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.     

Sex Partner Type,Drug Use and Condom Use Self-Efficacy Among African Americans from Disadvantaged Neighborhoods: Are Associations with Consistent Condom Use Moderated by Gender?

Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type (steady versus casual), drug use, and condom use self-efficacy regarding consistent condom use (CCU) among a community-based sample of adults. The sample included 1,357 African American men and women (M age 37.0, SD 13.1 years; 44% women, 66% men) from 61 disadvantaged census block groups in Atlanta, GA as part of a study of individual and neighborhood characteristics and HIV risk-taking. Having a steady partner decreased the odds of CCU, while higher condom use self-efficacy increased the odds of CCU. Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only. Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners.     

Relations Among Religiousness,Spirituality, and Sexual Practices

Although religiousness is commonly associated with limited sexual activity, little is known about spirituality's unique effect. Study aims involved measuring spirituality's unique affect on young adults' sexual practices (frequency of sex, number of sexual partners, and condom use) and determining whether spirituality adds significant increment over well-established predictors. Three hundred fifty-three (61% female) heterosexual young adults aged 17 to 29 completed this cross-sectional, self-report questionnaire study. Hierarchical regression analyses demonstrated spirituality is positively associated with participants' number of sexual partners and frequency of sex without a condom. Spirituality contributed to the prediction of participants' number of partners and condom use above and beyond the variance accounted for by religiousness, alcohol use, and impulsivity. A moderating effect for gender was found. Spirituality appears to have a unique and strong association with the sexual practices of young adults, particularly women, and should be assessed in future studies of young adults' sexual practices.     

Patterns of Intimate Partner Violence and Sexual Risk Behavior among Young Heterosexually Active Men

Intimate partner violence (IPV) victimization is linked to sexual risk exposure among women. However, less is known about the intersection of IPV perpetration and sexual risk behavior among men. This study used data from a diverse, community sample of 334 heterosexually active young men, aged 18 to 25, across the United States to examine whether and how men with distinct IPV-related behavior patterns differed in sexual risk–related behavior and attitudes. Participants were recruited and surveyed online, and grouped conceptually based on the types of IPV perpetration behavior(s) used in a current or recent romantic relationship. Groups were then compared on relevant sexual risk variables. Men reporting both physical abuse and sexual coercion against intimate partners reported significantly higher numbers of lifetime partners, higher rates of nonmonogamy, greater endorsement of nonmonogamy, and less frequent condom use relative to nonabusive men or those reporting controlling behavior only. This group also had higher sexually transmitted infection (STI) exposure compared to men who used controlling behavior only and men who used sexual coercion only. Findings suggest that interventions with men who use physical and sexual violence need to account for not only the physical and psychological harm of this behavior but also the sexual risk to which men may expose their partners.     

Young and Sexual in Norway and Croatia: Revisiting the Scandinavian Versus Mediterranean Gendered Pattern of Sexual Initiation

ABSTRACT

This article describes and analyzes patterns of first sexual intercourse and contraception use from a bicultural perspective. Study results are based on a 2009–2010 large-scale national probability survey of young adults aged 18 to 24 years in Croatia (n = 1,005) and Norway (n = 871). The findings corroborated the persistence of the dual model of sexual initiation in Europe (Scandinavian vs. Mediterranean), in which Norwegian women and Croatian men reported coital debut at an earlier age than their gender counterparts. Age difference between partners and the prevalence of condom use at first coitus were similar in both countries, with differences in contraceptive choices emerging with time. Young Norwegian men and women switched from using condoms to hormonal contraception when having been coitally active for some time. Interestingly, “the pill” remains rather unpopular among young Croatian women. Controlling for selected variables, using a condom at most recent sexual intercourse was significantly associated with condom use at first intercourse in all groups except Norwegian men, as well as with years of coital activity (except among Croatian men). Additionally, the odds of a condom being used at most recent intercourse were significantly correlated with same-sex sexual experience (only among Norwegian men) and with reporting the most recent intercourse with a casual partner (only among Norwegian participants). Country-specific patterns of contraceptive use are discussed in the context of public health and prevention.     

