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College students sexuality education, sexual behaviors and sexual behavioral intent.

Abstract: Louisiana has higher than the national pregnancy and STD rates among unmarried individuals aged 15 to 24 years. The purpose of this study was to assess the sexual behaviors and protective sexual behavior intentions of college students attending four state universities and to assess differences on race, gender, year in school and previous sexuality education. Of 1,168 participants, 666(57%) indicated having had sexual intercourse. About 13% never received sexuality education. Less than 50% rated it good. More White than African American students reported engaging in sexual behaviors. Previous sexuality education was statistically significantly related to selected protective sexual behavior intentions.

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The health impact of pre-college and college students sexual behaviors is a primary concern of health educators and health care providers (Gilbert & Alexander, 1998; Turner, Korpita, Mohn, & Hill, 1993). Young people are at higher risk of acquiring STDs than older adults for many reasons. Many have multiple sexual partners, engage in unsafe or unprotected sexual intercourse, and may select partners who have an STD (Centers for Disease Control and Prevention [CDC], 2002a).

Data from the Youth Risk Behavioral Survey (YRBS) indicate that nationwide, half (45.6%) of all pre-college age students have engaged in sexual intercourse during their lifetime, and 6.6% of students have engaged in sexual intercourse before age 13 years (CDC, 2002b). During the college years, the rate of students engaging in intercourse increases even more. According to data from the 1995 College Health Risk Behavioral Survey (CHRBS) (CDC, 1997), nationwide, 86.1% of college students had had sexual intercourse during their lifetime, and more than one third (34.5%) have had sexual intercourse with six or more partners.

Predictors of college students' risky sexual behaviors are varied: number of partners in last six months, religious values, condom attitudes, age at first sex and binging on alcohol (Langer, Warheit, & McDonald, 2001). Alcohol use, furthermore, was most often linked to unsafe sexual practices of pre-college and college age students (Dunn, Bartee, & Perko, 2003; Poulson, Eppler, Satterwhite, Wuensch, & Bass, 1998; Temple & Leigh, 1992).

Unprotected sexual practices place individuals at risk for STDs. Every year, about three million teens get an STD (CDC, 2002a). Approximately 15% of sexually active teenage women are infected with the human papilloma virus (HPV), many with the type of HPV that is linked to cervical cancer. Sexual behaviors of college students living in southern states are especially problematic because the South has consistently higher STD rates than the national average (CDC, 2002a). Most alarming is that, of the cumulative MDS cases in Louisiana, 16% are 13 to 24 years old, and 68% are individuals aged 25 to 44 (Louisiana Office of Public Health [LOPH], 2001a). Given the number of years between HIV infection and AIDS, these young people would have been in their teens or early twenties at time of infection. Other Louisiana STD rates are also high: gonorrhea cases (13,265) are 3rd highest in the nation (34% of cases are ages 20-24) while Chlamydia is 5th in the nation (42% among 15-19 year-olds and 36% among 20-24 year-olds) (LOPH, 2001b).

Unplanned pregnancies are also a problem. Each year in the United States, 800,000 to 900,000 adolescents 19 years of age or younger become pregnant (CDC, 2000). Even though the U.S. teen pregnancy rate has declined, Louisiana's rank is currently at 19 (National Campaign to Prevent Teen Pregnancy, 2000a). The Louisiana pregnancy rate per 1,000 girls ages 15 to 19 is 97 per 1,000 women (national is 83.6); and in 18 to 19 year olds, it is 148 per 1,000 (national is 116.9) (Alan Guttmacher Institute, 2004; National Campaign to Prevent Teen Pregnancy, 2000b).

The risk factors for acquiring STDs or unplanned pregnancies are behavioral choices. Such choices include condom use, birth control use, and number of sexual partners. Youth need comprehensive sexuality education programs to acquire sexual knowledge and skills needed to resist early onset of sexual activity and to help them make wise decisions related to their sexual behaviors (Kirby, 1997, 2000; Kirby, Short, Collins, Rugg, Kolbe, Howard, M., et al., 1994). Prior to attending college, many young adults may have had very little sexuality education because not all states require sexuality education. In Louisiana, sexuality education is recommended but not mandated. In most schools, it may not begin until seventh grade, a time at which many youth are already engaging in sexual behaviors. It is likely, therefore, that many Louisiana students have not had quality sexuality education before attending college.

The purposes of the present study were to assess the sexual behaviors and protective sexual behavior intentions of Louisiana college students and to assess relationship to race, gender, year in college, previous sexuality education, and perceptions of quality of sexuality education.

