Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.     

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.     

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.     

Discrepant Responding across Self-Report Measures of Men's Coercive and Aggressive Sexual Strategies

Researchers have worked to refine the measurement of women's experiences with sexual victimization. Less is known about the validity and reliability of measures that assess men's use of sexual coercion and aggression. These studies explore the consistency of men's responses to two distinct, but similar, measures of sexual coercion and aggression. The two measures both assess historical use of verbal coercion, sexual assault involving drugs or alcohol, and sexual assault through threat or force. Study 1 used college men as participants (N = 398), whereas Study 2 used a mixed sample of college and community men (N = 184). In both studies, participants’ responses were largely inconsistent across the two measures. This article explores potential measurement issues that may account for the observed reporting discrepancies and offers suggestions for future research.     

Attitudes and Acts of Sexual Aggression on a University Campus*

There is increasing understanding of the widespread extent of men's physical sexual coercion of women in this society. In this study, we document the amount of that coercion among a sample of college students. We try to explain that coercion in terms of certain valucs (traditional sex-role conceptions that amount to an ideology of gender inequality). We also try to explain that coercion in terms of attitudes towards physical sexual coercion. For purposes of this study, we measured both females’experience as victims of sexual aggression and males’experience as perpetrators of sexual aggression. We also measured both males’and females’values regarding gender inequality and attitudes regarding sexual aggression. We found that female college students in our sample had experienced a considerable amount of sexual aggression. We also found that male and female students’values regarding gender inequality and their attitudes regarding physical sexual coercion differed widely. Finally, we found strong relationships between male students’values and attitudes and their participation in sexual aggression.     

Gender differences in psychological,physical, and sexual aggression among college students using the revised conflict tactics scales

In response to criticisms of the Conflict Tactics Scales, Straus revised the original scale to include sexual aggression and injury. The purpose of the present study was to use this new scale to replicate and expand existing knowledge of psychological, physical, and sexual aggression in dating relationships. Four-hundred-eighty-one college students completed the Revised Conflict Tactics Scales. As expected, females reported perpetrating more psychological aggression than males; there were no gender differences in reported physical aggression; and psychological and physical aggression tended to co-occur. Contrary to previous research, there were no gender differences in injuries. As expected, males reported perpetrating more sexual coercion than females; however, females also reported perpetrating sexual aggression, and there were no gender differences in reported victimization. For males, sexual coercion perpetration (not victimization) was related to the perpetration and victimization of physical and psychological aggression. For females, both sexual coercion perpetration and victimization were related to the perpetration and victimization of psychological aggression and victimization from physical aggression, but not to physical aggression perpetration.     

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.     

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.     

Understanding the Relationship Between Alcohol and Sex: Latino and White College Students and Problematic Sexual Experiences While Drinking

Objectives: The authors examined whether the relationship between alcohol expectancies and sexual experiences while drinking differed between Latino and white college students. Participants: The authors considered students if they were white or Latino, unmarried, aged 18-25 years, reported any drinking, and had at least 1 sexual partner in the present school year. Methods: The investigators collected surveys from a random sample of 13,868 undergraduate students from the 14 California public university campuses. They used tests of group differences and hierarchical multiple regressions. Results: Social-facilitation alcohol expectancies were associated with the total number of different alcohol-related sexual experiences among Latino students. Neither social facilitation nor sexual-enhancement alcohol expectancies were differentially predictive of white or Latino students' frequency of sexual experiences. Conclusions: Additional research is necessary to determine whether concepts targeted by alcohol prevention programs operate in a differential manner for Latino students.     

College Women's Sexual Decision Making: Cognitive Mediation of Alcohol Expectancy Effects

Abstract

Objective: Alcohol has been linked to a variety of risky sexual practices, including inconsistent condom use. Due to the high rates of alcohol consumption among underage college women, greater understanding of the role of alcohol in young women's sexual decision making is warranted. Participants and Methods: Female underage (18- to 20-year-old) social drinkers (N = 94) participated in an experiment in which they projected themselves into a written hypothetical sexual situation with a new partner. One half of the situations portrayed alcohol consumption; one half did not involve alcohol consumption. Their appraisals of the situation's sexual potential, impelling and inhibiting cognitions, and sexual behavior intentions were assessed. Results: Results revealed that alcohol's expectancy effects on young women's unprotected sexual intentions were mediated by their cognitive appraisals of the situation. Conclusions: These findings indicate that alcohol expectancies and their influence on women's sexual decisions should be incorporated into sexual risk reduction efforts.     

