There is extensive research on the prevalence of college student engagement in risky sexual behaviors and its potentiating factors in college/university settings. However, there remains limited data and study on the use of campus health centers, as well as the patterns of how students seek sexual health care, its relationship to student gender identity, and student engagement in sexual risk behaviors. Despite literature surrounding student health centers and how students seek out medical care, the minimal data in the field regarding campus health center use, if and how students specifically seek out sexual health services, and how this collectively might vary across students with different gender identities, clearly indicate a need for further research on the experiences of students on college campuses in this regard. This dissertation is a secondary data analysis of the American College Health Association-National College Health Assessment III. This study’s specific aims were to: 1) describe key characteristics of students utilizing student health centers 2) describe if and how frequently college students are regularly seeking sexual health services; and 3) evaluate the relationship between a student’s gender identity and engagement in risky sexual behaviors. Drawing on a nationally representative sample of undergraduate students, analyses illustrated that students utilizing health services were primarily heterosexual female undergraduate students, with differing rates of utilization health services and sexual health services depending on race/ethnicity, year in school, and primary source of health insurance.The results confirmed that there are barriers to college student utilization of sexual health services, specifically for students who are non-heterosexual and transgender. Fewer students are seeking out their student health center and are seeking out care from services from other medical locations or may not be seeking out care at all. These findings highlight the need to ensure that student health centers on college campuses are inclusive of all students, regardless of gender identity. Given the important role that campus health center services play in promoting positive health outcomes and reducing sexual risk among its students, universities should consider efforts to increase student health center utilization, as it is a primary source of college student healthcare.

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The problem this study addressed involves how college students since the year 2020 in the U.S. have been negotiating romance, dating, and sexual relationships in the unique historical period of the COVID-19 pandemic. Further, this study addressed the problem of needing to determine how the pandemic may have disrupted college students’ intimate sexual experiences—and impacted their mental health, physical health, and experiences of social support. The main purpose was to identify significant predictors of the study outcome variable of a higher rating of self-efficacy for engaging in safer sexual behaviors. An additional purpose of the study was to determine if there were significant differences in students’ mean ratings—when comparing mean scores for 5 time periods (i.e. 1-2018-2019/freshman year before the pandemic; 2-2019-2020/second semester of sophomore year during pandemic; 3-2020-2021/junior year during pandemic; 4-2021-2022/senior year during the pandemic; and, 5-currently, especially the past 3 months)—for physical health, mental health, social support, and level of involvement in romantic, intimate, serious dating, or sexual relationships. Overall, comparisons for time periods found deterioration during the pandemic years with some signs of improvement by the current time period of Spring 2023. Findings showed females had higher self-efficacy to perform safer sexual behaviors, but also that survey respondents who lived independently had higher self-efficacy to perform safer sexual behaviors, those who had a COVID-19 diagnosis in the past two years had higher self-efficacy to perform safer sexual behaviors, and survey respondents whose college did have a sexual assault media campaign had higher self-efficacy to perform safer sexual behaviors. The results of the backwards stepwise regression found that higher self-efficacy to perform safer sexual behaviors was significantly predicted by higher age, higher income, higher BMI, lower social support, higher current romantic involvement, higher exposure to sexual assault information on campus, lower alcohol/drug use during sex, and higher stage of change for engagement in safer sex—as a global mean score capturing four risk reduction behaviors; and, 56.4% of the variance was explained by the model. Implications and recommendations are discussed with a focus on the need for longitudinal studies with a nationally representative sample.