METHODS

PARTICIPANTS

College students (n = 1,168) attending four universities in southern Louisiana participated in the study through the completion of a survey instrument. A systematic sampling process was utilized to obtain a sample representative of each university and inter-university population. To assure obtaining a similar sample representative of each university, course selection was from Psychology; Biology, English, Kinesiology/Physical Education, and Health Education classes.

PROCEDURES

The Institutional Review Board at all four universities approved the study. Letters to faculty requesting permission to survey their classes were sent by email along with file attachments of the instrument and cover letter. At the time of survey administration, data collectors explained the purpose of the study. Students were informed of their rights according to human subjects review, were given information about the types of questions to be asked, were not coerced to complete the questionnaire, and were assured of full anonymity. All individuals who participated in data collection were trained in the instrument administration protocol. Data collection was completed by the researchers and paid student assistants.

INSTRUMENTATION

The instrument included items eliciting basic demographics, sexual behaviors, protective sexual behavioral intentions, and quantity and quality of previous sexuality education. The Stages of Acquisition (SAC) Model has been found to be effective in predicting alcohol, tobacco and other drug use (Kelley, Denny & Young, 1999; Werch & Anzalone, 1995; Werch, Meers, & Farrell, 1993). For that reason, items assessing protective sexual behavioral intentions were designed similar to the alcohol, tobacco, and other drug use items utilized in previous surveys. The SAC was adapted from the Stages of Change, a component of the Transtheoretical Model (Prochaska & DiClemente, 1982; Prochaska, Norcross, & DiClemente, 1994).

Eight items focused on intentions to engage in sexual behaviors and protective sexual behaviors: (1) being in a relationship, (2) engaging in sexual activities with a partner, (3) talking with the dating partner about the importance of avoiding HIV or other STD, (4) limiting sex to only kissing or touching to prevent HIV or AIDS (5) refusing to have sexual intercourse to prevent HIV or other STDs, (6) refusing to have sex without a condom, (7) getting tested for HIV if one does not think he/she is infected, and (8) getting tested for HIV if one does think he/she is infected. Participants responded to these items on a five point response scale that ranged from "definitely" intending to engage in the behavior to "definitely not" intending to engage in the behavior.

Sexual behavior items focused on petting/making out, sexual intercourse, and oral sex. Students responded to these items using a set of responses indicating never engaging in the behavior, engaging in the behavior only occasionally, or regular engagement.

Items addressing sexuality education required students to indicate each grade level in which it was received (grade school, middle or junior high, high school, college). This was followed by a list of 15 sexuality education topics (e.g., abstinence, condom use, HIV/ AIDs). Participants identified those topics they had ever received and rated the quality of instruction of each on a 6-point scale anchored by "extremely poor" to "extremely good." A mean value of these items was calculated for each participant, representing the overall perceived quality of sex education received. Reliability analysis of this scale yielded a coefficient of internal consistency (Cronbach's alpha) of r = .94 and a Guttman Split-half coefficient of r = .90.

To ascertain readability of the instrument, it was first piloted to approximately 100 undergraduate students taking general education classes. To provide evidence of content validity of the instrument, it was sent to four external sexuality education teachers or professors for review and comments. After both of these processes, revisions were made to the instrument. The behavior and behavioral intent questions used in this survey have been found to produce robust and replicable categorical classification.

LIMITATIONS

A limitation of the study was that sampling was based on a systematic selection of intact classes rather than a random selection of students. The researchers did, however, attempt to obtain a sample of students representative of each university in terms of gender, race, year in school and a wide variety of majors.

RESULTS

DEMOGRAPHICS

A total of 1168 students completed usable surveys. Demographic characteristics of the sample are presented in Table 1. A majority of respondents were less than 23 years of age; females outnumbered males 65% to 36%; and the sample was primarily White (75%) and African American (18%). These distributions generally reflect the student populations of the universities from which participants were drawn. The college classification of the sample was well distributed among the four undergraduate levels, with somewhat more freshmen and seniors. Reflective of the most populated areas of the state, more students indicated being from the southeastern and southwestern sections of the state than central and northern areas.

SEXUALITY EDUCATION

One-hundred fifty-three (13.1%) of the participants indicated never receiving sexuality education in school, 172 (14.7%) indicated having received sexuality education in primary school grades, 579 (49.6%) in middle and junior high school, 708 (60.6%) at the high school level, and 617 (52.8) during college. These responses were used to develop categories inclusive of all educational levels in which each participant received sexuality education. As shown in Table 2, less than 40% of students indicated having received sexuality education in college plus at least one lower educational level, yet over 20% had received either no sexuality education or only during K-8 grades.

