Oral Cancer Risk Behaviors Among Indiana College Students: A Formative Research Study

Objectives: In fall 2004, the authors used a survey to assess the knowledge, attitudes, motivations, and behaviors of college students relative to oral cancer prevention to inform development of targeted prevention programming. Participants: A convenience sample of 1,003 undergraduate students at one public university in Indiana participated. Methods: Discriminant function analysis was employed to analyze participants' motivations; perceived risks; individuals who influence participants' alcohol, tobacco, and marijuana use; and factors that facilitate and discourage use. The study sample was divided into users and nonusers to differentiate between groups and predictor (discriminating) variables. Multiple regression analysis was used to determine the extent to which participants' knowledge, attitudes, peer perceptions, sex, age, and ethnicity contributed to participants' combined alcohol, tobacco, and marijuana use behaviors. Results: With 2 exceptions, discriminant function analysis (p < .01) correctly categorized user status (ie, nonusers vs combined users of alcohol and cigarettes; nonusers vs combined users of alcohol, cigarettes, and marijuana) by the predictor variables. Multiple regression analysis to determine whether independent variables predicted combined drug use generated significant (p < .01) results across all combined use behaviors. Conclusions: Multiple oral cancer prevention program options along with additional formative research efforts were suggested by study results.     

Club Drug Use,Sexual Behavior,and HIV Risk Among Community and Internet Samples of Hispanic MSM: Implications for Clinicians

ABSTRACT

Hispanic men who have sex with men (MSM) are at high risk of HIV infection. This study reports on the club drug use and sexual behaviors of two distinct samples (community and Internet) of Hispanic MSM living in the AIDS epicenter of Miami-Dade County. Both samples reported high rates of unprotected anal sex and high numbers of sex partners; rates of club drug use (cocaine, ecstasy, methamphetamines, GHB, amyl nitrites, and Viagra) were also high. Recent use of club drugs was associated with both unprotected receptive and insertive anal sex in the Internet sample, but not in the community sample. Implications for social work practice are discussed.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

The Impact of Living in Co-ed Resident Halls on Risk-taking Among College Students

Abstract

Objective: Although previous research has suggested that college housing impacts student behavior and outcomes, recent research linking college housing to risk-taking has been limited. In this study, we investigate if patterns of risk behavior differ based on the type of college housing environment students reside in. Participants: This study utilizes 510 college students living in on-campus college housing. Methods: Students were recruited from 5 college sites across the United States. Participants responded to survey items online that measured current risk-taking behaviors such as binge drinking and sexual activity. Results: After controlling for an assortment of demographic and psychological variables, results indicated that students living in co-ed housing were more likely than students living in gender-specific housing to binge drink and consume alcohol, have more permissive sexual attitudes, and have more recent sexual partners. Conclusions: On-campus housing environments impact college student risk behaviors. Implications are discussed in light of the decline of in loco parentis on most college campuses.     

An Episodic Analysis of Substance Use and Risky Sexual Behavior in a Racially Diverse Sample of Young Men Who Have Sex with Men

Many studies have examined the relations between drug use and sexual behaviors; however, few have utilized episodic data to examine the co-occurrence of both behaviors within the same episode. This study surveyed 403 racially and ethnically diverse gay, bisexual, and other young men who have sex with men (YMSM; ages 18–29) in New York City. Men were surveyed about their sexual behavior and concurrent use of illicit substances and alcohol during their most recent sexual encounter with their main and/or casual partner(s). Logistic regression models were built to analyze predictors of unprotected oral and anal intercourse with main and casual partners. Results suggest that use of inhalant nitrates and alcohol increased the odds of men engaging in unprotected receptive anal intercourse (URAI) and men who identified as middle or high socioeconomic status (SES) were at lower odds of engaging in URAI with their main partner. Use of other illicit substances was not associated with unprotected sexual intercourse. These findings indicate a need to further consider the role of licit substances used by YMSM as a means of further reducing the incidence of HIV infection in this population. In addition, the high rates of unprotected anal intercourse among men reporting a main partner has the potential to be a significant source of HIV risk, and should be further explored among YMSM.     

Dimensions of ethnic identity as protective factors for substance use and sexual risk behaviors in African American college students

Objective: To examine ethnic identity and ethnic socialization as potential protective factors for risk behaviors among US college students. Participants: Participants were 398 African American and Afro-Caribbean students recruited from 30 colleges and universities during September 2008–October 2009. Methods: Data on hazardous alcohol use, substance use, sexual behaviors, ethnic identity, and ethnic/racial socialization were collected. Hierarchical linear and negative binomial regression analyses were conducted to determine the degree to which ethnic identity and ethnic/racial socialization predicted the risk behaviors. Results: Ethnic Identity affirmation, belonging, and commitment (EI-ABC) significantly predicted lower substance use and hazardous alcohol use. Ethnic/racial socialization was not a significant predictor of substance use or sexual risk behaviors. Conclusions: Components of ethnic identity are potentially protective against alcohol and substance use behaviors. Additional research is recommended to determine effective intervention strategies.     

