Sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong

PubMed Central

2013-01-01

Background Little is known about sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong. It is of public health importance to investigate this topic to inform sex education, policymaking, and prevention and intervention programs. Methods Based on the Youth Sexuality Survey conducted by Hong Kong Family Planning Association (FPAHK) in 2011, this study explored the characteristics of sexual knowledge, attitudes, and high-risk sexual behaviors among 1,126 unmarried youth aged 18 to 27 years. Multiple logistic regressions were performed to examine factors associated with unmarried youth’s premarital sex, casual relationships, multiple sex partners, and premarital pregnancy. Results Unmarried youth in Hong Kong had adequate sex knowledge, but contraceptive knowledge was deficient. The majority of unmarried youth (63.8%) held liberal attitudes toward premarital sex and about half held liberal attitudes toward any form of sexual activity and premarital pregnancy. Around 60% held conservative attitudes toward causal sex relationships and multiple sex partners. Males tended to hold more liberal attitudes toward high-risk sex behaviors than female youth. Approximately 41.5% of unmarried youth reported having engaged in premarital sex, whereas less than 10% engaged in high-risk sexual behaviors. Males also reported higher amounts of premarital sex, casual sex relationships, and multiple sex partners. Females reported higher levels of sexual coercion. Logistic regressions indicated that being older, coming from a divorced family, out of school status and liberal attitudes toward risky sex behavior were more likely to engage in premarital sex or high-risk sex behaviors, and being female, being better educated and being immigrants were less likely to engage in premarital sex. However, being immigrants was more likely to engage in casual relationship and to have multiple partners. Conclusions Premarital sex is becoming more prevalent among unmarried youth in Hong Kong, and a small proportion of young adults are engaging in high-risk sexual behaviors. Sex education and HIV prevention programs should equip them with adequate knowledge on contraception and condom use. Intervention programs can start with their attitudes toward sex. PMID:23895326

Sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong.

PubMed

Yip, Paul S F; Zhang, Huiping; Lam, Tai-Hing; Lam, Kwok Fai; Lee, Antoinette Marie; Chan, John; Fan, Susan

2013-07-29

Little is known about sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong. It is of public health importance to investigate this topic to inform sex education, policymaking, and prevention and intervention programs. Based on the Youth Sexuality Survey conducted by Hong Kong Family Planning Association (FPAHK) in 2011, this study explored the characteristics of sexual knowledge, attitudes, and high-risk sexual behaviors among 1,126 unmarried youth aged 18 to 27 years. Multiple logistic regressions were performed to examine factors associated with unmarried youth's premarital sex, casual relationships, multiple sex partners, and premarital pregnancy. Unmarried youth in Hong Kong had adequate sex knowledge, but contraceptive knowledge was deficient. The majority of unmarried youth (63.8%) held liberal attitudes toward premarital sex and about half held liberal attitudes toward any form of sexual activity and premarital pregnancy. Around 60% held conservative attitudes toward causal sex relationships and multiple sex partners. Males tended to hold more liberal attitudes toward high-risk sex behaviors than female youth. Approximately 41.5% of unmarried youth reported having engaged in premarital sex, whereas less than 10% engaged in high-risk sexual behaviors. Males also reported higher amounts of premarital sex, casual sex relationships, and multiple sex partners. Females reported higher levels of sexual coercion. Logistic regressions indicated that being older, coming from a divorced family, out of school status and liberal attitudes toward risky sex behavior were more likely to engage in premarital sex or high-risk sex behaviors, and being female, being better educated and being immigrants were less likely to engage in premarital sex. However, being immigrants was more likely to engage in casual relationship and to have multiple partners. Premarital sex is becoming more prevalent among unmarried youth in Hong Kong, and a small proportion of young adults are engaging in high-risk sexual behaviors. Sex education and HIV prevention programs should equip them with adequate knowledge on contraception and condom use. Intervention programs can start with their attitudes toward sex.

Anal intercourse without condoms among HIV-positive men who have sex with men recruited from a sexual networking web site, United States.

PubMed

Margolis, Andrew D; Joseph, Heather; Hirshfield, Sabina; Chiasson, Mary Ann; Belcher, Lisa; Purcell, David W

2014-12-01

The changing landscape of HIV prevention in the United States underscores the need to improve our ability to efficiently reach HIV-positive men who have sex with men (MSM) who engage in behaviors that could transmit HIV. We examined the prevalence of anal intercourse (AI) without condoms with HIV-negative or unknown serostatus partners ("at-risk partners") among 1319 HIV-positive adult male members of a sexual networking Web site for MSM. Sexual behaviors and substance use were measured over a 60-day recall period. Logistic regression was used to identify correlates of insertive and receptive AI without condoms with at-risk partners. Approximately 25% of the men had been diagnosed as having HIV 12 months or less before study enrollment. Overall, 32% of men engaged in AI without condoms with at-risk partners. Multiple logistic regression identified behavioral predictors of insertive AI without condoms with at-risk partners, including HIV diagnosis within the last 12 months, sex with multiple male partners, substance use in conjunction with sex, and use of phosphodiesterase type 5 inhibitors. Receptive AI without condoms with at-risk partners was associated with younger age (19-24 years), residing outside metropolitan cities, substance use in conjunction with sex, and having multiple male partners. High levels of sexual risk were found among these MSM. Increased Internet-based HIV prevention marketing efforts and prevention strategies should be considered to efficiently reach HIV-positive MSM who engage in serodiscordant AI without condoms.

Intensive sex partying amongst gay men in Sydney.

PubMed

Hurley, Michael; Prestage, Garrett

2009-08-01

Intensive sex partying is a framework developed to analyse specific frequent behaviours amongst a small minority of gay men in Sydney, Australia. The behaviours included a higher frequency of dance party attendance, more frequent sex, more anal sex, multiple sex partners, more unprotected anal intercourse with casual partners and more frequent drug taking. These occur at a contextual intersection between a sub-group of sexually adventurous gay men and 'party boys'. The men appear to be involved in both high-risk, adventurous sex practices and a specific form of partying distinguishable from dance partying and 'clubbing'. Sex partying occurs on multiple sites (domestic spaces; within dance parties; sex parties; sex-on-premises venues) and appears to be geared to the maximisation of sexual pleasure. Intensive sex partying describes this coincidence of factors and locates them in relation to the multiple pleasures offered by sex partying. It emphasises the importance of 'intensity' in order to understand better the relations between sex, drug use, pleasure, care and risk in some gay men's lives.

Prevalence and correlates of non-disclosure of HIV serostatus to sex partners among HIV-infected female sex workers and HIV-infected male clients of female sex workers in India.

PubMed

Saggurti, Niranjan; Raj, Anita; Mahapatra, Bidhubhusan; Cheng, Debbie M; Coleman, Sharon; Bridden, Carly; Battala, Madhusudana; Silverman, Jay G; Pardeshi, Manoj H; Samet, Jeffrey H

2013-01-01

This study examines non-disclosure of HIV serostatus to sex partners among HIV-infected adults involved with transactional sex in Mumbai, India. Surveys were conducted with HIV-infected female sex workers (n = 211) and infected male clients (n = 205) regarding HIV knowledge, awareness of sex partners' HIV serostatus, alcohol use, transactional sex involvement post-HIV diagnosis and non-disclosure of HIV serostatus. Gender-stratified multiple logistic regression models were used for analysis. Non-disclosure of one's serostatus to all sex partners was reported by almost three-fifths of females and two-fifths of males. Predictors of non-disclosure included lack of correct knowledge about HIV and no knowledge of sex partners' HIV serostatus. Among females, recent alcohol consumption also predicted non-disclosure. Among males, 10 + paid sexual partners in the year following HIV diagnosis predicted non-disclosure. Secondary HIV prevention efforts in India require greater focus on HIV disclosure communication and integrated alcohol and sexual risk reduction.

Similarities and Differences in Sexual Risk Behaviors Between Young Black MSM Who do and do Not Have Sex with Females

PubMed Central

Crosby, Richard A.; Mena, Leandro; Geter, Angelica; Hickson, DeMarc

2015-01-01

Objective To determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. Methods YBMSM (N=400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Results Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P=.01), unprotected fellatio (P=.04), multiple partners as a bottom (P<.02), any unprotected anal sex as a bottom (P<.013), and any anal sex (P=.007). They were equally likely to report favorable attitudes toward serosorting (P=.80), multiple male partners as a top (P=.20), unprotected anal insertive sex with males (P=.15). Frequency of sex with males as a top (P=.61) or bottom (P=.61) did not differ. Conclusion Compared to YBMSM not having sex with females, those having sex with females may be exercising greater caution. PMID:26547716

Factors Associated with Alcohol Use Before or During Sex Among Men Who Have Sex with Men in a Large Internet Sample from Asia.

PubMed

Yang, Cui; Guadamuz, Thomas E; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2016-04-01

We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions.

Unprotected Sex of Homeless Youth: Results from a Multilevel Analysis of Individual, Social Network, and Relationship Factors

PubMed Central

Kennedy, David P.; Tucker, Joan S.; Green, Harold D.; Golinelli, Daniela; Ewing, Brett

2012-01-01

Homeless youth have elevated risk of HIV through sexual behavior. This project investigates the multiple levels of influence on unprotected sex among homeless youth, including social network, individual, and partner level influences. Findings are based on analyses of an exploratory, semi-structured interview (n=40) and a structured personal network interview (n=240) with randomly selected homeless youth in Los Angeles. Previous social network studies of risky sex by homeless youth have collected limited social network data from non-random samples and have not distinguished sex partner influences from other network influences. The present analyses have identified significant associations with unprotected sex at multiple levels, including individual, partner, and, to a lesser extent, the social network. Analyses also distinguished between youth who wished they used condoms after having unprotected sex and youth who did not regret having unprotected sex. Implications for social network based HIV risk interventions with homeless youth are discussed. PMID:22610421

High-Risk Behaviors Among Men Who Have Sex With Men in 6 US Cities: Baseline Data From the EXPLORE Study

PubMed Central

Koblin, Beryl A.; Chesney, Margaret A.; Husnik, Marla J.; Bozeman, Sam; Celum, Connie L.; Buchbinder, Susan; Mayer, Kenneth; McKirnan, David; Judson, Franklyn N.; Huang, Yijian; Coates, Thomas J.

2003-01-01

Objectives. We describe the prevalence of risk behaviors at baseline among men who have sex with men (MSM) who were enrolled in a randomized behavioral intervention trial conducted in 6 US cities. Methods. Data analyses involved MSM who were negative for HIV antibodies and who reported having engaged in anal sex with 1 or more partners in the previous year. Results. Among 4295 men, 48.0% and 54.9%, respectively, reported unprotected receptive and insertive anal sex in the previous 6 months. Unprotected sex was significantly more likely with 1 primary partner or multiple partners than with 1 nonprimary partner. Drug and alcohol use were significantly associated with unprotected anal sex. Conclusions. Our findings support the continued need for effective intervention strategies for MSM that address relationship status, serostatus of partners, and drug and alcohol use. PMID:12773357

Sexual behavior and condom use among male students in Dar-Es-Salaam, Tanzania with emphasis on contact with barmaids.

PubMed

Maswanya, Edward S; Moji, Kazuhiko; Yamamoto, Taro; Aoyagi, Kiyoshi; Yahata, Yuichiro; Takemoto, Tai-Ichiro

2012-03-01

The objective of this quantitative study was to identifying factors that influence young men to participate in risky sexual behavior that place them at risk of HIV infection, as young people are at higher risk for HIV infection than adults. A cross-sectional study design that employed face-to-face interview questionnaire to identify socio-demographic characteristics, sexual behavior, knowledge of HIV, STD, attitudes towards condoms was administered to 175 sexually active male students between 17 and 24 years old in college settings of Dar-es-Salaam city, Tanzania. In the previous 12 months, 80% of students had at least one steady sex partner (girlfriend), 71% had sex with a barmaid, 33% had sex with a casual partner and 83% had multiple sex partners. Condoms had been used at some time by 83% of students, and in the latest sexual encounter by 56%. However, only 37%, 22%, and 11% consistently used condoms during sex with girlfriends, casual partners and barmaids, respectively. Condom use was least popular during sex with barmaids, and 94% and 91% of students had experienced oral and anal sex with barmaids, respectively. STD infection was reported by 42% of students. Sex with barmaids was associated with alcohol and illicit drug intake, sex under their respective influences, and STD infection. Despite the high prevalence of these risky behaviors, 64% of students replied that they were at low or no risk of HIV infection. Our findings suggest that HIV prevention programs for male students should emphasize risks associated with multiple sexual partners, and sex with barmaids and casual partners, to increase the risk perception of HIV/AIDS. Condom use needs to be promoted.

Prevalence of consistent condom use with various types of sex partners and associated factors among money boys in Changsha, China.

PubMed

Wang, Lian-Hong; Yan, Jin; Yang, Guo-Li; Long, Shuo; Yu, Yong; Wu, Xi-Lin

2015-04-01

Money boys with inconsistent condom use (less than 100% of the time) are at high risk of infection by human immunodeficiency virus (HIV) or sexually transmitted infection (STI), but relatively little research has examined their risk behaviors. We investigated the prevalence of consistent condom use (100% of the time) and associated factors among money boys. A cross-sectional study using a structured questionnaire was conducted among money boys in Changsha, China, between July 2012 and January 2013. Independent variables included socio-demographic data, substance abuse history, work characteristics, and self-reported HIV and STI history. Dependent variables included the consistent condom use with different types of sex partners. Among the participants, 82.4% used condoms consistently with male clients, 80.2% with male sex partners, and 77.1% with female sex partners in the past 3 months. A multiple stepwise logistic regression model identified four statistically significant factors associated with lower likelihoods of consistent condom use with male clients: age group, substance abuse, lack of an "employment" arrangement, and having no HIV test within the prior 6 months. In a similar model, only one factor associated significantly with lower likelihoods of consistent condom use with male sex partners was identified in multiple stepwise logistic regression analyses: having no HIV test within the prior six months. As for female sex partners, two significant variables were statistically significant in the multiple stepwise logistic regression analysis: having no HIV test within the prior 6 months and having STI history. Interventions which are linked with more realistic and acceptable HIV prevention methods are greatly warranted and should increase risk awareness and the behavior of consistent condom use in both commercial and personal relationship. © 2015 International Society for Sexual Medicine.

Partner violence, power and gender differences in South African adolescents’ HIV/STI behaviors

PubMed Central

TEITELMAN, Anne M.; JEMMOTT, John B.; BELLAMY, Scarlett L.; ICARD, Larry D.; O'LEARY, Ann; HEEREN, G. Anita; NGWANE, Zolani; RATCLIFFE, Sarah J.

2016-01-01

Objectives Low relationship power and victimization by intimate partner violence (IPV) have been linked to HIV risks among adult females and adolescent girls. This article examines associations of IPV and relationship power with sexual-risk behaviors and whether the associations differ by gender among South African adolescents. Methods Sexual-risk behaviors (multiple partners in past 3 months; condom use at last sex), IPV, and relationship power were collected from 786 sexually experienced adolescents (mean age = 16.9) in Eastern Cape Province, South Africa during the 54-month follow-up of a HIV/STI risk-reduction intervention trial. Logistic regression examined associations of sexual-risk behaviors with IPV and relationship power and whether the associations differed by gender. Results Adolescent boys were less likely to report condom use at last sex (p=.001) and more likely to report multiple partners (p< .001). A Gender x IPV interaction (p=.002) revealed that as IPV victimization increased, self-reported condom use at last sex decreased among girls, but increased among boys. A Gender x Relationship Power interaction (p=.004) indicated that as relationship power increased, self-reported condom use at last sex increased among girls, but decreased among boys. A Gender x IPV interaction (p=.004) indicated that as IPV victimization increased, self-reports of having multiple partners increased among boys, but not among girls. As relationship power increased, self-reports of having multiple partners decreased irrespective of gender. Conclusions HIV risk-reduction interventions and policies should address gender differences in sexual-risk consequences of IPV and relationship power among adolescents and promote gender equity. PMID:27111184

Partner violence, power, and gender differences in South African adolescents' HIV/sexually transmitted infections risk behaviors.

PubMed

Teitelman, Anne M; Jemmott, John B; Bellamy, Scarlett L; Icard, Larry D; O'Leary, Ann; Heeren, G Anita; Ngwane, Zolani; Ratcliffe, Sarah J

2016-07-01

Low relationship power and victimization by intimate partner violence (IPV) have been linked to HIV risks among adult and adolescent women. This article examines associations of IPV and relationship power with sexual-risk behaviors and whether the associations differ by gender among South African adolescents. Sexual-risk behaviors (multiple partners in past 3 months; condom use at last sex), IPV, and relationship power were collected from 786 sexually experienced adolescents (mean age = 16.9) in Eastern Cape Province, South Africa, during the 54-month follow-up of a HIV/sexually transmitted infection (STI) risk-reduction intervention trial. The data were analyzed with logistic regression models. Adolescent boys were less likely to report condom use at last sex (p = .001) and more likely to report multiple partners (p < .001). A Gender × IPV interaction (p = .002) revealed that as IPV victimization increased, self-reported condom use at last sex decreased among girls, but increased among boys. A Gender × Relationship Power interaction (p = .004) indicated that as relationship power increased, self-reported condom use at last sex increased among girls, but decreased among boys. A Gender × IPV interaction (p = .004) indicated that as IPV victimization increased, self-reports of having multiple partners increased among boys, but not among girls. As relationship power increased, self-reports of having multiple partners decreased irrespective of gender. HIV risk-reduction interventions and policies should address gender differences in sexual-risk consequences of IPV and relationship power among adolescents and promote gender equity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Involvement in Specific HIV Risk Practices among Men Who Use the Internet to Find Male Partners for Unprotected Sex

PubMed Central

2013-01-01

Purpose. Men who have sex with other men (MSM) account for more than one-half of all new HIV infections in the USA. This study reports on the prevalence of a variety of HIV risk behaviors in one specific subpopulation of risk-seeking MSM. Methods. The study was based on a national sample of 332 MSM who use the Internet to find partners for unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Results. Unprotected oral and anal sex was commonplace among study participants. Men engaged in a large number of other risky behaviors as well, including having had multiple recent sex partners (mean number = 11), simultaneous double-penile penetration of the anus (16%), eating semen out of another man's anus (17%), engaging in multiple-partner sexual encounters (47%), engaging in anonymous sex (51%), and having sex while “under the influence” (52%). Conclusions. HIV intervention and prevention programs need to address numerous behaviors that place MSM at risk for contracting/transmitting HIV. Merely focusing on unprotected anal sex does a disservice to members of this community, who typically engage in many types of behavioral risks, each of which requires addressing if HIV transmission rates are to be reduced. PMID:24826369

Unprotected sex of homeless youth: results from a multilevel dyadic analysis of individual, social network, and relationship factors.

PubMed

Kennedy, David P; Tucker, Joan S; Green, Harold D; Golinelli, Daniela; Ewing, Brett

2012-10-01

Homeless youth have elevated risk of HIV through sexual behavior. This project investigates the multiple levels of influence on unprotected sex among homeless youth, including social network, individual, and partner level influences. Findings are based on analyses of an exploratory, semi-structured interview (n = 40) and a structured personal network interview (n = 240) with randomly selected homeless youth in Los Angeles. Previous social network studies of risky sex by homeless youth have collected limited social network data from non-random samples and have not distinguished sex partner influences from other network influences. The present analyses have identified significant associations with unprotected sex at multiple levels, including individual, partner, and, to a lesser extent, the social network. Analyses also distinguished between youth who did or did not want to use condoms when they had unprotected sex. Implications for social network based HIV risk interventions with homeless youth are discussed.

Factors Associated with Alcohol Use Before or During Sex Among Men Who Have Sex with Men in a Large Internet Sample from Asia

PubMed Central

Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2016-01-01

Abstract We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions. PMID:26789393

Similarities and Differences in Sexual Risk Behaviors Between Young Black MSM Who Do and Do Not Have Sex with Females.

PubMed

Crosby, Richard A; Mena, Leandro; Geter, Angelica; Hickson, DeMarc

2016-04-01

The objective of this study is to determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. YBMSM (N = 400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P = .01), unprotected fellatio (P = .04), multiple partners as a bottom (P < .02), any unprotected anal sex as a bottom (P < .013), and any anal sex (P = .007). They were equally likely to report favorable attitudes toward serosorting (P = .80), multiple male partners as a top (P = .20), unprotected anal insertive sex with males (P = .15). Frequency of sex with males as a top (P = .61) or bottom (P = .61) did not differ. Compared to YBMSM not having sex with females, those having sex with females may be exercising greater caution.

The association between smartphone dating applications and college students' casual sex encounters and condom use.

PubMed

Choi, Edmond P H; Wong, Janet Y H; Lo, Herman H M; Wong, Wendy; Chio, Jasmine H M; Fong, Daniel Y T

2016-10-01

This study aims to explore the association between using smartphone dating applications (apps) and having unprotected sex with a casual sex partner. This is a cross-sectional study. Students were recruited from four university campuses in Hong Kong by convenience sampling. Subjects completed a structured questionnaire asking about the use of dating apps, sexual history and socio-demographic information. Multiple logistic regressions were used to explore the association between using dating apps and having unprotected sex with a casual sex partner. Six hundred and sixty-six subjects were included in the analysis. Users of dating apps were more likely to have had unprotected sex with a casual sex partner the last time they engaged in sexual intercourse (aOR: 10.06). Using dating apps for more than 12 months was associated with having a casual sex partner in the last sexual intercourse (aOR: 3.21), as well as having unprotected sex with that casual partner (aOR: 13.56). We found a robust association between using dating apps and having unprotected sex with a casual sex partner, implying that using dating apps is an emerging sexual risk factor. We recommend that interventions promoting the safe use of dating apps should be implemented. Copyright © 2016 Elsevier B.V. All rights reserved.

A Population-Based Study on Alcohol and High-Risk Sexual Behaviors in Botswana

PubMed Central

Weiser, Sheri D; Leiter, Karen; Heisler, Michele; McFarland, Willi; Korte, Fiona Percy-de; DeMonner, Sonya M; Tlou, Sheila; Phaladze, Nthabiseng; Iacopino, Vincent; Bangsberg, David R

2006-01-01

Background In Botswana, an estimated 24% of adults ages 15–49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors. Methods and Findings We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men) as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking) and several risky sex outcomes including: (a) having unprotected sex with a nonmonogamous partner; (b) having multiple sexual partners; and (c) paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap ≥10 y), higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32), multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87), and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37). Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28), multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07), and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18). A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers. Conclusions Alcohol use is associated with multiple risks for HIV transmission among both men and women. The findings of this study underscore the need to integrate alcohol abuse and HIV prevention efforts in Botswana and elsewhere. PMID:17032060

Individual, partner, and partnership level correlates of anal sex among youth in Baltimore City.

PubMed

Hebert, Luciana E; Lilleston, Pamela S; Jennings, Jacky M; Sherman, Susan G

2015-04-01

Anal sex is an efficient mode of STI transmission and studies indicate that anal sex is common among heterosexuals, including adolescents. We examined the association between individual, partner, and sexual partnership-level characteristics with anal sex among a household survey of 263 individuals aged 15-24 years in Baltimore City, Maryland. We used weighted multiple logistic regression to examine correlates of anal sex in a heterosexual partnership by gender. Twenty-nine percent of males and 15% of females reported anal sex in a partnership in the past 6 months. For males, anal sex was associated with having two or more partners in the past 3 months (AOR = 13.93, 95% CI 3.87-50.12), having been tested for HIV (AOR = 0.30, 95% CI 0.12-0.72), and oral sex with a partner (AOR = 8.79, 95% CI 1.94-39.78). For females, anal sex was associated with reporting having a main partner (AOR = 6.74, 95% CI 1.74-23.65), partner meeting place (AOR = 3.03, 95% CI 1.04-8.82), partner history of STI (AOR = 0.20, 95% CI 0.05-0.85), and oral sex with a partner (AOR = 8.47, 95% CI 1.08-66.25). Anal sex was associated with inconsistent condom use for both males (OR = 5.77, 95% CI 1.68-19.79) and females (OR = 5.16, 95% CI 1.46-18.30). We conclude that anal sex is a prevalent risk behavior among heterosexual youth and is associated with a range of factors at the individual and partnership levels. These findings provide support for comprehensive sex education that includes information about anal sex; findings from this study can inform public health campaigns targeting youth at risk for STIs.

Prevalence and Correlates of Non-Disclosure of HIV Serostatus to Sex partners among HIV-Infected Female Sex Workers and HIV-infected Male Clients of Female Sex Workers in India

PubMed Central

Raj, Anita; Mahapatra, Bidhubhusan; Cheng, Debbie M.; Coleman, Sharon; Bridden, Carly; Battala, Madhusudana; Silverman, Jay G.; Pardeshi, Manoj H.; Samet, Jeffrey H.

2013-01-01

This study examines non-disclosure of HIV serostatus to sex partners among HIV-infected adults involved with transactional sex in Mumbai, India. Surveys were conducted with HIV-infected female sex workers (n = 211) and infected male clients (n = 205) regarding HIV knowledge, awareness of sex partners’ HIV serostatus, alcohol use, transactional sex involvement post-HIV diagnosis and non-disclosure of HIV serostatus. Gender-stratified multiple logistic regression models were used for analysis. Non-disclosure of one’s serostatus to all sex partners was reported by almost three-fifths of females and two-fifths of males. Predictors of non-disclosure included lack of correct knowledge about HIV and no knowledge of sex partners’ HIV serostatus. Among females, recent alcohol consumption also predicted non-disclosure. Among males, 10 + paid sexual partners in the year following HIV diagnosis predicted non-disclosure. Secondary HIV prevention efforts in India require greater focus on HIV disclosure communication and integrated alcohol and sexual risk reduction. PMID:22810892

Recreational drug use and risks of HIV and sexually transmitted infections among Chinese men who have sex with men: Mediation through multiple sexual partnerships.

PubMed

Xu, Jun-Jie; Zhang, Chen; Hu, Qing-Hai; Chu, Zhen-Xing; Zhang, Jing; Li, Yong-Ze; Lu, Lin; Wang, Zhe; Fu, Ji-Hua; Chen, Xi; Yan, Hong-Jing; Zhuang, Ming-Hua; Jiang, Yong-Jun; Geng, Wen-Qing; Vermund, Sten H; Shang, Hong; Qian, Han-Zhu

2014-12-02

Recreational drug use (RDU) may result in sexual disinhibition and higher risk for HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in China. We assessed whether RDU was associated with HIV, syphilis, and herpes simplex virus type 2 (HSV-2) within the context of multiple sexual partnerships and unprotected sex. We conducted a cross-sectional study among sexually-active MSM in six Chinese cities (Kunming, Jinan, Changsha, Zhengzhou, Nanjing, and Shanghai) in 2012-2013. We interviewed participants regarding RDU and sexual activity and drew blood for HIV, syphilis, and HSV-2. We fit multiple logistic regression models to assess associations of drug use and HIV, syphilis and HSV-2 infections, controlling for number of sexual partners and unprotected sex. Of 3830 participants, 28% reported ever using ≥1 of these drugs in the past 6 months: popper (alkyl nitrites), ecstasy, ice (methamphetamine), amphetamine, tramadol, and ketamine. In the past six months, 62% of MSM reported ≥2 sexual partners and 76% did not use condoms at last sexual encounter. HIV, syphilis and HSV-2 prevalences were 9.2%, 12.2%, and 10.3%, respectively.RDU was associated with HIV infection (aOR = 1.67; 95% CI, 1.31-2.13). Men with RDU were more likely to report multiple sexual partners (OR = 1.69; 95% CI, 1.44-1.98) and unprotected sex (aOR = 1.25; 95% CI, 1.05-1.49). The RDU-HIV association persisted (aOR = 1.58; 95% CI = 1.23-2.02) after adjusting for numbers of partners. RDU was associated with multiple sexual partnerships, unprotected sex, and HIV among Chinese MSM. It is plausible that RDU is a driver of increased sexual/HIV risk and/or may be an associated behavior with sexually risky lifestyles. Community engagement is needed.

Randomized trial of supplementary interviewing techniques to enhance recall of sexual partners in contact interviews.

PubMed

Brewer, Devon D; Potterat, John J; Muth, Stephen Q; Malone, Patricia Z; Montoya, Pamela; Green, David L; Rogers, Helen L; Cox, Patricia A

2005-03-01

People with multiple sex partners tend to forget a significant proportion when recalling them. Randomized trial of supplementary interviewing techniques during routine partner notification contact interviews for chlamydia, gonorrhea, and syphilis in Colorado Springs, CO. Cases with multiple sex partners in the last 3 months (n = 123) participated. Interviewers prompted nonspecifically and read back the list of elicited partners after cases recalled partners on their own. We then randomly assigned cases to receive 1 of 3 sets of recall cues: (1) an experimental set of cues consisting of locations where people meet partners, role relationships, network ties, and first letters of names; (2) another experimental set including common first names; and (3) control cues referring to individual characteristics (e.g., physical appearance). Nonspecific prompting and reading back the list each increased the number of additional partners elicited and located by 3% to 5% on average. On average, the combined location/role/letter/network cues elicited more additional partners (0.57) than did the first-name (0.29) and individual characteristics (0.28) cues. The location and first-name cues were the most effective in eliciting located partners. The supplementary techniques increased the number of new cases found by 12% and, importantly, identified branches of the sexual network that would not otherwise have been discovered. Elicitation of sex partners can be enhanced in contact interviews with simple interviewing techniques, resulting in improved network ascertainment and sexually transmitted disease case finding.

