This article was downloaded by: [University of Sydney] On: 04 January 2015, At: 14:32 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of American College Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vach20
HIV-Related Sexual Behaviors of College Students a
b
Ann H. Butcher MPH, MS , D. Thompson Manning PhD & Edgar C. O'neal PhD a
a
Department of Psychology , Tulane University , New Orleans, USA
b
Department of Education , Tulane University , New Orleans, USA Published online: 09 Jul 2010.
To cite this article: Ann H. Butcher MPH, MS , D. Thompson Manning PhD & Edgar C. O'neal PhD (1991) HIV-Related Sexual Behaviors of College Students, Journal of American College Health, 40:3, 115-118, DOI: 10.1080/07448481.1991.9936266 To link to this article: http://dx.doi.org/10.1080/07448481.1991.9936266
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
HIWRelated Sexual Behaviors of College Students
Downloaded by [University of Sydney] at 14:32 04 January 2015
Ann H. Butcher, MPH, MS; D. Thompson Manning, PhD; and Edgar C. O’Neal, PhD
Abstract. A follow-up study explored the prevalence of behavioral risk factors for HIV infection in a population of college students. Two hundred forty-three single students ranging in age from 17 to 24 years who identified themselves as heterosexual completed questionnaires related to planned and unplanned sexual intercourse and such other factors as alcohol and nonprescription drug use that might increase the risk of HIV infection. Forty-seven percent of the men and 57% of the women stated that they had had sexual intercourse from 1 to 5 times primarily because they were intoxicated, a phenomenon that increased with age until only 19% of those over 21 had never had sex because of intoxication. Seventeen percent of the sexually active men and 21% of the women said that they had used condoms. Nineteen percent of the men and 33% of the women acknowledged consenting to sexual intercourse because they felt awkward in refusing. The dangerous interaction between alcohol use and high-risk sexual activities suggested that college HIV prevention efforts should make the connection between the two risk factors explicit. Key Words. Alcohol and HIV, college students, HIV infection
nly a small proportion of all cases of human immunodeficiency virus (HIV) infection (4% in men and 6% in women) have been reported in the 20- to 24-year-old age group that includes traditional college undergraduates.’ Because of the long latency period of HIV, however, it is likely that most cases of AIDS in the 25- to 35-year-old age group were acquired when the individuals were in their late teens or early twenties. College students frequently believe that HIV infection is not an issue of personal concern.* The years spent at college are, for many, a period of sexual e~ploration,~ an interval of risk to students who are mis-
The authors are all at Tulane University in New Orleans, where Ann H. Butcher is in the Department of Psychology, D. Thompson Mannhg is an associate profesrsor in the Department of Education, and Edgar C. O’Neal is a professor in the Department of Psychologv. VOL 40. NOVEMBER 1991
informed or who fail to take precautions to prevent exposure to HIV. Although about three quarters of adolescents are sexually active, few are pracpicing “safer sex,” despite an awareness of the identified risks for HIV infe~tion.~.’ Only 15% of adolescents surveyed by telephone reported having changed their behavior to avoid contracting AIDS. Of those who had changed, only 20% mentioned using truly effective precautions. In contrast, more than 40% of surveyed college students reported that concerns about AIDS had affected their sexual behavior, but the most common change was greater selectivity in choice of partners, with little or no decrease in frequency of sexual contact.6 Use of condoms has been consistently low among college students,’ but the relationship between college students’ selfassessment of risk and reduced sexual contacts has been shown to be significant.’ College students are also known for their frequent and sometimes adventurous experiments with the use of alcoholic beverages, so the interaction between alcohol use and HIV infection is an area of growing concern. Seigel’ pointed out that alcohol and other drugs may be co-factors in the acquisition, development, worsening, or transmission of HIV infection. Robertson and Plant’ found that respondents in an adult sample in Scotland who had consumed alcohol immediately prior to first sexual intercourse were markedly less likely than others to have used condoms. Two studies of undergraduates’ knowledge and beliefs about AIDS were conducted by Manning et al at a private university in the South.”.” The university’s student health service had carried out a vigorous AIDS prevention program that included frequent AIDS information sessions in the dormitories and free condoms on demand at the health center. Subjects had mean scores in a study of knowledge about AIDS of 78% and of 87% in a survey of beliefs about the syndrome. Although scores were above national averages, an analysis of the responses to questions concerning students’ beliefs sug115
COLLEGE HEALTH
gested that undergraduates did not feel very susceptible to AIDS and were unlikely to practice safer sex. This suggested that we needed a follow-up study to learn more about students’ actual behaviors.
