Sexual Hookups and Adverse Health Outcomes: A Longitudinal Study of First-Year College Women

Abstract

“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.

Acknowledgments

The authors thank Annelise Sullivan for her assistance with data collection and the Center for AIDS Research (P30-AI050409) at Emory University for conducting the STI testing.

Notes

¹Participants who completed all 13 surveys (n = 309) and those who missed one or more surveys (n = 174) were compared on demographic variables, baseline alcohol use, and precollege hookup and romantic sexual behavior, depression, SV, and STIs. The only difference was that those who completed all 13 surveys (M = 0.74) reported fewer precollege SV events than those who missed one or more surveys (M = 1.40), t (265) = 2.43, p = .02.

^a Ranges presented for continuous variables only.

^b Includes only the 334 women who reported having been tested for sexually transmitted infections in their lifetime.

Note. N = 334. B = regression estimate; SE = standard error; AOR = adjusted odds ratio; CI = confidence interval; STI = sexually transmitted infection. Hookup and romantic behavior includes performing oral sex, receiving oral sex, or having vaginal sex with casual and romantic partners, respectively. Precollege STI diagnosis, impulsivity, sensation seeking, and drinks per week were included in the model, but their coefficients were fixed to zero because they were highly nonsignificant (Z < 1) and fixing these coefficients improved the model as measured by the Bayesian information criterion (BIC).

^a Dummy-coded: 0 = no; 1 = yes.

At the time of data collection, Robyn L. Fielder, Kate B. Carey, and Michael P. Carey were with the Center for Health and Behavior, Syracuse University. Robyn L. Fielder is now at the Center for Integrated Healthcare, Syracuse VA Medical Center.