The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high‐risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer‐assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one‐time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.     

The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high-risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer-assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one-time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.     

The association between sensation seeking and e-cigarette use in Texas young adults: A cross-sectional study

Objective: To examine the associations between sensation seeking and ever and current e-cigarette use in Texas young adults (18–29 years old). Current cigarette use was examined as a potential effect modifier of the associations. Participants: Participants included college students enrolled in four-year and two-year colleges in four metropolitan areas in Texas (n = 5,418) who completed the survey between November 2014 and February 2015. Methods: This cross-sectional study utilized mixed effects logistic regression to determine the associations between mean sensation seeking scores and ever and current e-cigarette use after controlling for covariates. Results: After controlling for covariates, significant associations between sensation seeking and both ever and current e-cigarette use were observed; however, these associations were significant for noncurrent smokers only (adjusted odds rations [AOR] = 1.55, 95% confidence interval (CI) = 1.39, 1.73; AOR = 1.82, 95% CI = 1.54, 2.15, respectively). Conclusions: Sensation seeking is an important factor in identifying college students who may be at increased risk for e-cigarette use behaviors.     

Sexual compulsivity among heterosexual college students

A growing body of literature suggests that an association exists between sexual compulsivity and participation in sexual behaviors that are high risk in terms of HIV/STD infection. In most of these studies, sexual compulsivity has been measured using the Sexual Compulsivity Scale (SCS; Kalichman & Rompa, 1995). As yet, sexual compulsivity has only been assessed with this scale among individuals who are members of “high risk” groups for HIV infection or who are HIV‐positive. In this study, we found support for reliability and construct validity of the SCS in a sample of 876 heterosexual college students, a group not yet examined in the sexual addiction and compulsivity literature. Construct validity was substantiated by the presence of significant relationships of sexual compulsivity with frequencies of sexual behaviors and numbers of sexual partners. The scale was also related to gender and age. Sexual compulsivity scores were associated with frequency of risky sexual behaviors. The relationships between sexual compulsivity and solo, partner, public, and risky sexual behaviors remained significant when we controlled for demographic variables. Although we found support for construct validity of the SCS in our sample, it is not clear whether the scale distinctly measures sexual compulsivity or taps into other constructs, such as sexual desire and sexual exploration.     

Is Early Exposure to Pornography a Risk Factor for Sexual Compulsivity? Findings from an Online Survey among Young Heterosexual Adults

ABSTRACT

The aim of this retrospective study was to assess the relationship between early exposure to pornography and sexual compulsivity among Croatian young adults. Using online survey data on pornography use and sexual behavior among 1,528 heterosexual women and men aged 18–25, we tested a hypothesis that pornography use at the age of 14 is a marker for sexual compulsivity in late adolescence and young adulthood. After satisfactory reliability of a four-item subscale of the Sexual Compulsiveness Scale (Kalichman & Rompa, 1995 Kalichman, S. C. and Rompa, D. 1995. Sexual sensation seeking and sexual compulsivity scales: Reliability, validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65: 586–601. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) was confirmed in this sample, construct validity of this composite indicator focused on out of control sexual thoughts and behaviors was assessed. High sexual compulsivity was associated with sexual risk taking, though mainly among women, decreased levels of relationship intimacy and lesser sexual contentment. However, we found no significant association between early exposure to pornography and high sexual compulsivity either among men or women.     

What “likes” have got to do with it: Exposure to peers' alcohol-related posts and perceptions of injunctive drinking norms

Objective: Examine 1) whether observed social reinforcements (i.e., “likes”) received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status. Participants: First-year university students (N = 296) completed an online survey in September, 2014. Method: Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of “likes” received when posted by peers. Results: Observed social reinforcement (i.e., “likes”) for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students. Conclusions: For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant “likes” may increase perceptions of peer approval for risky drinking.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

Objective: This study examined college student drinkers by sexual orientation (SO), alcohol use, and negative consequences in a national sample that self-identified gender and SO. Participants: Students completing the Spring 2005 National College Health Assessment (N = 54,111). Methods: A secondary analysis was conducted examining student responses by SO to items regarding negative consequences associated with alcohol. Results: Bisexual students had the highest mean scores on an index of alcohol-related harm. Significant differences were found by SO among male high-risk drinkers for alcohol-related consequences of “fighting” and “injuring another,” and females for “injuring another” and “unprotected sex.” Bisexual students had significantly greater than expected cell counts for significant results, including a significant finding for bisexual low-risk female students for alcohol-related “regret.” Conclusion: These findings suggest that more research is necessary to discern real differences in alcohol-related risk among college students by sexual orientation.     