Downloaded by [University of Sydney] at 14:32 04 January 2015
METHOD
Our purpose in this study was to investigate whether safer sex behaviors were actually practiced on that same campus. Volunteers were students in psychology courses, who could fulfill one course requirement by participating in this or some other study approved by the human subjects committee. The first author explained the purpose of the study to potential volunteers, and participants gave informed consent according to approved university protocols governing use of human subjects. All questionnaires were answered anonymously. Questions included whether students had ever had sexual intercourse, age at first intercourse, number of sexual partners in the month and year preceding the study, and number of male and female partners. We also asked students about their usual type of sexual contact (one-night-only contacts; many times, usually with the same partner; or exclusively with a lover or spouse) and frequency of condom use. Other items dealt with alcohol use, perceived effectiveness of condoms in preventing HIV infection, types of behavior changes already made because of the threat of HIV infection, and previous AIDS prevention education. We measured frequency of unplanned intercourse and assertive behavior by asking how often students had consented to sexual intercourse because they felt that refusing to accept would be awkward, how often they had consented to have intercourse without using a condom because of embarrassment, and how often intoxication had led to sexual intercourse. Other items addressed perceived self-efficacy related to condom use and knowledge about likelihood of infection. RESULTS Demographic Characteristics
The sample was composed of 87 men and 152 women, of whom 87% were white, 5% were black, 4% were Hispanic, and 3% were Asian. Because the study targeted young, single, heterosexual students, we excluded data for 18 students who identified themselves as homosexual or bisexual. One third of the participants were firstyear students, 23% were sophomores, 15% were juniors, and 28% were seniors. They ranged in age from 17 to 24 years ( M = 19.46, SD = 1.40). Sexual Activity As is true of others in their age range nationally, the majority indicated that they were sexually active. Twenty-four percent of the students (n = 58) stated that they had never had sexual intercourse, whereas 76% (n = 182) indicated they were sexually active. Of the sexually active individuals, 30% (n = 55) had had no partners in 116
TABLE 1 Number of Partners in the Month Preceding the Study (n = 182)
Partners None One
More than one
Men (Yo)
Women (Yo)?
34 53 13
27 59 13
?Does not add up to 100% because of rounding.
TABLE 2 Usual Type of Sexual Contact (n = 182)
Men (Yo) Women (Yo)t
One night only Usually with same partner Exclusively with one partner
13 41
40
6 32 63
?Does not add up to 100% because of rounding.
the last month, 56% (n = 103) had had only one, and 13% (n = 24) had had more than one. Fifty-nine percent of the sexually active women claimed to have had only one partner in the past month, compared with 53% of the men. Twenty-seven percent of sexually active women professed to no partners in the last month, compared with 34% of the men (Table 1). The mean number of partners in the year preceding the study was 3.6 for men and 2.3 for women. The mean number of partners in the month preceding the study was .88 for men and .92 for women. Thirteen percent of men and 6% of women claimed that their primary type of sexual contact was for one night only (Table 2). Previous Exposure to AIDS Education
Sixty-three percent of the students had been exposed to some form of AIDS education before this study, including programs in high school (36% of the subjects), college (21%), or on television (73%). Seventy-nine percent had read about AIDS, and 16% reported other forms of AIDS education, such as knowing a person with AIDS. Attitudes and Knowledge Ten items assessed attitudes and general knowledge about AIDS. Eight of these were directly comparable to those asked on a national survey conducted monthly by the National Center for Health Statistics.” Responses of students in this sample were comparable to those of the respondents in their age group nationally, although JA CH
SEXUAL BEHAVIORS
had never had intercourse as a result of intoxication. When asked whether they had ever had intercourse without using a condom because of embarrassment, 17% of the sexually active men and 21% of the women acknowledged that they had done so. Nineteen percent of the men and 33% of the women also acknowledged that they had consented to intercourse when they did not want to because refusing to do so made them feel awkward.
