Purpose

Obtaining affirmative consent, a hallmark of sexual violence prevention education on college campuses, may influence sexual communication and behaviors such as condom use. This study examined the relationship between self-efficacy to obtain sexual consent with sexual health communication and behaviors among a sample of U.S. college students.

Methods

Data were from 2,291 students enrolled in a cluster-randomized controlled trial conducted on 28 college campuses from 2015 to 2017. Students reported their self-efficacy to obtain sexual consent, communication about sexual health, and sexual health behaviors. Multivariable logistic regression, adjusted for school clustering, history of violence victimization, and sexually transmitted infection history, estimated odds ratios and 95% confidence intervals (CIs) for sexual consent self-efficacy and sexual health communication.

Results

Females (n = 1,150) reported higher self-efficacy to obtain consent than males (b₁ = .32, 95% CI = .23, .41), but lower odds of communication about condom use (adjusted odds ratio [AOR] = .75, 95% CI = .60, .96) and HIV prevention (AOR = .63, 95% CI = .48, .81). Black and other race students reported higher odds of HIV/sexually transmitted infection prevention communication than white students. Odds of consistent condom use were highest among students reporting condom use communication and high self-efficacy to obtain sexual consent (AOR = 1.99, 95% CI = 1.58, 2.51).

Conclusions

Campus sexual assault prevention education that focuses narrowly on obtaining sexual consent may be missing an opportunity to enhance sexual health communication broadly, including condom and contraceptive use discussion to promote overall sexual health.

中文翻译：

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大学生的性交流和性同意自我效能：对预防性传播感染的启示

目的

获得肯定同意是大学校园性暴力预防教育的标志，可能会影响性交流和安全套使用等行为。本研究调查了美国大学生样本中获得性同意的自我效能与性健康交流和行为之间的关系。

方法

数据来自 2015 年至 2017 年在 28 个大学校园进行的一项集群随机对照试验的 2,291 名学生。学生报告了他们在获得性同意、性健康方面的沟通和性健康行为方面的自我效能。多变量逻辑回归，针对学校聚类、暴力受害史和性传播感染史、性同意自我效能和性健康沟通的估计优势比和 95% 置信区间 (CI) 进行了调整。

结果

女性 (n = 1,150) 报告的获得同意的自我效能高于男性 (b ₁  = .32, 95% CI = .23, .41)，但关于安全套使用的沟通几率较低（调整优势比 [AOR] = .75, 95% CI = .60, .96) 和 HIV 预防 (AOR = .63, 95% CI = .48, .81)。黑人和其他种族学生报告的艾滋病毒/性传播感染预防交流的几率高于白人学生。在报告使用安全套交流和获得性同意的自我效能感高的学生中，持续使用安全套的几率最高（AOR = 1.99, 95% CI = 1.58, 2.51）。

结论

校园性侵犯预防教育只关注获得性同意，可能会错过广泛加强性健康交流的机会，包括讨论避孕套和避孕药具的使用以促进整体性健康。