Urban Adolescent Girls’ Perspectives on Multiple Partners in the Context of the Sexual Double Standard and Intimate Partner Violence

PubMed Central

Teitelman, Anne M.; Tennille, Julie; Bohinski, Julia; Jemmott, Loretta S.; Jemmott, John B.

2013-01-01

This article describes the influence of abusive and non-abusive relationship dynamics on the number of sex partners among urban adolescent girls. Focus groups were conducted with 64 sexually active adolescent girls ages 14 to 17 years. General coding and content analyses identified patterns, themes, and salient beliefs. More than one third (37.5%) reported having experienced physical, intimate partner violence; 32.8% had 2 or more recent sex partners, and 37.5% had ever had a sexually transmitted infection (STI) or HIV. Although some girls in abusive relationships feared retribution if they had more than one partner, others sought additional partners for solace or as an act of resistance. Adolescent HIV/STI prevention programs need to address the influence of gender norms such as the sexual double standard as well as partner pressure and partner abuse on adolescent decision-making about safer sex, and also promote healthy relationships as integral to advancing HIV/STI risk reduction. PMID:23790274

Attitudes to sex and sexual behaviour in rural Matabeleland, Zimbabwe.

PubMed

Vos, T

1994-01-01

Though HIV prevention campaigns in Zimbabwe have increased public awareness of HIV, they have not meaningfully changed sexual behaviour. Possibly these campaigns are based on wrong assumptions about sexual behaviour. By means of 111 structured interviews with hospital patients, secondary school students and teachers, and 11 focus group discussions with traditional healers, midwives, village community workers, secondary school students and teachers, and commercial sex workers in a rural district of Matabeleland in Zimbabwe, this low-budget study explores attitudes towards sex and sexual behaviour in order to define more appropriate health education messages. Results indicate that traditional sex education no longer takes place and that communication between sexual partners is limited. The almost ubiquitous expectation of women to get rewards for sex outside marriage motivates mostly single women out of economic necessity to meet the male demand for sexual partners, which is created by large scale migrant labour and men's professed 'biological' need for multiple partners. Types of sexual behaviour other than penetrative vaginal sex are uncommon and considered deviant. Safe sex messages from the West therefore are inappropriate in the Zimbabwean context. Recommendations are given to restore traditional communication about sexual matters across generations and to urge sexual partners to discuss sex. Women who, for economic reasons, engage in casual sex should at least learn to negotiate the use of condoms. Men seriously need to reconsider their attitudes to sex and sexual practices in view of the high HIV sero-prevalence. Faithfulness, rather than multiple sexual contacts, should become a reason to boast.

Coverage of HIV prevention components among people with long-standing diagnosed HIV infection in El Salvador.

PubMed

Jacobson, Jerry O; Creswell, Jacob; Guardado, Maria Elena; Lee, Janet C; Isabel Nieto, Ana; Paz-Bailey, Gabriela

2012-09-01

There is scarce information on prevention coverage and management of sexually transmitted infections (STIs) in people with HIV in resource-limited settings. Six hundred eighty nine sexually active people diagnosed with HIV ≥12 months before the study, including 110 men who have sex with men, 237 heterosexual men, and 342 women, were recruited from HIV support groups and hospitals in El Salvador and completed self-administered computer-assisted questionnaires and STI testing. Logistic models identified correlates of exposure to posttest counseling (POC) and subsequent prevention interventions (PIs). Past-year transmission risk factors included unprotected sex with noncommercial partners (28.7%), having multiple sex partners (76.4%), a casual sex partner (31.4%), selling (3.5%) and purchasing sex (6.4%), herpes simplex virus type 2 (86.3%), and treatable STIs (18.6%). Men who have sex with men reported more recent casual partners, sex work, and alcohol and drug use than other subgroups. POC (22.8%), PIs (31.3%), and access to advice and information regarding HIV at the point of HIV care (24.1%) were limited. Of subjects with past-year STI symptoms (N = 267), 44.1% had sought medical attention. In multivariate analysis, POC was negatively associated with multiple partners. PI was associated with self-initiated testing, treatable STIs, and female sex. Both outcomes were associated with HIV-related discrimination outside of the health services context. Coverage of POC, PIs, and treatment-seeking for STI symptoms was low among individuals with diagnosed HIV infection, although most were in regular contact with care and treatment. Prevention programs at testing and treatment sites should be intensified and should incorporate risk behavior screening to improve targeting.

Recollections of sexual socialisation among marginalised heterosexual black men

PubMed Central

Dunlap, Eloise; Benoit, Ellen; Graves, Jennifer L.

2013-01-01

This paper describes the sexual socialisation process of marginalised, drug-using heterosexual black men, focusing primarily on the sources and content of sexual information. Analysing qualitative interview data, we discovered that the men in our sample both learn about sex and become sexually active at an early age. They most often learn about sex from the media and least often learn about sex from family members. The content of sexual information varies in specifics, but overall tends to equate sex with pleasure, encourage sexual activity with multiple partners, and emphasise using protection. Our goal is to use this data to better understand how sexual socialisation contributes to the prevalence of multiple sexual partners and high rates of HIV among heterosexual black men in order to inform future risk-reduction intervention programmes. PMID:24482611

Trichomonas vaginalis infection and associated risk factors in a socially-marginalized female population in coastal Peru.

PubMed

Leon, Segundo R; Konda, Kelika A; Bernstein, Kyle T; Pajuelo, Jose B; Rosasco, Ana M; Caceres, Carlos F; Coates, Thomas J; Klausner, Jeffrey D

2009-01-01

The epidemiology of Trichomonas vaginalis infection among sexually active socially-marginalized women in three urban, coastal Peruvian cities was examined in order to quantify the prevalence of trichomonas infection and identify associated risk factors. We conducted a cross-sectional, venue-based study of women from socially-marginalized populations in three coastal Peruvian cities. Among the 319 women enrolled, the overall prevalence of trichomonal infection was 9.1% (95% CI, 5.9%-12.3%). The mean age was 26.3 years, and 35.5% reported having had unprotected intercourse with nonprimary partners and 19.8% reported two or more sex partners in the last three months. Trichomonal infection was associated with increased number of sex partners (PR 2.5, 95% CI 1.4-4.6) and unprotected sex with nonprimary partner in the last three months (PR 2.3, 95% CI 1.1-4.9). A moderately high prevalence of trichomonal infection was found among women in our study. Trichomonal infection was associated with unprotected sex and multiple sex partners. Efforts to control the continued spread of trichomonal infection are warranted.

Current active and passive smoking among adults living with same sex partners in Spain.

PubMed

Perales, Jaime; Checa, Irene; Espejo, Begoña

2017-05-19

To assess the association between current active and passive tobacco smoking and living with a same-sex partner in Spain. We analysed data from two cross-sectional national surveys of the Spanish population 15 years and older (2011-Encuesta Nacional de Salud en España and 2014-Encuesta Europea de Salud en España). Analyses included only people living with their partner. Associations were calculated using multiple logistic regressions adjusting for gender, social class and age. Current active and passive smoking were significantly associated with living with same sex partners (odds ratio: 2.71 and 2.88), and particularly strong among women. Spanish adults living with same-sex partners are at higher risk of active and passive smoking. This risk varies by gender. Spanish national surveys should include items on sexual orientation for improved data on health disparities. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Situational, partner, and contextual factors associated with level of risk at most recent intercourse among Black men who have sex with men.

PubMed

Kelly, Jeffrey A; DiFranceisco, Wayne J; St Lawrence, Janet S; Amirkhanian, Yuri A; Anderson-Lamb, Michelle

2014-01-01

African American men who have sex with men (MSM) in the United States bear a disproportionate burden of HIV infection and disease incidence. 178 Black MSM provided detailed situational information concerning their most recent act of anal intercourse (AI) with a male partner including condom use, partner characteristics, serostatus disclosure, and substance use. Participants completed scales assessing AIDS-related as well as broader contextual domains. Most recent AI acts occurred with same-race partners outside of main relationships. Over one-third of AI acts were unprotected, and almost half of the unprotected acts were not between known HIV-concordant partners. Nearly half of men reported substance use before sex. In a multiple regression analysis, unprotected AI with a partner not known to be concordant was predicted by low risk reduction intentions and indicators of a casual relationship. The findings highlight issues and partner contexts associated with risk for contracting HIV infection among Black MSM.

I Want Your Sext: Sexting and Sexual Risk in Emerging Adult Minority Men.

PubMed

Davis, Mikaela Jessica; Powell, Adeya; Gordon, Derrick; Kershaw, Trace

2016-04-01

Sexting, sending, or receiving sexually suggestive or explicit messages/photos/videos, have not been studied extensively. The aims of this study is to understand factors associated with sexting among minority (e.g., African- American, Hispanic) emerging adult males and the association between sexting and sexual risk. We recruited 119 emerging adult heterosexual males and assessed sexting and sexual risk behaviors. Fifty-four percent of participants sent a sext, and 70% received a sext. Participants were more likely to sext with casual partners than with steady partners. Multiple regression analyses showed that participants who sent sexts to steady partners had significantly more unprotected vaginal intercourse and oral sex. Participants who sent sexts to casual partners had significantly more partners, and participants who received sexts from casual partners had significantly more unprotected oral sex and sex while on substances. We found that sexting is a frequent and reciprocal behavior among emerging adults, and there were different patterns of significance for sexts with casual and steady partners.

HIV Test: MedlinePlus Lab Test Information

MedlinePlus

... with an HIV-infected partner Have had multiple sex partners Have injected drugs, such as heroin , or shared drug needles with someone else HIV can spread from mother to child during birth and through breast milk, ...

Qualitative exploration of HIV-related sexual behaviours and multiple partnerships among Chinese men who have sex with men living in a rural area of Yunnan Province, China.

PubMed

Chow, Eric P F; Gao, Liangmin; Koo, Fung Kuen; Chen, Liang; Fu, Xiaoxing; Jing, Jun; Wilson, David P; Zhang, Lei

2013-12-01

The HIV epidemic has been spreading rapidly among men who have sex with men (MSM) in China. The present study explored the pattern of HIV-related high-risk sexual practices among MSM in a rural Chinese setting. Data were collected by semistructured in-depth interviews conducted among 15 MSM in Yuxi Prefecture, Yunnan Province, China. Fifteen respondents were recruited through a local non-governmental organisation via purposive sampling. Thematic analysis was used. Technological changes, risk behaviours, social stigma and high migration rates have played a significant role in the spread of HIV among MSM in rural China. The Internet has become the primary channel for soliciting casual sex partners in the MSM community. Bisexuality and having concurrent and multiple sexual partners were common among rural MSM. A large number of sexual partners and low condom use in all MSM partnership types were noted. Due to Chinese cultural traditions and social stigma, Chinese rural MSM were reluctant to disclose their homosexuality. Rural-to-urban migrant MSM were often engaged in the commercial sex trade. Rural MSM is a distinctive and complex population with multiple identities in China. Concurrent multiple sexual partnerships, high mobility and low disclosure rate are the major challenges for HIV prevention and intervention programs in MSM.

Understanding sex partner selection from the perspective of inner-city black adolescents.

PubMed

Andrinopoulos, Katherine; Kerrigan, Deanna; Ellen, Jonathan M

2006-09-01

Black adolescents in inner-city settings are at increased risk for HIV and other STDs. Sex partner characteristics, as well as individual behavior, influence individuals' STD risk, yet little is known about the process of sex partner selection for adolescents in this setting. Semistructured in-depth interviews were conducted during the summer and fall of 2002 with 50 inner-city black adolescents (26 females and 24 males) who had been purposively recruited from an STD clinic. Content analysis was used to study interview texts. Young women desire a monogamous romantic partner, rather than a casual sex partner; however, to fulfill their desire for emotional intimacy, they often accept a relationship with a nonmonogamous partner. Young men seek both physical and emotional benefits from being in a relationship; having a partner helps them to feel wanted, and they gain social status among their peers when they have multiple partners. For men, these benefits may help compensate for an inability to obtain jobs that would improve their financial and, as a result, social status. Both women and men assess partners' STD risk on the basis of appearance. HIV and other STD prevention initiatives must go beyond the scope of traditional messages aimed at behavior change and address the need for social support and socioeconomic opportunities among at-risk, inner-city adolescents.

Sexual practices among unmarried adolescents in Tanzania.

PubMed

Kazaura, Method R; Masatu, Melkiory C

2009-10-06

Sexual activities are increasingly changing from the cultural point of view what they used to be. Knowledge of these practices among adolescents may be a basis to create awareness among adolescents on practices that involve risks. This study aims to assess sexual practices among unmarried adolescents in Tanzania. A cross-sectional survey was conducted among in-school and out-of-school but unmarried adolescents aged 10 to 19 in five locations in Tanzania. A questionnaire was used to collect information and to characterize sexual practices among these adolescents. About 32% of adolescents reported being sexually active; a higher proportion being males than females. The only inquired and reported sexual practices include vaginal sex, masturbation, oral and anal sex. About 15% of sexually active adolescents reported having multiple sexual partners. Significantly more males reported having multiple partners than females. Nearly 42% of sexually active adolescents reported having used a condom during most recent sexual act. Females reported older partners at first sexual act. Adolescents experience several sexual practices that include penetrative and non-penetrative. More males reported being sexually active than females. Despite adolescents reporting having multiple sexual partners, reported condom use during the most recent sexual act was low. We advocate for a more enhanced approach of reproductive health education that includes safer sex to adolescents without forgetting those in-schools.

Sexual Health Risk Behavior Disparities Among Male and Female Adolescents Using Identity and Behavior Indicators of Sexual Orientation.

PubMed

Paul Poteat, V; Russell, Stephen T; Dewaele, Alexis

2017-12-04

Sexual minority adolescent sexual risk behavior studies often overlook young women, do not consider behavior- and identity-based sexual orientation indicators in combination, and focus mainly on condomless sex. We examined multiple risk behaviors in a large sample of adolescent young men and women using combined behavior- and identity-based indices. The 2015 Dane County Youth Assessment data included 4734 students in 22 high schools who had ever voluntarily engaged in sexual contact (51.7% male; 76.0% White, non-Hispanic). Items assessed having sex with unfamiliar partners, sex while using substances, using protection, and STI testing. Logistic regressions tested for disparities based on combined identity- and behavior-based sexual orientation indicators. For both young men and women, youth who reported heterosexual or questioning identities-but who had sex with same-sex partners-were at consistently greater risk than heterosexual youth with only different-sex partners. Also, for both young men and women, bisexuals with partners of both sexes more consistently reported higher risk than heterosexual youth than did bisexuals with only different-sex partners. Risk behavior for gay young men who had sex only with men mirrored those in extant literature. Risk levels differed for specific groups of sexual minority young women, thus deserving further attention. Findings underscore the need for sexual health research to consider sexual orientation in a more multidimensional manner.

78 FR 33957 - Lesbian, Gay, Bisexual, and Transgender Pride Month, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-06

... time, voters in multiple States affirmed marriage equality for same-sex couples. State and local... orientation and gender identity in Federal housing, and extended benefits for same-sex domestic partners...

Behavioural disinhibition in the general population during the antiretroviral therapy roll-out in Sub-Saharan Africa: systematic review and meta-analysis.

PubMed

Legemate, Eva M; Hontelez, Jan A C; Looman, Caspar W N; de Vlas, Sake J

2017-07-01

Improved life expectancy and reduced transmission probabilities due to ART may result in behavioural disinhibition - that is an increase in sexual risk behaviour in response to a perceived lower risk of HIV. We examined trends in sexual risk behaviour in the general population of sub-Saharan African countries 1999-2015. We systematically reviewed scientific literature of sexual behaviour and reviewed trends in Demographic and Health Surveys. A meta-analysis on four indicators of sexual risk behaviour was performed: unprotected sex, multiple sexual partners, commercial sex and prevalence of sexually transmitted infections. Only two peer-reviewed studies met our inclusion criteria, while our review of DHS data spanned 18 countries and 16 years (1999-2015). We found conflicting trends in sexual risk behaviour. Reported unprotected sex decreased consistently across the 18 countries, for both sexes. In contrast, reporting multiple partners was decreasing over the period 1999 to the mid-2000s, yet has been consistently increasing thereafter. Similar trends were found for reported sexually transmitted infections and commercial sex (men only). In conclusion, we found no clear evidence of behavioural disinhibition due to expanded access to ART in sub-Saharan Africa. Substantial increases in condom use coincided with increases in reported multiple partners, commercial sex and sexually transmitted infections, especially during the period of ART scale-up. Further research is needed into how these changes might affect HIV transmission. © 2017 John Wiley & Sons Ltd.

The Effects of Sexual Partnerships and Relationship Characteristics on Three Sexual Risk Variables in Young Men Who Have Sex with Men

PubMed Central

Newcomb, Michael E.; Ryan, Daniel T.; Garofalo, Robert; Mustanski, Brian

2014-01-01

Young men who have sex with men (YMSM) in the United States are experiencing an alarming increase in HIV incidence. Recent evidence suggests that the majority of new HIV infections in YMSM occur in the context of serious relationships, which underscores the importance of examining predictors of sexual risk behavior in the context of sexual partnerships, including relationship type, sexual partner characteristics, and relationship dynamics. The current study aimed to evaluate relationship and sexual partnership influences on sexual risk behavior in YMSM, including differentiating between multiple sexual risk variables (i.e., any unprotected anal or vaginal intercourse, unprotected insertive anal or vaginal intercourse, and unprotected receptive anal intercourse). More serious/familiar partnerships were associated with more sexual risk across all three risk variables, while wanting a relationship to last was protective against risk across all three risk variables. Some variables were differentially linked to unprotected insertive sex (partner gender) or unprotected receptive sex (partner age, partner race, believing a partner was having sex with others, and partners repeated across waves). Sexual risk behavior in YMSM is inconsistent across sexual partnerships and appears to be determined in no small part by sexual partner characteristics, relationship dynamics, and sexual role (i.e., insertive or receptive partner). These influences are critical in understanding sexual risk in YMSM and provide important targets for intervention. PMID:24217953

The effects of sexual partnership and relationship characteristics on three sexual risk variables in young men who have sex with men.

PubMed

Newcomb, Michael E; Ryan, Daniel T; Garofalo, Robert; Mustanski, Brian

2014-01-01

Young men who have sex with men (YMSM) in the United States are experiencing an alarming increase in HIV incidence. Recent evidence suggests that the majority of new HIV infections in YMSM occur in the context of serious relationships, which underscores the importance of examining predictors of sexual risk behavior in the context of sexual partnerships, including relationship type, sexual partner characteristics, and relationship dynamics. The current study aimed to evaluate relationship and sexual partnership influences on sexual risk behavior in YMSM, including differentiating between multiple sexual risk variables (i.e., any unprotected anal or vaginal intercourse, unprotected insertive anal or vaginal intercourse, and unprotected receptive anal intercourse). More serious/familiar partnerships were associated with more sexual risk across all three risk variables, while wanting a relationship to last was protective against risk across all three risk variables. Some variables were differentially linked to unprotected insertive sex (partner gender) or unprotected receptive sex (partner age, partner race, believing a partner was having sex with others, and partners repeated across waves). Sexual risk behavior in YMSM is inconsistent across sexual partnerships and appears to be determined in no small part by sexual partner characteristics, relationship dynamics, and sexual role (i.e., insertive or receptive partner). These influences are critical in understanding sexual risk in YMSM and provide important targets for intervention.

Young Thai women who use methamphetamine: Intersection of sexual partnerships, drug use, and social networks

PubMed Central

German, Danielle; Sherman, Susan A.; Latkin, Carl A.; Sirirojn, Bangorn; Thomson, Nick; Sutcliffe, Catherine G.; Aramrattana, Apinun; Celentano, David D.

2009-01-01

Background Given high rates of methamphetamine (MA) use among young people in Thailand and evidence of an association between MA and increased sexual risk behavior, we examined the association between women’s recent sexual partnerships, social network characteristics and drug and alcohol use. Methods Female participants (n=320) in an HIV behavioral trial among young (18–25 years) MA users in Chiang Mai completed a drug and sexual behavior survey and social network inventory. Multinomial regression analyses accounting for clustered data examined individual and network characteristics associated with recent sexual partnership category. We compared women with only one male partner in the past year (39%) to those with multiple male partners (37%) and those with only female partners (24%). Results Differences in levels of drug and alcohol use and social and sexual network characteristics were dependent on recent sexual partnership profiles. The multiple partner group reported an average of five male partners in the past year; 12% reported consistent condom use in the past 30 days. Compared to both groups, women with multiple male partners used MA more frequently, had larger non-sex networks with more MA users, were more likely to have an MA-using sex partner, and received less emotional support from their partners. Women with multiple male partners and only female partners reported more frequent alcohol use. Conclusions Policy and intervention efforts targeting drug use and sexual behavior among young Thai women are drastically needed and may benefit from consideration of the diversity within the population. These data point to the need for targeted prevention approaches that take into account the varying characteristics and social influences of these different groups of women. PMID:18191393

Patterns of disclosure among youth who are HIV-positive: a multisite study.

PubMed

Dempsey, Allison G; MacDonell, Karen E; Naar-King, Sylvie; Lau, Chuen-Yen

2012-03-01

Disclosure of serostatus is critical in preventing the transmission of HIV among youth. The purpose of this exploratory study was to describe serostatus disclosure in a multisite study of youth living with HIV. This study investigated serostatus disclosure and its relationship to unprotected sex among 146 youth participating in a multisite study of young people living with HIV who were sexually active within the past 3 months. Forty percent of participants reported a sexual relationship with a partner to whom they had not disclosed their serostatus. Participants with multiple sexual partners were less likely to disclose their serostatus than those with one partner. Disclosure was more frequent when the serostatus of the sexual partner was known. Disclosure was not associated with unprotected sex. Prevention initiatives should focus on both disclosure and condom use in this high-risk population, particularly for youth with multiple sexual partners. Copyright © 2012 Society for Adolescent Health and Medicine. All rights reserved.

Infrequent condom use with casual partners among New Zealand gay and bisexual men.

PubMed

Saxton, Peter J; Dickson, Nigel P; Hughes, Anthony J; Ludlam, Adrian H

2015-12-04

To identify predictors of non-condom use among gay and bisexual men (GBM) in New Zealand with casual male partners. We analysed anonymous self-completed data from GBM who participated in the communitybased Gay Auckland Periodic Sex Survey (GAPSS) and Internet-based Gay Online Sex Survey (GOSS), undertaken in 2014. Infrequent condom use was defined as not using condoms "always" or "almost always" during anal intercourse in the prior six months. Of the 1,912 GBM reporting anal intercourse with a casual partner, 27.2% reported infrequent condom use. Being recruited from Internet dating sites, Pacific ethnicity, having over 20 recent male partners, infrequent condom use with a current regular partner, or being HIV-positive were independently predictive of infrequent condom use. Conversely, being older, having a tertiary degree, using a condom at first anal intercourse, being exclusively receptive with a casual partner/s, and seeing condoms promoted through multiple channels predicted frequent condom use. Attitudes to condoms and safe sex were strongly predictive of actual condom use. Social marketing should target the modifiable predictors of condom use, such as attitudes to safe sex. Interventions also need to engage successfully with GBM reporting non-modifiable traits such as HIV-positive GBM.

Peer Influences on Sexual Activity among Adolescents in Ghana.

PubMed

Bingenheimer, Jeffrey B; Asante, Elizabeth; Ahiadeke, Clement

2015-03-01

Little is known about the influences of peers on the sexual activity of adolescents in sub-Saharan Africa. Better understanding of these issues could lead to more effective sexual and reproductive health interventions. Using two waves of survey data from 1,275 adolescents in two southeastern Ghanaian towns, we examine age, sex, and community differences in peer group characteristics. We also examine prospective associations between peer group characteristics and self-reported sexual initiation and multiple partnerships during a 20-month follow-up period. Sex differences in peer-context variables were small. Affiliation with antisocial peers and perceived peer norms favoring sex increased the odds of transition to first sex. Having more friends increased the odds among younger respondents of acquiring multiple new sexual partners. Among males, perceived peer norms favoring sex increased the odds of acquiring multiple partners. We discuss the implications of these findings for adolescent sexual and reproductive health intervention strategies in sub-Saharan Africa, and conclude that peer-based interventions may be best suited to the needs of at-risk adolescent boys. © 2015 The Population Council, Inc.

Heterosexual Transmission of HIV in China

PubMed Central

YANG, HONGMEI; LI, XIAOMING; STANTON, BONITA; LIU, HONGJIE; LIU, HUI; WANG, NING; FANG, XIAOYI; LIN, DANHUA; CHEN, XINGUANG

2006-01-01

Objective: The objective of this study was to address the role of heterosexual transmission of HIV in China. Goal: The goal of this study was to explore the prevalence of unsafe sex and the likelihood of HIV spread heterosexually from core populations to others. Study: The authors conducted a review of behavioral studies. Results: Drug users were more likely to be involved in higher-risk sexual behaviors than were those who abstained from using drugs. Most female drug users (52-98%) reported having engaged in commercial sex. Most female sex workers (FSWs) and individuals with sexually transmitted diseases (STDs) had concurrent sexual partners. Many continued to have unprotected sex after noticing STD symptoms in themselves or their sexual partners. From 5% to 26% of rural-to-urban migrants had multiple sexual partners and 10% of males patronized FSWs during migration. Conclusions: Factors such as high rates of FSW patronage, low rates of condom use during commercial sex, having sex with both commercial and noncommercial sexual partners, and high rates of STD infection may promote a heterosexual epidemic in China. PMID:15849527

An assessment of risk behaviours to HIV/AIDS vulnerability among young female garment workers in Bangladesh.

PubMed

Sayem, A; Popsci, M

2010-02-01

This study attempted to assess the risk behaviours for HIV/AIDS among female garment workers aged 15-24 years.A total of 300 garment workers in Dhaka city were assessed with a semi-structured interview. Their knowledge of HIV/AIDS was moderate with high rates of misperception regarding modes of transmission. Further, symptoms of possible sexually transmitted infections (STIs) such as genital ulcer disease and vaginal discharge were prevalent, and risk behaviours such as low use of condoms, multiple sex partners and drug abuse were also found. Logistic regression identified that women who sourced information through radio/television, health service providers or friends had higher age at first intercourse and higher HIV/AIDS knowledge scores and were more likely to use condoms. Those who gained information through radio/television or health service providers and those who abused drugs were more likely to have sex with multiple sex partners, while information gained through health service providers, and higher HIV/AIDS knowledge were protective against drug abuse, whereas sex with multiple partners was a predictor of drug abuse. We conclude that in Bangladesh, female garment workers are at risk of HIV/AIDS due to low education, lack of knowledge, STIs and risky behaviour.

Response inhibition moderates the association between drug use and risky sexual behavior.

PubMed

Nydegger, Liesl A; Ames, Susan L; Stacy, Alan W; Grenard, Jerry L

2014-09-01

HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.

Patient-Delivered Partner Treatment and Trichomonas vaginalis Repeat Infection Among Human Immunodeficiency Virus-Infected Women

PubMed Central

Gatski, Megan; Mena, Leandro; Levison, Judy; Clark, Rebecca A.; Henderson, Harold; Schmidt, Norine; Rosenthal, Susan L.; Martin, David H.; Kissinger, Patricia

2013-01-01

Background Repeat infections with Trichomonas vaginalis (TV) among human immunodeficiency virus (HIV)-infected women are common and may increase the risk of HIV transmission. Patient delivered partner treatment (PDPT) has been shown to reduce repeat infections of other sexually transmitted diseases. The purpose of this study was to evaluate adherence to PDPT and possible causes of repeat TV infection among HIV-infected women. Methods A multicentered cohort study was conducted in 3 US cities. Women coinfected with HIV and TV were treated with metro-nidazole and given treatment to deliver to all reported sex partners. A test-of-cure visit was conducted 6 to 12 days post index treatment completion and behavioral data were collected. Results Of 252 women (mean age = 40 years, s.d. 9.1) enrolled, 92.5% were black, 26.2% had CD4 cell counts <200/mm3, 34.1% had plasma viral loads >10,000 copies, 58.3% were taking antiretrovial therapy, and 15.1% had multiple partners. Of the 183 women with partners at baseline, 75.4% provided PDPT to all partners and 61.7% reported they were sure all of their partners took the medication. Factors associated with not giving medications to all partner(s) were multiple sex partners, being single, and having at least one partner unaware of the index woman’s HIV status. At test-of-cure, 10.3% were TV-positive and 16.7% reported having sex since baseline. Of the 24 repeat infections, 21 (87.5%) reported adherence to medication and no sexual exposure. Conclusion HIV-infected women with TV reported high adherence to PDPT, and treatment failure was the most common probable cause of repeat infection. PMID:20502393

HIV-positive men sexually active with women: sexual behaviors and sexual risks.

