Effects of Online Friendships on Safer Sex Communication and Behavior among Black Sexual Minority Men: A Study of Network Exposure

This study draws on social normative and social learning theories to examine the masspersonal safer sex communication (i.e., Facebook posts about safer sex) and safer sex behavior (i.e., condom use) in a cohort of Black sexual minority men (BSMM) (N = 340), with an eye toward understanding their relationship with the safer sex communication and behaviors of their BSMM Facebook friends. Using linear network autocorrelation regression models, results showed that BSMM's safer sex communication and condom use behavior were each associated with the communication and behavior of their online peers. Specifically, BSMM's condom use was positively associated with their friends' condom use and friends' safer sex communication, and BSMMs' safer sex communication was positively associated with friends' safer sex communication. Moreover, contrary to prior research, BSSM's safer sex communication and condom use were not related to one another, suggesting that talking about safer sex on social media should not be interpreted to be an indication of engageDment in safer sex behavior. These findings underscore an opportunity to leverage peer influence in social media networks, particularly in the form of masspersonal communication, to encourage cascades of safer sex messaging among peers and adoption of safer sex behavior.

Factors affecting the safe sexual behaviors of Korean young adults by gender: a structural equation model

PURPOSE

The aim of this study was to determine the factors that influence safe sexual behaviors of Korean young adults and identify differences by gender.

METHODS

This study aimed to determine which factors affected safe sexual behaviors based on the Theory of Planned Behavior. Data from 437 Korean young adults (in their 20s and 30s) were collected via online survey between January 3 and January 28, 2022. The questionnaire included items on sexual body image, sexual role perception, sexual attitudes, sexual socialization, sexual communication, and safe sexual behaviors. Structural equation modeling was performed.

RESULTS

According to the overall model fit of the hypothetical model, the final model was acceptable and explained 49% of safe sexual behaviors. Sexual attitudes (β=-.70, p<.001) and sexual communication (β=.53, p<.001) directly affected safe sexual behaviors, and sexual role perception (β=.42, p<.001) indirectly affected safe sexual behaviors in a combined model. There were gender differences in the path from sexual attitudes (β=-.94, p<.001) and sexual communication (β=.66, p<.001) to safe sexual behaviors and from sexual body image (β=.27, p<.001) to sexual communication.

CONCLUSION

Sexual attitudes and sexual communication were predictors of safe sexual behaviors, which differed by gender. Strategies that consider sexual attitudes, sexual communication, sexual role perception, and differences between men and women should be developed to improve the safe sexual behaviors of young adults.

The Relationship between the Sexual Double Standard and Women's Sexual Health and Comfort

The current research explores the relationship between Sexual Double Standard (SDS) endorsement and women's sexual health and attitudes. Women (n = 705) completed an SDS endorsement scale, and then answered a variety of questions in three main categories of outcome variables: sexual comfort, sexual reputation, and sexual health. Results suggest that women's SDS endorsement was not related to women's sexual comfort. Further, SDS endorsement was slightly positively related to how concerned women were about their sexual reputation. Regarding sexual health, SDS endorsement was related to a shorter timespan since women's last OBGYN screening, and unrelated to women's discomfort discussing birth control with their OBGYN. Results suggest there is much more to explore in targeted studies on the relationship of SDS endorsement to women's perceptions of their sexual reputations and their interactions with OBGYNs with respect to the SDS. Previous and related research is discussed, along with implications of the current research.

Psychological Distress as a Primer for Sexual Risk Taking Among Emerging Adults

Emerging adults experience increased morbidity as a result of psychological distress and risky sexual behavior. This study examines how sexual behaviors (e.g., condom use inconsistency and past year STI history) differ among emerging adults with low, moderate, and high psychological distress. Participants are 251,254 emerging adults attending colleges and universities in the United States who participated in the National College Health Assessment (NCHA). Findings suggest a dose-response relationship between psychological distress, condom use inconsistency, and past STI history, such that an association between greater psychological distress and condom use inconsistency and/or past year history of sexually transmitted infections (STIs).

