Factors affecting condom-use behaviors among female emerging adults in South Korea

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Jungmin Lee (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Ratchneewan Ross

Abstract: Emerging adulthood is a life stage of people between 18 and 25 years and represents a period where people transition from adolescence to adulthood, involving physical, mental, and social changes. In early adulthood, the value system related to sexuality is not fully established, which may increase people’s vulnerability when making subjective judgments or choices regarding their sexual behaviors. Additionally, during this period, they often have their first experience of sexual intercourse and engage in sexual activities. Also, they act in the moment, and their sexual urges are stronger than those of people in other age groups. In South Korea, the number of new STD and HIV infection has continued to increase from 2012 to 2016, especially among people in their 20s. From 2015 to 2017, unprotected sex was the most common route of transmission for new HIV cases among young people. In 2014, the prevalence of gonorrhea, chlamydia, and HIV was highest in people between 19 and 34 years old. Additionally, of all newly diagnosed HIV cases in 2017, 33.7% were in their 20s, and this group accounted for the highest proportion. Strategies to address problems related to STD and HIV transmission depend primarily on prevention. Among various contraceptive methods for those in their 20s, the male condom is used most often. Male condoms are considered to be cost-effective, readily accessible, and 85% effective at preventing STDs and HIV. However, condom use has been found to be very low among young people in South Korea. Previous studies showed that about 50-80% of emerging adults still do not use condoms during sexual intercourse. Based on the literature review, several gaps exist. First, structured sex education tailored to emerging adults is not common in South Korea. Second, there is a limited number of studies examining the components for predicting condom use behaviors among South Korean emerging adults. Third, no study exists that explores the association between gender-driven power dynamics and the decision-making process for condom use in the South Korean context. Therefore, this study aimed to identify predictors of condom use behaviors among female emerging adults in South Korea. This investigation draws on theoretical concepts used in the Theory of Gender and Power (TGP), which includes sexual double standards, sexual assertiveness, and sexual security, and the Theory of Planned Behavior (TPB), which considers attitudes, subjective norms, perceived behavioral control, and barriers (in this case toward condom use). Participants were 170 sexually active, unmarried, heterosexual female college students aged 18–25 years (mean age = 20.97 ± 1.76 years) exclusively in South Korea. A cross-sectional survey was conducted between November 25 and December 5, 2019, using Qualtrics software. Fifteen items were measured on participants’ demographic characteristics, including their sexual experience. Next, sexual double standards were measured using the 10-item, 5-point-Likert Double Standard Scale (DSS). Low scores suggest an open and progressive gender standard and a positive outlook on gender equity. Third, sexual assertiveness was measured using the 18-item, 4-point-Likert Sexual Assertiveness Scale (SAS). Higher scores indicate a high ability to initiate sex if desire, refuse unwanted sexual practice or contact, and negotiate condom use to prevent pregnancies and STDs. Fourth, sexual security was measured using the 5-item, 7-point-Likert Global Measure of Sexual Satisfaction Scale (GMSEX), cross-culturally translated into Korean to measure participants’ overall sexual satisfaction. Higher scores indicate high sexual satisfaction during sexual relationships. Lastly, their sexual risk-taking behavior was measured using the cross-culturally translated Sexual Risk Behavior Belief and Self-efficacy scale (SRBBS) to measure participants’ attitudes, subjective norms, self-efficacy, and barriers toward condom use. Data were analyzed using descriptive statistics for general characteristics, general sex-related information, predictors, and condom-use behaviors; Spearman’s rho was used to determine relationships among predictors. Gamma regression was applied to determine the factors affecting condom use. About half (45.9%) of participants indicated that they always used condoms during sexual intercourse. The sexual double standards score was low (M = 15.62, SD = 4.93), indicating open and progressive gender standards, and a positive outlook on gender equality. Scores for sexual assertiveness (M = 60.79, SD = 4.56), attitude (M = 13.98, SD = 2.26), subjective norms (M = 13.82, SD = 2.44), and barriers toward condom use (M = 6.06, SD = 1.92) were moderate. These results suggest participants’ moderate ability to (a) initiate sex if desired; (b) refuse unwanted sexual practices or contact; (c) negotiate condom use to prevent pregnancy and sexually transmitted diseases; (d) abstain from risky sexual behaviors; and (e) purchase or carry a condom. Lastly, sexual security (M = 27.46, SD = 5.43) and self-efficacy toward condom use scores were high (M = 22.48, SD = 3.08), indicating that participants had high sexual satisfaction during sexual relationships and a strong intention to abstain from risky sexual behaviors. Results showed that sexual double standards and attitudes toward condom use were significantly positively associated with condom-use behaviors among female college students. In particular, attitudes toward condom use was the stronger predictor of condom use behaviors than sexual double standards. A significant implication of this study is the need for new approaches to addressing condom use in female emerging adults in South Korea. Such approaches should be informed by gender dynamics and should have cultural and social relevance for South Korean society. The current findings inform future interventions tailored to the population to promote condom use and thus preventing STDs/HIV, unwanted pregnancies, abortions, and other negative consequences in female emerging adults in South Korea.

Additional Information

Language: English
Date: 2020
Behavior, Condom, Emerging adults, Reproductive health, Sexual, South Korea
Young women $x Sexual behavior $z Korea (South)
Condom use $z Korea (South)

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