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We examined the associations between sexual hookup behavior and depression, sexual victimization SVand sexually transmitted infections STIs among first-year college women. In this longitudinal study, women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. Covariates included levels of the outcome, alcohol use, impulsivity, sensation-seeking, and romantic sex. Hookup sex, OR 1. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.
Emerging adulthood, the life-stage between adolescence and adulthood ages 18 to 25is replete with important developmental tasks, including identity formation and exploration of romantic and sexual intimacy Arnett, The first year of college marks an important developmental time, as emerging adults transition from more structured social environments i.
The developmental tasks of emerging adulthood coupled with new freedoms and social opportunities facilitate an increase in sexual exploration. Sexual exploration among emerging adults increasingly occurs outside of traditional courtship relationships i. The term hookup lacks a single, universal definition, but there appears to be consensus among young people and scholars that hookups are sexual interactions that occur outside of committed romantic relationships cf.
Hookups involve a wide range of sexual behaviors e. Little is known about the health consequences of hooking up. In the popular press e. However, the evidential basis for these portrayals remains limited Bersamin et al. Therefore, we focused our investigation of the health consequences of hookups on women. However, in several cross-sectional studies Bersamin et al.
Evidence regarding the association between hooking up and sexual victimization SV is more limited. A longitudinal study found that hookup behavior during high school and the first semester of college was a risk factor for SV during the first year of college Testa et al. First, alcohol use and hookup behavior frequently co-occur LaBrie et al. Therefore, when examining the relationship between hooking up and SV, it is important to control for alcohol use.
Taken together, these factors may create risk for SV. Third, hooking up may also increase risk for SV by providing more opportunities to encounter a sexually aggressive partner Franklin, Evidence regarding the association between hooking up and STIs is also limited. In sum, although it is plausible to predict associations between hookups and depression, SV, and STIs among women, there is a paucity of research on these predictions. Most studies of hooking up and mental health have been cross-sectional e. Only one longitudinal study has explored the link between hookups and SV Testa et al.
Moreover, the effect of depression and SV on later hookup behavior has not been investigated. Therefore, the current study was deed to examine the effect of hooking up on depression, SV, and Women seeking real sex Clinton Massachusetts in women. We included several covariates in our study to rule out alternative explanations for the association between hookups and the outcomes.
First, we controlled for romantic sex i. Third, to rule out third-variable explanations related to personality, impulsivity and sensation-seeking were included in all models given their associations with sexual risk taking Charnigo et al. Fourth, when examining SV only, we controlled for sorority membership, which has been identified as a risk factor for SV among college women e.
Fifth, we controlled for demographic characteristics i.
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Lastly, we controlled for prior levels of each outcome to ensure that relationship between hookups and the outcomes were not better explained by prior history of the outcome e. In summary, the purpose of our study was to assess the associations of sexual hookup behavior with depression, SV, and STIs among first-year college women. We focused on penetrative i. We sampled college students because of the prevalence of hooking up among this group Garcia et al.
To improve upon prior research, we recruited a large sample and used frequent measurements and a longitudinal de. To determine whether hooking up poses a unique risk, sexual behavior in the context of romantic relationships was used as a basis of comparison, and to rule out third variable explanations, we controlled for other empirically and theoretically relevant variables, as noted above.
Participants were first-year female undergraduates attending a private university in upstate New York. Exclusion criteria were: under age 18 or over age 25 at baseline women younger than 18 were excluded due to logistical difficulties associated with obtaining parental consent, women older than 25 were excluded due to our focus on emerging adults and scholarship athlete excluded due to National Collegiate Athletic Association restrictions on receiving payments while a student-athlete. We used a longitudinal de with a baseline T1 and 12 monthly follow-ups T2-T Participants indicated how well each item e.
Sensation-seeking was measured at baseline using six items Magid et al. At T7, participants indicated whether they had ed a sorority during the Spring semester. Wave seven was the first survey after sorority rush was completed. Some people call these hookups. Participants who indicated one or more partners or who left the of physical intimacy partners questions blank proceeded to questions about oral and vaginal sex. Rather than asking participants directly about hookups e.
