Determinants Influencing Male Condom use Among University Students in Portugal

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

The moderating effect of alcohol use on protective and risky sex behaviors among college students in the Southeast United States

ABSTRACT

Objective: College students are a high-risk population for new human immunodeficiency viruses (HIV) diagnoses. Although condom use self-efficacy and HIV knowledge can protect against risky sexual behavior (RSB), these same protective factors have been shown to exacerbate RSB. The influence of alcohol use can further complicate these protective factors to influence RSB. Participants: 689 African American/Black and non-Hispanic White college students attending a public university in the Southeast United States. Method: This study sought to examine the relations between condom use self-efficacy and HIV knowledge with RSB and the moderating effect of alcohol use. Results: Findings showed positive associations between RSB and HIV knowledge and alcohol use. Unexpectedly, low frequency drinkers with high condom use self-efficacy were at increased risk for RSB compared to high frequency drinking counterparts. Conclusions: Findings point to the need to target prevention services for low-risk drinkers in college settings.     

Contact Reduces Transprejudice: A Study on Attitudes towards Transgenderism and Transgender Civil Rights in Hong Kong

ABSTRACT

This paper examines the relationship between Hong Kong Chinese people's contact with transgender/transsexual (TG/TS) people and attitudes toward transgenderism and transgender civil rights, based on Allport's Contact Hypothesis. The term transprejudice is introduced to refer to the negative valuing, stereotyping and discriminatory treatment of TG/TS people. Data are presented from a population-based survey with a random sample of 856 Hong Kong Chinese persons aged between 15 and 64, using the Chinese Attitudes towards Transgenderism and Transgender Civil Rights Scale (CATTCRS). Attitudes, assessed on both personal and institutional dimensions, are examined in relation to participants’ gender, age, educational level, religiosity, and previous contact with transpeople. Results suggest that previous contact with transpeople was significantly associated with attitudes reflected in the scale; decreased social distance, decreased social discrimination, and decreased transprejudice, increased awareness of discrimination against transpeople, increased support for equal opportunities, increased support for post-operative transsexual civil rights, and increased support for anti-discrimination legislation. Our findings support the contact hypothesis, that contact has a positive effect on attitudes towards TG/TS persons. We discuss the implications of these findings for public education interventions and public policy, as well as for research.     

General Statement of Ethical Principles and Guidelines

Objective: The authors examined the effects of relational commitment (high commitment versus low commitment) and relationship maintenance goals (high threat versus low threat) on decisions to request the use of a condom. Methods: The authors conducted a 2-part study using a survey of responses to hypothetical scenarios and decisions in actual relationships. Results: Results indicated that people with high relational commitment were less likely to request a condom than were people with low relational commitment. People who perceived threats to relationship maintenance goals if a condom was requested were less likely to request a condom than were people who did not perceive threats to relationship maintenance goals. Conclusions: Findings from this study highlight the influence that relational threats and commitment levels have on condom use decision making.     

Prevalence of Insomnia and Its Psychosocial Correlates Among College Students in Hong Kong

Abstract

Objective: This study examined the prevalence of insomnia and its psychosocial correlates among college students in Hong Kong. Participants: A total of 529 Hong Kong college students participated in the study. Methods: Participants completed a self-reported questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Revised Life Orientation Test, the Perceived Stress Scale, and the Beck Depression Inventory, and questions about sociodemographic and lifestyle factors. A PSQI global score equal to or greater than 5 indicated insomnia. Results: Results indicated that 68.6% of the participants were insomniacs. Adjusted regression analyses revealed that optimism, stress, and depression significantly predicted insomnia (p < .01). Conclusions: These results suggest that insomnia is very common among Hong Kong college students and associated with other psychosocial factors. This study provides preliminary data on sleep quality and risk factors for insomnia, which may be used to guide sleep hygiene promotion and intervention among college students.     

Cultural Factors and Program Implications

ABSTRACT

Despite the effectiveness of condoms in HIV prevention, programs and services encouraging HIV prevention have failed to increase condom use among U.S. Latino populations. The authors identify six “myths” preventing condom use among Latinos. It is suggested that programs address these myths surrounding condom use in HIV prevention strategies targeting Latino communities in order to make interventions more salient to Latino populations and, therefore, more effective.     

