Nationwide survey of contraceptive and sexually transmitted infection knowledge,attitudes and skills of university students in Portugal

Sexually transmitted infections and (STIs) unintended pregnancies are contemporary public health concerns. Understanding factors (e.g. knowledge, attitudes and skills) influencing sexual behaviours of university students are critical to develop targeted and tailored risk-reduction interventions for this vulnerable population. Thus, the goals of this study were to describe sexual behaviours and analyze differences between genders for sexual behaviours; to identify whether differences exist between genders and age groups regarding knowledge, attitudes and skills concerning contraceptive methods and STIs, and to evaluate the association of knowledge with attitudes and skills with sexual behaviour among university students in Portugal. The sample included 3278 students. Results show that the majority were sexually active and use condoms and oral contraceptives. In general, university students have high knowledge, positive attitudes and skills about contraception and STIs. Gender analyses indicated that women had greater knowledge, and more favourable attitudes, and higher skills toward contraceptive and STI preventive behaviour College students, in particular, face new challenges in sexual health and would benefit from more comprehensive education aimed at promoting healthy decision-making about family planning and STI prevention.     

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.     

Sexual Intent Perceptions: The Role of Perceiver Experience and the Real‐Person Reduction1

What factors influence the amount of sexual intention accorded to a person's behavior? A perceiver's gender and personal experiences, and the nature of the relationship with the perceived were investigated. Two findings emerged. First, perceiver sexual and dating experiences predicted perceptions in addition to and independent of perceiver gender, but only for a “self” target. Second, hypothetical targets were perceived more sexually relative to targets that represented real people. These findings extended previous research suggesting that features of targets and perceivers in addition to gender are predictive of sexual perceptions. These target features (e.g., “self” vs. other, “real” vs. hypothetical) have distinct influences on sexual perceptions, suggesting that the choice of a target in research studies should be considered carefully.     

Gender Differences in Perceptions of Women’s Sexual Interest during Cross-Sex Interactions: An Application and Extension of Cognitive Valence Theory

Researchers have consistently found that men report that women display more sexual interest than women report they actually do in cross-sex interactions (e.g., Abbey, 1982). Cognitive Valence Theory is employed to provide a theoretical framework to help understand these findings (Andersen, 1989). A series of perceptual and cognitive processes consistent with Cognitive Valence Theory were examined as possible explanations for the gender difference. Gender differences emerge for both perceptual and cognitive variables. In addition, perceptions of sexually motivated behaviors and variables associated with appropriateness judgments and personal receptivity were found to predict perceptions of women’s sexual interest.     

Integrated Cognitive-Behavioral Therapy for Social Anxiety and HIV/STI Prevention for Gay and Bisexual Men: A Pilot Intervention Trial

Given the alarmingly high HIV and sexually transmitted infection (STI) incidence among gay and bisexual men (GBM) worldwide, there is a critical need for HIV prevention interventions specifically for GBM. Social anxiety, or anxiety about being evaluated in interpersonal situations, is a risk factor for condomless anal sex (CAS) among GBM (e.g., Hart & Heimberg, 2005; Hart, James, Purcell, & Farber, 2008). Social anxiety may also increase substance use in sexual situations, which is another risk factor for HIV/STIs in this risk group (Semple, Strathdee, Zians, McQuaid, & Patterson, 2011). The goal of the Sexual Confidence Study was to provide initial evidence of efficacy for a 10-session integrated cognitive-behavioral therapy for social anxiety, substance use management in sexual situations, and HIV sexual risk reduction for HIV-negative GBM. Diagnostic and self-report assessments were completed at baseline, posttreatment, 3-month follow-up, and 6-month follow-up. In this open trial design, we observed a 50% reduction in engagement in HIV/STI sexual risk behavior at 6-month follow-up. We also observed large uncontrolled treatment effect sizes for reductions in social anxiety disorder and problematic alcohol use. These preliminary findings suggest that the present treatment may offer an efficient way of concurrently reducing social anxiety, problematic alcohol use, and the risk of contracting HIV and STIs via CAS with serodiscordant partners among HIV-negative GBM.     

