Graduation Year

2012

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Public Health

Major Professor

Bruce L. Levin

Co-Major Professor

Eric R. Buhi

Keywords

casual sexual partners, college women, committed sexual partners, condom use, positive sexuality, sexual activity discrepancy

Abstract

Sexual health is an important component to overall well-being and quality of life. Yet so much of sexual health research is focused solely on the negative consequences of sexuality, such as unintended pregnancy and transmission of sexually transmitted infections. Recently, the need for a positive, health promotion focused framework for research and understanding sexual health has received attention, including from the World Health Organization and the Centers for Disease Control and Prevention. This transition of public health research and practice from a disease-based framework to a positive, health promotion framework necessitates exploring what factors are associated with positive sexuality and how it is experienced. This study contributed to fulfilling this need.

This study focused on healthy sexuality in young college women. Specifically, this study sought to explore what young women find sexually satisfying in different types of sexual relationships (e.g., casual and committed partners). Next, this study identified variables that are important to the healthy sexuality of young college women, including sexual self-concept, communication with sexual partners, sexual satisfaction, and condom use. Lastly, this study aimed to understand the statistical relationship between these variables.

This was a two-phase mixed methods study. Phase one consisted of thirty face to face individual interviews with college women aged 18-25 years, and took place in the fall semester of 2011 and the spring semester 2012 at a large public urban university located in the southeastern United States. Phase two took place in the spring semester 2012 and consisted of an online quantitative survey measuring sexual self-concept, communication with partners, sexual satisfaction and condom use. Analyses for the quantitative data included bivariate correlations and structural equation modeling.

Qualitative results indicated that these young college women experienced sexual satisfaction with both committed and casual sexual partners, although they identified different reasons why each type of partnership was satisfying. Specifically, the emotional connection and comfort felt with committed relationship partners made sex satisfaction. With more casual or uncommitted partners, these women identified the benefits of maintaining their freedom and not having an obligation to another person. These young women shared their thoughts on how sex could be more satisfying for women and they indicated that communicating sexual desires and needs to partners as one of the most important factors.

The quantitative portion of this study found that sexual self-concept was directly positively associated with communication with sexual partners (B=1.45, 95% CI=1.05 1.84, beta=.72), and directly positively related to sexual satisfaction (B=.49, 95% CI= .70, 2.35, beta=.49). Communication with partners was associated with lower discrepancies between wanted and experienced sexual activities (B=-3.96, 95% CI=-4.96, -2.95,

beta=-.41). For respondents reporting on committed partnerships, communication with partners was directly related to higher sexual satisfaction (B=.74, 95% CI=.17, 1.32, beta=.43). For those reporting on casual sexual partners, communication was related to sexual satisfaction only through lower sexual activity discrepancy scores (B=.07, 95% CI=.01, .13, beta=.04).

Overall the findings from this study suggest that communicating with casual sexual partners impacts sexual satisfaction partially through decreasing the discrepancies between wanted and experienced sexual activities. However, for committed partners, discrepancies were not significantly related to sexual satisfaction, directly or indirectly, although communication was directly associated with sexual satisfaction. This suggests that communication is impacting sexual satisfaction through a different mechanism for committed partners than casual partners.

The significance of this study lies in its contribution to the positive sexuality literature, which is currently still in its infancy. This study has implications for public health practice in the improvement of health promotion/sex education programs. This study identified sexual self-concept and communication between partners as important factors for achieving authentic sexual experiences. The implications of this study for public health research include the identification of variables important to understanding women's experience of positive sexuality. Specifically, this study found sexual self-concept to be important to communication and sexual satisfaction, and identified communication as important for both risk reduction (e.g., condom use) and sexual health promotion (e.g., sexual satisfaction).

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