Personality,Sexuality, and Substance Use as Predictors of Sexual Risk Taking in College Students

Sexual risk taking among college students is common and can lead to serious consequences, such as unintended pregnancies and sexually transmitted infections. This study utilized responses from 310 undergraduate psychology students aged 18 to 23 to examine personality, sexuality, and substance use predictors of sexual risk behaviors over a six-month period. Data were collected from 2005 to 2006 at a medium-sized Midwestern U.S. university. Results indicated that greater alcohol and recreational drug use, higher extraversion, and lower agreeableness were related to sexual risk taking in men. For women, greater alcohol and drug use, higher sexual excitation, and lower sexual inhibition were predictive of sexual risk taking. Among women, but not men, sensation seeking was found to mediate the relationship between the four significant substance use, personality, and sexuality variables and sexual risk taking. Implications for sexual risk behavior prevention and intervention programming are discussed.     

Sensation Seeking and Impulsivity: Combined Associations with Risky Sexual Behavior in a Large Sample of Young Adults

Although prior studies have shown that sensation seeking and impulsive decision-making are related to sexual risk-taking, it is still unclear whether these personality traits operate independently or synergistically. The purpose of this study was to elucidate the joint contribution of these personality traits to HIV and sexually transmitted disease (STD) risk behaviors using data from a large sample of sexually active young adults (N = 2,386). Regression modeling indicated that both sensation seeking and impulsive decision-making were consistently associated with sexual risk behaviors across 11 risk-related outcomes. Results further indicated that sensation seeking and impulsive decision-making operated synergistically with respect to the outcome variables of sex acts using drugs, acts with a partner using alcohol, and acts with a partner using drugs. In contrast to this, sensation seeking and impulsive decision-making operated independently with respect to the other sexual risk outcomes. Theoretical implications, as well as implications for HIV/STD prevention among high sensation seekers and impulsive decision-makers, are discussed.     

Outcomes from a homegrown HIV prevention program for extremely high-risk,substance-using men who have sex with men with multiple health disparities

ABSTRACT

From February 2010 through December 2014, 585 substance-using men who have sex with men (MSM) were enrolled into a “homegrown” risk reduction intervention. Participants evidenced significant iterative factor reductions in the odds of substance use including alcohol (AOR = 0.79) and marijuana (AOR = 0.78; both p ≤ 0.05) and marginally significant reductions in the odds of methamphetamine use (AOR = 0.83; p ≤ 0.07). Participants also evidenced significant reductions in sexual risks including the odds of reporting drug/alcohol use before or during sex (AOR = 0.80) and of condomless anal intercourse (AOR = 0.72; all significant at p ≤ 0.05). Results demonstrate that the homegrown intervention was effective at reducing HIV risk behaviors among high-risk MSM.     

Urging College Alcohol and Drug Policies That Target Adverse Behavior,Not Use

Abstract

Although “zero tolerance” policies are being enacted on campuses nationwide, these policies may not be the most effective means of creating safer and healthier environments for students. Many historical precedents illustrate the value of moderation over prohibition College drug and alcohol policies should focus primarily on dysfunctional and disruptive student behaviors, not on student drug and alcohol use only.     

Is Being Popular a Risky Proposition?

Longitudinal associations between social preference, perceived popularity, and risk behaviors (smoking, alcohol use, and sexual activity) were examined in a sample of high school students. Social preference did not predict any of the risk behaviors assessed, although the interaction between gender and social preference was predictive of sexual behavior. Perceived popularity in Grade 10 was predictive of increased alcohol use and sexual activity in Grade 12 for both boys and girls. A reciprocal relationship was found for boys, in which smoking in Grade 10 also predicted gains in perceived popularity over time. Furthermore, results suggested that gains in perceived popularity may be associated with subsequent losses in social preference over time, lending support for the “cycle of popularity” observed by Eder. Implications are discussed, including the personal impact of risk behaviors on perceived popular teens, as well as the broader influence their behavior may have on their less popular counterparts.     

A longitudinal examination of risk and protective factors associated with drug use and unsafe sex among young African American females

This study prospectively examined associations among multiple theoretically informed risk (e.g., depression, sexual sensation seeking, and risky peers norms) and protective factors (e.g., social support, STI knowledge, and refusal to have sex self efficacy) on unsafe sex among 715 African American adolescent females aged 15–21 who participated in an STI/HIV prevention intervention. Generalized estimating equation models were used to assess associations between baseline characteristics and sexual risk over a 12-month follow-up period. Overall risk in this population was high: at baseline, nearly a third of women reported sex under the influence of alcohol or substances; ≥ 2 partners for vaginal sex, and casual sex partners in the 60 days prior to baseline, and nearly 75% of those reporting vaginal sex used condoms inconsistently. In multivariable analysis, when risk and protective factors were simultaneously considered, higher levels of sexual sensation seeking were associated with having multiple sex partners and inconsistent condom use. Greater perception of risky peer norms was associated with a higher risk of having sex under the influence of alcohol or drugs. In addition, higher sex refusal self-efficacy was protective against having multiple; casual; and concurrent sex partners. Incorporating these salient factors into prevention programs may be critical to the development of targeted interventions for this population.     