The prevalence of sexual aggression and victimization among homosexual men

This study examined the prevalence of unwanted sexual contacts among a sample of 310 homosexual men with an average age of 21.8 years recruited in Berlin, Germany. A modified version of the Sexual Experiences Survey was developed to record unwanted contacts involving different means of coercion, sexual acts, and victim‐perpetrator relationships. Reports were elicited about (a) sexual victimization and (b) perpetration of sexually aggressive acts. Three methods of victimization were studied: physical force, exploitation of the victim's incapacitated state, and verbal coercion. Of the 310 respondents, about 15% reported sexual victimization through the use or threat of forcé. Twenty percent were victimized through exploitation of their inability to offer resistance when in an incapacitated state. Ten percent reported victimization through verbal coercion. In terms of being the perpetrator of sexual aggression, over 5% of respondents reported using or threatening to use physical force. Over 16% reported exploiting a person's incapacitated state, and over 6% admitted to the use of verbal coercion. Acceptance of money for sex was identified as a risk factor for both victimization and perpetration. The data show that sexual aggression is a serious problem among homosexual men which requires further exploration.     

Relationship Between Vigorous Exercise Frequency and Substance Use Among First-Year Drinking College Students

Objective: The authors explored the relationship between self-reported vigorous exercise frequency and alcohol, tobacco, and other drug (ATOD) use behaviors among first-year college students who self-identified as drinkers. Participants: The authors recruited 391 freshman college students in Northeast Florida to participate in an alcohol abuse prevention study. Methods: The authors conducted a multivariate analysis of variance to assess the relationship between vigorous exercise frequency and 6 measures of ATOD use at baseline. Results: Frequent exercisers drank significantly more often and a significantly greater quantity than did infrequent exercisers. However, frequent exercisers smoked cigarettes significantly less often than did infrequent exercisers. Conclusions: These findings suggest that vigorous exercise frequency is differentially associated with alcohol and cigarette consumption among college students. Researchers should further examine the reasons for these differences.     

The Effect of Religiosity and Campus Alcohol Culture on Collegiate Alcohol Consumption

Abstract

Religiosity and campus culture were examined in relationship to alcohol consumption among college students using reference group theory. Participants and Methods: College students (N = 530) at a religious college and at a state university complete questionnaires on alcohol use and religiosity. Statistical tests and logistic regression were utilized to examine alcohol use, religiosity, and campus environment. Results: Alcohol consumption was significantly higher among students at the university (M = 26.9 drinks) versus students at the religious college (M = 11.9 drinks). University students also had lower religiosity scores (M = 23.8) than students at the religious college (M = 26.5). Students who attend a secular university are 4 times more likely to be moderate or heavy drinkers compared to students attending a religiously affiliated college. Students with the least religiosity were 27 times more likely to be a heavy alcohol user and 9 times more likely to be a moderate alcohol user compared to students with greater religiosity.     

Number of sexual partners and sexual assertiveness predict sexual victimization: do more partners equal more risk?

In previous studies, number of sexual partners and sexual assertiveness were examined as independent risk factors for sexual victimization among college women. Using a sample of 335 college women, this study examined the interaction of number of sexual partners and sexual assertiveness on verbal sexual coercion and rape. Approximately 32% of the sample reported unwanted sexual intercourse, 6.9% (n = 23) experienced verbal sexual coercion, 17.9% (n = 60) experienced rape, and 7.2% (n = 24) experienced both. As number of sexual partners increased, instances of verbal sexual coercion increased for women low in relational sexual assertiveness but not for women high in relational sexual assertiveness. A similar relationship was not found for rape. Among women who experienced both verbal sexual coercion and rape, increases in number of partners in the context of low refusal and relational assertiveness were associated with increases in verbal sexual coercion and rape. Findings suggest sexual assertiveness is related to fewer experiences of sexual coercion.     

