Journal of Health Communication International Perspectives
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Examining the Principles of Influence on Safer Sex Communication During Casual and Committed Sexual Encounters Tobias Reynolds-Tylus, Anna Rinaldi-Miles & Brian L. Quick To cite this article: Tobias Reynolds-Tylus, Anna Rinaldi-Miles & Brian L. Quick (2015) Examining the Principles of Influence on Safer Sex Communication During Casual and Committed Sexual Encounters, Journal of Health Communication, 20:10, 1214-1223, DOI: 10.1080/10810730.2015.1018631 To link to this article: http://dx.doi.org/10.1080/10810730.2015.1018631
Published online: 10 Jul 2015.
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Date: 06 November 2015, At: 23:46
Journal of Health Communication, 20:1214–1223, 2015 Copyright # Taylor & Francis Group, LLC ISSN: 1081-0730 print/1087-0415 online DOI: 10.1080/10810730.2015.1018631
Examining the Principles of Inﬂuence on Safer Sex Communication During Casual and Committed Sexual Encounters TOBIAS REYNOLDS-TYLUS1, ANNA RINALDI-MILES2, and BRIAN L. QUICK3 1
Department of Communication, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA School of Kinesiology and Recreation, Illinois State University, Normal, Illinois, USA 3 Department of Communication and College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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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 ¼ 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.
It is estimated that there are more than 110 million sexually transmitted infections (STIs) in the United States, with an additional 20 million new infections reported each year (Centers for Disease Control and Prevention, 2013). Not only are STIs increasingly prevalent, but their effect on health and well-being can be signiﬁcant as medical costs associated with STIs approach $16 billion annually. HIV, for example, directly leads to the death of 18,000 people in the United States each year. The Centers for Disease Control and Prevention (2013) reported that individuals between the ages of 15 and 24 years are particularly at risk, accounting for only 25% of the sexually active population, while making up 50% of newly diagnosed STIs. For young people then, understanding one’s level of risk is critical for maintaining favorable health. One effective strategy is for individuals to engage in safer sex communication with one’s partner, which is a type of substantive communication that may include topics such as (a) inquiring about a partner’s sexual history, (b) revealing one’s own sexual history, (c) probing about a partner’s STI=HIV serostatus, or (d) asking about a partner’s last date of testing (Noar, Carlyle, & Cole, 2006). The rationale for safer sex communication is that by ﬁnding out a potential partner has engaged in risky sexual behaviors, been sexually indiscriminate, or has not Address correspondence to Brian L. Quick, Department of Communication and College of Medicine, University of Illinois at Urbana-Champaign, 3001 Lincoln Hall, Urbana, IL 61801, USA. E-mail: [email protected]
recently been tested may indicate an elevated level of risk for contracting an STI (Lucchetti, 1999). In addition, by discussing risk-related topics with one’s partner, these conversations open the door for individuals to discuss and enact sexual precautions such as using condoms (Anderson, Kunkel, & Dennis, 2010). Whereas, historically, some researchers have doubted the effectiveness of encouraging safer sex communication as a strategy for reducing one’s risk of contracting STIs (Cline, Johnson, & Freeman, 1992; Metts & Fitzpatrick, 1992), more recently others have contended that the potential for safer sex communication as a preventative safer sex behavior that has been inadequately studied (Noar, Zimmerman, & Atwood, 2004; Wolitski & Branson, 2002). More speciﬁcally, meta-analyses support the effectiveness of safer sex communication as a health protective behavior. For example, Sheeran, Abraham, and Orbell (1999) found that communication about condom use was the strongest (r ¼ .46) predictor of actual condom use. More recently, Noar and colleagues (2006) found a moderate effect size (r ¼ .22) of safer sex communication on reported condom use. Speciﬁcally, communication about condom use (r ¼ .25) and discussion of sexual histories (r ¼ .23) had a signiﬁcantly larger effect on condom use than general safer sex communication (r ¼ .18). Taken together these studies suggest a consistent relation between safer sex communication and enacting protective sexual health behaviors such as condom use. Still, a more nuanced understading of how these discussions differ in commited and casual relations is warranted (Noar et al., 2006; Noar et al., 2004).
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Safer Sex Communication The overarching goal of this investigation is to better understand young peoples’ perceptions of the speciﬁc interpersonal communication strategies that are inﬂuential during sexual encounters. With this goal in mind, two objectives serve as the foundation for the present study. First, we intend to examine whether young people perceive these inﬂuence strategies to differ among casual and committed sexual encounters. Second, if differences arise, we aim to assess which strategies are viewed as most inﬂuential in affecting safer sex communication between partners. Ascertaining if relationship context moderates the perceptions of the effectiveness of safer sex communication strategies would be useful information for practitioners promoting safer sex behaviors. With the overarching goal and objectives of the present study put forward, we begin with a review of the safer sex communication literature. Safer Sex Communication Despite the importance of safer sex communication, research demonstrates that young people do not consistently engage in these discussions with their sexual partners (Faulkner & Mansﬁeld, 2002; Lewis, Kaysen, Rees, & Woods, 2010). Instead, young people often assume partner safety on the basis of unreliable characteristics such as likeability, trustworthiness, or similarity (Bolton, McKay, & Schneider, 2010; Masaro, Dahinten, Johnson, Ogilvie, & Patrick, 2008). Unfortunately, when these discussions do happen, they often do not include adequate information for proper risk assessment. For example, Nichols (2012), in her investigation of college students’ discussions of their sexual history, found that young people often disclose signiﬁcantly less information than they believed their partner is entitled to know. Perhaps most alarming is that most useful risk assessment information (i.e., types of sexual behavior partner engaged in, length of time since testing) is discussed least frequently (Nichols, 2012). Oftentimes, research on sexual behavior does not consider the relational context in which the sexual behavior occurs (Furman & Shaffer, 2011; Noar et al., 2004). In committed relationships, there are many reasons why individuals may eschew safer sex communication with their partner. For example, the sharing of prior sexual experiences is considered by many to violate the normal expectations of scripted sexual behavior (Emmers-Sommer & Allen, 2004). That is, many individuals consider disclosing sexual histories as nonnormative, often citing social norms such as kissing-and-telling is rude (Allen, Emmers-Sommer, & Crowell, 2002), ‘‘the past should be the past’’ (Anderson, Kunkel, & Dennis, 2010), and that asking about one’s sexual past is ‘‘nobody’s business’’ (Emmers-Sommer, Warber, Passalacqua, & Luciano, 2010). Engaging in these discussions then is often seen as taboo (Emmers-Sommer et al., 2010) and correspondingly these conversations are reported to be awkward and difﬁcult (Bolton et al., 2010; Faulkner & Mansﬁeld, 2002). Among heterosexual college couples, past sexual partners and experiences are noted as the least discussed topics among partners, even more so than other conﬂict-inducing topics such as