Do Alcohol and Marijuana Use Decrease the Probability of Condom Use for College Women?

Alcohol and marijuana use are thought to increase sexual risk taking, but event-level studies conflict in their findings and often depend on reports from a limited number of people or on a limited number of sexual events per person. With event-level data from 1,856 sexual intercourse events provided by 297 college women (M _age = 18 years; 71% White), we used multilevel modeling to examine associations between alcohol and marijuana use and condom use as well as interactions involving sexual partner type and alcohol-sexual risk expectancies. Controlling for alternative contraception use, partner type, regular levels of substance use, impulsivity and sensation seeking, and demographics, women were no more or less likely to use condoms during events involving drinking or heavy episodic drinking than during those without drinking. However, for drinking events, there was a negative association between number of drinks consumed and condom use; in addition, women with stronger alcohol-sexual risk expectancies were marginally less likely to use condoms when drinking. Although there was no main effect of marijuana use on condom use, these data suggest marijuana use with established romantic partners may increase risk of unprotected sex. Intervention efforts should target expectancies and emphasize the dose-response relationship of drinks to condom use.     

Use of Drinking Protective Behavioral Strategies and Sexual Perceptions and Behaviors in U.S. College Students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.     

Temporal Relationship of Sex Risk Behaviors and Substance Use Severity Among Men in Substance Use Treatment

Sex risk behaviors and substance use are intertwined. Many men continue to engage in high-risk sexual behaviors even when enrolled in substance use disorder (SUD) treatment. We hypothesized that changes in sex risk behaviors would coincide with changes in drug/alcohol use severity among men in SUD treatment. During an HIV risk-reduction trial, men in methadone maintenance and outpatient drug-free treatment (N = 359) completed assessments at baseline and six months after. We assessed changes in sex risk and substance use severity, using the Addiction Severity Index–Lite (ASI-Lite), controlling for treatment condition. In multinomial logistic regressions, decreased alcohol severity was significantly associated with decreases in reported sex partners, and increased alcohol severity was significantly associated with increases in reported sex partners. Increasing drug use severity was significantly associated with maintaining and initiating sex with a high-risk partner, while decreasing alcohol use severity was significantly associated with discontinuing sex under the influence. However, changes in drug/alcohol use severity were not associated with changes in unprotected sex. Substance use reductions may decrease HIV risk behaviors among male substance users. Our findings highlight the importance of integrating interventions in SUD treatment settings that address the intersection of sex risk behaviors and substance use.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

Bullying and suicide in high school students: Findings from the 2015 California youth risk behavior survey

ABSTRACT

School bullying and cyberbullying have been linked to suicidal behaviors through depression and alcohol, tobacco, marijuana, and other drug use. However, how these associations may differ across racial/ethnic groups remains relatively unknown. Using data from the 2015 California Youth Risk Behavior Survey, this study aims to examine two questions in different racial/ethnic subgroups: (1) Does bullying affect suicide? and (2) Does bullying have an indirect effect on suicide through depression and use of alcohol, tobacco, marijuana and other drugs? The sample consisted of 1,765 Californian youth attending grades 9–12. Logistic regression analyses indicate that being bullied is associated with increased odds of suicide across all racial/ethnic groups; depression mediates the effect of bullying on suicide for all racial/ethnic groups; alcohol use mediates the effect only for Hispanic youth; other drug use mediates the effect only for White youth; marijuana and tobacco use have no mediating role. These findings suggest that bullying may lead to suicide through different risk behaviors for youths of different racial/ethnic groups. Professionals who work with bullied youths need to treat depression more effectively to prevent suicide in service planning and provision. They also need to be aware of the racial/ethnic differences in the risk behaviors intercorrelated with bullying and suicide and provide appropriate treatment to the youth of specific race/ethnicity.     

Fraternity Membership and Sexual Aggression: An Examination of Mediators of the Association

Abstract

Objective: This prospective study examined attitudes (ie, hostility toward women, acceptance of rape myths), peer influences (ie, peer pressure to have sex, peer approval of forced sex), and risky behaviors (ie, high-risk alcohol use, number of sexual partners) as possible mediators of the association between fraternity membership and sexual aggression. Participants: The sample included 424 males recruited as freshmen from a large state university in the southeastern United States. Methods: Respondents completed survey measures in their first, second, and third years of enrollment at the university. Results: Path analyses revealed that the prospective effect of fraternity membership on sexual aggression was mediated by high-risk alcohol use. Conclusions: The findings indicate that high-risk alcohol use accounts for much of the association between fraternity membership and sexual aggression.     

