Young and Sexual in Norway and Croatia: Revisiting the Scandinavian Versus Mediterranean Gendered Pattern of Sexual Initiation

ABSTRACT

This article describes and analyzes patterns of first sexual intercourse and contraception use from a bicultural perspective. Study results are based on a 2009–2010 large-scale national probability survey of young adults aged 18 to 24 years in Croatia (n = 1,005) and Norway (n = 871). The findings corroborated the persistence of the dual model of sexual initiation in Europe (Scandinavian vs. Mediterranean), in which Norwegian women and Croatian men reported coital debut at an earlier age than their gender counterparts. Age difference between partners and the prevalence of condom use at first coitus were similar in both countries, with differences in contraceptive choices emerging with time. Young Norwegian men and women switched from using condoms to hormonal contraception when having been coitally active for some time. Interestingly, “the pill” remains rather unpopular among young Croatian women. Controlling for selected variables, using a condom at most recent sexual intercourse was significantly associated with condom use at first intercourse in all groups except Norwegian men, as well as with years of coital activity (except among Croatian men). Additionally, the odds of a condom being used at most recent intercourse were significantly correlated with same-sex sexual experience (only among Norwegian men) and with reporting the most recent intercourse with a casual partner (only among Norwegian participants). Country-specific patterns of contraceptive use are discussed in the context of public health and prevention.     

Barrier versus oral contraceptive use: a study of female college students

Although they provide birth control and are easier to use, oral contraceptives (OCPs) are not the preferred approach to preventing sexually transmitted disease (STD). Do the knowledge, attitudes, and experiences of oral contraceptive users place them at greater risk for STDs than those who employ barrier methods? This study examined differences between sexually active female college students (ie, those who reported ever having had vaginal intercourse) who used OCPs and those who employed barrier methods of contraception at the time of their most recent intercourse. The authors analyzed HIV- and other STD-related knowledge, attitudes, and behaviors from three consecutive annual health surveys of young women about to begin their first year of college. Findings showed barrier and OCP users to be comparable in knowledge about the effectiveness of various contraceptive methods in protecting them against STDs, perceived personal susceptibility to HIV, and experiences with alcohol before sexual intercourse. Oral contraceptive users, compared with those in the group who used barrier methods, reported a greater number of recent partners (p less than .03) and greater perceived vulnerability to STDs (p less than .03). Student healthcare providers must develop creative educational strategies to encourage simultaneous use of both oral contraceptives and barrier methods to protect students against STDs and pregnancy.     

Intrapersonal and Interpersonal Sexual Behaviors of Chinese University Students: Gender Differences in Prevalence and Correlates

The main aim of the present study was to investigate gender differences among university students in contemporary China regarding (1) the prevalence of various types of intrapersonal and interpersonal sexual behaviors and (2) their sociodemographic and psychosocial predictors. A total of 1,397 university students (M_age = 20.3 years) completed related questionnaires. Intrapersonal behaviors (i.e., sexual fantasizing, solitary masturbation, and viewing pornography) were generally reported more frequently than interpersonal behaviors (i.e., petting, oral sex, and intercourse). Gender differences were most evident for intrapersonal sexual behaviors, all of which were reported more frequently by men. Men reported significantly more heterosexual intercourse than women but not petting or oral sex. Several correlates (i.e., age, educational aspiration, family income, urbanity, relationship experience, and Internet use) were significant predictors of various intrapersonal and interpersonal sexual behaviors. Gender significantly moderated these correlations in three cases: Family income was a stronger negative predictor of intercourse for women, romantic relationship history was a stronger positive predictor of intercourse for men, and Internet use was a stronger positive predictor of sexual fantasizing for men. We discuss the implications of these findings for sexuality education and sexual health policies and practices in contemporary China.     

Situational and relational factors associated with coitus during vaginal bleeding among adolescent women

Menstruation is a normal, developmental event anchored in contradictory value systems. Although it demarcates a transition to womanhood, it is often associated with negative sentiments such as shame, camouflage and discomfort. Certain behavioral expectations, including avoiding sexual intercourse, also accompany menstruation. Research has generally suggested that sex does decrease during menstruation. However, not all sexual activity is suppressed during menses; both individual and relationship factors provide influence. Accordingly, this study investigated situational and relational factors associated with the day-to-day likelihood of sex and vaginal bleeding among 387 (aged 14-17 at enrollment) adolescent women. Generalized estimating equation logistic regression, in SUDAAN 9.0, was used; predictors of coitus and bleeding included recent sexual activity, past coitus/bleeding, marijuana use before intercourse and higher partner support, higher sexual interest and lower feelings of being in love. The findings highlight appropriate areas of focus for information, education and STI prevention counseling.     