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.     

Characteristics of precollege sexual violence victimization and associations with sexual violence revictimization during college

Abstract

Objective: To examine the prevalence and characteristics of precollege sexual victimization (SV) experiences and associations with revictimization and recent substance use behaviors among a sample of college students who reported precollege SV. Participants: A sub-sample of 931 college students who reported precollege SV at baseline data collection for an ongoing multi-site clinical trial. Methods: Data were collected via electronic surveys between September 2015 and March 2017. Measures included precollege and during college SV, recent substance use, and alcohol-related harm reduction behaviors. Results: Precollege SV characteristics associated with revictimization included: Nonpenile penetration (aOR: 1.51, 95%CI: 1.04–2.19); pressured sex (aOR: 1.46, 95%CI: 1.06–2.01); and stranger assault (aOR: 2.03, 95%CI: 1.22–3.40). Past 30-day binge drinking was also associated with revictimization (aOR: 1.86, 95%CI: 1.36–2.54). Conclusions: The relationship between precollege SV and alcohol, especially binge drinking, may require a more integrated approach to preventing subsequent revictimization.     

Trends in long-acting reversible contraceptive (LARC) use,LARC use predictors,and dual-method use among a national sample of college women

Objective: Assess long-acting reversible contraceptive (LARC) and other contraceptive use trends, identify LARC use predictors, and examine dual method use. Participants: Women in the American College Health Association-National College Health Assessment (ACHA-NCHA) II, aged 18–24 years, who reported having vaginal sex (N = 37,899). Methods: Secondary analyses of Fall 2011–2014 ACHA-NCHA II data. Results: Statistically significant increases in LARC usage and, specifically, implant usage, were found. Characteristics associated with LARC use included age, race/ethnicity, relationship status, and school type. Students reporting LARC use had lower odds of condom usage compared with non-LARC hormonal method users. Conclusion: This analysis of LARC predictors and dual LARC/condom use has implications for research and health promotion efforts. Findings suggest that college health services are well positioned to meet the sexual and reproductive health needs of diverse populations of students. College health professionals should elicit students' individual and/or relationship priorities to tailor messaging/services offered for pregnancy/STI prevention.     

Safer Sex and the Health Belief Model

Abstract

The goal of the present study was to build on the Health Belief Model (HBM) by adding predictors of late adolescent safer sex behavior: perceptions of peer norms for sexual behavior, and sexual attitudes that emerge from socialization. Sexually active, late adolescent college students (N = 154, 62.3% female; mean age 20.8 years, 76% European American) participated in the study. Predictors from the original HBM included perceived vulnerability, condom use self-efficacy, and attitudes about condoms. In addition, peer norms for condom use and sexual behavior, general sexual attitudes, and endorsement of the sexual double standard were included as predictors of safer sex behavior. Attitudes about condoms, perceived vulnerability, condom use self-efficacy, and the sexual double standard emerged as significant correlates of condom use. General sexual attitudes and the sexual double standard were significantly correlated with alcohol use before or during sex. With the addition of these variables, the regression models accounted for 28% of the variance in condom use, and 14% of the variance in alcohol use before or during sex.     

Relationship intentions,race, and gender: Student differences in condom use during hookups involving vaginal sex

Abstract

Objective: To examine the relationship between race, gender, and pre-hookup relationship intentions and college students’ participation in condomless vaginal sex. Participants: 3,315 Black and White college students who participated in the Online College Social Life Survey (OCSLS). Methods: Secondary data analysis of the OCSLS using Chi-square and multiple logistic regression analyses. Results: The model revealed that students who did not want a relationship with their hookup partners and students unsure of their relationship intentions were more likely to use condoms during their last vaginal hookup. Further, White and Female students were less likely to have used condoms during their last vaginal hookup.

Conclusions: White and female students, as well as students desiring romantic relationships with hookup partners may be at risk for sexually transmitted infections (STIs) due to decreased condom use. However, more research is needed to explore the factors driving STI disparities facing Black students despite higher condom use.