Methods:As part of a Substance Use and Mental Health Services Administration (SAMHSA) grant award, students in first year on-campus dormitory lounges were asked to complete a substance use and sexual risk survey. A convenience sample of 213 students volunteered to complete the survey in Spring 2016 (89% African American, 55% female, 12% non-heterosexual). An initial assessment of sexual outcomes by gender and sexual orientation revealed that: 1.3% of heterosexual males reported history of pregnancy and 2.6% reported a history of STI/HIV, 0% of non-heterosexual males reported history of pregnancy and 0% reported history of STI/HIV, 2.4% of heterosexual females reported history of pregnancy and 2.4% reported history of STI/HIV, and 16.0% of non-heterosexual females reported history of pregnancy and 17.4% reported history of STI/HIV. Hence, females had 85% of STI/HIV/pregnancy and it was determined that the subsequent analysis should be specific to them. History of ever having STI/HIV and pregnancy were merged into a composite binary variable STI/HIV/pregnancy. Eleven mental health, sexual behavior, and alcohol use risks associated with risky sexual behavior for STI/HIV/pregnancy were entered into a forward stepwise logistic regression predicting STI/HIV/pregnancy to determine the strongest independent correlates.
Results:The associations with sexual outcomes in multivariate analysis were with unwanted sex—having been “forced to have sex or being too “drunk or out of it” to know what was happening” in the past 12 months, reported by 12.3% (Odds Ratio [OR] 7.44, 95% confidence interval [CI] 1.36-40.59); alcohol problems, reported by 38.5% (OR 9.18, CI 1.38-60.97); and non-heterosexual sexual orientation, reported by 20.7% (OR 8.07, CI 1.57-41.38).
Conclusions:These findings suggest that among rural freshmen HBC students, unwanted sex, alcohol problems, and non-heterosexual orientation are associated with STI/HIV/Pregnancy. STI/HIV/pregnancy prevention programs may need to address these factors to be effective in this population.