Sexual Health

1. Sexual Health and the College Student

2. Sexual Health Defined • Physical, emotional, mental, and social well-being • Not merely the absence of disease • Requires a positive approach -("Defining sexual health," 2006)

3. Target Population • Traditional college-aged students • Ages 18-25 • Diverse group with just as diverse individuals • Young adults attending college across the nation

4. Common Goals • Healthy People 2020 • Improve the healthy development, health, safety, and well-being of adolescents and young adults • Improve pregnancy planning and spacing, and prevent unintended pregnancy. • Promote healthy sexual behaviors • Create social and physical environments that promote good health for all. ("Healthy people 2020," 2013)

5. Demographics • Young adults ages 18 to 25 attending a college in the United States • First time out on their own • Predominant age for binge drinking • Excessive Stress • A time to experiment • Expectations of a “party-culture”

6. Cultural Descriptors • High stress lifestyle • No parental supervision • Parties • Poor sleep cycles • Drug and alcohol use • Increased incidence of casual sex

7. Biases • Men typically report having casual sex, or “hooking up,” more often • People often overestimate their peers’ sexual activities • STDs • Homosexuality and AIDS • Blacks overrepresented -(Clark, 2001) -(Owen, Rhoades, Stanley, & Finchman, 2010) -(Younge, Corneille, Lyde, & Cannaday, 2013)

8. Health-Risk Factors • General risk factors • Smoking, drinking, stress, illicit use of drugs, gambling, depression, and weight gain • Risk factors for hookups • Intentions, impulsivity, thrill-seeking, previous hookups, drug and alcohol use, and other situational triggers -(Fielder, Walsh, Carey, & Carey, 2013)

9. Health-Risk Factors • Post-hookup risk factors • Pregnancy • Sexually transmitted diseases • Negative social responses • Negative emotional consequences • Low self-esteem -(Fielder, Walsh, Carey, & Carey, 2013)

10. Sociodeterminants • Race, status, attitude, mental health, cigarette use, academic achievement, relationship status… • Not consistent predictors of sexual hookups • More research is needed -(Fielder, Walsh, Carey, & Carey, 2013)

11. Statistics • One in four college students has had an STD • Only 54% of students regularly use condoms during vaginal intercourse • 80% of people who have a sexually transmitted disease experience no noticeable symptoms - (Nursing Schools, 2010)

12. Statistics • Only 60% of women know how to use a condom correctly and a whopping 60% also say they would still have sex even if their partner refused to wear a condom • HIV/AIDS is now considered the leading cause of death for individuals aged 15 to 24 years of age. The most affected persons within this age group are college students - (Nursing Schools, 2010)

13. Statistics • In one survey 60% of women reported that they are in committed relationships while only 38% of men reported the same • More than half the participants in a study done among college students believe they can tell if someone has an STI just by looking at them - (Nursing Schools, 2010)

14. Health Belief Model • Describes a person’s health behavior as an expression of health beliefs • Designed to predict one’s health behavior • Consists of perceived benefits, barriers, and stimuli -(Farlex, 2013)

15. Health Belief Model • One study applied this to discover students’ beliefs about sexual risk taking • 71 students at a large Midwestern University whom have had at least one hookup • Predominately white, Christian, heterosexuals • Assessed students’ perception of sexual norms, the events prior to the hookup, their evaluation of the experience, and perceptions of the risk -(Downing-Matibag & Geisinger, 2009)

16. Health Belief Model • Results were analyzed with the HBM • In order for an individual to take preventative action, they must: • Believe they are at risk • Think adverse effects are undesirable • Accept prevention is a better alternative • Seek attainable prevention actions • 50% were concerned about STDs -(Downing-Matibag & Geisinger, 2009)

17. Health Belief Model • In other words…

18. Wrapping it up • 18-25 year old students are at risk for many complications involving sex • They are made of a very diverse demographic • Some biases exist that skew information • Many students are severely under-informed about the risks • STDs are more prevalent than they seem • Preventative action can be assessed with the Health Belief Model

19. References • CDC Office of Women’s Health (2012, August 20). College Health and Safety. http://www.cdc.gov/family/college/ • Centers for Disease Control and Prevention. (2012, June 20). Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention. http://www.cdc.gov/ HealthyYouth/sexualbehaviors/ • Clark, S. (2001). Parents, peers, and pressure: Identifying the influences on responsible sexual decision-making. Adolescent Health, 2(2), Retrieved from http://www.naswdc.org/practice/adolescent_health/ah0202.asp • Crocker, S. (2012, September 18). Thoughts on the intersection of race, religion, politics, ministry, sports and culture. In Crocker Chronicle: 2012 Demographics For U.S. College Students. Retrieved July 16, 2013, from http://crockerchronicle.blogspot.com/2012/09/2012-demographics-for-us - college.html • Downing-Matibag, T., & Geisinger, B. (2009). Hooking up and sexual risk taking among college students: a health belief model perspective. Qualitative Health Research, 19(9), 1196-1209. doi:10.1177/1049732309344206. Retrieved from CINAHL.

20. References • Farlex. (2013). Health belief model . In The Free Dictionary. Retrieved July 15, 2013, from http://medical-dictionary.thefreedictionary.com/health+belief+model • Fielder, R. L., Walsh, J. L., Carey, K. B., & Carey. M. P. (2013). Predictors of Sexual Hookups: A Theory-Based, Prospective Study of First-Year College Women. Center for Health and Behavior and Department of Psychology. Retrieved from PubMed. • Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of Nursing: The Art and Science of Nursing Care (7th ed., p. 72). Philadelphia, PA: WoltersKluwer Health-Lippincott Williams & Wilkins. • Mongkue, M. Y., Mushi, R. J., & Thomas, R. (2010) Perception of HIV/AIDS and socio- cognitive determinants of safe sex practices among college students attending a historically black college and university in the United States of America. Journal of AIDS and HIV Research, 2(3) 032-047. Retrieved from http://www.academicjournals.org/JAHR/ • Nursing Schools. (2010, May 17). 10 Truly Shocking Stats On STDs and College Students. http://www.nursingschools.net/blog/2010/05/10-truly-shocking- stats-on-stds-and-college-students/

21. References • Owen, J. J., Rhoades, K. G. Stanley, S. M., & Fincham, F. D. (2010). “Hooking Up” Among College Students: Demographic and Psychosocial Correlates. Archives of Sexual Behavior, 39(3), 653-663. DOI 10.1007/s10508-008-9414-1 • Younge, S.N., Corneille, M.A., Lyde, M., & Cannaday, J. (2013) The Paradox of Risk: Historically Black College/University Students and Sexual Health. Journal of American College Health, 61(5), 254-262.