Adolescent Sexual Health: Risks & Benefits of Safe Behavior

“It’s not the years in your life that count. It’s the life in your years”

Abraham Lincoln

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Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less. ― Marie Curie

This essay will examine the different variables that potentially impact the adolescence and early adulthood sexual health behavior which was evaluated in most studies as safety use (condom and contraception) (Allen & Walter, 2018) that leads to alarming rates of sexually transmitted diseases (STDs) and unintended pregnancies. (Walsh & Ward, 2010; Brown & Walsh-Childers, 2002; Hudek-Knežević, Kardum & Krapić, 2008). This essay is based on “Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students” from Journal of adolescence as central article which reviews perception of risks and benefits of safe sexual behavior, condom use, knowledge and awareness and its association with the sexual risk behavior. Additionally, how temptation, and self-efficacy are correlated with sexual risk behavior and potentially vital predictors. However, it will also examine other aspects that was not covered within the main article such as intention and sexual arousal impact on judgment and decision making and how it’s tied to temptation. Moreover, analysis on the reliability of self-efficacy measurement, substance use correlation with the sexual behavior, and potential interventions.

Evolving to adult life which occurs between 14 to 22 years of age is a complicated time for all youthful individuals and incorporates a period of autonomy decision when they acquire adult roles in work, self-reliant living, and social relations. (Davis & Niebes-Davis, 2010; McDaniels & Fleming, 2018; Benthin, Slovic, & Severson, 1993; Caffray & Schneider, 2000). Moreover, it is a crucial phase in life due to the physiological development in reproductive organs that have aroused in the life of adolescents, frequently function as a motivating drive in their pursuit to explore their sexuality and a first step is formed into sexual maturation and adolescents are inclined to inquire into their sexuality. Azuzu (1994) indicated that an ordinary adolescent at age 14 years would have matured a normal sensation that would need him to be touched, desired, and cared for by another individual of the other sex. Subsequently, it is the time in which routines of behavior that has long-lasting results are developed and set up. It is broadly known that teenagers choose to take an interest in different unsafe practices which will have life-changing results. This essay is concentrating on sexual risk-taking which is an essential element contributing to sexual transmitted diseases, impairment, and potentially death where statistics demonstrate that early adulthood is a period of high tendency to the exposure of unintended pregnancy and sexually transmitted diseases (STDs), with almost 50% of all STDs arise between 15 and 24 years old (Benthin, Slovic, & Severson, 1993; Caffray & Schneider, 2000; Allen & Walter, 2018; Adeniyi & Okewole, 2014; Walsh & Ward, 2010; Brown & Walsh-Childers, 2002; Hudek-Knežević, Kardum & Krapić, 2008). There are many different variables that might impact and predict the sexual behavior, in this essay, the focus will be on 5 different variables and how it’s tied to other variables. First, knowledge and awareness of STDs, numerous prevention programs for sexual risk-taking engagements have been based on the assumption that information regarding the unsafe outcome will discourage risk-taking where numerous campuses arrange extensive knowledge on the benefits of utilizing condoms in pursuit of STDs avoidance. (Parsons, Halkitis, Bimbi & Borkowski, 2000). These programs, however, seldom raise safer-sex practices (Schlaama, Abraham, Gillmore, & Kok, 2004) and, adolescents, are likely to participate in unsafe sex in spite of considerable information with respect to the risky consequences related with their activities, proposing that precise information in regards to the different health threats of unsafe sex is an inadequate variable in encouraging protected sexual behaviors (Parsons, Halkitis, Bimbi & Borkowski, 2000) Nevertheless, in a research, there was a slight trend for those who disclose continuous usage of a condom (39%) to have a greater knowledge of STDs than those who irregularly or never utilized a condom (27%). (Machel, 2001).