Since early 1983, the incidence and prevalence of heterosexually transmitted AIDS among women have increased at an alarming rate. However, due to the conceptualization of AIDS as a "gay male" disease, little research attention has been devoted to the prevention of HIV infection among women. The purpose of the current intervention was to test the utility of extending a behavioral social influence/diffusion of innovation approach to a group of heterosexual women. A randomized experimental field design was used to compare a community intervention (AIDS education materials plus the training of individuals identified as key opinion leaders to serve as peer behavior change agents) with a comparison intervention (AIDS education materials alone). The study was conducted at a small liberal arts college for women. Two dormitories were randomly assigned to either an intervention or comparison condition. Twenty-four women, living in the intervention dormitory, were identified as key opinion leaders among their female peers. These key opinion leaders then received information concerning the basic epidemiology of AIDS and other STDs, misconceptions about the transmission of AIDS/STDs among heterosexual women, gender constraints that impact health behavior change among women, and practical risk reduction strategies. Opinion leaders also received training in specific conversation skills to endorse HIV-protective behavior and to convey a change in normative sexual behavior to women living in the intervention dormitory. At pre- and post-intervention, 580 surveys were collected from both the intervention and comparison dormitories. Using an anonymous identification code, survey data were matched for 192 comparison and intervention participants. The major dependent variables included (a) AIDS/STD risk behavior knowledge, (b) perceived risk, (c) perception of peer norms for HIV-risky and HIV-protective behaviors, (d) stage of health behavior change, (e) intentions to practice safer sex, (f) socially and sexually assertive behavior, (g) HIV-risky sexual behavior, and (h) alcohol and drug use. Condom-taking behavior provided a nonreactive measure of behavioral intentions. A number of direct training effects were found for the key opinion leaders, including an increase in AIDS/STD risk behavior knowledge, conversation skills, and empathic assertion. However, there was no change in behavioral intentions, stage of change, perceptions of peer norms for HIV-protective behavior, or reported HIV-risky behavior. Analysis of covariance on posttest scores, using pretest scores as covariates, showed that, relative to the comparison participants, the intervention participants increased their AIDS/STD risk behavior knowledge and the number of AIDS/STD related peer conversations. No other treatment effects due to diffusion of innovation were found. The rate of risky sexual behavior for the intervention period was relatively low. However, descriptive statistics revealed a pattern of HIV-risky behavior in the current sample suggesting that HIV/STD risk may increase over time as a function of unprotected vaginal and oral intercourse and serial monogamy. The implication of these findings are discussed in terms of future interventions targeting heterosexual women. / Ph. D.