PubMed

Aidala, Angela A; Lee, Gunjeong; Howard, Joyce Moon; Caban, Maria; Abramson, David; Messeri, Peter

2006-07-01

This study examines patterns of sexual behavior, sexual relating, and sexual risk among HIV-positive men sexually active with women. A total of 278 HIV-positive men were interviewed every 6-12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many were not sexually active at all for months at a time; many continued to have multiple female and at times male partners. Over one-third of the cohort had one or more periods when they had engaged in unprotected sex with a female partner who was HIV-negative or status unknown (unsafe sex). Periods of unsafe sex alternated with periods of safer sex. Contextual factors such as partner relations, housing status, active drug use, and recently exchanging sex showed the strongest association with increased odds of unsafe sex. A number of predictors of unsafe sex among African American men were not significant among the Latino sub-population, suggesting race/ethnic differences in factors contributing to heterosexual transmission. Implications for prevention interventions are discussed.

Sexual minority status and violence among HIV infected and at-risk women.

PubMed

Pyra, Maria; Weber, Kathleen; Wilson, Tracey E; Cohen, Jennifer; Murchison, Lynn; Goparaju, Lakshmi; Cohen, Mardge H

2014-08-01

Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence. To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV. Longitudinal study of 1,235 HIV infected and 508 uninfected women of the Women's Interagency HIV Study (WIHS) cohort, from New York City, NY, Chicago, IL, Washington D.C., and San Francisco, CA, 1994-2012. Primary exposures are sexual identity (heterosexual, bisexual, lesbian/gay) and sexual behavior (male, female, or male & female partners). Primary outcomes are sexual abuse, intimate partner violence (IPV) and physical violence; high-risk sex and substance use were examined as mediators. Bisexual women were at increased odds for sexual abuse [aOR 1.56 (1.00, 2.44)], IPV [aOR 1.50 (1.08, 2.09)], and physical violence [aOR 1.77 (1.33, 2.37)] compared to heterosexual women. In a separate analysis, women who reported sex with men and women (WSMW) had increased odds for sexual abuse [aOR 1.65 (0.99, 2.77], IPV [aOR 1.50 (1.09, 2.06)] and physical violence [aOR 2.24 (1.69, 2.98)] compared to women having sex only with men (WSM). Using indirect effects, multiple sex partners, cocaine and marijuana were significant mediators for most forms of abuse. Transactional sex was only a mediator for bisexual women. Women who reported sex only with women (WSW) had lower odds of sexual abuse [aOR 0.23 (0.06, 0.89)] and physical violence [aOR 0.42 (0.21, 0.85)] compared to WSM. Women who identify as bisexual or report both male and female sex partners are most vulnerable to violence; multiple recent sex partners, transactional sex and some types of substance use mediate this relationship. Acknowledging sexual identity and behavior, while addressing substance use and high-risk sex in clinical and psychosocial settings, may help reduce violence exposure among women with and at-risk for HIV.

Trichomonas vaginalis Infection and Associated Risk Factors in a Socially-Marginalized Female Population in Coastal Peru

PubMed Central

Leon, Segundo R.; Konda, Kelika A.; Bernstein, Kyle T.; Pajuelo, Jose B.; Rosasco, Ana M.; Caceres, Carlos F.; Coates, Thomas J.; Klausner, Jeffrey D.

2009-01-01

Objective. The epidemiology of Trichomonas vaginalis infection among sexually active socially-marginalized women in three urban, coastal Peruvian cities was examined in order to quantify the prevalence of trichomonas infection and identify associated risk factors. Methods. We conducted a cross-sectional, venue-based study of women from socially-marginalized populations in three coastal Peruvian cities. Results. Among the 319 women enrolled, the overall prevalence of trichomonal infection was 9.1% (95% CI, 5.9%–12.3%). The mean age was 26.3 years, and 35.5% reported having had unprotected intercourse with nonprimary partners and 19.8% reported two or more sex partners in the last three months. Trichomonal infection was associated with increased number of sex partners (PR 2.5, 95% CI 1.4–4.6) and unprotected sex with nonprimary partner in the last three months (PR 2.3, 95% CI 1.1–4.9). Conclusions. A moderately high prevalence of trichomonal infection was found among women in our study. Trichomonal infection was associated with unprotected sex and multiple sex partners. Efforts to control the continued spread of trichomonal infection are warranted. PMID:19584943

Sexual partner preference in female Japanese macaques.

PubMed

Vasey, Paul L

2002-02-01

Whether animals ever exhibit a preference for same-sex sexual partners is a subject of debate. Japanese macaques represent excellent models for examining issues related to sexual preference in animals because females, in certain populations, routinely engage in both heterosexual and homosexual behavior over the course of their life spans. Multiple lines of evidence indicate that female homosexual behavior in Japanese macaques is a sexual behavior, not a sociosexual one. Additional evidence indicates that female Japanese macaques do not engage in homosexual behavior simply because acceptable male mates are unavailable or unmotivated to copulate. Patterns of sexual partner choice by female Japanese macaques that are the focus of intersexual competition indicate that females of this species choose same-sex sexual partners even when they are simultaneously presented with a motivated, opposite-sex alternative. Thus, in some populations of Japanese macaques, females prefer certain same-sex sexual partners relative to certain male mates, and vice versa. Taken together, this evidence suggests that female Japanese macaques are best characterized as bisexual in orientation, not preferentially homosexual or preferentially heterosexual.

Perceived risks and protective strategies employed by young men who have sex with men (YMSM) when seeking online sexual partners.

PubMed

Bauermeister, José A; Giguere, Rebecca; Carballo-Diéguez, Alex; Ventuneac, Ana; Eisenberg, Anna

2010-09-01

This study examined the perceptions of risk by young men who have sex with men (YMSM) regarding meeting sexual partners through the Internet. Fifty-four YMSM ages 18-29 who reported engaging in bareback sex ("intentional unprotected anal intercourse in high-risk contexts") completed a structured assessment and a face-to-face interview. Participants reported using the Internet to meet sexual partners at least once per week, having had multiple sexual partners in the past 2 months (M = 10.50, SD = 9.25), and engaging in occasions of unprotected receptive (M = 5.35, SD = 6.76) and insertive (M = 5.06, SD = 10.11) anal intercourse. A third of the sample reported having had unprotected sex with a partner who was serodiscordant or of unknown serostatus. Despite the obvious HIV risks, the most commonly perceived risks included threats to physical safety and difficulties trusting a stranger. Risk reduction strategies included leaving information about partner and whereabouts with a friend, meeting in a public place, and screening partner through online chatting. Those YMSM who meet partners online may be at risk for physical violence in addition to HIV or sexually transmitted infections (STIs). Public health campaigns should increase awareness of safety concerns when meeting sexual partners online and support YMSM's self-protective actions.

Sexual risk and bridging behaviors among young people in Hai Phong, Vietnam.

PubMed

Duong, Cong Thanh; Nguyen, Tran Hien; Hoang, Thi Thanh Ha; Nguyen, Van Vi; Do, Thi Minh Nguyet; Pham, Van Han; Detels, Roger

2008-07-01

The risk of the HIV epidemic spreading from high-risk groups to the general population in Vietnam depends on sexual risk and bridging behaviors between high- and low-risk individuals. A cross-sectional study was used to describe sexual activities of youth aged 18-29 years. Nearly half (41.4%) were sexually active. Premarital sex was reported by 43.3% of them; 78.3% of sexually active males and 13.5% of sexually active females. Multiple sex partners were reported by 31.0%; 56.7% of males and 9.2% of females. Almost 27% of males and 5% of females engaged in sexual bridging behaviors. Being unmarried was significantly associated with having sex with non-regular partners. Being unmarried and early age at first intercourse were associated with having sex with a sex worker. Consistent condom use was high with commercial sex workers but low with regular partners. Education to delay early sexual debut, increased employment, and strategies to inform young sexually active people to adopt safer behaviors are urgently needed.

Prevalence and sex-related risk factors of premarital pregnancy and reproductive tract infections among female undergraduates in Wuhan, China.

PubMed

Cao, Yue; Xiao, Han; Yan, Hong; Li, Jingjing; Li, Shiyue

2015-03-01

In China, more and more female college students engage in premarital sex. Few seek reproductive health services, increasing their risk for unintended pregnancy and reproductive tract infections (RTIs). The present study aims to explore the prevalence and sex-related risk factors of premarital pregnancy and RTIs among female undergraduates in China. A total of 4769 females were recruited using randomized cluster sampling and anonymously completed questionnaires. Of the 4,769 females, 863 (18.1%) reported ever having sexual intercourse, 17.5% of which had become pregnant, and 22.7% had contracted RTIs. Younger age or not using a condom at first sex and having multiple sex partners contributed to premarital pregnancy. Majoring in arts, being from less-developed regions of China, having multiple partners, and self-reported pregnancy contributed to RTIs. Findings suggest importance of sexual health education among undergraduates, especially women from less-developed regions of China and/or majoring in arts. © 2015 APJPH.

Sexual practices among unmarried adolescents in Tanzania

PubMed Central

Kazaura, Method R; Masatu, Melkiory C

2009-01-01

Background Sexual activities are increasingly changing from the cultural point of view what they used to be. Knowledge of these practices among adolescents may be a basis to create awareness among adolescents on practices that involve risks. This study aims to assess sexual practices among unmarried adolescents in Tanzania. Methods A cross-sectional survey was conducted among in-school and out-of-school but unmarried adolescents aged 10 to 19 in five locations in Tanzania. A questionnaire was used to collect information and to characterize sexual practices among these adolescents. Results About 32% of adolescents reported being sexually active; a higher proportion being males than females. The only inquired and reported sexual practices include vaginal sex, masturbation, oral and anal sex. About 15% of sexually active adolescents reported having multiple sexual partners. Significantly more males reported having multiple partners than females. Nearly 42% of sexually active adolescents reported having used a condom during most recent sexual act. Females reported older partners at first sexual act. Conclusion Adolescents experience several sexual practices that include penetrative and non-penetrative. More males reported being sexually active than females. Despite adolescents reporting having multiple sexual partners, reported condom use during the most recent sexual act was low. We advocate for a more enhanced approach of reproductive health education that includes safer sex to adolescents without forgetting those in-schools. PMID:19804651

Relation of sexual risks and prevention practices with individuals' stigmatising beliefs towards HIV infected individuals: an exploratory study

PubMed Central

Liu, H; Li, X; Stanton, B; Fang, X; Mao, R; Chen, X; Yang, H

2005-01-01

Methods: A cross sectional survey was conducted to assess HIV related stigmatising beliefs, risk sexual behaviours, and preventive practices among sexually experienced rural to urban migrants aged 18–30 years in 2002 in Beijing and Nanjing, two large Chinese cities. Results: Among 2153 migrants, 7.2% reported having had more than one sexual partner in the previous month, 9.9% had commercial sex partners, and 12.5% had an episode of a sexually transmitted disease (STD). Only 18% reported frequently or always using condoms, with 20% sometimes or occasionally using them. 57% of the Chinese migrants were willing to take a voluntary HIV test, and 65% had HIV related stigmatising beliefs towards people living with HIV. Multiple logistic regression analysis depicts that individual's stigmatising beliefs towards people with HIV were positively associated with having had an episode of an STD, having multiple sex partners, or having had commercial sex partners, and were negatively associated with condom use and the willingness to accept an HIV test. Conclusion: The finding that one's own stigmatising belief is a potential barrier to HIV related preventive practices highlights the difficulties and challenges in implementing behavioural interventions. PMID:16326857

Prospective Associations between Alcohol and Drug Consumption and Risky Sex among Female College Students

ERIC Educational Resources Information Center

Caldeira, Kimberly M.; Arria, Amelia M.; Zarate, Elizabeth M.; Vincent, Kathryn B.; Wish, Eric D.; O'Grady, Kevin E.

2009-01-01

Females who had vaginal sex were interviewed annually in their first two years of college (n=386, ages 17 to 20 at study outset) and asked about risky sex behaviors and substance use. In year one, 60.2%[subscript wt] had intoxicated sex, 31.4%[subscript wt] had multiple sex partners, and 48.9%[subscript wt] had unprotected sex (i.e., without a…

Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25–65 Years

PubMed Central

Winer, Rachel L.; Hughes, James P.; Feng, Qinghua; Stern, Joshua E.; Xi, Long Fu; Koutsky, Laura A.

2016-01-01

Background. The risk of incident high-risk human papillomavirus (HR-HPV) infection associated with recent sexual behaviors is undefined in mid-adult women (defined as women aged 25–65 years). Methods. Triannually, 420 female online daters aged 25–65 years submitted vaginal specimens for HPV testing and completed health and sexual behavior questionnaires. The cumulative incidence of and risk factors for incident HR-HPV detection were estimated by Kaplan–Meier and Cox proportional hazards methods. Results. The 12-month cumulative incidence of HR-HPV detection was 25.4% (95% confidence interval [CI], 21.3%–30.1%). Current hormonal contraceptive use was positively associated with incident HR-HPV detection. Lifetime number of male sex partners was also positively associated but only among women not recently sexually active with male partners. In analysis that adjusted for hormonal contraceptive use and marital status, women reporting multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership had a hazard of incident HR-HPV detection that was 2.81 times (95% CI, 1.38–5.69 times) that for women who reported no male sex partners in the past 6 months. Thus, among women with multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership, approximately 64% of incident HR-HPV infections were attributable to one of those partners. Conclusions. Among high-risk mid-adult women with recent new male partners, multiple male partners, or male partners who were casual or had ≥1 concurrent partnership, about two thirds of incident HR-HPV detections are likely new acquisitions, whereas about one third of cases are likely redetections of prior infections. PMID:27009602

Adolescent Sexual Risk and Multiple Contexts: Interpersonal Violence, Parenting, and Poverty

ERIC Educational Resources Information Center

Rodgers, Kathleen Boyce; McGuire, Jenifer K.

2012-01-01

In this study we estimated the combined effects of violence experiences, parenting processes, and community poverty on sexual onset, alcohol or other drug (AOD) use at last sex, multiple sex partners, and prior pregnancy in a sample of 7th-, 9th-, and 11th-grade adolescents (n = 7,891), and the subsample of sexually experienced adolescents (n =…

Same-sex partner preference in zebra finches: pairing flexibility and choice.

PubMed

Tomaszycki, Michelle L; Zatirka, Brendon P

2014-11-01

This study examined flexibility and choice in same-sex pair-bonding behavior in adult zebra finches (Taeniopygia guttata). Zebra finches form life-long monogamous relationships and extra pair behavior is very low, making them an ideal species in which to study same-sex pairing. We examined same-sex behaviors using both semi-naturalistic choice paradigms and skewed sex ratios. In the first experiment, we allowed zebra finches to pair in aviaries with equal sex ratios as part of multiple experiments. On average, 6.4% (N = 78) of unmanipulated pairs were same-sex: all but one was female-female. In a second experiment, we identified pairs from same-sex cages and selected 20 total same-sex pairs (10 of each sex). We then gave pairs a chance to court and pair with members of the opposite sex and observed their behavior for three days. Females did not retain their partner, but most paired with males. In contrast, some males did retain their partner. Similarly, females were more likely to engage in pairing behaviors with males than with their partners or other females whereas males were equally likely to engage in same-sex and opposite-sex pairing behaviors. These findings suggest that same-sex partnerships in zebra finches can be facultative, based on the sex ratio of the group in which they live, but can also be a choice, when opportunities to pair with opposite-sex individuals are possible. Furthermore, it is possible that females are more flexible in this choice of same-sex partnerships than are males.

Intimate Partner Violence, Relationship Power Inequity and the Role of Sexual and Social Risk Factors in the Production of Violence among Young Women Who Have Multiple Sexual Partners in a Peri-Urban Setting in South Africa

PubMed Central

Zembe, Yanga Z.; Townsend, Loraine; Thorson, Anna; Silberschmidt, Margrethe; Ekstrom, Anna Mia

2015-01-01

Introduction This paper aims to assess the extent and correlates of intimate partner violence (IPV), explore relationship power inequity and the role of sexual and social risk factors in the production of violence among young women aged 16–24 reporting more than one partner in the past three months in a peri-urban setting in the Western Cape, South Africa. Recent estimates suggest that every six hours a woman is killed by an intimate partner in South Africa, making IPV a leading public health problem in the country. While there is mounting evidence that levels of IPV are high in peri-urban settings in South Africa, not much is known about how it manifests among women who engage in concomitantly high HIV risk behaviours such as multiple sexual partnering, transactional sex and age mixing. We know even less about how such women negotiate power and control if exposed to violence in such sexual networks. Methods Two hundred and fifty nine women with multiple sexual partners, residing in a predominantly Black peri-urban community in the Western Cape, South Africa, were recruited into a bio-behavioural survey using Respondent Driven Sampling (RDS). After the survey, focus group discussions and individual interviews were conducted among young women and men to understand the underlying factors informing their risk behaviours and experiences of violence. Findings 86% of the young women experienced IPV in the past 12 months. Sexual IPV was significantly correlated with sex with a man who was 5 years or older than the index female partner (OR 1.7, 95% CI 1.0–3.2) and transactional sex with most recent casual partner (OR 2.1, 95% CI 1.1–3.8). Predictably, women experienced high levels of relationship power inequity. However, they also identified areas in their controlling relationships where they shared decision making power. Discussion Levels of IPV among young women with multiple sexual partners were much higher than what is reported among women in the general population and shown to be associated with sexual risk taking. Interventions targeting IPV need to address sexual risk taking as it heightens vulnerability to violence. PMID:26599394

Disparities in HIV/AIDS Risk Behaviors After Youth Leave Detention: A 14-Year Longitudinal Study

PubMed Central

Abram, Karen M.; Stokes, Marquita L.; Welty, Leah J.; Aaby, David A.

2017-01-01

OBJECTIVES: To examine changes in the prevalence of 15 HIV/AIDS sex and drug risk behaviors in delinquent youth during the 14 years after they leave detention, focusing on sex and racial/ethnic differences. METHODS: The Northwestern Juvenile Project, a prospective longitudinal study of 1829 youth randomly sampled from detention in Chicago, Illinois, recruited between 1995 and 1998 and reinterviewed up to 11 times. Independent interviewers assessed HIV/AIDS risk behaviors using the National Institutes on Drug Abuse Risk Behavior Assessment. RESULTS: Fourteen years after detention (median age, 30 years), one-quarter of males and one-tenth of females had >1 sexual partner in the past 3 months. One-tenth of participants reported recent unprotected vaginal sex with a high-risk partner. There were many sex and racial/ethnic differences. For example, African American males had 4.67 times the odds of having >1 partner than African American females (95% confidence interval [CI], 3.22–6.76). Over time, compared with non-Hispanic white males, African American males had 2.56 times the odds (95% CI, 1.97–3.33) and Hispanic males had 1.63 times the odds (95% CI, 1.24–2.12) of having multiple partners, even after adjusting for incarceration and age. Non-Hispanic white females were more likely to have multiple partners than racial/ethnic minority females. CONCLUSIONS: Although rates decrease over time, prevalence of sex risk behaviors are much higher than the general population. Among males, racial/ethnic minorities were at particular risk. The challenge for pediatric health is to address how disproportionate confinement of racial/ethnic minority youth contributes to disparities in the HIV/AIDS epidemic. PMID:28115541

Correlates of Suicidal Ideation and Attempt Among Female Sex Workers in China

PubMed Central

HONG, YAN; LI, XIAOMING; FANG, XIAOYI; ZHAO, RAN

2007-01-01

The purpose of this study was to explore the factors associated with suicidal ideation and attempt among female sex workers (FSWs) in China. A cross-sectional survey was administered among 454 FSWs in a rural county of Guangxi, China. About 14% of FSWs had thought of suicide and 8% had attempted suicide in the past 6 months. Multiple logistic regression analyses indicated that those FSWs who were dissatisfied with life, abused alcohol, were deceived or forced into commercial sex, and had stable sexual partners were more likely to report suicidal ideation. Female sex workers who had multiple stable partners, experienced sexual coercion, and worried about an inability to make enough money were more likely to report a suicide attempt. These FSWs who entered commercial sex because of financial needs or who were influenced by the peers were less likely to report a suicide attempt. Our data suggested that the rates of suicidal ideation and attempts were high among FSWs in China, and there were multiple factors associated with their suicidality. Future health education and promotion efforts among FSWs need to take into consideration substance abuse, interpartner conflict, and psychological stress. PMID:17469002

Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities

PubMed Central

Hickson, DeMarc A.; Mena, Leandro A.; Wilton, Leo; Tieu, Hong-Van; Koblin, Beryl A.; Cummings, Vanessa; Latkin, Carl; Mayer, Kenneth H.

2017-01-01

Abstract The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009–2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis. PMID:28402405

Male-on-male intimate partner violence and sexual risk behaviors among money boys and other men who have sex with men in Shanghai, China.

PubMed

Dunkle, Kristin L; Wong, Frank Y; Nehl, Eric J; Lin, Lavinia; He, Na; Huang, Jennifer; Zheng, Tony

2013-05-01

Intimate partner violence (IPV) is known to increase HIV risk among heterosexual women, but less is known about IPV and HIV among men who have sex with men (MSM), with almost no data from non-Western countries. This study examined the prevalence of IPV and links between IPV and HIV risks among MSM in Shanghai, China. A cross-sectional sample of 404 money boys (male sex workers) and other MSM were recruited via respondent-driven sampling. Overall, 51% of the sample reported emotional, physical, or sexual abuse from a male sexual partner. Money boys reported more overall abuse than did other MSM, and more were likely than other MSM to report experiencing multiple types of abuse. MSM who reported violence or abuse from male partners reported more overall sexual risk behavior, and specifically, more unprotected sex and more sex linked to alcohol and other substance use. The association between experience of abuse from male partners and increased HIV risk did not differ between money boys and other Chinese MSM. We conclude that violence and abuse from male partners are highly prevalent among Chinese MSM, and that experience of violence from male sexual partners is linked to increased HIV risk. HIV prevention targeting Chinese MSM must address the increased risk associated with experience of male-on-male IPV. Future research should explore links between HIV risk and MSM's perpetration of violence against male partners, as well as exploring the role of violence in the male-female relationships of men who have sex with and men and women.

Socio-demographics, sexual behaviours, and use of HIV prevention services among men who have sex with men and women in Western China.

PubMed

Dai, Zhenzhen; Zhong, Xiaoni; Peng, Bin; Zhang, Yan; Liang, Hao; Peng, HongBin; Zhong, Xiao Hua; Liu, Xiyao; Huang, Ailong

2016-02-01

This paper looks into the differences of sexual risk behaviours and prevention services among men who have sex with men and women and men who have sex with men only. The data from a cross-sectional survey of 159 men who have sex with men and women and 1186 men who have sex with men only in western China is analysed. It is found that men who have sex with men and women, with multiple anal sex partners, have higher rates of selling and buying sex than men who have sex with men only, but obtain less HIV-related knowledge from partners or HIV consulting and testing services. More efforts should be made to promote safer sexual behaviours and reduce the barriers for access to health services. © The Author(s) 2015.

Health Care Use, Health Behaviors, and Medical Conditions Among Individuals in Same-Sex and Opposite-Sex Partnerships: A Cross-Sectional Observational Analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.

PubMed

Blosnich, John R; Hanmer, Janel; Yu, Lan; Matthews, Derrick D; Kavalieratos, Dio

2016-06-01

Prior research documents disparities between sexual minority and nonsexual minority individuals regarding health behaviors and health services utilization. However, little is known regarding differences in the prevalence of medical conditions. To examine associations between sexual minority status and medical conditions. We conducted multiple logistic regression analyses of the Medical Expenditure Panel Survey (2003-2011). We identified individuals who reported being partnered with an individual of the same sex, and constructed a matched cohort of individuals in opposite-sex partnerships. A total of 494 individuals in same-sex partnerships and 494 individuals in opposite-sex partnerships. Measures of health risk (eg, smoking status), health services utilization (eg, physician office visits), and presence of 15 medical conditions (eg, cancer, diabetes, arthritis, HIV, alcohol disorders). Same-sex partnered men had nearly 4 times the odds of reporting a mood disorder than did opposite-sex partnered men [adjusted odds ratio (aOR)=3.96; 95% confidence interval (CI), 1.85-8.48]. Compared with opposite-sex partnered women, same-sex partnered women had greater odds of heart disease (aOR=2.59; 95% CI, 1.19-5.62), diabetes (aOR=2.75; 95% CI, 1.10-6.90), obesity (aOR=1.92; 95% CI, 1.26-2.94), high cholesterol (aOR=1.89; 95% CI, 1.03-3.50), and asthma (aOR=1.90; 95% CI, 1.02-1.19). Even after adjusting for sociodemographics, health risk behaviors, and health conditions, individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of ≥3 physician visits in the last year compared with opposite-sex partnered individuals. A combination of individual-level, provider-level, and system-level approaches are needed to reduce disparities in medical conditions and health care utilization among sexual minority individuals.

HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks

PubMed Central

Lee, Gunjeong; Howard, Joyce Moon; Caban, Maria; Abramson, David; Messeri, Peter

2006-01-01

This study examines patterns of sexual behavior, sexual relating, and sexual risk among HIV-positive men sexually active with women. A total of 278 HIV-positive men were interviewed every 6–12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many were not sexually active at all for months at a time; many continued to have multiple female and at times male partners. Over one-third of the cohort had one or more periods when they had engaged in unprotected sex with a female partner who was HIV-negative or status unknown (unsafe sex). Periods of unsafe sex alternated with periods of safer sex. Contextual factors such as partner relations, housing status, active drug use, and recently exchanging sex showed the strongest association with increased odds of unsafe sex. A number of predictors of unsafe sex among African American men were not significant among the Latino sub-population, suggesting race/ethnic differences in factors contributing to heterosexual transmission. Implications for prevention interventions are discussed. PMID:16770702

Maternal Drinking and Risky Sexual Behavior in Offspring

PubMed Central

De Genna, Natacha M.; Cornelius, Marie D.

2015-01-01

Teenage mothers are more likely to use drugs, and their children are more likely to use substances and become pregnant during adolescence. Teenage mothers’ substance use may play a role in the intergenerational risk for adolescent pregnancy. Pregnant adolescents (12–18 years) were seen during pregnancy and postnatal years 6, 10, 14, and 16 (n = 332). Teenage mothers reported on substance use and family characteristics. The offspring reported substance use (starting at age 10) and sexual behavior (ages 14 and 16). Prenatal alcohol exposure was associated with offspring (a) having a risky first sex partner and (b) multiple sex partners in the past year. Heavy maternal drinking during childhood was associated with offspring reports of a risky first sex partner and early teenage pregnancy. Findings from this unique birth cohort have implications for alcohol prevention efforts with girls during and after a teenage pregnancy and interventions to prevent risky sex in high-risk youth. PMID:25156314

Gay Apps for Seeking Sex Partners in China: Implications for MSM Sexual Health.

PubMed

Bien, Cedric H; Best, John M; Muessig, Kathryn E; Wei, Chongyi; Han, Larry; Tucker, Joseph D

2015-06-01

Anti-gay stigma and harsh local environments in many low and middle-income countries (LMIC) encourage men who have sex with men (MSM) partner-seeking mobile application (gay app) use. To investigate the sexual risk profiles of gay app users and guide future HIV prevention programs, we conducted a cross-sectional online survey among 1,342 MSM in China examining associations between gay app use and sexual behaviors, including HIV and sexually transmitted disease testing. Compared to non-app users, app users were more likely to be younger, better educated, "out" about their sexual orientation, and single. They were also more likely to report multiple recent sex partners and HIV testing, but there was no difference in condomless sex between the two groups. Future research among MSM in LMIC is needed to characterize gay app use and explore its potential for future public health interventions.

A comparison of HIV-risk behaviors between young black cisgender men who have sex with men and young black transgender women who have sex with men.

PubMed

Crosby, Richard A; Salazar, Laura F; Hill, Brandon; Mena, Leandro

2018-06-01

This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P < .001) and pharyngeal gonorrhea ( P = .04) occurred among YBTWSM; however, both associations were moderated and only significant for HIV-uninfected volunteers. YBTWSM had more oral sex partners and more frequent engagement in oral sex. The number of new sex partners for anal receptive sex was greater in YBTWSM. YBTWSM were more likely to exchange sex for money/drugs ( P < .001), have sex with men recently in prison ( P < .001), who were "anonymous" ( P = .004), or who were "one night stands" ( P < .001). YBTWSM were more likely to depend on sex partners for money food, etc. ( P < .001), to miss meals due to lack of money ( P = .01), and to report having ever being incarcerated ( P = .009). Compared to cisgender YBMSM, YBTWSM experience multiple risk factors relative to the acquisition/transmission of STIs and HIV.

The sexual behaviour of British backpackers in Australia.