College Student Smokers' Cognitive Appraisal of High-Risk Activities

Abstract

Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, Environ Behav. 1999; 23:575–591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions. Methods: Participants were 303 college students. Cognitive Appraisal of Risky Activities (Fromme et al., Cognit Ther Res. 1997; 21:421–442) and smoking were assessed August–November, 2006. Results: Smokers reported significantly less risk, more benefit, and more involvement in risky behaviors than nonsmokers (p < .01). In hierarchical linear regression, risk perceptions moderated the association between smoking and (a) expected benefit from risky sexual behaviors (β = ?1.121, p < .05); and (b) expected involvement with illicit drugs (β = ?.313, p < .01). Conclusions: College smokers’ assessment of high-risk behaviors influenced their intended involvement. Risk perception change may therefore alter their involvement in high-risk behaviors.     

Should They Stay or Should They Go: Greek Housing on Campus as Substance Use Prevention?

Greek life on college campuses offers many student benefits, including leadership skills and career networking, but is also associated with risk factors such as excessive alcohol use. This cross-sectional study compares hazardous alcohol and drug use, and use of protective behavioral strategies among non-Greek and Greek-affiliated students at 2 universities and differences among students at a university that offers on-campus Greek housing and a college with off-campus Greek housing. Findings reveal that Greek-affiliated students report more alcohol use, and no difference in drug use or in protective behavioral strategies, than non-Greek students. Among Greek students, those living in on-campus Greek housing report significantly lower alcohol use than students residing in off-campus Greek housing. Regardless of Greek status, students at the college with off-campus Greek housing are significantly more likely to use alcohol and marijuana in a fraternity or sorority house than students at the university with on-campus Greek housing.     

A comparison of HIV risk practices among unprotected sex-seeking older and younger men who have sex with other men

Purpose: In recent years, much attention has been devoted to understanding the HIV risk behaviors of younger men who have sex with men (MSM). Recent data suggest that HIV is becoming an increasing problem for older adults, but little attention has been devoted to understanding their HIV risk behaviors or the factors that underlie their risk taking. This study provides a comparison of these issues among younger and older MSM. Methods: The data come from a subset of younger (ages 18–39, n?=?113) and older (ages 50+, n?=?109) men participating in a national study of 332 men who use the Internet to find other men for unprotected sex. Men were sampled randomly from 16 websites. Data were collected via telephone interviews conducted in 2008 and 2009. Results: Younger and older men reported comparable involvement in HIV risk, including involvement in unprotected sex, proportion of sex acts involving internal ejaculation, number of times having anonymous sex, and number of times having multiple-partner sex. Generally speaking, the factors underlying the risk practices of younger and older men were quite different (e.g. self-esteem and condom use self-efficacy for younger men, versus HIV serostatus and depression for older men). Conclusions: Older MSM using the Internet to find partners for unprotected sex engage in high rates of behaviors that place them at risk for contracting or transmitting HIV. They were just as likely as their younger counterparts to practice these behaviors. The factors “fueling” involvement in risk generally differ for older and younger men, thereby warranting the development of age-specific HIV interventions that can take into account the unique life circumstances and needs of older MSM.     

The alcohol contexts of consent,wanted sex,sexual pleasure,and sexual assault: Results from a probability survey of undergraduate students

Objective: To examine, in a probability sample of undergraduate students, characteristics of students’ most recent sexual experiences (including alcohol use) as well as their experiences with nonconsensual sex. Participants: In January and February 2015, 22,046 students were invited to participate in an anonymous, cross-sectional, Internet-based survey; 7,032 surveys were completed (31.9%). Methods: Measures included background characteristics (age, gender, sexual orientation), most recent sexual event items (sexual pleasure, wantedness, alcohol use), and experiences with nonconsensual sex (since college and lifetime). Results: Respondents reporting sober consensual sex were more likely to report higher levels of sexual pleasure and wantedness. Nonconsensual oral, vaginal, or anal penetration occurring during college were reported by 15.8% of women and 7.7% of men. Students more often told friends, partners, or family members and rarely disclosed to university faculty or police. Conclusions: Implications for campus policy and health education are addressed.     

Longitudinal predictors of cigarette use among students from 24 Texas colleges

ABSTRACT

Objective: The purpose of this study is to examine differences between current and non-current cigarette users, focusing on sociodemographic factors, non-cigarette tobacco product use, parental and friend use, and alcohol and marijuana use; and to identify predictors of cigarette use sixmonths later. Participants: Participants included young adults (n = 4,296) from 24 Texas colleges, participating in a young adult cohort study, beginning in fall 2014. Methods: Mixed effects logistic regressions were conducted accounting for school-level variability. Results: Cigarette users were older, more likely to report use of non-cigarette tobacco products and peer use of cigarettes than non-current users. Wave 1 cigarette and non-cigarette tobacco product use, marijuana use and binge drinking, and peer use all uniquely predicted cigarette use at wave 2. Conclusions: Colleges need prevention programs targeting multiple tobacco products, because non-cigarette tobacco use and other risky behaviors appear to be independent risk factors for cigarette use in young adults.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.