Graduation Year

2017

Document Type

Dissertation

Degree

D.P.H.

Degree Name

Doctor of Public Health (Dr.PH.)

Degree Granting Department

Community and Family Health

Major Professor

Stephanie L. Marhefka, Ph.D.

Co-Major Professor

Julie A. Baldwin, Ph.D.

Committee Member

Eric R. Walsh-Buhi, Ph.D.

Committee Member

Cheryl A. Vamos, Ph.D.

Committee Member

Getachew Dagne, Ph.D.

Keywords

sexually transmitted infections, HIV, Internet, emerging adults, sexual health

Abstract

Introduction: Emerging adults (young people age 18 to 29) are increasingly using the Internet to seek sex partners, with over 30% having tried an online or mobile dating site. As more emerging adults use dating and sex-seeking websites (DSP) for their love and sexual pursuits, it is imperative to understand how DSPs contribute to HIV/STI risk.

Objectives: The objectives of this research were accomplished by pursuing the following specific aims: Aim 1. To systematically review and quantitatively synthesize evidence from published findings to determine the association between condom use and meeting venue (online and offline). Aim 2. To determine whether condom use behaviors during the first sexual interaction among heterosexual emerging adults vary depending on the venue in which participants met their partners in the past six months. Aim 3. To describe how the Information Motivation Behavioral (IMB) Skills Model applies to the relationship between condom use and meeting venue. Methods: This mixed methods study identified sexual risk behaviors of emerging adults. Men and women—recruited via social networking, classified ad and dating and sex-seeking websites— who met a heterosexual partner on a DSP and/or in-person in the past six months completed a survey about behavioral, communication and relationship factors that influence condom use. Additionally, a subset of people who met partners on DSPs and or offline (i.e., in-person) who completed the survey participated in qualitative interviews designed to explore in-depth factors that influence condom use during the first offline sexual encounter. The Information Motivation Behavioral (IMB) skills model was used to further understand the HIV/STI sexual risk behaviors of emerging adults with sex partners they met on DSP compared to those who met partner’s offline.

Results: The findings of this study were that DSP are not associated with greater risks of condomless sex compared to offline meeting venues. The qualitative findings suggest that emerging adults have an attitude that condoms are to be used in new sexual relationships. However, whenever emerging adults do not have condoms available, they are less likely to use a condom. Conclusion: Although the findings of this study suggest that there is no statistical difference in condomless sex by venue, DSPs are an important place for public health messaging about condom use for the prevention of HIV/STIs, and unintended pregnancy. DSPs can help achieve some of the objectives set by Healthy Campus 2020, Healthy People 2020, and the National HIV/AIDS Strategy. In addition to targeting DSPs, it is important to continue sexual health promotion efforts in offline meeting venues.

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