Inferring sexual interest from behavioral cues: Effects of gender and sexually relevant attitudes

Research has found that men impute more sexual meaning to others' behavior than do women. However, little research has examined the possibility that men and women share perceptions of the sexual connotativeness of certain behaviors but diverge in their perceptions of other behaviors. In Study 1, 162 male and 186 female undergraduates, predominantly Caucasian, rated the degree to which each of 27 behaviors of male and female targets connoted a desire for sexual intercourse. Multivariate analyses of variance revealed that, whereas men perceived all but two of the female target behaviors more sexually than women, men and women differed in their perceptions of the sexual connotativeness of only about half of the male target behaviors. A factor analysis revealed three factors for both male and female target behaviors, reflecting mundane dating behaviors, romantic behaviors, and sexual behaviors. Relative to women, men perceived only the mundane dating behaviors more sexually, although regression analyses showed these effects to be moderated by subjects' attitudes toward women. Study 2 examined the extent to which sexually relevant attitudes (e.g., sex role stereotyping, adversarial sexual beliefs, and rape myth acceptance) moderate subjects' perceptions of the sexual connotativeness of the behaviors. Men, particularly those who endorsed traditional, sexually relevant attitudes, were more likely than women to impute sexual meaning to the behaviors. The implications of this for dating situations are discussed.The author wishes to thank Mark Leary and two anonymous reviewers for their comments and suggestions on earlier versions of this article.     

A Tale of Two Standards: An Examination of Young Adults�� Endorsement of Gendered and Ageist Sexual Double Standards

Current North American sexual standards allow women to be sexual within committed relationships but may still restrict women??s sexuality to a greater extent than men??s. We investigated whether these gender double standards interact with an age double standard that describes the elderly as less sexual than the young, to create particularly limiting sexual standards for older women. 305 Canadian undergraduates completed a 2 (target age) × 2 (target gender) × 2 (participant gender) within-subjects study measuring perceptions of younger (own age) and older (over 65 years old) men??s and women??s interest in traditional sex (e.g., cuddling, intercourse with main partner) and experimental sex (e.g., extra-relationship sex, viewing erotic materials). ANCOVAs controlling for ageist and sexist beliefs revealed the ageist double standard; the elderly were perceived to be less interested in sex overall than the young. There was also a sexual double standard; women were perceived to be more interested in traditional sex than men, and men more interested in experimental sex than women. For traditional sex, women perceived younger targets as more interested than the older targets, and women targets as more interested than men. For experimental sex, a three-way interaction showed the interplay between the sexual and ageist double standards. Elderly female targets were perceived as least interested, and young male targets as most interested. Results reinforce that the current sexual standards distinguish between sex for intimacy and sex for other reasons (e.g., pleasure) and that the standards are particularly restrictive for older women.     

Verbal Sexual Coercion Experiences,Sexual Risk,and Substance Use in Women

Research has linked sexual assault, substance use, and sexually transmitted infection (STI) risk in women. Sexual assault by means of verbal sexual coercion (VSC) is more common than sexual assault by means of physical tactics, but VSC is rarely assessed independently. In addition, past work has established global connections among substance use, sexual assault history, and STI risk; however, assessing substance use during sexual behavior is less common. This study examined the relations among VSC, STI risk behavior, and substance use and attitudes. We hypothesized that women with larger numbers of VSC experiences would report more frequent sexual risk behaviors and substance use and attitudes. Participants with larger numbers of VSC experiences reported larger numbers of anal sex partners, more frequent penile–vaginal sex and sexual activity after substance use, and stronger sex-related alcohol expectancies. These findings suggest that VSC is associated with higher levels of STI risk in women.     

Sexual overperception: power, mating motives, and biases in social judgment

Results from 4 experiments suggest that power motivates heightened perceptions and expectations of sexual interest from subordinates. Having power over a member of the opposite sex activated sexual concepts that persisted across a temporal delay, indicating the activation of a mating goal (Study 1). Having power increased participants' expectations of sexual interest from a subordinate (Study 2) but only when a mating goal was attainable (i.e., when the subordinate was romantically available; Study 3). In a face-to-face interaction between 2 participants, power heightened perceptions of sexual interest and sexualized behavior among participants with chronically active mating goals (i.e., sexually unrestricted individuals; Study 4). Tests of mediation demonstrated that sexual overperception mediated power's effect on sexually tinged behavior. Through its capacity to induce goal pursuit, power can activate mating goals that sexualize interactions between men and women. This research demonstrates one route through which power might lead to sexual harassment.     

Flirting with Meaning: An Examination of Miscommunication in Flirting Interactions

Men tend to view women's behaviors as more sexual than do women in cross-sex interactions (e.g., Abbey, 1982). This difference may result because men view specific behaviors as sexually motivated, whereas women attribute a different motivation to the behaviors. It is proposed that people flirt for a variety of different reasons including the desire to increase sexual interaction. Six flirting motivations derived from the literature are considered in this study: sex, fun, exploring, relational, esteem, and instrumental. The motivations attributed to flirting behaviors by men and women in typical flirting interactions are explored. Gender differences emerge for several flirting motivations (i.e., sex, relational, and fun). Men tend to view flirting as more sexual than women do, and women attribute more relational and fun motivations to flirting interactions than do men. No gender differences emerge for esteem, exploring, or instrumental motivations. The discussion focuses on how miscommunication may occur during flirting interactions.     

