Hooking up and sexual risk taking among college students: a health belief model perspective

"Are you OK doctor?" An expanded health belief model exploration of doctors' experiences and perspectives of on-shift health behaviour

PURPOSE

Understanding doctors' health beliefs is essential for developing effective and competent healthcare practices that benefit doctors and their patients. This study aimed to qualitatively explore doctors' perceptions of on-shift health-protective behaviours and their perceived effects on competence.

METHODS

The research applied theoretically driven Expanded Health Belief Model (EHBM) enquiry methods to explore beliefs and experiences through an occupational context survey, 14 individual depth interviews, and two focus groups. Semantic and deductive themes associated with EHBM domains were examined, and an inductive thematic analysis of the interviews was conducted.

RESULTS

Doctors' beliefs were strongly imbued by their perceived identity within the systemic context; they expressed impaired self-efficacy in reacting to their health needs on shift, and several disclosed harm to themselves and patients. Dominant themes included the psychosocial effects of the systemic culture and the influence of the situational occupational context in impacting health-protective behavioural action. The context and implications of experiences during the COVID-19 pandemic are discussed.

CONCLUSIONS

This study presents key belief-oriented factors influencing doctors' health-protective behaviour at work and its implications for competent practice. Further doctor-led guidance on focus points for evidence-based theoretically driven health improvement solutions is provided regarding operational practice, formulating policies, developing interventions and further research.

"Not me!": Optimistic bias and college students' perceived susceptibility, severity, benefits, and self-efficacy in following COVID-19 preventive guidelines

Objective The COVID-19 pandemic has created unprecedented challenges for university administrators and health professionals to keep doors open and students safe. Optimistic bias and the Health Belief Model serve as foundations for understanding students' perceived susceptibility and severity for contracting the virus and their perceived benefits and self-efficacy for following prevention recommendations. Participants: A total of 1,773 undergraduate and graduate students from a large mid-western university participated. Methods: Students were emailed an online survey examining their perceptions and knowledge of COVID-19 and their adherence to recommended preventive measures. Results: Almost one-half of students do not think they will get COVID-19 but said their friends are at risk. The majority are following most Centers for Disease Control and Prevention recommendations and understand the perceived benefits of doing so. Conclusions: Results could aid university officials in developing effective COVID-19 messages that could lead to reductions in cases numbers, deaths, and spread of the virus.

Using peer-ethnography to explore the health and well-being of college students affected by COVID-19

PURPOSE

COVID-19 continues to infect and affect college-aged youth. We lack information about how students experienced the pandemic day-to-day and what they need for recovery, from their own perspectives. This study employed peer ethnography to explore student's insights for current and future prevention and care.

METHODS

A team of eight students were trained as peer ethnographers to observe and record conversations with their peers in 15-minute increments during the COVID-19 pandemic. Transcripts of 200 conversations were collated and analysed via theme analysis to identify patterns.

RESULTS

Student conversations revealed dichotomous perspectives about COVID-19. Some students prioritized safety, captured via three themes-caution, rethinking routines, and protecting others. Other students struggled to follow prevention guidelines and took risks, also captured by three themes-parties, denial, and misinformation. A third category of themes captured the results of this dichotomy-tense campus relationships and a health leadership vacuum.

CONCLUSIONS

Our findings identify specific locations for intervention (e.g., off campus parties) and needed community collaborations (e.g., bars and universities) for COVID-19 and future pandemics. Our findings suggest that overarching approaches, like harm reduction or affirmation (versus shame), are helpful intervention frameworks. Findings also celebrate the value of peer-ethnography, to learn about pandemics and solutions from the ground up.

Risk Perception About HIV Among University Students in One of the Last Hotspots for HIV Transmission in Europe

BACKGROUND

HIV testing in the Northern Kosovo province is challenging, because the infrastructure is being rebuilt after the ethnic conflict. The purpose of this research was to examine self-perceived risk for acquiring HIV infection and factors associated with risk assessment among university students.

METHODS

Students completed a questionnaire on socio-demographic data, knowledge about HIV prevention and transmission, attitudes toward people living with (PLHIV) and self-perceived risk for HIV infection. The self-perceived risk was categorized as low, unknown and high.

RESULTS

The majority of students (72.5%) assessed their risk as low, 8.5% assessed their risk as high and 19.1% did not know their risk. Compared to low self-perceived risk, high self-perceived HIV risk was associated with being male, having lower knowledge about HIV prevention, less strong Segregation and protection attitude toward PLHIV, stronger Ignorance and indifference attitude toward PLHIV and positive opinion about gays/lesbians. Students who perceived own risk for acquiring HIV as high had lower knowledge about HIV transmission and prevention. However, those who were previously tested for HIV, despite their poorer knowledge about HIV prevention, assess their HIV-related risk as low.

CONCLUSIONS

Students assessed their risk of HIV infection mostly as low. Still, lower knowledge of HIV prevention has been consistently associated with a high and unknown risk of HIV. Moreover, being ignorant and indifferent about PLHIV was associated with increased self-perceived HIV risk. These findings highlight the need for continuous specialized HIV-related education to reduce fear and stigma of PLHIV and HIV testing as well as risky behaviors.

Need for Sexual, Reproductive, and Mental Health Promotion Among Diverse College Students in a COVID-19 Era

In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health among adolescents and emerging adults. This position paper reviews existing literature on the effects of the COVID-19 pandemic on SRH, sexual violence, unintended pregnancy, sexually transmitted illness and human immunodeficiency virus rates and highlights issues specific to college-aged males, females, racial/ethnic and sexual minorities, and individuals with disabilities. The need to conceptualize SRH as an integral component of normal development, overall health, and well-being in the context of COVID-19 is discussed. The need to prioritize the design and implementation of developmentally appropriate, evidence-based SRH interventions specifically targeting college students is identified. Furthermore, an intergenerational approach to SRH that includes parents/caregivers and/or college faculty and staff (e.g., coaches, trainers) could facilitate comprehensive SRH prevention programming that enhances sexual violence prevention training programs currently mandated by many colleges. Policies and programs designed to mitigate adverse pandemic-related exacerbations in negative SRH outcomes are urgently needed and should be included in mainstream clinical psychology, not only focused on preventing unwanted outcomes but also in promoting rewarding interpersonal relationships and overall well-being. Recommendations for clinical psychologists and mental health researchers are made.

Friends as Informal Educators: The Role of Peer Relationships in Promotion of Sexual Health Services among College Students

This ethnographic study of one United States university's sexual health resources explores the role of peer relationships in sexual health promotion to understand how these relationships shaped students' interactions with campus sexual health resources. Through analysis of seventeen semi-structured interviews with students, five policy interviews with providers and university personnel, and participant-observation of peer health educator training, the authors examine how trust in peer relationships can serve as a form of social capital to influence sexual health information sharing. The article introduces the term "peer administrator" to describe student actors who sit at the intersection of friend and official resource and explores the importance of these mentoring relationships for sexual health promotion. The analysis also considers how more individualistic models of public health promotion limit the impact of peer relationships and concludes with a discussion of how universities might imagine new forms of sexual health promotion among students.

