An Assessment of University Students’ Knowledge, Attitudes, and Behaviors toward Sex

Previous research provides varying results in the effects of sex education. While the goal of sex education is to educate and therefore protect oneself from high-risk sexual behaviors, research suggests support that knowledge and attitudes do not always comply with behavior. The purpose of this study is to test college students’ knowledge about sexual topics, their attitudes toward condom use, and compare these with the assessment of students’ sexual behaviors. Results from the study support the hypothesis that knowledge about sexual issues and attitudes toward condom use cannot predict sexual behavior. The study indicates that students’ knowledge about sexual issues is insufficient. Respondents most commonly indicated that unwanted pregnancy and STDs were less prevalent than facts actually indicate. Several gender differences were found pertaining to attitudes about condom use, which provide information to more specifically target attitudes that may lead to risky sexual behavior. Lastly, the study found several common risky sexual behaviors -including sex without a condom due to drugs and/or alcohol, continuance of sexual activity after the breakage of a condom, and ceasing to use a condom -increased when respondents became more comfortable in their relationships. In conclusion, the study found a lack of knowledge about pertinent sexual issues, gender differences in attitudes toward condom use, and several common risky sexual behaviors among the sample population. These findings provide support for the need for a broader range of issues that should be implemented into sex education. Republication not permitted without written consent of the author. THE UNIVERSITY OF CENTRAL FLORIDA UNDERGRADUATE RESEARCH JOURNAL 29 www.URJ.ucf.edu INTRODUCTION Entry into a university can be overwhelming. Any freedoms restricted by parents are now a free-for-all. According to Caron and Halteman (1993), one-third of college freshmen have had sexual intercourse with at least two new partners since arriving at college. If this is a pattern that continues throughout students’ college careers, at least one-third of college freshmen are at a high-risk for unwanted pregnancy and obtaining sexually transmitted infections ( STIs ). The purpose of this study is to test college students’ general knowledge about sexual topics, to assess their attitudes about condom use, and to determine their sexual behavior. Do university students’ knowledge and attitudes about sexual topics comply with their sexual behavior? REVIEW OF LITERATURE Students' sexual education background Evaluating the effectiveness of sex education is important. If a goal of sex education is to promote safe sex practices, it can only be assumed that programs are having the desired effects without assessing actual knowledge, attitudes, and behaviors. Much previous research (Kyes, 1990; Moran, 1991; Kirby, 2002; Abdullah, Fielding, & Hedley, 2003) found that sex education guides students’ attitudes toward promoting safer sex practices. Sex education has been found to have a positive effect on attitudes toward condom use. However, this does not mean that people actually used condoms more, only that they had an increased willingness, or attitude adjustment, to do so. One study, for example, found that learning about sexuality in a sex education class had a very strong relationship to reports of increased condom use (Moran, 1991). Another study also found that there is a strong relationship in the use of condoms or other forms of contraceptives following sex and HIV education (Kirby, 2002). Furthermore, Kyes (1990) reports that viewing a safe-sex film does affect positive change in attitudes toward condoms and an increased willingness, in women, to have their partners use them. Important to sex education is the relevance and content of the subject matter. Over the past decade, Abdullah, Fielding, and Hedley (2003) found an increase in the amount of content in which schools are educating their students about safe sex. For example, beginning in the mid-1990s, a widespread campaign for AIDS education in secondary schools promoted consistent condom use. Results from the AIDS awareness campaigns in schools concluded a positive impact in the rates of condom use, as well as shaping negative attitudes toward casual sex (Abdullah, Fielding, & Hedley, 2003). As a result of integrating vital information that at one time was considered taboo into sex education, positive, safer outcomes for young people are now possible. However, not all research has found a positive correlation between sex education, positive attitudes, and safe sex behaviors. Guthrie and Bates (2003) compared data collected in 1991 to data collected in 2000, and found that although students more frequently reported receiving sex education in 2000, their attitudes toward utilizing sexual precautions became more lax. How can sex education be viewed as beneficial if those receiving the education are developing attitudes that are in opposition to the goals of sex education? It is this example that provides support for the need for consistent assessment of the nature and needs of sex education. Although sex educators have made great strides toward improving the accuracy and thoroughness of the content of information covered, many pressing issues still are not discussed. For example, a study that assessed the sex education programs in multiple schools found that many important topics are not covered in schools (Kirby, 2002). Additional research has found that students had a common misunderstanding about the prevalence of STIs (Cohen & Bruce, 1997); they did not seem to understand that each disease is unique in transmission and prevalence rates. Perhaps topics such as these need to be consistently integrated into contemporary sex education. Attitudes toward condom use Being able to identify and understand attitudes toward condom use is important so that education can be geared to adjust attitudes that may predict high-risk behavior. Previous research has identified high-risk attitudes toward condoms that lead to risky sexual behavior. For example, Symons (1993) found that participants felt condoms reduced pleasure and intimacy in the relationship, and resulted in making safe-sex decisions more difficult. Like many issues, attitudes toward condom use differ among males and females. Previous research finds that attitudes toward condoms are significantly related to gender (Campbell, Peplau, & DeBro, 1992); women were consistently more positive about using condoms than were men. Also, women with less traditional attitudes, that is, attitudes which did not adhere to the historical sexual double standard, were found to be more likely to 1:28–37 THE UNIVERSITY OF CENTRAL FLORIDA UNDERGRADUATE RESEARCH JOURNAL 30 www.URJ.ucf.edu discuss, provide, and use a condom during sexual activity (Caron & Halteman, 1993). These differences between genders, as well as differences within genders, are important for sex educators in order to provide an