Rates Of Risky Sexual Behavior Research Articles

Risky Business in Student Dorms: Sexual Health and Sexually Transmitted Infection Prevention Programming Imperative for College Campuses

Copyright: © 2013 Reel JJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Not only do college students engage in high rates of risky sexual behaviors (American College Health Association, 2010), but multiple studies e.g. [1] have shown that college students are vulnerable for developing sexually transmitted infections (STIs). For example [1] surveyed 688 college students and found that 77% of students were sexually experienced. Other studies have found that between 50% and 80% of college students are sexually active [1,2] with 25% of female students and 60% of male students engaging in casual sex [1,2]. Furthermore, the 2003 National College Health Risk Behavior Survey found that 34% of college students reported having 6 or more sex partners in their lifetime, and only 30% of students reported using a condom during their last sexual intercourse [1]. The National College Health Assessment (NCHA) [3] also found low rates of consistent condom use. Alarmingly, less than half of the sexually active students responded that they “always or mostly” used condoms during sexual intercourse (American College of Health Association [4].

Gender-Specific Relationships Between Depressive Symptoms, Marijuana Use, Parental Communication and Risky Sexual Behavior in Adolescence

A large body of research has identified correlates of risky sexual behavior, with depressive symptoms and marijuana use among the most consistent psychosocial predictors of sexual risk. However, substantially less research has examined the relationship between these risk variables and adolescent risky sexual behavior over time as well as the interaction of these individual-level predictors with family-level variables such as parenting factors. Additionally, most studies have been restricted to one index of risky sexual behavior, have not taken into account the complex role of gender, and have not controlled for several of the factors that independently confer risk for risky sexual behavior. Therefore, the current study investigated the association between depressive symptoms and parameters of parenting on marijuana use, number of sexual partners and condom usage measured 9 months later for both boys and girls. Participants were 9th and 10th grade adolescents (N = 1,145; 57.7% female). We found that depressive symptoms may be a gender-specific risk factor for certain indices of risky sexual behavior. For boys only, marijuana use at Time 2 accounted for the variance in the relationship between depressive symptoms at Time 1 and number of partners at Time 2. Additionally, strictness of family rules at Time 1 was associated with the number of partners with whom girls engaged in sex at Time 2, but only among those with lower levels of depressive symptoms at Time 1. Results from the current investigation speak to the utility of examining the complex, gender-specific pathways to sexual risk in adolescents. Findings suggest that treatment of mental health and substance use problems may have important implications in rates of risky sexual behavior and, conceivably, controlling the high rates of serious individual and public health repercussions.

ADHD Symptomatology, Fear of Intimacy, and Sexual Anxiety and Behavior Among College Students in China and the United States

Objective: ADHD is marked by an apparent contradiction in social relationships: Those with the disorder have more difficulty establishing close relationships but report increased rates of risky sexual behavior. Two studies examined the relationship between ADHD symptomatology and fear of intimacy, sexual anxiety, and sexual behavior in college students. Method: In the first study, college students in China (n = 300) and the United States (n = 233) completed a series of questionnaires. In the second, 192 American college students completed a follow-up series of measures. Results: In the first study, those with more ADHD symptoms did not report lower levels of sexual anxiety but did report greater fear of intimacy. In the second, students partially replicated the results of the first study, reporting greater fear of intimacy in those with more symptoms of ADHD. Those with more symptoms also reported lower expectations for the intimacy in their relationships and lower levels of relationship self-competence on one of four domains. Discussion: ADHD symptomatology, particularly inattention, was related to multiple aspects of risky sexual behavior.

