HIV Insight: Sexual Behaviour & Risk of Sexually Transmitted Infections in Young Female Healthcare Students in Spain

Background.

Several authors have examined the risk for sexually transmitted infections (STI), but no study has yet analyzed it solely in relation with sexual behaviour in women. We analyzed the association of sexual behaviour with STI risk in female university students of healthcare sciences.

Methods.

We designed a cross-sectional study assessing over three months vaginal intercourse with a man. The study involved 175 female university students, without a stable partner, studying healthcare sciences in Spain. Main outcome variable: STI risk (not always using male condoms). Secondary variables: sexual behaviour, method of orgasm, desire to increase the frequency of sexual relations, desire to have more variety in sexual relations, frequency of sexual intercourse with the partner, and age. The information was collected with an original questionnaire. A logistic regression model was used to estimate the adjusted odds ratios (ORs) in order to analyze the association between the STI risk and the study variables.

Results.

Of the 175 women, 52 were positive for STI risk (29.7%, 95% CI [22.9–36.5%]). Factors significantly associated with STI risk (p < 0.05) included: orgasm (not having orgasms →OR = 7.01, 95% CI [1.49–33.00]; several methods →OR = 0.77, 95% CI [0.31–1.90]; one single method →OR = 1; p = 0.008) and desiring an increased frequency of sexual activities (OR = 0.27, 95% CI [0.13–0.59], p < 0.001).

Conclusions.

Women’s desire for sexual activities and their sexual function were significant predictors of their risk for STI. Information about sexual function is an intrinsic aspect of sexual behaviour and should be taken into consideration when seeking approaches to reduce risks for STI.

Analysis of STI risk in female university students from Alicante (Spain). 2005–2009 data.

Variable	Total	STI risk	Adj. OR	95% CI	p-value
	175	52(29.7%)
	n(%)∕x ± s	n(%)∕x ± s
Sexual orientation:
Heterosexual	168(96.0)	48(28.6)	N/M	N/M	N/M
Bisexual or other*	7(4.0)	4(57.1)
Method of orgasm:
No orgasm	13(7.4)	9(69.2)	7.01	1.49–33.00	0.008a
Several methods	131(74.9)	32(24.4)	0.77	0.31–1.90
A single method*	31(17.7)	11(35.5)	1
Desire to increase the frequency of sexual relations:
Yes	92(52.6)	18(19.6)	0.27	0.13–0.59	<0.001
No*	83(47.4)	34(41.0)	1
Desire to have more variety in sexual relations:
Yes	60(34.3)	13(21.7)	0.58	0.27–1.26	0.168
No*	115(65.7)	39(33.9)	1
Age (years)	20.8 ± 2.2	20.9 ± 2.0	N/M	N/M	N/M
Frequency of sexual intercourse with the partner	3.8 ± 1.2	4.0 ± 1.4	1.17	0.86–1.60	0.396

Notes.

STI: Sexually transmitted infections
Adj. OR: adjusted odds ratio
CI: Confidence interval
N/M: Not in the model

*Reference.

ap-value for the complete factor. The p-values for the comparison with the reference are: (1) No orgasm: 0.014; (2) Several methods: 0.571. Frequency of sexual intercourse with partner (6 = 5–7 times/week; 5 = 3–4 times/week; 4 = 1–2 times/week; 3 = 2–3 times/month; 2 = once/month; 1 = Never). Goodnessof-fit of the model: (1) likelihood ratio test: X2 = 26.1, p < 0.001; (2) Hosmer-Lemeshow test: X2 = 13.6, p = 0.092.

Below: Predicted probabilities of STI risk in relation to Methods of Orgasm category in female university students from Alicante (Spain). 2005–2009 data

Below: Predicted probabilities of STI risk in relation to Desire to increase the frequency of sexual relationships in female university students from Alicante (Spain). 2005–2009 data