Growth Trajectories of Peer Norms, Self-efficacy and Condom Use Behavior Among Sexually Active Chinese Men Who Have Sex with Men: Latent Class Analysis and Growth Mixture Modeling

Data from a randomized controlled trial in 2015 were used to estimate the growth trajectories of peer norms, self-efficacy, and condom use behavior, and to identify associated sociodemographic and behavioral factors among a sample of 804 Chinese men who have sex with men (MSM). Latent class analysis and growth mixture modeling were conducted using Mplus. Two growth trajectories were estimated for each outcome variable with good model fit. The growth trajectories of peer norms were related to age (β = - 0.066, p < 0.05). The growth trajectories of self-efficacy were related to age (β = 0.057, p < 0.01) and using a condom during first sexual encounter with another man (β = 0.777, p < 0.001). The growth trajectories of condom use behavior were related to income (β = 0.366, p < 0.01) and having casual male partners (β = - 1.016, p < 0.001). Predictors for the growth factors within each latent class were also estimated. For subsets of MSM who are older, richer, used a condom during their first sexual encounter with another man, and do not have a casual male partner, condom videos may not have sufficient efficacy and other interventions may be necessary.

"It's just in that sea of things that I never cared about": perception of hepatitis B amongst university students in Aberdeen, North-East Scotland

Background

A significant proportion of international students at UK universities are from regions with medium to high hepatitis B prevalence rates. Understanding the perception of students regarding hepatitis B infection is crucial for the development of appropriate information and services for this population group.

Methods

Twenty semi-structured interviews were conducted with students from the University of Aberdeen. The following key areas were covered: knowledge, awareness, practices including testing, cultural and social aspects and general attitudes to health information and services. Interviews were transcribed verbatim and coded using a framework analysis approach.

Results

The participants acknowledged hepatitis B to be a serious disease yet did not consider themselves to be at risk. They felt able to go to their General Practitioner if concerned about hepatitis B but emphasised that there was no indication that this was required. There was a general lack of knowledge about the disease including confusion over other types of hepatitis. This was linked to the perceived lack of attention given to hepatitis B in, for example, sexual health education and disease awareness raising campaigns. The participants expressed a desire for information on hepatitis B to be relevant to the student population, easy to understand, socially acceptable and easily accessible on student portals and social media platforms.

Conclusions

Our study suggests that students in Aberdeen, North East Scotland lack knowledge and awareness of hepatitis B and do not perceive themselves as being at risk of hepatitis B infection. There is a need for more tailored hepatitis B messages to be incorporated into a range of contexts with clearer risk communication for the student population.

Mental Representation of Self in Relationships Indirectly Affects Young Black Women's Engagement in Risky Sexual Behaviors Through Psychosocial HIV/STI Risk Factors

Black females are disproportionately affected by HIV/STIs, though individual-level sexual risk factors do not appear to explain racial/ethnic HIV incidence rate disparities. The current study examined the roles of attachment representations, working models of self and others, with psychosocial risk factors related to population-level sexual network features in association with risky sexual behaviors. A total of 560 Black emerging adult females (M age= 20.58, SD = 1.89) enrolling in a behavioral HIV prevention intervention trial completed the baseline assessment used in the current analyses. A series of multiple mediator models examined indirect effects of working models of self and others on sexual risk engagement through the following psychosocial HIV/STI risk factor: (a) partner communication self-efficacy, (b) fear of condom negotiation, (c) peer norms for risky sexual behavior, (d) partner trust, and (e) sex-related alcohol expectancies. Results indicated indirect effects of working model of self on: condom use with boyfriend/main partner through peer norms for risky sex (ab = .08 ,95% CI [.02, .17]); any alcohol use prior to sex through peer norms for risky sex (ab = -.06, 95% CI [-.12, -.02]); and alcohol use prior to sex through sex-related alcohol expectancies (ab = -.13, 95% CI [-.21, -.05]). Findings indicated direct associations between working model of self and all the psychosocial HIV/STI risk factors included in the mediation models. Working model of self may help identify Black females elevated risk for HIV/STI through these psychosocial risk factors.

An abridged Spanish version of Sexual Double Standard Scale: Factorial structure, reliability and validity evidence

Sexual double standard (SDS) has long been associated to several dimensions of sexual health. Therefore the assessment of SDS is relevant and requires self-reported measures with adequate psychometric properties. This study aims to adapt the Sexual Double Standard Scale (SDSS) into heterosexual Spanish population and examine its psychometric properties. Method: Using quota incidental sampling, we recruited a sample of 1,206 individuals (50% women), distributed across three groups based on their age (18-34, 35-49 and 50 years old and older). Results: We performed both, Exploratory Factor Analysis and Confirmatory Factor Analysis. An abridged version was yielded, consisting of 16 items distributed into two factors (Acceptance for sexual freedom and Acceptance for sexual shyness). A second-order factor structure was also adequate, which facilitates the use of a global index for SDS. Reliability, based on internal consistency and temporal stability was good for the factors. Evidence of validity is also shown and reported. Conclusions: This adapted version of the SDSS is reliable and valid. The importance for its use to estimate the prevalence of both traditional and modern forms of this phenomenon is discussed.

