Dissertation Title: Sexual Health Communication as Prevention for Sexual Risk and Associated Outcomes

Student Concentration: Health Promotion and Behavior

Dissertation Chair: Dr. Dennis Reidy

Dissertation Abstract: 

Adolescents and emerging adults are disproportionately afflicted by adverse sexual health outcomes, including sexually transmitted infections (STI), human immunodeficiency virus (HIV), unintended pregnancy, and sexual violence victimization (SVV). The disproportionate rates of sequelae are largely a consequence of the emergence and exploration of dating and romantic relationships. There are demonstrated protective factors associated with engaging in healthy sexual practices, including effective communication about sexual health. Sexual health communication (SHC) also has the potential to be detrimental when done ineffectively, inappropriately, or inaccurately. SHC is vaguely understood and crudely evaluated. The measurement of SHC, and subsequently the scope of its influence, are relatively unclear. Albeit the limited existing research on discussing sexual health with partners generally reveals protective effects. The overarching objective of this research is to present empirical support for the benefits of SHC to refine and improve interventions and prevention programs.

The dissertation comprises three studies that will inform mechanisms of action through which SHC prevents sexual risk and associated outcomes. The studies are progressive in how SHC is to be understood in public health. The first study applies a qualitative methodology to conceptualize SHC practices among emerging adults and examine how unique sources of sex education informed their experiences. Study two builds upon findings from study one and extant literature to develop a novel, comprehensive measure of SHC using a sample of young adults. Finally, study three replicates and validates findings from study two to analyze SHC’s relationship with factors that facilitate and impact SHC.

SHC practices among emerging adults are nuanced. They cited several sources for learning how to discuss sexual health, as well as numerous impediments to effectively communicating with sexual partners about sexual health topics. A multidimensional measure was generated encompassing the many elements of SHC as experienced by emerging adults and established in existing literature. Using this measure, it was determined that a number of determinants influence communication both positively and negatively. With a deepened understanding of SHC, this research provides valuable insights to inform innovative interventions and strategies to encourage healthier sexual behaviors and outcomes.