Underestimating Protection and Overestimating Risk: Examining Descriptive Normative Perceptions and Their Association with Drinking and Sexual Behaviors

Individuals who engage in risky sexual behavior face the possibility of experiencing negative consequences. One tenet of social learning theory is that individuals engage in behaviors partly based on observations or perceptions of others’ engagement in those behaviors. The present study aimed to document these norms–behavior relationships for both risky and protective sexual behaviors, including alcohol-related sexual behavior. Gender was also examined as a possible moderator of the norms–behavior relationship. Undergraduate students (n = 759; 58.0% female) completed a Web-based survey, including various measures of drinking and sexual behavior. Results indicated that students underestimate sexual health-protective behaviors (e.g., condom use and birth control use) and overestimate the risky behaviors (e.g., frequency of drinking prior to sex, typical number of drinks prior to sex, and frequency of casual sex) of their same-sex peers. All norms were positively associated with behavior, with the exception of condom use. Furthermore, no gender differences were found when examining the relationship between normative perceptions and behavior. The present study adds to the existing literature on normative misperceptions as it indicates that college students overestimate risky sexual behavior while underestimating sexual health-protective behaviors. Implications for interventions using the social norm approach and future directions are discussed.     

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.     

Risk factors associated with overweight and obesity in college students

College obesity is increasing, but to the authors' knowledge, no researchers to date have evaluated risk factors in this population. OBJECTIVE: The authors assessed whether abnormal eating perceptions and behaviors were associated with overweight in college students. PARTICIPANTS AND METHODS: A sample of undergraduates (N = 4,201) completed an online survey containing demographic questions and the Eating Attitudes Test-26 (EAT-26) questionnaire. The authors stratified participants into normal-weight and overweight/obese groups and evaluated physical activity, EAT-26 score, purging behaviors, and answers to selected overweight screening questions on the basis of body mass index. A modified EAT-26 score of > or = 11 was associated with overweight (p = .016). RESULTS: Compared with normal-weight peers, overweight participants displayed an increased fear of bingeing, preoccupation with food, desire to be thinner, and engagement in dieting behavior. Mean body mass index also increased with age and physical inactivity (p < .001). CONCLUSIONS: Because physical inactivity, disordered eating perceptions, and disordered behaviors are associated with increased rates of overweight and obesity, identification of these risk factors in obese youths may increase understanding of weight loss barriers and facilitate the treatment of adolescent obesity.     

Examining the role of racism in the risky alcohol use behaviors of black female college students

Objective: This study explores the impact racism has on the drinking behaviors of Black college women. Little is known about Black college women's experience of racism and the impact racism has on their psychological wellbeing and drinking behaviors. The current study fills a gap in our understanding of the role racism plays in the risky drinking behavior of Black college women. Participants: 469 Black college women ages 18–29 were sampled from 8 colleges and universities across the US, in 3 waves from December 2014-August 2017. Results: Findings suggest that general life stress and perceived racism are significantly associated with alcohol use among Black college women. However, only increased experiences of racism increase Black college women's engagement in risky drinking. Conclusions: The findings of this study serve as an entry point for a more nuanced assessment of stressors among Black college women that may inform drinking behaviors in this population.     

Young adults and casual sex: the relevance of college drinking settings

This study investigated the relevance of college drinking settings on the likelihood of students having sexual intercourse with a stranger. A random sample of 7,414 undergraduates at 14 public California universities responded to questions regarding frequency of attendance at six different setting types since the beginning of the semester (e.g., Greek, residence-hall parties, and bars or restaurants), drinking behavior, and sexual activity. Multi-level modeling examined the association between each setting type and the occurrence of alcohol-related sexual intercourse with a stranger. Findings indicated strong, positive associations between frequency of attendance at Greek parties, residence-hall parties, off-campus parties, and the occurrence of alcohol-related sex with a stranger. Frequency of attending the six settings and proportion of times drunk at the settings were also positively associated with alcohol-related sex with a stranger. Efforts aimed at preventing outcomes associated with casual sex (e.g., pregnancy, sexually transmitted infections, or mental health) should target specific drinking settings where students might be at high risk for risky alcohol use and unsafe sex behaviors.     