Consequently, Adolescents and early adults are competent of theoretically understand that there are benefits and costs linked with condom usage. It is uncertain, however, whether youth involve themselves in measuring these benefits and costs and utilize this as the fundament of having sex with a condom. Here, perception research comes into play and proposes a vital aspect in predicting the sexual risk behavior. The main study proposes that among early adults, perception of the benefits related with unprotected sex were predictive of sexual risk-taking than were perceived benefits or costs related with condom use (Parsons, Halkitis, Bimbi & Borkowski, 2000; Parsons, Siegel & Cousins, 1997). This corroborates other studies, that, adolescents who perceive condoms as effective in preventing STDs transmission, does not decrease the sexual pleasure, who had consulted it with a doctor and potentially concerned of having the disease, were more prone to use condoms (Hingson, Strunin, Berlin & Heeren, 1990). On the other hand, findings from the main article, proposed that sexual risk-taking behavior positively correlates with level of temptation (Parsons, Halkitis, Bimbi & Borkowski, 2000) which is potentially affiliated with the intention, sexual arousal level, substance use. Where perceived benefits and perceived risks were identified to be vital determinants of behavioral intentions, this reinforces previous research that classify adolescents as “sensation seekers” and are likely to be driven by antisocial behaviour, impulsive thrill seeking, sensation-seeking, resisting tradition along with convention and illustrating growth, development and autonomy (Parsons, Siegel & Cousins, 1997; Hudek-Knežević, Kardum & Krapić, 2008; Casey, Jones, Rebecca & Hare, 2008; Hale & Viner, 2016; Donohew, Zimmerman, Cupp, Novak, Colon & Abell, 2000). Possibly, sensation seeking plays a significant part both in vulnerability to substance use. Some research assert substance use (alcohol & drug) correlates positively with sexual risk behaviour where numerous young individuals describe that condoms are not regularly utilized when individuals are drinking or using drugs (Biglan, Metzler, Wirt, et al., 1990; Adeniyi & Okewole, 2014; Davis, Hendershot, George, Norris & Heiman, 2007; Hingson, Strunin, Berlin & Heeren, 1990; Baranowski & Hecht, 2015). This implicates notable rise in probability of unprotected sex at great levels of intoxication contrary to low-level intoxication which was related with raise the probability of participating in oral or safe sex. (Simons, Simons, Maisto, Hahn & Walters, 2018). In spite of the social importance of choices taken in the ‘‘heat of the moment,’’ exceptionally few studies has inspected the impact of sexual arousal on judgment and decision making. Two study, suggested that sexual arousal had a high effect on judgment and decision-making and acts as an amplifier of sorts, illustrating the significance of situational forces on inclinations (Ariely & Loewenstein, 2006; MacDonald, MacDonald, Zanna & Fong, 2000). Furthermore, subjects’ failure to foresee these impacts on their own behaviour where a trend is identified that activities which are not perceived as arousing when adolescents are not sexually stimulated come to be sexually charged and alluring when they are aroused, and those exercises that are alluring indeed when not aroused, ended up more alluring under the impact of arousal as well, this it implicates that people seem to have only limited insight into the impact of sexual arousal on their own judgments and behaviour (Ariely & Loewenstein, 2006). In contrast, another research were unsuccessful in finding an association between alcohol and condom consistent usage in the course of participants’ most recent intercourse with their current or new partners and explain that individuals who utilize condoms when they are sober, do tend to utilize them when drinking; while individuals who lack using condoms when drinking are likely to lack using t when sober (Weinhardt & Carey, 2000).

Thirdly, the main study propose that sexual risk-taking negatively correlates with self-efficacy which was indicated to be a significant predictor for the following five stages of change and regular use of condoms: precontemplation, contemplation, action, maintenance. (Parsons, Halkitis, Bimbi & Borkowski, 2000; Parsons, Siegel & Cousins, 1997; Lauby, Semaan, Cohen, Leviton & et al., 1998). Nevertheless, an examination pointed to test the reliability of self-efficacy demonstrated that the scales measuring self-efficacy and advantages/pros of the behaviours were reasonably to exceedingly reliable, whereas those evaluating disadvantages/ cons were much less reliable, this implies that further research are needed to deeply investigate the measurement of self-efficacy particularly the cons (Lauby, Semaan, Cohen, Leviton, Gielen, Pulley & O'Campo, 1998). Fourthly, there has been a continuous dialog in terms of if gender influence the sexual risk behaviour. The association between gender and STD risk are complex and different culturally (Strebel, Crawford, Shefer, Cloete, Henda, et al., 2006). Gender differences were distinguished within the central study, with females describing more benefits of condom usage and costs of unsafe sex, less benefits of unsafe sex and costs of condom use, better self-efficacy for engaging in protected sex, and less circumstantial temptation for risky sex (Parsons, Halkitis, Bimbi & Borkowski, 2000). In spite of the fact that most research display that more men than woman are likely to participate in risky sex, one study dispute the generalisability of this conclusion, Patrick, Maggs & Abar (2007), indicated that significance of having safe sex did not vary by gender (Patrick, Maggs & Abar, 2007). From a different angle, some other evidence reveals that culture and gender role ideologies have its impact, where a research took place in Maputo, Mozambique propose that whereas gender roles work against women in general due to sexual double standard for virginity, middle-class youthful women had less sexual partners, were more frequent users of condoms, have the aspect of challenging the sex standards and were more confident than their working-class partners, which potentially, situated them at an advantage in sexual negotiation. (Machel, 2001). The findings implicate that men and women's gender role ideology in society were significant predictor for both men and women’ sexual behaviours (Lefkowitz, Shearer, Gillen & Graciela, 2014). It also implicates that, as long as the beliefs that situate women as inferior and women felt unequal in regards of decision making and self-assertiveness, remains, young women’s susceptibility to STDs will carry on (Machel, 2001).