1215 religion and politics (Anderson et al., 2010). The implications of the challenges in discussing sexual topics with a committed partner are profound. Recently, Bolton and colleagues (2010) found young women in committed relationships often avoided direct communication with their partner when assessing their risk for STIs, instead relying on assumption-based assessments (i.e., presumed monogamy, lack of visible STI symptoms). Further complicating this issue is research suggesting that young people are regularly engaging in sexual behaviors outside of a committed romantic relationship. Casual sex, also commonly known as nonromantic sexual behavior or hook-ups (Furman & Shaffer, 2011), is described as any sexual behaviors (oral, vaginal, or anal intercourse) that occur between partners who do not deﬁne the relationship as romantic or committed (Weaver & Herold, 2000). Casual sex is common among young people, with approximately half of sexually active undergraduates reporting having sexual intercourse with at least one nonromantic partner (Grello, Welsh, & Harper, 2006), and often times with multiple partners (Manning, Giordano, & Longmore, 2006). Young people cite concerns about their reputation and the potential for loss of sexual experience as major determinants in their decision to avoid safer sex discussions during casual sex (Allen et al., 2002; Faulkner & Mansﬁeld, 2002; Lucchetti, 1999). Casual sex is typically characterized by spontaneity as it is often unplanned (Holman & Sillars, 2012) and predicated by heavy alcohol consumption (Downing-Matibag & Geisinger, 2009). It is unsurprising, then, that many young people lack the willingness and ability to engage in effective safer sex communication during casual sex (Abbey, Saenz, & Buck, 2005; Ariely & Lowenstein, 2006). As a result, consequently for young people the information needed to inform healthy sexual decision making is often unknown at the time when casual sex occurs. Given the barriers inherent in engaging in safer sex communication during casual and committed sexual encounters, it is instructive to understand the factors inﬂuencing these discussions. More speciﬁcally, understanding how young peoples’ perception of their peers’ safer sex message strategies will be useful for practitioners attempting to promote safer sex behaviors among this demographic. Norms are an important construct in several theoretical models on behavior change (Azjen, 1985; Fishbein & Azjen, 1975; Rimal & Real, 2003, 2005) and have been shown to be important in understanding sexual behaviors, particularly sexual risk taking behaviors. For example, Kapadia and colleagues (2012) found that among Latino youth, peer norms encouraging safer sex behavior were associated with consistent condom use, even controlling for individual and partner-related factors. In sum, the importance for understanding young peoples’ perceptions of their peers’ inﬂuence strategies used during sexual encounters is paramount given the consequences linked to having unprotected sex. Moreover, the need for this type of work is compounded considering that less than half of young people use a condom during casual sex (Lescano et al., 2006) and condom use is often inconsistent in committed relationships (Bearinger et al., 2011; Civic, 1999).
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1216 A greater understanding of the underlying factors inﬂuencing young peoples’ safer sex communication practices is warranted and encouraged in the extant literature (Noar et al., 2004). One way to examine inﬂuences on safer sex communication is through an examination of heuristic cues that young people perceive as inﬂuencing these discussions. Often, when individuals are not able to, nor motivated to, scrutinize every message they encounter (Petty & Cacioppo, 1986), they rely on a limited number of heuristics to help simplify decision-making processes (Tversky & Kahneman, 1974). Cialdini (1984) summarized past research on social inﬂuence by indicating there are six core principles affecting individuals’ tendencies to comply with a request (authority, consistency, liking, reciprocity, scarcity, and social proof). Cialdini’s (1984) principles are sometimes referred to as weapons of inﬂuence, as compliance professionals often use these strategies to successfully trigger what Cialdini (2007) refers to as ﬁxed-action patterns, a type of automatic compliance. Thus, these principles of inﬂuence operate like heuristics (Cialdini, 1987). Although heuristic cues have been shown to function during sexual decision-making, such as when assessing a potential sexual partner’s HIV risk (Renner, Schma¨lzle, & Schupp, 2012), no known literature has examined the inﬂuence of heuristics on safer sex discussions. Given that individuals’ decision-making abilities during sexual encounters are inhibited by factors inherent to the situation such as sexual arousal, time constraints, and alcohol use (Ariely & Lowenstein, 2006; Downing-Matibag & Geisinger, 2009; Holman & Sillars, 2012), as well as the importance of communicating with one’s partner about safer sex (Noar et al., 2006; Noar et al., 2006), we believe it is appropriate to consider the application of Cialdini’s (1984) principles in the realm of safer sex communication. Principles of Inﬂuence The following is how Cialdini (1984) deﬁned his six principles of inﬂuence. The authority principle relies on the belief that those with a high social status or position of power in society demonstrate correct social conduct, which thereby results in social pressure to comply with requests made by these individuals (Cialdini, 2007). Social status has been shown to be a major inﬂuential factor in sexual behaviors such as partner selection and enactment of safer sex practices (Marston & King, 2006). Therefore, it may be that individuals who perceive their partner to have a higher social status may be more likely to adopt their partners’ communication preferences during sexual encounters. The consistency principle can be successful because people often use their past behavior to guide their future actions. Once an individual has made a commitment, they are more willing to agree to requests that are consistent with their prior behavior as an attempt to reduce uncertainty (Cialdini, 2007). This principle is apparent during sexual encounters, as condom use at ﬁrst intercourse has been related to subsequent condom use (Stulhofer, Bacak, Ajdukovic, & Graham, 2010). Thus, it may be that individuals rely on their past safer sex communication behaviors to inﬂuence future communication practices. The liking principle is often effective as individuals are more likely
T. Reynolds-Tylus et al. to say ‘‘yes’’ to people they like. The halo effect (Nisbett & Wilson, 1977), whereby a single positive characteristic dominates how others view an individual, is one of the oldest and most widely known ﬁndings in the social psychology literature. During sexual decision making, college students have been shown to presume partner safety based on characteristics such as similarity or likeability (Bolton et al., 2010; Masaro et al., 2008). Therefore, it may be that how much an individual likes another person may inﬂuence their decision to engage in speciﬁc conversations about safer sex topics. The reciprocity principle relies on the feeling of obligation to repay someone in the future for a service provided. This tactic is often effective as social sanctions against violators of this principle can be harsh (Cialdini, 2007). For example, men often perceive a woman to be more sexually available when she allows a man to purchase her a drink (George, Gournic, & McAfee, 1988) or dinner (Emmers-Sommer et al., 2010). Thus, it may be that individuals are more likely to share their sexual past if their partner ﬁrst shares their own, due to feelings of reciprocity. The scarcity principle often increases the value of an object or action by persuading people that there is a limited number available or time restriction. This principle is often successful because it creates a sense of urgency, leading individuals to act quickly for fear of potentially missing out on an opportunity (Cialdini, 2007). During sexual encounters, the limited window of opportunity to engage in sexual behaviors has been found to inﬂuence individuals’ perceived ability to engage in safer sex practices, and subsequently, inﬂuences their enactment of safer sex behaviors (Lear, 1996). It may also be then that a perceived limited amount of time to engage in safer sex discussions similarly affects subsequent safer sex communication behaviors. Last, social proof is a principle that relies on the fact that decisions are often informed by the actions of others. This principle is especially powerful in situations where individuals are unsure how to behave, as they are more likely to look to others to guide their actions (Cialdini, 2007). In the context of sexual behaviors, peer norms have been shown to be important determinants of college students’ safer sex practices (Boone & Lefkowitz, 2004). Therefore, it is likely that individuals rely on their peers’ behaviors to determine their safer sex communication strategies. The Present Study The present study examines whether Cialdini’s (1984) principles of inﬂuence are used more often during casual compared to committed sexual encounters. Theoretical perspectives on cognitive processing including the heuristic systematic model (Chaiken, 1980) and the elaboration likelihood model (Petty & Cacioppo, 1986) propose that when individuals’ motivation or ability to process information is impaired, peripheral cues and heuristics become more inﬂuential. With this in mind, Cialdini’s (1984) principles of inﬂuence, which operate like heuristics, are most effective in situations in which the individual is either unwilling or unable to scrutinize messages (Cialdini, 1987). Because casual sex is often characterized by spontaneity and uncertainty (Holman & Sillars, 2012), it is
Safer Sex Communication likely then that these principles are more often used during casual sexual encounters than during committed sexual encounters. Therefore,
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Hypothesis 1: Each principle of inﬂuence will be perceived as more inﬂuential during casual sexual encounters than during committed sexual encounters.