Knowledge of Acute Human Immnuodeficiency Virus Infection Among Gay and Bisexual Male College Students

Abstract

Objective: To examine human immunodeficiency virus (HIV)–related knowledge, attitudes, and behaviors in at-risk college men who have sex with men (MSM), focusing on knowledge about acute HIV infection (AHI). Participants and Methods: A one-time anonymous survey was administered to college students attending a lesbian, gay, bisexual, transgender, and queer conference in February 2012. This article reports on a study subsample of MSM. Results: A total of 100 MSM completed the survey. Participants had an average age of 20.4 years. Sixty-six percent reported condom use the last time they had sex. Only 46% had ever heard of symptoms related to AHI. Forty-two percent would likely seek medical care when showing acute symptoms in a setting consistent with AHI. Conclusion: Despite having multiple risk factors for HIV infection, many MSM college students are unaware of AHI. HIV prevention programs should target this population and include information about signs, symptoms, and diagnosis of AHI.     

HIV-Negative Seroconcordant Gay Male Couples' Attitudes,Intentions, and Perceived Behavioral Control for Planned Condom Use Within and Outside of Their Relationships

ABSTRACT

Despite high HIV rates among gay male couples, limited research exists about their attitudes, intentions, social norms, and perceived behavioral control for planned condom use within and outside of their relationships. Our cross-sectional study used multilevel modeling with dyadic data from 142 HIV-negative gay male couples to examine and identify which factors were statistically associated with planned condom use within and outside the relationship. Several differences for planned condom use were also noted based on the sample's prior history of unprotected anal intercourse and relationship type. Findings suggest additional prevention tools are needed for some HIV-negative gay male couples who are at risk for HIV.     

The Trouble With Condoms: Norms and Meanings of Sexuality and Condom Use Among School-Going Youth in Kenya

ABSTRACT

Despite knowledge of the effectiveness of condoms in preventing HIV transmission, condoms continue to be reported in only a minority of sexual encounters even with nonpermanent partners. This study used focus-group discussions with youth and interviews with community leaders from 22 communities in the Nyanza and Rift Valley provinces, Kenya, to examine the sociocultural influences on condom use among school-going youth. Three overarching themes emerged from a thematic analysis of the data. Condoms did not fit with the purposes, meanings, and understandings of sexuality; in fact, condom use violated most of these. Condoms were also thought to be dangerous for girls and women, to contribute to the spread of HIV, and to be unnecessary for protection against HIV. Finally, given the hardships of life and multiple diseases and circumstances that threatened life, HIV was seen as just another trouble of living. Sex without a condom, within this context, was described as one of the pleasures of a short life. The complexities of sexuality evidenced in the discussions of these youth and adults challenge the viability of the ABC (abstain, be faithful, use a condom) message as a preventive measure against HIV transmission.     

A Novel,Self-guided,Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Abstract

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a repeated measures design with the primary follow-up assessment occurring 6 weeks after enrollment. Results: Forty-five percent of men reported a reduced frequency of unprotected insertive penile–anal intercourse in the past 30 days compared with baseline (p = .01). Consistency of condom use improved (p = .013), as did motivation to use condoms correctly, condom use self-efficacy, and condom attitudes. All participants indicated that they were glad they participated, would recommend the program, and that overall, they had liked the program. Conclusions: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).     

Understanding heterosexual Chinese college students' intention to adopt safer sex behaviors

This study aimed to examine Chinese college students' safer sex behaviors and to explore whether or not the Theory of Reasoned Action would be useful in understanding AIDS/HIV‐prevention behaviors of Chinese students. A total of 455 Chinese college students (161 males and 267 females) in Hong Kong participated in the study. Results revealed that 24% of the students were sexually active during the surveyed year, with only 38.2% of them reporting regular condom use. About one third of the students intended to experiment with casual sex in the future, but only 64% would use condoms regularly if they were to have future casual sexual encounters. Results indicated that the Theory of Reasoned Action was most applicable in understanding Chinese college students’ intention to use condoms in future casual sexual encounters, rather than in current and future regular sexual activities. Specifically, students who intended‐to use condoms in future casual sex encounters tended to have accurate AIDS/HIV information, show little prejudice against people with AIDS/HIV, demonstrate greater concern about contracting AIDS/HIV, feel confident in condom use, and have positive attitudes toward safer sex behaviors. Gender disparity was also noted in the pattern of associations between safer sex behaviors and various psychological variables. Limitations of the present study and implications for future research were also discussed.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