Downloaded by [University of Sydney] at 14:32 04 January 2015
their responses indicated they were slightly more knowledgeable than those in the national survey. Respondents also typically reported feeling it was unlikely that they or someone they knew would contract AIDS.
Behaviors Fifty percent of men and 60% of women stated that they had changed their behaviors to avoid HIV infection, mostly by reducing the number of their sexual partners. Of the sexually active students, those who had changed their behavior most to avoid HIV infection were in the group aged 20 years; however, when we compared them with the other age groups, the difference was not significant. Eighty-seven percent (n = 211) of those in the sample endorsed the belief that condoms were effective in preventing HIV infection, but condom use was evidently not widespread. Of the sexually active students, 29% (n = 53) indicated that they never used condoms, 32% (n = 59) that they sometimes used condoms, 23% (n = 42) that they almost always did, and 15% (n = 28) claimed they always used condoms. (Does not add up to 100% because of rounding.) Younger students tended to use condoms more frequently than did older students. Students up to 19 years of age claimed to use condoms significantly more often than older students, fll, 182) = 11.20, p = .001. Most first-year students claimed they always or almost always used condoms (see Table 3), but sophomores, juniors, and seniors tended to use condoms never or only sometimes, f l l , 182) = 13.93, p < .001. Three questions investigated planned and unplanned intercourse. Forty-seven percent of the men and 57% of women said that they had engaged in intercourse from 1 to 5 times primarily because they were intoxicated, 8% of both men and women had had intercourse from 6 to 10 times while intoxicated, and 16Vo of men and 5% of women had had intercourse due to intoxication more than 10 times. Twenty-nine percent of the men and 31% of the women stated that they had never had intercourse because of intoxication. Although 30% of the l&year-olds indicated they had never had sexual intercourse because of intoxication, this number decreased through the age groups, and, among those aged over 21 years, only 19%
DISCUSSION Although the small number of subjects limits generalizability of results of our study, it is clear that the chance of HIV infection may be increased when students engage in behaviors that affect their judgment, such as drug or alcohol use. Alcohol consumption is common among young adults, and the majority of respondents said they had had sexual intercourse because of intoxication. Relatively few students stated that they had never had intercourse because of intoxication, and the numbers rose in older student groups. These womsome behaviors are even more troubling when considered in conjunction with students’ sexual practices. Most said they had changed their behavior to avoid HIV infection, but they usually did so by reducing the number of sexual partners. The majority of the students claimed to have had only one sexual partner during the preceding month, but the average number of partners in the last year was nearly three. Most students had never used condoms, which would have provided a margin of safety against HIV infection, and most admitted they had consented to sexual intercourse because they were intoxicated. When alcohol is combined with the common practice among college students of unprotected sexual intercourse with many different partners, the risk of HIV infection is increased. The dangerous interaction between increased alcohol intake and decreased likelihood of practicing safer sex suggests that college efforts to prevent HIV infection should address alcohol use and safer sex practices simultaneously and should make explicit the connection between these behaviors and the risk of HIV infection.
I TABLE 3 Frequency of Condom Use During Intercourse (n = 185)
n
Never (Yo)
Sometimes (Yo)
Almost always (Yo)
Always
Class
First year Sophomore Junior? Seniort Other
49 48 31 56 1
18 31 39 34 100
22 37 29 37
31 17 23 21 0
29 15 10 7 0
(%)
I
I
0
?Does not add up to 100% because of rounding.
VOL 40, NOVEMBER 1991
117
COLLEGE HEALTH REFERENCES
Downloaded by [University of Sydney] at 14:32 04 January 2015
1. Centers for Disease Control. September 1990 statistics. 2. Gray LA, Saracino M. AIDS on campus: A preliminary study of students’ knowledge and behaviors. J Counseling and Development. 1989;68:199-202. 3. Jessor SL, Jessor R. Problem Behavior and Psycho-socia1 Development: A Longitudinal Study of Youth. New York: Academic Press; 1977. 4. Centers for Disease Control. HIV-related knowledge and behaviors among high school students-Selected US sites. MM WR. June 15, 1990;39:385-389, 3%-397. 5. Stunin L, Hingson R. Acquired immunodeficiency syndrome and adolescents: Knowledge, beliefs, attitudes, and behavior. Pediatrics. 1987;79:825-828. 6. Carroll L. Concerns with AIDS and other sexual behaviors of college students. J Marriage and the Family. 1988;50: 405-41 1 .