Multiple Casual Sex Scripts: Shared Beliefs about Behavior among Portuguese Emerging Adults

Objective

Empirical research to differentiate casual sex scripts is still limited. We aimed to ascertain the sexual scripts for three main types of casual sexual relationships: hookup, friends with benefits and one-night stands.

Methods

Through a mixed-method approach, we performed a study consisting in two sequential tasks to (1) complete three lists of script actions, and (2) identify the most agreed-upon actions for each casual sexual relationship.

Results

An important number of actions and events were identified for the three casual sexual scripts, reflecting a high level of elaboration and structure. Following a cognitive-script methodology, the actions retained for the content of the script for each casual sexual relationship were those obtaining at least 60% in respect to the mean of their centrality to the encounter. Only 16.5% of actions were shared among the three scripts, demonstrating their distinctiveness.

Conclusion

Knowledge about the different casual sex scripts can be used to develop relational and personal skills within CSRs and decrease unwanted experiences such as condomless sex.

Incidence and laboratory diagnosis of sexually-transmitted infections among university students in a high-prevalence community

Objective: The purpose of this study was to determine the incidence of four sexually-transmitted infection (STI) agents among university students. Participants: A total of 1744 Milwaukee, Wisconsin metropolitan area student encounters at two university health clinics. Methods: Following consent, participants completed an eight-item demographic and behavioral questionnaire and provided a specimen for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium RNA testing. Results: C. trachomatis (7.2%) and M. genitalium (6.7%) detection rates were highest, with C. trachomatis more likely to result in symptomatic infection in males and females. Female M. genitalium detection rates did not differ as a function of symptomatic status. Students identifying as African American were more likely to test positive for M. genitalium than other races/ethnicities. M. genitalium detection in both genders was a function of reported condom usage. Conclusions: Students would benefit from familiarity with emerging STI agents, as well as behaviors associated with increased risk of STI.

Assessing Knowledge and Perceptions About Cancer Among American Indians of the Zuni Pueblo, NM

American Indians (AIs) in New Mexico have lower cancer screening rates compared to other populations and are more likely to be diagnosed with cancer at an advanced stage of the disease as reported by Li et al. (Archives of Internal Medicine 163(1):49-56, 2003). AIs also have the lowest 5-year cancer survival rates compared to any ethnic/racial group in the USA as reported by Clegg et al. (Arch Intern Med 162:1985-1993, 2002) and Edwards et al. (Cancer 97:1407-1427, 2005). Numerous barriers such as cultural beliefs, fear, fatalism, mistrust, stigma, and lack of culturally appropriate interventions could contribute to low cancer screening rates as reported by Daley et al. (J Health Dispar Res Pract 5(2), 2012); Filippi et al. (J Prim Care Community Health 4(3):160-166, 2013); James et al. (Prev Chronic Dis 10:E170, 2013); and Schumacher et al. (Cancer Causes Control 19(7):725-737, 2008). Trained Community Health Representatives (CHRs) from the Zuni Pueblo and native Zuni undergraduate students led six 1-h focus group sessions using a structured focus group guide with probes. The focus groups were conducted among 51 participants from different age groups (20-29 years, n = 19; 30-49 years, n = 17; and 50 years and older, n = 15) stratified by sex. Focus groups were conducted in both English and Shiwi (Zuni) languages. Sessions were audio recorded, and team members took notes. CHRs transcribed the notes and audio recordings, and created a codebook for qualitative data analysis. In the focus groups, participants provided Zuni-specific cultural context, opinion, and experience regarding (1) general knowledge about cancer, (2) cancer risk, (3) cancer risk reduction, (4) personal experiences with cancer, and (5) culturally competent delivery of cancer information and resources. Understanding the perceptions of cancer within the Zuni Pueblo is an essential component in the development of interventional/preventative measures and improvement of current care. Ultimately, this information will provide a basis for the next steps in culturally sensitive cancer care for the Zuni Pueblo.

Comparative analysis of sexual behavior and assessment of awareness of STIs and HIV infection among young people of two generations

Background: A comparative analysis of the results of a survey of young people (belonging to two different generations: millennials and zoomers) on sexual behavior and awareness of STIs and HIV infection allows us to assess the existing characteristics of the sexual behavior of young people and contribute to the further improvement of preventive measures among young people regarding STI/HIV infection. Aims: Comparative analysis of sexual behavior and assessment of the level of knowledge about STIs and HIV infection among young people (generations Y and Z). Materials and methods: For a comparative assessment of the level of awareness on the issues of prevention and risky sexual behavior in relation to STIs and HIV infection, data from earlier sociological surveys of young people in 20012002 and in 20172020 in the city of Novosibirsk were used. Among the respondents, a questionnaire was used, consisting of 23 questions, developed by the staff of the Department of Dermatovenereology of the St. acad. I.P. Pavlov and the Center for the Sociology of Deviance and Social Control of the Institute of Sociology of the Russian Academy of Sciences, adapted by the authors. Statistical analysis was carried out using Microsoft Excel and SPSS programs. The 2 test and the independent Student's t-test were evaluated. Statistical significance was set as p0.05 Results: A total of 772 young men took part in the study, of which 321 students were interviewed in 2001-2002. (Generation Y), and 451 students in 2017-2020. (Generation Z). The results show that generations of young people (millineals and zoomers) differ from each other in terms of the source of information about STIs, sexual intercourse with strangers, condom use, and the frequency of same-sex sexual intercourse. Conclusions: There is a positive trend in the sexual behavior of the younger generation. But a more structured promotion of STI/HIV prevention is needed, which will take into account current trends and features of obtaining information from young people.

HIV and syphilis knowledge, perceptions, and practices among Myanmar migrant workers in Samut Sakhon Province, Thailand

BACKGROUND

Thailand has been one of the largest migration hubs in Southeast Asia for the past four decades and keeps attracting migrants from neighboring countries. Due to difficulties associated with their status, migration can place individuals at a heightened risk for sexually transmitted diseases. This study aimed to examine factors influencing HIV and syphilis preventive behaviors among Myanmar migrants in Samut Sakhon, Thailand.

METHODS

A cross-sectional mixed-method study was conducted among Myanmar migrants aged 18 years and above in Samut Sakhon Province, Thailand. To fulfill this study's aims, four hundred seventy-three respondents completed a survey to provide quantitative data, and eight participants completed in-depth qualitative interviews. The factors associated with protective sexual behaviors were identified with multiple logistic regression analysis of the quantitative study data and thematic analysis of the qualitative data.

RESULTS

The respondents showed good knowledge of HIV and syphilis (50.1%), but over half (55.6%) exhibited the negative perception of sexually transmitted disease prevention; about 81.4% of male respondents never used a condom when they had sexual intercourse in the past year. Based on multivariate analysis, income expenses-balance (adjusted odds ratio (AOR) = 2.379, 95% confidence interval (CI): 1.002-5.731, p = 0.049), number of sex partners (AOR = 3.044, 95% CI: 1.339-6.924, p = 0.008), and having sex with a prostitute (AOR = 6.085, 95% CI: 1.28-28.918, p = 0.023) were all statistically associated with unprotected sex. In the qualitative analysis, knowledge, understanding, beliefs; the influence of culture, community, and environment; and condom perceptions were also important factors.

