When book-smart is not life-smart: Contexts of sex risk at an Ivy-League university

Dana Lorrain Fry, University of Pennsylvania


The goal of this study was to improve college HIV/STI prevention programs by furthering our understanding of how developmental challenges, distress, substance use, and self-efficacy relate to unprotected sex among undergraduates. The study focused on factors associated with unprotected sex with non-steady partners and unprotected sex while using drugs or alcohol, two contexts where little is known about what differentiates condom users from non-users. A convenience sample of 501 undergraduates at an urban, Ivy-League university completed a survey consisting of demographic questions, the Short Form of the Multiscore Depression Inventory (SMDI), the Condom-Use Self-Efficacy Scale (CUSES), the Substance Use and Drinking Scale (SUDS), and a sex risk behavior measure. Condom-use outcomes were based on the student's most recent sexual encounter. Focus groups were then conducted to provide deeper descriptions of the mechanisms of risk and of risk reduction. Approximately half of the survey sample reported they did not use a condom the last time they had sex, despite a consistent theme in the focus groups that unprotected sex is “stupid.” First-year students and students who engaged in frequent, high levels of substance use were at increased risk to have unprotected sex, unprotected sex with a non-steady partner, and unprotected sex under the influence of intoxicants. First-years did not differ in alcohol or drug use; but they engaged in more sexual risk, supporting focus-group observations that they may drink “less in control.” Substance use before sex was associated with having sex with a non-steady partner, but not with condom use. Depressed students had lower condom-use self-efficacy but were not at increased risk for unprotected sex. These and other variables (condom-use intentions, condom-use self-efficacy, and using another type of birth control) were combined to create explanatory models for unprotected sex in different contexts. Findings were integrated with focus-group themes. Differences among students and across sexual contexts have important implications for HIV and other STI prevention programs.

Subject Area

Health education|Social psychology|Higher education|Public health

Recommended Citation

Fry, Dana Lorrain, "When book-smart is not life-smart: Contexts of sex risk at an Ivy-League university" (1999). Dissertations available from ProQuest. AAI9937722.