AIDS risk reduction strategies among United States and Swedish heterosexual university students

Abstract

Attitudes toward sex and condoms in the U.S. are more negative and less monolithic than in Sweden. We investigated the possible effect of this on AIDS prevention strategies by comparing women and men who were heterosexual university students in the two countries (Sweden: n = 570; U.S.: n = 407). Using self-administered questionnaires, subjects were asked about their sexual activities, safer sex practices, numbers of partners, and condom use. American students took a more multifaceted approach to safer sex--combining changes in sexual activities, reductions in casual sex, and increased condom use with both steady and nonsteady partners. Swedish students took a more singular approach--consistently using condoms with nonsteady partners. It is suggested that the difference in Swedish practices results from fundamental differences in sexual attitudes between the countries.

PIP: In general, Swedes are more tolerant about sex than are people in the US. Schools in Sweden provide extensive sex education and there is greater openness about sexual matters in family and church. In addition, sex education in Sweden emphasizes mutual responsibility between sex partners and has long promoted the use of condoms. The authors explored the possible effect of these cultural and educational differences upon AIDS prevention strategies by comparing male and female heterosexual university students aged 20-22 years in the 2 countries. 570 students in Sweden and 407 at a large midwestern US university completed self-administered questionnaires on their sexual activities, safer sex practices, number of sex partners, and condom use. 68% of the surveyed US students and 65% of the Swedish students were female. Most Swedish and US students indicated that AIDS had not driven them to have less vaginal intercourse, oral-genital contact, or anal intercourse. Substantial proportions of Swedish and American students used no condom with casual partners, did not try to reduce their number of partners, and continued to have unsafe sex. However, some behavior changes were made by many students in both countries. Of the 4 country/gender groups, US males were at the highest risk, while Swedish men had a low-risk behavior profile. Fewer differences were found between the women. In general in the current context of HIV/AIDS, the US students who changed their sexual activities reduced their engagement in casual sex and used condoms more regularly with both regular and nonregular partners. Swedish students, however, already had high self-masturbation rates and simply always used condoms with nonregular partners.