Coital and Non-coital Sexual Behaviors and Risk Reduction Practices among College Students

Many young people perceive oral and anal sex to be safer than vaginal sex, although any form of sexual contact can transmit sexually transmitted infections (STIs). This study aimed to characterize the prevalence of several risk reduction practices for coital and non-coital behaviors among college students.  In 2011, a cross-sectional study was conducted among 1,047 students attending two public universities in New York State. An anonymous, internet-based survey included questions on risk reduction practices associated with vaginal, anal, and oral sex.  Oral sex was the most commonly reported behavior (75%), followed by vaginal sex (72%), and anal sex (14%).  Ever using a condom to reduce STI risk was much more common for vaginal sex (96%) than oral sex (11%) or anal sex (62%).  Respondents reported greater reliance on ineffective measures for oral sex, such as "choosing partners you know" (75%) and not ejaculating in the mouth (29%) and for anal sex, using artificial lubricant (39%) and not ejaculating in the anus (37%). Significant gender differences in risk reduction practices were noted.  Females were more likely to report using monogamy as risk reduction for all three sexual behaviors and to report using withdrawal, monogamy, and "choosing partners you know" as risk reduction for vaginal sex.  The findings from this study among young adults underscores the need to increase knowledge about STI risks, dispel myths about "safe practices" and  educate on effective risk reduction measures for sexual encounters.