Sexual Orientation and Behavior in HIV-infected Individuals in Southeast Asia

ABSTRACT The response of sexual behavior to HIV is an important input to predicting the path of the epidemic and to focusing prevention efforts. Existing estimates suggest limited behavioral response, but fail to take into account possible differences across individuals. Transmission through sexual contact is estimated to accounts for 75 to 85% of cumulative cases of HIV/AIDS to date. Mode of transmission is important predictors of risk. The statistical risk of infection through vaginal intercourse is notably low regardless of which partner is infected. Anal intercourse has higher infectivity due to the likelihood of damage to epithelial integrity. Generally, the environment for men who have sex with men (MSM), lesbians and transgender individuals is unsupportive and unsafe. They are usually victims of discrimination or more subtly as indifference. The stress on these individuals face as they cope with sexual orientation stigma may help to explain higher rates of risky sexual behaviors and injected drug use. Very little research has focused on Asian youth with altered sexual orientation. These individuals are at a higher risk of contracting the HIV virus than their heterosexual counterparts. Until we acknowledge these behaviors and work with people involved with these behaviors, we are not going to halt and reverse the HIV epidemic. Scaling up services adequately for key populations at higher risk for HIV infection globally, particularly in concentrated epidemics, is essential to halt and reverse epidemics at the population level. It is essential that the expansion of MSM HIV prevention and care services across Asia be driven by an agreed upon set of quality standards and guidelines.

Gender differences in sexual risk behaviours and sexually transmissible infections among adolescents in mental health treatment

Adolescents with a history of psychiatric disorder(s) are particularly vulnerable to contracting sexually transmissible infections (STIs) as a result of psychological and emotional states associated with higher rates of risky sexual behaviour. The present study examined gender differences in sexual risk behaviours and STI among adolescents in mental health treatment. Three hundred and seventy nine sexually active adolescents, aged 13-18 years, from a larger multisite study, who received mental health treatment during the past year, completed an audio computer-assisted self interview assessing sociodemographics, psychiatric symptomatology and HIV/STI risk behaviours, and provided urine specimens tested for STI. After controlling for covariates, multivariate logistic regression models indicated that female adolescents were more likely to have had an HIV test (adjusted odds ratio (AOR)=3.2, P=0.0001), obtain their HIV test results (AOR=2.9, P=0.03), refuse sex out of fear for STI acquisition (AOR=1.7, P=0.04), or avoid a situation that might lead to sex (AOR=2.4, P=0.001), and were less likely to have a casual sex partner (AOR=0.40, P=0.002). Additionally, females were more likely to report inconsistent condom use (AOR=2.60, P=0.001) and have a STI (AOR=9.1, P=0.0001) than their male counterparts. Female adolescents receiving mental health treatment were more than nine times as likely to have an STI and more likely to use condoms inconsistently. The standard of care for mental health practice for adolescents should include referrals for STI screening and treatment as well as assessment and discussion of risky sexual behaviours as part of the treatment plan when indicated. Effective programs should address gender-specific communication and behavioural skills.

Sexual and Reproductive Health Behaviors of California Community College Students

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

Parents, Peers, and Risky Sexual Behaviors in Rural African American Adolescents

ABSTRACT In this study, the authors examined the relationships among parenting factors (closeness, communication, support, and monitoring), peer deviance, and adolescent risky sexual behavior in a sample of rural African American youth (N = 689). Descriptive analyses revealed that risky sexual activity in this sample was common, with a little over half of the sample endorsing participation in one or more risky sexual behaviors. Despite promising associations between parent variables and risky sexual activity, only peer deviance was predictive of risky sexual behavior in the final model. Thus, findings indicate that peer deviance was a salient predictor of risky sexual behaviors in this rural African American sample. Due to the high rates of risky sexual behaviors in the present sample and the serious consequences that may result from such behaviors, future researchers need to focus on their etiology in this understudied population.

Men who have sex with men and women in Bangalore, South India, and potential impact on the HIV epidemic

The aim of this study was to quantify differences in patterns of sexual behaviour among men who have sex with men and women (MSMW) compared with men who have sex with men only (MSMO), and to examine the extent to which bisexual behaviour may act as a bridge for introducing HIV infection into the general population. A cross-sectional survey in Bangalore city in 2006, which sampled men seeking sex with men in public places and hammams (bath houses where transgender individuals sell sex to men). Among a sample of 357 men reporting same-sex behaviour; 41% also reported sex with a woman in the past year and 14% were currently married to a woman, only two of whom had informed their wives about having sex with men. Condom use was very inconsistent with all male partners, while 98% reported unprotected vaginal sex with their wives. MSMW reported lower rates of risky behaviour with other men than MSMO: fewer reported selling sex (17% vs 58%), or receptive anal sex with known (28% vs 70%) or unknown (30% vs 59%) non-commercial partners. Bisexual behaviour was common among men seeking sex with men sampled in this survey. Although MSMW reported lower rates of risky sexual behaviour with male partners than MSMO, inconsistent condom use with both male and female partners indicates a potential means of HIV transmission into the general population. HIV prevention programmes and services should reach bisexual men who potentially expose their male and female partners to HIV.

