Prevalence of Human Immunodeficiency Virus Testing and Associated Risk Factors in College Students

Abstract

Objective: This study documents the prevalence of human immunodeficiency virus (HIV) testing in a sample of college students and examines associated demographic and behavioral characteristics. Participants: College students aged 18 or older were randomly selected to participate in a health behavior survey at a southeastern university in September 2011. Methods: Only sexually active students were included (N = 905). Relationships between demographic and sexual behavior characteristics were explored using logistic regression and classification regression tree (p ≤.05). Results: Only 36.2% reported having been tested for HIV. Age was the most significant factor associated with testing. Factors associated with those least likely to be tested were race and anal sexual activity. Unsafe sexual behaviors were also associated with lower rates of HIV testing. Conclusions: Findings support the need for targeted HIV interventions on college campuses. Such interventions need to be tailored for at-risk students and take into consideration factors likely to contribute to HIV testing.     

Development of a short version of the Aging Males’ Symptoms scale: Mokken scaling analysis and Rasch analysis

The aim of this study was to develop a psychometrically sound short version of the 17-item Aging Males’ Symptoms (AMS) scale using Mokken scale analysis (MSA) and Rasch analysis. We recruited a convenient sample of 1787 men (age: mean (SD)?=?43.8 (11.5) years) who visited a men’s health polyclinic in Taiwan and completed the AMS scale. The scale was first assessed using MSA. The remaining items were assessed using Rasch analysis. We used a stepwise approach to remove items with χ² item statistics and mean square values while monitoring unidimensionality. The item reduction process resulted in a 6-item version of the AMS scale (AMS-6). The AMS-6 scale included a 5-item psychosomatic subscale (original items 1, 4, 5, 8, and 9) and a 1-item sexual subscale (original item 16). Analyses confirmed that the 5-item psychosomatic subscale was a Rasch scale. The AMS-6 correlated well with the AMS scales: the 5-item psychosomatic subscale correlated with the AMS scale (r between 0.50 and 0.92); the 1-item sexual subscale correlated with the sexual subscale of the AMS scale (r?=?0.81). A 6-item short form of the AMS scale had satisfactory measurement properties. This version may be useful for estimating psychosomatic and sexual symptoms as well as health-related quality of life with a minimal burden on respondents.     

Profiles of African American College Students’ Alcohol Use and Sexual Behaviors: Associations With Stress,Racial Discrimination,and Social Support

Though studies show that alcohol use and sexual activity increase during emerging adulthood, few studies examine within–ethnic group differences, particularly among African American college students. This investigation utilized a latent class analytic methodology to identify risk behavior profiles of alcohol use (frequency and amount of alcohol consumed), sexual activity (number of intimate partners), and co-occurring risk behaviors (drinking before sexual intercourse) among 228 African American college students. This investigation also examined whether identified risk behavior profiles were associated with stress (interpersonal, intrapersonal, academic, and environmental), experiences of racial discrimination, and social support (from family, friends, and the college community). Results identified five distinct profiles within this sample: (a) High Sexual Risk—above-average sexual activity; (b) Abstainers—below-average alcohol use and sexual activity; (c) Low Risk—average alcohol use and sexual activity; (d) Alcohol Risk—above-average alcohol use and below-average sexual activity; and (e) Co-Occurring Risk—above-average alcohol use and sexual activity. Identified profiles differed across interpersonal and environmental stress, and self-reported frequency of experiences with racial discrimination. Implications for prevention programs and interventions aimed at reducing alcohol and sexual activity for African American college students are discussed.     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.     

Psychometric Confirmation of the Sexual Health Survey as a Useful Tool for College Health Professionals

Abstract

Objective: To conduct a confirmatory factor analysis on the 17-item Sexual Health Survey (SHS), a comprehensive instrument designed to be used with college students. Participants: College students (N = 515) aged 18 to 26 years enrolled at a Midwest public university October 2009. Methods: Confirmatory factor analysis with maximum likelihood estimation was performed to test the stability of the constructs. Results: All factor loadings were significant (p < .001), ranging from .55 to .99 (standardized). The range of squared multiple correlations of items was .31 to .98, and the intercorrelations among the 5 factors were from ?.03 to .52. These small to moderate levels of intercorrelation support discriminant validity of 5 constructs. Conclusions: This study supports the 5-factor version of the 17-item SHS as a viable scale that can measure sexual health overall and 5 distinct areas. College health professionals should consider use of this scale for assessment purposes and evaluation of programmatic efforts.     