QUALITY OF SEXUALITY EDUCATION

Figure 1 depicts the percent of respondents who rated the quality of education on one or more of 15 topics as either "good" or "extremely good." The highest rated topics included STDs, STD protection, HIV/ MDS, and sexual anatomy/physiology, with over 50% indicating the quality of the education received on these topics was good or extremely good. By comparison, less than 30% indicated receiving high quality education on condom use, abortion, and homosexuality.

[FIGURE 1 OMITTED]

Respondents' quality ratings for all categories were averaged to create an "overall quality" of sexuality education score. A total of 181 participants' (18%) overall quality ratings ranged between 5.0 and 6.0 (good to extremely good), 377 (38%) had overall quality ratings ranging between 4.0 and 4.9 (average to good), 299 (30%) between 3.0 and 3.9 (poor to average), and 136 (14%) had overall quality ratings of 2.0 or lower (poor).

SEXUAL BEHAVIORS

Participants' sexual behaviors, specifically the frequency of their engagement in petting or "making out," having sexual intercourse, and oral sex are depicted in Table 3. Over half of the participants who responded indicated regularly petting/making out (64%) and having sexual intercourse (56%), while 46% reported regularly engaging in oral sex.

Frequencies of sexual behavior categories (never, occasionally, and regularly) were compared using Chi Square analyses across four grouping variables: race, gender (African American vs. White respondents), year in school, and previous sexuality education. The traditional value of.05 was used as the criterion for statistical significance. As shown in Table 3, White students reported engaging in all three behaviors more often than did African American students, and Chi Square analyses indicated these differences were statistically significant. Two sexual behaviors varied by gender, with more females reporting regular sexual intercourse and oral sex than males. Sexual activity also differed according to year in school, with both intercourse and oral sex increasing from freshman to senior levels. Reported frequencies of engaging in these behaviors were not statistically significantly different between students who reported they received and those who reported they did not receive sexuality education.

INTENT TO ENGAGE IN PROTECTIVE SEXUAL BEHAVIORS

Responses to items included in the "intent to engage in sexual behaviors" section were coded dichotomously. Those indicating "probably" or "definitely" intending to engage in a behavior were coded as a positive response. The majority of respondents indicated anticipating dating or being in a relationship in the next six months (80.9%) and having sex with this person (64.7%). Relatively fewer reported intent to take precautions to prevent HIV or STDs, such as discussing it with a sexual partner (41%), limiting sexual activity (25%), avoiding intercourse (25%), or refusing to have sex without a condom (52%). When asked about getting tested for HIV, only 25% indicated plans to get tested if they did not believe they were infected, while over 85% indicated they would be tested if they did believe they were infected (see Table 4).

As shown in Table 4, frequencies of positive responses to protective sexual behaviors were analyzed using Chi Square analyses relative to year in school, gender, race, and having or not having received sexuality education. The alpha level of .05 was used as the criterion for statistical significance. Statistically significant gender differences were observed. More females than males reported intent to talk with a sexual partner about avoiding HIV or STDs, intent to limit sexual activity to avoid HIV or STDs, and intent to avoid intercourse without a condom.

Statistically significant differences between African American and White students were observed in responses to two items. More African American than White students indicated plans to discuss HIV or STDs with sexual partners; however, White students were more likely to get tested for HIV given the belief that they were infected. Analysis of responses to the other items did not indicate significant differences, but the trend for African American students to indicate greater intent to engage in protective actions was present (e.g., 28% of African American students indicated refusing to have sex to avoid HIV or STDS, compared to 24% of White students).

More freshman and sophomores than juniors and seniors responded positively to intent to engage in protective behaviors. It could be that juniors and seniors were in committed relationships and not as concerned about acquiring an STD. Siegel, Klein, and Roghmann (1999) found that seniors reported an increased level of oral contraceptive use among partners, indicating a concern to prevent pregnancy rather than prevention of an STD.

An examination of participants' responses clearly indicated that those who received sexuality education were more likely to engage in protective action. Moreover, when groups were compared using Chi Square analyses, participants who had received sexuality education were found to be significantly more likely than those who had not received sexuality education to refuse intercourse if their partner did not use a condom.

