Barriers to condom use in primary and nonprimary relationships among Hispanic STD clinic patients

Some programs designed to reduce the spread of AIDS and other STDs encourage consistent condom use among sexually active, at-risk individuals. A random sample of 283 Hispanic men and women seeking services at a public STD clinic in New York City were surveyed in an examination of differences in their attitudinal patterns, normative beliefs, and practices related to condom use with primary and nonprimary sex partners. 60% of the participants were male. The group was of mean age 30.9 years, with 46% having graduated from high school. 44.5% were born in the US, although 73.8% had lived in mainland US for the previous ten years or longer. 52.7% were single, 19.8% married, and the remaining 27.5% were either divorced, separated, or widowed. Only 3.2% of men and women reported having same-sex relationships, although the authors suggest that the respondents may have underreported the extent of their bisexual and homosexual behavior. 58.3% of men and 53.3% of women reported having had a prior STD, 82.2% of men and 74.8% of women had experience using a condom, and 31.3% of men and 13.3% of women reported having nonprimary partners. Both the men and women report that they are more likely to use condoms in nonprimary than primary relationships and that they perceive fewer barriers to doing so. Issues related to trust and social acceptability are more salient in primary relationships. Interventions to promote condom use among Hispanics must acknowledge the different psychosocial influences upon condom use in different relationships and target the specific attitudinal and behavioral changes desired.     

Factors Affecting HIV Contraceptive Decision-Making Among Women

We examined contraceptive decision-making among African American, Latina, and European American women ages 18–50 years. Logistic regressions examined relationships between demographic and religious factors, unintended pregnancies, sexually transmitted diseases (STDs), reasons for sex, and contraceptive decision-making. Women who were older, single, African American, used pregnancy prevention, and had histories of STDs and unintended pregnancies made contraceptive decisions alone. Older and African American women were more likely to choose no contraception. Among contraceptive users, African Americans used effective methods of pregnancy, but not disease, prevention. Women with STD histories, and younger, more educated women were more likely to use methods that prevent against both pregnancy and disease. Theoretical implications about contraceptive choices among ethnically diverse women are discussed.     

Parent-child relations in offenders who commit violent sexual crimes against children

One hundred eighty-one men were compared on parent–child relations, using the Clarke Parent–Child Relations Questionnaire. The sample included 66 heterosexual pedophiles, 29 homosexual pedophiles, 36 incest offenders and 50 controls. The offender groups were further divided into those who used force (20%) versus those who did not; into those sexually victimized as children themselves (53.2%) versus those not victimized; and into those physically abused as children (47.5%) versus those not abused. Results showed that the offender groups had more disturbances than controls in father–son relations, contrary to earlier findings showing disturbances in mother–son relations among individuals who interact sexually with minors. The offenders who used force in their offenses differed only in being more aggressive to their fathers as children, but otherwise did not differ from offenders who did not use force in their offenses. Offenders both sexually and physically abused as children showed more disturbances in father relationships than offenders who were not abused during their childhoods. Disturbed parent-child relations undoubtedly leave residual difficulties in sex offenders in later life, but in the present sample, they did not play the expected critical role in explaining the use of force by perpetrators who coerce children into sex.     

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.     

The relationship of assertiveness to college students' safer sex behaviors.

Educational programs designed to curtail the present sexually transmitted disease (STD) epidemic emphasize the role of assertiveness in reducing personal risk. This study investigated the relationship between assertiveness tendencies and safer sex behaviors in heterosexual college students. It was predicted that assertiveness would vary positively, and nonassertiveness negatively, with three types of precautionary behaviors: caution about engaging in sexual intimacy, inquiry about a potential partner's STD risk history, and frequency of condom use. A convenience sample of 253 undergraduates (159 females and 94 males) anonymously completed a sexual behavior/demographic questionnaire and the Intimate Relationships Questionnaire (IRQ), designed for this study and involving assertive, nonassertive, and aggressive responses to scenarios relevant to safer sex. The findings confirmed the hypothesized relationships between IRQ assertiveness tendencies and safer sex practices. Gender differences were discovered on the IRQ and in the health-protective behaviors of using caution and inquiring about a prospective partner's STD risk history. Implications for STD prevention strategies are discussed.     

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.     

Patient–Provider Communication About Sexual Health: The Relationship with Gender, Age, Gender-Stereotypical Beliefs, and Perceptions of Communication Inappropriateness

This investigation examined patient–provider communication about sexual health related to gender and age. Data were collected from 277 individuals, aged 18–60, via convenience and snowball sampling at a large university in southwestern United States. Results indicate women are more proactive about their sexual health than men and tested for STDs more frequently. Women, more than men, initiate discussions with their healthcare provider about sexual health matters and healthcare providers are more likely to initiate communication about such matters with women than men. Men hold stronger gender-stereotypical beliefs than women, are less likely to initiate conversations about sexual issues with their provider, and believe sexual discussions with their partner are inappropriate. Age relates to sexual activity initiation and perceived STD risk.     