Use of the word hookup was intentionally minimized i. A sexual hookup was operationally defined as oral or vaginal sex with a casual partner; this definition reflects the extant research on partner types, sexual behaviors, and the defining characteristic of a hookup Epstein et al.
This assessment strategy reduced ambiguity in interpretations of questions about hookups. Three items assessed the of oral sex performedoral sex receivedand vaginal sex with casual partners i. A parallel set of three items assessed sexual behavior in the context of romantic relationships, henceforth referred to as romantic behavior.
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At baseline T1participants were asked about their lifetime; at subsequent monthly assessments T2-T13participants were asked about the last month, and anchor dates were provided to facilitate recall. Participants indicated how often they were bothered by each symptom e.
The PHQ-9 scoring algorithm Spitzer et al. Dichotomous variables were created to capture depression at baseline, between T2 and T5, between T6 and T9, and between T10 and T Findings related to depression and hooking up may differ based on use of a continuous versus dichotomous outcome see Mendle et al. With regard to the data reported in the present study, the pattern of findings was similar using a continuous indicator of depressive symptom severity, but we present the findings using the dichotomous indicator of depression viz.
SV was assessed every four months using items adapted by Testa et al.
Due to limited variability in the frequency of SV, which precluded use of count regression analyses, we created dichotomous variables indicating whether participants experienced one or more incidents of SV before entering college, between T2 and T5, between T6 and T9, and between T10 and T We focused on the most severe forms of SV that reflect legal definitions of rape U.
Department of Justice, Compared to a broader definition of SV i. The decision not to include unwanted sexual contact and verbal coercion in the operational definition of SV does not reflect a belief that unwanted sexual contact or verbally coerced SV is in any way acceptable or inconsequential; rather, it reflects our focus on the most severe outcomes at this initial stage of research.
Self-reported STI diagnosis was assessed every four months. Participants were asked if they had been tested for an STI in their lifetime at baseline and since the last assessment at T5, T9, and T13 [anchor dates were provided] ; if so, they were asked if they had been diagnosed with an STI. For the STI outcome, participants were classified as having a new STI based on either a self-reported diagnosis at any of the three follow-ups or a laboratory-confirmed diagnosis at T9.
STIs were assessed by biological testing at the end of the academic year i. All three STIs can be detected accurately using a single self-collected vaginal swab Caliendo et al. Sensitivity and specificity of the three assays was Specimens were obtained using self-collected vaginal swabs, as recommended by the National Institutes of Health Hobbs et al. Vaginal swabs have numerous logistical advantages over urine samples and are more sensitive than urine samples in the detection of CT and Gc, and as sensitive as endocervical swabs Hobbs et al.
Furthermore, because TV primarily affects the vagina, rather than the cervix, vaginal swabs are optimal for its detection. Recruitment began one month before the start of the Fall semester with a mass postal mailing to 1, incoming first-year female students who would be at least 18 years old by the start of the study. International students and scholarship athletes were excluded from the mailing due to uncertain timing of mail delivery to foreign addresses and ineligibility, respectively.
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The mailing comprised a letter introducing our study of health behaviors and relationships and directing interested women to the study website; women who ed up on the website were ed instructions for scheduling an orientation session to learn more.
Three supplemental recruitment strategies were also used to try to reach our desired sample size of campus flyers, word of mouth, and the psychology department participant pool. During their first three weeks on campus, interested students attended a brief orientation session, at which time the study was explained and participants provided written informed consent.
All data were collected online using a secure survey website. Follow-up surveys began at the end of September T2 and continued through the end of August T Surveys were linked over time using unique identification codes, and identifying information was stored separately from survey responses.
At the end of each month, participants were ed an embedded link to a confidential survey site, and they had one week to complete the survey. Surveys were deed to be completed in 10—20 minutes. Participants were invited to provide a specimen for STI testing at the end of the academic year.
Participants were informed they could opt out of testing and still continue with monthly surveys.