Abstract
The current study examined how relational factors (i.e., communication, trust, relationship satisfaction, and commitment) link to sexual health outcomes (i.e., condom use, knowledge about a partner's sexual history, and condom use self-efficacy) among female college students in exclusive heterosexual dating relationships (n = 89). The hierarchical linear regression analyses revealed that female college students in exclusive dating relationships who reported greater dyadic trust were more likely to report consistently using condoms and asking partners about their sexual history. Findings suggest the need for sexual education curricula that utilize dimensions of dyadic trust to address safe sex practices among female college students. More detailed recommendations are also discussed.
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Notes
Articles from the CDC have identified young adults as those individuals aged 18–30 (Freedman et al., 2012). Therefore, the authors retained participants up to 30 years of age in this study.
References
Agnew, C. R., & Dove, N. (2011). Relationship commitment and perceptions of harm to self. Basic and Applied Social Psychology, 33(4), 322–332. https://doi.org/10.1080/01973533.2011.614134
Agnew, C. R., Harvey, S. M., VanderDrift, L. E., & Warren, J. (2017). Relational underpinnings of condom use: Findings from the project on partner dynamics. Health Psychology: Official Journal of The Division of Health Psychology, American Psychological Association, 36(7), 713–720. https://doi.org/10.1037/hea0000488
Ajayi, A. I. (2018). “It’s sweet without condom”: Understanding risky sexual behaviour among Nigerian female university students. Online Journal of Health and Allied Sciences, 16(4), 9
Alvarez, C., Bauermeister, J. A., & Villarruel, A. M. (2014). Sexual communication and sexual behavior among young adult heterosexual Latinos. Journal of the Association of Nurses in AIDS Care, 25(6), 577–588. https://doi.org/10.1016/j.jana.2014.06.005
Alvarez, M. J., & Garcia-Marques, L. (2011). Cognitive and contextual variables in sexual partner and relationship perception. Archives of Sexual Behavior, 40(2), 407–417. https://doi.org/10.1007/s10508-011-9725-5
American College Health Association. (2016). American college health association national college health assessment II: Reference group executive summary spring 2016. Hanover, MD: American College Health Association. Retrieved from http://www.acha-ncha.org/docs/ncha-ii%20spring%202016%20us%20reference%20group%20executive%20summary.pdf
Bauermeister, J. A., Zimmerman, M., Xue, Y., Gee, G. C., & Caldwell, C. H. (2009). Working, sex partner age differences, and sexual behavior among African American youth. Archives of Sexual Behavior, 38, 802–813. https://doi.org/10.1007/s10508-008-9376-3
Black, D. S., Sun, P., Rohrbach, L. A., & Sussman, S. (2011). Decision-making style and gender moderation of the self-efficacy-condom use link among adolescents and young adults: Informing targeted STI/HIV prevention programs. Archives of Pediatrics & Adolescent Medicine, 165(4), 320–325. https://doi.org/10.1001/archpediatrics.2011.17
Bolton, M., McKay, A., & Schneider, M. (2010). Relational influences on condom use discontinuation: A qualitative study of young adult women in dating relationships. Canadian Journal of Human Sexuality, 19(3), 91–104
Boyle, A. M., & O’Sullivan, L. F. (2010). General and sexual communication in established relationships: an exploration of possible links to condom use among young adults. Canadian Journal of Human Sexuality, 19(1), 53–64
Brafford, L. J., & Beck, K. H. (1991). Development and validation of a condom self-efficacy scale for college students. Journal of American College of Health, 39, 219–225. https://doi.org/10.1080/07448481.1991.9936238
Brien, T. M., Thombs, D. L., Mahoney, C. A., & Wallnau, L. (1994). Dimensions of self-efficacy among three distinct groups of condom users. Journal of American College Health, 42(4), 167–174. https://doi.org/10.1080/07448481.1994.9939665
Catania, J. (1986). Help-seeking: An avenue for adult sexual development (Unpublished doctoral dissertation). University of California, San Francisco.
