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Heterosexual men's sexual safety behavior is important to controlling the U.S. epidemic of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). While sexual safety is often treated as a single behavior, such as condom use, it can also be conceptualized as resulting from multiple factors. Doing so can help us achieve more nuanced understandings of sexual risk and safety within partner-related contexts. We used latent class analysis with data collected online from 18- to 25-year-old heterosexually active U.S. men (n = 432) to empirically derive a typology of the patterns of sexual safety strategies they employed. Indicators were sexual risk-reduction strategies used in the past year with the most recent female sex partner: condom use, discussing sexual histories, STI testing, agreeing to be monogamous, and discussing birth control. We identified four subgroups: Risk Takers (12%), Condom Reliers (25%), Multistrategists (28%), and Relationship Reliers (35%). Partner-related context factors--number of past-year sex partners, relationship commitment, and sexual concurrency--predicted subgroup membership. Findings support tailoring STI prevention to men's sexual risk-safety subgroups. Interventions should certainly continue to encourage condom use but should also include information on how partner-related context factors and alternate sexual safety strategies can help men reduce risk for themselves and their partners.

Objective: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete., Method: Participants included adolescents (n=145), adult sexually transmitted disease clinic clients (n=167), college students (n=145), and men who have sex with men (n=147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period., Results: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use., Conclusions: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error.

This study compares condom use reported two ways. 251 heterosexual participants (63% female) reported condom use on a prospective daily diary and on a retrospective questionnaire. Proportion of condom use with vaginal sex was calculated from the diary data and contrasted with retrospective categories. Responses were consistent for some participants, especially those who used condoms never or always, but responses from others showed considerable variability. Participants with few sexual encounters were more likely than those with more encounters to use "never" and "every time" endpoints. The results call into question the way participants interpret the meaning of retrospective categories.

Although it is often assumed that drinking alcohol interferes with condom use, most studies on this topic do not meet the conditions required for causal interpretation. We examined the association of drinking to condom use using data from diaries of alcohol use and sexual encounters, collected over 8 weeks from college students and clients of a sexually transmitted disease clinic. This method establishes the temporal relationships between drinking and condom use and controls for individual differences by using a within-subjects analysis. Multilevel models that predicted condom use from alcohol use before the sexual encounter, partner type, and the use of other contraception showed that drinking before sex was unrelated to condom use. These results do not support the persistent notion that alcohol causes people to engage in sexual risk that they would avoid when sober; instead, people tend to follow their usual pattern of condom use, regardless of alcohol use.

Context: Alcohol consumption often has been cited as increasing adolescents' risk of HIV, and several studies have shown positive relationships between drinking and risky sexual behavior among adolescents. Because most of these studies used global measures of drinking and risky sex, and conducted comparisons across persons, they could not determine whether alcohol use was a cause of risky sex or simply a correlate., Methods: A sample of 112 U.S. adolescents completed daily diaries about their health behaviors, including drinking and intercourse, for eight weeks. In analyses using t-tests and hierarchical linear modeling, each respondent's rate of condom use after drinking was compared with his or her rate of use when not drinking, and predictors of condom use were examined, Results: Rates of condom use did not differ significantly between sexual events preceded by drinking (use in 54% of events) and those not preceded by drinking (use in 52% of events). Condoms were more likely to be used during sexual events with casual partners than in those with steady partners, less likely to be used on occasions when other birth control was used and more likely to be used when the sexual encounter was expected. In the multivariate analyses, the odds of condom use were not associated either with whether a teenager had been drinking before sex or with the quantity of alcohol consumed., Conclusions: These findings challenge the widely accepted hypothesis that drinking is a cause of sexual risk-taking. Rather, they underscore the need for interventions to increase teenagers'access to and ability to use condoms.

Is daily data collection of sexual and other health-related behaviors reactive? This question was examined by exploring trends in daily reports of sexual intercourse, condom use, drinking, smoking, and vegetable and fruit consumption over a 2-month period. The trends were examined for evidence of fatigue effects and socially desirable responding. The effects of data collection method and gender were also examined. Results from a hierarchical linear modeling analysis showed a significant trend toward decreased reporting of drinking, smoking, and sexual intercourse, but no significant trends in fruit and vegetable consumption or condom use. These patterns are not consistent with fatigue effects or socially desirable responding. The results are discussed in relation to choosing data collection methods that minimize error. [ABSTRACT FROM AUTHOR]