CONCLUSION

Low use of condoms in sexual practice was identified, and the appropriate intervention or approach to improve the utilization of condoms in the community was provided.

Examination of Sex-Related Distress and Self-Medication Drinking Model in U.S. College Women

Adult sexual assault (ASA) in college remains a concern. Consequently, many college-aged women experience negative emotions surrounding sexual activity (sex-related distress). Consistent with self-medication theory, some drink to cope with sex-related distress, which may reduce distress, but lead to greater drinking quantity before sex and negative sexual consequences. How women with ASA histories navigate sexual situations and cope with sex-related distress is under researched. We examined ASA, sex-related distress, and drinking to cope motives to understand correlates of drinking before sex. First and second year college women (n = 300) reported on a recent sexual experience in the past six weeks. In the full sample, ASA severity was associated with a greater likelihood of drinking before sex, while general sex-related distress was associated with a lower likelihood. General sex-related distress was associated with event-specific sex-related distress and sexual consequences. There were no differences in number of pre-sex drinks or subjective intoxication during sexual activity based on ASA. In a subsample of women who drank before sexual activity (n = 179), drinking to cope with sex-related distress motives mediated the association between sex-related distress and sexual consequences. Interventions can draw on these findings to target self-medication drinking in consensual sexual situations.

The Impact of Religious Participation and Religious Upbringing on the Sexual Behavior of Emerging Adults in the Southern United States

Emerging adults face a disproportionate burden of unintended pregnancies and sexually transmitted diseases, especially in the southern United States. This study investigates how multiple dimensions of current religiosity as well as religious upbringing influence the sexual behaviors, including contraceptive usage, of individuals 18-25 years old (n=211) in the South. Based on regression analyses, results suggest that emerging adults with higher levels of current religiosity are more likely to remain abstinent, but less likely to use pregnancy prevention methods, such as birth controls pills and long-acting reversible contraceptives. Having a religious upbringing is also associated with lower contraceptive usage. Through the assessment of multiple dimensions of religiosity and various sexual behaviors, this study presents a nuanced picture of the complex associations between religion and sexual health, specifically among emerging adults in the southern United States.

Web‐based chlamydia education for university students: A pilot project

Aims

Chlamydia disproportionately affects individuals aged 15–24 years. A lack of chlamydia knowledge in this high‐risk group likely contributes to decreased testing, but interventions to increase chlamydia knowledge in this population are not well‐described in the literature. The purpose of this pilot project was to increase chlamydia knowledge in a sample of university students using nurse‐developed web‐based education.

Design

A pre‐ and post‐test design was used to evaluate participant knowledge of chlamydia before and after completing a nurse‐developed web‐based education intervention designed for university students.

Methods

Forty‐seven undergraduate students at one U.S. university participated. A focus group and scientific evidence informed the development of the web‐based education.

Results

Participants had a significant increase in chlamydia knowledge after completing the online educational intervention (M = 8.0, SD = 0.000) compared to baseline (M = 6.5, SD = 1.5), t(33) = −5.821, p < .0001. Pilot results provide promising evidence that web‐based nurse‐developed education designed specifically for university students can increase chlamydia knowledge.

itMatters: Optimization of an online intervention to prevent sexually transmitted infections in college students

ObjectiveTo describe an iterative approach to developing an online intervention targeting the intersection of alcohol use and sexual behaviors among first year college students. Methods and Participants: Using the multiphase optimization strategy (MOST), we conducted two iterative optimization trials to: (1) identify candidate intervention components (i.e., descriptive norms, injunctive norms, outcome expectancies, perceived benefits of protective behavioral strategies, and self-efficacy to use strategies); (2) revise components; and (3) identify the optimized intervention. Participants were first year college students at six geographically diverse universities (optimization trial 1 N = 5,880; optimization trial 2 N = 3,551) Results: For both optimization trials, the results indicated that only descriptive and injunctive norms produced a significant effect (p<.05). Conclusions: The iterative process of MOST allowed us to develop an optimized intervention which is an essential tool to maximize intervention effectiveness and efficiency to improve uptake, sustainability, and public health impact.

Heterosexual Young Adults’ Experience With and Perceptions of the Orgasm Gap: A Mixed Methods Approach

The “orgasm gap” refers to the finding that cisgender men, on average, have more orgasms than cisgender women during heterosexual partnered sex. In the current research, we replicated evidence for several orgasm discrepancies across sexual contexts and assessed men’s and women’s perceptions of the orgasm gap. Our sample consisted of 276 heterosexual, cisgender, sexually active undergraduate students (56.52% women; M age = 18.84). We assessed participants’ self-reported orgasm frequencies with a familiar partner, with a new partner, and during masturbation, as well as participants’ perceptions of their partners’ orgasm frequencies. We found evidence for orgasm discrepancies between young men and women within contexts and for women across contexts. Additionally, men perceived the size of the orgasm gap to be smaller than women perceived it to be. We used qualitative analyses to assess participants’ perceptions of driving forces behind the orgasm gap and their responses could be grouped into five overarching themes: Sociocultural Influence, Women’s Orgasm Difficulty, Biology, Men’s Fault, and Interpersonal Communication. This qualitative data can inform education and advocacy efforts focused on improving orgasm outcomes for young women, particularly by disproving prominent biological justifications for orgasm difference and addressing relevant sociocultural concerns. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/03616843221076410 .

An Empirical Examination of Hookup Definitions Across the Literature, 2000-2019

There has been a longstanding debate about what constitutes hooking up. To date, little research has analyzed how hookups are being defined such that the field can foster consistency across definitions. To inform this debate, we conducted a content analysis of 122 empirical articles across disciplines (e.g., human sexuality, public health) from 2000 to 2019 by systematically coding conceptual definitions of hooking up contained in the articles using five commonly discussed dimensions of hooking up (behaviors, nature of partner relationship, span of hookup interaction, frequency of hookup behavior, and level of romantic commitment expectation). Unspecified sexual intercourse (52.5%) was the most frequently identified behavior in definitions. The majority of hookup definitions did not mention the nature of partner relationship (e.g., acquaintance, friend), the duration of the hookup interaction, or the frequency of hookup behavior. Additionally, most conceptual definitions (82.0%) mentioned that the relationship was uncommitted, but only half discussed the level of romantic commitment expectations. Overall, most conceptual definitions relied on behaviors rather than all five dimensions, resulting in broad and non-descript definitions of hookups. We suggest that future hookup definitions explicitly reference behaviors, nature of partner relationship, span of hookup interaction, frequency of hookup behavior, and level of romantic commitment expectation to provide clarity, comparability, and validity across future research.

Dental dams in dermatology: An underutilized barrier method of protection

Dental dams are a barrier method of protection, which may help prevent the spread of sexually transmitted infections during oral-vaginal or oral-anal sex. Despite their relative simplicity of use, data on dental dams are limited and patients infrequently utilize this method of barrier protection because of the lack of awareness, perceived barriers to procurement and accessibility, and unfamiliarity on the part of health educators. Nevertheless, increased knowledge of dental dams may be beneficial especially in high-risk populations, where sexually transmitted infections are more common and remain a significant cause for morbidity. This article aims to increase awareness and knowledge of dental dams, as well as provide an informational guide on their procurement and use that may be helpful to dermatologists when counseling patients.