Use of Drinking Protective Behavioral Strategies and Sexual Perceptions and Behaviors in U.S. College Students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.     

Weight-related issues and high-risk sexual behaviors among college students

Individuals with high body mass index (BMI), negative body image, and unhealthy weight control behaviors may be more likely to engage in high-risk sexual behaviors than others. Researchers have not fully investigated these relationships in a sample of college students. The authors collected data regarding several weight-related issues and high-risk sexual behaviors (response rate = 39%) from 1,168 college students. Over half reported at least 1 high-risk sexual behavior. After the authors controlled for several demographic characteristics, they found that higher BMIs were associated with increased odds of having a casual sexual partner (odds ratio [OR] = 2.70) and being intoxicated at last intercourse (OR = 2.25). Among women, unhealthy weight control behaviors were associated with having a casual partner (OR = 2.12), using no or unreliable contraception (OR = 1.98), and being intoxicated at last intercourse (OR = 2.31). Weight-related issues were not associated with sexual behaviors among college men. The authors describe their findings within two health behavior frameworks, and they discuss implications for research and health education.     

Health behaviors of culturally diverse inner-city community college students

ABSTRACT

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies.     

Risky Sexual Behaviors and Pregnancy Outcomes in Young Adulthood Following Substantiated Childhood Maltreatment: Findings From a Prospective Birth Cohort Study

Childhood maltreatment is associated with a range of adverse mental and physical health outcomes, including increased rates of sexually transmitted infections (STIs) later in life. However, the impact on risky sexual behaviors and pregnancy outcomes has not been adequately studied. This is particularly true for physical abuse, emotional abuse, and neglect. We examined associations between prospectively substantiated childhood maltreatment and reports of risky sexual behaviors by men and women, as well as selected pregnancy outcomes in women. We followed up 3,081 (45.7% female) participants from the Mater-University of Queensland Study of Pregnancy, a prospective Australian birth cohort study. Using logistic regression, we examined the association between substantiated childhood maltreatment from birth to 14 years, and self-reported risky sexual behaviors and youth pregnancy outcomes at the 21-year follow-up. In adjusted analyses, children who had experienced multiple childhood maltreatment exhibited more risky sexual behaviors than their nonmaltreated counterparts. In specific models, those exposed to each form of childhood maltreatment, independent of co-occurring forms of childhood maltreatment, had an increased likelihood of risky sexual behaviors, particularly an early sexual debut and, for women, youth pregnancy. Neglect was also associated with multiple sexual partners, and emotional abuse with higher rates of miscarriage. There was no difference between men and women in how different forms of childhood maltreatment predicted risky sexual behaviors in young adulthood. All forms of substantiated childhood maltreatment, including multiple substantiations, were associated with risky sexual behavior in both sexes as well as higher rates of youth pregnancy in women. Moreover, emotional abuse persistently predicted miscarriages in young adult women. Understanding the association between childhood maltreatment and risky sexual behaviors and youth pregnancy outcomes may help suggest preventive strategies.     

Alcohol, drugs, and links to sexual risk behaviors among a sample of Virginia college students

This project was significant in that it administered the National College Health Risk Behavior Survey (NCHRBS), a health risk assessment, to a sample of students at three public universities in Virginia. Virginia was never included in the original or subsequent nationwide assessments using this instrument. This health risk assessment is comprehensive, easy to administer, and free. The NCHRBS assesses risk behaviors in six categories including: (1) behaviors that contribute to unintentional and intentional injuries; (2) tobacco use; (3) alcohol and other drug use; (4) sexual behaviors that contribute to unintended pregnancy and STDs, including the HIV infection; (5) unhealthy dietary behaviors; and (6) physical inactivity. This article focuses on student responses to questions about alcohol and other drugs and sexual behaviors linked to the use of these substances. It provided baseline data on health risk behaviors of college students which can help determine wellness/health education course objectives and health promotion programming and services provided to the students within the universities. In addition, this project provided protocol to expand use of the survey statewide.     