Weight-related issues and high-risk sexual behaviors among college students

Individuals with high body mass index (BMI), negative body image, and unhealthy weight control behaviors may be more likely to engage in high-risk sexual behaviors than others. Researchers have not fully investigated these relationships in a sample of college students. The authors collected data regarding several weight-related issues and high-risk sexual behaviors (response rate = 39%) from 1,168 college students. Over half reported at least 1 high-risk sexual behavior. After the authors controlled for several demographic characteristics, they found that higher BMIs were associated with increased odds of having a casual sexual partner (odds ratio [OR] = 2.70) and being intoxicated at last intercourse (OR = 2.25). Among women, unhealthy weight control behaviors were associated with having a casual partner (OR = 2.12), using no or unreliable contraception (OR = 1.98), and being intoxicated at last intercourse (OR = 2.31). Weight-related issues were not associated with sexual behaviors among college men. The authors describe their findings within two health behavior frameworks, and they discuss implications for research and health education.     

Date fighting experiences among college students: are they associated with other health-risk behaviors?

OBJECTIVE: The authors examined the clustering of health-risk behaviors among college students who reported date fight involvement. PARTICIPANTS AND METHODS: The authors administered a Web-based survey to a stratified random sample of 3,920 college students from 10 universities in North Carolina. RESULTS: Among men, 5.6% reported date fight victimization, and 1% reported date fight perpetration. Victimization among men was associated with (1) first drink at age 15 years or younger, (2) a recent threat of violence by someone who had been drinking, (3) smoking, (4) amphetamine use, and (5) older age. Among women, 6.7% reported date fight victimization, which was associated with (1) older age, (2) assault from a student who had been drinking, (3) sex with 2 or more persons, (4) consumption of alcohol in high school, (5) illegal drug use, (6) nonsexual assault requiring medical treatment, and (7) living off campus. Of the women, 4.2% reported date fight perpetration, which was associated with (1) minority race/ethnicity, (2) older age, (3) frequency of sexual intercourse, and (4) alcohol and marijuana use. CONCLUSIONS: Date fight experiences were associated with multiple health-risk behaviors among this sample of college students.     

Situational and Relational Factors Associated With Coitus During Vaginal Bleeding Among Adolescent Women

Menstruation is a normal, developmental event anchored in contradictory value systems. Although it demarcates a transition to womanhood, it is often associated with negative sentiments such as shame, camouflage, and discomfort. Certain behavioral expectations, including avoiding sexual intercourse, also accompany menstruation. Research generally has suggested that sex does decrease during menstruation. However, not all sexual activity is suppressed during menses; both individual and relationship factors provide influence. Accordingly, this study investigated situational and relational factors associated with the day-to-day likelihood of sex and vaginal bleeding among 387 (aged 14–17 at enrollment) adolescent women. Generalized estimating equation logistic regression, in SUDAAN 9.0, was used. Predictors of coitus and bleeding included recent sexual activity; past coitus/bleeding; marijuana use before intercourse; and higher partner support, higher sexual interest, and lower feelings of being in love. The findings highlight appropriate areas of focus for information, education, and sexually transmitted infection (STI) prevention counseling.     

Is “Sexual Competence” at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status?

The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on “early” first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010–2012, this study examined whether a context-based measure of first intercourse—termed sexual competence—was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as “sexually competent” at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were “equally willing,” and that it happened at the “right time.” A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.     

Coitus‐dependent contraceptives: Factors associated with effective use

The factors associated with adequate contraceptive use among university women relying on coitus‐dependent contraceptives were examined. Sixty‐nine sexually active women between the ages of 18 and 34 completed daily logs of their sexual activity, contraceptive behavior and basal body temperature over three menstrual cycles. Contraceptive use was analyzed by menstrual cycle phase and results indicated that frequency of use was significantly higher during the ovulatory phase as compared to the menstrual period. Additional findings using discriminant function analysis indicated that compared to risk takers, non‐risk takers were more likely to initiate sexual intercourse, have more orgasms, have a non‐Catholic background, be living with their partners and have been in their relationships longer. These data suggest that women in less stable relationships and with more sexual inhibitions may be more at risk of an unwanted pregnancy.     

