Sexual Health Knowledge and Sexual Self-Efficacy as Predictors of Sexual Risk Behaviors in Women

According to the Center for Disease Control (CDC), the proportion of acquired immunodeficiency syndrome (AIDS) diagnoses among women in the United States has more than doubled between 1984 and 2019 and rates of sexually transmitted diseases (STDs) in all individuals increased 30% between 2015 and 2019. Further, the CDC has designated women ages 13 to 44 years as a group vulnerable to human immunodeficiency virus (HIV) and STD infection, in part due to frequency of engaging in sexual risk behaviors. Sexual self-efficacy is associated with decreased sexual risk behaviors and counters norms that emphasize passivity and compliance as traditional sexual behavior in women. In the current study, we assessed knowledge of HIV and STD transmission and risk factors, sexual self-efficacy, and frequency of sexual risk behaviors in 281 woman-identified respondents aged 18–44 years in an online survey. Knowledge of HIV and STDs was low (averages of 63.3% and 49.9%, respectively). Younger women, and women who identified as single, White, and/or LGBTQ+ reported more sexual risk behaviors. HIV knowledge and sexual self-efficacy were independently associated with fewer risk behaviors and significantly interacted to predict sexual risk behaviors. STD knowledge and sexual self-efficacy were independently associated with fewer sexual risk behaviors. These findings highlight the need for comprehensive, widespread, and identity-inclusive sexual health education.