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College students’ first experiences of six different sexual behaviors

12/14/2015

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​I’ve been in HDFS at Penn State for more than 17 years, and one thing we do well is advanced developmental methodology. Indeed, I have my share of papers with multilevel or growth curve modeling, latent class analysis, and APIM.

But I sometimes find myself coming back to the basics. And one procedure I return to again and again is straight out asking participants how they feel about something, with open-ended responses. In the University Life Study, we tracked college students for 7 semesters, and each semester asked about their engagement in 6 different sexual behaviors. Thus, we could catch the first time they engaged in any of these behaviors.  When they reported engaging in any behavior for the first time, we asked them how they felt about it. We then put together a team to code the emotions expressed in these responses. Sara Vasilenko (lead author), Megan Maas, and I reported the findings in a recent paper in Journal of Adolescent Research. In the end, because the data were nested, we had to use MLM, but I think the true story is in the simplicity.

Across the different behaviors (kissing, touching, performing oral sex, receiving oral sex, vaginal sex, and anal sex) the most commonly expressed emotions after first experience were happy, excited, fearful, and indifferent. One of my favorite quotes, reported in the paper, was a young woman describing her first experience of vaginal sex during her first year of college: “It felt awesome and I’m happy I lost my virginity to my boyfriend and I am happy I did it at the time I did. I had a great time and I don’t think I will ever regret it.” I can just picture her saying that (or texting that) to a friend. Another favorite is this young man’s description of his first experience of kissing in his third year of college: “Heart racing—disbelief. Very exhilarating.” Reponses were not all positive though; this one, by a young woman who experienced first vaginal sex in her second year, is heartbreaking: “I felt like I had made a horrible mistake. I felt ill and sick with myself. I was depressed.”

Emotions varied by type of behavior. Overall, students reported more positive than negative emotions. Students were generally more excited and less negative about kissing than about vaginal sex. Less positivity was expressed about anal sex and performing oral sex than about vaginal sex. Overall, emotions seemed to be more positive if individuals perceived low risk/threat, and/or received more direct stimulation.

There were also some gender differences, with young men more likely to report feeling happy and excited than young women about all behaviors. Young women felt more negative about vaginal sex, anal sex, and performing oral sex than young men did. It may be that young women feel more pressure to comply with behaviors before they feel ready, and also put more emphasis on foreplay than men do.

Overall, the findings highlight the positive feelings that many young adults have about sexual experiences that first occur in late adolescence/early adulthood.

“The post College students’ first experiences of six different sexual behaviors first appeared on Eva Lefkowitz’s blog on December 14, 2015.”
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Males’ contraceptive attitudes matter more than females’ attitudes in adolescent couples

11/30/2015

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Sara Vasilenko, Derek Kreager, and I recently published a paper in Journal of Research on Adolescence. We used couple data from Add Health to examine how partners’ contraceptive attitudes correlate within dyads over time, and how well male and female partners’ attitudes predict subsequent condom use. Our findings demonstrated that even after controlling for adolescents’ own attitudes, partners’ prior attitudes predicted subsequent attitudes for both male and female adolescents. The association, however, was stronger for female than for male adolescents. In addition, when put in the same model, males’ attitudes but not females’ attitudes predicted couple’s subsequent condom use. These findings suggest that male adolescents may have more power or influence on contraceptive decisions within adolescent relationships.

The post “Males’ contraceptive attitudes matter more than females’ attitudes in adolescent couples” was first published on Eva Lefkowitz's blog on November 30, 2015.


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College students’ sexual behaviors are associated with better sexual esteem

11/13/2015

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Extensive works considers the negative physical and mental health correlates of sexual behavior during adolescence, but less work considers the potential positive role that sexual behavior plays. By the college years, when engagement in sexual behavior is relatively normative, sexual behavior may be associated with positive wellbeing, much as it is in adulthood. In a recently published paper,  Megan Maas and I examined how sexual esteem relates to sexual behavior in the University Life Study. We found that sexual esteem was higher for students who had oral sex more frequently, had more oral and penetrative sex partners in the past 3 months, and had spent more semesters during college in romantic relationships, than for their counterparts. There were some interactions with gender. For instance, the association between sexual esteem and number of penetrative sexual partners was stronger for male than for female students.
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In addition, male students who never used contraception tended to have higher sexual esteem, whereas female students who never used contraception tended to have lower sexual esteem, compared to students who used contraception.