PubMed

Hughes, K; Downing, J; Bellis, M A; Dillon, P; Copeland, J

2009-10-01

To explore sexual behaviour and risk-taking among British backpackers in Australia and to investigate the influence of substance use and social settings on sexual behaviour abroad. A cross-sectional design was used. The questionnaire gathered information on sexual and substance use behaviour in the 12 months prior to leaving the UK and during backpackers' stays in Australia. A total of 1008 backpackers, recruited in hostels in Sydney and Cairns, were included in the study. In total, 73.2% had sex during their stay in Australia, including 68.9% of those who arrived without a partner. Across all backpackers, mean number of sexual partners increased from 0.3 per 4-week period in the UK in the 12 months prior to the trip to 1.0 per 4-week period spent in Australia. Over a third (39.7%) had multiple partners in Australia, increasing to 45.7% in those arriving single. Of those arriving single and having sex, 40.9% reported inconsistent condom use and 24.0% had unprotected sex with multiple partners. Number of sexual partners in the UK, length of stay in Australia at time of interview, planned length of stay, frequent visits to bars/clubs, high frequency of alcohol intake and use of illicit substances in Australia were indicators for risky sexual behaviour. Backpackers are at high risk of sexually transmitted infections and other negative sexual health outcomes. Multi-agency sexual health promotion strategies that address the relationship between sex, drugs and alcohol should be targeted at backpackers prior to, and during, their travels.

What puts them at risk? A cross-sectional case-control survey of demographic profile and sexual behavior of patients with sexually transmitted infections at a tertiary care center in North India.

PubMed

Raj, Rama; Gupta, Vishal; Pathak, Mona; Sreenivas, Vishnubhatla; Sood, Seema; Singh, Sarman; Verma, Kaushal K; Khanna, Neena; Das, Bimal K; Gupta, Somesh

2017-01-01

Sexually transmitted infections (STIs) are a major public health problem in developing nations. Identification of risk factors can help in formulating effective strategies against them. The present study was conducted in a tertiary care hospital in North India over 1 year to identify the risk factors associated with STIs. A questionnaire-based cross-sectional case-control survey was conducted where participants answered questions on demographic details, sexual behavior, and awareness of STIs. Cases were patients with STIs whereas controls were randomly selected from healthy individuals accompanying patients with nonvenereal complaints attending our hospital. There were 106 cases and 64 controls. STI patients had sexual debut 2 years before controls. A higher proportion of STI cases had lower education, multiple sexual partners, lived separately from their partner, had nonregular partners, had protected sex in the last month, had sex under influence of alcohol/illicit drugs, sex in unstructured settings, and engaged in transactional sex, in comparison to controls ( P < 0.05). More cases were aware of the symptoms/preventive measures of STIs ( P < 0.001). On multivariate analysis, multiple sexual partners, sex under influence of alcohol/illicit drugs with nonregular partner, protected sex in the last month, and knowledge of preventive measures were found to be statistically associated with STIs ( P < 0.05). Our study identifies risk-behavior patterns in patients with STIs, which should be modified to reduce the burden of these diseases. Increasing the knowledge about STIs in these patients can translate into more common condom usage that lends support for strengthening sexual health programs at grass-root levels. The small size of the study population could have led to decreased power of the study to detect differences between cases and controls. The external validity of our results needs to be tested in different population groups involving larger sample sizes.

Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia.

PubMed

Abdala, Nadia; Kershaw, Trace; Krasnoselskikh, Tatiana V; Kozlov, Andrei P

2011-07-01

This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11-2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36-0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33-0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49-0.97, p = 0.03). Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

Disassortative mixing patterns of drug-using and sex networks on HIV risk behaviour among young drug users in Yunnan, China.

PubMed

Li, J; Luo, J; Li, J; Liu, H

2015-09-01

The dominant mode of HIV transmission in China has changed from injection drug use to sexual contact. The objectives of this study were to describe the disassortative and assortative mixing patterns of drug-using and sex networks among young drug users in China. Cross-sectional study. Respondent-driven sampling (RDS) was used to recruit young drug users in an egocentric network study in Yunnan, China. Egos were categorized as having disassortative mixing network patterns if they reported both sex and drug-using networks. Egos who only had a sex network (no drug-using network), or only a drug-using network (no sex network) were categorized as having assortative mixing network patterns. Multiple logistic regression was performed to analyze the relationships between disassortative patterns with risky sexual behaviour and drug-using practices. A total of 426 participants were recruited into the study. Two hundred forty-two egos reported disassortative mixing patterns and 139 egos had assortative patterns. The RDS-adjusted proportion of having a disassortative pattern was 53.2%. Participants with disassortative patterns were more likely to engage in HIV risk behaviour compared to those with assortative patterns. Specifically, drug users with disassortative patterns reported more multiple sex partners (31.4% vs 19.6%), concurrent partnerships (52.1% vs 39.0%), non-regular sex partners (12.0% vs 4.3%), and sex partners who were IDUs (24.9% vs 12.5%). Consistent condom use with regular or non-regular partners was low (between 18.9% and 47.2%) regardless of the mixing pattern. However, parenteral risk for HIV transmission was relatively low in both groups. The transition of the HIV epidemic in China from injection drug use to sexual contact may be attributed to disassortative mixing in drug-use and sexual networks. HIV programs should consider disassortative mixing patterns when designing new behavioural interventions. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Estimates of Self, Parental and Partner Multiple Intelligences in Iran: A replication and extension.

PubMed

Furnham, Adrian; Kosari, Afrooz; Swami, Viren

2012-01-01

Two hundred and fifty-eight Iranian university students estimated their own, parents', and partners' overall (general) intelligence, and also estimated 13 'multiple intelligences' on a simple, two-page questionnaire which was previously used in many similar studies. In accordance with previous research, men rated themselves higher than women on logical-mathematical, spatial and musical intelligence. There were, however, no sex differences in ratings of parental and partner multiple intelligences, which is inconsistent with the extant literature. Participants also believed that they were more intelligent than their parents and partners, and that their fathers were more intelligent than their mothers. Multiple regressions indicated that participants' Big Five personality typologies and test experience were significant predictors of self-estimated intelligence. These results are discussed in terms of the cross-cultural literature in the field. Implications of the results are also considered.

Sex on the beach: the influence of social norms and trip companion on spring break sexual behavior.

PubMed

Lewis, Melissa A; Patrick, Megan E; Mittmann, Angela; Kaysen, Debra L

2014-06-01

Spring Break trips are associated with heavy drinking and with risky sexual behavior (e.g., unprotected sex, multiple partners, unwanted sexual contact), especially for those students who go on trips with friends. The present study adds to this growing event-specific risk literature by examining Spring Break-specific normative perceptions of sexual risk behavior and the role that these perceptions and taking a trip with a friend or with a romantic partner have on Spring Break sexual behavior. College students (N = 1,540; 53.9 % female) were asked to report descriptive normative perceptions of sex with casual partners, drinking prior to sex, number of drinks prior to sex, and condom use as well as their own Spring Break drinking and sexual behaviors. Students perceived the typical same-sex student to have engaged in more frequent sexual behavior for all outcomes than students' own self-reported sexual behavior. Furthermore, results revealed that these perceptions were positively associated with behavior. The choice of travel companion (friend(s) versus romantic partner) also differentially predicted sexual behaviors. Results suggested that intervention efforts aimed at reducing risks for Spring Break trip-takers may be strongest when they incorporate corrective normative information and target those traveling with friends.

Sex on the Beach: The Influence of Social Norms and Trip Companion on Spring Break Sexual Behavior

PubMed Central

Lewis, Melissa A.; Patrick, Megan E.; Mittmann, Angela; Kaysen, Debra L.

2014-01-01

Spring Break trips are associated with heavy drinking and with risky sexual behavior (e.g., unprotected sex, multiple partners, unwanted sexual contact), especially for those students who go on trips with friends. The present study adds to this growing event-specific risk literature by examining Spring Break-specific normative perceptions of sexual risk behavior and the role that these perceptions and taking a trip with a friend or with a romantic partner have on Spring Break sexual behavior. College students (N = 1,540; 53.9% female) were asked to report descriptive normative perceptions of sex with casual partners, drinking prior to sex, number of drinks prior to sex, and condom use as well as their own Spring Break drinking and sexual behaviors. Students perceived the typical same-sex student to have engaged in more frequent sexual behavior for all outcomes than students’ own self-reported sexual behavior. Furthermore, results revealed that these perceptions were positively associated with behavior. The choice of travel companion (friend(s) vs. romantic partner) also deferentially predicted sexual behaviors. Results suggested that intervention efforts aimed at reducing risks for Spring Break trip-takers may be strongest when they incorporate corrective normative information and target those traveling with friends. PMID:24464322

It is complicated: sexual partner characteristic profiles and sexually transmitted infection rates within a predominantly African American population in Mississippi.

PubMed

Alexander, Jalen; Rose, Jennifer; Dierker, Lisa; Chan, Philip A; MacCarthy, Sarah; Simmons, Dantrell; Mena, Leandro; Nunn, Amy

2015-05-01

Mississippi has among the highest prevalence of sexually transmitted infections (STIs) in the United States. Understanding sexual networks can provide insight into risk factors for transmission and guide prevention interventions. Participants included 1437 primarily African American (95%) adults presenting for care at an STI clinic in Jackson, Mississippi. Latent class analysis identified underlying population subgroups with unique patterns of response on a comprehensive set of 14 sexual partner variables, such as living with or having a child with a partner, partner dependence and trust, 1-time sexual encounters, multiple main partners, substance use, sexual concurrency, and incarceration. Classes were compared on participant age, sex, sexual orientation, public assistance, lifetime partners, relationship status, and self-reported past-year STI. Three classes emerged. Class 1 (n = 746) participants were less dependent on partners and less likely to live with or have a child with a partner. Class 2 participants (n = 427) endorsed multiple STI risk factors, including partner incarceration, 6 or more lifetime partners, sexual concurrency, 1-time sexual encounters, and substance use at last sex. Class 3 participants (n = 226) were more likely to be in dependent, committed relationships with children. Class 2 had a higher proportion of self-report past-year STIs (36.7%) compared with classes 1 (26.6%) and 3 (26.1%). Certain partner factors such as incarceration, substance use, and concurrency may contribute to increased STI risk. Partner factors may be useful proxies for STI risks and could be useful questions to include in screening questionnaires in clinical settings.

"Eyes that don't see, heart that doesn't feel": coping with sex work in intimate relationships and its implications for HIV/STI prevention.

PubMed

Syvertsen, Jennifer L; Robertson, Angela M; Rolón, María Luisa; Palinkas, Lawrence A; Martinez, Gustavo; Rangel, M Gudelia; Strathdee, Steffanie A

2013-06-01

Partner communication about HIV sexual risk behaviors represents a key area of epidemiologic and social importance in terms of infection acquisition and potential for tailored interventions. Nevertheless, disclosing sexual risk behaviors often presents myriad challenges for marginalized couples who engage in stigmatized behaviors. Using qualitative data from a social epidemiology study of risk for HIV and other sexually transmitted infections (STIs) among female sex workers and their intimate, non-commercial male partners along the Mexico-U.S. border, we examined both partners' perspectives on sex work and the ways in which couples discussed associated HIV/STI risks in their relationship. Our thematic analysis of individual and joint interviews conducted in 2010 and 2011 with 44 couples suggested that broader contexts of social and economic inequalities profoundly shaped partner perspectives of sex work. Although couples accepted sex work as an economic contribution to the relationship in light of limited alternatives and drug addiction, it exacted an emotional toll on both partners. Couples employed multiple strategies to cope with sex work, including psychologically disconnecting from their situation, telling "little lies," avoiding the topic, and to a lesser extent, superficially discussing their risks. While such strategies served to protect both partners' emotional health by upholding illusions of fidelity and avoiding potential conflict, non-disclosure of risk behaviors may exacerbate the potential for HIV/STI acquisition. Our work has direct implications for designing multi-level, couple-based health interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Correlates of amphetamine-type stimulants use and associations with HIV-related risks among young women engaged in sex work in Phnom Penh, Cambodia

PubMed Central

Couture, Marie-Claude; Evans, Jennifer L.; Sothy, Neth San; Stein, Ellen S.; Sichan, Keo; Maher, Lisa; Page, Kimberly

2011-01-01

Background Amphetamine-type stimulant (ATS) use has increased in Cambodia and emerged as a significant problem among female sex workers (FSWs), potentially contributing to increased risk of HIV. We examined the prevalence of ATS use and its effect on sexual risk behaviors, and sexually transmitted infections (STI) among FSWs in Phnom Penh, Cambodia. Methods A one-year prospective study among young women engaged in sex work in brothels, entertainment establishments and on a freelance basis. Socio-demographics, sexual risks, and recent ATS use were assessed by self-report. Blood and urine samples were collected to detect HIV, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Bivariate and multivariate longitudinal analyses were conducted to assess the effects of ATS use on number of sex partners, inconsistent condom use with paying partners and incident STI. Results ATS use was higher among women working freelance (35.6%) and in brothels (34.8%) compared to women working in entertainment establishments (17.7%) or in multiple venues (14.8%). ATS users reported more sex partners and days drunk in the previous month. In multivariate longitudinal analysis, ATS use was associated with having a higher number of sex partners (Adjusted Risk Ratio 1.49; 95% CI: 1.00–2.21) and incident STI (Adjusted Odds Ratio 5.41; 95% CI: 1.15–25.48), but not inconsistent condom use with paying partner. Conclusion ATS users had more sex partners, high level of alcohol use, and were at increased risk of STI. Our findings underscore ATS use as an important emerging risk exposure that should be integrated into HIV prevention interventions targeting this population. PMID:21820251

Relationship between Migration and HIV Risky Behavior: a Comparative Study of Returning Migrants and Non Migrants Based on Rural Out-of-school Youth in Jilin, China.

PubMed

Zhu, Guang Rong; Ji, Cheng Ye; Yang, Xing Hua

2015-06-01

To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China. A cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China. 58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse (4.3% for males and 5.5% for females, P<0.01), multiple sexual partners (24.1% for males and 44.1% for females, P<0.01), and HIV knowledge rate (35.2% for males and 25.5% for females, P<0.001). While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration. Among rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

African American adolescents meeting sex partners online: closing the digital research divide in STI/HIV prevention.

PubMed

Whiteley, Laura B; Brown, Larry K; Swenson, Rebecca R; Valois, Robert F; Vanable, Peter A; Carey, Michael P; DiClemente, Ralph; Salazar, Laura F; Romer, Daniel

2012-02-01

Minority adolescents are affected disproportionately by HIV and STIs, and the Internet is a popular venue to meet sex partners. Little is known about the risks of this behavior for minority adolescents. The majority of studies that have examined sexual risk behavior online or STI/HIV prevention programs online have been among adult MSM. In this study, data from 1,045 African American youth found that 6% met sex partners online and in chat rooms. Odds ratios, adjusting for gender, found this behavior was associated with alcohol (AOR = 2.33, 95% CI [1.1, 4.7]) and drug use (AOR = 3.45, 95% CI [1.9, 6.1]), unprotected vaginal (AOR = 4.71, 95% CI [1.9, 8.4]) and anal sex (AOR = 4.77, 95% CI [1.3,17.1]) in the last 90 days, more lifetime vaginal (AOR = 3.65, 95% CI [2.0, 6.8]) and anal sex (AOR = 2.74, 95% CI [1.5, 4.8]), greater sexual sensation seeking (AOR = 2.92, 95% CI [1.5, 5.7]) and greater depression (AOR = 2.06, 95% CI [1.2, 3.6]. A final multiple logistic regression analyses found that male gender (AOR = 3.13, 95% CI [1.7, 5.8]), drug use at last sex (AOR = 2.41, 95% CI [1.3, 4.5]), lifetime history of vaginal (AOR = 2.90, 95% CI [1.5, 5.5]) and anal sex (AOR = 2.09, 95% CI [1.2, 3.6]), and cocaine use (AOR = 8.53, 95% CI [2.7, 27.3]) were independently associated with having sex with a partner met online. Meeting sex partners online is associated with a variety of risks among African American youth; however, the Internet may be an opportunity for intervention.

Intimate partner, familial and community violence among men who have sex with men in Namibia

PubMed Central

Stephenson, Rob; Hast, Marisa; Finneran, Catherine; Sineath, Craig R.

2015-01-01

Men who have sex with men in sub-Saharan Africa are known to experience high levels of violence, yet little research has focused on their perceptions of intimate partner violence (IPV). This study examines the perceived typologies and sources of multiple forms of violence, including IPV, family/community violence and discrimination from healthcare workers, among men who have sex with men in Namibia. Focus-group discussions and in-depth interviews were conducted with a 52 men residing in five cities across Namibia. Results indicate that violence, in varying forms, is commonplace in the lives of men who have sex with men in this community, and may be associated with HIV testing patterns. PMID:24735113

Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study.

PubMed

Thirumurthy, Harsha; Masters, Samuel H; Mavedzenge, Sue Napierala; Maman, Suzanne; Omanga, Eunice; Agot, Kawango

2016-06-01

Increased uptake of HIV testing by men in sub-Saharan Africa is essential for the success of combination prevention. Self-testing is an emerging approach with high acceptability, but little evidence exists on the best strategies for test distribution. We assessed an approach of providing multiple self-tests to women at high risk of HIV acquisition to promote partner HIV testing and to facilitate safer sexual decision making. In this cohort study, HIV-negative women aged 18-39 years were recruited at two sites in Kisumu, Kenya: a health facility with antenatal and post-partum clinics and a drop-in centre for female sex workers. Participants gave informed consent and were instructed on use of oral fluid based rapid HIV tests. Participants enrolled at the health facility received three self-tests and those at the drop-in centre received five self-tests. Structured interviews were conducted with participants at enrolment and over 3 months to determine how self-tests were used. Outcomes included the number of self-tests distributed by participants, the proportion of participants whose sexual partners used a self-test, couples testing, and sexual behaviour after self-testing. Between Jan 14, 2015, and March 13, 2015, 280 participants were enrolled (61 in antenatal care, 117 in post-partum care, and 102 female sex workers); follow-up interviews were completed for 265 (96%). Most participants with primary sexual partners distributed self-tests to partners: 53 (91%) of 58 participants in antenatal care, 91 (86%) of 106 in post-partum care, and 64 (75%) of 85 female sex workers. 82 (81%) of 101 female sex workers distributed more than one self-test to commercial sex clients. Among self-tests distributed to and used by primary sexual partners of participants, couples testing occurred in 27 (51%) of 53 in antenatal care, 62 (68%) of 91 from post-partum care, and 53 (83%) of 64 female sex workers. Among tests received by primary and non-primary sexual partners, two (4%) of 53 tests from participants in antenatal care, two (2%) of 91 in post-partum care, and 41 (14%) of 298 from female sex workers had positive results. Participants reported sexual intercourse with 235 (62%) of 380 sexual partners who tested HIV-negative, compared with eight (18%) of 45 who tested HIV-positive (p<0·0001); condoms were used in all eight intercourse events after positive results compared with 104 (44%) after of negative results (p<0·0018). Four participants reported intimate partner violence as a result of self-test distribution: two in the post-partum care group and two female sex workers. No other adverse events were reported. Provision of multiple HIV self-tests to women at high risk of HIV infection was successful in promoting HIV testing among their sexual partners and in facilitating safer sexual decisions. This novel strategy warrants further consideration as countries develop self-testing policies and programmes. Bill & Melinda Gates Foundation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationships among Substance Use, Multiple Sexual Partners, and Condomless Sex: Differences between Male and Female U.S. High School Adolescents

ERIC Educational Resources Information Center

Zhao, Yunchuan; Kim, Heejung; Peltzer, Jill

2017-01-01

Male and female students manifest different behaviors in condomless sex. This cross-sectional, exploratory, correlational study examined the differences in risk factors for condomless sex between male and female high school students, using secondary data from 4,968 sexually active males and females participating in the 2011 National Youth Risk…

Excitement, Adventure, Indifference: Romance Readers' Perceptions of How Romance Reading Impacts Their Sex Lives

ERIC Educational Resources Information Center

Anderton, Gretchen E.

2009-01-01

This mixed-methods study examined romance readers' perceptions of how reading romance novels has impacted their sex lives, feelings about their sex partners, knowledge of sexuality and their sexual behavior. Fifty-three women romance readers over the age of 18 completed an online survey composed of multiple choice and open-ended essay questions. …

‘It is not expected for married couples’: a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania

PubMed Central

Mtenga, Sally Mmanyi; Geubbels, Eveline; Tanner, Marcel; Merten, Sonja; Pfeiffer, Constanze

2016-01-01

Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although social-structural factors are crucial in understanding sexual behavior, only a few studies focus on understanding safer sex dialogue in a broader social context. Design Drawing on the WHO-Commission on the Social Determinants of Health (WHO-CSDH) framework, this study explored key social-structural constructs for studying health in the context of improving safer sex dialogue between polygamous and monogamous partners. Twenty-four in-depth interviews (IDIs) and six focus group discussions (FGDs) with 38 men and women aged 18–60 years were conducted in Ifakara town located in Kilombero district, Tanzania. The study was nested within the community health surveillance project MZIMA (Kiswahili: ‘being healthy’). Partners’ experiences of safer sex dialogue in polygamous and monogamous relations were investigated and the challenges to safer sex dialogue explored. Results The study revealed that open safer sex dialogue in marriage is limited and challenged by social norms about marriage (a view that safer sex dialogue imply that partners are ‘not really’ married); marital status (a belief that safer sex dialogue is not practical in polygamous marriages, the elder wife should be exempted from the dialogue since she is at lower risk of engaging in extramarital affairs); relationship quality (marital conflicts, extramarital affairs, trust, and sexual dissatisfaction); and gender power relations (the notion that females’ initiative to discuss condom use and HIV couple counseling and testing may lead to conflict or divorce). Conclusions Implementing safer sex practices requires interventions beyond promotion messages. HIV prevention interventions in Tanzania should be carefully adapted to the local context including respective social norms, gender systems, marital context and relationship uncertainties as aspects that facilitate or hinder safer sex dialogue between partners. The WHO-CSDH framework could be strengthened by explicitly integrating relationship quality, marital status, and social norms as additional determinants of health. PMID:27633036

Patterns of Gender-Based Violence and Associations with Mental Health and HIV Risk Behavior Among Female Sex Workers in Mombasa, Kenya: A Latent Class Analysis.

PubMed

Roberts, Sarah T; Flaherty, Brian P; Deya, Ruth; Masese, Linnet; Ngina, Jacqueline; McClelland, R Scott; Simoni, Jane; Graham, Susan M

2018-03-30

Gender-based violence (GBV) is common among female sex workers (FSWs) and is associated with multiple HIV risk factors, including poor mental health, high-risk sexual behavior, and sexually transmitted infections (STIs). Prior studies have focused on GBV of one type (e.g. physical or sexual) or from one kind of perpetrator (e.g., clients or regular partners), but many FSWs experience overlapping types of violence from multiple perpetrators, with varying frequency and severity. We examined the association between lifetime patterns of GBV and HIV risk factors in 283 FSWs in Mombasa, Kenya. Patterns of GBV were identified with latent class analysis based on physical, sexual, or emotional violence from multiple perpetrators. Cross-sectional outcomes included depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, disordered alcohol and other drug use, number of sex partners, self-reported unprotected sex, prostate-specific antigen (PSA) in vaginal secretions, and a combined unprotected sex indicator based on self-report or PSA detection. We also measured HIV/STI incidence over 12 months following GBV assessment. Associations between GBV patterns and each outcome were modeled separately using linear regression for mental health outcomes and Poisson regression for sexual risk outcomes. Lifetime prevalence of GBV was 87%. We identified 4 GBV patterns, labeled Low (21% prevalence), Sexual (23%), Physical/Moderate Emotional (18%), and Severe (39%). Compared to women with Low GBV, those with Severe GBV had higher scores for depressive symptoms, PTSD symptoms, and disordered alcohol use, and had more sex partners. Women with Sexual GBV had higher scores for disordered alcohol use than women with Low GBV, but similar sexual risk behavior. Women with Physical/Moderate Emotional GBV had more sex partners and a higher prevalence of unprotected sex than women with Low GBV, but no differences in mental health. HIV/STI incidence did not differ significantly by GBV pattern. The prevalence of GBV was extremely high in this sample of Kenyan FSWs, and different GBV patterns were associated with distinct mental health and sexual risk outcomes. Increased understanding of how health consequences vary by GBV type and severity could lead to more effective programs to reduce HIV risk in this vulnerable population.

Student Sex: More or Less Risky than Other Young Adults?

ERIC Educational Resources Information Center

Burke, Lorraine; Nic Gabhainn, Saoirse; Young, Honor

2015-01-01

Sexually active young adults are at an increased risk of acquiring sexually transmitted infections (STIs) or experiencing an unplanned pregnancy. Sexual behaviours such as inconsistent condom use, multiple partners and casual sex are known risk factors for negative sexual health outcomes. Sexually active higher education students are classified as…

Relationship Factors Associated with Sexual Risk Behavior and High-Risk Alcohol Consumption Among Latino Men Who Have Sex with Men: Challenges and Opportunities to Intervene on HIV Risk.

PubMed

Martinez, Omar; Muñoz-Laboy, Miguel; Levine, Ethan C; Starks, Tyrel; Dolezal, Curtis; Dodge, Brian; Icard, Larry; Moya, Eva; Chavez-Baray, Silvia; Rhodes, Scott D; Fernandez, M Isabel

2017-05-01

The HIV epidemic continues to be a major public health concern, affecting communities with varying prevention and treatment needs. In the U.S., Latino men who have sex with men (MSM) bear a disproportionate burden of HIV incidence. While recent studies have highlighted the relevance of relationship factors for HIV transmission among MSM generally, the unique needs and experiences of Latino MSM have received relatively little attention. Consequently, associations between relationship factors and HIV risk among Latino MSM remain unknown. This mixed-method study examined relationship status and dynamics and potential HIV-related risk behaviors among Latino MSM. Quantitative analyses with 240 Latino MSM investigated associations between relationship status and engagement in condomless anal intercourse (CAI). Focus groups with 20 Latino male couples and 10 health service providers explored the impact of relationship dynamics on sexual behaviors, as well as opportunities to intervene on HIV risk. The majority of participants were predominantly Spanish speaking, most screened positive for high-risk alcohol consumption in the past month, more than half engaged in CAI in the past 3 months, and a majority reported multiple sexual partners in this period. Among participants in same-sex relationships (n = 175), approximately half reported multiple partners in the previous 3 months and more than two-thirds reported CAI in this time period. Being in a same-sex relationship was positively associated with high-risk alcohol consumption and being age 30 or older and negatively associated with having multiple partners. Moreover, being in a same-sex relationship significantly increased the likelihood that participants would report engaging in CAI. Qualitative analyses identified themes related to relationship dynamics and sexual behavior, as well as opportunities to intervene on HIV risk. Despite the challenges encountered by Latino male couples, most participants expressed commitment to and support for their partners. As such, prevention efforts involving Latino male couples must address relationship dynamics and the role they play in sexual health, including safer sex practices.

Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis.

PubMed

Prudden, Holly J; Beattie, Tara S; Bobrova, Natalia; Panovska-Griffiths, Jasmina; Mukandavire, Zindoga; Gorgens, Marelize; Wilson, David; Watts, Charlotte H

2015-01-01

Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this. National, urban and rural data on HIV prevalence, the percentage of younger (15-24) and older (25-49) women and men reporting multiple (2+) partners in the past year, HIV prevalence among female sex workers (FSWs), men who have bought sex in the past year (clients), and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other. National population HIV prevalence varies between 0 4-2 9% for men and 0 4-5.6% for women. ART coverage ranges from 6-23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence. In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners.

Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities.

PubMed

Hickson, DeMarc A; Mena, Leandro A; Wilton, Leo; Tieu, Hong-Van; Koblin, Beryl A; Cummings, Vanessa; Latkin, Carl; Mayer, Kenneth H

2017-05-01

The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Maternal drinking and risky sexual behavior in offspring.

PubMed

De Genna, Natacha M; Cornelius, Marie D

2015-04-01

Teenage mothers are more likely to use drugs, and their children are more likely to use substances and become pregnant during adolescence. Teenage mothers' substance use may play a role in the intergenerational risk for adolescent pregnancy. Pregnant adolescents (12-18 years) were seen during pregnancy and postnatal years 6, 10, 14, and 16 (n = 332). Teenage mothers reported on substance use and family characteristics. The offspring reported substance use (starting at age 10) and sexual behavior (ages 14 and 16). Prenatal alcohol exposure was associated with offspring (a) having a risky first sex partner and (b) multiple sex partners in the past year. Heavy maternal drinking during childhood was associated with offspring reports of a risky first sex partner and early teenage pregnancy. Findings from this unique birth cohort have implications for alcohol prevention efforts with girls during and after a teenage pregnancy and interventions to prevent risky sex in high-risk youth. © 2014 Society for Public Health Education.

High levels of bisexual behavior and factors associated with bisexual behavior among men having sex with men (MSM) in Nigeria.