Everything's Better in Moderation: Young Women's Gender Role Attitudes and Risky Sexual Behavior

This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18-19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of risky sexual behavior. Both women with egalitarian role attitudes and those with traditional role attitudes have about a 10% higher prevalence of risky behavior compared to women with more moderate gender role attitudes. Existing, seemingly contradictory contentions about the relationship between gender role attitudes and risky sexual behavior may be more coherent than they seem. By shifting focus from risk to protection, the results suggest that moderate gender role attitudes are protective against risky sexual behavior. Future studies should investigate the causal mechanisms and intervention implications of this protective relationship.

Predictors of Risky Sexual Behavior With New and Regular Partners in a Sample of Women Bar Drinkers

We designed the current study to assess the rates of risky sexual behavior among women bar drinkers, as well as differences in predictors of risky sexual behavior, based on partner type-new or regular. We conducted comprehensive, in-person interviews with 241 young women who reported weekly drinking in bars. Several constructs (e.g., individual characteristics, social and sexual behavior, substance use) that we hypothesized would predict risky sexual behavior were assessed in two separate hierarchical regression models for new and regular sexual partners. Rates of risky sexual behavior were significantly higher with regular partners compared with new partners. Increased risky sexual behavior with new partners was significantly associated with having had a riskier regular partner in the past 6 months, lower sexually transmitted disease (STD)/pregnancy prevention assertiveness, increased expectations of sexual disinhibition when drinking, a greater history of prior sexual risk taking, and more frequent drinking in bars. Increased risky sexual behavior with a regular partner was significantly associated with being older, the use of oral contraceptives, lower assertiveness for STD/pregnancy prevention, a greater history of prior sexual risk taking, and increased drug use. Among young women who regularly drink in bars, sexual risk taking was significantly higher with regular partners than with new partners. The predictors of risky sexual behavior differed based on partner type. These findings have implications for including information about the role of alcohol, drinking context, and drug use, as well as individual difference characteristics and partner type in targeted prevention strategies to reduce sexual risk taking.

Clinical characteristics of treatment-seeking adolescents with opioid versus cannabis/alcohol use disorders

ObjectivesTo assess the clinical characteristics of adolescents with DSM-IV opioid use disorder (OUD) and compare them to adolescents with cannabis/alcohol use disorders. Method94 adolescents (ages 14–18years) with a current OUD and 74 adolescents with a current non-OUD cannabis/alcohol use disorders were recruited from admissions, predominantly residential, to a substance abuse treatment program in Baltimore, ML. Participants were assessed cross-sectionally using standardized interviews and self-reports. Chi-square, t-tests and ANCOVA (adjusting for age, gender and treatment setting, race and residence) were performed to determine group differences on demographic, substance use, psychiatric and HIV-risk behaviors; logistic regression analyses, both unadjusted and adjusted for the above five factors were conducted to assess the strength of associations. ResultsThe OUD group was more likely to be Caucasian, to have dropped out of school and to live in the suburbs (trend). They also had greater substance use severity with higher proportion of current sedative and multiple substance use disorders (SUD). There were generally no differences in rates of criminal behaviors. Both groups had high rates of current psychiatric disorders (83% vs. 78%, n.s.) but the OUD adolescents reported higher depressive symptoms, mostly in the moderate range. Injection drug use (IDU) and needle sharing was almost exclusive to the OUD group, while both groups reported similar high rates of risky sexual behaviors. ConclusionsWhile there were similarities between the two groups, OUD adolescents evidenced greater impairment in academic, substance use, depressive symptom and IDU-related HIV-risk areas. Findings suggest poorer long-term prognosis and highlight the need for specialized interventions for treatment-seeking OUD adolescents.