A systematic review of international students' sexual health knowledge, behaviours, and attitudes

The demand for higher education has increased student mobility across the world. Studying abroad provides an opportunity for young adults to engage in sexual behaviours, some of which may be risky. Yet, little is known about international students' current sexual health knowledge or practices. The aim of this review was to identify their sexual health knowledge, behaviours, and attitudes. A search of five databases yielded 21 studies that met inclusion criteria. These studies used quantitative (n=13), qualitative (n=7) and mixed methods (n=1) and included a total of 4666 international and exchange students from diverse cultural backgrounds. Findings were grouped into three themes: sexual health knowledge, sexual behaviours, and sexual health attitudes. Asian international students had poorer levels of knowledge, suggesting a need for culturally appropriate sex education. They were less sexually experienced and were older than domestic students at first age of sex. Fewer engaged in risky sexual behaviours when compared to domestic students. They also reported fewer sexual partners and higher condom usage. However, culture influenced the sexual behaviours and attitudes of international students; in particular, Asian female international students, who tested risk-taking behaviours, such as casual sex, in more liberal Western countries. Appropriate intervention and further education are needed to decrease international students' sexual health risks.

Barriers to condom use in casual sexual relationships known as ukujola in KwaZulu-Natal, South Africa

South Africa has the largest number of people living with HIV in the world. Of the nine provinces in South Africa, KwaZulu-Natal is the worst affected. HIV is largely transmitted through unprotected penetrative sexual intercourse. Male latex condoms are central to HIV prevention because of their effectiveness in preventing HIV transmission in almost all sexual encounters if used consistently and correctly. There are, however, various barriers to condom use. This study sought to unpack barriers to condom use in the context of ukujola (casual or informal sexual relationships) in a South African, isiZulu-speaking community. A generic qualitative approach was used, drawing on a range of methods - four focus groups and twenty in-depth interviews. The study was conducted exclusively with isiZulu-speaking African participants, aged 21-34 years, from the uMgungundlovu district in KwaZulu-Natal, South Africa. Ukujola relationships encompass all casual relationships, i.e. those in which there has never been involvement of the families. The involvement of families in negotiating ilobolo (bride wealth) is a prerequisite for legitimate relationships, particularly marriage. Multiple concurrent sexual partnerships typically exist in ukujola relationships, and unprotected sex is common. The interviews suggest the existence of various barriers to condom use, including lack of trust, sexual pleasure and alcohol. There is a need for increased HIV prevention campaigns with particular emphasis on consistent condom use.

Awareness, Knowledge and Risky Behaviors of Sexually Transmitted Diseases among Young People in Greece

Sexually transmitted diseases (STDs) affect mainly young individuals and cause health, social, and economic problems worldwide. The present study used a web questionnaire to assess the awareness, knowledge, sexual behaviors, and common practices regarding STDs in young Greek adults. The 1833 individuals, aged 18–30 years, who responded to the study seem to be particularly knowledgeable regarding STDs such as AIDS (97.7%), warts (97%), Chlamydia (92.2%), genital herpes (89.9%), syphilis (81.9%), and gonorrhea (72.1%), whereas lower percentages were noted for trichomoniasis (39.3%), Molluscum contagiosum (12.9%), mycoplasmosis (11.6%), and amoebiasis (7.4%). Regarding oral STD transmission, participants replied correctly for genital herpes (45%), warts (35.8%), and AIDS (HIV; 33.8%), whereas 30.2% were unfamiliar with oral sexual transmission. Of the participants, 52% were not aware that STDs might cause infertility. Only 40.4% of the respondents reported always using condoms during sexual intercourse, and 48.6% had never been tested for STDs. The majority of the young population (55%) presented a moderate knowledge STD score (41–60%) and was associated with demographic parameters such as age, gender, sexual preference, number of sexual partners, and residence (p < 0.05). These findings provide important information regarding the prevention of STDs and highlight the significance of developing more effective sex education programs for young people in Greece.

Sexual Risk Taking Intentions Under the Influence of Relationship Motivation, Partner Familiarity, and Sexual Arousal

Condom negotiation is typically a dyadic process, influenced by a host of factors that can impact sexual health decision-making. The current paper investigated the influence of sexual arousal, relationship motivation, and partner familiarity on sexual risk taking intentions in women and men. In Study 1, 331 participants were recruited online and responded to items assessing condom use intentions. Participants higher in relationship motivation were more likely to consider perceived partner desire for condom use when considering initiating condom negotiation. In Study 2, 169 undergraduate students participated in a sexual arousal manipulation and responded to scenarios depicting sexual encounters with more or less familiar hypothetical partners. Participants reported greater sexual risk taking intentions with more (vs. less) familiar hypothetical partners. Men (vs. women) showed greater risk taking intentions overall. Higher sexual arousal was associated with increased sexual risk-taking intentions, regardless of gender. With less familiar partners, participants higher in relationship motivation showed somewhat greater concern that insisting on condom use would interfere with the sexual encounter, though concern was greatest among men for both more and less familiar partner types. These findings offer some support for the notion that a stronger orientation toward forming long-term relationships can facilitate sexual risk taking behavior.

Association between perceived risk of harm and self-reported binge drinking, cigarette smoking, and marijuana smoking in young adults

OBJECTIVES

Evaluate the association between perceived risk of harm and self-reported binge drinking, cigarette smoking, and marijuana smoking among college students.

PARTICIPANTS

Participants were 599 students (ages 19-28) at a large Midwestern university recruited from October 2015 to December 2017.

METHODS

Hurdle regression was used to test the relationship between perceived risk of harm from substance use (i.e., binge drinking, cigarette smoking, and marijuana smoking), and self-reported use. Demographic characteristics were tested as moderators of this relationship.

RESULTS

Engagement in all three substance use behaviors was less likely when perceived risk was high. Age moderated the association between perceived risk and self-reported marijuana smoking with younger participants demonstrating a stronger relationship between perceived risk of smoking marijuana and self-reported marijuana smoking.

CONCLUSION

Intervention programs will be most effective when perceived risk of substance use is high. Therefore, intervention programs should aim to increase college students' perceived risk of substance use.

A Hybrid Evaluation-Optimization Trial to Evaluate an Intervention Targeting the Intersection of Alcohol and Sex in College Students and Simultaneously Test an Additional Component Aimed at Preventing Sexual Violence

BACKGROUND

Using the multiphase optimization strategy (MOST), we previously developed and optimized an online behavioral intervention, itMatters, aimed at reducing the risk of sexually transmitted infections (STI) among first-year college students by targeting the intersection of alcohol use and sexual behaviors.

PURPOSE

We had two goals: (a) to evaluate the optimized itMatters intervention and (b) to determine whether the candidate sexual violence prevention (SVP) component (included at the request of participating universities) had a detectable effect and therefore should be added to create a new version of itMatters. We also describe the hybrid evaluation-optimization trial we conducted to accomplish these two goals in a single experiment.

