Study suggests why some young adults may be more likely to engage in unsafe sex

Gender, sexual orientation, and the desire to form lasting romantic relationships appear to influence sexual risk-taking among young adults, according to a new research published in the Journal of Sex Research.

As far as the researchers are aware, this is the first study to directly compare how heterosexual men, heterosexual women, and men who have sex with men (MSM) differ in their approach to condom decision-making with a new sexual partner.

The findings may help explain why some young people engage in unsafe sex even though they are aware of the risk for sexually transmitted infections (STIs), HIV, cervical cancer, and unplanned pregnancy.

To explore this aspect of risk, researchers studied how heterosexual men (157 participants), heterosexual women (177), and MSM (106) aged 18–25 years, recruited from Amazon’s Mechanical Turk system (a crowdsourcing marketplace) and a university in Canada, make decisions about using condoms.

Participants were presented with a vignette describing an encounter with a hypothetical new sexual or romantic partner and were asked to rate their attitudes and likelihood of choosing particular courses of action, as well as their relationship motivation.

Results showed that all three groups had a preference for different condom negotiation strategies— heterosexual men tended to choose more passive strategies (and were most likely to agree to sex without a condom); heterosexual women tended to choose more assertive strategies (like withholding sex); and MSM tended to aim for a balance, choosing more verbal strategies than heterosexual men, but selecting strategies that were not confrontational.

The findings may also explain some of the motives and reasoning that influence risky behaviours. For example, the study suggests that heterosexual women may be more willing to take risks when they both have stronger relationship motivation and view their partner as having more relationship potential.

“Understanding what factors make it more difficult to recognize risk during a sexual encounter, such as the desire for a long-term romantic relationship and partner familiarity, can lead to better prevention”, says Dr. Shayna Skakoon-Sparling from the University of Guelph, Canada who led the research. “It is particularly striking that women had lower expectations that their partner would be interested in condom use—this highlights how challenging heterosexual women expect the negotiation of condom use to be.”

The authors conclude that the findings have important implications for policy and prevention and should inform the creation of more effective sexual health education programs and interventions.

This is an observational study, so no firm conclusions can be drawn about cause and effect and the authors point to several limitations including that it did not involve women who have sex with women, or any other gender/sexuality minority groups, which could limit the generalisability of the findings. They also note that a hypothetical scenario may not invoke the same emotional response or reflect real-life behavior.