PubMed

Sheehy, Meredith; Tun, Waimar; Vu, Lung; Adebajo, Sylvia; Obianwu, Otibho; Karlyn, Andrew

2014-01-01

Nigerian men who have sex with men (MSM) have a high burden of HIV infection and are known to engage in bisexual behavior. This study presents the first data on characteristics and correlates of Nigerian men having sex with men and women (MSMW) in three Nigerian cities. Five hundred and fifty-seven MSM who engaged in anal sex with men completed a behavioral survey; 48.1% of these MSM also engaged in sex with women in the previous 2 months. MSMW displayed high levels of risky sexual behavior with female sex partners; casual (56.0%) and multiple female partners were common (69.0%) and 66.0% had unprotected vaginal sex. As much as 45.1% MSMW had anal sex with female partners of which 74.0% did not use protection in the 2 months prior. In bivariate analyses, bisexual behavior was associated (p<0.05) with being married or living with a women (OR 5.0, 95% CI = 2.6-9.4), less education (OR 2.0, 95% CI = 1.4-3.0), bisexual/straight identity (OR 2.3, 95% CI = 1.6-3.2), being an insertive partner (OR 3.0, 95% CI = 1.9-4.5), being HIV-negative (OR 1.6, 95% CI = 1.1-2.5), living in Lagos (OR 2.3, 95% CI = 1.7-2.2), being Muslim (OR 1.7, 95% CI = 1.1-2.5), and being away from home (OR 1.5, 95% CI = 1.0-2.1). In the multivariate model, being married to or living with a woman (AOR = 5.1; 95% CI = 2.5-10.3), bisexual/straight identity (AOR = 2.2; 95% CIs = 1.5-3.3), being an insertive partner (AOR = 3.0; 95% CI = 1.9-4.9), being away from home (AOR = 1.6; 95% CI = 1.1-2.3) and living in Lagos (AOR = 1.7; 95% CI = 1.0-2.8) remained significant (p< 0.05). High levels of bisexual behavior exist among Nigerian MSM, and these men engage in risky sexual behaviors with both male and female sex partners. While decriminalization of same-sex behavior in Nigeria will promote access to HIV prevention programs, current MSM interventions must incorporate information on safe sex with both male and female sex partners.

Prevalence and Risk Factors for Human Immunodeficiency Virus (HIV) and Syphilis Infections Among Military Personnel in Sierra Leone

DTIC Science & Technology

2017-03-01

partners, unintended sex after alcohol use and use of condoms were independently associated with HIV status (pɘ.05). After adjustment, HIV infection...was associated with female gender, unin- tended sex after alcohol use, condom use at last sex , having multiple sexual partnerships in the same week...transmitted through heterosexual contact, principal risk factors for HIV transmission have been identi- fied as having sex with a commercial sex worker and

HIV Partner Notification Values and Preferences Among Sex Workers, Fishermen, and Mainland Community Members in Rakai, Uganda: A Qualitative Study.

PubMed

Quinn, Caitlin; Nakyanjo, Neema; Ddaaki, William; Burke, Virginia M; Hutchinson, Naadiya; Kagaayi, Joseph; Wawer, Maria J; Nalugoda, Fred; Kennedy, Caitlin E

2018-01-25

HIV partner notification involves contacting sexual partners of people who test HIV positive and referring them to HIV testing, treatment, and prevention services. To understand values and preferences of key and general populations in Rakai, Uganda, we conducted 6 focus group discussions and 63 in-depth interviews in high prevalence fishing communities and low prevalence mainland communities. Participants included fishermen and sex workers in fishing communities, male and female mainland community members, and healthcare providers. Questions explored three approaches: passive referral, provider referral, and contract referral. Qualitative data were coded and analyzed using a team-based matrix approach. Participants agreed that passive referral was most suitable for primary partners. Provider referral was acceptable in fishing communities for notifying multiple, casual partners. Healthcare providers voiced concerns about limited time, resources, and training for provider-assisted approaches. Options for partner notification may help people overcome barriers to HIV serostatus disclosure and help reach key populations.

Female methamphetamine users: social characteristics and sexual risk behavior.

PubMed

Semple, Shirley J; Grant, Igor; Patterson, Thomas L

2004-01-01

The primary objective of this research was to expand our knowledge regarding the personal and social characteristics of female methamphetamine (meth) users, their motivations for using meth, patterns of meth use, medical and social problems associated with meth use, and the relationship between meth use and sexual risk behaviors. The sample consisted of 98 HIV-negative, heterosexually-identified, meth-using females residing in San Diego, California. Female meth users were characterized by personal and social disadvantage, high rates of psychiatric symptomatology, and high levels of sexual risk behavior, including multiple partners, risky partner types (e.g., anonymous sex partners), and high rates of unprotected vaginal and oral sex. Meth use was also associated with the subjective positive experience of sex. These finding suggest that behavioral interventions should be tailored to the social characteristics of female meth users, and program content should reflect the intertwining of women's sexual experience and meth use.

HIV-related sexual risk behaviors among male-to-female transgender people in Nepal.

PubMed

Bhatta, Dharma Nand

2014-05-01

Transgender women are a vulnerable and key risk group for HIV, and most research has shown an increased frequency of HIV infection among this minority population. This study examined the prevalence of HIV-related sexual risk behaviors and the socio-demographic correlates with HIV-related sexual risk behaviors among male-to-female (MtF) transgender persons. Data were collected from a sample of 232 individuals through venue-based and snowball sampling and face-to-face interviews. The HIV-related sexual risk behaviors among the MtF transgender persons were: sex without using a condom (48.3%; 95% confidence interval (CI) 41.8-54.8), unprotected anal sex (68.1%; 95% CI 62.0-74.2), and unprotected sex with multiple partners (88.4%; 95% CI 84.3-92.5). Statistically significant differences were found for age, income, education, alcohol habit, and sex with more than two partners per day for these three different HIV-related sexual risk behaviors. MtF transgender persons with a secondary or higher level of education were three times (OR 2.93) more likely to have unprotected sex with multiple partners compared to those with a primary level or no education. Age, education, income, frequency of daily sexual contact, and an alcohol habit remain significant with regard to HIV-related sexual risk behavior. There is an urgent need for programs and interventions to reduce risky sexual behaviors in this minority population. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men.

PubMed

Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P

2017-01-01

We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.

Empowering Factors Among Breast Cancer Screening Compliant Underserved Populations

DTIC Science & Technology

2005-10-01

sex 17 Promiscuous sex (Multiple sexual, partnersý) 18 Chewing Tobacco 19 Being Female 20 Being Male 21 H. Barriers to Cancer Screening For each...Behavior among Preteen Black and White Children. JNMA, 96: (2) 200-208; 2004. 7. Elzey JD and Ahmed NU. A Whole New Life: an illness and a healing by

Male Rural-to-Urban Migrants and Risky Sexual Behavior: A Cross-Sectional Study in Shanghai, China

PubMed Central

Wu, Jun-Qing; Wang, Ke-Wei; Zhao, Rui; Li, Yu-Yan; Zhou, Ying; Li, Yi-Ran; Ji, Hong-Lei; Ji, Ming

2014-01-01

This study examined the prevalence and the determinants of risky sexual behavior (defined as having multiple sex partners and paying for sex) among male rural-to-urban migrants in China. An anonymous questionnaire was used to collect information on socio-demographics, knowledge, attitudes, and behavior associated with increased risk of risky sexual behavior from 4,069 subjects. In total 1,132 (27.8%) participants reported two or more sex partners and 802 (19.7%) participants paid for sex. A considerable proportion (29.6%–41.5%) did not use a condom during risky sexual behavior. Logistic regression analysis revealed that unmarried status (OR: 0.62, CI: 0.42–0.85 for married), earlier age at first sexual experience (OR: 0.67, 95% CI: 0.31–0.91 for ≥22 years old), poor perception of risk of acquiring HIV/AIDS (OR: 1.51, 95% CI: 1.33–1.96 for unlikely; OR: 2.38, 95% CI: 1.61–3.70 for impossible), frequent exposure to pornography (OR: 0.67, 95% CI: 0.60–0.81 for sometimes; OR: 0.31, 95% CI: 0.11–0.43 for never), attitudes toward legalization of commercial sex (OR: 0.39, 95% CI: 0.21–0.59 for no), peer influence (OR: 0.51, 95% CI: 0.27–0.88 for no), and not knowing someone who had/had died from HIV/AIDS (OR: 0.35, 95% CI: 0.20–0.53 for yes) were all significantly associated with having multiple sex partners. Those who paid for sex showed similar findings. PMID:24619119

Mujeres que Consumen Sustancias y su Vulnerabilidad frente al VIH en Santiago de Chile

PubMed Central

Irarrázabal, Lisette P.; Ferrer, Lilian; Villegas, Natalia; Sanhueza, Sebastián; Molina, Yerko; Cianelli, Rosina

2017-01-01

Introduction Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. Methodology A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. Results The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation (p < 0.05) between substance abuse and HIV risk behaviors. Conclusion It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community. PMID:27257222

Mujeres que Consumen Sustancias y su Vulnerabilidad frente al VIH en Santiago de Chile (Women Who Consume Substances and Their Vulnerability to HIV in Santiago of Chile).

PubMed

Irarrázabal, Lisette P; Ferrer, Lilian; Villegas, Natalia; Sanhueza, Sebastián; Molina, Yerko; Cianelli, Rosina

2016-06-01

Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation (p < 0.05) between substance abuse and HIV risk behaviors. It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community. © The Author(s) 2016.

Sexual Orientation Disparities in Sexually Transmitted Infection Risk Behaviors and Risk Determinants Among Sexually Active Adolescent Males: Results From a School-Based Sample

PubMed Central

Schnarrs, Phillip W.; Rosario, Margaret; Garofalo, Robert; Mustanski, Brian

2014-01-01

Objectives. We examined disparities in risk determinants and risk behaviors for sexually transmitted infections (STIs) between gay-identified, bisexual-identified, and heterosexual-identified young men who have sex with men (YMSM) and heterosexual-identified young men who have sex with women (YMSW) using a school-based sample of US sexually active adolescent males. Methods. We analyzed a pooled data set of Youth Risk Behavior Surveys from 2005 and 2007 that included information on sexual orientation identity, sexual behaviors, and multiple STI risk factors. Results. Bisexual-identified adolescents were more likely to report multiple STI risk behaviors (number of sex partners, concurrent sex partners, and age of sexual debut) compared with heterosexual YMSW as well as heterosexual YMSM and gay-identified respondents. Gay, bisexual, and heterosexual YMSM were significantly more likely to report forced sex compared with heterosexual YMSW. Conclusions. Our results provide evidence that sexual health disparities emerge early in the life course and vary by both sexual orientation identity and sexual behaviors. In particular, they show that bisexual-identified adolescent males exhibit a unique risk profile that warrants targeted sexual health interventions. PMID:24825214

Who pays for sex? An analysis of the increasing prevalence of female commercial sex contacts among men in Britain.

PubMed

Ward, H; Mercer, C H; Wellings, K; Fenton, K; Erens, B; Copas, A; Johnson, A M

2005-12-01

In the United Kingdom the incidence of sexually transmitted infections (STI) and risky sexual behaviours is increasing. The role of commercial sex in this trend is poorly understood. Little is known about the men who pay for sex. We examined the epidemiology of female commercial sex contacts reported by men in 1990 and 2000. National probability sample surveys of sexual attitudes and lifestyles (Natsal) of men aged 16-44 resident in Britain in 1990 (n = 6000) and 2000 (n = 4762). The proportion of men who reported paying women for sex in the previous 5 years increased from 2.0% (95% CI 1.6 to 2.5) in 1990 to 4.2% in 2000 (95% CI 3.6 to 4.9). In both surveys, paying for sex was more frequent in men aged between 25 years and 34 years, who were never or previously married, and who lived in London. There was no association with ethnicity, social class, homosexual contact, or injecting drug use. Men who paid for sex were more likely to report 10 or more sexual partners in the previous 5 years; only a minority of their lifetime sexual partners (19.3%) were commercial. They were more likely to meet partners abroad and to report previous STI. Only 15% reported having had an HIV test. The proportion of men who reported paying for heterosexual sex has increased, and these men have multiple commercial and non-commercial partners. Their higher rates of STI and low level of HIV testing suggest the need for prevention interventions for clients as well as sex workers.

Sexual risk behavior and type of sexual partners in transnational indigenous migrant workers.

PubMed

Caballero-Hoyos, Ramiro; Villaseñor-Sierra, Alberto; Millán-Guerrero, Rebeca; Trujillo-Hernández, Benjamín; Monárrez-Espino, Joel

2013-06-01

Indigenous migrant workers (IMWs) have a high vulnerability to HIV and STDs due to poverty and marginalization. This study examined factors associated with sexual risk behavior (SRB) according to type of partner in transnational young male IMWs at a sugar cane agro-industrial complex in western Mexico. A total of 192 sexually active IMWs were recruited from four laborer shelters to participate in a sexual partner survey. The IMWs were interviewed about their sexual partners and practices over the last 12 months during which it emerged that they had had a total of 360 sexual partners. Multiple linear regression analyses were performed to identify factors related to SRB in 222 main (spouse, mistress and girlfriend) and 138 casual partners (colleague, friend, casual encounter and sex worker). Results showed a significantly higher SRB score with casual partners. For the main partner regression model, prior exposure to HIV- and STD-preventive information and sexual intercourse with higher employment status partners (formal workers vs. self-employed in informal activities and unemployed) were associated with lower SRB scores, but if the sexual relations occurred in Mexico (vs. the U.S.), the SRB scores increased. For the casual partner model, the practice of survival sex (sex in exchange for basic needs), sexual relations in Mexico (vs. the U.S.), and being a circular migrant (person traveling for temporary work to return home when the contract is over) were related to higher SRB scores. Findings support the implementation of preventive interventions using different messages depending on the type of partners, main or casual, within the labor migrant context.

Prevalence of HIV, Syphilis, HCV and Their High Risk Behaviors among Migrant Workers in Eastern China

PubMed Central

Wang, Qing; Zheng, Hui; Chen, Xin; Su, Jing; Peng, Zhihang; Yu, Rongbin; Wang, Ning

2013-01-01

Objective The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. Methods A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. Results 17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (P<0.05 for single); male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. Conclusions Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers in China. PMID:23451193

Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues.

PubMed

Semple, Shirley J; Pitpitan, Eileen V; Goodman-Meza, David; Strathdee, Steffanie A; Chavarin, Claudia V; Rangel, Gudelia; Torres, Karla; Patterson, Thomas L

2017-01-01

Condomless anal sex between male partners is the primary risk factor for HIV transmission among men who have sex with men (MSM). Correlates of condomless anal sex have been well-studied in developed countries, but they have received less attention in lower-to-middle income countries (LMIC), where MSM are often subject to stigma, discrimination, intolerance, and even the criminalization of same sex behavior. In Mexico, a LMIC where traditional views on homosexuality are common, HIV prevalence among MSM is high (16.9%), yet little research has been conducted on the correlates of condomless anal sex in this high-risk population. The present study examined correlates of condomless anal sex among 201 MSM recruited in Tijuana, Mexico, with a focus on the role of public sex venues in relation to sexual risk behavior. Eligibility requirements were: biologically male, 18 years of age or older, resident of Tijuana, and self-reported anal or oral sex with a male partner in the past year. Participants completed an interviewer-administered, demographic and psychosocial survey, and were tested for HIV and syphilis. A hierarchical multiple linear regression model was tested to identify correlates of condomless anal sex. Thirty-eight percent of participants (N = 76) reported condomless anal sex with a male partner in the past 2 months. Higher levels of condomless anal sex were associated with higher levels of depressive symptoms, greater sexual compulsivity, and more frequent seeking out of sex partners in a public venue in the past 2 months. In view of these findings, we recommend the development of multi-level, "combination" interventions, which in the Mexican context should include enhanced condom promotion and distribution, improved availability and access to mental health treatment and counseling services, and expanded HIV/STI testing in public venues.

Correlates of condomless anal sex among men who have sex with men (MSM) in Tijuana, Mexico: The role of public sex venues

PubMed Central

Semple, Shirley J.; Pitpitan, Eileen V.; Goodman-Meza, David; Strathdee, Steffanie A.; Chavarin, Claudia V.; Rangel, Gudelia; Torres, Karla

2017-01-01

Condomless anal sex between male partners is the primary risk factor for HIV transmission among men who have sex with men (MSM). Correlates of condomless anal sex have been well-studied in developed countries, but they have received less attention in lower-to-middle income countries (LMIC), where MSM are often subject to stigma, discrimination, intolerance, and even the criminalization of same sex behavior. In Mexico, a LMIC where traditional views on homosexuality are common, HIV prevalence among MSM is high (16.9%), yet little research has been conducted on the correlates of condomless anal sex in this high-risk population. The present study examined correlates of condomless anal sex among 201 MSM recruited in Tijuana, Mexico, with a focus on the role of public sex venues in relation to sexual risk behavior. Eligibility requirements were: biologically male, 18 years of age or older, resident of Tijuana, and self-reported anal or oral sex with a male partner in the past year. Participants completed an interviewer-administered, demographic and psychosocial survey, and were tested for HIV and syphilis. A hierarchical multiple linear regression model was tested to identify correlates of condomless anal sex. Thirty-eight percent of participants (N = 76) reported condomless anal sex with a male partner in the past 2 months. Higher levels of condomless anal sex were associated with higher levels of depressive symptoms, greater sexual compulsivity, and more frequent seeking out of sex partners in a public venue in the past 2 months. In view of these findings, we recommend the development of multi-level, “combination” interventions, which in the Mexican context should include enhanced condom promotion and distribution, improved availability and access to mental health treatment and counseling services, and expanded HIV/STI testing in public venues. PMID:29065132

HIV risk practices sought by men who have sex with other men, and who use internet websites to identify potential sexual partners.

PubMed

Klein, Hugh

2008-09-01

Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the USA, with higher than average rates of drug use and unprotected sex being cited as the principal reasons underlying their high rates of HIV infection. Recent evidence has suggested that the use of websites specifically designed to promote unsafe sexual practices may be particularly common among MSM, thereby fostering their risky behaviours. In light of these findings, the present study is based on a content analysis of 1316 ads/profiles posted on one of the most popular MSM websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence. Data were collected between September 2006 and January 2007. Rates of advertised for high-risk sexual behaviours were very high, particularly for oral sex involving ejaculation into the mouth (88.0% for receptive oral sex, 77.4% for insertive oral sex), anal sex involving ejaculation into the anus (79.7% for insertive anal sex, 69.4% for receptive anal sex), multiple partner sex (77.9%) and felching (16.5%). A multivariate analysis of the correlates of sexual risk preferences identified seven factors that were related to a propensity towards enhanced sexual risk: younger age (beta = 0.12, P = 0.0001), not being African American (beta = 0.05, P = 0.0341), self-identification as a sexual 'bottom' (beta = 0.20, P = 0.0001), not caring about one's potential sex partners' HIV serostatus (beta = 0.15, P = 0.0001), preferring to have sex while under the influence of drugs (beta = 0.08, P = 0.0022), a greater involvement in and commitment to the use of the website to locate potential unprotected sex partners (beta = 0.16, P = 0.0001) and not being HIV-negative (beta = 0.08, P = 0.0081). The HIV intervention-related implications of these findings are discussed.

Relationship Factors Associated with Sexual Risk Behavior and High-Risk Alcohol Consumption among Latino MSM: Challenges and Opportunities to Intervene on HIV Risk

PubMed Central

Martinez, Omar; Muñoz-Laboy, Miguel; Levine, Ethan; Starks, Tyrel; Dolezal, Curtis; Dodge, Brian; Icard, Larry; Moya, Eva; Chavez-Baray, Silvia; Rhodes, Scott D.; Fernandez, M. Isabel

2016-01-01

The HIV epidemic continues to be a major public health concern, affecting communities with varying prevention and treatment needs. In the United States, Latino men who have sex with men (MSM) bear a disproportionate burden of HIV incidence. While recent studies have highlighted the relevance of relationship factors for HIV transmission among MSM generally, the unique needs and experiences of Latino MSM have received relatively little attention. Consequently, associations among relationship factors and HIV risk among Latino MSM remain unknown. This mixed-methods study examined relationship status and dynamics and potential HIV-related risk behaviors among Latino MSM. Quantitative analyses with 240 Latino MSM investigated associations between relationship status and engagement in condomless anal intercourse (CAI). Focus groups with 20 Latino male couples and 10 health service providers explored the impact of relationship dynamics on sexual behaviors, as well as opportunities to intervene on HIV risk. The majority of participants were predominantly Spanish speaking, most screened positive for high-risk alcohol consumption in the past month, more than half engaged in CAI in the past three months, and a majority reported multiple sexual partners in this period. Among participants in same-sex relationships (n=175), approximately half reported multiple partners in the previous three months and more than two-thirds reported CAI in this time period. Being in a same-sex relationship was positively associated with high-risk alcohol consumption and being age 30 or older, and negatively associated with having multiple partners. Moreover, being in a same-sex relationship significantly increased the likelihood that participants would report engaging in CAI. Qualitative analyses identified themes related to relationship dynamics and sexual behavior, as well as opportunities to intervene on HIV risk. Despite the challenges encountered by Latino male couples, most participants expressed commitment to and support for their partners. As such, prevention efforts involving Latino male couples must address relationship dynamics and the role they play in sexual health, including safer sex practices. PMID:27633063

Event-level analysis of alcohol consumption and condom use in partnership contexts among men who have sex with men and transgender women in Lima, Peru.

PubMed

Delgado, Jeanne R; Segura, Eddy R; Lake, Jordan E; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2017-01-01

We explored the association between alcohol use and condomless receptive (CRAI) and insertive (CIAI) anal intercourse within partnership contexts of men who have sex with men (MSM) and transgender women (TGW) in Lima, Peru. From 2012-2014, we surveyed men and TGW (n=1607) who reported anal intercourse with ≥1 male or TGW. Alcohol use with up to 3 sexual partners during the prior 90days was evaluated. Bivariate and multivariate analyses used generalized estimating equations to assess event-level associations between alcohol use, CRAI, CIAI, and partnership characteristics while adjusting for participant clustering from multiple partners. Of 4774 sexual partnerships reported, 48% were casual, 34% primary, 10% anonymous, and 8% commercial. Alcohol use preceding sex was significantly (p<0.05) associated with CRAI (PR=1.26) and CIAI (PR=1.37). Partnership characteristics significantly associated with alcohol use included commercial sex work (PR=2.21) and trended (p<0.10) towards alcohol use with casual (PR=1.16), transgender (PR=1.48), and moderno ("versatile"; PR=1.17) partners. CRAI and CIAI were more common among participants who reported knowing they (PR=1.52; PR=1.41, respectively) or their partner (PR=1.47; PR=1.44, respectively) was HIV-uninfected. Yet, only CIAI (PR=1.42) was more commonly reported with known HIV-infected partners. Participants who drank alcohol prior to sex were less likely to know their partner's HIV serostatus. Alcohol use prior to intercourse was associated with CRAI and CIAI, varied by partnership type, and may impair knowledge of partner HIV serostatus. Detailed knowledge of alcohol use within partner-specific contexts is essential for informing condom-based and alternative HIV prevention strategies for MSM and TGW in Peru. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does Alcohol Use among Sexually Active College Students Moderate HIV Risk Behavior?

ERIC Educational Resources Information Center

Lewis, John E.; Malow, Robert M.; Norman, Lisa

2008-01-01

College students frequently use alcohol and are very sexually active, but do the two behaviors result in greater HIV risk? We employed the AIDS Risk Reduction Model to assess condom use during vaginal intercourse for sexually active college students using and not using alcohol proximal to sex. Students reported multiple lifetime sex partners and…

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China.

PubMed

Chen, Xi; Li, Xingli; Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using "snowball" techniques, and internet advertisements were used to recruit study participants. Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM.

Estimates of Self, Parental and Partner Multiple Intelligences in Iran: A replication and extension

PubMed Central

Kosari, Afrooz; Swami, Viren

2012-01-01

Two hundred and fifty-eight Iranian university students estimated their own, parents’, and partners’ overall (general) intelligence, and also estimated 13 ‘multiple intelligences’ on a simple, two-page questionnaire which was previously used in many similar studies. In accordance with previous research, men rated themselves higher than women on logical-mathematical, spatial and musical intelligence. There were, however, no sex differences in ratings of parental and partner multiple intelligences, which is inconsistent with the extant literature. Participants also believed that they were more intelligent than their parents and partners, and that their fathers were more intelligent than their mothers. Multiple regressions indicated that participants’ Big Five personality typologies and test experience were significant predictors of self-estimated intelligence. These results are discussed in terms of the cross-cultural literature in the field. Implications of the results are also considered. PMID:22952548

Sexual risk factors for partner age discordance in adolescent girls and their male partners.

PubMed

Morrison-Beedy, Dianne; Xia, Yinglin; Passmore, Denise

2013-12-01

To investigate differences in sexual risk factors between adolescent girls reporting similar-aged or older sex partners. Adolescent girls are at significant risk of heterosexual-acquired HIV infection and other long-term reproductive health issues. Sexual partner age discordance in teen girls has been correlated with STIs, lack of protection, multiple partners and earlier age of sexual transition. A descriptive study comparing girls currently involved with age-discordant partners to those with similar-aged partners. Two-sample t-test for continuous variables and chi-squared test or Fisher's exact test for categorical variables were used to compare groups. Baseline data from 738 sexually active, urban, adolescent girls aged 15-19 were analysed to determine which behaviours were more likely to occur in girls with older partners. Data were collected as part of a gender-specific HIV-prevention intervention in a randomised controlled trial (RCT) tailored to adolescent girls. Multiple reported sexual risk behaviours were found to significantly differ between the two groups at baseline. Overall, girls with older partners had more episodes of sexual instances (vaginal, anal and oral). Specific sexual risk behaviours were found to be statistically significant between the two groups. Girls with older partners started having sex at earlier ages, had more lifetime sexual partners, higher incidents of STIs and were reluctant to discuss using condoms with their partners. Girls with similar-aged partners were less willing to engage in risky sexual behaviours. Findings from this investigation support data from other studies. Relationships with older male partners place adolescent girls at increased risk of HIV/STIs and unintended pregnancy. Adolescent girls in age-discordant relationships are at risk of immediate and long-term sexual health morbidities. Identifying girls who are at increased risk by asking tailored questions will enable nurses to recommend appropriate diagnostics for this population and provide age-specific counselling. © 2013 John Wiley & Sons Ltd.

SI – SRH Sexual-risk factors of partner age-discordance in adolescent girls and their male partners

PubMed Central

Morrison-Beedy, Dianne; Xia, Yinglin; Passmore, Denise

2013-01-01

Aim and objectives To investigate differences in sexual-risk factors between adolescent girls reporting similar-aged or older sex partners. Background Adolescent girls are at significant risk for heterosexual-acquired HIV infection and other long term reproductive health issues. Sexual partner age-discordance in teen girls has been correlated with STIs, lack of protection, multiple partners, and earlier age of sexual transition. Design A descriptive study comparing girls currently involved with age-discordant partners to those with similar-aged partners. Two-sample t-test for continuous variables and for categorical variables, Chi-square or Fisher exact test were used to compare groups. Methods Baseline data from 738 sexually-active, urban, adolescent girls ages 15 to 19, were analyzed to determine which behaviors were more likely to occur in girls with older partners. Data were collected as part of a gender specific HIV-prevention intervention in a randomized controlled trial tailored to adolescent girls. Results Multiple reported sexual risk behaviors were found to significantly differ between the two groups at baseline. Overall, girls with older partners had more episodes of sexual instances (vaginal, anal, and oral). Specific sexual risk behaviors were found to be statistically significant between the two groups. Girls with older partners started having sex at earlier ages, had more lifetime sexual partners, higher incidents of STIs and were reluctant to discuss using condoms with their partners. Girls with similar-aged partners were less willing to engage in risky sexual behaviors. Conclusions Findings from this investigation support data from other studies. Relationships with older male partners place adolescent girls at increased risk for HIV/STIs and unintended pregnancy. Relevance to clinical practice Adolescent girls in age-discordant relationships are at risk for immediate and long term sexual health morbidities. Identifying girls who are at increased risk by asking tailored questions will enable nurses to recommend appropriate diagnostics for this population and provide age specific counseling. PMID:24580784

Patterns and Correlates of Serostatus Disclosure to Sexual Partners by Perinatally-Infected Adolescents and Young Adults.

PubMed

Weintraub, Amy; Mellins, Claude A; Warne, Patricia; Dolezal, Curtis; Elkington, Katherine; Bucek, Amelia; Leu, Cheng-Shiun; Bamji, Mahrukh; Wiznia, Andrew; Abrams, Elaine J

2017-01-01

Similar to same-age peers, perinatally HIV-infected (PHIV+) youth in the US are engaging in sex, including condomless sex. Understanding decisions about serostatus disclosure to sexual partners is important to domestic and global HIV prevention efforts, since large numbers of PHIV+ children are entering adolescence and becoming sexually active. Using Social Action Theory (SAT) to inform variable selection, we examined correlates of disclosure among 98 PHIV+ adolescents/young adults in New York City. Over half of these youth reported not disclosing to any casual partners (59 %) or to any partners when using condoms (55 %). In bivariate analyses, increased disclosure was associated with older age; being female; earlier age of learning one's serostatus; and increased STD knowledge, disclosure intentions, and parent-child communication. Multiple regression analyses revealed a strong fit with the SAT model. As with adults, disclosure to sexual partners is difficult for PHIV+ youth and challenges prevention efforts. Effective interventions that help youth with disclosure decisions are needed to curb the epidemic.