Number of Sexual Partners and Relationship Status Are Associated With Unprotected Sex Across Emerging Adulthood

Sex with multiple partners, consecutively or concurrently, is a risk factor for contracting sexually transmitted infections (STIs) as multiple partner-partner contacts present increased opportunity for transmission. It is unclear, however, if individuals who tend to have more partners also use protection less reliably than those with sexual histories of fewer partners. Longitudinal data can elucidate whether an individual shows a consistent pattern of sex with multiple partners. We used latent class growth analyses to examine emerging adult survey data (N = 2244) spanning 10 waves of assessment across 6 years. We identified three trajectory classes described with respect to number of partners as (a) Multiple, (b) Single, and (c) Rare. Trajectory group, relationship status, and their interactions were tested as predictors of using protection against STIs and pregnancy at each wave. The Multiple Partners class had the greatest odds ratio of reporting sex without protection against STIs and pregnancy, followed by the Single and Rare classes. Exclusive relationship status was a risk factor for unprotected sex at earlier waves, but a protective factor at most later waves. There was no significant interaction between relationship status and trajectory class in predicting use of protection. The Multiple Partners class reported more permissive values on sex and an elevated proportion of homosexual behavior. This group overlaps with an already identified at-risk population, men who have sex with men. Potential mechanisms explaining the increased risk for sex without protection, including communication, risk assessment, and co-occurring risk behaviors are discussed as targets for intervention.

Sex Rules: Emerging Adults' Perceptions of Gender's Impact on Sexuality

Past research often explains gender differences in sexual behavior according to differences in social norms for men and women. Yet, individuals' perceptions and internalizations of current social norms are not well understood. This study aimed to examine emerging adults' perceptions of how being male or female impacts their sexuality and how their perceptions would differ if they were another gender. Participants (N = 205) were college students, 61% female, and ranged from age 18-25 (M = 20.5, SD = 1.7). Participants answered open-ended questions about gender and responses were coded for content, positive tone, and negative tone. In describing how being female affected their sexual thoughts and feelings, women were more likely than men to focus on reputation concerns and describe limits and contexts in which sexual behavior was acceptable. In describing how being male affected their sexual thoughts and feelings, men were more likely than women to focus on issues of desire. Women's perceptions about how their sexual thoughts and feelings would differ if they were male were consistent with men's perceptions of their own gender's actual impact on sexuality, and vice versa. Women's descriptions of their own gender's impact on sexuality were more emotionally laden than men's. Finally, being older was associated with less negative and more positive emotional tone in men's and women's responses respectively.

Examining the Principles of Influence on Safer Sex Communication During Casual and Committed Sexual Encounters

Teens and young people are at risk for contracting sexually transmitted infections. Understanding how relationship context may moderate the effectiveness of safer sex communication strategies among this demographic is important information for practitioners striving to promote safer sex behaviors. In this study, focus groups (N = 9) with college students were conducted and analyzed to examine the relation between 6 principles of influence (authority, consistency, liking, reciprocity, scarcity, and social proof) and safer sex communication during committed and casual sexual encounters. Results revealed that with the exceptions of social proof and consistency, the principles of influence were endorsed more frequently for casual than committed sexual encounters. For casual sexual encounters, the principles of authority, reciprocity, and scarcity arose as influential principles. For committed sexual encounters, the principles of consistency, liking, and reciprocity arose as influential principles. These results are discussed with an emphasis on the theoretical and practical implications.

Exposure to Theory-Driven Text Messages is Associated with HIV Risk Reduction Among Methamphetamine-Using Men Who have Sex with Men

Fifty-two non-treatment-seeking methamphetamine-using men who have sex with men were enrolled in Project Tech Support, an open-label pilot study to evaluate whether exposure to theory-based [social support theory (SST), social cognitive theory (SCT), and health belief model (HBM)] text messages could promote reductions in HIV sexual risk behaviors and/or methamphetamine use. Multivariable analyses revealed that increased relative exposure to HBM or SCT (vs. SST) text messages was associated with significant reductions in the number of HIV serodiscordant unprotected (i.e., without a condom) anal sex partners, engagement in sex for money and/or drugs, and frequency of recent methamphetamine use; additionally, increased relative exposure to HBM (vs. SCT or SST) messages was uniquely associated with reductions in the overall number of non-primary anal sex partners (all p ≤ 0.05, two-tailed). Pilot data demonstrated that text messages based on the principles of HBM and SCT reduced sentinel HIV risk and drug use behaviors in active methamphetamine users.