7. Baldwin JD, Baldwin JI. Factors affecting AIDS-related sexual risk taking behavior among college students. J Sex Res. 1988;25:181-1%. 8. Seigel L. AIDS: Relationship to alcohol and other drugs. J Substance Abuse Treatment. 1986;3:271-274. 9. Robertson JA, Plant MA. Alcohol, sex and risks of HIV infection. Drug and Alcohol Dependence. 1988;22:75-78. 10. Manning DT, Barenberg N, Gallese L, Rice JC. College students’ knowledge and health beliefs about AIDS: Implications for education and prevention. J A m CON Health. 1989; 37~254-259. 11. Manning DT, Balson PM, Barenberg N, Moore TM. Susceptibility to AIDS: What college students do and don’t believe. J A m Coll Health. 1989;38:67-73. 12. National Center for Health Statistics. AIDS knowledge and attitudes for October and November 1988: Provisional data from the National Health Interview Survey. Advance Data From Vital and Health Statbtics. 1989; No 167.
The computer system for International Travel Advice
0
/a What it is: A computer program which contains health information and U.S. State Department Travel Advisories on over 200 countries For these computers: IBM PC (MS-DOS 2.x) (and other compatibles) What it does: 1. Produces reports for individual travelers to any number of countries; includes a summary statement of all preventive measures 2. Provides immediate access to all recommendations including CDC, WHO and U.S. State Department Travel Advisories
118
Dept. B
93 Timber Drive Storrs, CT 06268 203/487-0611 FAX (203)429-1663 Is it current? The master program is updated daily as needed to reflect changes in world conditions; new diskettes can be mailed weekly or monthly as desired. Who is using Immunization Alert? physicians in primary care specialists in Infectious Diseases state and local health departments travel clinics group practices and HMO’s corporations whose employees must travel medical libraries
JACH
Journal of American College Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vach20
HIV-Related Sexual Behaviors of College Students a
b
Ann H. Butcher MPH, MS , D. Thompson Manning PhD & Edgar C. O'neal PhD a
a
Department of Psychology , Tulane University , New Orleans, USA
b
Department of Education , Tulane University , New Orleans, USA Published online: 09 Jul 2010.
To cite this article: Ann H. Butcher MPH, MS , D. Thompson Manning PhD & Edgar C. O'neal PhD (1991) HIV-Related Sexual Behaviors of College Students, Journal of American College Health, 40:3, 115-118, DOI: 10.1080/07448481.1991.9936266 To link to this article: http://dx.doi.org/10.1080/07448481.1991.9936266
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
HIWRelated Sexual Behaviors of College Students
Downloaded by [University of Sydney] at 14:32 04 January 2015
Ann H. Butcher, MPH, MS; D. Thompson Manning, PhD; and Edgar C. O’Neal, PhD
Abstract. A follow-up study explored the prevalence of behavioral risk factors for HIV infection in a population of college students. Two hundred forty-three single students ranging in age from 17 to 24 years who identified themselves as heterosexual completed questionnaires related to planned and unplanned sexual intercourse and such other factors as alcohol and nonprescription drug use that might increase the risk of HIV infection. Forty-seven percent of the men and 57% of the women stated that they had had sexual intercourse from 1 to 5 times primarily because they were intoxicated, a phenomenon that increased with age until only 19% of those over 21 had never had sex because of intoxication. Seventeen percent of the sexually active men and 21% of the women said that they had used condoms. Nineteen percent of the men and 33% of the women acknowledged consenting to sexual intercourse because they felt awkward in refusing. The dangerous interaction between alcohol use and high-risk sexual activities suggested that college HIV prevention efforts should make the connection between the two risk factors explicit. Key Words. Alcohol and HIV, college students, HIV infection
nly a small proportion of all cases of human immunodeficiency virus (HIV) infection (4% in men and 6% in women) have been reported in the 20- to 24-year-old age group that includes traditional college undergraduates.’ Because of the long latency period of HIV, however, it is likely that most cases of AIDS in the 25- to 35-year-old age group were acquired when the individuals were in their late teens or early twenties. College students frequently believe that HIV infection is not an issue of personal concern.* The years spent at college are, for many, a period of sexual e~ploration,~ an interval of risk to students who are mis-
The authors are all at Tulane University in New Orleans, where Ann H. Butcher is in the Department of Psychology, D. Thompson Mannhg is an associate profesrsor in the Department of Education, and Edgar C. O’Neal is a professor in the Department of Psychologv. VOL 40. NOVEMBER 1991