The researchers were also interested in examining the extent to which variances in students' perceptions of the perceived quality of sexuality education received were associated with intent to engage in protective behaviors. Participants were categorized in two groups: intending or not intending to engage in each protective behavior. Independent t-tests were then conducted comparing the two groups' ratings of the overall quality of sex education. Individuals who indicated intending to engage in protective sexual behaviors reported higher perceived quality of sexuality education (see Table 5). Statistically significant differences (p < .05) were found for talking to a partner about avoiding HIV or STDs, refusing to have intercourse to avoid HIV or STDs, and getting tested for HIV if one thinks he/she might be infected. For each of these three variables, the effect size indicating the magnitude of the difference between groups was nearly one fourth of a standard deviation unit.

DISCUSSION

This study was conducted in order to examine Louisiana college students' sexual behaviors and their intentions to use protective sexual behaviors. The findings indicate that gender and race are significantly related factors. In addition, the findings support the importance of sexuality education in impacting sexuality health-based decisions.

Of this sample of Louisiana college students, most indicated receiving school-based sexuality education at some level, with only 13% having never received any. Students' ratings of the quality of sexuality education they received, however, were generally low, with less than 50% rating it good or extremely good on most topics. One topic rated as lower quality included condom use even though consistent and accurate condom use is protective of most STDs and 98% effective for preventing pregnancy (SIECUS, 2002). Pre- and college students who are engaging in sexual intercourse need condom and other contraceptive information as a part of quality sexuality education.

Fifty-six percent of college students participating in this study reported regularly having sexual intercourse. These data indicate more frequent sexual activity as compared to the results of a study assessing the sexual practices of college students on a commuter campus wherein 40% of 1,919 students reported having sex at least once per week (Prince & Bernard, 1998). The current findings, however, are lower than the findings of the 1995 CHRBS in which 86% of college students reported ever having had sexual intercourse (CDC, 1997).

The frequency of sexual behaviors was higher among White students and females. This finding differs from the results of the 1995 CHBRS indicating that African American students were at greater risk of engaging in sexual intercourse than White students regardless of gender (CDC, 1997). It is possible that the social norms in Louisiana create different sexual activity patterns when compared nationally, or that the results are impacted by other characteristics of the student populations at the universities studied (all affordable public four-year institutions). This is the first relatively large-scale study of sexual behaviors among college students in Louisiana, and examining factors that may help to explain differences in sexual behaviors of Louisiana college students compared to those in other states or nationally may be a fruitful avenue of further study. It was also somewhat surprising to find that frequency of sexual behaviors did not vary significantly between students who did versus those who did not receive previous school-based sexuality education.

Of concern is that over 60% of the participants in the current study indicated intending to have sex in the next few months, but only 41% planned to discuss STDs with partners. More African American (54.8%) than White students (36.7%) and more females (45.7%) than males (34.2%) reported intentions to talk with partners about avoiding HIV or other STDs. The gender difference is consistent with Prince and Barnard's (1998) results; significantly more women than men reported they would communicate with sexual partners about HIV/AIDS concerns.

In this study, 51.8% intended to refuse to have sex without a condom, again with more females (55.9%) than males (44.7%) reporting probably or definitely intending to do so. This finding differs from the CHBRS (1995) data wherein male students (32.4%) were significantly more likely than female students (25.1%) to report consistent condom use. The racial values in the present study paralleled the CHRBS results, with more African American students (57.9%) intending to use a condom than White (50.2%) students. An encouraging finding in the present study was that 85% of all participants planned to get tested for HIV if they held a belief in possible infection while only twenty-five percent would not.

It was heartening to find that there was a pattern of greater intent among students who had received sexuality education to engage in protective sexual behaviors such as talking with a partner about avoiding HIV/AIDS, refusing sex without a condom, and getting tested for HIV. However, a statistically significant difference was only found for refusing to have sex without a condom. When the relationship between perceived quality of sexuality education and intent to engage in protective behaviors was examined, a clear pattern of results was found. Students who planned to engage in protective behaviors rated the quality of sexuality education higher than those who did not plan to engage in the protective behaviors.

Rather than encouraging sexual experimentation or increased sexual activity, studies commissioned by several organizations (the National Campaign to Prevent Teen Pregnancy, Joint United Nations Programme on HIV/AIDS, and the World Health Organization's Global Programme on AIDS) demonstrate that sexuality education has been shown to: (a) increase sexuality related knowledge, (b) aid youth in more responsible sexual decision making, (c) promote abstinence, and (d) delay the age at which first sexual intercourse occurs (Gordon, 1992; Kirby, 1997, 2000; SIECUS, 1999).