A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.

PubMed

Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan

2014-03-01

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs.

Positive and Negative Aspects of Relationship Quality and Unprotected Sex among Young Women.

PubMed

Brady, Sonya S; Gruber, Sandra K; Wolfson, Julian A

2016-01-01

The aim of this study was to examine both positive and negative aspects of relationship quality in relation to condom use. Sexually active young women aged 14-18 years (n=111; 34% non-white) were recruited from community clinics and schools in the Midwest USA and provided data via an online survey. The number of unprotected sex acts in the past month with the most recent male partner was regressed on relationship quality with that partner, adjusting for demographics and other characteristics. Negative relationship quality was associated with a greater number of unprotected sex acts among women reporting a low level of positive relationship quality and among women taking hormonal/IUD contraception. Positive relationship quality was associated with unprotected sex among women who reported multiple partners in the past month. Both positive and negative aspects of relationship quality may confer risk for unprotected sex. This risk appears modified by patterns of contraceptive use and other sexual behaviours. Health professionals may be more effective in promoting condom use if they ask questions about both positive and negative aspects of young people's relationship quality and tailor their conversations based on the responses received.

Exploring Risk Behaviors and Vulnerability for HIV among Men Who Have Sex with Men in Abidjan, Cote d′Ivoire: Poor Knowledge, Homophobia and Sexual Violence

PubMed Central

Aho, Josephine; Hakim, Avi; Vuylsteke, Bea; Semde, Gisèle; Gbais, Honorat G.; Diarrassouba, Mamadou; Thiam, Marguerite; Laga, Marie

2014-01-01

Men who have sex with men (MSM) are at high risk of HIV. Few data are available on MSM and HIV-related risk behaviors in West Africa. We aimed to describe risk behaviors and vulnerability among MSM in Abidjan, Cote d′Ivoire. We conducted a cross-sectional respondent-driven sampling survey with 601 MSM in 2011–2012. Sociodemographic and behavioural data as well as data related to emotional state and stigma were collected. Population estimates with 95% confidence intervals were produced. Survey weighted logistic regression was used to assess factors associated with inconsistent condom use in the prior 12 months. Most MSM were 24 years of age or younger (63.9%) and had attained at least primary education (84.4%). HIV risk behaviors such as low condom and water-based lubricant use, high numbers of male and female sex partners, and sex work were frequently reported as well as verbal, physical and sexual abuse. Inconsistent condom use during anal sex with a male partner in the prior 12 months was reported by 66.0% of the MSM and was positively associated with history of forced sex, alcohol consumption, having a regular partner and a casual partner, having bought sex, and self-perception of low HIV risk. MSM in Abidjan exhibit multiple and frequent HIV-related risk behaviors. To address those behaviours, a combination of individual but also structural interventions will be needed given the context of stigma, homophobia and violence. PMID:24959923

Exploring risk behaviors and vulnerability for HIV among men who have sex with men in Abidjan, Cote d'Ivoire: poor knowledge, homophobia and sexual violence.

PubMed

Aho, Josephine; Hakim, Avi; Vuylsteke, Bea; Semde, Gisèle; Gbais, Honorat G; Diarrassouba, Mamadou; Thiam, Marguerite; Laga, Marie

2014-01-01

Men who have sex with men (MSM) are at high risk of HIV. Few data are available on MSM and HIV-related risk behaviors in West Africa. We aimed to describe risk behaviors and vulnerability among MSM in Abidjan, Cote d'Ivoire. We conducted a cross-sectional respondent-driven sampling survey with 601 MSM in 2011-2012. Sociodemographic and behavioural data as well as data related to emotional state and stigma were collected. Population estimates with 95% confidence intervals were produced. Survey weighted logistic regression was used to assess factors associated with inconsistent condom use in the prior 12 months. Most MSM were 24 years of age or younger (63.9%) and had attained at least primary education (84.4%). HIV risk behaviors such as low condom and water-based lubricant use, high numbers of male and female sex partners, and sex work were frequently reported as well as verbal, physical and sexual abuse. Inconsistent condom use during anal sex with a male partner in the prior 12 months was reported by 66.0% of the MSM and was positively associated with history of forced sex, alcohol consumption, having a regular partner and a casual partner, having bought sex, and self-perception of low HIV risk. MSM in Abidjan exhibit multiple and frequent HIV-related risk behaviors. To address those behaviours, a combination of individual but also structural interventions will be needed given the context of stigma, homophobia and violence.

Cross-sectional study of sexual behaviour and knowledge about HIV among urban, rural, and minority residents in Viet Nam.

PubMed

Bui, T D; Pham, C K; Pham, T H; Hoang, L T; Nguyen, T V; Vu, T Q; Detels, R

2001-01-01

A cross-sectional survey was conducted in three districts of Quang Ninh province, Viet Nam, to find out what proportion of the people who lived there engaged in behaviour that put them at risk of becoming infected with HIV, and to measure their knowledge about HIV infection and AIDS. The survey was conducted in a rural district, Yen Hung; a mountainous district inhabited primarily by ethnic minority groups, Binh Lieu; and an urban district, Ha Long. Participants aged 15-45 years were randomly selected from the general population to be interviewed. A total of 630 people from 707 households were interviewed; 8% were not home despite repeated visits and 3% refused to participate. The prevalence of premarital intercourse ranged from 9% to 16% among married men and 4% to 7% among married women. Among single men the proportion who had ever had intercourse ranged from 6% to 16%. Fewer than 3% reported having ever had sex with a sex worker. The median number of extramarital sex partners was 1. Knowledge about HIV/AIDS was high in the urban and rural areas but low in the mountainous area. Being male and being 20-29 years old were associated with having multiple sex partners. The low prevalence of individuals reporting that they had had intercourse with sex workers and partners other than their spouse may explain the low rates of HIV infection among the heterosexual population; these rates are in contrast to the high rates of HIV infection found among injecting drug users. The association between having extramarital partners and being a younger man suggests that the tendency to have more sexual partners may increase in the future. If this happens, the potential for HIV to be spread through heterosexual sex will increase.

Consuming sex: the association between modern goods, lifestyles and sexual behaviour among youth in Madagascar

PubMed Central

2013-01-01

Background Ethnographic evidence suggests that transactional sex is sometimes motivated by youth’s interest in the consumption of modern goods as much as it is in basic survival. There are very few quantitative studies that examine the association between young people’s interests in the consumption of modern goods and their sexual behaviour. We examined this association in two regions and four residence zones of Madagascar: urban, peri-urban and rural Antananarivo, and urban Antsiranana. We expected risky sexual behaviour would be associated with interests in consuming modern goods or lifestyles; urban residence; and socio-cultural characteristics. Methods We administered a population-based survey to 2, 255 youth ages 15–24 in all four residence zones. Focus group discussions guided the survey instrument which assessed socio-demographic and economic characteristics, consumption of modern goods, preferred activities and sexual behaviour. Our outcomes measures included: multiple sexual partners in the last year (for men and women); and ever practicing transactional sex (for women). Results Overall, 7.3% of women and 30.7% of men reported having had multiple partners in the last year; and 5.9% of women reported ever practicing transactional sex. Bivariate results suggested that for both men and women having multiple partners was associated with perceptions concerning the importance of fashion and a series of activities associated with modern lifestyles. A subset of lifestyle characteristics remained significant in multivariate models. For transactional sex bivariate results suggested perceptions around fashion, nightclub attendance, and getting to know a foreigner were key determinants; and all remained significant in multivariate analysis. We found peri-urban residence more associated with transactional sex than urban residence; and ethnic origin was the strongest predictor of both outcomes for women. Conclusions While we found indication of an association between sexual behaviour and interest in modern goods, or modern lifestyles, such processes did not single-handedly explain risky sexual behaviour among youth; these behaviours were also shaped by culture and conditions of economic uncertainty. These determinants must all be accounted for when developing interventions to reduce risky transactional sex and vulnerability to HIV. PMID:23510104

Consuming sex: the association between modern goods, lifestyles and sexual behaviour among youth in Madagascar.

PubMed

Stoebenau, Kirsten; Nair, Rama C; Rambeloson, Valérie; Rakotoarison, Paul Ghislain; Razafintsalama, Violette; Labonté, Ronald

2013-03-19

Ethnographic evidence suggests that transactional sex is sometimes motivated by youth's interest in the consumption of modern goods as much as it is in basic survival. There are very few quantitative studies that examine the association between young people's interests in the consumption of modern goods and their sexual behaviour. We examined this association in two regions and four residence zones of Madagascar: urban, peri-urban and rural Antananarivo, and urban Antsiranana. We expected risky sexual behaviour would be associated with interests in consuming modern goods or lifestyles; urban residence; and socio-cultural characteristics. We administered a population-based survey to 2, 255 youth ages 15-24 in all four residence zones. Focus group discussions guided the survey instrument which assessed socio-demographic and economic characteristics, consumption of modern goods, preferred activities and sexual behaviour. Our outcomes measures included: multiple sexual partners in the last year (for men and women); and ever practicing transactional sex (for women). Overall, 7.3% of women and 30.7% of men reported having had multiple partners in the last year; and 5.9% of women reported ever practicing transactional sex. Bivariate results suggested that for both men and women having multiple partners was associated with perceptions concerning the importance of fashion and a series of activities associated with modern lifestyles. A subset of lifestyle characteristics remained significant in multivariate models. For transactional sex bivariate results suggested perceptions around fashion, nightclub attendance, and getting to know a foreigner were key determinants; and all remained significant in multivariate analysis. We found peri-urban residence more associated with transactional sex than urban residence; and ethnic origin was the strongest predictor of both outcomes for women. While we found indication of an association between sexual behaviour and interest in modern goods, or modern lifestyles, such processes did not single-handedly explain risky sexual behaviour among youth; these behaviours were also shaped by culture and conditions of economic uncertainty. These determinants must all be accounted for when developing interventions to reduce risky transactional sex and vulnerability to HIV.

Practices of receptive and insertive anal sex among transgender women in relation to partner types, sociocultural factors, and background variables.

PubMed

Nemoto, Tooru; Bödeker, Birte; Iwamoto, Mariko; Sakata, Maria

2014-04-01

It is urgent to develop efficacious HIV prevention programs to curb the reported extremely high HIV prevalence and incidence among transgender women (male-to-female transgender persons) who reside in large cities in the USA. This study aimed to describe unprotected receptive anal sex (URAS) and unprotected insertive anal sex (UIAS) among high-risk transgender women in relation to partner types, psychosocial factors, and background variables. Based on purposive sampling from the targeted communities and AIDS service organizations in San Francisco and Oakland, a total of 573 transgender women who had a history of sex work were recruited and individually interviewed using a structured survey questionnaire. Significant correlates with URAS with primary, casual, and commercial sex partners were found (e.g., needs for social support, frequency of social support received, exposure to transphobia, self-esteem, economic pressure, norms toward practicing healthy behaviors, and self-efficacy toward practicing safe sex). Multiple logistic regression analyses revealed that transgender women who had engaged in URAS with commercial partners were more likely to have higher levels of transphobia or lower levels of the norms or self-efficacy to practice safe sex. Among the participants who did not have vaginoplasty (preoperative transgender women), 16.4% had engaged in insertive anal sex (IAS) with commercial partners in the past 30 days. The participants who were HIV positive and had engaged in IAS were more likely to be African-American or Caucasians, coinfected with sexually transmitted infections, or identified themselves as homosexual. Practices of IAS among transgender women have not been thoroughly investigated in relation to sexual and gender identity. UIAS with homosexual and bisexual men in addition to URAS may be a cause for high HIV incidence among transgender women. An HIV prevention intervention study must be developed and evaluated, which aims to reduce HIV-positive and -negative transgender women's URAS and UIAS.

Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults.

PubMed

Benotsch, Eric G; Zimmerman, Rick S; Cathers, Laurie; Heck, Ted; McNulty, Shawn; Pierce, Juan; Perrin, Paul B; Snipes, Daniel J

2016-04-01

The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.

Risk Prediction Score for HIV Infection: Development and Internal Validation with Cross-Sectional Data from Men Who Have Sex with Men in China.

PubMed

Yin, Lu; Zhao, Yuejuan; Peratikos, Meridith Blevins; Song, Liang; Zhang, Xiangjun; Xin, Ruolei; Sun, Zheya; Xu, Yunan; Zhang, Li; Hu, Yifei; Hao, Chun; Ruan, Yuhua; Shao, Yiming; Vermund, Sten H; Qian, Han-Zhu

2018-05-21

Receptive anal intercourse, multiple partners, condomless sex, sexually transmitted infections (STIs), and drug/alcohol addiction are familiar factors that correlate with increased human immunodeficiency virus (HIV) risk among men who have sex with men (MSM). To improve estimation to HIV acquisition, we created a composite score using questions from routine survey of 3588 MSM in Beijing, China. The HIV prevalence was 13.4%. A risk scoring tool using penalized maximum likelihood multivariable logistic regression modeling was developed, deploying backward step-down variable selection to obtain a reduced-form model. The full penalized model included 19 sexual predictors, while the reduced-form model had 12 predictors. Both models calibrated well; bootstrap-corrected c-indices were 0.70 (full model) and 0.71 (reduced-form model). Non-Beijing residence, short-term living in Beijing, illegal drug use, multiple male sexual partners, receptive anal sex, inconsistent condom use, alcohol consumption before sex, and syphilis infection were the strongest predictors of HIV infection. Discriminating higher-risk MSM for targeted HIV prevention programming using a validated risk score could improve the efficiency of resource deployment for educational and risk reduction programs. A valid risk score can also identify higher risk persons into prevention and vaccine clinical trials, which would improve trial cost-efficiency.

Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis

PubMed Central

Prudden, Holly J.; Beattie, Tara S.; Bobrova, Natalia; Panovska-Griffiths, Jasmina; Mukandavire, Zindoga; Gorgens, Marelize; Wilson, David; Watts, Charlotte H.

2015-01-01

Background Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this. Methods National, urban and rural data on HIV prevalence, the percentage of younger (15–24) and older (25–49) women and men reporting multiple (2+) partners in the past year, HIV prevalence among female sex workers (FSWs), men who have bought sex in the past year (clients), and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other. Findings National population HIV prevalence varies between 0 4–2 9% for men and 0 4–5.6% for women. ART coverage ranges from 6–23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence. Interpretation In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners. PMID:26698854

Agency, lapse in condom use and relationship intimacy among female sex workers in Jamaica.

PubMed

Bailey, Althea E; Figueroa, John Peter

2018-05-01

This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.

Exchange Sex and HIV Infection Among Men Who Have Sex with Men: 20 US Cities, 2011.

PubMed

M Nerlander, Lina; Hess, Kristen L; Sionean, Catlainn; E Rose, Charles; Thorson, Anna; Broz, Dita; Paz-Bailey, Gabriela

2017-08-01

This study assessed the prevalence of exchanging sex for money or drugs among men who have sex with men (MSM) in the 2011 US National HIV Behavioral Surveillance system. Prevalence of HIV, being HIV-positive but unaware (HIV-positive-unaware), risk behaviors and use of services were compared between MSM who did and did not receive money or drugs from one or more casual male partners in exchange for oral or anal sex in the past 12 months. Among 8411 MSM, 7.0 % exchanged sex. MSM who exchanged sex were more likely to be non-Hispanic black, live in poverty, have injected drugs, have multiple condomless anal sex partners, be HIV-positive and be HIV-positive-unaware. In multivariable analysis, exchange sex was associated with being HIV-positive-unaware (aPR 1.34, 95 % CI 1.05-1.69) after adjusting for race/ethnicity, age, education, poverty, and injecting drugs. MSM who exchange sex represent an important group to reach with HIV prevention, testing, and care services as they were more likely to report behavioral risk factors that put them at risk of HIV.

Reconceptualizing adolescent sexual behavior: beyond did they or didn't they?

PubMed

Whitaker, D J; Miller, K S; Clark, L F

2000-01-01

Adolescent sexual behavior is typically studied as a dichotomy: Adolescents have had sex or they have not. Broadening this view would lead to a greater understanding of teenagers' sexual behavior. Interview data from 907 high school students in Alabama, New York and Puerto Rico were used to examine the relationships between sexual experience and a variety of social, psychological and behavioral variables. Four groups of teenagers are compared: those who did not anticipate initiating sex in the next year (delayers), those who anticipated initiating sex in the next year (anticipators), those who had had one sexual partner (singles) and those who had had two or more partners (multiples). Compared with delayers, anticipators reported more alcohol use and marijuana use; poorer psychological health; riskier peer behaviors; and looser ties to family school and church. Similarly, multiples reported more alcohol and marijuana use, riskier peer behaviors and looser ties to family and school than singles. Risk behaviors, peer behaviors, family variables, and school and church involvement showed a linear trend across the four categories of sexual behavior. The traditional sex-no sex dichotomy obscures differences among sexually inexperienced teenagers and among adolescents who have had sex. Prevention efforts must be tailored to the specific needs of teenagers with differing sexual experiences and expectations, and must address the social and psychological context in which sexual experiences occur.

HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia.

PubMed

Koh, Kwee Choy; Yong, Lit Sin

2014-01-01

We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM) clients who received voluntary counseling and testing (VCT) services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9%) clients rated themselves as low risk, 118 (27.9%) as medium risk, 36 (8.5%) as high risk, and 168 (39.7%) were unsure of their risk. Twenty-four (9.4%) clients tested HIV positive (4 (4%) low risk, 9 (7.6%) medium risk, 11 (30.6%) high risk, and 13 (7.7%) unsure risk). We found a positive correlation between risk perception and HIV infection in this study. Clients with high HIV risk perception have 17x the odds of testing HIV positive compared to low risk clients. High HIV risk perception was significantly associated with multiple sex partners, multiple types of sex partners, alcohol use before intercourse, unprotected sex beyond 6 months, and inconsistent condom use during anal sex compared to low risk clients. There were no statistically significant differences between medium risk and unsure risk clients compared to low risk clients. Strategies should be targeted towards change in sexual practices among those who are perceived to be at high risk.

Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection.

PubMed

Couture, Marie-Claude; Page, Kimberly; Stein, Ellen S; Sansothy, Neth; Sichan, Keo; Kaldor, John; Evans, Jennifer L; Maher, Lisa; Palefsky, Joel

2012-07-28

Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia. We conducted a cross-sectional study among 220 young women (15-29 years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection. The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection. This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia.

[One-night-stand behavior and associated factors among young men who have sex with men in Wuhan, China].

PubMed

Mao, Y X; Xiao, C C; Wang, T; Li, S Y; Yan, H

2017-06-10

Objective: This present study was to examine the prevalence and determinants of one-night-stand behavior among young men who have sex with men (YMSM). Methods: A total of 403 YMSM aged 16 to 25 were recruited through internet promotion, extending activity and HIV VCT in Wuhan. Data was gathered through anonymous questionnaire. Binary logistic regression was used to examine factors associated with one-night-stand behavior. Results: Of the 398 YMSM, 48.99 % (195/398) reported having had casual sex in the last 6 months. Of the ones having had casual sex, 34.29 % (60/175) and 28.65 % (49/171) reported using condoms consistently during anal or oral sexual contacts, respectively. These figures were lower than those of YMSM not having casual sexual contacts [with anal sex as 49.08 % (80/163) and oral sex as 38.85 % (61/157)]. 76.80 % (149/194) of the YMSM reported having had multiple sexual partners, with the figure higher than those without [33.15 % (60/181)] ( P <0.01). Results from the logistic regression analysis showed that the following factors seemed to be associated with casual sex activities among YMSM, including: often using internet, ( OR =4.89, 95 %CI : 1.90-12.54), taking illegal drugs ( OR =2.72, 95 %CI : 1.60-4.63). Conclusions: YMSM who had engaged in casual sex, practicing unprotected sex or having multiple sexual partners, were recognized as high risk population. Targeted intervention programs are needed to decrease the one-night-stand behavior. Internet intervention strategy seemed an important method to serve the purpose.

Factors associated with sexual risk behavior among persons living with HIV: gender and sexual identity group differences.

PubMed

Courtenay-Quirk, Cari; Pals, Sherri L; Colfax, Grant; McKirnan, David; Gooden, Lauren; Eroğlu, Doğan

2008-09-01

Factors associated with HIV transmission risk may differ between subgroups of persons living with HIV/AIDS (PLWHA). This study examined such factors in a sample of PLWHA recruited in 3 US metropolitan areas. Sexually active participants were categorized as gay or bisexual men (GBM) (n = 545), heterosexual men (HSM, n = 223), or women (n = 214). Of 982 participants, 27.1% reported serodiscordant unprotected anal or vaginal sex (SDUAV). SDUAV was associated with multiple (2 or more) partners, using poppers, and lower safer sex self-efficacy among GBM. SDUAV was associated with multiple partners among HSM. Among women, factors examined were not associated with SDUAV. These findings are consistent with prior research and facilitate our ability to target those who may be most at risk for transmitting HIV among HIV-positive GBM. More research must be conducted to identify factors associated with risk behavior among HSM and women.

Sexual behaviors and sexual risk in a prospective cohort of HIV-positive men and women in New York City, 1994-2002: implications for prevention.

PubMed

Aidala, Angela A; Lee, Gunjeong; Garbers, Samantha; Chiasson, Mary Ann

2006-02-01

As an ever-increasing number of people infected with HIV are living longer, healthier lives, concerns about continued transmission are growing along with an awareness of the need to develop "prevention for positives." This study of HIV-positive adults in New York City is the first examination of patterns of sexual behavior in a large, representative cohort of HIV-infected individuals followed over an extended time period. A total of 968 HIV-positive adults were interviewed every 6-12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many persons were not sexually active at all for months at a time; some continued to have multiple partners. Over one third of the cohort had one or more periods when they had engaged in unprotected sex with a partner who was HIV-negative or status unknown (unsafe sex) and one in five reported exchanging sex. Periods of unsafe sex alternated with periods of safer sex. Predictors of sexual risk varied by gender, and among men who had sex with men, and men sexually active with women only. Contextual factors such as partner relations, housing status, and receipt of HIV services were as important as individual attributes as predictors of unsafe sex and sex exchange. The variability observed in sexual risk behavior reported over time provides new insight into the importance of engaging persons living with HIV in ongoing prevention programs.

Masculine gender roles associated with increased sexual risk and intimate partner violence perpetration among young adult men.

PubMed

Santana, M Christina; Raj, Anita; Decker, Michele R; La Marche, Ana; Silverman, Jay G

2006-07-01

This study sought to assess the association between traditional masculine gender role ideologies and sexual risk and intimate partner violence (IPV) perpetration behaviors in young men's heterosexual relationships. Sexually active men age 18-35 years attending an urban community health center in Boston were invited to join a study on men's sexual risk; participants (N=307) completed a brief self-administered survey on sexual risk (unprotected sex, forced unprotected sex, multiple sex partners) and IPV perpetration (physical, sexual and injury from/need for medical services due to IPV) behaviors, as well as demographics. Current analyses included men reporting sex with a main female partner in the past 3 months (n=283). Logistic regression analyses adjusted for demographics were used to assess significant associations between male gender role ideologies and the sexual risk and IPV perpetration behaviors. Participants were predominantly Hispanic (74.9%) and Black (21.9%); 55.5% were not born in the continental U.S.; 65% had been in the relationship for more than 1 year. Men reporting more traditional ideologies were significantly more likely to report unprotected vaginal sex in the past 3 months (OR(adj) = 2.3, 95% CI = 1.2-4.6) and IPV perpetration in the past year (OR(adj) = 2.1, 95% CI = 1.2-3.6). Findings indicate that masculine gender role ideologies are linked with young men's unprotected vaginal sex and IPV perpetration in relationships, suggesting that such ideologies may be a useful point of sexual risk reduction and IPV prevention intervention with this population.

Masculine Gender Roles Associated with Increased Sexual Risk and Intimate Partner Violence Perpetration among Young Adult Men

PubMed Central

Raj, Anita; Decker, Michele R.; La Marche, Ana; Silverman, Jay G.

2006-01-01

This study sought to assess the association between traditional masculine gender role ideologies and sexual risk and intimate partner violence (IPV) perpetration behaviors in young men's heterosexual relationships. Sexually active men age 18–35 years attending an urban community health center in Boston were invited to join a study on men's sexual risk; participants (N=307) completed a brief self-administered survey on sexual risk (unprotected sex, forced unprotected sex, multiple sex partners) and IPV perpetration (physical, sexual and injury from/need for medical services due to IPV) behaviors, as well as demographics. Current analyses included men reporting sex with a main female partner in the past 3 months (n=283). Logistic regression analyses adjusted for demographics were used to assess significant associations between male gender role ideologies and the sexual risk and IPV perpetration behaviors. Participants were predominantly Hispanic (74.9%) and Black (21.9%); 55.5% were not born in the continental U.S.; 65% had been in the relationship for more than 1 year. Men reporting more traditional ideologies were significantly more likely to report unprotected vaginal sex in the past 3 months (ORadj = 2.3, 95% CI = 1.2–4.6) and IPV perpetration in the past year (ORadj = 2.1, 95% CI = 1.2–3.6). Findings indicate that masculine gender role ideologies are linked with young men's unprotected vaginal sex and IPV perpetration in relationships, suggesting that such ideologies may be a useful point of sexual risk reduction and IPV prevention intervention with this population. PMID:16845496

“Eyes that don’t see, heart that doesn’t feel”: Coping with sex work in intimate relationships and its implications for HIV/STI prevention

PubMed Central

Syvertsen, Jennifer L.; Robertson, Angela M.; Rolon, Maria Luisa; Palinkas, Lawrence A.; Martinez, Gustavo; Rangel, M. Gudelia

2013-01-01

Partner communication about HIV sexual risk behaviors represents a key area of epidemiologic and social importance in terms of infection acquisition and potential for tailored interventions. Nevertheless, disclosing sexual risk behaviors often presents myriad challenges for marginalized couples who engage in stigmatized behaviors. Using qualitative data from a social epidemiology study of risk for HIV and other sexually transmitted infections (STIs) among female sex workers and their intimate, non-commercial male partners along the Mexico-U.S. border, we examined both partners’ perspectives on sex work and the ways in which couples discussed associated HIV/STI risks in their relationship. Our thematic analysis of individual and joint interviews conducted in 2010 and 2011 with 44 couples suggested that broader contexts of social and economic inequalities profoundly shaped partner perspectives of sex work. Although couples accepted sex work as an economic contribution to the relationship in light of limited alternatives and drug addiction, it exacted an emotional toll on both partners. Couples employed multiple strategies to cope with sex work, including psychologically disconnecting from their situation, telling “little lies,” avoiding the topic, and to a lesser extent, superficially discussing their risks. While such strategies served to protect both partners’ emotional health by upholding illusions of fidelity and avoiding potential conflict, non-disclosure of risk behaviors may exacerbate the potential for HIV/STI acquisition. Our work has direct implications for designing multi-level, couple-based health interventions. PMID:23631772

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China

PubMed Central

Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

Objective To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). Method A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using “snowball” techniques, and internet advertisements were used to recruit study participants. Results Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Conclusion Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM. PMID:25950912

Declining HIV Prevalence in Parallel With Safer Sex Behaviors in Burkina Faso: Evidence From Surveillance and Population-Based Surveys.

PubMed

Kirakoya-Samadoulougou, Fati; Nagot, Nicolas; Samadoulougou, Sekou; Sokey, Mamadou; Guiré, Abdoulaye; Sombié, Issiaka; Meda, Nicolas

2016-06-20

To investigate trends in HIV prevalence and changes in reported sexual behaviors between 1998 and 2014 in Burkina Faso. We obtained data on HIV prevalence from antenatal care (ANC) surveillance sites (N = 9) that were consistently included in surveillance between 1998 and 2014. We also analyzed data on HIV prevalence and reported sex behaviors from 3 population-based surveys from the Demographic and Health Surveys (DHS), conducted in 1998-99, 2003, and 2010. Sex behavior indicators comprised never-married youth who have never had sex; sex with more than 1 partner; sex with a nonmarital, non-cohabiting partner; condom use at last sex with a nonmarital, non-cohabiting partner; and sex before age 15. We calculated survey-specific HIV prevalence with 95% confidence intervals (CIs) and used the chi-square test or chi-square test for trend to compare HIV prevalence across survey years and to analyze trends in reported sex behaviors. HIV prevalence among pregnant women ages 15-49 decreased by 72% in urban areas, from 7.1% in 1998 to 2.0% in 2014, and by 75% in rural areas, from 2.0% in 2003 to 0.5% in 2014. HIV declined most in younger age groups, which is a good reflection of recent incidence, with declines of 55% among 15-19-year-olds, 72% among 20-24-year-olds, 40% among 25-29-year-olds, and 7% among those ≥30 years old (considering urban and rural data combined). Data reported in the DHS corroborated these declines in HIV prevalence: between 2003 and 2010, HIV prevalence dropped significantly-by 89% among girls ages 15-19, from 0.9% (95% CI, 0.2 to 1.6) to 0.1% (95% CI, 0.0 to 0.4), and by 78% among young women ages 20-24, from 1.8% (95% CI, 1.6 to 3.0) to 0.4% (95% CI, 0.0 to 0.7). During the same time period, people reported safer sex behaviors. For example, significantly higher percentages of never-married youth reported they had never had sex, lower percentages of sexually active youth reported multiple sex partners, and lower percentages of youth reported having sex before age 15. In addition, the percentage of men ages 20-49 reporting sex with a nonmarital, non-cohabiting partner declined significantly, while condom use at last sex with such a partner increased significantly among both men and women ages 15-49. Both ANC surveillance and population-based surveys report sharp declines in HIV prevalence in Burkina Faso between 1998 and 2014, accompanied by improvements in reported risky sex behaviors. © Kirakoya-Samadoulougou et al.

