The understudied half of undergraduates: Risky sexual behaviors among community college students

Abstract

Objective: This study examines the prevalence and risk factors associated with risky sexual behaviors in community college students. Participants: A diverse sample of 18–19-year-old community college students (N?=?264). Methods: Baseline data from an online prevention program administered in 2015. Results: Community college students in this sample disproportionately experienced sexual assault and were unlikely to test for STIs. Higher intentions to engage in risky sexual behaviors were associated with gender and sexual experience, but also with having lower intentions to communicate with a sexual partner about pregnancy and STIs, and having higher gender norm endorsement. Conclusions: Older adolescents attending community colleges may be at high risk for poor sexual health outcomes, and appropriate theory-based education should be tailored to meet the needs of these underserved students.     

Socio-Environmental and Behavioral Correlates of Having Ever Had Sexual Intercourse Among Adolescents in Peru: A School-Based Cross-Sectional Study

Objective: We assessed the socio-environmental and behavioral correlates of having ever had sexual intercourse among Peruvian adolescents aged 12–18 years in Lima. Methods: A cross-sectional study was conducted in 2014. Result: Of 950 participants, 26.5% of males and 13.0% of females had ever had sexual intercourse. Early adolescents who ever had sexual intercourse had higher odds of being insulted, being involved in a fight, and smoking; whereas late adolescents having sexual experiences were more likely to be male and to report smoking, alcohol consumption, involvment in a fight, and having no/low parental understanding. Conclusion: An integrated approach is useful in addressing risk behaviors in adolescents.     

Associations between Croatian Adolescents’ Use of Sexually Explicit Material and Risky Sexual Behavior: A Latent Growth Curve Modeling Approach

Objectives: The aim of this biobehavioral longitudinal study was to assess the association between sexually explicit material (SEM) use and risky sexual behavior among Croatian adolescents (n?=?577). Methods: The data were collected over the period of 15?months. Conditional dual-domain latent growth modeling was used. Results: Male adolescents’ initial SEM use, but not subsequent growth, was related to changes in sexual risk taking over the observed period. Among female adolescents, SEM use and sexual risk taking were significantly related only at baseline. Conclusions: Our findings point to gender-specific association between adolescents’ SEM use and risky sexual behavior.     

Gender Differences in the Sexual Well-Being of Mexican Adolescents

Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high sexual satisfaction and refusal of unwanted sex among females. Conclusions: the findings suggest the relevance of overcoming traditional sex roles to achieve adolescent sexual well-being. In this sense, health and population policies should direct more substantial efforts in the promotion of gender equality among the adolescents and in the development of critical attitudes towards traditional gender norms.     

Sex Differences and HIV Risk Behaviors: The Interaction between the Experience of Multiple Types of Abuse and Self-Restraint on HIV Risk Behaviors

Adolescents with abuse histories have been shown to be at increased risk to acquire human immunodeficiency virus and sexually transmitted infections. In addition, teens with lower levels of self-restraint or higher levels of distress, such as those with psychiatric concerns, have also demonstrated increased sexual risk behaviors. This study explored sex differences in sexual risk behaviors among a sample of adolescents in a therapeutic/alternative high school setting. Moderated regression analysis showed that a lower level of self-restraint was associated with sexual risk behaviors in boys but not in girls. Rather, the interaction of self-restraint and multiple types of abuse was associated with greater sex risk within girls in this sample. Results suggest that girls and boys with abuse histories and low levels of self-restraint may have different intervention needs related to sexual risk behaviors.     

Prevalence and Behavioral Correlates of Depression and Anxiety Among Male Sex Workers in Vietnam

ABSTRACT. Objectives: This study assessed depression and anxiety symptoms and their association with high-risk sexual and drug behaviors among male sex workers in 3 Vietnamese cities. Methods: Male sex workers ages 16 to 35 years old completed an interview that included the Center for Epidemiological Studies Depression Scale to assess depressive symptoms and the Beck Anxiety Inventory to assess anxiety symptoms, as well as questions assessing drug and sexual risk practices. Results: A majority of participants reported depressive symptomatology, although fewer reported symptoms of anxiety. Risky sexual and drug use practices predicted both types of symptoms. Conclusions: Mental distress is associated with drug and sexual risk among male sex workers.     

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.     

Examining residence status as a risk factor for health risk behaviors among college students

Objective: The current study is aimed to evaluate college student residence as a unique risk factor for a range of negative health behaviors. Participants: We examined data from 63,555 students (66% females) from 157 campuses who completed the National College Health Assessment Survey in Spring 2011. Methods: Participants answered questions about the frequency of recent use of alcohol, tobacco, marijuana, and illicit drugs, as well as sexual risk behavior in the last 30 days. Sexual risk behaviors were operationalized as having unprotected vaginal sex (yes/no) and the number of sexual partners. Results: Logistic regression analyses revealed that living off-campus is a unique predictor of alcohol, tobacco, marijuana, and illicit drug use, as well as engaging in unprotected sex and a greater number of sexual partners (all ps <. 01). Conclusions: Students living off-campus exhibit more substance use and sexual risk behaviors than students living on-campus, independent of gender, age, or race.     

