The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents

Adolescents, particularly African American adolescents, are at high risk for sexually transmitted infections (STIs). The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages 15 and 21. Binary generalized estimating equation models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over six- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over six-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over six- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior.     

Gender Relations and HIV Transmission in North-Central Nigeria

Nigeria’s most recent National HIV/AIDS and Reproductive Health Survey of 2012 shows a decline in the national prevalence rate from 3.6% in 2007 to 3.0% in 2012. Despite this moderate decrease, the rate for the North-central geopolitical zone: (5.7 and 3.4%, respectively) remained higher than the national average for both years. Besides, virtually all of the HIV and AIDS surveys conducted in Nigeria from 1999 till date have consistently shown higher rates among females than males. For instance, it was 4.0 and 3.5% among females; and 3.5 and 3.3% in males in 2007 and 2012 respectively. UNAIDS reported that studies on the mode of transmission in 2008 found the bulk of new infections among cohabiting and married sexual partners who are not engaged in high risk sex (42.2%) compared to casual heterosexual sex (9.1%) and sex workers (3.4%). Higher vulnerability among married females implies higher risk of parent to child transmission, yet married women are perceived as a “low risk” group. Against this backdrop, I studied some gender related socio-cultural factors that influence HIV transmission among married women in two ethnic groups in North-central Nigeria. Results of the qualitative study conducted through 24 in-depth interviews and 36 focus group discussions in six communities indicate that marital consent; women’s poor access to safe sex; double standards in marital sexual practices; gender based violence against women; among others influence the spread of HIV infection in married heterosexual couples. In conclusion, marriage does not necessarily reduce HIV vulnerability in women.     

Low Prospects and High Risk: Structural Determinants of Health Associated with Sexual Risk Among Young African American Women Residing in Resource-Poor Communities in the South

African American women at increased risk of HIV/sexually transmitted infection (STI) may engage in risky sex as a coping mechanism for depressed economic conditions. This study examines the association between high-risk sexual behavior and structural determinants of sexual health among a sample of young African American women. 237 young African American women (16–19 years old) from economically disadvantaged neighborhoods in North Carolina were enrolled into a randomized trial testing the efficacy of an adapted HIV/STI prevention intervention. Logistic regression analyses predicted the likelihood that young women reporting lack of food at home, homelessness and low future prospects would also report sexual risk behaviors. Young women reporting a lack of food at home (22 %), homelessness (27 %), and low perceived education/employment prospects (19 %) had between 2.2 and 4.7 times the odds as those not reporting these risk factors of reporting multiple sex partners, risky sex partners including older men and partners involved in gangs, substance use prior to sex, and exchange sex. Self-reported structural determinants of sexual health were associated with myriad sexual risk behaviors. Diminished economic conditions among these young women may lead to sexual risk due to hopelessness, the need for survival or other factors.     

Predictors of Risky and Precautionary Sexual Behaviors Among Single and Married White Women1

Risky and precautionary sexual behaviors were examined in a community sample of 260 single and married/cohabitating White women. Structural equation modeling was used to assess the ability of age, socioeconomic status (SES), marital status, religiosity, and 9 health belief constructs to predict risky sexual behavior with one's partner, using a barrier method of birth control, unintended pregnancies, and number of sexual partners in the past year. The pattern of results suggests that single White women appear to feel more vulnerable to HIV and STD infection and more likely to engage in risky sexual behavior than do married White women. The discussion focuses on the importance of sociocultural factors in understanding risk behaviors within the social context of relationship status, the complexity of the concept of risk reduction, and the need for going beyond the health belief model in order to develop different HIV prevention strategies for single and married White women.     

