Correlates of First Year, Rural, Historically Black College Student Sexual Outcomes Including Sexually Transmitted Diseases, Human Immunodeficiency Virus, and Pregnancy

Introduction:It is well known that the first year of college is often a time of experimentation with alcohol and sex, and sexual outcomes of this behavior can include unprotected and unplanned sexual activity. Hence, many sexually transmitted infections (STI), human immunodeficiency virus (HIV), and pregnancy college prevention programs focus on binge drinking and condom use. Nevertheless, the relationship of these behaviors to actual STI/HIV/pregnancy (sexual outcomes) is not well documented. The aim of this study was to examine alcohol and sexual behavior correlates of STI/HIV/pregnancy in a sample of first-year students at a Mid-Atlantic, rural historically black college (HBC).

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.