The post-80s generation: exploring the attitudes toward family and housing

ABSTRACT

Previous literature has paid attention to housing pathways and cohort features of young people, but studies connecting the two themes are lacking. This paper offers a perspective on the cohort analysis of young people based on their housing choices and aspirations. With empirical evidence from a two-round social survey, this study explores the ‘not leaving home’ pattern of the housing choices of young people in Hong Kong. With some supplementary subgroup analysis, the cohort label of a ‘post-80s generation’ in Hong Kong is challenged. Contradictions are revealed in the views of our young people about housing and family life, and further analysis is conducted to examine the impacts of economic and sociocultural factors in the local context of Hong Kong. This study argues that we need to look beyond the shared features and subgroup differences and consider how sociocultural factors, particularly gender, marriage, education, and social norms, interact with economic factors to shape housing choices, aspirations and apparent contradictions in the viewpoints of young people regarding their personal development and housing futures. In doing so, the paper also engages with debates around intra and intergenerational dynamics and inequalities. The paper focuses on Hong Kong but these debates have international resonance.     

Why Do Women Want Children? The Case of Hong Kong,China: A Lowest-Low Fertility Context

ABSTRACT

Governments in low fertility countries tend to tackle low birth rates by addressing macro-level factors rather than the meaning that having a child holds for men and women. Yet whether or not an individual decides to have a child depends in part on what they think having a child will mean for their lives. This study examines the meanings that constitute reasons for wanting a child among a sample of middle-class, married, Hong Kong Chinese women who wanted children. These women were living in Hong Kong when it had one of the lowest total fertility rates in the world and the lowest in its history. Using semi-structured, in-depth interviews, it finds that for these women, to have a child makes one’s family complete; is the next stage of life; provides happiness, fun, and enjoyment; brings care and company in old age; and children are “lovely” and “cute.” Governments concerned about low birth rates can use research on what having a child means for women to improve policy so as to make having a child more attractive, and to create messages that hold greater appeal to women.     

The Relationship Between Use of Sexually Explicit Media and Sexual Risk Behavior in Men Who Have Sex with Men: Exploring the Mediating Effects of Sexual Self-Esteem and Condom Use Self-Efficacy

ABSTRACT

Objectives: This study tests the following 3 hypotheses: (1) there is a direct association between consumption of sexually explicit media (SEM) depicting non-condom use and sexually transmitted infection (STI)-related sexual risk behavior among men who have sex with men (MSM); (2) the association between SEM consumption and STI-related sexual risk behavior is mediated by men's sexual self-esteem; and (3) the relationship between SEM consumption and sexual risk behavior is mediated by condom use self-efficacy. Methods: A cross-sectional, Internet-based survey on exposure to SEM and sexual behavior of 1,391 MSM in the United States was conducted in 2011. Results: The results confirmed Hypotheses 1 and 3, while Hypothesis 2 was rejected. Accordingly, a significant association between the use of SEM picturing condom use and STI-related sexual risk behavior among MSM was found. Likewise, we found that the association between the use of SEM and sexual risk behavior was mediated by condom use self-efficacy in an indirect path. However, SEM did not influence sexual risk behavior via sexual self-esteem. Conclusions: To promote STI prevention, the actors in SEM may be used as role models in managing condom use in sexual contexts.     

Internet Use Among People with HIV/AIDS

ABSTRACT

The Internet offers people with HIV/AIDS timely information about treatment advances and supportive social contacts for this stigmatized disease, yet little is known about Internet use patterns among people with HIV/AIDS. This study of 120 persons with HIV/AIDS in the U.S. found approximately 19% used the Internet for HIV/AIDS-related purposes, much lower than the rate for general Internet use among the U.S. population. Lower incomes were associated with lower rates of use, echoing the “digital divide” found in the general population. Access from home was most common and information sought was primarily on medical treatments and medications. Possible reasons for low access rates, strategies for increasing access, and implications for other client groups are discussed.     

