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.     

Disclosure of sexual assault experiences among undergraduate women at historically black colleges and universities (HBCUs)

ABSTRACT

Objective: To document the sexual assault disclosure experiences of historically black college or university (HBCU) students. Participants: A total of 3,951 female, undergraduate students at 4 HBCUs. Methods: All women at the participating schools were recruited in November 2008 to participate in a Web-based survey including both closed- and open-ended questions. Survey data were weighted for nonresponse bias. Results: The majority of sexual assault survivors disclosed their experience to someone close to them, but disclosure to formal supports, particularly law enforcement agencies, was extremely rare. Nonreporters had concerns about the seriousness of the incident and their privacy. On the basis of qualitative data, strategies identified by students to increase reporting included more education and awareness about sexual assault, more survivor services and alternative mechanisms for reporting, and better strategies for protecting the confidentiality of survivors. Conclusions: Official sexual assault victimization data are of limited utility in conveying the extent of sexual assault among HBCU students, and efforts to increase reporting, such as peer education and enhanced confidentiality procedures, are needed.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

An empirical assessment of writing and research proficiency in HBCU social work students

ABSTRACT

Lack of proficiency in writing and research among social work students has increasingly concerned social work educators and practitioners. Given the significance of written communication with clients and emphasis on evidence-based practice in the field of social work, it is critical to assess students’ competence in both writing and research. However, deficit-based approaches to assessing writing and research competence have disadvantaged students at historically black colleges and universities (HBCUs). This pilot study aims to assess writing and research proficiency of HBCU master’s of social work (MSW) students through empirical analysis of their capstone papers and surveys from educators to provide implications for developing a writing and research manual for social work programs at HBCUs. Ten capstone papers were randomly selected and qualitatively analyzed; nine faculty and one field supervisor completed the survey, and their respondents were analyzed using cross-case analysis. Analyses of the capstone papers identified two themes for writing and research domains, respectively: (1) weakness in developing statements and lack of knowledge of writing style and (2) plagiarism and lack of understanding of research structure. Moreover, analyses of the surveys revealed four themes regarding assessment of writing and research skills among students struggling with basic writing mechanics, indicating that HBCU MSW students may have potential and capacity for learning, as evidenced by their ideas and critical thinking skills. These findings suggest both teaching- and research-oriented programs could employ the proposed writing and research assessment manual, as well as a writing and research lab/center for improving writing and research skills among their students.     

The State of the Union: Sexual Health Disparities in a National Sample of US College Students

Abstract

Objective: To examine sexual health disparities between blacks and whites in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18–24; M = 20.1) responding to the Spring 2007 American College Health Association–National College Health Assessment; 64% were female and 94.7% were white. Results: Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. Conclusions: This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.     

Sexual and reproductive health knowledge and information-seeking behavior among middle eastern female university students: a systematic review

Objectives: The objective of this study was to collate the level of sexual and reproductive health knowledge, awareness, attitudes, and behavior among female university students, in addition to identifying their sources of information in Middle Eastern and North African countries. Methods: A systematic review was conducted with a search in Medline, EMBASE, Web of Knowledge, PsycINFO, and CINAHL from inception to February 2013. Included were studies in any language describing sexual and reproductive health knowledge and attitudes among female university students. Results: Nine studies were included, and all were cross-sectional surveys. There was a general lack of knowledge of sexual and reproductive health. The highest knowledge levels reported were for HIV. Conclusions: There are deficiencies in sexual and reproductive health knowledge and behavior in Middle Eastern and North African countries. Studies are needed to evaluate how to provide culturally sensitive sexual and reproductive health information.     

Masturbation and Sexual Health

Abstract

In this study we applied research examining the hypothesized benefits of masturbation in dealing with sexual problems to the urgent health crisis posed by the HIV/AIDS pandemic. This is the first study to test the hypothesized relationship between masturbation and HIV risk as predicted by the Sexual Health Model, a sex-positive approach to sexual health developed in response to the need for a more explicit focus on sexuality and relationships in HIV prevention. This is also the first study to examine the relationship between several masturbation variables (i.e., masturbation guilt, lifetime masturbation, and current masturbation) and HIV-related sexual behaviors and attitudes in a sample of African American women (N =239). Data was collected using face-to-face structured interviews as part of the Women's Initiative for Sexual Health (WISH), a randomized, controlled trial of an HIV prevention intervention based on the Sexual Health Model, targeting low income, adult African American women. Contrary to expectations, results showed that participants who reported masturbating were more likely to report having multiple partners, being in a nonmonogamous relationship and engaging in high-risk sexual behaviors. There was no significant relationship between level of masturbation guilt and HIV risk nor between masturbation and consistent condom use or attitudes toward condoms. This study adds to the growing empirical support for associations between sexual health variables and safer sex and argues for a more explicit focus on sexuality in HIV prevention.     

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.     

Difference in Condom Use Among Sexually Active Males at Historically Black Colleges and Universities

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

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.     

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.     