METHODS

First year college students (N = 3,098) at four universities in the USA were individually randomized in a hybrid evaluation-optimization 2 × 2 factorial trial. Data were analyzed using regression models, with pre-test outcome variables included as covariates in the models. Analyses were conducted separately with (a) immediate post-test scores and (b) 60-day follow-up scores as outcome variables.

RESULTS

Experimental results indicated a significant effect of itMatters on targeted proximal outcomes (norms) and on one distal behavioral outcome (binge drinking). There were no significant effects on other behavioral outcomes, including the intersection of alcohol and sexual behaviors. In addition, there were mixed results (positive short-term effect; no effect at 60-day follow-up) of the SVP component on targeted proximal outcomes (students' self-efficacy to reduce/prevent sexual violence and perceived effectiveness of protective behavioral strategies).

CONCLUSIONS

The hybrid evaluation-optimization trial enabled us to evaluate the individual and combined effectiveness of the optimized itMatters intervention and the SVP component in a single experiment, conserving resources and providing greatly improved efficiency.

TRIAL REGISTRATION

NCT04095065.

First-year college students' alcohol and hookup behaviours: sexual scripting and implications for sexual health promotion

This study used a sexual scripting framework to analyse data from the Online College Social Life Survey to examine the role of individual, (e.g. gender, race and alcohol use), relational (partner type, condom use behaviours), and contextual factors (sex ratios and fraternity/sorority affiliation) influencing 4,292 first-year college students' hookup experiences. Results suggest that hookups are relatively "safe", with the the majority involving non-penetrative sexual behaviour, condom use, and familiar partners. However, alcohol use affected hookup behaviours and lower levels of condom use were associated with heavy alcohol use, even with less well known partners. Findings point to the importance of interventions that reinforce first-year students' positive behaviours and present them with protective behavioural strategies to use in the context of alcohol, and with repeat or well-known partners to reduce risk and have enjoyable, consensual sexual experiences.

The Influence of Emerging Adulthood on the Risky and Dangerous Behaviors of LGBT Populations

During emerging adulthood, traditional social bonds and turning points may be delayed, not present, or may not work in the same manner as they had for prior generations, leading many to engage in risky and dangerous behaviors. Lesbian, Gay, Bisexual and Transgendered emerging adults may be at particular risk for engaging in risky and dangerous behavior during emerging adulthood due to the lack of social bonds, reaching of turning points, as well as the historic stigmatization of these populations. Focusing on LGBT populations in the United States, the influence of emerging adulthood on risky and dangerous behaviors is presented; a theoretical examination of the relationship between LGBT populations and risky and dangerous behaviors is provided; the influence of emerging adulthood on LGBT populations is explored; research on the role of emerging adulthoods influence on the risky and dangerous behaviors of LGBT populations is presented; and theoretical and policy implications are offered.

(Mis)perceptions of HIV and HPV among female college students: a qualitative study

Background This study aims to investigate college women's misperceptions about the human papillomavirus virus (HPV) and the human immunodeficiency virus (HIV).

METHODS

Twenty college women from an urban, Midwestern university in the United States were recruited to participate in interviews exploring their beliefs about HIV and HPV. In-depth interviews were conducted and analysed via interpretive methods.

RESULTS

The college women in this study often conflated or confused HPV and HIV and revealed misperceptions about the severity and prevalence of HPV and HIV.

CONCLUSION

The results have important implications for understanding college women's sexual risk behaviour and, as a result, can inform the practices of both healthcare providers and public health professionals.

Social and Environmental Influences on Sexual Behaviors of College Black Women: Within Group Diversity Between HBCU vs. PWI Experiences

Black women carry a disproportionate number of new HIV infections in the USA. Studies that have assessed HIV risk perception along with HIV prevention interventions for Black women have primarily focused on Black women of low socioeconomic status. Few studies have assessed HIV risk perceptions and sexual behavior among college-educated Black women of higher socioeconomic status despite their high risk of HIV. College-educated Black women are most likely to acquire HIV while in college, and there has been a marked absence of research assessing the environmental and cultural influences present throughout college-campuses, coupled with evaluating how these factors shape sexual behaviors. We conducted surveys with Black female students attending a historically Black college and Black female students attending a predominately White university, and compared baseline differences in sexual behaviors among both populations. Results showed that for participants attending the historically Black college certain sociocultural elements, such as music and media, had a significantly stronger influence on sexuality and sexual behaviors compared with students attending predominately White universities. The development of future HIV prevention interventions for Black women necessitates an understanding of the diverse microcultures that Black women come from. This research is high priority for college-educated Black women given this population's lack of inclusion in HIV prevention research.

A Short-Term Longitudinal Investigation of the Perceived Hookup Attitude of Gender-Specific Close Friends and Hookup Behavior

Research suggests that peer injunctive norms (i.e., perceived attitudes) have an indirect effect on youth’s behavior. Few studies have explored the underlying mechanism of the relationship between the perceived attitude of gender-specific close friends and hookup behavior. Following the social norm approach and the social learning theory, a person’s own hookup attitude and their emotional reaction after a hookup would influence this relationship as mediators. We therefore examined the association between perceived hookup attitudes of students’ same-sex/opposite-sex close friends and the number of hookup partners via mediated variables (i.e., own hookup attitude and affect following a recent hookup) in Chinese college students (N = 314) who completed self-report measures at 6-month intervals. The results of a path analysis showed that students’ own attitudes toward hookups and negative affect following a hookup significantly mediated the association between perceived hookup attitudes of same-sex close friends and the number of hookup partners over 6 months. These findings indicate that same-sex close friends’ injunctive norms were more strongly associated with future hookup behavior, as compared to opposite-sex friends’ injunctive norms. To better understand the relationship between peer norms and hookup behavior, both students’ hookup attitudes and negative emotional responses should be considered.

Patterns of condom use in a university student population residing in a high-risk area for HIV infection

OBJECTIVE

The study objective was to investigate factors associated with condom use among university students.

METHODS

During the 2013-2014 academic year, 1017 first and fourth year students from the University of Pristina temporarily seated in Kosovska Mitrovica, northern Kosovo, completed a questionnaire on sociodemographic data, HIV-related knowledge, attitudes and risky behaviours.

RESULTS

Condom use during the most recent sexual encounter and with casual partners was reported by just over half of participants. Factors associated with condom use during the most recent sexual encounter were: being male (35.1%), using medical sources of information about HIV (35.7%), having a positive approach to HIV testing (40.1%) and a positive attitude towards sex workers (17.7%), as well as not having had a sexually transmitted infection in the past year (54.2%). Factors associated with more frequent condom use with casual partners were: being single (28.9%), not living in a rented apartment or own home (32.1%), frequenting night clubs at the weekend (35.3%), not using drugs/opioids (54.1%), not being sure whether to keep a contact after learning of their HIV-positive status (10.1%), and having stronger opinions (either positive or negative) on homosexual individuals (15.5% and 32.1%, respectively), sex workers (18.7% and 23.9%, respectively) and drug users (13.2% and 36.5%, respectively).

CONCLUSION

Condom use among students in northern Kosovo was low. Strategies for HIV prevention should be focussed on promoting healthy behaviours, especially among female students and students who live alone while at university. Moreover, sexuality education should be carried out in schools and primary health care centres to provide support and enable young people to negotiate safe sex.