Preliminary efficacy of a computer-based HIV intervention for African-American women

This study evaluated the preliminary efficacy of a computer-based HIV intervention to enhance HIV-protective sexual behaviours, based on a randomised controlled trial among 135 African-American women, 21-29 years of age, seeking services at Planned Parenthood in Atlanta, GA. Participants were randomised either to a control session two, 60-minute computer-based HIV intervention sessions administered on a laptop computer that each concluded with a 15-minute small group session or to a control session of general health information including discussion on HIV prevention. Relative to controls, participants in the computer-based HIV intervention were more knowledgeable about HIV/STD prevention and reported higher scores on the measure of condom use self-efficacy at 3 months post-intervention; they also reported a higher percentage of condom-protected sex and were more likely to use condoms consistently for vaginal sex (odds ratio, OR = 5.9; p < 0.039) and were more likely to use condoms consistently for oral sex (OR = 13.83; p < 0.037). This relatively brief intervention provides preliminary support that an evidence-based group-based HIV prevention intervention for young African-American women can be adapted to a computer-based HIV intervention.     

High risk behaviors in a sample of Mexican-American college students

This study explored different types of high risk behaviors of Mexican-American college students attending a small university in south Texas. High risk behaviors for contracting HIV/AIDS examined in this study included unprotected sex, drug use, and alcohol abuse. In 1995 in the United States, HIV/AIDS is the leading cause of death in people between the ages of 25 and 44. Because use of alcohol and certain recreational drugs lowers inhibitions, their use could increase the possibility of having unprotected and unplanned sex with multiple partners. Thus, it was expected that Mexican-American college students who use drugs and alcohol would be more likely to engage in unprotected sex. Data were from 105 men and 211 women between the ages of 18 and 30 years. Drug use and alcohol abuse were significantly associated with high risk sexual behavior. Individuals in monogamous relationships were more likely to not use condoms than those involved in casual relationships. Self-reported religiosity was not correlated with high risk behaviors, although there were implications that stronger religious affiliation did alter sexual beliefs and practices. Lastly, parental communication was not significantly associated with high risk behaviors, but family unity did seem related to some risky sexual practices.     

The Effect of Target's Physical Attractiveness and Dominance on STD-Risk Perceptions

Utilizing a 2 × 2 design, the present study examined the effect of a female's physical attractiveness and dominance on men's sexual motivation and sexually transmitted disease (STD) risk perceptions in a sample of 72 heterosexual male college students. As predicted. participants were more motivated to have sex with more physically attractive women. Nonetheless, they also believed that the more physically attractive women had been more promiscuous in the past, and believed that unprotected sex with a physically attractive woman implied a relatively somewhat higher risk of contracting an STD. In contrast, the more socially dominant women were perceived as having practiced safer sex more regularly and as having had less risky sexual partners in the past. Practical implications of this study are discussed.     

Ethnic Differences in Substance Use Patterns in a Sample of Pregnant Substance‐Using Women in Treatment

This study investigated substance use patterns among 192 pregnant substance‐using women to assess whether ethnic differences exist regarding drugs of choice, frequency and recency of use, and severity of use. Substance use patterns differed across ethnic groups. Alaska Native women were more likely to choose alcohol as their primary drug of choice and less likely to choose cocaine; White women used a wider variety of substances in their lifetime and used substances more often. Alaska Native women had an earlier age of onset of use and more blackouts. These findings suggest that prevention and intervention efforts have to be tailored to the targeted audience.     

AIDS and intimate relationships: Adolescents’ knowledge and attitudes

The knowledge level about HIV/AIDS among American adolescents aged 16 to 19 has been assessed on several occasions, showing that in recent years their knowledge base has improved. The knowledge bases of British adolescents and of adolescents younger than 16 have been largely ignored. In attempting to assess the likely impact on present or future behaviors of increasing adolescents’ knowledge base about AIDS it is important to also know something of adolescents’ attitudes to intimate relationships and to sex within those relationships. Previous studies have not linked these two aspects. In this study two hundred London schoolchildren aged 14 and 15 years completed a questionnaire tapping both their knowledge about HIV infection and its transmission and their attitudes to intimate relationships. Their answers revealed that they had absorbed the simple media messages about AIDS, that it kills and that use of a condom during sex offers protection. However they were less well informed on detailed aspects of prevention, although, worryingly, they believed that they knew all that they needed to about preventive measures. The majority had attitudes to intimate relationships that were compatible with the message of restricting their number of sexual partners; however, a significant minority did not. The latter were more likely to deny the risk associated with promiscuity. It is suggested that school-based AIDS education programs should help individuals to develop new attitudes to intimate relationships that are compatible with risk avoidance.     