TOWARD AN UNDERSTANDING OF GENDER DIFFERENCES IN INFERRING SEXUAL INTEREST

Research has shown that, after brief opposite-gender interactions, men perceive women more sexually than women perceive men (e.g., Abbey, 1982 ). This study examined interpersonal perceptions following dyadic cross-gender interactions between unacquainted individuals. Of particular concern were perceptions of sexual traits, interaction qualities, and physical attractiveness. The influence of being gender schematic on sexual judgments was examined. The results provide further support for Abbey's finding that men oversexualize women following brief interactions but failed to support the hypothesized gender schema effects. Additional analyses suggest the presence of another gender difference in judging attraction. Women who rated their partners as physically attractive also attributed more positive qualities to their partner and the interaction. By contrast, men's ratings of women revealed more limited associations with perceived physical attractiveness. Results are discussed in terms of gender differences in judging sexual attraction, the correlates of physical attractiveness, and continuing efforts to explain oversexualization.     

African American Adolescent Females' Perceptions of Neighborhood Safety, Familial Strategies, and Sexual Debut

Sexual debut represents a developmental transition that holds possibility for growth and for risk. Family and neighborhood may impact timing of debut. This qualitative study examined family strategies (e.g., moving, parental monitoring), perceptions of neighborhood, and attitudes about sex and sexual debut among sexually experienced and inexperienced African American adolescent females living in disadvantaged urban neighborhoods. Findings show that more familial strategies were reported by sexually inexperienced females, suggesting that strategies may delay sexual debut. Furthermore, experiences with neighborhood violence related to attitudes about sex and sexual debut, suggesting a linkage between death anxiety and sexual debut among female youth.     

Feelings Matter: Depression Severity and Emotion Regulation in HIV/STI Risk-Related Sexual Behaviors

Human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention models may not address psychological complexities among adolescents with mental illnesses. This study examined contextual factors related to HIV/STI risk among heterosexually active Black adolescents with mental illnesses to inform the development of targeted HIV/STI prevention strategies. Black adolescent males and females (aged 14–17) were recruited from outpatient mental health programs in Philadelphia, PA to complete a computer-assisted personalized interview on sociodemographics, sexual behaviors, and emotion regulation (N?=?53). Two sample t-tests, Wilcoxon Rank Sum tests and regression modeling were used to examine differences in the study measures by gender and relationship status. Reports of sexual partner concurrency were high—both while already in a sexual relationship (67.3%) and multiple sexual partners in the same day (42.3%). Boys reported significantly more risk behaviors than girls. Sadness dysregulation predicted currently being in a relationship, older age at first oral sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters. Coping difficulties predicted a greater number of vaginal and oral sexual partners, and a lower age at first vaginal sex. Increasing depression severity was related to older age at first vaginal sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters in the past 3 months. This formative work suggests that coping mechanisms should be addressed in HIV/STI prevention research through the inclusion of activities targeted toward emotion regulation and decreasing sexual risk behaviors. Psycho-education and skills building may mitigate the psychopathology that contributes to HIV/STI risk in the target demographic.     

Body appreciation,sexual relationship status,and protective sexual behaviors in women

The relationship between body appreciation and sexual risk reduction behavior in women is under-explored. This cross-sectional study examined the relationships between body appreciation, male condom use, and sexually transmitted infection (STI) testing among a community-based sample of women (n = 285). Logistic regression results revealed that after controlling for age, BMI, and sexual orientation, having more than one sexual partner moderated body appreciation and current male condom use (OR = 4.21, p < .01, CI = 1.510–11.726). Body appreciation was not a significant predictor of STI testing in the previous 12 months. This suggests that women with higher body appreciation may be more likely to engage in some protective sexual health behaviors. Interventions that seek to improve body appreciation instead of body size change such as weight loss or gain may encourage certain protective sexual behaviors in women.     