Parallel sexual relationships in the Norwegian context

The purpose of the paper is to describe and analyse the prevalence of parallel sexual relationships among adult Norwegians in terms of social background variables, possibility factors and motivational factors. Data stem from two cross-sectional, postal questionnaire surveys in 1987 and 1992 on two separate representative samples of 10,000 Norwegians aged between 18 and 60. The results showed that 16% of the respondents reported one or more parallel sexual relationships. The prevalence of parallel sexual relationships increased with possibility factors, such as the number of travelling days and population density. Among motivational factors, parallel sexual relationships increased with the number of years married/cohabiting, except for those married the longest. It decreased with increasing age of first intercourse, and increased with the number of partners before the last partnership. Of those not satisfied with coital frequency with their permanent partner, 22% had parallel sexual relationship experience compared to 12% among those who were satisfied. Furthermore, more men than women reported parallel sexual relationships; respondents with higher levels of education more often reported parallel sexual activity than those with lower level of education; and subjects born between 1937 and 1956 reported more parallel sexual activity than the other cohorts. When controlled for the number of years married/cohabiting, the predicted trend suggests that for the cohorts born up to 1970, men and women with lower and higher levels of education have become more similar as regards parallel sexual behaviour. © 1998 John Wiley & Sons, Ltd.     

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.     

The Relationships among Childhood Maltreatment,Emotion Regulation,and Sexual Risk Taking in Men from Urban STD Clinics

This study sought to examine the relationships among emotion regulation difficulties, childhood maltreatment, and risky sexual behavior in a sample of 320 heterosexual men recruited from urban sexually transmitted disease clinics. Overall childhood maltreatment and several specific types of child abuse were significantly associated with emotion dysregulation, number of sexual partners, and sexually transmitted infection (STI) diagnosis. There was evidence of an additive effect of multiple forms of maltreatment on difficulties with emotion regulation and sexual risk taking. Impulse control difficulties and access to emotion regulation strategies, two components of emotion dysregulation, were related to measures of risky sexual behavior. Furthermore, limited access to emotion regulation strategies mediated the relationship between frequency of childhood sexual abuse and a greater number of lifetime sexual partners. This study has important implications for developing effective interventions to reduce the spread of STIs and HIV by expanding affect regulation and distress tolerance strategies among men who have experienced childhood maltreatment.     

Body image and risky sexual behaviors: an investigation in a tri-ethnic sample

The impact of negative body image on risky sexual behaviors has not been extensively investigated. The present study examined the relationship between two aspects of body image, appearance shame and appearance investment, and potentially risky behaviors. The study employed a tri-ethnic sample of 1547 women seeking services at two family planning clinics. Logistic regression was utilized to examine the relationship between potential risk behaviors and shame and investment. Results supported that these aspects of body image were significant predictors of inconsistent condom use, having multiple sex partners in the past year, and having sex after drinking alcohol or using drugs, and that demographic variables (e.g., age, marital status, ethnicity) could not fully account for these relationships. The importance of future research investigating the relationships among body image, perceived relationship security, affect-management strategies, and risky sexual behaviors is emphasized.     

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.     

Self-Assessed Risk of HIV and Other STIs Among Young Adults in Norway and Croatia

The purpose of the present study is to explore how sexually active young Norwegian and Croatian adults assess the risk of being infected with HIV and other STIs. Study results are based on a 2009–2010 large-scale national probability survey of young adults aged 18–24 in Croatia (n = 1,005) and Norway (n = 871). A majority of sexually active young adults in Croatia and Norway assessed the risk of becoming infected with HIV or other STIs as low or negligible. Among non-condom users, 85–98% determined they had low or no risk of getting infected with HIV. The corresponding figures for STIs were 77–79%. In both countries a higher HIV risk self-assessment was observed among those who had had same-sex sexual experience, those who reported a higher number of sex partners during the past year, and those who were single. When investigating the patterns of HIV/STI risk assessment, gender and country-related differences appeared. Condom use associated with higher risk assessment was significant only among Croatian men. The strong perception of condom use as being a male responsibility in Croatia may be the reason for a higher risk assessment for unwanted pregnancy and HIV/STIs when protection fails. The risk assessment for HIV/STIs was not associated with partner turnover in Croatian men. New campaigns need to develop gender-sensitive messages, particularly targeting men who believe that a great number of sexual partners is a sign of manliness and women who shy away from their responsibility to use protection.     