Willingness to have unprotected sex

Little is known about people's willingness to engage in sex without protection from unwanted pregnancy. This study surveyed 1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would "sometimes" or "maybe" engage in unprotected sex. In multivariate models, compared to non-Latino White respondents, Latinos who responded to the survey in English were 52% more likely and African Americans were 75% more likely to report willingness to have unprotected intercourse. Wanting a child within the next three years was associated with increased willingness to have unprotected sex. Age, gender, parity, and relationship status were not significant in multivariate models. A considerable proportion of women and men may be willing to have unprotected sex, even with access to subsidized contraceptive services and even when recently counseled about birth control. The dominant behavioral models of contraceptive use need to acknowledge the widespread likelihood of occasional unprotected sex, even among people motivated to usually use contraceptives. Findings underscore the need to make contraceptive methods accessible, easy to use, and even pleasurable.     

Sexual perceptions and practices of young people in Northern Thailand

This study draws together survey and qualitative data on sexual practices among more than 1,750 young Northern Thai people aged 17-20 years. The survey data indicate that sexually active young people frequently engage in, or are subjected to, risk-taking behaviours that may expose them to sexually transmitted infections and unwanted pregnancies. These include having multiple sexual partners and quite frequent partner turnover. High percentages also engage in unprotected sexual intercourse with various types of sexual partner (steady, casual and paid), and young women especially had often experienced sexual coercion. Qualitative data revealed a mixture of perceptions and practices affecting sexual intercourse among the young, such as having unplanned sex, engaging in sexual relations to display love or cement committed relationships, and having serial relationships, both monogamous and non-monogamous. We conclude that condom use should be a central focus of activities aimed at preventing adverse sexual health outcomes, but that new intervention approaches to encourage use of other contraceptives are also needed. Changes in sexual norms among young people also need to be acknowledged and accepted by older Thai generations in order for programs and interventions to combat negative sexual and reproductive health consequences to be more effective.     

Gender attitudes,sexual violence,and HIV/AIDS risks among men and women in Cape Town,South Africa

This study examined gender attitudes and sexual violence‐supportive beliefs (rape myths) in a sample of South African men and women at risk for HIV transmission. Over 40% of women and 16% of men had been sexually assaulted, and more than one in five men openly admitted to having perpetrated sexual assault. Traditional attitudes toward women's social and gender roles, as well as rape myths, were endorsed by a significant minority of both men and women. Multivariate analyses showed that for men, sexual assault history and rape myth acceptance, along with alcohol and other drug use history, were significantly related to cumulative risks for HIV infection. In contrast, although we found that women were at substantial risk for sexually transmitted infection (STI), including HIV, women's risks were only related to lower levels of education and alcohol use history. We speculate that women's risks for STI/HIV are the product of partner characteristics and male‐dominated relationships, suggesting the critical importance of intervening with men to reduce women's risks for sexual assault and STI/HIV.     

Predictor Factors Associated with Premarital Sexual Behaviors Among University Students in an Islamic Culture

ABSTRACT

We examined premarital sexual behaviors among Turkish university students and the predictor factors for these behaviors. The study included 638 eligible students (256 women and 382 men). Masturbation was reported by 53.3% of the participants, and sexual intercourse experience was reported by 26.3%. Men, heterosexual orientation, and non-religious/liberal religiosity were predictor factors for masturbation and premarital sexual intercourse/foreplay experience. Men having more sexual experiences than women may indicate gender double standards, while heterosexual orientation as a predictor of sexual behaviors could relate to homophobia, still prominent in Turkey. These findings highlight Islam's restrictive attitude towards sexuality despite continued Western influences.     