Femininity Ideology and Sexual Health in Young Women: A focus on Sexual Knowledge,Embodiment, and Agency

ABSTRACT

Traditional femininity ideology is associated with diminished sexual agency in women; yet we know little about its connection to sexual knowledge or experiences of one's body during sex. This study examined how femininity ideology related to sexual health knowledge, body comfort during sex, condom self-efficacy, and sexual assertiveness in college-age women. Femininity ideologies were related to decreased sexual-risk knowledge and lowered body esteem during sex. Femininity ideologies were also related to decreased sexual assertiveness and condom use self-efficacy. Results highlight the importance of understanding the association between femininity ideologies and sexual knowledge acquisition as an aspect of sexual agency, as well as sexual embodiment, in addition to the more commonly studied sexual self-efficacy and assertiveness.     

Condom use self-efficacy among U.S. and foreign-born Latinos in Texas

The objective of this study was to assess the influence of condom use self-efficacy on the reported condom use of Latinos. We conducted a rapid needs assessment study among U.S. and foreign-born Latinos living in Houston, TX, to identify behavioral and psychosocial factors that influence their risk for HIV. Bilingual Latino interviewers conducted confidential face-to-face interviews with individuals living in apartment complexes or residential areas primarily populated by Latinos. A total of 152 participants completed the survey. Regression results indicate that education and gender influenced condom use self-efficacy, which in turn influenced condom use in the last sexual encounter and with the primary sexual partner. However, gender and relationship risk were stronger predictors of condom use. Study results indicate that there are differences in condom use self-efficacy and sexual risk behaviors between Latino men and women that need further exploration.     

Condom Negotiation Strategies as a Mediator of the Relationship between Self-Efficacy and Condom Use

College students are a group at high risk of sexually transmitted infections due to inconsistent condom use and engaging in other risky sexual behaviors. This study examined whether condom use self-efficacy predicted the use of condom negotiation strategies (i.e., condom influence strategies) and whether condom influence strategies mediated the relationship between condom use self-efficacy and condom use within this population, as well as whether gender moderated the mediation model. Results showed a strong relationship between condom use self-efficacy and condom influence strategies. Additionally, condom influence strategies completely mediated the relationship between condom use self-efficacy and condom use. Although condom use self-efficacy was related to condom use, the ability to use condom negotiation strategies was the most important factor predicting condom use. The mediation model held across genders, except for the condom influence strategy withholding sex, where it was not significant for men. For women, condom use self-efficacy promoted the use of a very assertive negotiation strategy, withholding sex, and was consequently related to increased condom use. Overall, using assertive condom negotiation strategies (e.g., withholding sex and direct request) were found to be the most important aspects of increasing condom use for both women and men. Implications and suggestions for prevention programming are discussed.     

Sexual Behavior Changes Among Heterosexual,Lesbian and Gay Bar Patrons as Assessed by Questionnaire Over an 18-Month Period

Both an original and a follow-up questionnaire study of bar patrons in Greenwich Village, New York, ascertained concern about acquiring AIDS and resultant sexual behavioral changes. In 1986 (shortly before the Koop report), almost all of the gay men sampled, a majority of the lesbian and heterosexual women, but less than a quarter of the heterosexual men reported that a concern about AIDS had affected their sexual behavior. By 1987/88, almost all of the gay men and about 80% of heterosexual men, women and lesbians reported a sexual behavior change. The greatest specific behavioral changes between the studies involved increasing reports of declining casual sex (for all groups except the gay men, more than half of whom had reported this by the first study), and a greatly increased use of condoms by heterosexuals (who had rarely used them earlier) and by gay men (who had begun using them by 1986). Variables which predict heterosexual condom use for each gender are reported.     

Changes in Diverse Sexual and Contraceptive Behaviors Across College

Researchers have made repeated calls for a better understanding of normative sexuality development during adolescence and young adulthood. We examined how the occurrence of seven penetrative, nonpenetrative, and contraceptive behaviors changed longitudinally across seven waves, and how individual (gender) and contextual (romantic relationship status) factors related to these changes in a sample of college students (N = 730, M age = 18.4 at Semester 1; 51% female; 26% Hispanic/Latino American, 22% Black/African American, 30% Asian American/Pacific Islander, 45% White/European American). Across college, reported kissing, touching, performing and receiving oral sex, and penetrative sex rates increased, and contraception use (any type) and condom use (in particular) rates decreased, demonstrating changes with age independent of young adults’ romantic relationship experiences. Rates of all sexual behaviors were higher, and of contraception use lower, when students were in serious romantic relationships. Contraception use decreased more for men than for women, particularly in semesters men were not in serious relationships. Condom use decreased for men, and for women in semesters they were in serious relationships. Findings demonstrate normative trends in sexuality development, as well as suggesting the value of enhanced sexual health promotion programming, with a particular focus on contraceptive behaviors, across college.     