Sexual compulsivity among heterosexual college students

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

Child Abuse,Early Maladaptive Schemas,and Risky Sexual Behavior in College Women

Previous research suggests that individuals abused as children are more likely to engage in risky sexual behavior during adulthood. The present study examined early maladaptive schemas as mediators of the child abuse–risky sexual behavior relationship among 653 college women. Self-report surveys assessed three forms of child abuse: Sexual, physical, and emotional, and assessed early maladaptive schemas within two domains: Disconnection/rejection and Other-Directedness. Disconnection/rejection schemas fully mediated the relation between child emotional abuse and number of sexual partners and partially mediated the relationship for sexual and physical abuse. However, when frequency of specific risky sexual acts (e.g., sex without contraception) was examined in the previous six months, only abandonment was a partial mediator. Implications for intervention and future research are discussed.     

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college

Objective: To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. Participants: 184 community college students (ages 18–19) participated in the study from April–December 2015. Methods: Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Results: Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. Conclusions: The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.     

Sexual and Reproductive Health Behaviors of California Community College Students

Abstract

Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was administered in class to randomly selected classrooms at 12 institutions and electronically to randomly selected e-mails of students at 1 institution from March through April 2007. Results: This sample of community college students reported higher rates of risky sexual behaviors, unintended pregnancy, emergency contraception, and sexually transmitted diseases, and lower rates of human immunodeficiency virus (HIV) testing, than the overall ACHA-NCHA reference group. Those who had been tested for HIV reported more sexual partners, and lower rates of condom use. Conclusions: The data provide justification for broader educational programs and access to family planning services, condoms, and HIV testing on community college campuses.     

Perceptions of sexual coercion in heterosexual dating relationships: the role of aggressor gender and tactics

A large body of research has found a concerning prevalence rate of sexual coercion in heterosexual college student dating relationships; however, little research has examined how college students perceive and interpret these behaviors. In the current study we examined the impact of initiator gender and sexually coercive strategy (verbal pressure, purposeful intoxication, physical force, or control/mutual consent) on perceptions of the aggressor, victim, behavior, and relationship quality. Results indicated that men who coerce are viewed as aggressive; women who coerce are viewed as promiscuous. Targets of sexual coercion are not perceived as experiencing high levels of victimization following the incident. These findings suggest that college students do not perceive sexually coercive behaviors to be highly problematic. The results are discussed in terms of gender roles and practical implications for college student relationships.     

Child abuse, early maladaptive schemas, and risky sexual behavior in college women

Previous research suggests that individuals abused as children are more likely to engage in risky sexual behavior during adulthood. The present study examined early maladaptive schemas as mediators of the child abuse-risky sexual behavior relationship among 653 college women. Self-report surveys assessed three forms of child abuse: Sexual, physical, and emotional, and assessed early maladaptive schemas within two domains: Disconnection/rejection and Other-Directedness. Disconnection/rejection schemas fully mediated the relation between child emotional abuse and number of sexual partners and partially mediated the relationship for sexual and physical abuse. However, when frequency of specific risky sexual acts (e.g., sex without contraception) was examined in the previous six months, only abandonment was a partial mediator. Implications for intervention and future research are discussed.     

Sexual compulsivity among heterosexual college students

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

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.     

Texas college students' opinions of no-smoking policies, secondhand smoke, and smoking in public places

Abstract. The authors examined college student opinions of no-smoking policies, secondhand smoke, and smoking in public places. A convenience sample of 1,188 (66.4% female; 26.9% White, 64.1% Black, and 9.0% Hispanic) students attending 5 Texas colleges volunteered to complete a 60-item anonymous survey on tobacco attitudes and behaviors. Results of our study showed that women, Black students, and nonsmoking students reported the most favorable attitudes toward no smoking. Male students, white students, and students who smoked in the past 30 days (current smokers) reported the least favorable attitudes. The lowest level of agreement by all subgroups was provided for prohibiting smoking everywhere on campus (inside and outside of buildings). Implications for tobacco control on college campuses are discussed.