In addition to the abovementioned hypothesis, we are interested in how Cialdini’s (1984) principles of inﬂuence uniquely function in regards to safer sex communication in each relational context. A limitation with the extant literature on safer sex communication is a lack of investigations aimed at understanding important moderators of the safer sex communication and condom-use relationship not examined in the meta-analysis by Noar and colleagues (2006). In their call for future research, Noar and colleagues (2006) indicated that ‘‘a greater understanding of how discussions about safer sex differ in committed as compared with casual sex relationships is still needed’’ (p. 384). In an attempt to address this shortcoming in the literature, the following research questions are advanced: Research Question 1: To what extent is each principle of inﬂuence perceived as being inﬂuential for safer sex communication during casual sexual encounters? Research Question 2: To what extent is each principle of inﬂuence perceived as being inﬂuential for safer sex communication during committed sexual encounters?
Method Participants Undergraduate students from a large Midwestern university were recruited to participate in a study on sexual decision making. Participants were assigned to a focus group based on their availability and biological sex. Bifurcating participants by biological sex was done to facilitate greater honesty and openness because of the sensitive nature of the topic at hand. Overall, there were six female focus groups (n ¼ 37) and three male focus groups (n ¼ 11) resulting in a total of 48 participants. Participants ranged in age from 18 to 27 and the average age of the focus group participants was 21.19 (SD ¼ 1.85). The majority of participants were upperclassmen and self-identiﬁed as White=Caucasian (n ¼ 32), Asian (n ¼ 6), Black=African American (n ¼ 6), and Hispanic=Latino (n ¼ 2). Two participants reported some other race. The majority of participants (n ¼ 37) reported that they had previously engaged in sexual intercourse. Of those with sexual experience, participants reported their average number of partners in the past 12 months (M ¼ 1.43) and the average number of lifetime partners (M ¼ 7.97). The sample’s sexual experience is comparable to national data on college student sexual experience (American College Health Association, 2013).
Procedures Focus groups were comprised of three to eight same-sex participants and were conducted by a female moderator. Because we intended to examine socially constructed scripts, a focus group was an ideal method to use. Focus groups allow researchers to observe not only what but why participants think about a topic (Silk, Parrott, & Dillow, 2003). In addition, focus groups allow for the discovery of group effects, as participants are exposed to others’ ideas regarding the topics at hand (Lindlof & Taylor, 2002). This can produce data and insights that may be less accessible without this interaction. Previous work examining sexual topics among college students has successfully used focus groups (e.g., Kennedy, Nolen, Applewhite, Waiters, & Vanderhoff, 2007; Lee, Fu, & Fleming, 2006). Focus groups were interactive in nature and allowed participants to share personal stories they believed illustrated the discussed concepts. After signing the informed consent and ﬁlling out a brief questionnaire, the moderator led participants through a series of questions to examine the role of the six principles of inﬂuence on safer sex communication. After each principle was introduced, the moderator asked participants if they believed the principle affects safer sex communication during casual sex, followed by committed relationships. As the goal behind focus groups is to allow for a synergistic conversation that emerges from group dialogue, the moderator allowed participants to freely express their thoughts about each principle. All questions were asked using a third-person context (i.e., ‘‘Do you think your peers. . .’’) to reduce embarrassment and allow students to disassociate themselves from their responses (Kennedy et al., 2007). Because the focus group examined perceived peer inﬂuences of safer sex communication, previous sexual activity was not a requirement for participation. Each focus group was digitally recorded and transcribed verbatim by a professional transcribing service. Before analyzing the data, coding units were divided by physical distinctions (Krippendorff, 2004) and each unit of analysis was deﬁned as one talk turn in the transcript. Talk turns were deﬁned as any statement made by a participant during the session. Once a new participant or the moderator spoke, the talk turn was considered over. Within each talk turn, the content was analyzed for overall endorsement or rejection of the themes. Thus, coding themes were not mutually exclusive as each talk turn could consist of more than one code. Because of this nonindependence, Cochran’s Q tests were used. Overall, there were 1,628 talk turns coded. Talk turns that consisted of clariﬁcations (n ¼ 72) or information not relevant to the current investigation (n ¼ 534) were removed; leaving a total of 1,022 talk turns used in this analysis. Two coders were trained extensively on the six principles of inﬂuence and whether a principle was endorsed or rejected for each relational context. Endorsement was deﬁned as agreement by participants that the principle inﬂuences safer sex communication practices (e.g., ‘‘I think it does inﬂuence . . .’’). This included endorsement expressed through statements that the principle ‘shouldn’t’ inﬂuence
T. Reynolds-Tylus et al.
Table 1. Differences in endorsement and rejection of principles of inﬂuence by relational context (N ¼ 1,022) Casual Endorsement Authority Consistency Liking Reciprocity Scarcity Social proof
68 25 30 51 73 16
(6.7%) (2.4%) (2.9%)ef (5.0%)hi (7.1%)kl (1.6%)
Committed Rejection 1 18 0 4 4 10
(0.1%) (1.8%) (0%)e (0.4%)h (0.4%)k (1.0%)
Endorsement 17 12 8 11 0 8
(1.7%) (1.2%)c (0.8%)fg (1.1%)ij (0%)lm (0.8%)n
Rejection 13 2 1 2 28 24
(1.3%) (0.2%)c (0.1%)g (0.2%)j (2.8%)m (2.4%)n
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Note. Comparisons were made across each principle of inﬂuence using a Cochran’s Q test. In particular, Hypothesis 1 examined differences between the endorsement of each principle in casual and committed sexual encounters, whereas Research Questions 1 and 2 examined differences between the endorsement and rejection of each principle within each relational context. All superscripts indicate differences signiﬁcant at p < .05.