The Association Between Sexual Behavior and Affect: Moderating Factors in Young Women

Sexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women. Female first-year college students (N = 477) completed monthly assessments of their sexual behaviors and positive and negative affect. Participants reported more negative affect in months in which they engaged in sexual behavior compared to months in which they did not. This association was moderated by partner type, such that only sexual behavior with casual partners was associated with increased negative affect. Participants reported more positive affect during months with kissing/touching only compared to months without sexual behavior; however, this association did not differ significantly from the association between oral/vaginal sex and positive affect. Condom use did not moderate the association between vaginal sex and positive or negative affect. In this sample of young women transitioning to college, engaging in sexual behavior was generally associated with negative affect; however, changes in affect depended on partner type and sexual behaviors. Findings have implications for sexual health education.     

Predictors of safer sex on the college campus: a social cognitive theory analysis.

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N = 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjunction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.     

Predictors of Sexual Behavior Among Early and Middle Adolescents Affected by Maternal HIV

ABSTRACT. We describe the extent to which men who have sex with men and women (MSMW) tell their female sex partners that they have male sex partners and the association between disclosure of male partners and condom use with female partners. Data were from U.S. Internet-using MSMW recruited from a social networking Web site. Of 666 MSMW, 70% told their last female partner that they had male sex partners. MSMW who disclosed having male sex partners were equally likely to have used a condom during their last vaginal intercourse with a female partner (42%) as were men who did not disclose (47%). Because disclosure was not associated with condom use and condom use was low, it is important to continue efforts to promote consistent condom use, especially among females, regardless of the reported sexual orientation of their partners.     

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.     

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.     

Emotional Intimacy Power Predicts Different Sexual Experiences for Men and Women

Those who are more emotionally invested in relationships have less power than their partners. Furthermore, less powerful individuals may attempt to equalize power imbalances by offering rewards to their partner and using sex and condom use as exchange resources. Australian young adults reported their condom use and pressured sex experiences in both romantic (n = 708) and casual (n = 118) relationships. Results showed that greater power (lower relative emotional investment) predicted more condom use among those wanting to use condoms. In casual relationships, an interaction with gender showed that women in particular used condoms more when they had more power. Power also interacted with gender for pressured sex and, unexpectedly, men who had more power experienced more pressured sex. The possibility that condom use and pressured sex have different meanings for men and women is explored.     

Predictors of Safer Sex on the College Campus: A Social Cognitive Theory Analysis

Abstract

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N ? 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjuction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.     

The 90's

Gender differences in AIDS-related heterosexual concerns and sexual behavior with new sexual partners, with an emphasis on condom use and subjective condom experiences, were assessed by a questionnaire survey of middleclass bar patrons, on location, in New York City. Patrons were asked about their number of sexual partners, the extent of their AIDS-related womes and behavioral responses to such concerns, as well as their use of condoms in different sexual situations and their subjective condom experiences. Most people report that AIDS-related concerns have affected their behavior in some way, primarily in the increased use of condoms. Condom use varies according to type of relationship and type of sexual act and results generally in more peace of mind, but less sexual enjoyment. Peace of mind strongly predicts condom use during casual sex for both genders. In terms of gender differences, women worry about AIDS with new sexual partners more than men do and they tend to limit their number of partners more. Women appreciate the use of condoms more than men do, most likely because erection and ejaculatory concerns are fundamental aspects of men's, but not women's, condom experiences. "Worrying about AIDS" predicts condom use during casual sex for men, but not women. More men than women had a condom with them when surveyed.     

Gender,Generational Status,and Parent–Adolescent Sexual Communication: Implications for Latino/a Adolescent Sexual Behavior

There is little research on how specific parent–adolescent sexual communication topics influence Latino/a youth's sexual behaviors, and how gender and generational status may moderate effects. This study examined effects of three different messages on intercourse and condom use among 1,944 Latino/as from the National Longitudinal Study of Adolescent Health (T1 mean age = 15.46; SD = 1.50). Results indicated discussing health consequences predicted higher odds of intercourse 1 year later across gender and generation groups. Birth control recommendation effects on subsequent intercourse and condom use differed by generational status and gender. Results indicated that message content is important for understanding effects of parent–adolescent sex communication on adolescents' behavior and underscored the need to consider gender and generational status in Latino/a parent–adolescent sexual communication studies.