Condom Use,Condom Refusal,and Substituted Sexual Behaviors Among Youth at Higher and Lower Risk for HIV Infection

ABSTRACT

The purpose of this study was to describe sexual behaviors that youth substitute for protected intercourse when a partner refuses to use a condom or a condom is not used. Participants included: (a) 120 adolescents (mean age 17.2 years) undergoing substance abuse treatment and (b) 171 university students (mean age 21.3 years). The treatment sample reported significantly higher levels of discrete risk factors for HIV exposure. While only a small proportion of each sample experienced outright refusals by partners to use condoms, the majority of participants in each sample used condoms inconsistently with main partners. The university sample reported more substituted behaviors (lower risk and total) when partners did not want to use condoms. Yet, substantial proportions of participants in each sample engaged in unprotected intercourse. Implications for social work and health promotion efforts directed toward youth at risk for HIV/STD exposures are discussed.     

Are Online Sexual Activities and Sexting Good for Adults’ Sexual Well-Being? Results From a National Online Survey

Abstract

Objectives: Online sexual activities (OSA) and sexting are often framed as risk behaviors in adolescents. This study investigates experiences of adults. Methods: Based on the positive sexuality approach, the current study measured prevalence, predictors, and perceived outcomes of OSA and sexting in a national online sample of N?=?1,500 participants from Germany (ages 18–85). Results: 68% of adults reported previous involvement in OSA and 41% in sexting. Perceived positive OSA and sexting outcomes outweighed the negative. Conclusions: Sexual health professionals should acknowledge online sexual expression in adults of the general population as normal and mostly positive behavior.     

Parenting Practices and Adolescent Sexual Behavior: A Longitudinal Study

The effects of parental attitudes, practices, and television mediation on adolescent sexual behaviors were investigated in a study of adolescent sexuality and media (N = 887). Confirmatory factor analyses supported an eight‐factor parenting model with television mediation factors as constructs distinct from general parenting practices. Logistic regressions indicated that adolescents reporting greater parental disapproval and limits on viewing at Wave 1 were less likely to initiate oral sex between Waves 1 and 2. Adolescents who reported more sexual communication with parents were more likely to initiate oral sex. Results for vaginal intercourse were similar to those for oral sex. Coviewing was a significant negative predictor of initiation of sexual behavior. Parental attitudes and television mediation can delay potentially risky adolescent sexual behaviors.     

Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status

Sexual minority adolescents (SMA) report more suicide risk behaviors than heterosexual adolescents. Polyvictimization (co‐occurrence of multiple types of victimization) may be an important, underresearched correlate of this disparity. With the 2017 national Youth Risk Behavior Survey (N = 13,179), national estimates of polyvictimization and suicide risk were assessed among high school students by sexual minority status (SM vs. heterosexual), and multivariate relationships between sexual minority status, polyvictimization, and suicide risk were tested. Additionally, risk profiles of those who experienced polyvictimization (2 + types of victimization; n = 1,932) were compared across sexual minority status. Results confirm that SMA are more likely to experience polyvictimization than heterosexual adolescents (31.8% v. 12.9%, respectively); however, also indicate that polyvictimization does not fully explain elevated suicide risk among SMA.     

Relationships Between Social-Emotional Intelligence and Sexual Risk Behaviors in Adolescent Girls

Social-emotional intelligence (SEI) has been linked with a number of health behaviors in adolescent populations. However, little is known about the influence of SEI on sexual behavior. This study examined associations between three indicators of SEI (intrapersonal skills, interpersonal skills, stress management skills) and adolescent girls’ sexual risk behaviors. Data come from a cross-sectional sample of sexually active adolescent girls (ages 13 to 17 years) at high risk for pregnancy (N = 253), recruited from health care clinics in a Midwest metropolitan area during 2007 and 2008. Results of multivariable regression models controlling for participants’ age and race/ethnicity indicated that each aspect of SEI was related to distinct sexual risk behaviors. Specifically, girls with greater intrapersonal skills had significantly fewer male sex partners in the past six months (b = ?0.16). Participants with greater interpersonal skills reported earlier communication with their sexual partner about sexual risk (b = 0.14), and those with a better ability to manage stress reported more consistent condom use (b = 0.31). Study findings suggest that SEI may provide a protective buffer against sexual risk behaviors. Building adolescent girls’ social and emotional skills may be an effective strategy for reducing their risk for early pregnancy and sexually transmitted infections.     

What does self-esteem have to do with behavioral health among low-income youth in Chicago?