safer sex communication practices, but that in actuality they do. Rejection was deﬁned as agreement by participants that the principle does not inﬂuence safer sex communication practices (e.g., ‘‘I don’t think it inﬂuences . . .’’). This included rejection expressed through statements that the principle ‘should’ inﬂuence safer sex communication practices for the relational context, but that in actuality they do not. Statements that did not clearly ﬁt into a category or were ambiguous were ignored and not coded. Therefore, our coding constitutes a fairly conservative estimate of the endorsement and rejection of each principle. Each coder independently coded approximately 10% of the data (Lombard, Snyder-Duch, & Bracken, 2002). Intercoder reliability was calculated using both simple agreement and Cohen’s kappa. Simple agreement between coders ranged from .98 to 1.0, and Cohen’s kappa ranged from .76 to 1.0 across the six principles for both casual sex and committed relationships1. After establishing acceptable intercoder reliability, any inconsistencies or questions were clariﬁed. Following this, the coders independently coded the remaining transcripts on their own.
Results Hypothesis 1: Principle Differences Between Casual and Committed Sexual Encounters Hypothesis 1 proposed that each principle of inﬂuence would be endorsed more often for casual than in committed sexual encounters. To reduce the likelihood of a Type I error, the decision was made to adjust the conventional alpha level (a ¼ .05) for Hypothesis 1 with a Bonferroni-type correction accounting for the number of pairwise comparisons (15) resulting in an adjusted alpha of .003. Overall, four of the six principles of inﬂuence were more often endorsed for casual sex than committed relationships fauthority [5, Q (N ¼ 1,022) ¼ 31.34, p ¼ .000], liking [5, Q (N ¼ 1,022) ¼ 17.29, p ¼ .000], reciprocity [5, Q (N ¼ 1,022) ¼ 25.81, p ¼ .000], and scarcity [5, Q (N ¼ 1,022) ¼ 73.00, p ¼ .000]g. Consistency [5, Q (N ¼ 1,022) ¼ 4.57, 1 All simple agreement and Cohen’s kappa between coders were 1.0 with the exception of the endorsement of the principle of scarcity for casual sex (simple agreement .98, kappa .76) and the rejection of the principle of consistency for casual sex (simple agreement .99, kappa .80).
p ¼ .033] and social proof [5, Q (N ¼ 1,022) ¼ 2.67, p ¼ .102] did not differ in endorsement between casual sex and committed relationships. Therefore, our results largely supported Hypothesis 1. See Table 1 for an overview of ﬁndings. Research Question 1: Principles of Inﬂuence for Casual Sexual Encounters Research Question 1 examined the extent to which each principle of inﬂuence affected safer sex communication during casual sex. As shown in Table 1, overall, scarcity was endorsed the most (n ¼ 73, 7.1%), followed by authority (n ¼ 68, 6.7%), reciprocity (n ¼ 51, 5.0%), liking (n ¼ 30, 2.9%), consistency (n ¼ 25, 2.4%) and social proof (n ¼ 16, 1.6%), Q (5, N ¼ 1,022) ¼ 64.03, p ¼ .000. A post hoc analysis using McNemar tests showed that the principles of scarcity, authority, and reciprocity were all signiﬁcantly (p < .05) endorsed more than the principles of liking, consistency, and social proof. Scarcity was the most commonly endorsed principle inﬂuencing safer sex communication during casual sex. A Cochran’s Q test between endorsement and rejection of scarcity showed that this principle was more often endorsed than rejected, Q (1, N ¼ 1,022) ¼ 61.83, p ¼ .000. The major consensus was that the window of opportunity in which safer sex communication could occur during casual sex is very short. As one female participant put it, ‘‘There isn’t a large time to talk about it.’’ One male participant even gave an exact number, saying that the window of opportunity ‘‘May be a matter of about 10 seconds.’’ Because of time scarcity to discuss sexual topics during casual sex, many participants agreed that if safer sex communication occurred at all, it was often after the sexual act occurred. Authority was the second most commonly endorsed principle inﬂuencing safer sex communication during casual sex. A Cochran’s Q test between endorsement and rejection of authority showed that authority was endorsed more than rejected, Q (1, N ¼ 1,022) ¼ 65.06, p ¼ .000. Participants commented on how social status differences led to perceived differences in power, which was often a barrier to safer sex communication. As one female participant noted, ‘‘If there’s a huge power difference, you’re never going to want to ask, how many past partners they’ve had.’’ Another female
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Safer Sex Communication participant expressed a similar sentiment by saying, ‘‘The person with less power is not going to bring up sexual communication unless the person with the higher power does ﬁrst.’’ Reciprocity was the third most commonly endorsed principle that inﬂuenced safer sex communication during casual sex. A Cochran’s Q test between endorsement and rejection of reciprocity showed that principle was more often endorsed than rejected, Q (1, N ¼ 1,022) ¼ 40.16, p ¼ .000. Participants often agreed that individuals would be more likely to discuss their sexual history if their casual partner ﬁrst shared their sexual history. For example, one male participant said, ‘‘Sometimes it helps you out when somebody initiates the conversation because a lot of times in communication, the ice breaker is everything.’’ As another male participant put it, ‘‘Half the battle is bringing it up’’ and ‘‘Once it’s brought up, it’s out in the open’’ and therefore much easier to discuss. Liking was the fourth most commonly endorsed principle affecting safer sex communication during casual sex. A Cochran’s Q test between endorsement and rejection of liking showed that this principle was more often endorsed than rejected, Q (1, N ¼ 1,022) ¼ 30.00, p ¼ .000. The general consensus among participants was that greater liking towards a partner meant a greater chance of adopting that partner’s communication preferences during casual sex. As one female participant stated, ‘‘If you like someone more, you’re going to want to please them . . . so you’ll be more likely to undermine your own beliefs.’’ In addition, some participants said greater liking would lead to discussions about their partner’s sexual history. As one male participant put it, ‘‘The more they like [their casual partner] the more information they would want to know about that person . . . so that things can go further.’’ Consistency was the second least endorsed principle in inﬂuencing safer sex communication during casual sex. A Cochran’s Q test between endorsement and rejection of consistency showed the principle did not differ between endorsement and rejection, Q (1, N ¼ 1,022) ¼ 1.14, p ¼ .29. Some participants espoused the virtues of using consistent safer sex communication practices during casual sex. For example, one female participant said that when it comes to safer sex communication practices, ‘‘People tend to keep doing the same thing’’ and noted, ‘‘It’s difﬁcult to change a behavior.’’ In a similar vein, a male participant indicated that during casual sex, consistency ‘‘Helps reduce uncertainty’’ and ‘‘You’re going to feel a lot more conﬁdent’’ by using the same communication practices over and over. Some participants disagreed that prior safer sex communication practices may inﬂuence future behaviors during casual sex; particularly if the past behaviors had left them at risk. As one male participant put it, ‘‘Especially if [your past communication behaviors] haven’t worked, and you get an STD or something, it’s deﬁnitely going to inﬂuence your future communication.’’ Social proof was the least endorsed principle inﬂuencing safer sex communication during casual sex. Results showed that endorsement and rejection of social proof did not differ, Q (1, N ¼ 1,022) ¼ 1.39, p ¼ .24. Some participants agreed that peers’ opinions inﬂuenced safer sex communication
