Condoms and Contexts: Profiles of Sexual Risk and Safety Among Young Heterosexually Active Men

Abstract

Heterosexual men’s sexual safety behavior is important to controlling the U.S. epidemic of sexually transmitted infections (STIs), including HIV. While sexual safety is often treated as a single behavior, such as condom use, it can also be conceptualized as resulting from multiple factors. Doing so can help us achieve more nuanced understandings of sexual risk and safety within partner-related contexts. We used Latent Class Analysis with data collected online from 18-25 year old heterosexually active U.S. men (n = 432) to empirically derive a typology of the patterns of sexual safety strategies they employ. Indicators were sexual risk reduction strategies used in the past year with the most recent female sex partner: Condom use, discussing sexual histories, STI testing, agreeing to be monogamous, and discussing birth control. We identified four subgroups: Risk Takers (12%), Condom Reliers (25%), Multistrategists (28%), and Relationship Reliers (35%). Partner-related context factors – number of past-year sex partners, relationship commitment, and sexual concurrency – predicted subgroup membership. Findings support tailoring STI prevention to men’s sexual risk-safety subgroups. Interventions should certainly continue to encourage condom use, but should also include information on how partner-related context factors and alternate sexual safety strategies can help men reduce risk for themselves and their partners.

Examining Relationships Between Sexual Risk–Safety Behaviors and Physical Self-Concept by Gender: A Cluster Analytical Approach

“…The results yielded three distinctive sexual risk–safety profiles: birth control in a relationship (sexual health discussion, contraceptive use in a long-term stable relationship), condom users (consistent condom use, with regular partners), and risk-takers (sexual risk-taking behavior related to HIV transmission, unintended pregnancy, and multiple sexual partnerships). These findings are congruent with previous studies on adolescents and men (Beadnell et al, 2005; Masters et al, 2015). The cluster analysis approach provides an advantage over more traditional statistical techniques by identifying distinct sexual safety profiles that might best benefit from interventions.…”

“…Although the need to explore diverse sexual behaviors jointly, in a holistic, multidimensional way has been highlighted (Tolman & McClelland, 2011; Vasilenko et al, 2014; Wesche, Lefkowitz, & Vasilenko, 2017), person-oriented studies about sexual risk–safety behaviors remain relatively limited. A few have examined patterns of sexual relationships (Espinosa-Hernàndez & Vasilenko, 2015; Haydon, Herring, Prinstein, & Halpern, 2012; Lanza & Collins, 2008; Vasilenko, Kugler, & Lanza, 2016) or of sexual risk behaviors among young people (Beadnell et al, 2005; Hipwell, Stepp, Keenan, Chung, & Loeber, 2011; Masters et al, 2015; Vasilenko, Kugler, Butera, & Lanza, 2015; Wesche et al, 2017). Most of these were based on key variables such as condom use, number of partners, and frequency of sex and found three to five different sexual profiles (e.g., low-risk youth, high-risk youth, monogamy strategy, condom strategy; Newman & Zimmerman, 2000), identifying relatively healthy to risky patterns of sexual behavior among adolescents.…”

Predicting Sexual Assault Perpetration Among Heterosexually Active Young Men

“…It suggests the need for conceptually distinguishing between sexual behavior driven by callous misogyny, and non-coercive sexuality that is focused on variety and experience seeking. Indeed, in a separate examination of the sexual scripts of men in this sample (their ideas about how sex and relationships “should be”), we found that many men endorsed a sexuality not tied to romantic intimacy, but at the same time placed an emphasis on positive, mutual, consensual experiences for both themselves and their female partners (Masters et al, 2015). Thus, it may be important to more specifically elicit the sex-related cognitions or perceptions of cultural sexual norms related to an impersonal approach to sex which is inclusive of coercion, versus those associated with a mutually respectful, sex-positive approach that endorses non-monogamy and multiple partners over time.…”

Factors Associated With HIV Testing Among Men in Haiti: Results From the 2012 Demographic and Health Survey

“…The alternative is also plausible, where HIV testing and condom use are common among men in monogamous relationships, or even men with multiple partners, not only in order to prevent HIV but also to prevent other sexually transmitted infections or unwanted pregnancy. Other studies have also reported that men who use condoms consistently were more likely to get tested than those who do not (Masters et al, 2014). Further research is needed to investigate condom use and HIV testing in Haiti, paying close attention to correlates of HIV testing and consistency of condom use among men.…”