Prevalence and Correlates of HIV Risk Behaviors among Drug Users in China

This study examined the prevalence and correlates of HIV risk behaviors among 1,153 current drug users in China. Chi-squared tests of differences were used to test if drug users differed from non-users; logistic regression was used to identify behavior-specific risk factors. Results indicate that 60% of drug users injected drugs and more than one third shared needles. Compared to non-users, drug users had higher rates of risky sexual behavior and HIV/STDs. Among drug users, ethnic minorities and migrants were most vulnerable to unprotected casual sex and needle sharing. Drug users who experienced social isolation were associated with lower odds of risk behaviors; those who had experiences of anti-social behaviors and commercial sex, poor HIV knowledge, and perceived greater vulnerability were more prone to unprotected casual sex and needle sharing. Additional correlates of unprotected casual sex included being single, depression, and taking drugs/alcohol during sex. Additional risk factors of needle sharing included education and initiated drug use at younger ages. It is imperative that HIV interventions in China target drug users and address behavior-specific risk factors.

Demographic, HIV risk behavior, and health status characteristics of “crack” cocaine injectors compared to other injection drug users in three New England cities

Objectives To compare demographic, HIV risk behaviors, and health status characteristics of injection drug users (IDUs) who have injected “crack” cocaine with IDUs who have not. Methods Nine hundred and eighty-nine IDUs were recruited in New Haven, CT, Hartford, CT and Springfield, MA from January 2000 to May 2002. Participants were administered a modified version of the National Institute on Drug Abuse Risk Behavior Assessment Questionnaire. Results Nine percent ( n = 89) of participants reported “ever” injecting crack cocaine and 4.2% ( n = 42) reported injecting crack in the past 30 days. Lifetime and current crack injectors did not differ significantly on any demographic characteristics. Lifetime and current crack injectors did not differ on gender, age or marital status from IDUs who have never injected crack. Significant differences were found on race, education, employment and residence, with crack injectors more likely to be white, employed, better educated and living in New Haven than IDUs who have never injected crack. After adjusting for current (past 30 day) speedball and powder cocaine injection, crack injectors reported higher rates of risky drug use behaviors and female crack injectors reported higher rates of risky sexual behaviors. Crack injectors reported higher rates of abscesses, mental illness and Hepatitis C infection, but not Hepatitis B or HIV infection. Conclusions The emergence of crack cocaine injection requires urgent attention, as this new drug use behavior is associated with elevated rates of high risk behaviors.

Condom Use: Healthy Habits Begin in Youth

Rates of risky sexual behaviors and, consequently, sexually transmitted diseases (STDs) are very high among adolescents (see Journal Watch Infectious

Quality of parent communication about sex and its relationship to risky sexual behavior among youth in psychiatric care: a pilot study.

The number of HIV infections among adolescents is increasing, and youth in psychiatric care are at particular risk because of their high rates of risky sexual behavior. As part of a larger longitudinal study examining AIDS-risk behavior among adolescents in psychiatric care, this pilot study investigated the relationship between parent communication about sex and sexual risk-taking among treatment-seeking adolescents. Adolescents reported their risky sexual behavior (e.g., inconsistent condom use, sex with multiple partners), and parents reported how frequently they bring up topics related to sex, HIV/AIDS, and birth control. Parents and adolescents participated together in videotaped discussions of fictional vignettes describing situations related to sex, birth control, and AIDS/HIV. Quality of the parent-teen discussions was coded based on a system developed by Whalen, Henker, Hollingshead, and Burgess (1996) to code AIDS-related discussions. Quality but not frequency of parent-teen communication was associated with adolescent sexual risk-taking, and ethnic differences in communication were found. Findings from this pilot investigation underscore the importance of studying the relationship between parent-teen communication and risky sexual behavior among troubled youth and provide direction for the development of family-based intervention programs that focus on parental behavior during conversations with teens.