Casey, M., Timmerman, L., Allen, M., Krahn, S., & Turkiewicz, K. (2009). Response and self-efficacy of condom use: A meta-analysis of this important element of AIDS education and prevention. Southern Communication Journal., 74, 57–78. https://doi.org/10.1080/10417940802335953
Centers for Disease Control and Prevention. (2011). 10 ways STDs impact women differently from men. Retrieved from https://www.cdc.gov/std/health-disparities/stds-women-042011.pdf
Centers for Disease Control and Prevention. (2016). STDs in adolescents and young adults. Retrieved from https://www.cdc.gov/std/stats16/adolescents.htm
Centers for Disease Control and Prevention. (2017a). Sexually transmitted diseases. Retrieved from https://www.cdc.gov/std/life-stages-populations/adolescents-youngadults.htm
Centers for Disease Control and Prevention. (2017b). STDs at higher record high, indicating urgent need for prevention. Retrieved from https://www.cdc.gov/media/releases/2017/p0926-std-prevention.html
Centers for Disease Control and Prevention. (2017c). Reported STDs in the United States, 2016: High burden of STDs threaten millions of Americans. Retrieved from https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/std-trends-508.pdf
Centers for Disease Control and Prevention. (2017d). Sexually transmitted disease surveillance 2017. Retrieved from https://www.cdc.gov/std/stats17/appendix-a.htm
Centers for Disease Control and Prevention. (2019). Diagnoses of HIV infection in the United States and dependent areas, 2018 (Preliminary). Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-preliminary-vol-30.pdf
Choi, K. H., Catania, J. A., & Dolcini, M. M. (1994). Extramarital sex and HIV risk behavior among US adults: Results from the National AIDS Behavioral Survey. American Journal of Public Health, 84(12), 2003–2007. https://doi.org/10.2105/ajph.84.12.2003
Cipres, D., Rodriguez, A., Alvarez, J., Stern, L., Steinauer, J., & Seidman, D. (2017). Racial/ethnic differences in young women’s health-promoting strategies to reduce vulnerability to sexually transmitted infections. Journal of Adolescent Health, 60(5), 556–562. https://doi.org/10.1016/j.jadohealth.2016.11.024
Corneille, M. A., Zyzniewski, L. E., & Belgrave, F. Z. (2008). Age and HIV risk and protective behaviors among African American women. Journal of Black Psychology, 34(2), 217–233. https://doi.org/10.1177/0095798408314139
Crosby, R. A., Noar, S., Head, S., & Webb, E. (2011). Condoms and other barrier methods of STI and HIV prevention. In S. Gupta & B. Kumar (Eds.), Sexually transmitted infections. (2nd ed., pp. 1174–1191). Elsevier India.
Dennison, O., Wu, Q., & Ickes, M. (2014). Prevalence of human immunodeficiency virus testing and associated risk factors in college students. Journal of American College Health, 62(5), 309–318. https://doi.org/10.1080/07448481.2014.899232
DeVeaux, A.T. (2017). The STI crisis facing millennial women: A Cosmopolitan.com survey reveals the startling ways women are forced to carry the burden of safer sex. Retrieved from https://www.cosmopolitan.com/sex-love/a10235874/sti-statistics-millennial-women/
Drumright, L. N., Gorbach, P. M., & Holmes, K. K. (2004). Do people really know their sexual partners? Concurrency, knowledge of partner behavior and sexually transmitted infections within partnerships. Sexually Transmitted Diseases, 31, 437–442. https://doi.org/10.1097/01.OLQ.0000129949.30114.37
Fehr, S. K., Vidourek, R. A., King, K. A., & Nabors, L. A. (2017). Perceived barriers and benefits of condom use among college students. American Journal of Health Studies, 32(4), 219–233
Fincham, F. D., & Bradbury, T. N. (1987). The assessment of marital quality: A reevaluation. Journal of Marriage and the Family, 49, 797–809
Fonner, V. A., Dalglish, S. L., Kennedy, C. E., Baggaley, R., O’Reilly, K. R., Koechlin, F. M., Rodolph, M., Hodges-Mameletzis, I., & Grant, R. M. (2016). Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS (London, England), 30(12), 1973–1983. https://doi.org/10.1097/QAD.0000000000001145
Fortenberry, J. D. (2019). Trust, sexual trust, and sexual health: An interrogative review. Journal of Sex Research, 56(4–5), 425–439. https://doi.org/10.1080/00224499.2018.1523999
Freedman, K. S., Nelson, N. M., & Feldman, L. L. (2012). Smoking initiation among young adults in the United States and Canada, 1998–2010: A systematic review. Preventing Chronic Disease, 9, 1–14. https://doi.org/10.5888/pcd9.110037
Funk, J. L., & Rogge, R. D. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. Journal of Family Psychology, 21(4), 572–583. https://doi.org/10.1037/0893-3200.21.4.572
Gibbs, L., Manning, W. D., Longmore, M. A., & Giordano, P. C. (2014). Qualities of romantic relationships and consistent condom use among dating young adults. In L. Bourgeois & S. Cauchois (Eds.), Contraceptives: Predictors of use, role of cultural attitudes & practices and levels of effectiveness. (pp. 157–182). Nova Science Publishers Inc.
Gottman, J. M. (2011). The science of trust: Emotional attunement for couples. WW Norton & Company.