Development and Assessment of Measures of Adolescents' Attitudes about Sexual Relationship Rights

Objective: Develop and validate measures of adolescents' attitudes about sexual relationship rights. Methods: Items were completed by students in a large U.S. city (N = 655). The authors conducted an exploratory factor analysis, evaluated internal consistency, and assessed construct validity, including ability to predict sexual behavior at 1-year follow-up. Results: Factor analysis identified 2 distinct factors, comprising attitudes about rights to refuse unwanted sexual activity (5 items) and express sexual engagement needs (5 items) in a sexual relationship. The measures showed sound evidence of reliability and construct validity. Conclusions: The psychometric evidence supports the use of these measures in adolescent sexual health research.     

F.O.R.E.play: The Utility of Brief Sexual Health Interventions Among College Students

Abstract

Objectives: The authors aimed to determine the most effective brief sexual health intervention for college students, while also evaluating students’ preferences for learning about sexual health, in order to develop a university program. Methods: A total of 302 students enrolled in an introductory college course participated and were randomly assigned to 1 of 3 brief interventions during a regularly scheduled class and completed pre- and postsurveys assessing knowledge, motivation to use condoms, and condom self-efficacy. Results: Findings indicated that having an actual person in charge of the learning process resulted in higher knowledge gains and highlighted a student preference for discussion-based learning, viewing pictures of sexually transmitted infections, and hearing real-life experiences about the consequences of unsafe sex. Conclusions: These findings will be used to tailor a future intervention targeting college students for use with freshmen students at this university.     

Transactional sexual activity among university students: Prevalence and clinical correlates

Abstract

Objectives: This study examined the prevalence and mental health correlates of transactional sexual activity (sex for compensation) in a university sample. Methods: A 156-item anonymous survey was distributed via random email generation to 9,449 university students. Results: The prevalence of transactional sex was 2.1%. Respondents who had sold sex (n?=?30) reported significantly higher rates of risky sexual behavior and mental health problems than those who had not sold sex (n?=?1,405). Conclusions: Transactional sex in our sample of university students was associated with a range of impulsive or compulsive behaviors that may affect students’ health and well-being.     

Sexual and reproductive health knowledge and information-seeking behavior among middle eastern female university students: a systematic review

Objectives: The objective of this study was to collate the level of sexual and reproductive health knowledge, awareness, attitudes, and behavior among female university students, in addition to identifying their sources of information in Middle Eastern and North African countries. Methods: A systematic review was conducted with a search in Medline, EMBASE, Web of Knowledge, PsycINFO, and CINAHL from inception to February 2013. Included were studies in any language describing sexual and reproductive health knowledge and attitudes among female university students. Results: Nine studies were included, and all were cross-sectional surveys. There was a general lack of knowledge of sexual and reproductive health. The highest knowledge levels reported were for HIV. Conclusions: There are deficiencies in sexual and reproductive health knowledge and behavior in Middle Eastern and North African countries. Studies are needed to evaluate how to provide culturally sensitive sexual and reproductive health information.     

Improving alcohol screening for college students: Screening for alcohol misuse amongst college students with a simple modification to the CAGE questionnaire

ABSTRACT

Objective: To improve the CAGE (Cut down, Annoyed, Guilty, Eye opener) questionnaire's predictive accuracy in screening college students. Participants: The sample consisted of 219 midwestern university students who self-administered a confidential survey. Methods: Exploratory factor analysis, confirmatory factor analysis, receiver operating characteristics (ROC), and Cronbach's alpha were used to analyze factor structure, validity, and reliability. Results: The modified CAGE correctly classified students with alcohol abuse (“AA students”; area under the curve [AUC] = 0.7765) and students with alcohol dependency (“AD students”; AUC = 0.8392) more often than CAGE (AA students: AUC = 0.6977; AD students: AUC = 0.7437), and these differences are statistically significant (AA students: χ²(1) = 14.72, p < .001; AD students: χ²(1) = 7.71, p < .01). Using 2-point cut scores, CAGE correctly identified 59.38% of AD students as AD, whereas the modified CAGE correctly identified 87% of AD students as AD. Using 1-point cut scores, CAGE correctly identified 65% AA students, whereas the modified CAGE identified 85.29%. Conclusions: The modified CAGE has better accuracy than CAGE in predicting AA and AD among college populations.     