IMPLICATIONS

Lack of sexual knowledge contributes to risky sexual behaviors and subsequently to racial and ethnic disparities in STD and pregnancy rates. This study affirms that students attending colleges in Louisiana are engaging in sexual behaviors and report intent to engage in future sexual behaviors that place them at risk for unplanned pregnancy and STDs. There is clearly a need for quality college sexuality education programs focusing on protective sexual behaviors and protective sexual communication. Part of that education should include encouraging female students to obtain regular gynecological care and screening for infections in both males and females (Gilbert & Alexander, 1998). Therefore, from the time of student orientation throughout their years in college, comprehensive sexuality programming should become a coordinated effort of health centers, counseling centers, various academic departments and community health agencies. Sexual health messages can be conveyed using campus wide posters, brochures, media, presentations, and through academic courses (Ratliff-Crain, Donald & Dalton, 1999). In order to ultimately improve the sexual health of college students, the authors of the current study firmly believe that colleges do have a responsibility to provide ways in which college students can increase their sexuality knowledge, sexuality related communication skills and sexual health.

CHES AREA

Responsibility I--Assessing Individual and Community Needs for Health Education

Competency A. Obtain health-related data about social and cultural environments, growth and development factors, needs and interests.

Competency B. Distinguish between behaviors that foster and those that hinder well-being.

Responsibility IV--Evaluating Effectiveness of Health Education Programs

Competency A Develop plans to assess achievement of program objectives.

Competency B. Carry out evaluation plans

Competency C. Interpret results of program evaluation

Competency D. Infer implications from findings for future program planning.

Responsibility VI--Acting as a resource person in health education.

Competency A. Utilize computerized health information retrieval systems effectively.

Competency C. Interpret and respond to requests for health information

Responsibility VII--Communicating Health and Health Education Needs, Concerns, and Resources

Competency A. Interpret concepts, purposes and theories of health education.

Competency D. Foster communication between health care providers and consumers.

REFERENCES

Alan Guttmacher Institute (2004). News Release: U.S. Teenage Pregnancy Rate Drops For 10th Straight Year. Retrieved from http://www.agi-usa.org/media/nr/2004/02/19/index.html.

Centers for Disease Control and Prevention (2002a). Trends in sexual risk behaviors among high school students--United States, 1991-2001. MMWR, 51(38), 856-859.

Centers for Disease Control and Prevention (2002b). Youth risk behavioral survey. MMWR, 51(SS-4), 1314.

Centers for Disease Control and Prevention (1997). National College Health Risk Behavior Survey. MMWR, 46(SS-6), 1-54.

Centers for Disease Control and Prevention (2000). National and State-Specific pregnancy Rates among Adolescents-United States, 1995-1997. MMWR, 49(27), 605-611.

Dunn, M., Bartee, R., & Perko, M. (2003). Self-reported alcohol use and sexual behaviors of adolescents. Psychological Reports, 92, 339-348.

Gilbert, L., & Alexander L. (1998). A profile of sexual health behaviors among college women. Psychological Reports, 82, 107-166.

Gordon, S. (1992). Values-based sexuality education: Confronting extremists to get the message across. SIECUS Report, 20(6), 1-4.

Kelley, M., Denny G., & Young, M. (1999). Modified stages of acquisition of gateway drug use: A primary prevention application of the stages of change model. Journal of Drug Education, 29(3), 189-203.

Kirby, D. (1997). No easy answers: Research findings on programs to reduce teen pregnancy. Washington DC: National Campaign to Prevent Teen Pregnancy.

Kirby, D. (2000). Effective practices: Effective curricula and their common characteristics. ReCAPP, [Online]. Retrieved from http://www.etr.org/recapp/programs/index.htm

Kirby, D., Short, L., Collins, J, Rugg, D., Kolbe, L., Howard, M., et al. (1994). School-based programs to reduce sexual risk behaviors: a review of effectiveness. Public Health Reports, 109(3):339-60.

Langer, L., Warheit, G., & McDonald, L. (2001). Correlates and predictors of risky sexual practices among a multi-racial/ethnic sample of university students. Social Behavior and Personality, 29, 133-144.

Louisiana Office of Public Health (2001a). Louisiana HIV/AIDS Annual Report 2001. Retrieved from http:/ /www.dhh.state.la.us/OPH/hivstd/Default.htm.