I Did OK,but Did I Like It? Using Ecological Momentary Assessment to Examine Perceptions of Social Interactions Associated With Severity of Social Anxiety and Depression

Socially anxious and depressed individuals tend to evaluate their social interactions negatively, but little is known about the specific real-time contributors to these negative perceptions. The current study examined how affect ratings during social interactions predict later perceptions of those interactions, and whether this differs by social anxiety and depression severity. Undergraduate participants (N = 60) responded to a smartphone application that prompted participants to answer short questions about their current affect and social context up to 6 times a day for 2 weeks. At the end of each day, participants answered questions about their perceptions of their social interactions from that day. Results indicated that the link between negative affective experiences reported during social interactions and the end-of-day report of enjoyment (but not effectiveness) of those experiences was more negative when social anxiety was more severe. The link between negative affective experiences rated during social interactions and the end-of-day report of effectiveness (but not enjoyment) during those social encounters was more negative when depression was more severe. These findings demonstrate the importance of examining self-perceptions of social interactions based both on the extent to which individuals think that they met the objective demands of an interaction (i.e., effectiveness, mastery) and the extent to which they liked or disliked that interaction (i.e., enjoyment, pleasure). These findings also highlight how real-time assessments of daily social interactions may reveal the key experiences that contribute to negative self-evaluations across disorders, potentially identifying critical targets for therapy.     

Mental health correlates of HIV risk behaviour and STIs/HIV infection among university students from 22 low,middle and high income countries

The aim of this study was to determine mental health correlates of HIV risk behaviour and self-reported STIs/HIV infection among university students in 22 low, middle and high income countries. Data on mental health and HIV risk were collected from 16 567 undergraduate university students (mean age 20.9, SD = 2.9) from 23 universities in 22 countries across Asia, Africa and the Americas. Results indicate that overall 16.8% of the students had two or more sexual partners in the past 12 months, and among the sexually active, 73.7% had inconsistently used a condom in the past three months with their primary sexual partner, 3.2% had ever been diagnosed with a sexually transmitted infection (STI) and 0.6% had been diagnosed with HIV. In multivariate logistic regression poorer mental health and child abuse (physical and sexual) were associated with HIV risk behaviour, and child abuse (physical and sexual) was associated with STI and HIV positive diagnoses.     

My Physical Appearance at the Center of Others’ Concerns: What are the Consequences for Women’s Metadehumanization and Emotions?

Despite the frequency of women’s exposure to sexually objectifying behaviors in their daily life (e.g., through comments on their appearance, gazing or touching), no previous work has investigated how such a focus on their physical appearance influences women’s meta-perceptions. Capitalizing on recent studies showing that sexually objectified women are dehumanized by both male and female participants, the present paper investigates women’s metadehumanization (i.e., their perceptions of being viewed as less than fully human) and its emotional consequences following interpersonal sexual objectification. In three studies, we showed that when an interaction partner focuses on their physical appearance, women report higher levels of metadehumanization, as well as increased anger and sadness, than when the partner focuses on non-physical parts. Theoretical and empirical contributions of the present findings are discussed.     

Psychological and socio-demographic variables associated with sexual risk behavior for sexually transmitted infections/HIV

New diagnoses of sexually transmitted infections (STIs) and HIV are rising in the adult population. The main objective of this study was to analyze whether knowledge of STIs/HIV, worry about STIs/HIV and pregnancy, and self-efficacy to refuse sex are predictors of sexual risk behaviors among Spanish young and adults. The study sample was composed of 1,106 young and adults of both sexes aged between 17 and 55 years. Results showed that being single, homosexual, having been tested for HIV, having previously contracted an STI, having a college education and earning a monthly income of €900 or more were the characteristics associated with higher scores in knowledge of STIs/HIV. Self-efficacy to refuse sex predicted most vaginal and anal sexual behaviors (i.e., age at vaginal and anal sex initiation and the number of couples that have remained vaginal sex). We also found that participants with greater knowledge of STIs/HIV reported older age at vaginal sex initiation and higher condom use in the first vaginal sexual contact. We consider that these findings can be useful for the development of STI/HIV prevention programs.     

Self-Labeling Sexual Harassment

This study was designed to examine personal, stimulus, and organizational factors that predict the self-labeling of sexual harassment. Hypotheses were developed based on the social cognitive schema framework, which suggests that the activation of a victim's schema of sexual harassment influences self-labeling incidents as sexual harassment. Results of a secondary analysis of the 1995 Department of Defense Gender Issues dataset generally supported the hypotheses in that self-labeling is a multi-faceted process. Several findings were in the opposite direction from that predicted (e.g., perceptions that the military was implementing sexual harassment policies were negatively associated with self-labeling). Alternative explanations for the complexity of the self-labeling process were also examined. Portions of this article were presented as a poster at the 2000 Association for Women in Psychology conference in Salt Lake City, Utah. Authorship is listed alphabetically, both authors contributed equally to this study.