Explicit Verbal Sexual Consent Communication: Effects of Gender,Relationship Status,and Type of Sexual Behavior

Objectives: College students believe that they are supposed to be explicit and verbal in their sexual consent communication. We examined various contexts to determine when sexual consent is likely to be communicated explicitly and verbally. Method: We surveyed U.S. college students’ (n?=?707) sexual consent communication. Results: We identified contexts when explicit verbal consent cues are less likely—when the person is a woman, when the sexual relationship is casual, and when the sexual behavior is not vaginal-penile intercourse. Conclusions: If sexual consent is contextual, that means communicating consent should not ever be taken for granted.     

Identifying Demographic and Attitudinal Correlates of Young Adults’ Safer-Sex Self-Efficacy

Objectives: Using data from young-adult college students (N = 207), we identified demographic and attitudinal correlates of safer-sex self-efficacy. Female respondents reported higher levels of safer-sex self-efficacy than males. Methods: Participants completed a self-report survey about their sexual attitudes, values, and experiences. Results: In regression analyses only, the importance of safer-sex practices was related to safer sex self-efficacy in both men and women. Women's safersex self-efficacy was associated with additional demographic factors and sexual beliefs. Conclusions: The factors identified in this study may serve as intervention targets for young-adult sexual health programs. Reinforcing the importance of safer-sex practices may be particularly effective in increasing young adults’ safer-sex self-efficacy.     

The magnitude and potential impact of missing data in a sexual violence campus climate survey

Abstract

Objective: Assess the impact of survey non-response and non-completion for a campus climate survey. Participants: Intended for all degree-seeking students at a large, public, midwestern university, November 2014. Methods: The survey covered sexual assault experiences and related attitudes. We identify the magnitude and potential impact of survey non-response by comparing demographic data between respondents and non-respondents, sexual assault prevalence between early and late respondents, and demographic and attitudinal data between survey completers and partial completers. Results: Demographic groups were differentially represented in the survey. Sexual assault prevalence based on survey results may be underestimated for men, overestimated for women. Sensitive questions did not increase drop-off. Students completing more of the survey differed from those completing less. Conclusions: Colleges must plan survey administration and data sensitivity analysis to reduce potential for bias. Resources for sexual assault-related needs based on estimates from campus climate surveys with high non-response will likely be misallocated.     

Typologies of Childhood Exposure to Violence: Associations With College Student Mental Health

Abstract

Objective: This study examined typologies of childhood violence exposure (CVE) and the associations of profiles with current demographic characteristics and mental health in emerging adulthood. Participants: The study evaluated a sample of college students from 2 US geographic regions (Midwest, n = 195; Southeast, n = 200). Methods: An online questionnaire (collected 2013–2014) assessed CVE and current mental health. Latent class analysis was used to identify typologies of CVE. Follow-up analyses were conducted to distinguish differences between typologies in demographic characteristics and mental health. Results: Four distinct profiles emerged: High-Exposed, Domestic-Exposed, Community-Exposed, and Low-Exposed. High- and Domestic-Exposed groups were more likely to be first-generation college students and to experience symptoms of psychopathology. Conclusions: This study offers a unique presentation of CVE profiles and a nuanced interpretation of their differential relationship to current demographic characteristics and mental health. It may befit university mental health initiatives to engage first-generation students and utilize comprehensive assessments of previous victimization.     

Mental health literacy,stigma, and help-seeking behaviors among male college students

Objective: Mental health literacy (MHL) is low in college-aged men potentially resulting in impaired mental wellbeing. This study assessed MHL, psychosocial determinants, and help-seeking behaviors among male university students. Participants: Male undergraduate and graduate students were surveyed in Spring 2017 (n = 1,242) at a large southeastern university in the United States. Methods: Preexisting validated scales for MHL, psychosocial determinants, and help-seeking intention were used in measurement and demographic variables were collected. T-tests and one-way ANOVA were performed to measure differences between groups. Results: Participants showed low scores for all constructs with statistically significant differences between undergraduate and graduate students, as well as between races and major classifications. Undergraduate men had moderate MHL and low intentions to seek professional care. Conclusions: Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.     