Louisiana Office of Public Health (2001b). Louisiana Health Report Card. Morbidity. Retrieved from www.oph.dhh.state.la.us/recordsstatistics/statistics/docs/reportcards

National Campaign to Prevent Teen Pregnancy (2000a). Fact and Stats. United States pregnancy rates for teen, 15-19. Retrieved from http://www.teenpregnancy.org/fedprate.htm

National Campaign to Prevent Teen Pregnancy (2000b). Teen Pregnancy in Louisiana. Retrieved from http:/ /www.teenpregnancy.org/usa/la.htm

Prince, A. & Bernard, A. (1998). Sexual behaviors and safer sex practices of college students on a commuter campus. Journal of American College Health, 47, 11-21.

Poulson, R., Eppler, M., Satterwhite, T., Wuensch, K. & Bass, L. (1998). Alcohol consumption, strength of religious beliefs, and risky sexual behavior in college students. Journal of American College Health, 46, 227-231.

Prochaska, J., & DiClemente, C. (1982). Transtheoretical therapy toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 19(3), 276-287.

Prochaska, J., Norcross, J., & DiClemente, C. (1994). Changing for good. New York: William Morrow.

Ratliff-Crain, J., Donald, K. & Dalton, J. (1999). Knowledge, beliefs, peer norms, and past behaviors as correlates of risky sexual behaviors among college students. Personality and Health, 14, 625-641.

Sexuality Information and Education Council of the United States (1999). Issues and answers fact sheet on sexuality education. SIECUS Report, 27(6), 29-33.

Sexuality Information and Education Council of the United States (November, 2002). The truth about condoms fact sheet. Retrieved from http://www.siecus.org/pubs/fact/FS_truth condoms_02.pdf

Siegel, D., Klein, D., & Roghmann, K. (1999). Sexual behavior, contraception, and risk among college students. Journal of Adolescent Health, 25, 336-343.

Temple, M. & Leigh, B. (1992). Alcohol consumption and unsafe sexual behavior in discrete events. The Journal of Sex Research, 29, 207-219.

Turner, J., Korpita, E., Mohn, L., & Hill, W. (1993). Reduction of sexual risk behaviors among college students following a comprehensive health intervention. Journal of American College Health, 41, 187-193.

Werch, C. & Anzalone, D. (1995). Stage theory and research on tobacco, alcohol, and other drug use. Journal of Drug Education, 25(2), 81-98.

Werch, C., Meets, B., & Farrell, J. (1990). Determining drug use among employees in higher education: Implications for prevention. DOE FIPSE; Washington, DC.

Werch, C., Young, M, Clark, M, Hooks, S. & Moore, A. (1991). Experimentation and intentions to use drugs among 4th and 5th graders: Relationship to beliefs, peer use, self-esteem, and decision making. In R. H. Feldman & J. Humphrey (Eds.), Advances in health education: Current research (pp. 257-268). New York: AMS Press.

Werch C., Meets B., & Farrell J. (1993). Stages of drug use acquisition among college students: Implications for the prevention of drug abuse. Journal of Drug Education, 23, 375-726.

Linda Synovitz, RN, PhD, FASHA, CHES is an Associate Professor and Graduate Coordinator, Edwards Herbert, PhD is an Associate Professor and Department Head of the Department of Kinesiology and Health Studies at Southeastern Louisiana University. Gerald Carlson, PhD is the Dean of Education at the University of Louisiana at Lafayette. R. Mark Kelley, PhD is an Associate Professor in Health Promotion at Oklahoma State University in Tulsa. Address all correspondence to Linda Synovitz, RN, PhD, FASHA, CHES, Associate Professor, Department of Kinesiology and Health Studies, Southeastern Louisiana University, SLU 10845, Hammond, LA 70402; PHONE: 985-549-3867; Fax: 985-549-5119; E-MA/L: lsynovitz@selu.edu.
Table 1. Demographic Characteristics of the Sample

Demographic Variable n %

Age 18 133 11.4
 19 214 18.3
 20-23 343 29.4
 24-28 105 9.0
 29+ 58 5.0
 No response 315 27.0

Gender Female 744 63.7
 Male 415 35.5
 No response 9 0.8

Race/Ethnicity African American 214 18.3
 Asian 20 1.7
 Hispanic 28 2.4
 Native American 6 0.5
 White 876 75.0
 Other 20 1.7
 No response 4 0.3

College Freshman 346 29.6
Classification Sophomore 287 24.6
 Junior 213 18.2
 Senior 319 27.3
 No response 3 0.3

Region of State North 31 2.6
 Central 70 6.0
 Southwest 294 25.2
 Southeast 401 34.3
 No response 372 31.8