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These results are cross-sectional, so we cannot know whether having better sexual esteem is associated with engaging in more sexual behaviors, or whether engaging in more sexual behaviors leads to better sexual esteem. However, the results do demonstrate that unmarried sexual behavior after high school is linked with positive wellbeing. On the other hand, results also suggests that men with better sexual esteem might engage in riskier behavior, whereas women with better sexual esteem might be more likely to protect themselves, mirroring earlier findings Meghan Gillen, Cindy Shearer, and I had with body image.

I’m excited that more and more researchers are now approaching the study of adolescent and young adult sexuality from a normative, developmental perspective rather than consistently using a risk frame. Adolescents and young adults do engage in risky sexual behaviors, of course, but we need to understand risky behaviors in light of the positive contributions that sexual behavior provides to wellbeing.

“College students’ sexual behaviors are associated with better sexual esteem” first appeared on Eva Lefkowitz’s blog on November 12.

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Why predictors of HPV vaccination matter beyond early adolescence

9/24/2014

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Shannon Claxton and I are the first co-chairs of the Society for the Study of Emerging Adulthood Sexuality Topic Network. Shannon has launched a blog to address research issues in sexuality during emerging adulthood. Today I’m sharing my guest post for her blog.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States, with an infection rate highest among women age 20-24  (Baseman & Koutsky, 2005; Centers for Disease Control and Prevention, 2012; Dunne et al., 2007; Gerend & Magloire, 2012; Weinstock, Berman, & Cates, 2000). Individuals acquire HPV through genital skin-to-skin contact during sex. HPV can lead to genital warts and cervical cancer, as well as less frequently occurring cancers, such as cancer of the anus, penis, vulva, and throat (Bosch, Lorincz, & Munoz, 2002; Centers for Disease Control and Prevention, 2012; Christian, Christian, & Hopenhayn, 2009; Walboomers et al., 1999). In June 2006, the HPV vaccine, Gardasil® (Merck), was approved and released by the U.S. FDA. This vaccine protects against types of HPV responsible for 70% of cervical cancer cases, and types responsible for 90% of genital warts (Centers for Disease Control and Prevention, 2012).

In the United States, the HPV vaccine is recommended at age 11 to 12 (Committee on Infectious Diseases, 2012). Now that the vaccination has been available for several years, many adolescents will get vaccinated in middle school or high school while still living with their parents. Why, then, is it an emerging adulthood issue? Despite availability of the vaccination, some individuals will reach emerging adulthood without yet receiving vaccination. Several factors might determine lack of vaccination –cost/access being an important one. But another factor might be that some adolescents’ parents may not want to vaccinate them due to perceived health risks or religious or moral reasons. For example, as recently as 2010 only 1/3 of adolescent girls in the United States had received at least one HPV vaccination (Committee on Infectious Diseases, 2012; Laz, Rahman, & Berenson, 2012). Thus, an interesting question with this next generation will be what determines whether previously unvaccinated young people choose to get the HPV vaccination after leaving their parents’ home and/or reaching age 18.

We recently published a paper on HPV vaccination: among female college students. Our primary findings were:

·         Almost half of female students had received the HPV vaccination by their sophomore year. We collected these data very soon after Gardasil became available, so it was relatively quick uptake for half the sample.

·         Vaccination was more likely among students:

°         whose mothers were more educated

°         who were not African American/Black

°         who reported stronger adherence to their religion’s teachings about sex-related principles

°         who recently engaged in penetrative sex

The most surprising finding was the positive association between adherence to religion’s teaching and HPV vaccination. Past research suggests that parents who attend religious services more frequently are less likely to intend to vaccinate their children (Barnack, Reddy, & Swain, 2010). Researchers have interpreted this finding to mean that more religious families hesitate to provide their offspring with a vaccination that protects against an STI, given the implication that it might provide more sexual freedom or a license to have sex. However, our reverse findings in emerging adulthood suggest that young women may not only see HPV vaccination as an avenue toward safer sex, but as a more general health issue. It is also possible that more religious women were more concerned than other women about the stigma of STIs, and therefore were more likely to protect themselves.

