Robyn L. Fielder

Predictors and consequences of sexual "hookups" among college students: a short-term prospective study.

Abstract“Hookups,” sexual interactions between partners who do not expect a romantic commitment, are believed to be common among adolescents and young adults. Most existing research is cross-sectional and has not investigated the antecedents or consequences of hookups. To our knowledge, this study provides the first prospective investigation of the hypothesized predictors of penetrative sex hookups (i.e., oral, vaginal, and anal sex) and the first exploration of the short-term mental health consequences of hookups. A total of 140 first-semester college students (109 females, 31 males) completed an anonymous survey early in their first semester; the survey assessed 18 potential predictors of hooking up that were identified from theory and past research. At the end of their first semester, students again responded to a survey and provided data on their oral and vaginal sex hookup behavior (occurrence and number of partners), distress, and self-esteem. Baseline and follow-up data were linked using unique codes that protected participants’ anonymity. Pre-college hookup patterns, peak intoxication level, and situational triggers for hookups were consistent predictors of oral and vaginal sex hookup behavior (and number of hookup partners) in the first semester of college. Penetrative sex hookups increased psychological distress for females, but not for males. Implications for education and intervention as well as suggestions for future research are discussed.

Prevalence and characteristics of sexual hookups among first-semester female college students.

First-semester female college students (N = 118) completed surveys to estimate the prevalence of sexual hookups and event-level assessments to clarify the behavioral characteristics of their most recent hookup. Hookups involving oral, vaginal, or anal sex were reported by 51% before college, 36% during their first semester, and 60% by the end of their first semester. Event-level analyses revealed that hookups were more likely to involve friends (47%) or acquaintances (23%) rather than strangers (14%); alcohol use (median = 3 drinks) preceded 64% of hookups. Condoms were used during 69% of vaginal sex hookups.

Sexual Hookups and Adverse Health Outcomes: A Longitudinal Study of First-Year College Women

“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.

Are Hookups Replacing Romantic Relationships? A Longitudinal Study of First-Year Female College Students

PURPOSE To assess the prevalence and frequency of sexual hookups across the first year of college and to compare rates of hookups and romantic relationship sex. METHODS We surveyed 483 first-year female college students (mean age, 18.1 years; range, 18-21 years, 64% white) monthly over the first year of college about the frequency of sexual behavior in the context of hookups and romantic relationships. RESULTS The prevalence of hookups involving oral or vaginal sex was 34% before college and 40% during the first year, compared with 58% and 56%, respectively, with romantic partners. Fewer than one in five participants (7%-18%) had a sexual hookup each month, whereas 25%-38% had sex in the context of relationships each month. CONCLUSIONS Hooking up varies in frequency over the first year in college, but remains less common than sex in the context of relationships.

Hookah, cigarette, and marijuana use: a prospective study of smoking behaviors among first-year college women.

Better understanding of the temporal sequence of hookah, cigarette, and marijuana use will help to inform smoking prevention efforts. To address this gap in the literature, we assessed all three of these smoking behaviors in a sample of 424 first-year college women. Using a longitudinal design, we investigated whether hookah use predicts initiating/resuming cigarette and/or initiating marijuana use, and whether cigarette and/or marijuana use predicts initiating hookah use. Participants (67% White, M age = 18.1 years) completed nine monthly surveys. The initial (i.e., baseline) survey assessed demographics, sensation-seeking, impulsivity, and pre-college substance use. Follow-up surveys assessed past-month substance use; outcomes were initiating/resuming cigarette use, initiating marijuana use, and initiating hookah use during the first year of college. We controlled for sensation-seeking, impulsivity, binge drinking, and other smoking behaviors in our multivariate logistic regression models. The results showed that (a) pre-college hookah use predicted initiating/resuming cigarette use; (b) pre-college marijuana use predicted initiation of hookah tobacco smoking; and (c) pre-college cigarette use predicted neither hookah nor marijuana initiation. The findings highlight the co-occurrence of smoking behaviors as well as the need for bundling preventive interventions so that they address hookah, cigarette, and marijuana use.

Sexual Risk Reduction Interventions for Patients Attending Sexually Transmitted Disease Clinics in the United States: A Meta-Analytic Review, 1986 to Early 2009

Sexually transmitted disease (STD) patients are more likely to experience a future STD including human immunodeficiency virus (HIV). The aim of this study was to examine the efficacy of behavioral interventions to reduce sexual risk behavior and incident STDs among patients attending STD clinics in the United States. A meta-analysis of 32 studies with 48 separate interventions targeting STD patients (N = 67,538) was conducted. Independent raters coded study, sample, and intervention characteristics. Effect sizes, using both fixed- and random-effects models, were calculated. Potential moderators of intervention efficacy were assessed. Relative to controls, intervention participants increased their condom use and had fewer incident STDs, including HIV, across assessment intervals (d+s ranging from 0.05 to 0.64). Several sample (e.g., age and ethnicity) and intervention features (e.g., targeting intervention to a specific group) moderated the efficacy of the intervention. Behavioral interventions targeted to STD clinic patients reduce sexual risk behavior and prevent HIV/STDs. Widespread use of behavioral interventions in STD clinics should be a public health priority.