Longitudinal Evaluation of Peer Health Education on a College Campus: Impact on Health Behaviors

Objective: The authors investigated the longitudinal impact of peer health education on the health behaviors of undergraduate students pertaining to alcohol and drug use, eating and nutrition, and sexual health. Participants: From fall 2003 to spring 2006, the authors annually administered a Web-based survey to a cohort of 2,000 randomly selected undergraduate students. Results: Students who had contact with peer health educators were significantly more likely over time than other students to report less alcohol consumption and fewer related negative consequences. Results also show that students who had contact with peer health educators initially endorsed engaging in unhealthy weight management and fat talk behaviors during their first year but decreased these unhealthy behaviors by their third year. No significant differences in sexual health behaviors were found. Conclusions: Results indicate that peer health educators play an important role in promoting healthy behaviors in the areas of alcohol and drug use and in eating and nutrition.     

Gender Differences in the Associations Among Body Mass Index,Weight Loss,Exercise, and Drinking Among College Students

Abstract

Objective: To explore gender differences regarding weight management behaviors of college drinkers. Participants: Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II (N = 26,062 students). Methods: Structural equation modeling was used to examine potential gender differences in associations among exercise, weight loss behaviors, and alcohol use. Results: Critical ratio tests revealed that associations between exercise and weight loss behaviors were more strongly correlated among females as compared with males. For females, there was a small negative association between exercise and drinking behaviors; in contrast, for males, there was a positive relationship between exercise and alcohol use. Weight loss behaviors were positively associated with drinking for both female and male students; however, the association was significantly stronger for females. Conclusions: This investigation furthers previous research on drunkorexia and also sheds additional light on the gender-based differences in weight management behaviors of drinkers.     

Sexual Hookups and Adverse Health Outcomes: A Longitudinal Study of First-Year College Women

“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.     

Appropriate Terminology for the Alcohol,Eating, and Physical Activity Relationship

Abstract

“Drunkorexia” merges prior literature identifying positive relationships between (a) alcohol use/abuse and disordered eating/eating disorders, (b) alcohol use/abuse and physical activity, and (c) disordered eating/eating disorders and physical activity. The term, highlighting an individual's proactive and/or reactive weight management behaviors (ie, disordered eating, physical activity) in relation to alcohol consumption, originated in news editorials and has recently gained recognition via use in scholarly publications. The purpose of this commentary is to recommend discontinuing use of the term “drunkorexia” due to (a) inconsistent definitions of drunkorexia across investigations, (b) drunkorexia being a misnomer, and (c) the medical community's lack of recognition/acceptance of drunkorexia. Because the behaviors encompassed by drunkorexia are of concern to researchers and health professionals, future investigations are still warranted. However, until a medically recognized term/phrase is accepted, scholars should utilize more appropriate characterizations such as “weight-conscious drinkers,” “weight management behaviors of drinkers,” or “Eating Disorders Not Otherwise Specified” (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).     

Daily Associations Between Drinking and Sex Among College Students: A Longitudinal Measurement Burst Design

Daily links between alcohol use and sexual behaviors were examined in a longitudinal study of college students. Hierarchical linear models predicted sexual behaviors by characteristics of persons (N = 731, Level 3), semesters (N = 4,345, Level 2), and days (N = 56,372, Level 1). On a given day, consuming more drinks and binge drinking were associated with greater odds of kissing, touching, oral sex, and penetrative sex. Consistent with alcohol myopia and expectancy theories, associations between binge drinking and sexual behaviors were stronger for students not in romantic relationships, for students with stronger alcohol–sex expectancies, and for oral and penetrative sex. Findings suggest that within‐day links between alcohol use and sexual behaviors are evident across college, with variations based on individual and relationship factors.     

Partner‐specific relationship characteristics and condom use among young people with sexually transmitted diseases

This study describes associations of partner‐specific relationship characteristics with consistent condom use among 297 young people (ages 13–24) with sexually transmitted diseases (STD). Relationship‐specific variables were relationship quality, reasons for sex, relationship duration, duration of sexual relationship, coital frequency, “established” versus “new” sexual partner, cohabitation, children, sexual coercion, and drug or alcohol use associated with coitus. Relationship characteristics associated with consistent condom use included lower relationship quality, lower emotional reasons for sex, lower coital frequency, sex with a new partner, noncohabitation, and not having a child with the partner. Controlling for sociodemographic variables, factors exhibiting independent associations with consistent condom use were lower relationship quality, lower coital frequency, and not having a child with the partner. While condom use with potentially high risk new partners is important, other types of relationships are also risky but associated with lower likelihood of consistent condom use. Better understanding of complex relationship characteristics is necessary to improve STD intervention programs.