Many studies have examined risk factors associated with poorer behavioral health among low-income African American youth, such as low school engagement, delinquency, mental health problems, drug use, and risky sex. However, fewer studies have examined protective factors for such behavioral health risk behaviors. This study sought to address this gap by examining whether high levels of self-esteem were associated with better behavioral health factors for this population. A survey was administered to a sample of 638 low-income African American adolescents in Chicago to examine the degree to which high self-esteem was associated with less delinquency, substance use, and sexual risk behaviors, and more school engagement, and whether such associations varied by gender. Stepwise linear and logistic regression models were estimated to assess the influence of self-esteem. Higher self-esteem for this sample of low-income African American adolescents was associated with lower rates of delinquency, drug use, and risky sexual behaviors and increased rates of school engagement. Gender moderated only a few of these relationships. These findings suggest that programs that promote high self–esteem alone or in combination with other resilience factors may promote better behavioral health factors for African American adolescents.     

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.     

Does Asking Adolescents About Pornography Make Them Use It? A Test of the Question–Behavior Effect

Longitudinal survey design is the preferred method for the robust assessment of outcomes associated with socially undesirable or potentially harmful sexual behaviors. However, repeated measurement may induce the question–behavior effect (QBE)—the phenomenon where asking about a behavior changes the probability of engaging in the behavior in the future. Using an online panel sample of Croatian adolescents (M_{age at baseline} = 15.8, SD = .50), the present study explored the QBE in the context of adolescent pornography use. To this end we compared the frequency of pornography use six months after the initial survey (T2) between adolescents who participated in both baseline (T1) and T2 survey assessments (n = 1,053; 41% of males) and those who began the study at T2 (n = 130; 42% of males). In line with the findings from a recent Dutch study, we found no evidence that surveying adolescent pornography consumption increased participants’ reports of subsequent use. Implications of the findings for studying pornography use in young people are discussed.     

Behavioral health correlates of exposure to community violence among African-American adolescents in Chicago

AimsThough public health researchers are more aware of behavioral health concerns among African American youth, few studies have explored how exposure to community violence may be related to adverse youth concerns. This study examines the relationship between exposure to community violence and mental health problems, substance use, school engagement, juvenile justice involvement, and STI risk behaviors.MethodsA total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on exposure to community violence, mental health, school engagement proxies, substance use, delinquency markers and sexual risk behaviors.ResultsAdolescents who reported higher rates of exposure to community violence were significantly more likely to report poorer mental health, delinquent behaviors, a history of juvenile justice involvement, lower school bonding and student-teacher connectedness. These youth were also significantly more likely to use alcohol, cigarettes, and illicit substances, and engage in sexual risk behaviors.ConclusionsFindings suggest that there is a critical need for culturally relevant prevention and intervention efforts for African American adolescents who are frequently exposed to community violence.     

A Pilot Study to Evaluate Ethnic/Racial Differences in Depressive Symptoms,Self-Esteem,and Sexual Behaviors Among Men Who Have Sex with Men

Men who have sex with men (MSM) are at risk for certain physical and psychological health conditions. Ethnic minority MSM are at an increased risk related to the combination of sexual minority and ethnic minority status. The purpose of this pilot study was to compare the levels of depressive symptoms, self-esteem, and sexual behaviors by ethnicity in a sample of MSM (N = 70) residing in South Florida. More than one-third of the sample (N = 26; 37%) had high levels of depressive symptoms. Using non-parametric statistics, statistically significant differences were noted in the levels of depressive symptoms as African-American MSM had higher levels of depressive symptoms when compared to the other ethnic groups. Statistically significant differences were not found when self-esteem and sexual behaviors were compared by ethnicity. Regardless of ethnicity, MSM in this study were at risk for the sequela of depressive symptoms and infections with HIV and/or sexually transmitted infections because of the high levels of unsafe sexual behaviors. More research is needed to explore the relationship of mental health and sexual behaviors among the various ethnic groups of MSM.     

Alcohol,Sex, and Screens: Modeling Media Influence on Adolescent Alcohol and Sex Co-Occurrence

Alcohol use and sexual behavior are important risk behaviors in adolescent development, and combining the two is common. The reasoned action approach (RAA) is used to predict adolescents’ intention to combine alcohol use and sexual behavior based on exposure to alcohol and sex combinations in popular entertainment media. We conducted a content analysis of mainstream (n = 29) and Black-oriented movies (n = 34) from 2014 and 2013–2014, respectively, and 56 television shows (2014–2015 season). Content analysis ratings featuring character portrayals of both alcohol and sex within the same five-minute segment were used to create exposure measures that were linked to online survey data collected from 1,990 adolescents ages 14 to 17 years old (50.3% Black, 49.7% White; 48.1% female). Structural equation modeling (SEM) and group analysis by race were used to test whether attitudes, norms, and perceived behavioral control mediated the effects of media exposure on intention to combine alcohol and sex. Results suggest that for both White and Black adolescents, exposure to media portrayals of alcohol and sex combinations is positively associated with adolescents’ attitudes and norms. These relationships were stronger among White adolescents. Intention was predicted by attitude, norms, and control, but only the attitude–intention relationship was different by race group (stronger for Whites).