informed or who fail to take precautions to prevent exposure to HIV. Although about three quarters of adolescents are sexually active, few are pracpicing “safer sex,” despite an awareness of the identified risks for HIV infe~tion.~.’ Only 15% of adolescents surveyed by telephone reported having changed their behavior to avoid contracting AIDS. Of those who had changed, only 20% mentioned using truly effective precautions. In contrast, more than 40% of surveyed college students reported that concerns about AIDS had affected their sexual behavior, but the most common change was greater selectivity in choice of partners, with little or no decrease in frequency of sexual contact.6 Use of condoms has been consistently low among college students,’ but the relationship between college students’ selfassessment of risk and reduced sexual contacts has been shown to be significant.’ College students are also known for their frequent and sometimes adventurous experiments with the use of alcoholic beverages, so the interaction between alcohol use and HIV infection is an area of growing concern. Seigel’ pointed out that alcohol and other drugs may be co-factors in the acquisition, development, worsening, or transmission of HIV infection. Robertson and Plant’ found that respondents in an adult sample in Scotland who had consumed alcohol immediately prior to first sexual intercourse were markedly less likely than others to have used condoms. Two studies of undergraduates’ knowledge and beliefs about AIDS were conducted by Manning et al at a private university in the South.”.” The university’s student health service had carried out a vigorous AIDS prevention program that included frequent AIDS information sessions in the dormitories and free condoms on demand at the health center. Subjects had mean scores in a study of knowledge about AIDS of 78% and of 87% in a survey of beliefs about the syndrome. Although scores were above national averages, an analysis of the responses to questions concerning students’ beliefs sug115
COLLEGE HEALTH
gested that undergraduates did not feel very susceptible to AIDS and were unlikely to practice safer sex. This suggested that we needed a follow-up study to learn more about students’ actual behaviors.
Downloaded by [University of Sydney] at 14:32 04 January 2015
METHOD
Our purpose in this study was to investigate whether safer sex behaviors were actually practiced on that same campus. Volunteers were students in psychology courses, who could fulfill one course requirement by participating in this or some other study approved by the human subjects committee. The first author explained the purpose of the study to potential volunteers, and participants gave informed consent according to approved university protocols governing use of human subjects. All questionnaires were answered anonymously. Questions included whether students had ever had sexual intercourse, age at first intercourse, number of sexual partners in the month and year preceding the study, and number of male and female partners. We also asked students about their usual type of sexual contact (one-night-only contacts; many times, usually with the same partner; or exclusively with a lover or spouse) and frequency of condom use. Other items dealt with alcohol use, perceived effectiveness of condoms in preventing HIV infection, types of behavior changes already made because of the threat of HIV infection, and previous AIDS prevention education. We measured frequency of unplanned intercourse and assertive behavior by asking how often students had consented to sexual intercourse because they felt that refusing to accept would be awkward, how often they had consented to have intercourse without using a condom because of embarrassment, and how often intoxication had led to sexual intercourse. Other items addressed perceived self-efficacy related to condom use and knowledge about likelihood of infection. RESULTS Demographic Characteristics
The sample was composed of 87 men and 152 women, of whom 87% were white, 5% were black, 4% were Hispanic, and 3% were Asian. Because the study targeted young, single, heterosexual students, we excluded data for 18 students who identified themselves as homosexual or bisexual. One third of the participants were firstyear students, 23% were sophomores, 15% were juniors, and 28% were seniors. They ranged in age from 17 to 24 years ( M = 19.46, SD = 1.40). Sexual Activity As is true of others in their age range nationally, the majority indicated that they were sexually active. Twenty-four percent of the students (n = 58) stated that they had never had sexual intercourse, whereas 76% (n = 182) indicated they were sexually active. Of the sexually active individuals, 30% (n = 55) had had no partners in 116
TABLE 1 Number of Partners in the Month Preceding the Study (n = 182)
Partners None One
More than one
Men (Yo)
Women (Yo)?
