Examining Predictors of Protective and High-Risk Sexual Behaviors among Incoming Students at a Historically Black College/University Open Access

Terrell, Lynsey Allison (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/ff365558s?locale=en


Introduction. Engaging in high-risk sexual behaviors, such as having multiple partners and inconsistent condom use, may put college students at an increased risk for HIV and STI acquisition. In the limited studies that have compared college students by race, black college students have been disproportionately impacted by HIV and STIs, despite higher engagement in some protective sexual health behaviors compared with their white peers.

Objective. The purpose of this study was to fill a gap in the literature on the existing sexual health behaviors, knowledge, and attitudes of incoming, male students at a southeastern, historically black college/university (HBCU).

Methods. This study utilized a cross sectional design with a convenience sample of 211 incoming students attending New Student Orientation at a southeastern HBCU during summer 2015.

Results. Among participating students, 64% reported ever having oral, vaginal, or anal sex. The majority of men who reported having sex within 30 days of taking the survey reported that they had used a condom at their last sexual encounter (64%). Multivariate analyses found that men who reported their behavior as safe and those with higher condom use self-efficacy scores were significantly more likely to have used a condom at last sex. However, the majority of sexually experienced men (89%) reported their sex behaviors as "safe" or "very safe." Of men who perceived their behavior as safe, 29% had more than one sex partner in the past 30 days and 60% never had an HIV test. Significant predictors of reported history of HIV testing included having four or more lifetime sex partners, fewer perceived barriers to HIV testing resources, and lower anxiety regarding HIV testing. Nearly half of the students indicated not knowing where to get an HIV test (44%).

Conclusions. The findings supported the previous literature with regards to high-perceived levels of safety among male students, despite engagement in some high-risk sexual behaviors. Future strategies should utilize peer-led, targeted interventions to address perceived insusceptibility to poor sexual health outcomes and emphasize available resources on campus.

Table of Contents

Chapter 1: Introduction 1

Context 1

Statement of the Problem 1

Purpose 5

Research Aims 5

Significance of Study 6

Theoretical Perspectives 6

Emerging adulthood 6

Thesis Overview 9

Chapter 2: Literature Review 10

Sexual Health Disparities 10

Emerging adulthood and sexual health disparities 10

Emerging Adulthood and Sexual Health Knowledge 12

Age of Sexual Debut and Number of Sex Partners 14

Condom Use and Condom Use Self-Efficacy 15

Emerging Adults and HIV Testing Behaviors and Attitudes 18

Perceptions of Risk and Safety 20

Search Methods 21

Chapter 3: Methods 22

Design 22

Procedures 22

Participants 22

Measures 23

Sexual history and behaviors 23

Partner communication scale 23

Adolescent and young adult condom self-efficacy scale 24

STD Knowledge Questionnaire 25

HIV testing history and attitudes 26

Perceived barriers to HIV testing 27

Data Analysis 28

Chapter 4: Results 30

Sexual History and Behaviors 30

HIV Testing History and Attitudes 34

Condom Use at Last Sexual Encounter 34

History of HIV Testing 35

Chapter 5: Discussion 39

Implications and Recommendations 41

Filling gaps in the literature 41

Recommendations for future research 42

Recommendations for future interventions 43

Interventions targeting HBCU students 46

Limitations 49

References 52

Appendix 65

Appendix A: Cross-sectional Survey 65

Sexual behaviors 65

Partner Communication Scale 65

STD-Knowledge Questionnaire 66

Adolescent and Young Adult Condom Use Self-Efficacy Scale 69

Appendix B: STD Knowledge Questionnaire Codebook 71

Appendix C: Informed Consent Form 72

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