Table 2. Levels of Sexuality Education

Level(s) of education where formal
 sexuality education was received n %

0 No sexuality education 153 13.1
1 K-8 grades only 95 8.1
2 High school only 85 7.3
3 K-8 grades plus high school only 207 17.7
4 College only 152 13.0
5 K-8 grades or high school plus college 217 18.6
6 K-8 grades plus high school plus college 247 21.1

Table 3. Frequency of Engagement in Sexual Behaviors and Relationship
to Year in School, Race, Gender, and Presence/Absence of Sexuality
Education

Sexual Behavior Total Have not
 Responses

Petting or "making out"

Total responses 1152 100 (8.7%)

Freshmen 341 36 (10.6%)
Sophomores 283 25 (8.8%)
Juniors 212 17 (8.0%)
Seniors 313 20 (6.4%)
African American * 214 28 (13.1%)
White * 863 62 (7.2%)
Female 735 62 (8.4%)
Male 408 36 (8.8%)
Had sex education 988 75 (7.6%)
Had no sex education 152 21 (13.8%)

Sexual intercourse

Total responses 1157 195 (16.9%)
Freshmen * 343 91 (26.5%)
Sophomores * 283 44 (15.5%)
Juniors * 213 28 (13.1%)
Seniors * 315 31 (9.8%)
African American * 214 33 (15.4%)
White * 867 146 (16.8%)
Female * 737 132 (17.9%)
Male * 411 61 (14.8%)
Had sex education 993 162 (16.3%)
Had no sex education 152 27 (17.8%)

Oral sex

Total responses 1154 271 (23.5%)

Freshmen * 344 106 (30.8%)
Sophomores * 282 67 (23.8%)
Juniors * 212 45 (21.2%)
Seniors * 313 52 (16.6%)
African American * 213 92 (43.2%)
White * 865 160 (18.5%)
Female * 735 188 (25.6%)
Male * 410 81 (19.8%)
Had sex education 991 226 (22.8%)
Had no sex education 152 39 (25.7%)

Sexual Behavior Occasionally Regularly

Petting or "making out"

Total responses 315 (27.3%) 737 (64.0%)

Freshmen 101 (29.6%) 204 (59.8%)
Sophomores 77 (27.2%) 181 (64.0%)
Juniors 59 (27.8%) 136 (64.2%)
Seniors 78 (24.9%) 215 (68.7%)
African American * 69 (32.2%) 117 (54.7%)
White * 217 (25.1%) 584 (67.7%)
Female 194 (26.4%) 479 (65.2%)
Male 117 (28.7%) 255 (62.5%)
Had sex education 278 (28.1%) 635 (64.3%)
Had no sex education 31 (20.4%) 100 (65.8%)

Sexual intercourse

Total responses 309 (26.7%) 653 (56.4%)
Freshmen * 96 (28.0%) 156 (45.5%)
Sophomores * 81 (28.6%) 158 (55.8%)
Juniors * 60 (28.2%) 125 (58.7%)
Seniors * 72 (22.9%) 212 (67.3%)
African American * 74 (34.6%) 107 (50.0%)
White * 203 (23.4%) 518 (59.7%)
Female * 167 (22.7%) 438 (59.4%)
Male * 137 (33.3%) 213 (51.8%)
Had sex education 263 (26.5%) 568 (57.2%)
Had no sex education 43 (28.3%) 82 (53.9%)

Oral sex

Total responses 353 (30.6%) 530 (45.9%)

Freshmen * 106 (30.8%) 132 (38.4%)
Sophomores * 82 (29.1%) 133 (47.2%)
Juniors * 72 (34.0%) 95 (44.8%)
Seniors * 93 (29.7%) 168 (53.7%)
African American * 74 (34.7%) 47 (22.1%)
White * 249 (28.8%) 456 (52.7%)
Female * 195 (26.5%) 352 (47.9%)
Male * 154 (37.6%) 175 (42.7%)
Had sex education 309 (31.2%) 456 (46.0%)
Had no sex education 40 (26.3%) 73 (48.0%)

* Chi Square comparisons indicated significant differences (p<.05).

Table 4. Intent to Engage in Protective Sexual Behaviors and
Relationship to Year in School, Race, Gender and Previous
Sexuality Education.