Changes in Women’s Condom Use over the First Year of College

Most college students are sexually active, engage in serially monogamous relationships, and use condoms inconsistently. Little is known about how condom use changes during college, and even less about variables predicting changes in use. Latent growth modeling (LGM) was used to examine changes in condom use during the first year of college among 279 women (mean age = 18.0; 74% White), who provided monthly reports on condom use frequency. At study entry, participants also reported on theoretically suggested risk and protective factors. Predictors of changes in use were examined after controlling for use of alternative contraception and partner type. LGM showed that women decreased their condom use during the first year of college. Levels of condom use were initially lower among women with strong alcohol–sexual risk expectancies, women with more previous sexual partners, women who did not smoke marijuana, and African American women. Decreases in condom use were greater among women with lower grade point averages, women from lower socioeconomic status families, and women who engaged in binge drinking. Reductions in condom use may place women at greater risk of unplanned pregnancy and sexually transmitted infections. Identification of factors associated with decreases in condom use will enable targeted educational and intervention efforts.

Female College Students’ Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study

This longitudinal study describes women’s media use during their first year of college and examines associations between media use and academic outcomes. Female students (N = 483, M age = 18.1 years) reported on their use of 11 media forms and their grade point average (GPA), academic behaviors, academic confidence, and problems affecting schoolwork. Allowing for multitasking, women reported nearly 12 hr of media use per day; use of texting, music, the Internet, and social networking was heaviest. In general, media use was negatively associated with academic outcomes after controlling for prior academics and demographics. Exceptions were newspaper reading and music listening, which were positively associated with academic outcomes. There were significant indirect effects of magazine reading and social networking on GPA via academic behaviors, confidence, and problems. Results show that female college students are heavy users of new media, and that some forms of media use may adversely impact academic performance.

Do Alcohol and Marijuana Use Decrease the Probability of Condom Use for College Women

Alcohol and marijuana use are thought to increase sexual risk taking, but event-level studies conflict in their findings and often depend on reports from a limited number of people or on a limited number of sexual events per person. With event-level data from 1,856 sexual intercourse events provided by 297 college women (M age = 18 years; 71% White), we used multilevel modeling to examine associations between alcohol and marijuana use and condom use as well as interactions involving sexual partner type and alcohol-sexual risk expectancies. Controlling for alternative contraception use, partner type, regular levels of substance use, impulsivity and sensation seeking, and demographics, women were no more or less likely to use condoms during events involving drinking or heavy episodic drinking than during those without drinking. However, for drinking events, there was a negative association between number of drinks consumed and condom use; in addition, women with stronger alcohol-sexual risk expectancies were marginally less likely to use condoms when drinking. Although there was no main effect of marijuana use on condom use, these data suggest marijuana use with established romantic partners may increase risk of unprotected sex. Intervention efforts should target expectancies and emphasize the dose-response relationship of drinks to condom use.

Predictors of initiation of hookah tobacco smoking: a one-year prospective study of first-year college women.

Hookah tobacco smoking has become increasingly prevalent among American college students over the past decade. Hookah smoking is associated with poor health outcomes and exposes users to high levels of nicotine, carbon monoxide, and smoke. Research on the correlates of hookah use has begun to emerge, but all studies thus far have been cross-sectional. Little is known about hookah use during the transition to college, psychosocial factors related to hookah smoking, or prospective predictors of hookah initiation and frequency of use. This longitudinal cohort study examined risk and protective factors predicting initiation of hookah tobacco smoking during the first year of college. First-year female college students (n = 483; 64% White) provided data on demographic, behavioral, and psychosocial variables and precollege hookah use at baseline; they then completed 12 monthly online surveys about their hookah use from September 2009 to August, 2010. Among the 343 participants who did not report precollege use, 79 (23%) initiated hookah tobacco smoking during the year after college entry. Zero-inflated negative binomial regression showed that alcohol use predicted the likelihood of initiating hookah use; impulsivity, social comparison orientation, and marijuana use predicted the frequency of hookah use. These findings suggest that hookah prevention and intervention efforts may need to address other forms of substance use as well as hookah use.