allencompassing education. Norms surrounding condom use also play a significant role in predicting condom use and these norms also vary by gender. Mizuno, Kennedy, Seals, & Myllyluoma (2000) found that for female adolescents, the most powerful norm predicting condom use was the number of friends perceived to be using condoms. For male adolescents, the most powerful norm predicting condom use was the pressure exerted by parents, peers, or sexual partners to use condoms. These important findings provide support for norms that predict safe sex behavior. Sexual behavior In addition to creating safe-sex attitudes, another goal of sex education is to focus on ways to produce consistent safe-sex behaviors. One study found that among heterosexual college students, hooking up (i.e. any form of high-risk sexual behavior) has become normative behavior (Lambert, Kahn, & Apple, 2003). Therefore, if this norm continues, and sexual behaviors are not consistent with safe-sex attitudes, many college heterosexuals may be putting themselves at high risk for sexually transmitted infections or unwanted pregnancies. Furthermore, a study conducted among college students found that there are high estimates (65%) of sexual activity, sex without the use of a condom, and sex without a condom after drinking (LaBrie, 2000). The study pointed out the need to target more interventions for safe sex, especially when under the influence of alcohol. The ability to make safe-sex decisions has been difficult for many, whether under the influence of alcohol or not. Foreman (2003) found that there is a typical “override of cognition” when in the heat of the moment, and that until students realize that, their personal risk, high-risk sexual behaviors are unlikely to change. These high-risk behaviors among college students are largely due to students not recognizing any personal risk and due, in part, to the influence of alcohol when engaging in sexual activity. Although some research has found increased safe-sex practices, students’ knowledge about safe-sex practices and their attitudes about condom use do not always comply with their actual behavior. Baldwin and Whiteley (1990) found that a ten-week course on human sexuality did not predict actual condom use during sex, indicating that knowledge is not a strong predictor of behavior. Research such as this indicates that knowledge about sexuality is not a single predictor of safe sex behavior. PURPOSE AND HYPOTHESIS Purpose After reviewing the research, one could conclude that the effects of sex education vary. While the goal of sex education is to educate and therefore protect oneself from high-risk sexual behaviors, research has shown that knowledge and attitudes do not always comply with actual behavior. By testing college students’ knowledge about sexual topics and their attitudes toward condom use, and comparing these with the assessments of students’ sexual behaviors, one may reach some conclusions in regard to the broad range of sexual topics that should be implemented into sex education so that behavior might comply with knowledge and attitudes. Research Question The purpose of this research is to examine the relationships among the levels of knowledge about sexual issues, attitudes toward condom use, and sexual behavior. Hypotheses Hypothesis 1: Knowledge about sexual issues cannot be used to predict safe-sex behaviors. Hypothesis 2: There are differences in attitudes among men and women toward condom use. Hypothesis 3: There is a difference among men and women in the level of risky sexual behaviors. METHODOLOGY Participants in the study completed an anonymous group administered survey. First, the survey included questions regarding each participant’s demographic characteristics. Second, to objectively assess college students’ knowledge about general sexual issues, the study presented the participants with questions about sexual topics. Third, the survey contained items to test participants’ attitudes about condom use. It concluded with questions about their sexual behavior. Sample and Data Collection The participants in the study were University of Central Florida undergraduates who were chosen by means of a convenience method. The method of selection depended on participating professors’ permission to distribute the survey in their classes. Surveys were administered to one 1: 28-37 THE UNIVERSITY OF CENTRAL FLORIDA UNDERGRADUATE RESEARCH JOURNAL 31 www.URJ.ucf.edu class in the Sociology department, several business classes, and a marketing class. The number of participants is N=266. The study was submitted and approved by IRB in Spring 2004. Participants in the study remained completely anonymous. Each survey was identical so that participants in the study could not be identified. Participants signed a consent form stating that they understood that their identity would remain undisclosed and that they would have a full understanding of the nature of the survey and research being conducted. A list of contacts was provided on the consent form in case a participant felt the need to contact someone about issues raised within the study. Contacts included UCF Victim Services and Planned Parenthood. Measure of previous knowledge This section of the survey asked participants to answer factual questions about sexual topics. This was used to assess the range of general knowledge that university students have about sex-related topics. Items were measured by participants choosing correct or incorrect answers with the number of correct answers determining the strength of knowledge. Measurement of the level of knowledge was graded using a standard academic grading scale. Upon completion of the survey, participants received a fact sheet validating the answers to the questions they were asked. An example question was “Is it possible to contract a sexually transmitted disease when using a condom during sexual intercourse?” Measure of attitudes about condom use This section of the survey contained 28 items to measure participants’ attitudes about condom use. Of the 28 items, 20 items were taken from a previous measure of a similar study (Campbell, Peplau, & DeBro, 1992). Eight additional items were added. The items were intended to measure attitudes about condom issues and to determine any gender differences. Items are measured on a 5-point Likert scale, with 5 indicating strong agreement and 1 indicating strong disagreement. Measure of sexual behavior This section of the survey asked participants to provide information about their sexual behavior. The object of this portion was to compare the participants’ knowledge and attitudes about condom use with their actual sexual behavior. Items in the survey asked participants about their frequency of condom use and other such scenarios about their personal sexual behavior. Items were measured by categorizing participants’ responses into risky or nonrisky behaviors. Example scenarios: • I use drugs and/or alcohol when engaging in sexual activity. • Because of drug and/or alcohol use during sexual activity, I did not use a condom when otherwise I would have.