Sexual sensation-seeking and worry about sexually transmitted diseases (STD) and human immunodeficiency virus (HIV) infection among Spanish adolescents

The target of this study is to assess the relationship between sexual sensation-seeking, worry about STD/HIV infection, and risky sexual behaviours among 182 adolescents aged 13-18 years. Results showed that participants who engaged in a wider range of potentially risky behaviours (e.g., sexual experience, higher number of sexual partners in last six months, and the last sexual contact with a casual partner) obtained higher sensation-seeking scores. It was also found that adolescents who engaged in sex with a casual partner in their last sexual contact reported being worried about STD/HIV infection, but adolescents having sex with a steady partner underestimated their risk of STD/HIV infection. These results support the idea that preventive programmes may benefit from including components aimed at teaching adolescents to satisfy their preferences for sexual sensation-seeking through novel and stimulating sexual behaviours involving minimum risk. Similarly, the need to include components aimed at making adolescents become realistically aware of the STD/HIV risk involved in unprotected intercourse with steady love partners is highlighted.     

Predictors of multiple concurrent and multiple sexual partnerships among male and female youth aged 18–24 in South Africa

This study aimed to determine predictors of multiple concurrent and multiple sexual partnerships among South African male and female youth. Data were from a cross-sectional population-based household survey of 3 123 youths aged 18 to 24 years from four South African provinces (males = 53.6%, blacks = 97.8%). Results from a sub-sample of being sexually active in the past 12 months (n = 1787) indicate that 5.3% (7.1% in males and 3.1% in females) youth participants had multiple concurrent sexual partners, and 38.8% (50.1% in males and 25.8% in females) had had two or more sexual partners in the past 12 months. Among females, multiple concurrent partnerships were only predicted by lower social network resources. Predictors of multiple sexual partnerships (two or more sexual partners in the past 12 months) among males included high HIV risk perception, never been tested for HIV and hazardous or harmful alcohol use. By contrast, among females, high peer pressure, lower education and ever having taken drugs predicted involvement with multiple sexual partners. Multi-level health promotion interventions are indicated for sexual behaviour change among South African youth.     

Exploring risk and protective mechanisms associated with HIV infection among adolescents in South Africa

This study explored South African adolescents’ perceived risk and protection for HIV infection. Adolescents (N=28) with a mean age of 14.6 years receiving mental health care participated in Focus Group Discussions (FGDs) to engage in an in-depth exploration of their perceived risk and protective mechanisms for HIV prevention. The data were analysed using thematic content analysis. Themes that emerged from the FGDs associated with risk for HIV infection were: Alcohol and illicit drug use; Non-condom use; Prostitution and risky sexual activity with multiple partners; and Non-disclosure of HIV status. Themes that emerged as protective mechanisms included: HIV knowledge and appropriate HIV risk reducing behaviour; and Proactive parental attitudes and behaviour. These findings highlight the importance of ascertaining the perceptions of adolescents about risk and protection from HIV infection in order to inform future programs for HIV prevention among adolescents.     

Relationship Characteristics and Risk of HIV Infection: Rusbult's Investment Model and Sexual Risk Behavior of Gay Men in Steady Relationships1

This study examined the effects of relationship characteristics, as measured by Rusbult's (1980) investment model, on safer‐sex behavior between steady gay male partners. Analyses showed that low satisfaction with the relationship was associated with more risky unprotected anal intercourse (UAI). High commitment to the relationship was associated with more practice of negotiated safety (i.e., having safe UAI after both partners have tested negative for HIV and have reached sexual safety agreements). High relationship investment was associated with more risky UAI (borderline significant). We conclude that using relationship satisfaction, commitment, and investment as co‐determinants of sexual risk behavior could prove useful in the development of new HIV‐prevention strategies for gay men in relationships.     

Using Sex-Related Alcohol Expectancies to Predict Condom Use Among a General Sample of Men and Women in the United States

Sex-related alcohol expectancies (SRAE) are known to moderate the relationship between alcohol use and risky sexual behavior in high risk populations; however, SRAEs have not been thoroughly explored in populations traditionally viewed at lower risk for HIV and/or STI. Participants (n = 649) were recruited through internet-based direct marketing in the United States. Predictors of SRAE vary by gender. Controlling for alcohol use and other predictors, age predicted condom use among women, and SRAE was correlated with condom use for men. Sexual health programming geared towards non-traditionally identified high-risk populations is necessary and provides unique opportunities to increase condom usage.     