Determinants Influencing Male Condom use Among University Students in Portugal

ABSTRACT. A self-administered questionnaire was carried out among university students in Portugal, with the aim to examine determinants influencing male condom use, according to the information–motivation–behavioral skills model (J. Fisher & Fisher, 1992). Students’ levels of information, motivation, and behavioral skills regarding preventive sexual behavior (male condom use) were ascertained and were used to determine their association with condom use among 880 male and 1,807 female students aged 18 to 35 years old. Although 86.9% of respondents indicated that they used a condom during their first sexual intercourse, only 32.8% used a condom always during sexual intercourse in the last 12 months. Most young people, especially women, had a good level of information regarding HIV/AIDS transmission/prevention. They also showed reasonable positive attitudes and had positive subjective norms and intentions toward HIV/AIDS preventive behaviors. Men presented a higher perceived difficulty and a lower perceived effectiveness of HIV/AIDS preventive behavior, therefore reporting higher risk acceptance. A path analysis revealed that preventive sexual behavior did not depend directly on information level but on motivation and behavioral skills (especially among men). Information about HIV prevention/transmission was not significantly associated with condom use. The finding that motivation and behavioral skills were the strongest determinants of condom use suggested that these may be important factors in effective sexually transmitted infection-prevention programs.     

Heterosexual Anal Intercourse among Men in Long Beach,California

Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.     

The State of the Union: Sexual Health Disparities in a National Sample of US College Students

Abstract

Objective: To examine sexual health disparities between blacks and whites in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18–24; M = 20.1) responding to the Spring 2007 American College Health Association–National College Health Assessment; 64% were female and 94.7% were white. Results: Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. Conclusions: This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.     

College Student Behavior: A Ten-Year Look

Abstract

Lester and Perez¹ have suggested that student behavior can be usefully construed in terms of a traditional-hedonic, implicit value system. They demonstrated that drug use and sexual activity provide simple behavioral anchors for this dimension, and observed an increasingly hedonic orientation among students. Ten years after their initial study, the student population at the same institution was again sampled using an anonymous questionnaire. The 1980 sample included 208 subjects, and these were compared with 688 subjects who responded to the 1970 survey. This comparison was supplemented by an intensive week-long study of 53 students within one campus living unit.

Significant increases in pre-college sexual activity were noted for both men and women. Marijuana use in high school also increased for both men and women during this period, while alcohol use increased only among women. Previously observed differences between male and female pre-college sexual activity and marijuana use had largely disappeared by 1980. Significant increases in sexual activity while in college were found for women but not for men. For men, overall marijuana and alcohol use in college did not change during the study period, but there was an increase in the frequent use of these drugs. Increases in all categories of marijuana use were noted among women, along with overall increases in their alcohol use. The significant differences between male and female marijuana use noted in the 1970 study were absent in 1980. The intensive week-long study revealed that alcohol use was part of the daily lives of one-third to two-thirds of the students sampled, although they reported interpersonal conflicts, absences from class, accidents, and injuries among the consequences of their drinking. A significant inverse relationship between sleep and alcohol use was observed among women, but not among men.

These data suggest that student behavior has become increasingly hedonic during the past ten years, with women in particular closing the gap which previously differentiated their behavior from that of their male peers. Institutions of higher learning must take these changes into account in the planning of academic programs, residential life, and health services.     

Comment

In several anonymous questionnaire studies of college students, marijuana use has been reported to affect sexual behavior. In general, these studies show that marijuana smoking enhances sexual pleasure and increases sexual desire. Marijuana use has also been associated with more frequent sexual activity and an increased number of sexual partners. The purpose of this study was to determine the perceived effects of marijuana use on the sexual behavior and sexual practices of a sample of regular marijuana .users. In contrast to other studies, subjects were not drawn exclusively from college student populations and were interviewed rather than given a questionnaire. Results, in general, confirm results of previous studies. Subjects were primarily heterosexual and sexually active. Men were more likely than women to have had multiple sexual partners. Over two thirds reported increased sexual pleasure and satisfaction with marijuana. Increased desire for a familiar sexual partner was reported by about one half. The sensations of touch and taste were particularly enhanced by marijuana. Many felt marijuana was an aphrodisiac. Marijuana use in relation to initiation of sexual activity was also assessed. Although drug use occurred prior to first intercourse for about one third of the men and women, alcohol, not marijuana, was most frequently used in this context. Most had used marijuana as a preparation for intercourse on occasion, and 20% did this on a regular basis. Possible explanations for these effects are briefly discussed.