Group Sex Events and HIV/STI Risk in an Urban Network

PubMed Central

Friedman, Samuel R.; Bolyard, Melissa; Khan, Maria; Maslow, Carey; Sandoval, Milagros; Mateu-Gelabert, Pedro; Krauss, Beatrice; Aral, Sevgi O.

2012-01-01

Objectives To describe: a. the prevalence and individual and network characteristics of group sex events (GSE) and GSE attendees; and b. HIV/STI discordance among respondents who said they went to a GSE together. Methods and Design In a sociometric network study of risk partners (defined as sexual partners, persons with whom respondents attended a GSE, or drug-injection partners) in Brooklyn, NY, we recruited a high-risk sample of 465 adults. Respondents reported on GSE attendance, the characteristics of GSEs, and their own and others’ behaviors at GSEs. Sera and urines were collected and STI prevalence was assayed. Results Of the 465 participants, 36% had attended a GSE in the last year, 26% had sex during the most recent of these GSEs, and 13% had unprotected sex there. Certain subgroups (hard drug users, men who have sex with men, women who have sex with women, and sex workers) were more likely to attend and more likely to engage in risk behaviors at these events. Among 90 GSE dyads in which at least one partner named the other as someone with whom they attended a GSE in the previous three months, STI/HIV discordance was common (HSV-2: 45% of dyads, HIV: 12% of dyads, Chlamydia: 21% of dyads). Many GSEs had 10 or more participants, and multiple partnerships at GSEs were common. High attendance rates at GSEs among members of large networks may increase community vulnerability to STI/HIV, particularly since network data show that almost all members of a large sociometric risk network either had sex with a GSE attendee or had sex with someone who had sex with a GSE attended. Conclusions Self-reported GSE attendance and participation was common among this high-risk sample. STI/HIV discordance among GSE attendees was high, highlighting the potential transmission risk associated with GSEs. Research on sexual behaviors should incorporate measures of GSE behaviors as standard research protocol. Interventions should be developed to reduce transmission at GSEs. PMID:19186355

Understanding the link between early sexual initiation and later sexually transmitted infection: test and replication in two longitudinal studies.

PubMed

Epstein, Marina; Bailey, Jennifer A; Manhart, Lisa E; Hill, Karl G; Hawkins, J David; Haggerty, Kevin P; Catalano, Richard F

2014-04-01

Age at sexual initiation is strongly associated with sexually transmitted infections (STI); yet, prevention programs aiming to delay sexual initiation have shown mixed results in reducing STI. This study tested three explanatory mechanisms for the relationship between early sexual debut and STI: number of sexual partners, individual characteristics, and environmental antecedents. A test-and-replicate strategy was employed using two longitudinal studies: the Seattle Social Development Project (SSDP) and Raising Healthy Children (RHC). Childhood measures included pubertal age, behavioral disinhibition, and family, school, and peer influences. Alcohol use and age of sexual debut were measured during adolescence. Lifetime number of sexual partners and having sex under the influence were measured during young adulthood. Sexually transmitted infection diagnosis was self-reported at age 24. Early sex was defined as debut at <15 years. Path models were developed in SSDP evaluating relationships between measures, and were then tested in RHC. The relationship between early sex and STI was fully mediated by lifetime sex partners in SSDP, but only partially in RHC, after accounting for co-occurring factors. Behavioral disinhibition predicted early sex, early alcohol use, number of sexual partners, and sex under the influence, but had no direct effect on STI. Family management protected against early sex and early alcohol use, whereas antisocial peers exacerbated the risk. Early sexual initiation, a key mediator of STI, is driven by antecedents that influence multiple risk behaviors. Targeting co-occurring individual and environmental factors may be more effective than discouraging early sexual debut and may concomitantly improve other risk behaviors. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Safer sex and condom use: findings from the Second Australian Study of Health and Relationships.

PubMed

de Visser, Richard O; Badcock, Paul B; Rissel, Chris; Richters, Juliet; Smith, Anthony M A; Grulich, Andrew E; Simpson, Judy M

2014-11-01

Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. A representative sample of 20094 men and women aged 16-69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001-02 and 2012-13. Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.

Patterns and correlates of serostatus disclosure to sexual partners by perinatally-infected adolescents and young adults

PubMed Central

Weintraub, Amy; Mellins, Claude; Warne, Patricia; Dolezal, Curtis; Elkington, Katherine; Bucek, Amelia; Leu, Cheng-Shiun; Bamji, Mahrukh; Wiznia, Andrew; Abrams, Elaine J

2017-01-01

Similar to same-age peers, perinatally HIV-infected (PHIV+) youth in the US are engaging in sex, including condomless sex. Understanding decisions about serostatus disclosure to sexual partners is important to domestic and global HIV prevention efforts, since large numbers of PHIV+ children are entering adolescence and becoming sexually active. Using Social Action Theory (SAT) to inform variable selection, we examined correlates of disclosure among 98 PHIV+ adolescents/young adults in New York City. Over half of these youth reported not disclosing to any casual partners (59%) and to any partners when using condoms (55%). In simple regression analyses, increased disclosure was associated with older age; being female; earlier age of learning one’s serostatus; and increased STD knowledge, disclosure intentions, and parent-child communication. Multiple regression analyses revealed a strong fit with the SAT model. As with adults, disclosure to sexual partners is difficult for PHIV+ youth and challenges prevention efforts. Effective interventions that help youth with disclosure decisions are needed to curb the epidemic. PMID:26874846

Domains of acculturation and their effects on substance use and sexual behavior in recent Hispanic immigrant adolescents.

PubMed

Schwartz, Seth J; Unger, Jennifer B; Des Rosiers, Sabrina E; Lorenzo-Blanco, Elma I; Zamboanga, Byron L; Huang, Shi; Baezconde-Garbanati, Lourdes; Villamar, Juan A; Soto, Daniel W; Pattarroyo, Monica; Szapocznik, José

2014-06-01

This study evaluated the immigrant paradox by ascertaining the effects of multiple components of acculturation on substance use and sexual behavior among recently immigrated Hispanic adolescents primarily from Mexico (35 %) and Cuba (31 %). A sample of 302 adolescents (53 % boys; mean age 14.51 years) from Miami (n = 152) and Los Angeles (n = 150) provided data on Hispanic and US cultural practices, values, and identifications at baseline and provided reports of cigarette use, alcohol use, sexual activity, and unprotected sex approximately 1 year later. Results indicated strong gender differences, with the majority of significant findings emerging for boys. Supporting the immigrant paradox (i.e., that becoming oriented toward US culture is predictive of increased health risks), individualist values predicted greater numbers of oral sex partners and unprotected sex occasions for boys. However, contrary to the immigrant paradox, for boys, both US practices and US identification predicted less heavy drinking, fewer oral and vaginal/anal sex partners, and less unprotected vaginal/anal sex. Ethnic identity (identification with one's heritage culture) predicted greater numbers of sexual partners but negatively predicted unprotected sex. Results indicate a need for multidimensional, multi-domain models of acculturation and suggest that more work is needed to determine the most effective ways to culturally inform prevention programs.

Domains of Acculturation and their Effects on Substance Use and Sexual Behavior in Recent Hispanic Immigrant Adolescents

PubMed Central

Schwartz, Seth J.; Unger, Jennifer B.; Des Rosiers, Sabrina E.; Lorenzo-Blanco, Elma I.; Zamboanga, Byron L.; Huang, Shi; Baezconde-Garbanati, Lourdes; Villamar, Juan A.; Soto, Daniel W.; Pattarroyo, Monica; Szapocznik, José

2013-01-01

This study evaluated the immigrant paradox by ascertaining the effects of multiple components of acculturation on substance use and sexual behavior among recently immigrated Hispanic adolescents primarily from Mexico (35%) and Cuba (31%). A sample of 302 adolescents (53% boys; mean age 14.51 years) from Miami (n = 152) and Los Angeles (n = 150) provided data on Hispanic and U.S. cultural practices, values, and identifications at baseline and provided reports of cigarette use, alcohol use, sexual activity, and unprotected sex approximately one year later. Results indicated strong gender differences, with the majority of significant findings emerging for boys. Supporting the immigrant paradox (i.e., that becoming oriented toward U.S. culture is predictive of increased health risks), individualist values predicted greater numbers of oral sex partners and unprotected sex occasions for boys. However, contrary to the immigrant paradox, for boys, both U.S. practices and U.S. identification predicted less heavy drinking, fewer oral and vaginal/anal sex partners, and less unprotected vaginal/anal sex. Ethnic identity (identification with one’s heritage culture) predicted greater numbers of sexual partners but negatively predicted unprotected sex. Results indicate a need for multidimensional, multi-domain models of acculturation and suggest that more work is needed to determine the most effective ways to culturally inform prevention programs. PMID:23828449

Estimates of self, parental, and partner multiple intelligence and their relationship with personality, values, and demographic variables: a study in Britain and France.

PubMed

Swami, Viren; Furnham, Adrian; Zilkha, Susan

2009-11-01

In the present study, 151 British and 151 French participants estimated their own, their parents' and their partner's overall intelligence and 13 'multiple intelligences.' In accordance with previous studies, men rated themselves as higher on almost all measures of intelligence, but there were few cross-national differences. There were also important sex differences in ratings of parental and partner intelligence. Participants generally believed they were more intelligent than their parents but not their partners. Regressions indicated that participants believed verbal, logical-mathematical, and spatial intelligence to be the main predictors of intelligence. Regressions also showed that participants' Big Five personality scores (in particular, Extraversion and Openness), but not values or beliefs about intelligence and intelligences tests, were good predictors of intelligence. Results were discussed in terms of the influence of gender-role stereotypes.

Grindr, Scruff, and on the Hunt: Predictors of Condomless Anal Sex, Internet Use, and Mobile Application Use Among Men Who Have Sex With Men.

PubMed

Whitfield, Darren L; Kattari, Shanna K; Walls, N Eugene; Al-Tayyib, Alia

2017-05-01

In 2016, gay, bisexual, and other men who have sex with men (MSM) comprise more than half of all new HIV diagnoses in the United States, with the primary mode of infection being condomless anal sex (CAS). While studies report an association between use of Internet-based social networking sites and increased CAS, the research on the relationship between cell phone mobile applications (e.g., Grindr, Scruff, Jack'd) and CAS is much less developed. The present study examines whether the manner in which gay, bisexual, and other MSM find sexual partners predicts an increase in likelihood of engaging in CAS in an urban, noncoastal U.S. city. Conducting a secondary data analysis of the 2011 National HIV Behavioral Surveillance survey for Denver ( N = 546), the authors performed binary logistic regression analyses to assess the models that predict how MSM find sexual partners, and the odds of engaging in CAS. While the results suggest that age and race are associated with the mode of finding sexual partners, using the Internet or a mobile app to find sexual partners was not predictive of CAS ( Z Wald = .41, p = .52; Z Wald = .80, p = .37). In terms of HIV prevention, these findings suggest a need for intervention to address HIV prevention on multiple levels (e.g., individual, group, community).

Grindr, Scruff, and on the Hunt: Predictors of Condomless Anal Sex, Internet Use, and Mobile Application Use Among Men Who Have Sex With Men

PubMed Central

Whitfield, Darren L.; Kattari, Shanna K.; Walls, N. Eugene; Al-Tayyib, Alia

2017-01-01

In 2016, gay, bisexual, and other men who have sex with men (MSM) comprise more than half of all new HIV diagnoses in the United States, with the primary mode of infection being condomless anal sex (CAS). While studies report an association between use of Internet-based social networking sites and increased CAS, the research on the relationship between cell phone mobile applications (e.g., Grindr, Scruff, Jack’d) and CAS is much less developed. The present study examines whether the manner in which gay, bisexual, and other MSM find sexual partners predicts an increase in likelihood of engaging in CAS in an urban, noncoastal U.S. city. Conducting a secondary data analysis of the 2011 National HIV Behavioral Surveillance survey for Denver (N = 546), the authors performed binary logistic regression analyses to assess the models that predict how MSM find sexual partners, and the odds of engaging in CAS. While the results suggest that age and race are associated with the mode of finding sexual partners, using the Internet or a mobile app to find sexual partners was not predictive of CAS (ZWald = .41, p = .52; ZWald = .80, p = .37). In terms of HIV prevention, these findings suggest a need for intervention to address HIV prevention on multiple levels (e.g., individual, group, community). PMID:28134002

Faster and Riskier? Online Context of Sex Seeking Among Men Who Have Sex With Men in China.

PubMed

Cao, Bolin; Liu, Chuncheng; Stein, Gabriella; Tang, Weiming; Best, John; Zhang, Ye; Yang, Bin; Huang, Shujie; Wei, Chongyi; Tucker, Joseph D

2017-04-01

Many men who have sex with men (MSM) seek sex partners online, creating barriers and opportunities for human immunodeficiency virus prevention. The purpose of this study was to examine the characteristics of MSM and the risks associated with seeking sex through websites, gay apps, and both platforms in China. Data were collected through a cross-sectional online survey from September through October 2014 from 3 large gay Web portals. Sociodemographic information, sexual behaviors, and online sex seeking behaviors were measured. Multinomial logistic regression was performed to compare sexual risk behaviors among website users, gay app users, and men who used both platforms. Of the 1201 participants, 377 (31.4%) were website-only users, 487 (40.5%) were gay app-only users, and 337 (28.0%) were men who used both platforms. These 3 MSM subgroups have distinct sociodemographic characteristics. Overall, 57.6% of participants reported having engaged in condomless anal sex with their last male partner in the past 6 months, but there was no significant difference in condomless sex between the 3 groups. Men who used both platforms viewed more sexually transmitted disease-related messages than website-only users (adjusted odds ratio, 2.19; 95% confidence interval, 1.57-3.05). Condom usage behaviors were unaffected by the medium through which sexual partners were found. However, the high frequency of condomless sex suggests that websites and gay apps are both risk environments. This study suggests using multiple platforms for human immunodeficiency virus/sexually transmitted disease social media interventions may be useful.

HIV risk among low-income African American mothers of elementary school children.

PubMed

Cummings, G L; Battle, R; Barker, J; Krasnovsky, F

1997-01-01

Data from 119 African American low-income mothers of school aged children in Oakland, California show that 38% engaged in behavior that might place them at risk of exposure to the human immunodeficiency virus (HIV). Risk behaviors that were investigated included having multiple partners and having a partner with an incarceration history. Of women studied, 23% were at risk because of multiple partners, while 15% were at risk as a result of having had an incarcerated partner. Women who were < or = 35 years of age were three times more likely to report having had an incarcerated partner compared to women > or = 36 years of age (22% vs. 6%) mean 2 = 5.59, P < or = .01). Single women were also more likely to report having had a partner who had been incarcerated, 21% compared to 9% of married women (mean 2 = 3.73, P < or = .05). Although no significant relationships were found with respect to condom use, a larger proportion of women with an incarcerated partner reported never using condoms (71%) compared to women without an incarcerated partner (63%); whereas, fewer women with multiple partners reported never using condoms (56%) compared to women without multiple partners (67%). Findings suggest that low-income African American women outside of traditional high-risk groups (i.e., generally studied in high-risk settings such as drug treatment centers, sexually transmitted disease [STD] clinics, hospitals or from the sex industry) may be at risk and should be targeted in HIV risk prevention programs. These women may not consider themselves to be at risk and are not generally targeted in HIV risk prevention programs because they are mothers, housewives, and working women.

Seeking sex partners through the internet and mobile phone applications among men who have sex with men in Taiwan.

PubMed

Ko, Nai-Ying; Tseng, Po-Chia; Huang, Yu-Chao; Chen, Yen-Chin; Hsu, Su-Ting

2016-07-01

It has become popular for men who have sex with men (MSM) to use mobile-phone geosocial networking applications (mobile apps) to find sex partners. A cross-sectional online survey was conducted in Taiwan to compare the sexual and substance-use behaviors of MSM seeking sex partners through the internet and mobile apps. Of the 1060 participants, 65.8% used the internet via computer and 37.7% used a mobile app to find sexual partners, while 30.3% used recreational drugs or alcohol in the previous 6 months. MSM who exclusively used mobile apps to seek sex partners were significantly more likely than MSM seeking sex via computer to be older, to have used recreational drugs or alcohol, and to have sex with HIV-positive partners. Additionally, using mobile apps to seek sex partners was significantly associated with having sex with online partners through either mobile apps or computer-based internet use (adjusted odds ratio (AOR), 7.12 [3.87-13.11]), self-reporting as HIV-positive (AOR, 2.24 [1.12-4.12]), using recreational drugs (AOR, 1.67 [1.21-2.32]), having disclosed HIV status to sexual partners (AOR, 1.44 [1.03-2.02]), and having sex with HIV-positive partners (AOR, 1.81 [1.06-3.10]). In conclusion, the mobile apps may serve as a feasible platform for HIV-positive MSM to find other HIV-positive partners.

Moderate Effects of Same-Sex Legislation on Dependent Employer-Based Insurance Coverage Among Sexual Minorities.

PubMed

Tran, Linda Diem

2016-12-01

A difference-in-difference approach was used to compare the effects of same-sex domestic partnership, civil union, and marriage policies on same- and different-sex partners who could have benefitted from their partners' employer-based insurance (EBI) coverage. Same-sex partners had 78% lower odds (Marginal Effect = -21%) of having EBI compared with different-sex partners, adjusting for socioeconomic and health-related factors. Same-sex partners living in states that recognized same-sex marriage or domestic partnership had 89% greater odds of having EBI compared with those in states that did not recognize same-sex unions (ME = 5%). The impact of same-sex legislation on increasing take-up of dependent EBI coverage among lesbians, gay men, and bisexual individuals was modest, and domestic partnership legislation was equally as effective as same-sex marriage in increasing same-sex partner EBI coverage. Extending dependent EBI coverage to same-sex partners can mitigate gaps in coverage for a segment of the lesbians, gay men, and bisexual population but will not eliminate them. © The Author(s) 2016.

Cell Phone Internet Access, Online Sexual Solicitation, Partner Seeking, and Sexual Risk Behavior among Adolescents

PubMed Central

Rice, Eric; Winetrobe, Hailey; Holloway, Ian W.; Montoya, Jorge; Plant, Aaron; Kordic, Timothy

2014-01-01

Online partner seeking is associated with sexual risk behavior among young adults (specifically men who have sex with men), but this association has yet to be explored among a probability sample of adolescents. Moreover, cell phone internet access and sexual risk taking online and offline have not been explored. A probability sample (N = 1,831) of Los Angeles Unified School District high school students was collected in 2011. Logistic regression models assessed relationships between specific sexual risk behaviors (online sexual solicitation, seeking partners online, sex with internet-met partners, condom use) and frequency of internet use, internet access points, and demographics. Students with cell phone internet access were more likely to report being solicited online for sex, being sexually active, and having sex with an internet-met partner. Bisexual-identifying students reported higher rates of being approached online for sex, being sexually active, and not using condoms at last sex. Gay, lesbian, and questioning (GLQ) students were more likely to report online partner seeking and unprotected sex at last sex with an internet-met partner. Additionally, having sex with an internet-met partner was associated with being male, online sexual solicitation, and online partner seeking. Internet- and school-based sexual health programs should incorporate safety messages regarding online sexual solicitation, seeking sex partners online, and engaging in safer sex practices with all partners. Programs must target adolescents of all sexual identities, as adolescents may not yet be “out,” and bisexual and GLQ adolescents are more likely to engage in risky sex behaviors. PMID:25344027

Cell phone internet access, online sexual solicitation, partner seeking, and sexual risk behavior among adolescents.

PubMed

Rice, Eric; Winetrobe, Hailey; Holloway, Ian W; Montoya, Jorge; Plant, Aaron; Kordic, Timothy

2015-04-01

Online partner seeking is associated with sexual risk behavior among young adults (specifically men who have sex with men), but this association has yet to be explored among a probability sample of adolescents. Moreover, cell phone internet access and sexual risk taking online and offline have not been explored. A probability sample (N = 1,831) of Los Angeles Unified School District high school students was collected in 2011. Logistic regression models assessed relationships between specific sexual risk behaviors (online sexual solicitation, seeking partners online, sex with internet-met partners, condom use) and frequency of internet use, internet access points, and demographics. Students with cell phone internet access were more likely to report being solicited online for sex, being sexually active, and having sex with an internet-met partner. Bisexual-identifying students reported higher rates of being approached online for sex, being sexually active, and not using condoms at last sex. Gay, lesbian, and questioning (GLQ) students were more likely to report online partner seeking and unprotected sex at last sex with an internet-met partner. Additionally, having sex with an internet-met partner was associated with being male, online sexual solicitation, and online partner seeking. Internet- and school-based sexual health programs should incorporate safety messages regarding online sexual solicitation, seeking sex partners online, and engaging in safer sex practices with all partners. Programs must target adolescents of all sexual identities, as adolescents may not yet be "out," and bisexual and GLQ adolescents are more likely to engage in risky sex behaviors.

Heterosexual behaviours among men who sell sex to men in coastal Kenya.

PubMed

Smith, Adrian D; Muhaari, Allan D; Agwanda, Carole; Kowuor, Dickens; van der Elst, Elise; Davies, Alun; Graham, Susan M; Jaffe, Harold W; Sanders, Eduard J

2015-12-01

African men who have sex with men often sell sex to men, and MSM who sell sex (MSM-SW) often also have female partners. We compared sexual risk behaviour of MSM-SW who were sexually active with female partners (bisexual MSW) to MSM-SW with only male partners (exclusive MSW). Descriptive behavioural study : A novel, validated daily event and partner diary self-completed by 82 MSM who sold sex over a follow-up period of 42 days with weekly review. Cumulative individual counts of sex and condomless sex were compiled by partner characteristics. The incidence of specific partnerships and sex acts were compared within and between bisexual and exclusive MSW. Most (59%) MSM-SW reported female partners during follow-up. The majority of both male and female partners were cash-paying clients originating locally. Bisexual MSW reported a similar rate of condomless sex with male and female partners, but significantly fewer male partners than exclusive MSW. Bisexual MSW had lower HIV prevalence, were more likely to only report insertive anal sex roles, and reported lower frequencies of condomless receptive anal sex than exclusive MSW. Bisexually active male sex workers in coastal Kenya create HIV and other sexually transmitted infection transmission pathways to partners and clients in both MSM and heterosexual networks, but differed from exclusive MSW in having lower HIV acquisition and transmission risks. Epidemiological projection methods are liable to overestimate bridging potential of MSM-SW and MSM populations without account for systematic differences in risk within these populations.

Understanding STI Risk and Condom Use Patterns by Partner Type Among Female Sex Workers in Peru.

PubMed

Kinsler, Janni J; Blas, Magaly M; Cabral, Alejandra; Carcamo, Cesar; Halsey, Neal; Brown, Brandon

2014-01-01

While brothel-based sex work is regulated by the Peruvian government, there is little data on STI risk factors reported by female sex workers (FSW). This study compared high risk behaviors among 120 Peruvian FSW from government regulated brothels with both clients and non-commercial partners. Our study found that 12% of FSW reported unprotected vaginal sex with clients (compared to 75% with non-commercial partners), and 42% reported unprotected anal sex with clients (compared to 87% with non-commercial partners). Group differences were observed in the expectation to have oral sex (32% for partners vs 60% for clients; p<0.01), and a history of anal sex (65% for partners vs 32% for clients; p<0.01) and both vaginal and anal sex with the same partners (46% for partners vs 25% for clients; p<0.001). These findings suggest that FSW constitute an important bridge population for STI/HIV transmission in Peru.

Sexual behaviour related to psycho-social factors in a population of Danish homosexual and bisexual men.

PubMed

Schmidt, K W; Fouchard, J R; Krasnik, A; Zoffmann, H; Jacobsen, H L; Kreiner, S

1992-05-01

An anonymous self-administered questionnaire was distributed to (1) male members of the Danish Gay and Lesbian Association (2) through a gay magazine and (3) to readers of a gay pornographic magazine. For the purpose of this study sexual practices were classified into three categories taking into account the HIV-status of the respondent and his partner(s): safe sex (mutual masturbation, sex with condoms, sex without condoms between two HIV-positives), potentially safe sex (oral-genital sex without condoms irrespective of HIV-status, anal-genital sex without condoms between two HIV-negatives), unsafe sex (anal-genital sex without condoms between discordant partners or partners of unknown HIV status). Of the 2058 respondents 29.7% had had unsafe sex in the last 12 months. Multivariate analysis by recursive graphical models showed that sexual practice was directly related (that is conditionally dependent given the rest of the variables) to having a steady partner. Among men without a steady partner sexual practice was also directly related to age and number of partners showing an increase in unsafe sex with number of partners and a decrease with age. Thus of the men 16-19 years of age 43.5% had had unsafe sex irrespective of number of partners vs 5.7% of men older than 44 years and with one to two partners. Sexual practice was not directly related to any other demographic or psychosocial factor in the study. The adopted classification of sexual practice preclude that the high occurrence of unsafe sex could be explained by unsafe sex taking place among partners of concordant HIV status. The results emphasize the need for further preventive efforts to reduce transmission of HIV among homosexual men.

Women with intellectual disabilities talk about their perceptions of sex.

PubMed

Bernert, D J; Ogletree, R J

2013-03-01

Sexuality is learned through sexual socialisation that women with intellectual disabilities (IDs) understand and express. Rules of sexual engagement for these women can include barriers for their socialisation, intimate partner selection, and sexual expression. These rules can become more limiting when coupled with rules of femininity that encourage sexual restraint for women. This ethnography explored how women with IDs perceived their sexuality and how sexuality functioned in their lives. Sources of data included 48 multiple and in-depth interviews and observations with 14 women. This article specifically describes how the women constructed 'sex' and how they described experiencing sex as two of their multiple expressions of sexuality in this study. Most of the women had very limited and exclusively heterosexual sexual experiences, and the majority of women reported practicing abstinence. Criteria they identified for sex included having protected sex, marital and monogamous sex for the purpose of procreation or parenting, and having feelings for a sexual partner. Most held negative perceptions of sex they attributed to fear of the first act, fear of experiencing negative consequences, physiological concerns about the act, and perceived or actual lack of pleasure.   Although the women displayed some sense of self-determinism in their sexual behaviour, negative perceptions of sex resulted in self-imposed abstinence predicated by fear of intercourse, intimacy, or outcome. Central to their sexuality education then is increasing self-efficacy perceptions and performance of safer sex practices to prevent negative sexual consequence. Sexuality education from a positive perspective that enhances their sexual self-determinism and encourages sexual health is recommended. © 2012 The Author. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men.

PubMed

Jarama, S Lisbeth; Kennamer, J David; Poppen, Paul J; Hendricks, Michael; Bradford, Judith

2005-12-01

This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed.

Moderate Effects of Same-Sex Legislation on Dependent Employer-Based Insurance Coverage among Sexual Minorities

PubMed Central

Tran, Linda Diem

2016-01-01

A difference-in-difference approach was used to compare the effects of same-sex domestic partnership, civil union, and marriage policies on same- and different-sex partners who could have benefitted from their partners’ employer-based insurance (EBI) coverage. Same-sex partners had 78% lower odds (ME=-21%) of having EBI compared to different-sex partners, adjusting for socioeconomic and health-related factors. Same-sex partners living in states that recognized same-sex marriage or domestic partnership had 89% greater odds of having EBI compared to those in states that did not recognize same-sex unions (ME=5%). The impact of same-sex legislation on increasing take-up of dependent EBI coverage among lesbians, gay men, and bisexual individuals (LGBs) was modest, and domestic partnership legislation was equally as effective as same-sex marriage in increasing same-sex partner EBI coverage. Extending dependent EBI coverage to same-sex partners can mitigate gaps in coverage for a segment of the LGB population but will not eliminate them. PMID:26762647

Cross-sectional study of sexual behaviour and knowledge about HIV among urban, rural, and minority residents in Viet Nam.

PubMed Central

Bui, T. D.; Pham, C. K.; Pham, T. H.; Hoang, L. T.; Nguyen, T. V.; Vu, T. Q.; Detels, R.