Graham, S. M., Negash, S., Lambert, N. M., & Fincham, F. D. (2016). Problem drinking and extradyadic sex in young adult romantic relationships. Journal of Social and Clinical Psychology, 35(2), 152–170. https://doi.org/10.1521/jscp.2016.35.2.152
He, F., Hensel, D. J., Harezlak, J., & Fortenberry, J. D. (2016). Condom use as a function of number of coital events in new relationships. Sexually Transmitted Diseases, 43(2), 67–70. https://doi.org/10.1097/OLQ.0000000000000390
Holland, K. J., & French, S. E. (2012). Condom negotiation strategy use and effectiveness among college students. Journal of Sex Research, 49(5), 443–453. https://doi.org/10.1080/00224499.2011.568128
Konkle-Parker, D., Fouquier, K., Portz, K., Wheeless, L., Arnold, T., Harris, C., & Turan, J. (2018). Women’s decision-making about self-protection during sexual activity in the deep south of the USA: A grounded theory study. Culture, Health & Sexuality, 20(1), 84–98. https://doi.org/10.1080/13691058.2017.1331468
Lam, C. B., & Lefkowitz, E. S. (2013). Risky sexual behaviors in emerging adults: Longitudinal changes and within-person variations. Archives of Sexual Behavior, 42(4), 523–532. https://doi.org/10.1007/s10508-012-9959-x
Larzelere, R. E., & Huston, T. L. (1980). The dyadic trust scale: Toward understanding interpersonal trust in close relationships. Journal of Marriage and the Family, 42, 595–604. https://doi.org/10.2307/351903
Levine, E. C., Herbenick, D., Martinez, O., Fu, T. C., & Dodge, B. (2018). Open relationships, nonconsensualnonmonogamy, and monogamy among US adults: Findings from the 2012 national survey of sexual health and behavior. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-018-1178-7
Magee, J. C., Bigelow, L., DeHaan, S., & Mustanski, B. S. (2012). Sexual health information seeking online: A mixed-methods study among lesbian, gay, bisexual, and transgender young people. Health Education and Behavior, 39(3), 276–289. https://doi.org/10.1177/1090198111401384
Marston, C., & King, E. (2006). Factors that shape young people’s sexual behavior: A systematic review. The Lancet, 368, 1581–1586. https://doi.org/10.1016/S0140-6736(06)69662-1
Matson, P. A., Fortenberry, J. D., Chung, S.-E., Gaydos, C. A., & Ellen, J. M. (2018). Weekly variations in feelings of trust predict incident STI within a prospective cohort of adolescent women from a US city. Sexually Transmitted Infections, 94(8), 594–597. https://doi.org/10.1136/sextrans-2017-053431
McLaurin-Jones, T. L., Lashley, M. B., & Marshall, V. J. (2017). Using qualitative methods to understand perceptions of risk and condom use in African American college women: Implications for sexual health promotion. Health Education & Behavior, 44(5), 805–814. https://doi.org/10.1177/1090198117728759
Misovich, S. J., Fisher, J. D., & Fisher, W. A. (1997). Close relationships and elevated HIV risk behavior: Evidence and possible underlying psychological processes. Review of General Psychology, 1(1), 72–107. https://doi.org/10.1037/1089-2680.1.1.72
Moore, E. W., & Smith, W. E. (2012). What college students do not know: Where are the gaps in sexual health knowledge? Journal of American College Health, 60(6), 436–442. https://doi.org/10.1080/07448481.2012.673521
Montgomery, C. M., Lees, S., Stadler, J., Morar, N. S., Ssali, A., Mwanza, B., Mntambo, M., Phillip, J., Watts, C., & Pool, R. (2008). The role of partnership dynamics in determining the acceptability of condoms and microbicides. AIDS Care, 20(6), 733–740. https://doi.org/10.1080/09540120701693974
Mullinax, M., Sanders, S., Dennis, B., Higgins, J., Fortenberry, J. D., & Reece, M. (2017). How condom discontinuation occurs: Interviews with emerging adult women. The Journal of Sex Research, 54(4–5), 642–650. https://doi.org/10.1080/00224499.2016.1143440
Negash, S., Veldorale-Brogan, A., Kimber, S. B., & Fincham, F. D. (2016). Predictors of extradyadic sex among young adults in heterosexual dating relationships: A multivariate approach. Sexual and Relationship Therapy, 34, 1–20. https://doi.org/10.1080/14681994.2016.1219334
Nesoff, E. D., Dunkle, K., & Lang, D. (2016). The impact of condom use negotiation self-efficacy and partnership patterns on consistent condom use among college-educated women. Health Education & Behavior, 43(1), 61–67. https://doi.org/10.1177/1090198115596168
Norwood, C. R., & Zhang, Y. (2015). Condom attitudes and use among African American college women students. Journal of Black Sexuality and Relationships, 2(1), 83–99. https://doi.org/10.1353/bsr.2015.0018