Are Perceptions of the Developmental Features of Emerging Adulthood and Endorsement of the Hookup Culture Associated with Number of Different Hookup Partners and Behaviors?

The purpose of this study was to examine the relationship between perceptions of each developmental feature of emerging adulthood and endorsement of each feature of the hookup culture with number of different hookup partners and hookup behaviors. Participants were 1219 college-attending emerging adults (ages 18-29 years) who completed an online survey about emerging adult experiences. After controlling for semester of data collection and known correlates of hooking up (e.g., age, sex, religiosity, and binge drinking experience), none of the developmental features of emerging adulthood were significantly associated with number of different hookup partners in the last 12 months. In addition, only one feature of the hookup culture was associated with number of different hookup partners: Hooking up is fun. In follow-up analyses among those who reported at least one hookup in the last 12 months (n = 807), some of the developmental features of emerging adulthood (e.g., experimentation/possibilities, negativity/instability) and features of the hookup culture (e.g., hooking up is fun, hooking up provides sexual freedom) helped differentiate reported involvement in various types of hookup behaviors. The most prominent and consistent correlate was number of different hookup partners in the last 12 months (increased likelihood of all behaviors, except deep kissing). Recommendations for understanding hooking up as a developmental and/or cultural experience are discussed.

Are We Blinded by Desire? Relationship Motivation and Sexual Risk-Taking Intentions during Condom Negotiation

Effective condom negotiation skills support better sexual health for both men and women. The current study explored relationship motivation (motivation to establish and maintain long-term romantic relationships), gender, and sexual orientation as factors influencing the condom negotiation process. Participants (177 heterosexual women, 157 heterosexual men, and 106 men who have sex with men) read a vignette describing an encounter with a hypothetical new sexual/romantic partner and responded to embedded items and scales. Stronger relationship motivation predicted increased willingness to have condomless sex among women who perceived greater familiarity with the hypothetical partner. Gender and sexual orientation predicted different preferences for condom insistence strategies. The findings suggest that there are a number of conditions that make it more difficult to recognize risk during a sexual encounter and demonstrate how the process of condom negotiation can be impacted by gender, sexual orientation, and relationship motivation.

Exploring Well Water Testing Behaviour Through the Health Belief Model

Health problems can arise from consuming contaminated well water. Well water testing can help prevent negative health outcomes associated with consuming contaminated water. The aim of this study was to understand the factors influencing well owner decisions to conduct water testing through the theoretical lens of the Health Belief Model. We conducted semi-structured interviews with 20 well owners and used framework analysis to sort and analyse the data. The results demonstrated that well owners' perceived susceptibility to well water contamination was low, while the perceived severity of contamination, benefits of testing, and self-efficacy towards testing were high. Cues to action to promote testing focused on increasing well owner education and awareness through well stewardship programmes and reminders to test. Participants faced some barriers to water testing. Increasing education and awareness about well water contamination and water testing, while reducing logistical barriers to testing, may improve compliance with water testing.

Emerging Adult Risky Sexual Behavior Predicted by Parental Overprotection: Moderated Mediation Analysis

Parental control behaviors are suggested to be related to emerging adult outcomes, such as risky sexual behavior. Although parental control behaviors are more likely to be considered protective against risky sexual behavior, the relation between parental overprotection and risky sexual behavior is unclear. Furthermore, parental overprotection may influence peer selection and prosocial behaviors in emerging adults, which may in turn influence outcomes of risky sexual behavior, as suggested by primary socialization theory. Thus, the current study investigated the relations among paternal and maternal overprotection, emerging adult peer alienation, and risky sexual behavior, and expanded on these relations by examining gender effects of both parents and children. The sample consisted of 505 participants (228 males and 277 females) ranging in age from 18 to 25 years. Analyses were conducted with AMOS path analysis and indicated that peer alienation mediated the effect between both maternal and paternal perceived overprotection and risky sexual behavior, but more strongly for males, suggesting moderated mediation. Overall, parental overprotection may be protective against risky sexual behavior via pathways that are harmful such as peer alienation, thus recommending research continues to clarify the nuances of these relations.

Predictors of Condomless Sex and Sexual Health Behaviors in a Sample of Portuguese Single Adults

INTRODUCTION

Several theoretical models and intervention programs overlook the importance of individual motivations for the decision to have condomless sex. For instance, people focused on promotion (ie, eager to pursue pleasure) report less intentions to use condoms, because they perceive a lower risk of acquiring sexually transmitted infections.

AIM

We aimed at understanding to what extent individual motivations are predictive of condomless sex behavior among single individuals.

METHODS

A sample of 415 Portuguese individuals (254 women) with ages ranging from 18-46 years (M = 23.30; SD = 5.28) were recruited to a cross-sectional study. All participants were neither dating nor in a romantic relationship at the time of the study. The link to an anonymous web survey was shared in social networking platforms.

MAIN OUTCOME MEASURE

The survey included self-reported demographic variables (eg, age and sex), recent condomless sex behavior, and previously validated measures assessing regulatory focus in sexuality, ability in sexual restraint, perceived control over condom use, perceived safety with sex partners, and salience of the condom use norm.

RESULTS

More than two-thirds of the sample had recently engaged in condomless sex. A logistic regression showed that condomless sex was more likely for participants predominantly focused on promotion in sexuality. It was also more likely among less educated participants, those with a lower ability to restrain their sexual behavior, those who perceive to have less control over condom use, those for whom the condom use norm was less salient, and those who perceived to be safer with their sex partners. No other results were significant.

CLINICAL IMPLICATIONS

Our results can be informative to sexual health care professionals when planning strategies to increase condom use awareness, by considering the role of specific individual motivations.

STRENGTHS & LIMITATIONS

This is the first study showing that individual motivations uniquely contribute to the decision to have condomless sex. This study has 2 main limitations that constraint the generalizability of the findings: (a) cross-sectional data prevents us from establishing causality, and (b) individual data does not account for dyadic processes in sexuality (eg, condom use negotiation).

CONCLUSION

Our findings showed that condomless sex results from an individual focus on seeking pleasure, a lack of control in sexual behavior, and a perception of sex partners as more trustworthy. Overall, these findings are likely to help researchers and health care professionals improving theoretical models predicting condom use and preventing the spread of sexually transmitted infections. Rodrigues DL, Lopes D, Pereira M, et al. Predictors of Condomless Sex and Sexual Health Behaviors in a Sample of Portuguese Single Adults. J Sex Med 2020;17:26-36.

How can university sexual health promotion events reach those most at risk? A cross-sectional study

Background The rate of notifications of sexually transmissible infections (STIs) in Australians has increased dramatically, especially in those aged 16-30 years. This age bracket, typical of university students, is the most likely to report multiple sexual partners in the previous year. Individuals who have sex with multiple partners in a year have a significantly increased chance of contracting an STI, making them an important audience for sexual health promotion. This study aimed to determine how university sexual health promotion events can better reach this higher-risk subset of the population.

METHODS

Two anonymous cross-sectional surveys were used to understand current and ideal sexual health promotion events through the perspectives of student leaders (n=62) and general university students (n=502).