Overall, the findings provide university health clinics, health care providers who work with emerging adults, and prevention scientists information about groups to target for intervention. Vaccination rates were lower among sexually inexperienced young women. Given that vaccination is more effective if received before the initiation of sexual activity (Centers for Disease Control and Prevention, 2012), sexually inexperienced women should be targeted for intervention. Our findings also suggest that African American/Black young women are particularly important to consider for vaccine education and access. Providing HPV education, access to vaccination, and, when possible, free vaccination programs to young women from lower SES backgrounds is of particular importance.

Although I don’t currently have the data to address it, if I were to follow up this line of research, I would want to examine the following:

o   Sexual behaviors subsequent to getting vaccinated (for instance, does vaccination decrease likelihood of using condoms, because students feel less at risk?)

o   Now that vaccination has been available for longer, differences between students who enter college already vaccinated, those who choose to get vaccinated after starting college, and those who do not get vaccinated.

o   HPV vaccination among young men, comparing rates and correlates for men vs. women

What do you think? Do you think that emerging adults will approach HPV vaccination the way they approach other vaccines? Do you think young men will be as likely to get vaccinated as young women? Share your thoughts in the comments.


The post “Why predictors of HPV vaccination matter beyond early adolescence,” first appeared on the Society for the Study of Emerging Adulthood Sexuality Topic Network blog on September 24, 2014.

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This week in Adolescent Development: Romantic relationships

4/22/2014

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You know it’s an interesting class when someone announces “I have an orgasm question.” And we’re not even getting to sex until next week.

We spent a long time talking about the measurement of romantic relationships. In particular, how to measure some ideal grouping variable to distinguish those in romantic relationships from those not.  One of the papers we read, by Meier and Allen (2009) used Add Health data and these 2 inclusion criteria: whether the participant reported a “special romantic relationship” in the past 18 months, OR, if there was one person with whom they held hands, hugged, and kissed in the past 18 months. 85% of the romantic relationship sample was identified through claiming a specific partner, and the remaining 15% through engaging in the 3 behaviors with the same person. Other suggestions that came up in class as possible relationship status indicators included time/length in relationship, behaviors engaged in with partner, asking friends/peers if the participant was in a relationship, or asking participants something like, “would your friends consider you to be in a romantic relationship?” No one really wanted to tackle the direct question of how to ask whether someone is in relationship, yes or no.

We talked about gender differences in romantic relationship behavior, which is perhaps my only excuse to play this in class. I don’t think I realized before today how perfectly the song fits into a David Buss framework of mate selection.

We talked about unreciprocated love (crushes!) based on a chapter I really like, but it is challenging to link to, by Welsh, Grello, and Harper. The perfect example for talking about crushes/unreciprocated love comes from a blog where the writer posted entries from her early adolescent diary. So awesome. You will have to scroll around to find multiple entries in the month I linked to, but it’s worth it – you’ll laugh, you’ll cringe, you’ll relate, and you’ll think, wow, just like what research says!

Our student presenter discussed whether non-relationship sex has increased during adolescence, and whether it is unhealthy. She referred to some not-yet-published longitudinal data that suggest that hooking up in college has increased in the past few decades. These data suggest that rates of sexual behavior in the past year haven’t changed much since the 80’s, but that there is a slight increase between the 1988-1996 college cohort compared to the 2002-2010 college cohort in casual sex/hooking up. Specifically, among sexually active students, those in the more recent cohort were more likely to have a casual date/pickup sexual partner in the past year (44% vs. 35%) or a friend as a sexual partner (69% vs. 56%) and less likely to have a serious romantic or marital sexual partner (77% vs. 85%). Her conclusion on the second question, whether it is unhealthy, was mixed, though more likely unhealthy for girls/young women. My research group also has a paper on the short-term consequences of sex that suggests that although sex with dating partners and with non-dating partners are equally associated with positive consequences of vaginal sex, there are more negative consequences when with non-dating partners – though we did not find differences by gender.

 “The post This week in Adolescent Development: Romantic relationships first appeared on Eva Lefkowitz’s blog on April 22, 2014.”

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    Eva S. Lefkowitz

    I write about professional development issues (in HDFS and other areas), and occasionally sexuality research or other work-related topics. 

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