1219 practices during casual sex. For example, one male participant noted the old saying that ‘‘Birds of a feather ﬂy together’’ and emphasized that ‘‘Your friends’ opinions actually carry merit on what you do.’’ Some participants disagreed, however, that peers’ opinions had any effect on communication practices during casual sex. As one female participant put it, ‘‘Everybody’s just going to do what they do. They might have [their peers’ opinions] in the back of their mind, but I don’t really think that it’s going to change too much.’’ Expanding on this idea, another female participant noted, ‘‘You may not want to follow the same communication practices that [your peers] follow, because their results weren’t what you wanted.’’ Research Question 2: Principles of Inﬂuence in Committed Sexual Encounters2 As illustrated in Table 1, Research Question 2 aimed to examine the extent to which each principle of inﬂuence affected safer sex communication in committed relationships. Overall, authority was endorsed the most (n ¼ 17, 1.7%), followed by consistency (n ¼ 12, 1.2%), reciprocity (n ¼ 11, 1.1%), liking (n ¼ 8, 0.8%), and social proof (n ¼ 8, 0.8%). No single statement was coded as endorsing the scarcity principle. Differences in endorsement among the six principles of inﬂuence were observed, Q (5, N ¼ 1,022) ¼ 17.07, p ¼ .004. A post hoc analysis using McNemar tests showed that all ﬁve principles were signiﬁcantly (p < .01) endorsed more than the scarcity principle. Authority was the most endorsed principle inﬂuencing safer sex communication in committed relationships. However, a Cochran’s Q test between endorsement and rejection of authority showed no difference in endorsement or rejection, Q (1, N ¼ 1,022) ¼ 0.53, p ¼ .47. Some participants agreed authority affected safer sex communication in committed relationships, particularly when one person was more ‘into’ the relationship than the other person. As one male participant put it, ‘‘[In a committed relationship] I feel like you would do a lot more and avoid a lot more [communication], just to make that other person happy.’’ However, others noted in more balanced relationships, authority does not have as strong of an inﬂuence. As one female participant said, ‘‘In a true, committed, equal partnership, [authority] is not an issue.’’ Consistency was the second most endorsed principle inﬂuencing safer sex communication in committed relationships. 2 Readers may be curious about potential sex differences in our ﬁndings, as our sample included fewer men than women. Overall, few sex differences emerged in our results. Although no sex differences were observed in our results for Hypothesis 1 and Research Question 1, it must be noted that several observed differences for Research Question 2 that were signiﬁcant at p < .05 in the entire sample did not remain so when analyses were conducted bifurcated by participant sex. In particular, for men, the difference in endorsement or rejection for the principles of social proof, liking, and consistency in committed sexual encounters no longer remained signiﬁcant (p > .05) when analyses were run with a male only sample. For women, the difference in endorsement or rejection for the principles of liking and reciprocity in committed sexual encounters no longer remained signiﬁcant (p > .05) when analyses were run with a female-only sample.
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1220 A Cochran’s Q test revealed that the principle was more often endorsed than rejected, Q (1, N ¼ 1,022) ¼ 7.14, p ¼ .008. Participants noted that in committed relationships, individuals are more invested in their partner, and thus more willing to engage in safer sex discussions. As one female participant put it, ‘‘If you’re going to be committed to one person, you’re going to take the extra time and effort, and you feel comfortable enough discussing what you’ve done in the past.’’ Another female participant indicated, ‘‘I think once you draw the line of commitment, that’s when you’re more, more open to disclosing information.’’ A male participant echoed a similar sentiment when he said, ‘‘In a committed relationship, you’re more comfortable talking to [your partner] about their past.’’ Reciprocity, which was endorsed more often than rejected, Q (1, N ¼ 1,022) ¼ 6.23, p ¼ .013, was the third most commonly endorsed principle inﬂuencing safer sex communication in committed relationships. The major consensus was that individuals in a committed relationship felt an obligation to reveal their sexual history if their partner revealed their sexual history ﬁrst. As one female participant remarked, ‘‘I feel I’d be a burden almost, if I didn’t [tell] the whole truth.’’ Another male participant put it this way, ‘‘If someone [in a committed relationship] brings it up ﬁrst, there is no reason for you not to reciprocate the conversation.’’ Liking was the fourth most endorsed principle inﬂuencing safer sex communication in committed relationships. A Cochran’s Q test between endorsement and rejection of liking showed that the principle was more often endorsed than rejected, Q (1, N ¼ 1,022) ¼ 5.44, p ¼ .020. The general consensus was that in committed relationships, partner liking meant individuals felt obligated to adopt their partner’s communication preferences. One male participant emphasized this in a hypothetical scenario by saying that if a person’s partner was ‘‘Totally against talking about their sexual past,’’ he felt that individuals would refrain from asking about this topic out of respect for their partner. Social proof was the second least endorsed principle inﬂuencing safer sex communication in committed relationships. It is not surprising that social proof was more often rejected than endorsed, Q (1, N ¼ 1,022) ¼ 8.00, p ¼ .005. The major consensus here was that over time, the effect that peers’ safer sex communication practices had on the communication practices of individuals in a committed relationship lessened. As a male participant said, over time, ‘‘Your partner would have more inﬂuence on you than your friends do.’’ One female participant rejected the inﬂuence of social proof by saying ‘‘It’s my business’’ and indicated it was not something she chooses to discuss with her friends at all. Not a single participant endorsed scarcity as inﬂuencing safer sex communication practices in committed relationships, and as a result, our analyses revealed that the principle was more often rejected than endorsed, Q (1, N ¼ 1,022) ¼ 28.00, p ¼ .000. The major consensus here was that, unlike during casual sex, there is a much larger window of opportunity for discussions about safer sex practices to occur within a committed relationship. Participants particularly emphasized how increased communication about all topics in committed relationships would mean that discussions about safer sex topics
T. Reynolds-Tylus et al. would inevitably arise. As one male participant put it, ‘‘You are talking about stuff all the time’’ and therefore safer sex topics ‘‘Could just pop up randomly at any moment in time.’’