Thesis (MA) -- Stellenbosch University, 2003. / ENGLISH ABSTRACT: Health and social problems associated with the high-risk sexual behaviour of young people worldwide gave rise to the priority status accorded to sex education in the past decade. Despite the attention focused on and the goals set for sexual health education, surveys indicate that the AIDS epidemic is still spreading, STD infections are increasing and a growing number of unwanted pregnancies are reported every year. It seems therefore that many young people are not yet able to manage their sexual health effectively and sex educators are confronted with the challenge to provide more effective sexl education interventions. This study attempted to address the need for effective sexuality education for young people by designing, implementing and evaluating a peer group sexuality psycho-education programme targeted at university students. The process of programme development was guided by the phases proposed by the Psycho-education model: Phase 1: Problem-identification. This phase entailed becoming aware of the problem through media attention, social awareness, discussions with members of the community and exploring problems around young people's sexual health through an extensive literature review. Phase 2: Situation Analysis. During this phase the researcher clarified the identified problem by conceptualizing and defining relevant concepts and identifying theoretical frameworks and principles that could be used to address the problem. as well as the Action Research model were identified as useful theories. Phase 3: Development of the programme. The Information-Motivation-Behavioural skills (1MB) model and the Guerney model were used to guide the design of the programme. Phases 4, 5 and 6: Implementation, evaluation and re-evaluation. These interdependent phases entailed three consecutive implementations of the sexuality psycho-education programme. The principles of Action Research were used to guide the implementation and evaluation processes. Evaluation of qualitative data obtained through participatory research after each implementation allowed for continuous adaptation and improvement of the programme. At the end of the third implementation quantitative data was supplemented by quantitative data obtained with a pen-and-paper test-retest method. Quantitative results indicated that the sexuality education programme significantly increased subjects' knowledge regarding sex en sexuality, but did not have a significant impact on attitudes and perceived behavioural skills. There was an indication that clarification of attitudes had been promoted, and that attitudes relating to the use of contraception had positively changed. Furthermore, a significant change in perceived behavioural skills regarding communication about and behaviour for the prevention of HIV/STDs had been achieved. Qualitative evaluation indicated that subjects felt more positive about using condoms and about communicating with their partners about the use of contraceptives. Step 6 and full circle back to step 1: Final Re-evaluation and problem-identification. During this phase the researcher reviewed the outcomes of the intervention. New problems were identified and recommendations made for future continuation. The researcher concluded that the deficits in research methodology, such as a lack of structured qualitative evaluation, hampered effective evaluation of the programme. Further research needs to be conducted to develop appropriate theoretical frameworks and measuringinstruments with which to inform and evaluate the effectiveness of sex education programmes. / AFRIKAANSE OPSOMMING: Die gesondheids- en maatskaplike probleme wat verband hou met die hoë-risiko seksuele gedrag van jongmense wêreldwyd het daartoe gelei dat seksonderrig gedurende die afgelope dekade voorrang geniet het. Ondanks die toespitsing op seksuele gesondheid, en die doelwitte daarvoor gestel, toon peilings dat die VIGS-epidemie steeds versprei, seksueel-oordraagbare siektes (STDs) toeneem, en 'n groeiende aantalongewenste swangerskappe jaarliks aangemeld word. Dit blyk dus dat 'n groot aantal jongmense nie in staat is om hulle seksuele gesondheid effektief te bestuur nie en seksopvoeders word gekonfronteer met die uitdaging om meer effektiewe seksopvoedingsintervensies te verskaf. Met hierdie studie is onderneem om die behoefte aan doeltreffende seksualiteitsopvoeding vir jongmense aan te spreek, deur die samestelling, toepassing en evaluering van 'n portuurgroep seksualiteit psigo-opleidingsprogram gemik op universiteitstudente. Die proses van programontwikkeling is gelei deur die fases wat voorgestel is deur die Psigo-onderrigmodel: Fase 1: Probleemidentifikasie: Dié fase het kennisname van die probleem behels as gevolg van die aandag daaraan gewy in die media en as gevolg van maatskaplike bewustheid, asook deur bespreking met lede van die gemeenskap en deur ondersoek van probleme in verband met die seksuele welstand van jongmense deur middel van 'n uitgebreide literatuurstudie. Fase 2: Situasieanalise: Gedurende hierdie fase het die navorser die geïdentifiseerde probleem duideliker omskryf deur die relevante konsepte te konseptualiseer en omskryf, en teoretiese raamwerke en beginsels te identifiseer wat gebruik kon word om die probleem aan te pak. Fase 3: Ontwikkeling van die program: Die Informasie-Motivering-Gedragsvaardigheidsmodel (IMG) en die Guernymodel is gebruik as raamwerke vir die ontwerp van die program. Fases 4, 5 en 6: Implementering, evaluasie en her-evaluasie. Hierdie interafhanklike fases het drie opeenvolgende implementerings van die seksualiteit-psigo-opleidingsprogram behels. Die beginsels van Aksienavorsing is toegepas in die implementering- en evaluasieprosesse. Evaluasie van kwalitatiewe data, verkry deur deelnemende navorsing na elke implementering, het deurlopende aanpassing en verbetering van die program moontlik gemaak. Aan die einde van die derde implementering is kwantitatiewe data aangevul deur data wat verkry is deur 'n pen-en-papier toets-hertoets-metode. Stap 6 en terug tot by stap 1: Finale re-evaluasie en probleemidentifikasie. Gedurende hierdie fase het die navorser die resultate van die intervensie ontleed. Nuwe probleme is geïdentifiseer en aanbeveliings vir toekomstige voortsetting is gemaak. Die navorser het tot die gevolgtrekking gekom dat die tekortkominge in die navorsingsmetodologie - byvoorbeeld, 'n gebrek aan gestruktureerde kwalitatiewe evaluering - verhinder het dat effektiewe evaluering van die program kon plaasvind. Verdere navorsing word benodig om toepaslike teoretiese raamwerke en meetinstrumente te ontwikkel wat aangewend kan word om die ontwerp van seksopvoedingsprogramme te rig en die effektief van programme te evalueer.