Pflieger, J. C., Cook, E. C., Niccolai, L. M., & Connell, C. M. (2013). Racial/ethnic differences in patterns of sexual risk behavior and rates of sexually transmitted infections among female young adults. American Journal of Public Health, 103(5), 903–909. https://doi.org/10.2105/AJPH.2012.301005
Prus, J., & Johnson, R. (1994). A critical review of student assessment options. New Directions for Community Colleges, 88, 69–83. https://doi.org/10.1002/cc.36819948811
Reel, J. J., & Hellstrom, E. (2013). Risky business in student dorms: Sexual health and sexually transmitted infection prevention programming imperative for college campuses. Journal of Community Medical Health Education, 3(211), 2161–0711. https://doi.org/10.4172/2161-0711.1000211
Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2012). A longitudinal investigation of commitment dynamics in cohabiting relationships. Journal of Family Issues, 33, 369–390. https://doi.org/10.1177/0192513X11420940
Robertson, A. A., Stein, J. A., & Baird-Thomas, C. (2006). Gender differences in the prediction of condom use among incarcerated juvenile offenders: Testing the information-motivation-behavior skills (IMB) model. Journal of Adolescent Health, 38(1), 18–25. https://doi.org/10.1016/j.jadohealth.2004.08.013
Rousseau, D. M., Sitkin, S. B., Burt, R. S., & Camerer, C. (1998). Not so different after all: A cross-discipline view of trust. Academy of Management Review, 23, 393–404. https://doi.org/10.5465/amr.1998.926617
Stanley, S. M., & Markman, H. J. (1992). Assessing commitment in personal relationships. Journal of Marriage and the Family, 54, 595–608. https://doi.org/10.2307/353245
Strachman, A., & Impett, E. A. (2009). Attachment orientations and daily condom use in dating relationships. Journal of Sex Research, 46(4), 319–329. https://doi.org/10.1080/00224490802691801
Swan, D. J., & Thompson, S. C. (2016). Monogamy, the protective fallacy: Sexual versus emotional exclusivity and the implication for sexual health risk. Journal of Sex Research, 53, 64–73. https://doi.org/10.1080/00224499.2014.1003771
Townes, A., Rosenberg, M., Guerra-Reyes, L., Murray, M., & Herbenick, D. (2020). Inequitable experiences between Black and White women discussing sexual health with healthcare providers: Findings from a US probability sample. The Journal of Sexual Medicine, 17(8), 1520–1528. https://doi.org/10.1016/j.jsxm.2020.04.391
Tung, W. C., Cook, D. M., & Lu, M. (2012). Sexual behaviors, decisional balance, and self-efficacy among a sample of Chinese college students in the United States. Journal of American College Health, 60(5), 367–373. https://doi.org/10.1080/07448481.2012.663839
Umphrey, L., & Sherblom, J. (2007). Relational commitment and threats to relationship maintenance goals: Influences on condom use. Journal of American College Health, 56, 61–67. https://doi.org/10.3200/JACH.56.1.61-68
Wang, X. (2013). The role of attitude functions, efficacy, anticipated emotions, and relationship status on college students’ condom use intentions. Journal of Sex Research, 50(7), 704–714. https://doi.org/10.1080/00224499.2012.687411
Williamson, L. M., Buston, K., & Sweeting, H. (2009). Young women and limits to the normalization of condom use: A qualitative study. AIDS Care, 21, 561–566. https://doi.org/10.1080/09540120802301857
Woolf-King, S. E., & Maisto, S. A. (2015). The effects of alcohol, relationship power, and partner type on perceived difficulty implementing condom use among African American adults: An experimental study. Archives of Sexual Behavior, 44(3), 571–581. https://doi.org/10.1007/s10508-014-0362-7
Wright, P. J., Randall, A. K., & Hayes, J. (2012). Predicting the condom assertiveness of collegiate females in the United States from the expanded health belief model. International Journal of Sexual Health, 24(2), 137–153. https://doi.org/10.1080/19317611.2012.661396
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This study was not funded by any grants; all authors declare no conflicts of interests. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Negash, S., Roberson, P.N.E., Seshadri, G. et al. Relational Factors and Sexual Health for Female College Students in Exclusive Heterosexual Relationships. Sexuality & Culture 25, 2111–2128 (2021). https://doi.org/10.1007/s12119-021-09867-0
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DOI: https://doi.org/10.1007/s12119-021-09867-0