34 53 13
27 59 13
?Does not add up to 100% because of rounding.
TABLE 2 Usual Type of Sexual Contact (n = 182)
Men (Yo) Women (Yo)t
One night only Usually with same partner Exclusively with one partner
13 41
40
6 32 63
?Does not add up to 100% because of rounding.
the last month, 56% (n = 103) had had only one, and 13% (n = 24) had had more than one. Fifty-nine percent of the sexually active women claimed to have had only one partner in the past month, compared with 53% of the men. Twenty-seven percent of sexually active women professed to no partners in the last month, compared with 34% of the men (Table 1). The mean number of partners in the year preceding the study was 3.6 for men and 2.3 for women. The mean number of partners in the month preceding the study was .88 for men and .92 for women. Thirteen percent of men and 6% of women claimed that their primary type of sexual contact was for one night only (Table 2). Previous Exposure to AIDS Education
Sixty-three percent of the students had been exposed to some form of AIDS education before this study, including programs in high school (36% of the subjects), college (21%), or on television (73%). Seventy-nine percent had read about AIDS, and 16% reported other forms of AIDS education, such as knowing a person with AIDS. Attitudes and Knowledge Ten items assessed attitudes and general knowledge about AIDS. Eight of these were directly comparable to those asked on a national survey conducted monthly by the National Center for Health Statistics.” Responses of students in this sample were comparable to those of the respondents in their age group nationally, although JA CH
SEXUAL BEHAVIORS
had never had intercourse as a result of intoxication. When asked whether they had ever had intercourse without using a condom because of embarrassment, 17% of the sexually active men and 21% of the women acknowledged that they had done so. Nineteen percent of the men and 33% of the women also acknowledged that they had consented to intercourse when they did not want to because refusing to do so made them feel awkward.
Downloaded by [University of Sydney] at 14:32 04 January 2015
their responses indicated they were slightly more knowledgeable than those in the national survey. Respondents also typically reported feeling it was unlikely that they or someone they knew would contract AIDS.
Behaviors Fifty percent of men and 60% of women stated that they had changed their behaviors to avoid HIV infection, mostly by reducing the number of their sexual partners. Of the sexually active students, those who had changed their behavior most to avoid HIV infection were in the group aged 20 years; however, when we compared them with the other age groups, the difference was not significant. Eighty-seven percent (n = 211) of those in the sample endorsed the belief that condoms were effective in preventing HIV infection, but condom use was evidently not widespread. Of the sexually active students, 29% (n = 53) indicated that they never used condoms, 32% (n = 59) that they sometimes used condoms, 23% (n = 42) that they almost always did, and 15% (n = 28) claimed they always used condoms. (Does not add up to 100% because of rounding.) Younger students tended to use condoms more frequently than did older students. Students up to 19 years of age claimed to use condoms significantly more often than older students, fll, 182) = 11.20, p = .001. Most first-year students claimed they always or almost always used condoms (see Table 3), but sophomores, juniors, and seniors tended to use condoms never or only sometimes, f l l , 182) = 13.93, p < .001. Three questions investigated planned and unplanned intercourse. Forty-seven percent of the men and 57% of women said that they had engaged in intercourse from 1 to 5 times primarily because they were intoxicated, 8% of both men and women had had intercourse from 6 to 10 times while intoxicated, and 16Vo of men and 5% of women had had intercourse due to intoxication more than 10 times. Twenty-nine percent of the men and 31% of the women stated that they had never had intercourse because of intoxication. Although 30% of the l&year-olds indicated they had never had sexual intercourse because of intoxication, this number decreased through the age groups, and, among those aged over 21 years, only 19%
DISCUSSION Although the small number of subjects limits generalizability of results of our study, it is clear that the chance of HIV infection may be increased when students engage in behaviors that affect their judgment, such as drug or alcohol use. Alcohol consumption is common among young adults, and the majority of respondents said they had had sexual intercourse because of intoxication. Relatively few students stated that they had never had intercourse because of intoxication, and the numbers rose in older student groups. These womsome behaviors are even more troubling when considered in conjunction with students’ sexual practices. Most said they had changed their behavior to avoid HIV infection, but they usually did so by reducing the number of sexual partners. The majority of the students claimed to have had only one sexual partner during the preceding month, but the average number of partners in the last year was nearly three. Most students had never used condoms, which would have provided a margin of safety against HIV infection, and most admitted they had consented to sexual intercourse because they were intoxicated. When alcohol is combined with the common practice among college students of unprotected sexual intercourse with many different partners, the risk of HIV infection is increased. The dangerous interaction between increased alcohol intake and decreased likelihood of practicing safer sex suggests that college efforts to prevent HIV infection should address alcohol use and safer sex practices simultaneously and should make explicit the connection between these behaviors and the risk of HIV infection.