Intimate partner violence,trauma, and mental health need among female community college students

ABSTRACT

Objective: The impact of interpersonal violence on college students has received considerable attention, yet no studies have been conducted among community college students, who comprise 40% of all American college students, and have unique risk factors and needs. Community College students are more likely to be women, people of color, working, parenting, and first generation college students. Participants: Data were collected from a simple random sample from four community colleges (n=435). Methods: A cross-sectional quantitative survey was used to assess the extent of intimate partner violence, trauma exposure, sexual violence, and associated mental health consequences among female students. Results: Over 27% of participants reported IPV in the past year, while 25% reported sexual assault and 34% reported other uncomfortable sexual experiences in their lifetime. Nearly 20%of participants were currently reporting PTSD symptoms. Conclusions: Community Colleges should work with service providers to build their capacity to respond to students' needs.     

College Students and HIV/AIDS: A Comparison of Nontraditional and Traditional Student Perspectives

Objective and Participants The authors compared nontraditional college students' knowledge and perceptions of HIV/AIDS and sexual practices with previously reported results about traditional students. Methods Nontraditional students completed an online survey with questions based on national HIV/AIDS surveys. Traditional students completed the same survey with paper and pencil. Results Overall, the authors found more similarities than differences between the 2 groups. The findings support previous research that suggests that although college students are knowledgeable about HIV and its risks, they express little personal concern about becoming infected. The authors also discuss how apparent differences between nontraditional and traditional students regarding personal concern about becoming infected, relationship status, and information sources may influence the development of effective prevention strategies geared toward nontraditional college students. Conclusions Institutional leaders need to adapt to these differences, and researchers should undertake additional studies to clarify these differences so that college students may be more effectively educated about HIV/AIDS and encouraged to get tested.     

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.     

Prevalence of Human Immunodeficiency Virus Testing and Associated Risk Factors in College Students

Abstract

Objective: This study documents the prevalence of human immunodeficiency virus (HIV) testing in a sample of college students and examines associated demographic and behavioral characteristics. Participants: College students aged 18 or older were randomly selected to participate in a health behavior survey at a southeastern university in September 2011. Methods: Only sexually active students were included (N = 905). Relationships between demographic and sexual behavior characteristics were explored using logistic regression and classification regression tree (p ≤.05). Results: Only 36.2% reported having been tested for HIV. Age was the most significant factor associated with testing. Factors associated with those least likely to be tested were race and anal sexual activity. Unsafe sexual behaviors were also associated with lower rates of HIV testing. Conclusions: Findings support the need for targeted HIV interventions on college campuses. Such interventions need to be tailored for at-risk students and take into consideration factors likely to contribute to HIV testing.     

Truth or Consequences: Dishonesty in Dating and HIV/AIDS-Related Issues in a College-Age Population

Abstract

This article examines the issue of dishonesty in dating among college students as it relates to the HIV/AIDS epidemic in the United States. The authors surveyed 171 undergraduates at a large midwestern university in January 1991. They conducted an analysis by gender and found significant differences in responses of male and female students. Of those students involved in monogamous relationships, 36% of the men and 21% of the women reported being sexually unfaithful to their current partner or to any of their previous partners. A greater percentage of women than of men inquired about past sexual histories before engaging in sexual activity. In addition, men admitted they had lied to their sexual partner or partners more often than did women. Because a large portion of HIV/AIDS and STD education involves teaching students to inquire about previous sexual histories, the results of this study should influence the direction and content of behaviorally focused educational programs. The authors also address implications for health educators and clinicians.     

Testing a New Measure of Sexual Health Knowledge and Its Connections to Students' Sex Education,Communication, Confidence,and Condom Use

ABSTRACT

This study investigates the nature of college students' sexual health knowledge, prior sex education coverage, and sexual communication and confidence. We created a new, comprehensive sexual health knowledge measure to assess 347 undergraduates' knowledge of reproductive health, contraception, condom use, sexually transmitted diseases (STDs), and HIV/AIDS. Overall, students demonstrated a fairly poor understanding of sexual health issues. Women were more knowledgeable than men, specifically on the topics of contraception and STDs. Prior exposure to sex education covering mainstream reproductive health issues or newer contraception methods was correlated with greater knowledge across all domains, particularly for men. Greater knowledge was also correlated with greater sexual assertiveness and confidence with condoms among women.     

Sexual Behavior,Mental Health,Substance Use,and HIV Risk Among Agency-Based Male Escorts in a Small U.S. City

Abstract

Relatively little research has examined the personal sex lives of indoor male sex workers (MSWs) or possible connections in this group between sexual behavior and factors related to HIV risk. As part of a larger project, this study collected data from 30 agency-based indoor MSWs (mean = 22.4 years) about their sexual behavior, mental health, and substance use. Few HIV risk behaviors with clients occurred. Drug use and mental health problems were relatively frequent, but not related to increased risk behavior. Instead, MSWs appeared to employ rational decision-making and harm-reduction strategies. Conceptualization of MSW sexual behavior may be required where HIV risk is not attributed to sex work per se, but to other influences such as economic and relational factors.     

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

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