The Paradox of Risk: Historically Black College/University Students and Sexual Health

Abstract

Objective: This literature review provides an analysis of the current state of the empirical research on sexual health among students attending historically black colleges and universities (HBCUs). Methods: Several electronic databases were used to identify 24 empirical studies that met criteria for inclusion in this review. Results: The results indicated that perceived human immunodeficiency virus (HIV) risk, religiosity, HIV testing, condom use, and substance use were as high or higher for black HBCU students in comparison with students of other racial/ethnic groups. Comment: Consistent with past findings, sexually transmitted infections continue to be of concern among HBCU students, as seen in the general black population. Limitations: This review only examined cross-sectional studies published between 2000 and 2013. Conclusions: The findings in this review suggest the importance of moving beyond individual risk models to examining structural barriers and assets related to promoting sexual health on HBCU campuses.     

THe Use of Hormone Therapy in the Male-to-Female Transgender Population: Issues for Consideration in Thailand

ABSTRACT

Objectives: Prejudice against transgender people is evident around the world with discrimination in many aspects of life, including access to health care. Even in Thailand, where male-to-female (MTF) transgender people are particularly visible and society is reputedly accepting, barriers to attaining appropriate health care still exist. The vast majority of MTF transgender people in Thailand are reported to be taking hormone therapy; however, most do not seek medical advice regarding these regimens, with the initiation and tailoring of medication often being guided by sympathetic peers instead. The objectives of this review are to consider hormone therapy in the context of the Thai population and provide recommendations regarding ways to improve practice and reduce health risks. Methods: The data analysis in this article represents a comprehensive literature review regarding hormone therapy for MTF transgender people including the guidelines for initiation, prescribing, and monitoring of hormone therapy, risks for serious adverse events and reported hormone use by the MTF transgender population in Thailand. Results: There is a notable lack of published research regarding hormone therapy in the transgender population. Guidelines, whilst relying considerably on expert opinion, do provide clear recommendations on the initiation, maintenance and monitoring of hormone therapy. Comparison of endocrine guidelines with reported practice in Thailand reveals significant opportunities for improvement in MTF transgender hormone therapy. Conclusions: The incautious use of hormone therapy may represent a considerable health risk behavior undoubtedly contributing to the morbidity and mortality in MTF transgender people. Although there is currently considerable focus on sexually transmitted infections in the MTF transgender population, a more comprehensive approach to health care is required, including education for transgender people and the health professionals who attend to them regarding appropriate hormone therapy.     

Investigating the role of individual characteristics,interpersonal sexual communication,media exposure,and gender differences on condom use among chinese college students in hunan

Objectives: The objective of this study was to investigate factors of condom use among a sample of 490 sexually active Chinese college students. Methods: A cross-sectional survey by systematic sampling was conducted on students' interpersonal sexual communication, media exposure, and condom use. Multiple regression was employed for analysis. Results: Self-efficacy, peer and partner sexual communication, parent norms about condom usage, HIV/AIDS information from brochures, and exposure to sexual content in books were associated with variables related to condom use. Conclusions: The current study underscores the importance of self-efficacy and peer and partner sexual communication in HIV preventive intervention programs that promote condom use among young Chinese.     

Low Self-Control and Co-occurrence of Gambling with Substance Use and Delinquency Among Chinese Adolescents

Relatively little is known about gambling co-morbidity in Asian youth populations. The role of trait self-control in co-morbidity also remains under-explored in the gambling literature. This study examined the association between gambling, substance use and delinquency among Chinese adolescents, and the extent to which these forms of risk behavior are commonly predicted by low self-control. Data from a cross-sectional questionnaire survey of a stratified, random sample of 4,734 high school students aged 12–23 years in Hong Kong were analyzed. The prevalence of gambling pathology, frequency and attitudes showed statistically significant, positive and consistent relationships with tobacco use, alcohol use, and delinquent acts at the p < .001 level. Further analyses revealed that low self-control significantly (p < .001) predicts at-risk/probable pathological gambling, frequent gambling, strong permissiveness toward gambling, heavy use of tobacco and alcohol, and delinquent involvement, even after controlling for the potential shared correlates of socioeconomic characteristics, parental monitoring and peer delinquency. Hence, the concept that gambling problems and strong receptivity to gambling are likely to be part of a general problem behavior syndrome is evinced cross-culturally among young people in a Chinese context. It may also be cost-effective to increase intervention efforts to improve the self-control deficit in adolescents, as this should reduce their gambling and concurrent problem behavior.