Exploring heterosexual African American college men's definition of risky sex: Implications for sexual health education

Introduction: Avoiding risky sexual practices (unprotected oral, anal or vaginal intercourse) is an important facet of sexual health education. Heterosexually identified African American college men's definitions of sex may influence how they interpret and internalize HIV, STI and pregnancy prevention messages.

Methods: Qualitative interviews were conducted with twenty self-identified heterosexual African American men attending a university in the south. We asked participants to describe what counts or does not count in their definition of sex. Item level and constant comparison analysis techniques were used to compare responses within question and across interviews.

Results: Definitions of sex included anal and vaginal penetration. Most articulated oral sex, sex texting, foreplay, erotic games, masturbation, digital stimulation, and intimate touching as things that did not count as sex. When asked definitions of risky sex most men stated unprotected sex and multiple partners as the main constructs and subsequently most reported low risk for HIV.

Discussion: Although the men in this study have accurate perceptions of risky sex, their definitions seem limited to vaginal and anal intercourse. Subsequently, there appears a wide range of behaviors these men engage in that also increases risk for adverse sexual health outcomes (i.e. STI, pregnancy) that is rarely addressed in current education programs.

Conclusion: Health education for HIV, STI and Pregnancy prevention are not mutually exclusive. For the African American men in this study their definitions of sex are critical to understanding perceptions of risky sex, as well as how they may internalize and interpret prevention messages.