Discussion Consistent with earlier works examining the effectiveness of safer sex conversations (Anderson et al., 2010; Noar et al., 2004, 2006), the overarching objective of the present study was to apply the principles of inﬂuence (Cialdini, 1984) to further our understanding of the cues young people perceive as inﬂuencing these conversations within the context of casual and committed sexual encounters. In general, our results suggest that for young people, these six principles were perceived as inﬂuencing their peers’ safer sex communication in both contexts. However, what became clear in the results is that these principles were thought to operate more often during casual sex than in committed relationships. With the exceptions of social proof and consistency, all of the principles of inﬂuence were signiﬁcantly more endorsed as inﬂuencing safer sex communication during casual sex than in committed relationships. These results are not entirely surprising, as when the ability to cognitively process a message is limited, individuals are prone to rely on cognitive shortcuts (Chaiken, 1980; Petty & Cacioppo, 1986) such as the six principles employed within the current study. Thus, our results would suggest there are often limited opportunities for planning and negotiating safer sex decisions during casual sex whereas the same cannot be said within committed relationships. From a public health perspective, these casual sexual encounters may be hidden epidemics (Holman & Sillar, 2012) of STI transmission. Intervention strategies to promote sexual communication in these contexts are of the utmost importance and are discussed below. Because our data suggest that these principles are seen as more inﬂuential during casual sex than in committed relationships, for intervention purposes, the role of alcohol during casual sex cannot be overlooked. Alcohol has a ubiquitous presence in casual sex accounts (DowningMatibag & Geisinger, 2009; Flack et al., 2007; Holmes & Sillar, 2012; Paul & Hayes, 2002) and should be addressed. The relation between alcohol intoxication and casual sex communication can be potentially harmful because alcohol has been found to increase risky sex in college students (Cooper, 2002) and decrease condom negotiation intentions (Purdie et al., 2011). Participants in our study noted that they believed a majority of the time casual sex occurred after consuming alcohol, thus further exacerbating the already small window for safer sex communication to occur. According to one male participant, alcohol predicates casual sex ‘‘about 80–90% of the time.’’ Another male participant succinctly put it, ‘‘Sexual communication isn’t where it needs to be on this campus, mostly because of alcohol.’’ Our ﬁndings would suggest then that alcohol-abuse prevention programs should emphasize the fact that alcohol plays a key role in sexual decision-making during casual sex, and these programs should promote responsible alcohol behaviors on college campuses. Speciﬁcally, interventions to reduce
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Safer Sex Communication impulsive decisions should use techniques that include behavioral rehearsal, such as sexual communication initiation, to increase the probability of an automatic response of the desired behavior (Donohew et al., 2000). The second most endorsed principle inﬂuencing safer sex communication during casual sex was the authority principle. In regards to this principle, we discovered that during casual sex, social status differences were indicated as a barrier to discussing safer sex practices. In particular, participants noted that if their peers perceived their partner had power over them, they would be less likely to discuss safer sex topics such as one’s sexual history or prior testing for STIs. Risky sexual practices resulting from a power imbalance for fear of losing the relationship have been noted in the literature, mostly in the context of intimate partner violence (Fuentes, 2011). Interventions should address the inﬂuence of perceived power differences on safer sex communication by increasing self-esteem and personal affect. Negative personal affect has been found to be directly associated with partner communication as well as an indirect predictor of condom use (DePadilla, Windle, Wingood, Cooper, & DiClemente, 2011). Emphasizing these psychological factors may attenuate the inﬂuence of the authority principle by countering feelings of insecurity and peer pressure during these sexual encounters and should be teased out in future studies. Reciprocity was one of the most endorsed principles for both casual and committed sexual encounters and should be addressed in interventions as well. However, many participants indicated their peers were often suspicious of how honest their partners were in disclosing their sexual history, particularly in disclosing their number of sexual partners. One common theme expressed by participants was the ‘rule of three,’ popularized in ﬁlms such as American Pie. As explained by a female participant, ‘‘Whatever the girl says you multiply by three, and whatever the guy says, you divide by three.’’ In addition, some participants indicated they believed individuals would change their responses to what they perceived to be their partners desired answer. As one female participant noted, ‘‘I think it’s easier after you’ve heard what someone else has said to be like, okay, like yeah, I’ll drop that number a few.’’ Although not all participants agreed their peers would be dishonest in their responses with a casual partner. As one male said, ‘‘If you see that the person is being honest with you, whether it’s the truth or not, in your mind you are going to want to be honest with that person as well.’’ Undeniably, the fact that individuals may be dishonest with their casual partner is an important consideration and one that deserves pause for reﬂection. Historically, scholars have critiqued the potential effectiveness of promoting discussion of sexual histories as a safer sex strategy for this very reason (Metts & Fitzpatrick, 1992). Although our data indicate that the truthfulness of the sexual history (i.e., past number of partners) may be questioned in some circumstances, many participants agreed that if a partner, casual or committed, shared their sexual history then it would inﬂuence the other partners sexual past sharing. While encouraging discussion of sexual histories may not be a magic bullet per se that invariably leads to condom use, by
discussing sexual topics with one’s partner, this may open the door for individuals to discuss and enact sexual precautions such as using condoms (Anderson et al., 2010). Our results seem to support the efﬁcacy of this strategy. Overwhelmingly, participants indicated that during casual and committed sexual encounters, individuals would feel obligated to disclose a sexual history if their partner disclosed ﬁrst. It is our position that by encouraging communication about sexual topics such as one’s sexual history, such conversations may lead to the discussion of other topics and behaviors important for one’s sexual health. This position is bolstered by recent meta-analytic evidence that posits a link between discussion of sexual histories and condom use (Noar et al., 2006). In sum, encouraging disclosure of sexual histories should not be seen as the end-all be-all strategy for promoting safer sex, but rather one part of a multipronged strategy for opening up lines of communication between partners about sexual topics. One theme worthy of discussion that arose in our discussions was the observation by participants that their peers often would not discuss safer sex topics until after a casual relationship had progressed to a committed relationship. As one female participant noted, ‘‘All of my friends have had sexual relationships before they’ve committed to a romantic relationship.’’ Our ﬁndings then would suggest that campaigns should emphasize the importance of discussing safer sex topics before the initiation of sexual activity, regardless of relationship status. Previous authors have noted that when young people enter into committed relationships, they often discontinue condom use without discussion of safer sex topics such as current STI status, prior STI testing, or sexual history (Bolton et al., 2010; Masaro et al., 2008). Exacerbating the spread of STIs is the common practice among young people of serial monogamy, whereby individuals engage in unprotected sex with several sexual partners over the course of a series of monogamous relationships (Bolton et al., 2010). Interventions should focus on encouraging discussion of safer sex topics before the initiation of sexual activity, not the initiation of a committed relationship, and should teach young people strategies for initiating these conversations. Limitations and Future Directions Despite the theoretical and practical implications of these ﬁndings, our study is not without limitations. One advantage of using focus groups was that we were able to obtain rich details from our participants about how Cialdini’s (1984) principles of inﬂuence were perceived to function during casual and committed sexual encounters. However, future work may beneﬁt from the use of individual interviews that may aid in better understanding individuals’ actual communication behaviors and attitudes as opposed to their perceptions of peer behavior. Missing data is an inherent limitation when conducting and analyzing focus group data. Relying on in-depth interviews is an alternative data collection strategy to use in future studies to mitigate missing data from arising. Given the fact that the current investigation
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1222 relied on a homogeneous sample of heterosexual individuals, our study notably lacked the perspectives of lesbian, gay, bisexual, and transgendered individuals. Although generalizability was not the goal of this project, given our modest sample size, we should caution that generalizing these results to other populations is not warranted. Future research should use alternative sampling and data collection techniques (i.e., surveys, individual interviews, experiments) to see whether our results generalize to other populations. For example, researchers could create vignettes based on these principles to see if more heterogeneous populations show a similar pattern of results. In addition, although in our study we included both male and female participants and separated focus groups based on biological sex, it is possible that the use of a female moderator may have inﬂuenced the responses of male participants. The present study was limited by the use of Cialdini’s (1984) principles of inﬂuence. Although we found broad support that these principles are used during both casual and committed sexual encounters, it is likely that these six principles are not an exhaustive list of the factors that inﬂuence sexual communication decision making among young people. It is possible that a more general question on how individuals decide to engage in safer sex communication practices would elicit alternative responses. Future research should attempt to validate these ﬁndings by asking young people more general questions about the inﬂuences on their safer sex communication practices. Conclusion This investigation was conducted to further understand how young people perceive interpersonal communication strategies that are inﬂuential during casual and committed sexual encounters. Previous research has not considered the differences in sexual communication practices between committed relationships and casual sex (Noar et al., 2006). In addressing this shortcoming in the literature, we applied Cialdini’s (1984) six principles of inﬂuence to further understand these differences. By applying a novel framework to this literature, we demonstrated that Cialdini’s (1984) principles of inﬂuence function within a sexual health context. Our results revealed that although these six principles are seen as inﬂuencing young peoples’ safer sex communication in both relational contexts, these principles are perceived to be more inﬂuential during casual sex. In particular, the principles of authority, reciprocity, and scarcity arose as inﬂuential principles for casual sex. As for committed relationships, the principles of consistency, liking, and reciprocity arose as the more inﬂuential principles. It is our hope that practitioners will consider these ﬁndings when designing campaigns aimed at promoting safer sex practices among young people.
References Abbey, A., Saenz, C., & Buck, P. O. (2005). The cumulative effects of acute alcohol consumption, individual differences and situational perceptions on sexual decision making. Journal of Studies on Alcohol and Drugs, 66, 82–90.
T. Reynolds-Tylus et al. Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl & J. Beckmann (Eds.), Action control: From cognition to behavior (pp. 11–39). New York, NY: Springer-Verlag. Allen, M., Emmers-Sommer, T. M., & Crowell, T. L. (2002). Couples negotiating safer sex behaviors: A meta-analysis of the impact of conversation and gender. In M. Allen, R. W. Preiss, B. M. Gayle & N. Burrell (Eds.), Interpersonal communication research: Advances through meta-analysis (pp. 263–279). Mahwah, NJ: Taylor & Francis. American College Health Association. (2013). National college health assessment: Reference group report, Spring 2013. Baltimore, MD: Author. Anderson, M., Kunkel, A., & Dennis, M. R. (2010). ‘‘Let’s (not) talk about that’’: Bridging the past sexual experiences taboo to build healthy romantic relationships. Journal of Sex Research, 47, 1–11. Ariely, D., & Lowenstein, G. (2006). The heat of the moment: The effect of sexual arousal on sexual decision making. Journal of Behavioral Decision Making, 19, 87–98. Bearinger, L. H., Sieving, R. E.., Duke, N. N., McMorris, B. J., Stoddard, S., & Pettingell, S. L. (2011). Adolescent condom use consistency over time: Global versus partner-speciﬁc measures. Nursing Research, 60, S68–S78. Bolton, M., McKay, A., & Schneider, M. (2010). Relational inﬂuences on condom use discontinuation: A qualitative study of young adult women in dating relationships. The Canadian Journal of Human Sexuality, 19, 91–104. Boone, T. L., & Lefkowitz, E. S. (2004). Safer sex and the health belief model: Considering the contributions of peer norms and socialization factors. Journal of Psychology & Human Sexuality, 16, 51–68. Centers for Disease Control and Prevention. (2013, February). Incidence, prevalence, and cost of sexually transmitted infections in the United States (Fact sheet). U.S. Department of Health and Human Services: Atlanta, GA. Retrieved from http://www.cdc.gov/std/ stats/sti-estimates-fact-sheet-feb-2013.pdf Chaiken, S. (1980). Heuristic versus systematic information processing and the use of source versus message cues in persuasion. Journal of Personality and Social Psychology, 39, 752–766. Cialdini, R. B. (1984). Inﬂuence: How and why people agree to things. New York, NY: William Morrow and Company, Inc. Cialdini, R. B. (1987). Compliance principles of compliance professionals: Psychologists of necessity. In M. Zanna, J. Olson, & C. Herman (Eds.), Social inﬂuence: The Ontario symposium (pp. 165–206). Hillsdale, NJ: Erlbaum. Cialdini, R. B. (2007). Inﬂuence: The psychology of persuasion (rev. ed.). New York, NY: HarperCollins. Civic, D. (1999). The association between characteristics of dating relationships and condom use among heterosexual young adults. AIDS Education and Prevention, 11, 343–352. Cline, R. J. W., Johnson, S. J., & Freeman, K. E. (1992). Talk among sexual partners about AIDS: Interpersonal communication for risk reduction or risk enhancement. Health Communication, 4, 39–56. Cobb, B. K. (1997). Communication types and sexual protective practices of college women. Public Health Nursing, 14, 293–301. DePadilla, L., Windle, M., Wingood, G., Cooper, H., & DiClemente, R. (2011). Condom use among young women: Modeling the theory of gender and power. Health Psychology, 30, 310–319. Donohew, L., Zimmerman, R., Cupp, P. S., Novak, S., Colon, S., & Abell, R. (2000). Sensation seeking, impulsive decision making, and risky sex: implications for risk-taking and design of interventions. Personality and Individual Differences, 28, 1079–1091. Downing-Matibag, T. M., & Geisinger, B. (2009). Hooking up and sexual risk taking among college students: A health belief model perspective. Qualitative Health Research, 19, 1196–1209. Emmers-Sommer, T. M., & Allen, M. (2004). Safer sex in personal relationships: The role of sexual scripts in HIV infection and prevention. Mahwah, NJ: Psychology Press.