I TABLE 3 Frequency of Condom Use During Intercourse (n = 185)
n
Never (Yo)
Sometimes (Yo)
Almost always (Yo)
Always
Class
First year Sophomore Junior? Seniort Other
49 48 31 56 1
18 31 39 34 100
22 37 29 37
31 17 23 21 0
29 15 10 7 0
(%)
I
I
0
?Does not add up to 100% because of rounding.
VOL 40, NOVEMBER 1991
117
COLLEGE HEALTH REFERENCES
Downloaded by [University of Sydney] at 14:32 04 January 2015
1. Centers for Disease Control. September 1990 statistics. 2. Gray LA, Saracino M. AIDS on campus: A preliminary study of students’ knowledge and behaviors. J Counseling and Development. 1989;68:199-202. 3. Jessor SL, Jessor R. Problem Behavior and Psycho-socia1 Development: A Longitudinal Study of Youth. New York: Academic Press; 1977. 4. Centers for Disease Control. HIV-related knowledge and behaviors among high school students-Selected US sites. MM WR. June 15, 1990;39:385-389, 3%-397. 5. Stunin L, Hingson R. Acquired immunodeficiency syndrome and adolescents: Knowledge, beliefs, attitudes, and behavior. Pediatrics. 1987;79:825-828. 6. Carroll L. Concerns with AIDS and other sexual behaviors of college students. J Marriage and the Family. 1988;50: 405-41 1 .
7. Baldwin JD, Baldwin JI. Factors affecting AIDS-related sexual risk taking behavior among college students. J Sex Res. 1988;25:181-1%. 8. Seigel L. AIDS: Relationship to alcohol and other drugs. J Substance Abuse Treatment. 1986;3:271-274. 9. Robertson JA, Plant MA. Alcohol, sex and risks of HIV infection. Drug and Alcohol Dependence. 1988;22:75-78. 10. Manning DT, Barenberg N, Gallese L, Rice JC. College students’ knowledge and health beliefs about AIDS: Implications for education and prevention. J A m CON Health. 1989; 37~254-259. 11. Manning DT, Balson PM, Barenberg N, Moore TM. Susceptibility to AIDS: What college students do and don’t believe. J A m Coll Health. 1989;38:67-73. 12. National Center for Health Statistics. AIDS knowledge and attitudes for October and November 1988: Provisional data from the National Health Interview Survey. Advance Data From Vital and Health Statbtics. 1989; No 167.
The computer system for International Travel Advice
0
/a What it is: A computer program which contains health information and U.S. State Department Travel Advisories on over 200 countries For these computers: IBM PC (MS-DOS 2.x) (and other compatibles) What it does: 1. Produces reports for individual travelers to any number of countries; includes a summary statement of all preventive measures 2. Provides immediate access to all recommendations including CDC, WHO and U.S. State Department Travel Advisories
118
Dept. B
93 Timber Drive Storrs, CT 06268 203/487-0611 FAX (203)429-1663 Is it current? The master program is updated daily as needed to reflect changes in world conditions; new diskettes can be mailed weekly or monthly as desired. Who is using Immunization Alert? physicians in primary care specialists in Infectious Diseases state and local health departments travel clinics group practices and HMO’s corporations whose employees must travel medical libraries
JACH