Protective Sexual Behavior Number of Positive
 responses responses

 n %

Will talk with partner about
 avoiding HIV or STDs
 Total responses 1074 445 (41.4%)
 Freshmen 324 120 (37.0%)
 Sophomores 264 114 (43.2%)
 Juniors 194 90 (46.4%)
 Seniors 289 119 (41.2%)
 African American * 197 108 (54.8%)
 White * 811 298 (36.7%)
 Female * 678 310 (45.7%)
 Male * 389 133 (34.2%)
 Had sexuality education 936 394 (42.1%)
 Had no sexuality education 133 49 (36.8%)
Will limit sexual activity to
 avoid HIV or STDs
 Total responses 874 221 (25.3%)
 Freshmen 253 66 (26.1%)
 Sophomores 224 65 (29.0%)
 Juniors 160 39 (24.4%)
 Seniors 235 51 (21.7%)
 African American 163 45 (27.6%)
 White 656 161 (24.5%)
 Female * 519 147 (28.3%)
 Male * 346 74 (21.4%)
 Had sexuality education 768 192 (25.0%)
 Had no sexuality education 100 28 (28.0%)
Will refuse to have intercourse
 to avoid HIV or STDs
 Total responses 861 211 (24.5%)
 Freshmen * 248 68 (27.4%)
 Sophomores * 221 63 (28.5%)
 Juniors * 155 36 (23.2%)
 Seniors * 236 43 (18.2%)
 African American 157 46 (29.3%)
 White 651 154 (23.7%)
 Female * 524 157 (30.0%)
 Male * 330 54 (16.4%)
 Had sexuality education 748 186 (24.9%)
 Had no sexuality education 108 25 (23.1%)
Will refuse to have intercourse
 if partner will not use a
 condom
 Total responses 872 452 (51.8%)
 Freshmen 250 140 (56.1%)
 Sophomores 224 119 (53.1%)
 Juniors 166 82 (49.4%)
 Seniors 231 111 (48.1%)
 African American 159 92 (57.9%)
 White 661 332 (50.2%)
 Female * 546 305 (55.9%)
 Male * 318 142 (44.7%)
 Had sexuality education * 759 404 (53.2%)
 Had no sexuality education * 107 43 (40.2%)
Will get tested for HIV if I DO
 NOT think I am infected
 Total responses 937 234 (25.0%)
 Freshmen 276 60 (21.7%)
 Sophomores 239 62 (25.9%)
 Juniors 162 46 (28.4%)
 Seniors 258 64 (24.8%)
 African American * 174 69 (39.7%)
 White * 699 139 (19.9%)
 Female 576 136 (23.6%)
 Male 353 94 (26.6%)
 Had sexuality education 810 210 (25.9%)
 Had no sexuality education 118 22 (18.6%)
Will get tested for HIV if I DO
 think I might be infected
 Total responses 907 773 (85.2%)
 Freshmen 267 227 (85.0%)
 Sophomores 233 192 (82.4%)
 Juniors 164 146 (89.0%)
 Seniors 242 207 (85.5%)
 African American * 173 138 (79.8%)
 White * 669 578 (86.4%)
 Female * 552 490 (88.8%)
 Male * 347 276 (79.5%)
 Had sexuality education 793 678 (85.5%)
 Had no sexuality education 105 88 (83.8%)

Note: Positive responses include those indicating
"probably" or "definitely" engaging in behavior.

* indicates comparison groups significantly different (p<.05).

Table 5. Comparisons of perceived quality of sexuality education
among respondents who did and did not plan to engage in protective
behaviors

Sexual behavior Definitely or Definitely
 probably will will not,
 engage in probably will
 behavior not, or
 unsure

 Mean (SD) Mean (SD) Effect
 overall overall Size
 perceived perceived
 quality of quality of
 sexuality sexuality
 education education

Will talk with partner about 4.18 (1.04) 3.92 (0.95) 0.27
 about avoiding HIV or STDs *
Will limit sexual activity to 4.11 (0.92) 3.96 (1.00) 0.15
 avoid HIV or STDs
Will refuse to have 4.16 (0.93) 3.92 (0.98) 0.24
 intercourse to avoid HIV
 or STDs *
Will refuse to have 4.04 (0.99) 3.99 (0.96) 0.05
 intercourse if partner will
 not use a condom
Will get tested for HIV 4.09 (0.95) 4.00 (0.99) 0.09
 if I don't think I am
 infected
Will get tested for HIV 4.05 (0.99) 3.80 (0.97) 0.25
 if I think I might be
 infected *

* indicates significant difference (p<.05)
COPYRIGHT 2005 University of Alabama, Department of Health Sciences
No portion of this article can be reproduced without the express written permission from the copyright holder.
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Author:Kelley, R. Mark
Publication:American Journal of Health Studies
Article Type:Survey
Geographic Code:1U7LA
Date:Jan 1, 2005
Words:6028
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