Downloaded by [Australian National University] at 23:46 06 November 2015
Safer Sex Communication Emmers-Sommer, T. M., Warber, K. M., Passalacqua, S., & Luciano, A. (2010). Communicating (and responding to) sexual health status: Reasons for STD (non) disclosure. Psychology, 1, 178–184. Faulkner, S. L., & Mansﬁeld, P. K. (2002). Reconciling messages: The process of sexual talk for Latinas. Qualitative Health Research, 12, 310–328. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley. Flack, W. F., Daubman, K. A., Caron, M. L., Asadorian, J. A., D’Aureli, N. R., Gigliotti, S. N., . . . Stine, E. R. (2007). Risk factors and consequences of unwanted sex among university students: Hooking up, alcohol, and stress response. Journal of Interpersonal Violence, 22, 139–157. Fuentes, C. (2011). Breaking the pathways between domestic violence and sexually transmitted infections: A test of two theories. Human Organization, 70, 128–138. Furman, W., & Shaffer, L. (2011). Romantic partners, friends, friends with beneﬁts, and casual acquaintances as sexual partners. Journal of Sex Research, 48, 554–564. George, W. H., Gournic, S. J., & McAfee, M. P. (1988). Perceptions of postdrinking female sexuality: Effects of gender, beverage choice, and drink payment. Journal of Applied Social Psychology, 18, 1295–1316. Grello, C. M., Welsh, D. P., & Harper, M. S. (2006). No strings attached: The nature of casual sex in college students. Journal of Sex Research, 43, 255–267. Holman, A., & Sillars, A. (2012). Talk about ‘‘hooking up’’: The inﬂuence of college student social networks on nonrelationship sex. Health Communication, 27, 205–216. Kapadia, F., Frye, V., Bonner, S., Emmanuel, P. J., Samples, C. L., & Latka, M. H. (2012). Perceived peer safer sex norms and sexual risk behaviors among substance-using Latino adolescents. AIDS Education and Prevention, 24, 27–40. Kennedy, S. B., Nolen, S., Applewhite, J., Waiters, E., & Vanderhoff, J. (2007). Condom use behaviours among 18–24 year-old urban African American males: A qualitative study. AIDS Care, 19, 1032–1038. Krippendorff, K. (2004). Content analysis: An introduction to its methodology. Thousand Oaks, CA: Sage. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174. Lee, T. S., Fu., L., & Fleming, P. (2006). Using focus groups to investigate the educational needs of female injecting heroin users in Taiwan in relation to HIV=AIDS prevention. Health Education Research, 21, 55–65. Lescano, C. M., Vazquez, E. A., Brown, L. K., Litvin, E. B., Pugatch, D., & Project SHIELD Study Group. (2006). Condom use with ‘‘casual’’ and ‘‘main’’ partners: What’s in a name? Journal of Adolescent Health, 39, 443.e1–443.e7. Lewis, M. A., Kaysen, D. L., Rees, M., & Woods, B. A. (2010). The relationship between condom-related protective behavioral strategies and condom use among college students: Global-and event-level evaluations. Journal of Sex Research, 47, 471–478. Lindlof, T. R., & Taylor, B. C. (2002). Qualitative communication research methods (2nd ed.). Thousand Oaks, CA: Sage. Lombard, M., Snyder-Duch, J., & Bracken, C. C. (2002). Content analysis in mass communication: Assessment and reporting of intercoder reliability. Human Communication Research, 28, 587–604. Lucchetti, A. E. (1999). Deception in disclosing one’s sexual history: Safe-sex avoidance or ignorance? Communication Quarterly, 47, 300–314.
1223 Manning, W. D., Giordano, P. C., & Longmore, M. A. (2006). Hooking up: The relationship contexts of ‘‘nonrelationship’’ sex. Journal of Adolescent Research, 21, 459–483. Marston, C., & King, E. (2006). Factors that shape young people’s sexual behaviour: A systematic review. The Lancet, 36, 1581–1586. Masaro, C. L., Dahinten, V. S., Johnson, J., Ogilvie, G., & Patrick, D. M. (2008). Perceptions of sexual partner safety. Sexually Transmitted Diseases, 35, 566–571. Metts, S., & Fitzpatrick, M. A. (1992). The risky business of ‘‘know your partner’’ advice. In T Edgar, M. A. Fitzpatrick & V. S. Freimuth (Eds.), AIDS: A communication perspective (pp. 1–19). Hillsdale, NJ: Erlbaum. Nichols, W. L. (2012). Deception versus privacy management in discussions of sexual history. Atlantic Journal of Communication, 20, 101–115. Nisbett, R. E., & Wilson, T. D. (1977). The halo effect: Evidence for unconscious alteration of judgments. Journal of Personality and Social Psychology, 35, 250–256. Noar, S., Carlyle, K., & Christi, C. (2006). Why communication is crucial: Meta-analysis of the relationship between safer sexual communication and condom use. Journal of Health Communication, 11, 365–390. Noar, S., Zimmerman, R. S., & Atwood, K. A. (2004). Safer sex and sexually transmitted infections from a relationship perspective. In J. H. Harvey, A. Wenzel & S. Sprecher (Eds.), Handbook of sexuality in close relationships (pp. 519–544). Mahwah, NJ: Erlbaum. Paul, E. L., & Hayes, K. A. (2002). The casualties of ‘casual’ sex: A qualitative exploration of the phenomenology of college students’ hookups. Journal of Social & Personal Relationships, 19, 639. Petty, R. E., & Cacioppo, J. T. (1986). Communication and persuasion: Central and peripheral routes to attitude change. New York, NY: Springer-Verlag. Purdie, M., Norris, J., Davis, K., Zawacki, T., Morrision, D., George, W., & Kiekel, P. (2011). The effects of acute alcohol intoxication, partner risk level, and general intention to have unprotected sex on women’s sexual decision making with a new partner. Experimental and Clinical Psychopharmacology, 19, 378–388. Renner, B., Schma¨lzle, R., & Schupp, H. T. (2012). First impressions of HIV risk: It takes only milliseconds to scan a stranger. PloS One, 7, e30460. Rimal, R. N., & Real, K. (2003). Understanding the inﬂuence of perceived norms on behaviors. Communication Theory, 13, 184–203. Rimal, R. N., & Real, K. (2005). How behaviors are inﬂuenced by perceived norms a test of the theory of normative social behavior. Communication Research, 32, 389–414. Sheeran, P., Abraham, C., & Orbell, S. (1999). Psychosocial correlates of heterosexual condom use: A meta-analysis. Psychological Bulletin, 125, 90–132. Silk, K, J., Parrott, R. L., & Dillow, M. R. (2003). Using theory to guide formative evaluation of ‘‘Who’s afraid of franken-food?’’: Implications for health message design. Communication Studies, 54, 1–17. Stulhofer, A., Bacak, V., Ajdukovic, D., & Graham, C. (2010). Understanding the association between condom use at ﬁrst and most recent intercourse: An assessment of normative, calculative, and habitual explanations. Social Science Medicine, 70, 2080–2084. Weaver, S. J., & Herold, E. S. (2000). Casual sex and women: Measurement and motivational issues. Journal of Psychology & Human Sexuality, 12, 23–41. Wolitski, R. J., & Branson, B. M. (2002). ‘‘Gray area behaviors’’ and partner selection strategies: Working toward a comprehensive approach to reducing the sexual transmission of HIV. In A. O’Leary (Ed.), Beyond condoms: Alternative approaches to HIV prevention (pp. 173–198). New York, NY: Kluwer.