RESULTS

Students who had more than one sexual partner in the previous year (the higher-risk group) made up 22.7% of the students sampled. Higher-risk students differed substantially from lower-risk students in terms of preferred event types, incentives and topics to be covered, often prioritising those rarely used in current university sexual health events.

CONCLUSION

While current university sexual health events include some features that align with student priorities, elements beyond sexual health information, such as social activity, alcohol incentives and on-site sexual health testing, can be helpful tools to attract students with higher numbers of sexual partners.

'A Healthy CIT': An Investigation into Student Health Metrics, Lifestyle Behaviours and the Predictors of Positive Mental Health in an Irish Higher Education Setting

Higher Education Institutions (HEIs) are potent health promotion settings, uniquely positioned to aid societal efforts to combat non-communicable diseases (NCDs). International evidence suggests that health metrics and lifestyle behaviours of higher education students are sub-optimal, yet a dearth of contemporary Irish data exists. This study aimed to examine sex differences in student lifestyle behaviours and identify significant predictors of positive mental health in an Irish HEI setting. An online questionnaire instrument distributed to all registered students (n = 11,261) gathered data regarding a multitude of health and lifestyle domains. Many items were adapted from previous Irish research. Further validated scales included the Alcohol Use Disorders Identification Test (AUDIT), Mental-Health Index 5 (MHI-5) and the Energy and Vitality Index (EVI). Self-reported height/body mass were also recorded. In total, 2267 responses were analysed (51.7% female, 48.3% male). Both sexes demonstrated poor sleeping patterns, hazardous drinking and sub-optimal fruit and vegetable intake. The calculated prevalence of overweight/obesity was 38.2%. Both sexes underestimated obesity. Males underestimated and females overestimated overweight. Males displayed riskier behavioural patterns with regard to illicit substances, drinking, and sexual partners. Females reported greater psychological distress. Multivariate linear regression identified 8 variables as predictors of positive mental health, accounting for 37% of the variance in EVI scores. In conclusion, HEI students would benefit from sex-specific multi-level health promotion initiatives to remove macro-level barriers to healthier lifestyles.

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

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.

Sexual Behaviors and Health Practices Among Student Service Members and Veterans

The purpose of the study was to determine whether veteran students and non-veteran students differed in their sexual behaviors and health practices and, furthermore, whether or not those differences were gender specific. Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with maximum likelihood multiple logistic regression. Results showed that student veterans were more likely than non-veteran students to have sex with multiple partners, with males and transgender students more likely than females to report multiple sexual partners. Student veterans were more likely than non-veterans to perform a self-examination for either breast cancer or testicular cancer, with transgender students more likely than females to report having engaged in a self-examination. Student veterans were also more likely than non-veterans to have been vaccinated against HPV or Hepatitis B, with male students more likely than females to have been vaccinated. Furthermore, transgender student veterans were less likely than female veterans to have been vaccinated. Finally, male student veterans were more likely than female veterans to report an STI-related doctor visit, with transgender student veterans more likely than female veterans to report an STI-related doctor visit. College campuses are increasingly implementing student veteran-specific programs and services; however, little if any research specifically has explored ways in which safety and health can be promoted within university settings. We recommend that institutions of higher education make concerted efforts to promote safety and health among its student veteran population.

"What Should Sex Look Like?" Students' Desires for Expanding University Sexual Assault Prevention Programs to Include Comprehensive Sex Education

Rates of sexual assault and sexual violence among college-aged adults are much higher than the national rates of sexual assault and sexual violence. Therefore, reduction and prevention of sexual violence among university students is critical and is consistent with national public health priorities. Often times, messages to students focus only on sexual assault and omit larger notions of sexual health. Four focus groups with a total of 24 participants (nine men, 15 women) highlighted three main perceptions about the sexual assault programming offered at this large university: themes of resistance to traditional programming, a need for holistic sexual health programming, and a desire to have an environment, which normalizes conversations surrounding sex, sexuality, and sexual health.

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.

Growing Up, Hooking Up, and Drinking: A Review of Uncommitted Sexual Behavior and Its Association With Alcohol Use and Related Consequences Among Adolescents and Young Adults in the United States

Hookups are uncommitted sexual encounters that range from kissing to intercourse and occur between individuals in whom there is no current dating relationship and no expressed or acknowledged expectations of a relationship following the hookup. Research over the last decade has begun to focus on hooking up among adolescents and young adults with significant research demonstrating how alcohol is often involved in hooking up. Given alcohol’s involvement with hooking up behavior, the array of health consequences associated with this relationship, as well as its increasing prevalence from adolescence to young adulthood, it is important to determine the predictors and consequences associated with alcohol-related hooking up. The current review extends prior reviews by adding more recent research, including both qualitative and experimental studies (i.e., expanding to review more diverse methods), research that focuses on the use of technology in alcohol-related hookups (i.e., emerging issues), further develops prevention and intervention potentials and directions, and also offers a broader discussion of hooking up outside of college student populations (i.e., expanding generalization). This article will review the operationalization and ambiguity of the phrase hooking up, the relationship between hooking up and alcohol use at both the global and event levels, predictors of alcohol-related hooking up, and both positive and negative consequences, including sexual victimization, associated with alcohol-related hookups. Throughout, commentary is provided on the methodological issues present in the field, as well as limitations of the existing research. Future directions for research that could significantly advance our understanding of hookups and alcohol use are provided.

Prevalence and factors associated with safe sex behaviors among adolescent vocational students in Nakhon Ratchasima Province, Thailand

Purpose

The purpose of this paper is to describe the prevalence and factors associated with safe sex behavior among vocational students in Nakhon Ratchasima Province, Thailand, and to determine the modifying factors listed as socio-demographic characteristic, the level of HIV and sexually transmitted infections’ knowledge, attitude toward reproductive health, and safe sex behavior among vocational students in Nakhon Ratchasima Province, Thailand.

Design/methodology/approach

A cross-sectional descriptive research was conducted from August to October 2018. The multistage stratified sampling, combined with purpose and random sampling, was used to select the participants. One vocational college with the highest number from urban, suburban and rural areas was purposely selected. The sample calculation by using Cochran’s formula, a random sampling by drawing from each college with male and female, was made to obtain the sample size of 355 students. Inclusion criteria included: vocational students, both male and female, aged between 15 and 19 years, resided in the study area, and volunteered to participate. Ethical consent including waiver of the parent’s consent for the participant aged under 18 years for this study was approved by the Institution Review Board for Human Research Ethics, Chulalongkorn University (Certification number JV 823/2561) A self-administered questionnaire was adapted by the principle researcher from the illustrative questionnaire for interview survey with young people (14), and The study of Prevalence of HIV, STD, Drug Use and Risk Behaviors in Adolescents and Young Adults, in Chaing Rai, Thailand (PRAYA) tool (15). All statistical analyses were performed by SPSS version 22.

