A Mixed-Methods Approach to Develop a Combined Model of U.S. College Student Alcohol-Associated Condomless Sex

Overview

Journal Arch Sex Behav

Specialties Psychiatry
Social Sciences

Date 2024 Mar 1

PMID 38429569

Authors

Alan Z Sheinfil

Madison Firkey

Veronica Bucci

Mikaela Gjoka

Sarah E Woolf-King

Affiliations

Soon will be listed here.

Abstract

Unhealthy alcohol use and sexually transmitted infections (STIs) are significant public health concerns for US college students. Because alcohol use and condomless sex often co-occur in this population, alcohol-associated condomless sex has been identified as a behavioral intervention target. Existing theoretical frameworks have not garnered sufficient empirical support to serve as the foundation for interventions. The primary goal of the current study was to use a mixed-methods approach to develop a model of college student alcohol-associated condomless sex that combines elements from well-established health behavior theories. In Aim 1, multilevel modeling was used to predict condomless vaginal sex in a sample of heterosexual college student drinkers (N = 53). Aim 2 consisted of in-depth interviews (n = 18) to gather perceptions about the role of alcohol in sexual activity and identify supplemental constructs omitted from theories in Aim 1. The multilevel model explained a significant proportion of variance in condomless vaginal sex at the between- and within-person level. Themes derived from the in-depth interviews identified complementary elements of condom use decision-making. Findings from both aims were synthesized to construct a combined model of alcohol-associated condomless sex. This model can be further refined and ultimately serve as the foundation of an alcohol-STI prevention-intervention.

References

Albarracin D, Gillette J, Earl A, Glasman L, Durantini M, Ho M . A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull. 2005; 131(6):856-97. PMC: 2713787. DOI: 10.1037/0033-2909.131.6.856. View

Albarracin D, Johnson B, Fishbein M, Muellerleile P . Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull. 2001; 127(1):142-61. PMC: 4780418. DOI: 10.1037/0033-2909.127.1.142. View

Baranowski T . Integration of two models, or dominance of one?. J Health Psychol. 2004; 10(1):19-21. DOI: 10.1177/1359105305048550. View

Blanco C, Okuda M, Wright C, Hasin D, Grant B, Liu S . Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. Arch Gen Psychiatry. 2008; 65(12):1429-37. PMC: 2734947. DOI: 10.1001/archpsyc.65.12.1429. View

Brown J, Gause N, Northern N . The Association between Alcohol and Sexual Risk Behaviors among College Students: A Review. Curr Addict Rep. 2016; 3(4):349-355. PMC: 5123847. DOI: 10.1007/s40429-016-0125-8. View

Brown J, Vanable P . Alcohol use, partner type, and risky sexual behavior among college students: Findings from an event-level study. Addict Behav. 2007; 32(12):2940-52. PMC: 2673796. DOI: 10.1016/j.addbeh.2007.06.011. View

Chen X, Dinaj-Koci V, Brathwaite N, Cottrell L, Deveaux L, Gomez P . Development of Condom-Use Self-Efficacy over 36 months among Early Adolescents: A Mediation Analysis. J Early Adolesc. 2015; 32(5):711-729. PMC: 4511497. DOI: 10.1177/0272431611419507. View

Chernoff R, Davison G . An evaluation of a brief HIV/AIDS prevention intervention for college students using normative feedback and goal setting. AIDS Educ Prev. 2005; 17(2):91-104. DOI: 10.1521/aeap.17.3.91.62902. View

Cooper M . Toward a person x situation model of sexual risk-taking behaviors: illuminating the conditional effects of traits across sexual situations and relationship contexts. J Pers Soc Psychol. 2010; 98(2):319-41. DOI: 10.1037/a0017785. View

10.

Cyders M . Impulsivity and the sexes: measurement and structural invariance of the UPPS-P Impulsive Behavior Scale. Assessment. 2011; 20(1):86-97. DOI: 10.1177/1073191111428762. View

11.

Danube C, Norris J, Stappenbeck C, Davis K, George W, Zawacki T . Partner Type, Sexual Double Standard Endorsement, and Ambivalence Predict Abdication and Unprotected Sex Intentions in a Community Sample of Young Women. J Sex Res. 2015; 53(4-5):601-13. PMC: 4814365. DOI: 10.1080/00224499.2015.1061631. View

12.

Dermen K, Thomas S . Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex. Psychol Addict Behav. 2011; 25(4):583-94. PMC: 3232340. DOI: 10.1037/a0025472. View

13.

Fielder R, Walsh J, Carey K, Carey M . Sexual hookups and adverse health outcomes: a longitudinal study of first-year college women. J Sex Res. 2013; 51(2):131-44. PMC: 3946692. DOI: 10.1080/00224499.2013.848255. View

14.

Fisher J, Fisher W . Changing AIDS-risk behavior. Psychol Bull. 1992; 111(3):455-74. DOI: 10.1037/0033-2909.111.3.455. View

15.

Fisher J, Fisher W, Williams S, Malloy T . Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychol. 1994; 13(3):238-50. DOI: 10.1037//0278-6133.13.3.238. View

16.

Francis D, Noar S, Widman L, Willoughby J, Sanchez D, Garrett K . Perceptions of a campus-wide condom distribution programme: An exploratory study. Health Educ J. 2016; 75(8):998-1011. PMC: 5130150. DOI: 10.1177/0017896916648994. View

17.

George W . Alcohol and Sexual Health Behavior: "What We Know and How We Know It". J Sex Res. 2019; 56(4-5):409-424. DOI: 10.1080/00224499.2019.1588213. View

18.

Glick S, Morris M, Foxman B, Aral S, Manhart L, Holmes K . A comparison of sexual behavior patterns among men who have sex with men and heterosexual men and women. J Acquir Immune Defic Syndr. 2012; 60(1):83-90. PMC: 3334840. DOI: 10.1097/QAI.0b013e318247925e. View

19.

Harkness A, Behar-Zusman V, Safren S . Understanding the Impact of COVID-19 on Latino Sexual Minority Men in a US HIV Hot Spot. AIDS Behav. 2020; 24(7):2017-2023. PMC: 7160054. DOI: 10.1007/s10461-020-02862-w. View

20.

COLLINS B . The UCLA Multidimensional Condom Attitudes Scale: documenting the complex determinants of condom use in college students. Health Psychol. 1994; 13(3):224-37. DOI: 10.1037//0278-6133.13.3.224. View