HIV/AIDS Among Probationers: An Assessment of Risk and Results from a Brief Intervention

A number of studies have examined HIV risk behaviors in prisoner populations, but relatively few have examined such behaviors in probationer populations. Since probationers have more opportunities to engage in risk behaviors than do prisoners. the potential importance of HIV interventions with probationers becomes readily apparent. This article examines a sample representative of the supervised probationer population in Delaware. The sample respondents received a baseline interview, then were randomly selected to receive either an enhanced version of NIDA standard HIV Intervention or a Focused Intervention based on a cognitive thought-mapping model. Intervention boosters were offered at two follow-up intervals in the following three months, and respondents were reinterviewed at six months. The data at baseline suggest that probationers in Delaware have levels of injection drug use, other serious drug use, and rates of risky sexual behaviors that approach those observed in prison populations. The interventions' effectiveness in changing attitudes and behaviors at the six-month interview was then examined. The data support the conclusion that brief interventions can significantly impact both drug use and sexual risk behaviors among probationers. However, there do not appear to be significant improvements for those receiving the more intensive Focused Intervention, as compared to those who receive the enhanced Standard Intervention. Further work will consider what components in programs and characteristics in clients should be considered in selecting the most appropriate interventions for probationers.

Predictors of risky sexual behavior in African American adolescent girls: implications for prevention interventions.

To describe empirically the risky sexual behavior of an at-risk sample of adolescent girls, to assess psychosocial correlates of risky behavior, and to examine the utility of applying a risk and protective model to predicting teens' risky sexual behavior. Participants included 158 African American girls, ages 12 to 19, who were receiving medical care in an adolescent primary care clinic. Teens completed measures of depression, conduct problems, substance use, peer norms, social support, HIV knowledge, sexual self-efficacy, and sexual behavior. Teens in this sample reported high rates of risky sexual behaviors, including early sexual debuts and frequent unprotected sexual encounters with multiple partners. African American girls who reported high rates of substance use and who reported that their peers engaged in risky behaviors also reported engaging in high rates of risky sexual behaviors. Little support was obtained for protective factors (HIV knowledge, social support, sexual self-efficacy) moderating the relations between risk factors and adolescents' risky sexual behavior in this sample. Teens presenting in primary care settings in urban environments seem to be at high risk for HIV, STDs, and substance abuse, and risk reduction strategies should be introduced during the preteen years. An interdisciplinary model of care in primary care settings serving adolescents is clearly indicated, and prevention-oriented interventions aimed at reducing risky behaviors and preventing the development of more significant health, mental health, or substance abuse disorders are needed.

HIV risk behaviors and their relationship to posttraumatic stress disorder among women prisoners.

This study assessed HIV risk behaviors and their association with psychiatric disorders among women prisoners. HIV risk behaviors practiced in the five years before incarceration were ascertained with the Risk Behavior Assessment interview for 177 inmates at the Maryland Correctional Institution for Women. The Structured Clinical Interview for the DSM-IV was used to determine the occurrence of posttraumatic stress disorder (PTSD), major depression, and dysthymic disorder among the women. Regression models were used to determine the association between HIV risk behavior and psychiatric disorders. HIV risk behaviors in the five years before incarceration included never or rarely having used condoms (56 percent of the women), injection drug use (42 percent), sexual intercourse with a partner who used injection drugs (42 percent), prostitution (30 percent), needle sharing (30 percent), receptive anal sex (19 percent), and having more than 100 sex partners (7 percent). After the analysis adjusted for age, education, race, HIV status, and addictive disorders, a lifetime occurrence of PTSD was associated with the practice of anal sex (odds ratio=1.7; 95 percent confidence interval=1.26 to 2.16; p<.02) and prostitution (OR=1.56; 95% CI=1.17 to 1.95; p<.03). HIV risk behaviors before incarceration were highly prevalent among the women in this study. Rates of PTSD, depression, and dysthymic disorder were also high. PTSD was associated with prostitution and receptive anal sex, and the disorder may contribute to high rates of risky sexual behavior. Targeted HIV risk reduction efforts among women prisoners should include evaluation for PTSD; conversely, women prisoners with a diagnosis of PTSD should be evaluated for prior HIV sexual risk behaviors.

Sexual Behavior, Drug Use, and Aids Knowledge among Midwestern Runaways

The authors evaluated sexual behaviors, drug use, and AIDS knowledge among Cleveland runaways (N = 108). Results indicated variable rates of risky sexual behaviors, minimal illicit drug use, and high levels of knowledge about true behavioral risks for HIV infection. These runaways demonstrated less frequent health-compromising sexual behavior and drug use compared to runaways described in other studies. Assumptions should not be made that all runaway youths engage in an unusually high rate of risky behaviors.