HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions

Abstract

BackgroundThe college environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. While the overall incidence of HIV infection has seen some decline in recent years, rates of HIV infection among young adults have not seen a proportionate decline. As in the general population, African American young adults have been disproportionately affected by the HIV/AIDS epidemic. This study examined the sexual risk behaviors and perception of HIV risk of students in a predominantly African American commuter urban university in the Midwest.MethodsStudents enrolled in randomly selected general education courses completed a paper and pencil survey. Data were collected in Fall 2007, and univariate, bivariate, and multivariate analyses were conducted using SPSS for Windows v.16.ResultsThe sample included 390 students, the majority (83%) of whom were never married and 87% were sexually experienced. Among males reporting male partnerships those who used marijuana (OR = 17.5, p = 0.01) and those who used alcohol along with illegal drugs (OR = 8.8, p = 0.03) were significantly more likely to report multiple partnerships. Among females reporting male partnerships, those 30 years and older were significantly less likely (OR = 0.09, p = 0.03) to report having multiple male partners. There were significant differences in condom use last sex (p = 0.01) and consistent condom use (p = 0.002) among the different age groups. Older students were less likely to report condom use. Females age 30 years and older (OR = 3.74, p = 0.05) and respondents age 20‐29 years (OR = 2.41, p = 0.03) were more likely to report inconsistent condom use than those below 20 years. Marijuana use was correlated with inconsistent condom use (p = 0.02) and alcohol with not using condom last sex among females. Perception of HIV risk was generally poor with 54% of those age 30 years and older, 48.1% of 20‐29 year olds, and 57.9% of those below the age of 20 years perceived themselves as not having any chance of being infected with HIV. Predictors of moderate/good perception of HIV risk were drug and alcohol use, inconsistent condom use, and multiple partnerships.ConclusionStudents in the study sample engaged in various HIV risk behaviors but have a poor appreciation of their risk of HIV infection. While low rates of condom use was a problem among older students (30 years and older), multiple partnerships were more common among younger students, and marijuana and alcohol use were related to low condom use among females. Our findings support the need for targeted HIV prevention interventions on college campuses.

Patterns of Alcohol Use and Expectancies Predict Sexual Risk Taking Among Non-Problem Drinking Women

“…The acute effects of alcohol can also increase risk-taking behavior by narrowing an individual's focus to only the most salient cues in the environment, a process referred to as alcohol myopia (Steele and Josephs, 1990;Taylor and Leonard, 1983). In a sexual encounter involving alcohol, the most salient cue may be sexual arousal rather than the potential risk associated with a sexual partner (e.g., Davis et al, 2007;George et al, 2009;MacDonald et al, 2000), thereby increasing the likelihood of risk-taking behavior (Adefuye et al, 2009).…”

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

“…In a sample of 390 students, having consumed at least one drink in the past 30 days was associated with not using a condom in both males (OR 1.24, CI 0.57-2.72, p≤0.05) and females (OR 1.81, CI 1.06-3.10, p=0.04). Having consumed alcohol in the past 30 days was a predictor of no condom use for females, especially those over 30 years of age (OR 3.43, CI 1.33-8.86, p=0.01) (Adefuye et al, 2009). The implications of this finding must be considered in light of the fact that many of these women also report fewer partners, and condom use is overall low in monogamous relationships (Adefuye et al, 2009).…”

“…Having consumed alcohol in the past 30 days was a predictor of no condom use for females, especially those over 30 years of age (OR 3.43, CI 1.33-8.86, p=0.01) (Adefuye et al, 2009). The implications of this finding must be considered in light of the fact that many of these women also report fewer partners, and condom use is overall low in monogamous relationships (Adefuye et al, 2009). No link between number of sexual partners and condom use was found (Sheer and Cline, 1995;Randolph et al, 2009).…”

“…Frequent drinking for non-African-American women and frequent binge drinking for older men were once again linked to a higher number of sex partners. At the same time, younger age and a better understanding of the HIV risk were associated with higher prevalence of condom use for both men and women (Adefuye et al, 2009;Randolph et al, 2009). In addition, certain personality traits, for example sensation seeking, impulsivity, and disinhibited behavvior due to alcohol consumption were indicators of unprotected sex in two samples (n=270 and n=490, respectively) of sexually-active college students (Sheer and Cline, 1995;Xiao et al, 2010).…”

Mental health and HIV sexual risk behaviour among University of Limpopo students

“…[5] Several reviews of the general population indicate a possible relationship between poor mental health, including substance use, and HIV risk behaviour, such as multiple sexual partners and unprotected sex. [6][7][8][9][10][11][12][13] Studies conducted among university students found that anxiety, [14] depression, [14,15] psychological distress, [15] alcohol use, [15][16][17][18][19][20] drug use, [19,20] and traumatic experiences [21] (in particular childhood abuse, physical abuse, and especially sexual abuse [22] ) were associated with various forms of HIV risk behaviour. Currently, there are not sufficient data on university students regarding the association between mental disorders, substance use and HIV sexual risk behaviour within the SA context.…”