With the spread of the Human Immuno-Deficiency Virus and sexually transmitted diseases, it is extremely important for sexually active individuals to protect themselves properly if they decide to engage in sexual intercourse. Knowledge of HIV and the Acquired Immune Deficiency Syndrome has been associated with safer sexual practices, but knowledge alone does not totally explain risky sexual practices. This study examined how 154 college students' knowledge of HIV/AIDS, relationship status, perceptions of condom use, and perceptions of personal risk affect condom use during sexual intercourse. The impact of trust and love justifications along with the approval of peers were also examined. Perceptions of condom use and perceptions of personal risk were compared by gender and ethnicity; how perception of personal risk is related to condom use and condom use intentions was also examined. Condom use intention was found to be a significant predictor of condom use, and a significant difference of means for condom use intentions was reported between individuals who used condoms during their last experience with sexual intercourse and those who did not use condoms during their last sexual experience

This study investigates whether sex information, experience, or attitudes are related to self-concept. The subjects were 120 students enrolled in a university sex-education course, All students completed questionnaires measuring sex information, experience, and attitudes. The Tennessee Self-Concept Scale was given to obtain self-concept scores. Correlation coefficients and correlation ratios were computed between sex information, sexual experience, sex attitudes, self-concept, and course grades. No pattern of relationships emerges between self-concept and the other variables studied. A strong negative correlation (P < .01) was found between sex experience and sexual attitude orthodoxy. Consistent with other research, males report more sex experience (D < .01) and more liberal sex attitudes (P < .01) than females.

This study extends previous research on safer sexual behavioral practices by exploring the relationship between self-esteem and risky sexual behavioral practices. The Health Belief Model is the theoretical model used in this research. The Health Belief Model has been used to predict preventive health behaviors (Weiss & Lonnquist, 1993). To test the model, a questionnaire was given to undergraduate Introductory Sociology students at a land-grant university. What this research found, was that self-esteem was statistically significantly related to risky behaviors; more specifically, for those sexual behavioral practices which carry the highest risk, such as unprotected anal intercourse and sharing of needles for the injection of drugs. Students with high levels of self-esteem, as well as high levels of knowledge of HIV/AIDS, reported engaging in safer behavioral practices, for the unconventional sexual behaviors than those with low and moderate levels of self-esteem. With respect to those more conventional sexual behavioral practices, such as unprotected vaginal/penile intercourse and unprotected sex with multiple sex partners, those with high self-esteem reported more risky sexual behaviors than those with low and moderate self esteem which was not as hypothesized. Males and females reported similar levels of unconventional risky sexual behavioral practices and conventional risky sexual behavioral practices. The results indicate that self-esteem operates differently in different contexts. An important result of this study is that factors which predict unconventional sexual behavioral practices are not the sa,me as those which predict conventional sexual behavioral practices. Theses differences need to be taken into account by those trying to influence less risky sexual behavioral practices. / Master of Science

In Ethiopia the number of young people going to college is steadily increasing. This predisposes them to risky sexual behaviour which leads to unwanted pregnancy, unsafe abortions and HIV. This study has aimed to determine the patterns of sexual practice and contraceptives use and risk behaviours among those students in central Ethiopia. A descriptive cross-sectional survey was employed. Data on sexual practice, knowledge and contraceptive use were collected from 327 college students. The data were cleaned, entered and analysed using SPSS version 20. The results revealed that despite their knowledge of the methods of safe sex, there are still considerable misconceptions regarding the effectiveness of contraceptives, their side effects and their proper use. In terms of the sexual practice reported by the respondents, 142 (43.4%) practised sex and 110 (77.5%) of respondents had used contraceptives at least once. The age of the respondents, the number of years for which they stayed in college and their fields of study were significantly associated with their sexual practice. In conclusion, a significant number of college students practised sex without using contraceptives to prevent pregnancy, and a considerable number of their partners disapproved of the use of contraceptives / Health Studies / M.A. (Public Health)

Eighty-nine single, sexually active, heterosexual college students (ages 17-24) participated in one of two intervention conditions. Experimental groups were taught skills specific to condom use and sexual communication via a multimedia presentation. Control groups viewed a video on an unrelated topic. Individuals in the experimental conditions were expected to show higher levels of self-efficacy, greater knowledge concerning diseases, and improved attitudes about condoms immediately following the intervention. They were also expected to report safer sexual practices at the one month follow-up. Findings reveal that improved attitude and knowledge scores did not translate into behavioral changes.