Quantifying the decisional satisfaction to accept or reject the Human Papillomavirus (HPV) vaccine: a preference for cervical cancer prevention

Objective

Only a portion of the US population is willing to consider HPV vaccination to date. The primary aim of this study is to determine the decisional satisfaction associated with HPV vaccination.

Study Design

This is a prospective survey conducted at an urban college where women 18–26 years old completed a decisional satisfaction survey about their HPV vaccine experience.

Results

Regardless of the decision to accept or reject HPV vaccination, the decisional satisfaction was very high (mean 5-item score = 21.2 (SD 3.8)). Women without HPV vaccination were decisionally neutral significantly more often than those already vaccinated; 22% were decisionally neutral for the option to accept HPV vaccination at that visit. Cervical cancer prevention was preferred significantly more often than genital wart prevention in all analyses.

Conclusions

Targeting those who are decisionally neutral about HPV vaccination may result in a higher uptake of HPV vaccination.

More than pop culture: depictions of HIV in the media and the effect on viewer's perception of risk

When young adults are questioned about where they gain their knowledge of HIV, overwhelmingly popular media (including television) is reported. Thus, the goal of this article is to question how media is used to educate and influence young people's present perceptions of HIV/AIDS. Narrative analysis of popular prime time shows was used focusing on the story lines and characters used to introduce the topic, as well as the myths and facts about HIV. Results presented provide researchers a clearer insight to how popular shows discuss HIV/AIDS while also highlighting the ways Social Cognitive Theory can still be utilized.

Perceptions of HIV risk among internet-using, HIV-negative barebacking men

The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) who use the Internet to seek unprotected sex. The research questions include the following: How great do these men perceive their HIV risk to be? Are their perceptions based on HIV knowledge or related to their risk behaviors? What factors are associated with greater/lesser perceived risk? Results revealed that more than half of the men believed that they had no or only a slight chance of contracting HIV. Risk perceptions were not related to HIV knowledge or to involvement in HIV risk practices. Four factors were identified as being associated with greater perception of HIV risk: self-identity as a sexual "bottom," having sex while high, greater use of bareback-focused websites, and younger age. Internet-using HIV-negative men who have sex with men tend to underestimate their risk for acquiring HIV, and interventions need to help them accurately assess their risk.

College women's HPV vaccine decision narratives

Drawing on 38 in-depth qualitative interviews with college women and college health clinicians, we collected human papillomavirus (HPV) vaccine decision narratives to identify the implicit and explicit values underlying HPV vaccine decision making. Narratives of vaccine acceptance and resistance were identified. Vaccine acceptance narratives consisted of four themes: supportive family messages, explicit health care provider endorsement, peer descriptive norms reducing stigma of vaccination, and disease framing (e.g., cancer, HPV) shaping vaccine benefit perceptions. Vaccine resistance narratives consisted of five themes: skepticism of vaccine safety, invoking alternative prevention strategies, articulating stigmatizing HPV messages, overcoming self-efficacy barriers (e.g., cost, availability, time, and fear of parental disclosure), and delay strategies. Common to all decision narratives was that relationship status framed college women's perceptions of HPV susceptibility. Theoretical and practical implications for designing HPV vaccine messages aimed at college-aged women are discussed.

The sexual consent scale-revised: development, reliability, and preliminary validity

The Sexual Consent Scale-Revised (SCS-R) measures an individual's beliefs, attitudes, and behaviors with respect to how sexual consent should be and is negotiated between sexual partners. This study extends previous research on sexual consent by revising a scale using the Theory of Planned Behavior (Ajzen, 1991, 2001, 2005) as its theoretical foundation. The psychometric properties of the SCS-R were established using factor analysis, construct validity tests, as well as internal consistency and test-retest reliability. Five factors emerged: perceived behavioral control, positive attitude toward establishing consent, sexual consent norms, indirect consent behaviors, and awareness of consent. Results indicated that the SCS-R can be useful for examining a variety of research questions relating to sexual consent.