Event-related clinical distress in college students: Responses to the 2016 U.S. Presidential election

Abstract

Objectives: College students have cited the 2016?U.S. presidential election as a significant source of stress. The current study examined the prevalence and demographic correlates of clinically significant election-related avoidance and intrusion symptoms among college students 2–3?months after the election. Participants: College students attending a large public university (N?=?769; M_age?=?19.19; 48.2% female; 58.4% White) were surveyed in January and February 2017. Methods: Participants completed a validated measure of clinically significant event-related distress symptoms (eg, intrusive thoughts, avoidance) and demographic questions. Results: One out of four students met criteria for clinically significant symptoms related to the election. Regression analyses suggested that sex, political party, religion, and perceived impact of the election on relationships were more useful predictors of stress symptoms than race or social class. Conclusions: The high level of event-related distress is concerning because elevated symptoms of event-related stress are predictive of future distress and subsequent PTSD diagnoses.     

Correlation between the Japanese Aging Male Questionnaire (JAMQ) and Aging Male’s Symptom (AMS) scale in Japanese male

Abstract

Objectives: To clarify the correlation between the Japanese Aging Male Questionnaire (JAMQ) and the Aging Males’ Symptoms (AMS) scale through the factor analysis in Japanese male.

Materials and methods: In 61 male patients who visited the LOH outpatient clinic of Teikyo University Hospital, subjective symptoms featuring LOH were evaluated using the JAMQ and AMS. Factor analysis was performed on each questionnaire to clarify the LOH-related factors. Correlational analysis between the subscale scores representing such factors and the serum hormone profiles was also performed.

Results: Factor analysis of the JAMQ revealed an internal structure consisting of three subgroups: somatic, psychological and sexual factors with good categorization of the indicators to the appropriate subgroup. In contrast, the indicators of the AMS showed incomplete conformity to the subgroups of the JAMQ. Correlational analysis showed that each score on the JAMQ subgroups had the highest coefficient of correlation with the corresponding AMS subgroup (p?<?0.001). There was no significant association between total and free serum testosterone levels and the total and subscale scores on either AMS or JAMQ.

Conclusions: The results of factor analysis suggest that the sexual perceptions of Japanese populations might differ from those of Caucasian populations. JAMQ would be useful to separately assess individual aspects of somatic, psychological and sexual symptoms related to LOH among Japanese males.     

A longitudinal study of the effects of a university human sexuality course on sexual attitudes

This study tested the hypotheses that students taking a university human sexuality course will have different attitudes over a 2‐year period than students not taking such a course, and more accepting attitudes toward the sexual behaviors of others, over a 2‐year period, than toward their own sexual behavior. Sexual attitudes of 127 human sexuality class students and 114 control class students at the University of Northern Iowa were measured at the beginning of class (pretest), the end of class (posttest), and 2 years after the end of class (follow‐up). There were no pretest differences between the treatment and control groups in university classification, marital status, political affiliation, religious affiliation, sex, age, grade point average, or sexual attitudes. Both hypotheses were supported. Human sexuality students developed more accepting attitudes and became more accepting of behaviors for others compared to behaviors for self. Control group students developed less accepting attitudes and became less accepting of behaviors for others compared to behaviors for self. The sex of the students and the session they attended class were also found to influence sexual attitudes.     

College Students and Condom Attitude: Validation of the Multi-Factor Attitude toward Condoms Scale (MFACS)

Abstract

Objective: Sexually transmitted infections and the human immunodeficiency virus incidence rates remain high among college-aged individuals. This study examined the validity and reliability of the Multi-Factor Attitude toward Condoms Scale (MFACS). Participants: Participants were recruited from a large midwestern university during February and March 2009. Methods: Data were collected using in-class data collection with a test–retest design from undergraduate courses. A total of 442 surveys were collected during initial testing and 421 during retesting. Results: Reliability assessments indicated a sufficient Cronbach's alpha for the total scale (α = .805) and each subscale: affective (α = .790), perceived effectiveness (α = .795), and manageability (α = .751). Further analyses provide evidence of construct validity. Conclusions: The study reaffirmed the psychometric properties of the MFACS among a sample of college students. The MFACS provides a contemporary way to examine condom attitudes as sexual health research is moving beyond only disease prevention efforts.