Findings

The finding revealed that 332 participants were male (57.8 percent) and female (42.2 percent) with an average age of 16.8 years (±1.7). Approximately 60 percent of males and 50 percent of females had experience of sexual intercourse, with their first experience of sexual intercourse at the average age of 15. Most respondents 63.1 percent used a condom and 63.6 percent used contraception in their latest sexual intercourse. About 41.9 percent consumed alcohol and 15 percent reported substance abused. Sexual intercourse among adolescents vocational students were significantly associated with high knowledge of contraception (OR=0.30, 95%CI=0.10–0.82). Positive attitude toward reproductive health had a significant association with sexual intercourse (OR=0.17, 95%CI=0.05–0.58). Sexual intercourse among vocational students were also significant associated with low risk behavior (OR=0.45, 95%CI=0.22–0.91) and high risk behaviors (OR=0.24, 95% CI=0.10–0.59). Contraceptive used in the latest sexual intercourse had a significant association with cues to action (OR=0.43, 95% CI=0.22–0.86).

Research limitations/implications

This study used a self-reported questionnaire to collect information from participants about safe sex behaviors, which might contain bias data and socially desirable answers. The time for collecting data did not match vocational students’ schedule as they were about to have their final exams. An error in this questionnaire was the absence of condom use as one of the contraception methods.

Practical implications

The study showed that both male and female vocational students in Nakhon Ratchasima have a low level of knowledge of HIV, STIs and contraception. This study revealed that females have higher knowledge of all the factors more than males. Males usually received more harassment from peers for being sexually active than females do. Condoms and contraceptive used are inconsistent in all research conducted and have no common ground. Communication related to sex for those who have no partner was poor compared to students who have a partner. The four factors associated with safe sex behaviors should always be considered and surveyed among vocational students, as the study showed that all results vary for a future adolescence study.

Social implications

This research aims at government authorities. The policy makers should include reproductive health and rights in the curriculum. The Ministry of Public health and The Ministry of Education should provide training for the trainer program for teachers concerning safe sex behaviors. For future research, in-depth interview and qualitative study should be used to increase the reliability of the result of the inconsistency of using a condom and contraception. The researcher should do further studies into vocational college semester schedules before collecting data and should spend more time in the college, so the students become more acquainted to the researcher and give a more truthful answer. Moreover, condom use should be added as one of the contraception methods.

Originality/value

This is the first study among vocational students in Nakhon Ratchasima Province which emphasizes specifically on safe sex behaviors and factors related to it. Regarding the population of vocational students, this study covers almost 80 percent of the population. Sensitive questions for sexual activity status and sexually history were answered by a self-administered questionnaire in order to increase sincere answers on their experiences because participants were not shy to disclose their sexual experiences.

How Do College Experience and Gender Differentiate the Enactment of Hookup Scripts Among Emerging Adults?

Empirical attention to "hooking up" has expanded over time, yet limited attention has been devoted to understanding the hookup experiences of emerging adults (ages 18-25) who have not attended college and how they may differ from those who have attended college. Guided by life course and scripting theories, we used a storytelling methodology to content analyze the hookup stories of a large sample of college-attending and non-college emerging adults (N = 407). We also compared stories based on gender, as several studies report gender differences but have yet to consider how hookup scripts may differ between men and women. Overall, we found that college-attending and non-college emerging adults reported using similar hookup scripts in their most recent hookup experience, as did emerging adult men and women. However, we found that greater proportions of non-college emerging adults reported sexual touch, meeting in an "other location," and positive reactions to their most recent hookup. Greater proportions of college-attending emerging adults reported their hookup occurred in a house/apartment. In terms of gender, greater proportions of women reported "having sex" and deep kissing, hooking up with an acquaintance, partner characteristics as a reason to hookup, and negative reactions to their most recent hookup. Greater proportions of men reported hooking up with a stranger, meeting at a bar/club, hooking up at a party, and hooking up at an "other location." Implications for future research and sexual health education and intervention are discussed.

Playing with gender borders: flirting and alcohol consumption among young adults in Denmark

In the present article we explore and discuss the gendered aspects of how flirting among young people is an integrated part of a night out among young adults in Denmark, specifically a night out in mainstream bars and clubs. Empirically, we base our analysis on 140 qualitative interviews with regular alcohol users between 18 - 25 years of age. Drawing on Ahmed's (2006) notion on orientation in combination with Thorne's (1993) notions on gender play and borderwork, our aim is to explore and discuss how flirting - for these young people - become an unavoidable interactional practice in Night Time Economy (NTE) contexts, which, in some cases is experienced as easy and enjoyable, and in others as uncomfortable and challenging. In the analysis we specifically focus on how gender norms related to the NTE is navigated and/or challenged by our participants, in relation to flirting. On this basis, we show how the gendered structures of the mainstream NTE are, in some instances, supportive of its participants flirting practices and experiences, and challenging in other cases. In conclusion, we emphasize that the young people relate challenges to queer flirting as well as heterosexual flirting, and that notions of risks in this context relate to risks of marginalization, rather than health risks.

Does attractiveness influence condom use intentions in women who have sex with men?

Objectives

Attractiveness judgements have been shown to affect interpersonal relationships. The present study explored the relationships between perceived attractiveness, perceived sexual health status, condom use intentions and condom use resistance in women.

Setting

The study data were collected using an online questionnaire.

Participants

480 English-speaking women who have sex with men, between 18–32 years old.

Outcome measures

Women were asked to rate the attractiveness of 20 men on the basis of facial photographs, to estimate the likelihood that each man had a sexually transmitted infection (STI), and to indicate their willingness to have sex with each man without a condom. Condom resistance tactics were also measured and their influence on condom use intentions was assessed.

Results

The more attractive a man was judged to be, the more likely it was that participants were willing to have sex with him (r (478) = 0.987, p < .001). Further, the more attractive a man was judged to be, the less likely women were to intend to use a condom during sex (r = -0.552, df = 478, p = .007). The average perceived STI likelihood for a man had no significant association with his average perceived attractiveness or with participants’ average willingness to have sex with him. The more attractive a participant judged herself to be, the more she believed that, overall, men are likely to have a STI (r = 0.103, df = 478, p < .05).

Conclusions

Women’s perceptions of men’s attractiveness influence their condom use intentions; such risk biases should be incorporated into sexual health education programmes and condom use interventions.

Exploring the Determinants of Risky Sexual Behavior Among Ethnically Diverse University Students: the Student Behavioral Health Survey-Web

Universities create policies and develop programs to prevent HIV and other sexually transmitted infections. Unfortunately, most historically Black colleges and Hispanic-serving institutions have limited information about student practices and program effectiveness. This study examined the prevalence and determinants of risky sex among students attending a Hispanic-serving university. A cross-sectional online survey was conducted to obtain sensitive data from a random sample of students. Nearly two-thirds (65.2%) of 632 respondents reported engaging in risky sex. Sexual risk was significantly associated with older age (AOR = 2.16, 95% CI 1.09-4.30), lower self-control (AOR = 0.58, 95% CI 0.34-0.97), and higher alcohol (AOR = 2.10, 95% CI 1.20-3.67) and drug use (AOR = 2.59, 95% CI 1.48-4.50). Most respondents were unaware of university policies and programs. Programs to improve sexual health must influence risk-taking students. Perceptions of self-control and use of alcohol and drugs affected sexual decision-making. These factors should be ascertained and addressed by behavioral interventions aimed at minimizing risky behaviors and limiting the transmission of sexually transmitted infections.