2 - 2.2 years; 65% female) read 16 hypothetical heterosexual behavior scenarios featuring Tom and Lucy and judged whether Tom (Lucy) would consider Lucy (Tom) to be a "sexual partner." Respondents thought the actors would be more likely to consider each other sexual partners if they had engaged in vaginal or anal intercourse as opposed to oral sex; if they had more frequent sex; or if they were in a steady dating relationship. Researchers and health care professionals should take contextual/situational factors into account when they ask respondents about their sexual partners.     

Influence of Time in Treatment and Follow-Up Duration on Methadone Treatment Outcomes

Data for 422 methadone treatment clients in the National Treatment Improvement Evaluation Study (NTIES) were analyzed. Clients maintained continuously in methadone treatment for longer than 12 months and clients who leftbetween 3–12 months were compared with clients treated for less than 3 months. Additionally, clients treated for 3–12 months who had short follow-up periods (6-month average) were compared with 3–12-month clients with long follow-up periods (11-month average). Positive treatment outcomes includinglower drug use, reduced risk of viral infectionand sexually transmitted disease (through needle sharing and multiple sex partners), and less criminality wereassociated with both longer duration treatment and shorter follow-up periods. The findings suggested that continuous methadone treatment of 12 or more months is optimal, whereas stays of less than3 months may be ineffective. Furthermore, stays of 3–12 months are likelyto be beneficial over a relatively short time span, for example 6 months.     

Psychosocial predictors of gay men's AIDS risk-reduction behavior.

Used psychosocial variables derived from the health belief model (Rosenstock, 1974), Bandura's (1986) self-efficacy framework, and protection motivation theory (Rogers, 1984) to predict self-reported AIDS risk-reduction behaviors in a sample of 389 homosexual men who participated in the Multicenter AIDS Cohort Study in Los Angeles and who knew their HIV antibody status. Hierarchical multiple regression analyses showed that self-efficacy, perceived risk, response efficacy, and prior sexual behavior accounted for approximately 70% of the variance in the total number of sexual partners and the number of anonymous partners over a 6-month interval, controlling for demographic variables, HIV antibody status, and presence of a primary partner. A logistic regression analysis showed that barriers to change predicted increased unprotected anal receptive intercourse over a 6-month interval, controlling for prior behavior. The relation of health beliefs to risk-reduction behavior was substantially different for HIV-seropositive men without primary partners than for other groups of gay men. Implications for interventions are discussed.     

Accuracy of self-reported arrests among a forensic SPMI population

Self-reports are prone to response error even in the most structured and standardized environment, but the highly stigmatizing nature of illegal behavior and the possible cognitive problems inherent to the SPMI population increase the likelihood of such error. Using administrative data as the gold standard, the validity of self-reported arrests was examined among 85 mentally ill substance-abusing individuals with justice involvement. The overall accuracy of self-reported arrests during a three-month recall period was 84.7%. Validity was higher among individuals who at the time of the follow-up interview were either in a jail diversion program or incarcerated. Individuals with a mood disorder appeared to be somewhat less accurate in their self-reports than subjects with schizophrenia, despite the implication of cognitive distortion accompanying this latter diagnostic category. Further research on issues such as the accuracy of self-reports over longer recall periods, or the accuracy of self-reported frequency of arrest, is necessary, given the reliance on self-report methodology in outcome studies.     

Sociosexual Orientation and Sexual Behavior in Mexican Adults

Sociosexual orientation includes individual differences in sexual attitudes and behaviors, in relation to the extent in which an individual could be sexually active without affective bonds and commitment. Sociosexuality is related to sexual behavior and can speak to the differences between men and women in how they express their sexuality ( Simpson & Gangestad, 1991 ; Hebl & Casi, 1995 ; Ostovich & Sabini, 2004 ). This study explores sociosexual orientation and sexual behavior in Mexican adults, in order to identify differences in sociosexual orientation related to biological sex and relationship status. It also assesses the relationship between sociosexual orientation and sexual behavior and to predict sexual behavior from sociosexual orientation. The sample was composed of 209 Mexican adults between 19 and 61 years of age. Thirty‐seven percent were male, and 63% were female. Participants answered a standardized Spanish version of the Sociosexual Orientation Inventory ( Simpson & Gangestad, 1991 ) and a Sexual Behavior Inventory developed for the present project ( García Rodríguez, 2007 ). In general, there is great variability in the frequency of each of the sexual behaviors assessed and in the total number of sexual partners. Moreover, participants perceive themselves restricted in their sexual attitudes and behaviors. Men are more permissive and less restricted in attitudes and behaviors than women, and individuals who are dating informally have a higher behavioral sociosexual orientation than those who are living with their partner. Additionally, the higher sociosexuality, the more frequent sexual practices are and the higher the number of sexual partners. Finally, sociosexuality predicts the frequency of sexual practices and the number of lifetime sexual partners.     

Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.     

The valence of sex:Automatic affective associations in erotophilia and erotophobia

Sexual stimuli may elicit positive and negative emotions that can impact sexual thoughts, responses, and behavior. To date, most research on affect and sexuality has focused on conscious processes and affective states. Less is known about how automatic and trait-level affective processes influence our reactions to sexual stimuli. This study used a priming task with backward masking and a trait measure of erotophobia-erotophilia - the tendency to respond to sex on a negative-to-positive continuum - to improve our understanding of the role of automatic and affective processes in response to sexual stimuli. Erotophilic individuals demonstrated automatic associations between sexual primes and positively-valenced targets, whereas erotophobic individuals classified negatively-valenced targets faster regardless of whether primes were sexual or neutral. The findings suggest that the valence of sexual stimuli can be processed automatically and is associated with trait-level affective responses to sex. Implications for research on risky sexual behavior and sexual dysfunction are discussed.     

Sexual behavior in Spanish adolescents of divorced parents

Marital breakup has been associated with numerous behavioral problems in children, such as sexual risk behaviors. This research is the first to examine sexual behaviors of Spanish adolescents related to whether their parents were married or divorced. Participants were 342 boys and girls aged between 14 and 18 years. The sample provided confidential information about their sexual behavior and birth control methods. Significant differences were only found in percentages of adolescents who had engaged in mutual masturbation, intercourse, or oral sex, and who had practiced these sexual relations in the last six months, in both cases, they were higher when the parents had broken their marital relationship. Regarding adolescents of divorced parents, engaging in intercourse is more likely in older teenagers who live with a stepparent. Moreover, older adolescents who were younger when parents divorced and who live in a reconstituted family, have more sexual partners. These and other findings are discussed.     

Anticipated Regret and Time Perspective: Changing Sexual Risk-taking Behavior

In two studies we test the effects of anticipated affective reactions such as regret on behavioral expectations and behavior. These effects were examined in the context of sexual risk-taking behavior. More specifically, we tested the impact of the anticipated feelings associated with unsafe sex on sexual risk-taking behavior. We assumed a difference between the feelingsabout unsafe sex and the feelings people anticipate to haveafter this behavior. Two studies tested the hypothesis that respondents who are induced to focus on their anticipated, post-behavioral feelings are more likely to report negative feelings such as regret and to adopt safer sexual practices than respondents who are asked to focus on their feelings about the behavior itself. Study 1 shows that anticipated feelings after unsafe sex were more negative than feelings about the behavioral act itself, and that respondents who were asked to consider these anticipated feelings expressed stronger expectations to reduce their risk in future interactions. Thus, asking respondents to take a wider time perspective, and to consider the feelings they would haveafter having had unsafe sex, resulted in ‘safer’ behavioral expectations. Study 2 replicates the findings of Study 1, and also yielded a reliable effect of the time perspective manipulation on actual, self-reported behavior. Respondents who were asked to report on their anticipated feelings after unsafe sex showed less risky behavior in the five months following the experiment than the remaining respondents. Thus, the induced focus on post-behavioral emotions increased the likelihood of preventive behavior. Implications of these findings for behavioral intervention programs are discussed.     

Parent-child sexual discussion: perceived communicator style and subsequent behavior

The purpose of this study was to investigate the relationship between perceived parental sexual communicator style and adolescent sexual behavior and information accuracy. Two hundred thirty-four college students provided data on their perceptions of parental sexual communicator style as well as self-reports of sexual behavior and knowledge across three time frames (junior high school, high school, and college). Significant relationships were found between perceived parental sexual communicator styles and sexual activity, contraceptive use, and sexual knowledge accuracy. In addition, significant differences were found between males and females on their sexual knowledge accuracy (females reported a higher level of sexual knowledge than did males). The findings are discussed, and recommendations for future research in the area of parent-adolescent sexual communication are offered.     

Trading Sex for Money or Compensation: Prevalence and Associated Characteristics from a Sexually Transmitted Infection (STI) Clinic Sample

The purpose of this study was to determine the prevalence and individual risk factors of people who trade or sell sex among sexually active individuals seeking HIV and sexually transmitted infection (STI) testing. Using electronic agency records, an analysis of the characteristics of 5,029 youth and adults who voluntarily obtained HIV and STI testing was conducted. Multiple imputation procedures for missing data from 3 variables and logistic regression were conducted. A total of 128 individuals reported having traded sex. Nine variables had statistically significant associations with trading sex. Individuals who identified as White and female had lesser odds of trading sex, whereas individuals who were transgender, were living in a shelter, had been sexually assaulted, had a previous STI, had high-risk sex, or used drugs had greater odds of trading sex. Elevated levels of high-risk behavior in addition to sexual trauma should be considered in intervention research and community health practice. Implications for service providers and researchers are discussed.