Assessing the health of a dyadic relationship in heterosexual and same‐sex partners

The purpose of this study was to assess characteristics of a measure of monitoring the health of a dyadic relationship based on data from self‐report surveys completed by both partners from dating heterosexual, married heterosexual, cohabiting gay male, and cohabiting lesbian couples from the United States (Ns = 127, 46, 81, and 224, respectively). Covariation among the measure’s 7 items conformed to 1 latent factor. Intraclass correlations between partners from the same couple were positive. Gender effects occurred only for married couples, with wives having higher scores than husbands. One’s own and one’s partner’s monitoring accounted for unique variance in one’s own commitment, even with controls for other variables. Monitoring buffered the negative effects of neuroticism on commitment.     

Predictors of Risky Sexual Behavior among High School Students in the United States

ABSTRACT

Risky sexual behavior among teenagers in the United States is a noted public health concern. The purpose of this study is to examine the correlates and theoretical predictors of risky sexual behavior among American teens. Data from the Youth Risk Behavioral Survey was utilized with concepts from Routine Activities Theory guiding analyzes. Bivariate regression results indicated that components of Routine Activities Theory are moderate to strong predictors of using substances before sexual activity and having multiple sexual partners.     

Gender Roles,Power Strategies,and Precautionary Sexual Self-Efficacy: Implications for Black and Latina Women's HIV/AIDS Protective Behaviors

This cross-sectional study tested a conceptual model of women's HIV/AIDS protective behaviors using gender roles, relationship power strategies, and precautionary sexual self-efficacy as predictors in a predominantly Black and Latina community sample of heterosexual women (N = 125). Results revealed no support for the full model, but partial confirmation for several components of the model. Education significantly predicted gender roles, and gender roles and use of direct power strategies were significant predictors of sexual self-efficacy. Most of the participants were married or partnered and were unconcerned about contracting HIV, suggesting that if women perceive that they are at low or no risk, their gender roles, power strategies, and precautionary sexual self-efficacy will be inconsequential to their HIV/AIDS risk reduction practices.     

The role of sexual arousal and sexual partner characteristics in HIV+ MSM's intentions to engage in unprotected sexual intercourse

OBJECTIVE: This study investigated the effects of sexual arousal and sexual partner characteristics as determinants of HIV+ men who have sex with men's (MSM) intentions to engage in unprotected sex. DESIGN: In a computer-based controlled experiment, 67 HIV+ MSM underwent a sexual arousal manipulation and indicated their intentions to engage in unprotected sex with hypothetical partners who differed in terms of HIV serostatus, physical attractiveness, relationship type, and preference for condom use. MAIN OUTCOME MEASURES: Computer-delivered questions assessed HIV+ MSM's intentions to engage in various sexual acts with each hypothetical partner. RESULTS: As predicted, sexually aroused HIV+ MSM indicated stronger intentions to engage in unprotected sex than nonaroused HIV+ MSM; and having a partner who was attractive, HIV+, long term, or who preferred not to use condoms, also led to riskier intentions. Several significant interactions among these factors were found, which were generally consistent with predictions and with theory and research on cognitive processing and decision making. CONCLUSIONS: These findings have implications for understanding risky sexual behavior among HIV+ individuals and for the development of interventions to reduce this risk.     

Risky sexual behavior among married alcoholic men.

The current study explored whether the wives of men entering alcoholism treatment are at risk for sexually transmitted infections (STIs) exposure as a result of their husbands' sexual risk behaviors. The extramarital relationships of married alcoholic men entering outpatient treatment (n = 125) were compared with those of a demographically matched community sample of nonalcoholic married men (n = 125). The proportion of alcoholic men who reported 1 or more extramarital affairs in the previous year (14%) was significantly higher than that of the community sample (4%). Additionally, only 2 alcoholic husbands and 1 nonalcoholic husband reported that his wife was aware of the extramarital relationship. For both groups, none of the men who engaged in extramarital relationships reported consistent use of condoms when having sexual intercourse with their wives or with their extramarital partners. These results suggest that wives of alcoholic men are unknowingly placed at risk for indirect exposure to STIs as a result of their husbands' sexual risk behaviors. Thus, infidelity in treatment-seeking alcohol-abusing men represents a significant public health issue.