The above implicates that prevention programs pointed at college-aged groups ought to address and concentrate on decrease perceived benefits of unprotected sex, not focusing only on condom usage or depending exclusively on highlighting knowledge of the risks and consequences. Additionally, research should be conducted to investigate why adolescents’ behaviour is more predicted by their perceived benefits than their perceived costs (Parsons, Siegel & Cousins, 1997; Parsons, Halkitis, Bimbi & Borkowski, 2000). Potential intervention may also takes into consideration the social culture of both genders (Strebel, Crawford, Shefer, Cloete & et al., 2006) and concentrate on preparing people to deal with the ‘‘heat of the moment’’, endorsing behaviour change if they seek to boost self-efficacy, underline trigger management methods to defy temptation in engaging in unsafe sexual behaviours. (Ariely & Loewenstein, 2006; Parsons, Halkitis, Bimbi & Borkowski, 2000; Parsons, Siegel & Cousins, 1997). Based on a critical review of the substance use literature, it is concluded that it is inaccurate and potentially even misleading to spread the message that alcohol contribute to sexual risk behaviour. Maybe the foremost exact representation is to show the current irregularity to intervention members (a) to demonstrate that not everybody gets to be more risky when drinking, and (b) to empower them to consider whether drinking may be a trigger for high-risk behaviour for them so that they can establish methodologies to refrain from drinking in circumstances where unprotected sexual action is likely (Weinhardt & Carey, 2000). Nevertheless, for adolescents particularly, the message can be conveyed more powerfully, since numerous teenagers encounter their sexual beginnings under the effect of alcohol, and these encounters arise along with less preparation, and with less probability of contraception, prevention programs should be planned with focus on this crucial experience and address risk-taking as an indication of non-conventional conduct (Sound & Viner, 2016).

To conclude, the main study found that college students' sexual risk behaviours were driven and more predictive by their perceptions of the benefits related with unsafe sex, in contrast to perceived costs, or unfavourable consequences, related with unprotected sex were irrelevant to sexual risk behaviours. This proposes that sexual risk-taking among college students may be more situated towards looking for the positive results or benefits that come from practicing unsafe sex. Besides, found that risk taking does not correlates with factual knowledge in regards the health-related threats of unprotected sex, positively correlates with level of temptation and sexual arousal (Ariely & Loewenstein, 2006) and negatively correlates with self-efficacy where an examination explored the reliability of self-efficacy evaluation procedure and propose that Pros were were reasonably to exceedingly reliable, whereas those evaluating disadvantages/ cons were much less reliable (Lauby, Semaan, Cohen, Leviton, Gielen, Pulley & O'Campo, 1998). The central research distinguished gender differences in perception (Parsons, Halkitis, Bimbi & Borkowski, 2000; Parsons, Siegel & Cousins, 1997) whereas other research indicated significant correlation between gender beliefs and ideologies and unsafe sex behaviour. Both, sensation seeking and alcohol influence on unsafe sexual behaviour studies have been conflicting and it is uncertain to spread the message that alcohol contribute to sexual risk behaviour (Weinhardt & Carey, 2000).

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