Measurement of motivations for and against sexual behavior

A multidimensional measure assessing distinct motivations for and against sex was shown to be reliable, valid, and configurally invariant among incoming first-year college students. Three Motivations Against Sex Questionnaire subscales were developed to measure motivations against sexual behavior (Values, Health, Not Ready) to complement and extend a set of Sexual Motivations Scale-Revised subscales assessing motivations for sexual behavior (Intimacy, Enhancement, Coping). Participants were surveyed the summer prior to college (N = 1,653; 58.4% female). Exploratory factor analysis on a random one quarter of respondents supported the hypothesized factors. Multigroup confirmatory factor analysis demonstrated good overall fit to the data and configural invariance across gender and ethnicity and across lifetime sexual experience. Motivations were associated with lifetime oral and penetrative sexual behaviors. This combined measure may be used for identifying motivations, predicting behaviors, and tailoring motivational interventions for sexual health among adolescents and young adults.

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

"Hooking up" with friends, strangers, and acquaintances is a popular way for college students to experience sexual intimacy without investing in relationships. Because hooking up often occurs in situations in which prophylactics against sexually transmitted infections (STIs) are not available or in which students' judgment is impaired, it can involve risky behaviors that compromise student health. As such, in-depth studies of the factors related to sexual risk taking during hookups are needed, to advance preventive research and programming. Based on semistructured interviews with 71 college students about their hooking-up experiences, the findings of this study demonstrate that the Health Belief Model can serve as a useful framework for understanding sexual risk taking during hooking up, and offers suggestions for sexual risk-prevention programs on college campuses. The results demonstrate why students' assessments of their own and their peers' susceptibility to STIs are often misinformed. The findings also show how situational characteristics, such as spontaneity, undermine students' sexual self-efficacy.

Sexual behaviors and attitudes and ethnic identity during college

This study examined ethnic differences in sexual behaviors and attitudes, and associations between ethnic identity commitment and sexual behaviors and attitudes. African American (32%), Latino American (29%), and European American (39%) first-year college students (N = 434; 52% female) completed surveys about their sexual behaviors (number of partners, condom use, and alcohol use before intercourse) and attitudes (conservative attitudes, condom-related beliefs, and fear of AIDS) and ethnic identity commitment. Analyses of covariance and hierarchical linear regressions were performed. Among the three groups, Latino Americans reported riskier condom-related behaviors and attitudes, whereas European Americans were less fearful of AIDS. Ethnic identity commitment was a protective factor against risky attitudes regardless of ethnicity. For sexual behaviors, however, ethnic identity served as a protective factor only for European Americans. This study contributes to the understanding of adolescents' sexuality during college and the role of ethnic identity in their sexual experiences.

Beliefs that condoms reduce sexual pleasure-gender differences in correlates among heterosexual HIV-positive injection drug users (IDUs)

Studies consistently find that negative condom beliefs or attitudes are significantly associated with less condom use in various populations, including HIV-positive injection drug users (IDUs). As part of efforts to reduce sexual risk among HIV-positive IDUs, one of the goals of HIV interventions should be the promotion of positive condom beliefs. In this paper we sought to identify the correlates of negative condom beliefs and examined whether such correlates varied by gender, using a subsample (those with an opposite-sex main partner; n = 348) of baseline data collected as part of a randomized controlled study of HIV-positive IDUs. In multivariate analyses, we found more significant correlates for women than for men. With men, perception that their sex partner is not supportive of condom use (negative partner norm) was the only significant correlate (Beta = -0.30; p < 0.01; R (2) = 0.18). Among women, negative partner norm (Beta = -0.18; p < 0.05); having less knowledge about HIV, STD, and hepatitis (Beta = -0.16; p < 0.05); lower self-efficacy for using a condom (Beta = -0.40; p < 0.01); and more episodes of partner violence (Beta = 0.15; p < 0.05) were significantly associated with negative condom beliefs (R (2) = 0.36). These findings suggest important gender-specific factors to consider in interventions that seek to promote positive condom beliefs among HIV-positive IDUs.

Sex-related communication with mothers and close friends during the transition to university

The current study examines communication about sex-related topics with close friends and mothers during the first semester of college. Students (N = 182, 50% female, mean age = 18.5) completed surveys about the frequency and quality of their sex-related communication with same-sex close friends and mothers, and sexual experience and attitudes. Sex-related communication was more frequently reported by women than men and with close friends than with mothers. Sexually active students discussed most topics more frequently than abstinent students. Communication with close friends was a stronger correlate of sexual attitudes than communication with mothers. Finally, the quality of communication with close friends was more strongly associated with sexual experience and attitudes than communication with mothers. Findings suggest the importance of understanding the role of friends in assigning meaning to sexual behaviors and beliefs.