Sex ratio and mate preferences: a cross‐cultural investigation

Sex ratio is the number of men per 100 reproductive‐age women within a specified mating pool. We generated and tested two hypotheses about the cross‐cultural relationships between sex ratio and mate preferences using preference ratings of 18 characteristics provided by 9809 participants and corresponding sex ratio data secured from an international organization. The Classical Sex Ratio Mate Preference Shifts Hypothesis predicts that in imbalanced sex ratio societies, the more numerous sex will lower their standards, to facilitate acquisition of a partner of the less numerous sex. The Alternative Sex Ratio Mate Preference Shifts Hypothesis predicts that in lower sex ratio societies, men will lower their standards to secure more short‐term matings, whereas women will raise their standards to avoid deception by men seeking short‐term relationships. Results supported the Classical Sex Ratio Mate Preference Shifts Hypothesis for men, and the Alternative Sex Ratio Mate Preference Shifts Hypothesis for women. Discussion addresses limitations of the current research and highlights future directions for research on the relationships between sex ratio and mating psychology and behavior. Copyright © 2006 John Wiley & Sons, Ltd.     

Loving and leaving: Sex differences in romantic attachments

We propose a two-part generalization about sex differences in entering into and giving up romantic attachments: (1) Men tend to fall in love more readily than women; (2) women tend to fall out of love more readily than men. Evidence in support of these generalizations is derived from a longitudinal study of 231 college student dating couples. The data suggest that women are more cautious than men about entering into romantic relationships, more likely to compare these relationships to alternatives, more likely to end a relationship that seems ill fated, and better able to cope with rejection. We consider several possible explanations of these sex differences from the standpoints of psychoanalytic theory, the social and economic context of mate selection, and the socialization of men and women in the management of their own emotions. To evaluate these (and any other) explanations, further research might profitably investigate whether and to what degree these sex differences are found in other segments of the population.This research was supported by National Science Foundation grant GS-27422 to Zick Rubin. The authors are grateful to Claire Engers, Sherry Ward, and Susan Willard for their contribution to this research and to Jessie Bernard, Nancy Chodorow, George W. Goethals, Paul Rosenblatt, Ann Swidler, and Shelley Taylor for their helpful comments.     

The Influence of Religion on Victims of Childhood Sexual Abuse

Survey responses of 5,417 women were studied to obtain information about childhood sexual abuse, religion, and mental health. There were 653 (13%) who reported being sexually abused while growing up. When studying those who were sexually abused, it was found that this childhood experience was associated with less emotional maturity, lower self-esteem, more instability in their relationships with partners, and higher levels of depression. The highest scores on the mental health indicators were found for women who were not abused and highly religious, then highly religious and abused, and the lower scores for no abuse and low religiosity, low religiosity and abuse, and medium religiosity and abuse. These findings were interpreted as demon- strating that religion could help ameliorate negative mental health outcomes associ- ated with childhood sexual abuse.     

Correlates of premarital relationships among unmarried youth in Pune district, Maharashtra, India

CONTEXT: Although premarital partnerships-whether or not they involve sex-are widely discouraged in India, some youth do form such partnerships. It is important to know more about the nature of and the factors associated with these relationships. METHODS: Data are drawn from a community-based study of 15-24-year-olds in urban slum and rural settings in Pune District, Maharashtra. Multivariate analyses were conducted to identify associations between youths' individual, peer and family factors and their experience of romantic relationships and physical intimacy, including intercourse. RESULTS: Among young men, 17-24% had had a romantic relationship, 20-26% had engaged in some form of physical intimacy and 16-18% had had sex; the proportions among young women were 5-8%, 4-6% and 1-2%, respectively. Exposure to alcohol, drugs or pornographic films and having more frequent interaction with peers were positively associated with romantic and sexual relationships for both young women and young men. Educational attainment was negatively associated with both types of relationships for young women, but only with sexual relationships for young men. Closeness to parents was negatively associated with relationships only for young women. Young women whose father beat their mother were more likely than other young women to form romantic partnerships, and those beaten by their family had an elevated risk of entering romantic and sexual partnerships. Youth who reported strict parental supervision were no less likely than others to enter relationships. CONCLUSIONS: Program interventions should ensure that youth are fully informed and equipped to make safe choices and negotiate wanted outcomes, while positively influencing their peer networks; encourage closer interaction between parents and children; and be tailored to the different circumstances and experiences of young women and men.     

Improving Predictions of Condom Behavioral Intentions With Partner-Specific Measures of Risk Perception

Inconsistent findings regarding the predictive validity of perceptions of risk for a sexually transmitted disease (STD) and HIV may be related to the use of nonspecific measures. The objective of this study was to determine whether more specific measures of perceptions of risk for SI Ds and HIV are associated with intentions to use a condom. We interviewed 490 male and female adolescents, 14 to 19 years old, from a free municipal STD clinic. Controlling for whether a condom was used at last sex, the association between perceptions of risk for an STD and HIV with a casual sex partner and intentions to use a condom with a casual sex partner was significant (β_HIV= 14, p < .01, and β_STD=.20, p < .01), as was the association between perceptions of risk for an STD and HIV with a main sex partner and intentions to use a condom with a main sex partner (β_HIV= .31, p <.001, and β_STD= .32, p < .001). This supports the continued inclusion of this construct in models of sexual and other health-related behaviors.