2001-01-01

OBJECTIVE: A cross-sectional survey was conducted in three districts of Quang Ninh province, Viet Nam, to find out what proportion of the people who lived there engaged in behaviour that put them at risk of becoming infected with HIV, and to measure their knowledge about HIV infection and AIDS. METHODS: The survey was conducted in a rural district, Yen Hung; a mountainous district inhabited primarily by ethnic minority groups, Binh Lieu; and an urban district, Ha Long. Participants aged 15-45 years were randomly selected from the general population to be interviewed. FINDINGS: A total of 630 people from 707 households were interviewed; 8% were not home despite repeated visits and 3% refused to participate. The prevalence of premarital intercourse ranged from 9% to 16% among married men and 4% to 7% among married women. Among single men the proportion who had ever had intercourse ranged from 6% to 16%. Fewer than 3% reported having ever had sex with a sex worker. The median number of extramarital sex partners was 1. Knowledge about HIV/AIDS was high in the urban and rural areas but low in the mountainous area. Being male and being 20-29 years old were associated with having multiple sex partners. CONCLUSION: The low prevalence of individuals reporting that they had had intercourse with sex workers and partners other than their spouse may explain the low rates of HIV infection among the heterosexual population; these rates are in contrast to the high rates of HIV infection found among injecting drug users. The association between having extramarital partners and being a younger man suggests that the tendency to have more sexual partners may increase in the future. If this happens, the potential for HIV to be spread through heterosexual sex will increase. PMID:11217661

[Status on sexual partners among men who have sex with men among college students in Qingdao, 2016].

PubMed

Zhang, X F; Lyu, C X; Zheng, J T; Dong, L; Jiang, Z X; Fu, J H

2017-12-10

Objective: To investigate the situation of sexual partners and related factors among men who have sex with men (MSM) in college students. Methods: Snowball sampling and Convenience sampling were both used to recruit MSM from colleges in Tsingtao in 2016. Questionnaire-based interviews were conducted to collect data of socio-demographic and situation of sexual partners. Sample Size was estimated based on cross-sectional study, and theoretical 267. SPSS 17.0 software was used for statistical analysis. Results: A total of 300 MSM, average aged 20.7, were analyzed. Both first sex partner and the last same-sex sexual partner were met instantly, with proportions as 58.7% (176/300) and 62.3% (187/300) respectively. Among all the MSM, 88.3% (265/300) preferred selecting men as sex partners and 42.7% (128/300) enjoyed finding sex partners in college, while 86.0% (258/300) preferred finding their sex partners through internet. Conclusions: Internet had been the major way of looking for sex partner among MSM in college students, the male sexual partner were met instantly. We should focus on men who have sex with men and their sexual health among college students to prevent and control HIV/AIDS.

Declining Segregation of Same-Sex Partners: Evidence from Census 2000 and 2010

PubMed Central

2013-01-01

Despite recent media and scholarly attention describing the “disappearance” of traditionally gay neighborhoods, urban scholars have yet to quantify the segregation of same-sex partners and determine whether declining segregation from different-sex partners is a wide-spread trend. Focusing on the 100 most populous places in the United States, I use data from the 2000 and 2010 Decennial Census to examine the segregation of same-sex partners over time and its place-level correlates. I estimate linear regression models to examine the role of four place characteristics in particular: average levels of education, aggregate trends in the family life cycle of same-sex partners, violence and social hostility motivated by sexual orientation bias, and representation of same-sex partners in the overall population. On average, same-sex partners were less segregated from different-sex partners in 2010 than in 2000, and the vast majority of same-sex partners lived in environments of declining segregation. Segregation was lower and declined more rapidly in places that had a greater percentage of graduate degree holders. In addition, segregation of female partners was lower in places that had a greater share of female partner households with children. These findings suggest that sexual orientation should be considered alongside economic status, race, and ethnicity as an important factor that contributes to neighborhood differentiation and urban spatial inequality. PMID:24187412

Declining Segregation of Same-Sex Partners: Evidence from Census 2000 and 2010.

PubMed

Spring, Amy L

2013-10-01

Despite recent media and scholarly attention describing the "disappearance" of traditionally gay neighborhoods, urban scholars have yet to quantify the segregation of same-sex partners and determine whether declining segregation from different-sex partners is a wide-spread trend. Focusing on the 100 most populous places in the United States, I use data from the 2000 and 2010 Decennial Census to examine the segregation of same-sex partners over time and its place-level correlates. I estimate linear regression models to examine the role of four place characteristics in particular: average levels of education, aggregate trends in the family life cycle of same-sex partners, violence and social hostility motivated by sexual orientation bias, and representation of same-sex partners in the overall population. On average, same-sex partners were less segregated from different-sex partners in 2010 than in 2000, and the vast majority of same-sex partners lived in environments of declining segregation. Segregation was lower and declined more rapidly in places that had a greater percentage of graduate degree holders. In addition, segregation of female partners was lower in places that had a greater share of female partner households with children. These findings suggest that sexual orientation should be considered alongside economic status, race, and ethnicity as an important factor that contributes to neighborhood differentiation and urban spatial inequality.

Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador.

PubMed

Hernandez, Isabel; Reina-Ortiz, Miguel; Johnson, Ayesha; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo

2017-09-01

The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador.

Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador

PubMed Central

Hernandez, Isabel; Reina-Ortiz, Miguel; Johnson, Ayesha; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M.; Teran, Enrique; Izurieta, Ricardo

2016-01-01

The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador. PMID:27161984

Partner notification of sexually transmitted diseases: practices and preferences.

PubMed

Gursahaney, Priya R; Jeong, Kwonho; Dixon, Bruce W; Wiesenfeld, Harold C

2011-09-01

Timely notification and treatment of sex partners exposed to a sexually transmitted disease (STD) is essential to reduce reinfection and transmission. Our objectives were to determine factors associated with patient-initiated notification of sex partners and preferences regarding standard partner referral versus expedited partner therapy (EPT). Participants diagnosed with gonorrhea, chlamydia, trichomoniasis, or nongonococcal urethritis within the previous year were administered a baseline survey asking about demographics, sexual history, and partner treatment preferences (standard partner referral vs. EPT). They identified up to 4 sex partners within the past 2 months, and answered questions on relationship characteristics, quality, and notification self-efficacy. At follow-up, participants with a current STD were asked whether they notified their partners. Generalized estimating equations were used to evaluate the associations between predictor variables and partner notification. Of the 201 subjects enrolled, 157 had a current STD diagnosis, and 289 sex partners were identified. The rate of successful partner notification was 77.3% (157/203 sex partners). Partner notification was increased if the subject had a long-term relationship with a sex partner (odds ratio: 3.07; 95% confidence interval: 1.43, 6.58), considered the partner to be a main partner (odds ratio: 2.53; 95% confidence interval: 1.43, 6.58), or had increased notification self-efficacy. Overall, participants did not prefer EPT over standard referral; however, females, those with higher education levels, and those with a prior STD preferred EPT. Patient-initiated partner referral is more successful in patients with increased self-efficacy who have stronger interpersonal relationships with their sex partners.

The Committed Intimate Partnerships of Incarcerated African-American Men: Implications for Sexual HIV Transmission Risk and Prevention Opportunities.

PubMed

Khan, Maria R; El-Bassel, Nabila; Golin, Carol E; Scheidell, Joy D; Adimora, Adaora A; Coatsworth, Ashley M; Hu, Hui; Judon-Monk, Selena; Medina, Katie P; Wohl, David A

2017-10-01

Incarceration is thought to influence HIV transmission by disrupting partnerships that provide support and protect against sex risk-taking. Current correctional facility-based family-strengthening programs focus on marital partnerships, a minority of inmates' partnerships. Research on the sex partnerships of incarcerated African-American men and the types of partnerships most likely to protect against HIV-related sex risk is limited. Improved understanding can inform expansion of correctional facility-based family-strengthening programs to a greater proportion of protective partnerships and HIV risk reduction programs to partnerships vulnerable to sex risk. Project DISRUPT is a cohort study of African-American men being released from prison in North Carolina who were in committed heterosexual partnerships at prison entry. Using baseline survey data (N = 189), we conducted latent class analysis (LCA) to identify subgroups of participants with distinct relationship profiles and measured associations between relationship characteristics and multiple partnerships of inmates and their partners in the six months before incarceration. LCA indicated a two-class solution, with relationships distinguished by satisfaction/stability (satisfied/stable class: 58.0%; dissatisfied/unstable class: 42.0%); each class had comparable relationship length and levels of marriage and cohabitation. Dissatisfied/unstable relationships were associated with multiple partnerships among participants (AOR 2.93, 95% CI 1.50, 5.72) and partners (AOR 4.95, 95% CI 1.68, 14.58). Satisfaction indicators-versus length, marriage, or cohabitation-were the strongest independent correlates of inmates' and partners' multiple partnerships. Pre-incarceration economic deprivation, mental disorder symptoms, substance use, and violence in relationships were associated with dissatisfaction/instability. Prison-based programs designed to maintain healthy partnerships, strengthen relationship skills, and reduce HIV risk-taking and violence in relationships are warranted and should be targeted to both marital and nonmarital partnerships. Programming also should address the poverty, mental illness, and substance use factors that threaten relationship satisfaction/stability and increase HIV risk.

Factors Associated With Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006-2010 and 2011-2013.

PubMed

Nasrullah, Muazzam; Oraka, Emeka; Chavez, Pollyanna R; Johnson, Christopher H; DiNenno, Elizabeth

2017-04-01

Condom-less sex can increase the risk of acquiring or transmitting HIV. To characterize the prevalence of condom use at the most recent sex act and identify factors associated with use of a condom at the most recent sex act in adults in the United States. Data from the cross-sectional National Survey of Family Growth from cycles 2006 through 2010 and 2011 through 2013 were analyzed for sexually active men and women 18 to 44 years old who reported having sex (vaginal, anal, or oral) with an opposite-sex partner in the past 12 months. HIV-related sexual risk behaviors (SRBs) in the past 12 months included sex with at least four opposite-sex partners; exchanging sex for money or drugs; sex with an injection drug user; sex with an HIV-positive person; sex with a man who previously had sex with a man (women only); sex with a man (men only); or sex with a partner who had sex with other partners. The outcome for this analysis was condom use at the most recent anal or vaginal sex act. Overall prevalence of condom use was 24.8%; only 33.8% of adults with at least one SRB reported the use of a condom. Only 46.4% of unmarried or single men (vs 14.7% married or cohabitating men) and 32.3% unmarried or single women (vs 14.1% married or cohabitating women) with SRBs reported using a condom at the most recent sexual encounter and were less likely to use a condom at the most recent sexual encounter compared with those who did not report SRBs. We did not find a significant relation between using a condom and SRBs in married or cohabitating men and women. Our analysis adds to the literature on how condom use varies by marital status. We measured the use of condoms at the most recent sexual act, which might not reflect an individual's previous behavior of condom use. Nonetheless, condom use at the most recent sexual act has been documented in previous studies as a valid proxy of condom use over time. Continued efforts are needed to promote condom use in heterosexual adults in the United States, particularly those at high risk for HIV, namely individuals engaging in anal sexual acts and with multiple sex partners. Nasrullah M, Oraka E, Chavez PR, et al. Factors Associated With Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006-2010 and 2011-2013. J Sex Med 2017;14:541-550. Published by Elsevier Inc.

The influence of substance use, social sexual environment, psychosocial factors, and partner characteristics on high-risk sexual behavior among young Black and Latino men who have sex with men living with HIV: A qualitative study.

PubMed

VanDevanter, Nancy; Duncan, Alexandra; Burrell-Piggott, Tiphani; Bleakley, Amy; Birnbaum, Jeffrey; Siegel, Karolynn; Lekas, Helen-Marie; Schrimshaw, Eric; Cohall, Alwyn; Ramjohn, Destiny

2011-02-01

Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16-24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions.

Sexual behavior differences between amphetamine-type stimulants users and heroin users.

PubMed

Jia, Zhen-jun; Yan, Shi-yan; Bao, Yan-ping; Lian, Zhi; Zhang, Hao-ran; Liu, Zhi-min

2013-01-01

To explore the sexual behavior of amphetamine-type stimulant (ATS) users and heroin users, and to find out the dangerous sexual behaviors, even related risk factors among them. Four hundred thirty-eight ATS users and 524 heroin users were recruited in 10 compulsory detoxification treatment centers and voluntary detoxification centers in Beijing, Shenzhen, Guangzhou, Xi'an, and Taiyuan. Their sociodemographic characteristics, history of drug taking, and sexual behaviors were surveyed. Many variables of sociodemographic characteristics and sexual behaviors were significantly different between ATS users and heroin users (P < 0.05). Dangerous sexual behaviors among ATS users include sexual intercourse often or each time after taking drug (30.1%), multiple sexual intercourse (16.5%), casual sex partners (34.0%), homosexual partners (2.5%), and never or occasionally using condom with a steady sex partner (79.3%) or with casual sex partners (39.1%). The rate of ever-infecting sexually transmitted disease (STD) was high in both the groups (ATS, 20.5%; heroin, 30.9%). Sexual behavior is the main way to transmit STD and human immunodeficiency virus among ATS users. The study results will promote the government's awareness of the issue and take necessary steps to slow the spread of STD and human immunodeficiency virus among the ATS users.

Violence Against Women in Selected Areas of the United States.

PubMed

Montgomery, Brooke E E; Rompalo, Anne; Hughes, James; Wang, Jing; Haley, Danielle; Soto-Torres, Lydia; Chege, Wairimu; Justman, Jessica; Kuo, Irene; Golin, Carol; Frew, Paula; Mannheimer, Sharon; Hodder, Sally

2015-10-01

We determined the prevalence of recent emotional, physical, and sexual violence against women and their associations with HIV-related risk factors in women living in the United States. We performed an assessment of women ages 18 to 44 years with a history of unprotected sex and 1 or more personal or partner HIV risk factors in the past 6 months from 2009 to 2010. We used multivariable logistic regression to examine the association of experiencing violence. Among 2099 women, the prevalence of emotional abuse, physical violence, and sexual violence in the previous 6 months was 31%, 19%, and 7%, respectively. Nonmarried status, food insecurity, childhood abuse, depression symptomology, and posttraumatic stress disorder were significantly associated with multiple types of violence. All types of violence were associated with at least 3 different partner or personal HIV risk behaviors, including unprotected anal sex, previous sexually transmitted infection diagnosis, sex work, or partner substance abuse. Our data suggested that personal and partner HIV risk behaviors, mental illness, and specific forms of violence frequently co-occurred in the lives of impoverished women. We shed light on factors purported to contribute to a syndemic in this population. HIV prevention programs in similar populations should address these co-occurring issues in a comprehensive manner.

Violence Against Women in Selected Areas of the United States

PubMed Central

Rompalo, Anne; Hughes, James; Wang, Jing; Haley, Danielle; Soto-Torres, Lydia; Chege, Wairimu; Justman, Jessica; Kuo, Irene; Golin, Carol; Frew, Paula; Mannheimer, Sharon; Hodder, Sally

2015-01-01

Objectives. We determined the prevalence of recent emotional, physical, and sexual violence against women and their associations with HIV-related risk factors in women living in the United States. Methods. We performed an assessment of women ages 18 to 44 years with a history of unprotected sex and 1 or more personal or partner HIV risk factors in the past 6 months from 2009 to 2010. We used multivariable logistic regression to examine the association of experiencing violence. Results. Among 2099 women, the prevalence of emotional abuse, physical violence, and sexual violence in the previous 6 months was 31%, 19%, and 7%, respectively. Nonmarried status, food insecurity, childhood abuse, depression symptomology, and posttraumatic stress disorder were significantly associated with multiple types of violence. All types of violence were associated with at least 3 different partner or personal HIV risk behaviors, including unprotected anal sex, previous sexually transmitted infection diagnosis, sex work, or partner substance abuse. Conclusions. Our data suggested that personal and partner HIV risk behaviors, mental illness, and specific forms of violence frequently co-occurred in the lives of impoverished women. We shed light on factors purported to contribute to a syndemic in this population. HIV prevention programs in similar populations should address these co-occurring issues in a comprehensive manner. PMID:25790408

Sex Partnership and Self-Efficacy Influence Depression in Chinese Transgender Women: A Cross-Sectional Study

PubMed Central

Yang, Xiaoshi; Wang, Lie; Hao, Chun; Gu, Yuan; Song, Wei; Wang, Jian; Chang, Margaret M.; Zhao, Qun

2015-01-01

Background Transgender women often suffer from transition-related discrimination and loss of social support due to their gender transition, which may pose considerable psychological challenges and may lead to a high prevalence of depression in this population. Increased self-efficacy may combat the adverse effects of gender transition on depression. However, few available studies have investigated the protective effect of self-efficacy on depression among transgender women, and there is a scarcity of research describing the mental health of Chinese transgender women. This study aims to describe the prevalence of depression among Chinese transgender women and to explore the associated factors. Methods A cross-sectional study was conducted in Shenyang, Liaoning Province of China by convenience sampling from January 2014 to July 2014. Two hundred and nine Chinese transgender women were interviewed face-to-face with questionnaires that covered topics including the Zung Self-Rating Depression Scale (SDS), demographic characteristics, transition status, sex partnership, perceived transgender-related discrimination, the Multidimensional Scale of Perceived Social Support (MSPSS) and the adapted General Self-efficacy Scale (GSES). A hierarchical multiple regression analysis was performed to explore the factors associated with SDS scores. Results The prevalence of depression among transgender women was 45.35%. Transgender women with regular partners or casual partners exhibited higher SDS scores than those without regular partners or casual partners. Regression analyses showed that sex partnership explained most (16.6%) of the total variance in depression scores. Self-efficacy was negatively associated with depression. Conclusions Chinese transgender women experienced high levels of depression. Depression was best predicted by whether transgender women had a regular partner or a casual partner rather than transgender-related discrimination and transition status. Moreover, self-efficacy had positive effects on attenuating depression due to gender transition. Therefore, interventions should focus on improving the sense of self-efficacy among these women to enable them to cope with depression and to determine risky sex partnership characteristics, especially for regular and casual partners. PMID:26367265

Sex Partnership and Self-Efficacy Influence Depression in Chinese Transgender Women: A Cross-Sectional Study.

PubMed

Yang, Xiaoshi; Wang, Lie; Hao, Chun; Gu, Yuan; Song, Wei; Wang, Jian; Chang, Margaret M; Zhao, Qun

2015-01-01

Transgender women often suffer from transition-related discrimination and loss of social support due to their gender transition, which may pose considerable psychological challenges and may lead to a high prevalence of depression in this population. Increased self-efficacy may combat the adverse effects of gender transition on depression. However, few available studies have investigated the protective effect of self-efficacy on depression among transgender women, and there is a scarcity of research describing the mental health of Chinese transgender women. This study aims to describe the prevalence of depression among Chinese transgender women and to explore the associated factors. A cross-sectional study was conducted in Shenyang, Liaoning Province of China by convenience sampling from January 2014 to July 2014. Two hundred and nine Chinese transgender women were interviewed face-to-face with questionnaires that covered topics including the Zung Self-Rating Depression Scale (SDS), demographic characteristics, transition status, sex partnership, perceived transgender-related discrimination, the Multidimensional Scale of Perceived Social Support (MSPSS) and the adapted General Self-efficacy Scale (GSES). A hierarchical multiple regression analysis was performed to explore the factors associated with SDS scores. The prevalence of depression among transgender women was 45.35%. Transgender women with regular partners or casual partners exhibited higher SDS scores than those without regular partners or casual partners. Regression analyses showed that sex partnership explained most (16.6%) of the total variance in depression scores. Self-efficacy was negatively associated with depression. Chinese transgender women experienced high levels of depression. Depression was best predicted by whether transgender women had a regular partner or a casual partner rather than transgender-related discrimination and transition status. Moreover, self-efficacy had positive effects on attenuating depression due to gender transition. Therefore, interventions should focus on improving the sense of self-efficacy among these women to enable them to cope with depression and to determine risky sex partnership characteristics, especially for regular and casual partners.

[The status of HIV disclosure to primary sexual partners and sexual behaviors among HIV-infected men who have sex with men of 3 cities in China].

PubMed

Chen, Fang; Ding, Fan; Lin, Xiaojie; Wang, Xiaodong; He, Huan; Huang, Wen; Dong, Yanyan; Yang, Qiaohong; Zhang, Hongbo

2014-11-01

To investigate the status of HIV disclosure to primary partners and to explore the correlates of HIV disclosure among HIV-infected men who have sex with men (MSM) in Guangzhou, Chongqing and Chengdu. This survey was conducted in Chengdu, Chongqing and Guangzhou by using "snowballing" sample from December, 2012 to May, 2013. Participants who were eighteen years old or elder, HIV-infected, had sex with men and lived in three cities when the survey was conducted were eligible for subjects of this survey. Primary partners and disclosure status of participants were investigated. Multiple Unconditioned Logistic Regression analysis was used to analyze the influence factors associated with HIV disclosure.Of 600 participants, 541 were excluded because of logical problem or incomplete items in questionnaire and the effective response rate was 90.2%. Of the 541 HIV-positive MSM participants, the mean age was (30.2 ± 7.7) years old, 78.2% (423/541) of the participants had male primary partners.Of the 423 participants who had male primary partner, 10.9% (46/423) had wife, 58.9% (249/423) had one primary partner, and 41.1% (174/423) had two or more. The proportion of HIV disclosure to all male primary sexual partners and wife was 41.8% (177/423) and 4.5% (19/423) respectively, 20.3% (86/423) of them disclosure to some of male primary partners and 37.8% (160/423) not disclosure to any male primary partners. Participants who had HIV-positive male partners in the past 6 months (accounting for 35.2% (149/423)) were more likely to disclose HIV infection to their primary sexual partners (70.5% (105/149)) than those who had non-HIV-positive sexual partners (26.3% (72/274)) (χ(2) = 77.46, P < 0.01). Participants who had male unknown HIV-status sexual partners in the past 6 months(accounting for 52.7% (223/423)) were less likely to disclosure HIV infection to primary sexual partners (22.4% (50/223) ) than those who had already known HIV-status sexual partners (63.5% (127/200)) (χ(2) = 73.11, P < 0.01). The possibility of HIV disclosure to primary sexual partner among participants who had HIV-positive sexual partner increase to 6.36 (3.75-10.80) times of those who had HIV -negative partners, and the possibility among participants who had sexual partners of unknown HIV status decreased to 0.44 (0.25-0.76) times of those who had sexual partners of already known HIV status. Compared with having non-anal sex behaviors with male primary partner, the possibility of HIV disclosure to primary sexual partner decreased to 0.46 (0.22-0.95) times among participants who had anal sex behavior with male primary partners. There were low proportion of HIV disclosure to primary sexual partners among HIV-infected MSM in Guangzhou, Chongqing and Chengdu.HIV disclosure to primary sexual partners may be associated with characteristics of their sexual partners, and participants who had HIV-positive male partners were more likely to disclose HIV infection to their primary sexual partners.

Surveillance Among Men Who have Sex with Men in the United States: A Comparison of Web-Based and Venue-Based Samples.

PubMed

Chen, Yen-Tyng; Bowles, Kristina; An, Qian; DiNenno, Elizabeth; Finlayson, Teresa; Hoots, Brooke; Paz-Bailey, Gabriela; Wejnert, Cyprian

2018-07-01

Although men who have sex with men (MSM) recruited through web-based and venue-based sampling methods have been compared, no large web-based and venue-based samples using similar survey instruments have been examined in the U.S. This study describes the differences in sociodemographic characteristics and risk behaviors between the 2012 Web-based HIV Behavioral Survey (n = 3221) and 2011 National HIV Behavioral Surveillance (n = 9256). Compared with participants in the venue-based sample, participants in the web-based sample were older, less likely to be black or Hispanic, more likely to have higher socioeconomic status, and more likely to have anal sex without a condom with their last male sex partner. Web-based participants were less likely to have multiple male sex partners, ever injected drugs, been tested for HIV in the past 12 months, and received free condoms than venue-based participants. The method for sampling MSM into a behavioral survey should consider the sub-population of MSM to be reached.

76 FR 11684 - Presumption of Insurable Interest for Same-Sex Domestic Partners

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... 842 RIN 3206-AM20 Presumption of Insurable Interest for Same-Sex Domestic Partners AGENCY: Office of... amend its regulations to include same-sex domestic partners to the class of persons for which an... employees with same-sex domestic partners from the evidentiary requirements in existing regulations for...

Comfort Relying on HIV Pre-exposure Prophylaxis and Treatment as Prevention for Condomless Sex: Results of an Online Survey of Australian Gay and Bisexual Men.

PubMed

Holt, Martin; Draper, Bridget L; Pedrana, Alisa E; Wilkinson, Anna L; Stoové, Mark

2018-03-21

HIV-negative and untested gay and bisexual men from Victoria, Australia (n = 771) were surveyed during August-September 2016 about their comfort having condomless sex with casual male partners in scenarios in which pre-exposure prophylaxis (PrEP) or treatment as prevention were used. Men not using PrEP were most comfortable with the idea of condomless sex with HIV-negative partners (31%), followed by partners using PrEP (23%). PrEP users were more comfortable with the idea of condomless sex with these partner types (64 and 72%, respectively). Very few men not taking PrEP were comfortable with condomless sex with HIV-positive partners (3%), even with undetectable viral loads (6%). PrEP users were more comfortable with condomless sex with HIV-positive partners (29%), and those with undetectable viral loads (48%). Being on PrEP, having recent condomless sex with casual partners or a HIV-positive regular partner were independently associated with comfort having condomless sex.

Forced bachelors, migration and HIV transmission risk in the context of China's gender imbalance: a meta-analysis.

PubMed

Liu, Huijun; Li, Shuzhuo; Feldman, M W

2012-01-01

China has experienced continual increase in the sex ratio at birth (SRB) since the 1980s, which has led to a serious gender imbalance. To identify whether the future forced bachelors, especially those who migrate to cities, will increase the risk of HIV spread, a systematic review was carried out of studies published since 2000 that include the sexual risks of male migrants of China. Five studies comparing risk differences between migrants and non-migrants showed male migrants had greater risk of having multiple sexual partners and engaging in commercial sex. Ten studies concerning the relationship between sexual risks and socio-demographic characteristics showed that unmarried male migrants were more likely to engage in commercial sex and be infected with STDs than married migrants, while male migrants with higher income were more likely to have multiple sexual partners and be infected with STDs. In an analysis stratified by sample characteristics, the association between marriage and sexual risk was greater among samples with lower mean age, higher average income and education. In addition, the risk selection on education and income disappeared in the samples of migrants of whom more than half were unmarried.

Environmental factors in relation to unprotected sexual behavior among gay, bisexual, and other MSM.

PubMed

Pollock, James A; Halkitis, Perry N

2009-08-01

This descriptive article illustrates the casual sexual behaviors of a diverse sample (N = 311) of gay, bisexual, and other men who have sex with men (MSM) regularly attending gyms in New York City. Approximately 88% of the sample noted sex with a casual partner in the previous 6 months. Participants reported the frequency of unprotected sexual acts, the perceived HIV status of their partners, and the contexts where they met their casual sex partners. The study findings suggest that the context in which MSM choose to meet casual sex partners has an effect on both the number of casual sex partners they meet and the number of casual sex partners with whom they engage in unprotected receptive anal intercourse and unprotected insertive anal intercourse. We found that the highest risk sexual behaviors took place at bareback sex parties, which are often held at private venues. Men who meet their sexual partners at bareback sex parties are also likely to frequent bathhouses/sex clubs and nonbareback sex parties, suggesting a varied exploration of sexual contexts, partners, and behaviors. We attempt to enhance individual-level models of understanding sexual behavior and risk by proposing that the individual is influenced by the physical context where he makes his decisions.

Adolescent Maltreatment in the Child Welfare System and Developmental Patterns of Sexual Risk Behaviors

PubMed Central

Fowler, Patrick J.; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John

2018-01-01

In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M=15.5, SD=1.49) at baseline (n=714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare–involved adolescents and inform practices to promote positive transitions within the system. PMID:25155702

Mates but not sexes differ in migratory niche in a monogamous penguin species.

PubMed

Thiebot, Jean-Baptiste; Bost, Charles-André; Dehnhard, Nina; Demongin, Laurent; Eens, Marcel; Lepoint, Gilles; Cherel, Yves; Poisbleau, Maud

2015-09-01

Strong pair bonds generally increase fitness in monogamous organisms, but may also underlie the risk of hampering it when re-pairing fails after the winter season. We investigated whether partners would either maintain contact or offset this risk by exploiting sex-specific favourable niches during winter in a migratory monogamous seabird, the southern rockhopper penguin Eudyptes chrysocome. Using light-based geolocation, we show that although the spatial distribution of both sexes largely overlapped, pair-wise mates were located on average 595 ± 260 km (and up to 2500 km) apart during winter. Stable isotope data also indicated a marked overlap between sex-specific isotopic niches (δ¹³C and δ¹⁵N values) but a segregation of the feeding habitats (δ¹³C values) within pairs. Importantly, the tracked females remained longer (12 days) at sea than males, but all re-mated with their previous partners after winter. Our study provides multiple evidence that migratory species may well demonstrate pair-wise segregation even in the absence of sex-specific winter niches (spatial and isotopic). We suggest that dispersive migration patterns with sex-biased timings may be a sufficient proximal cause for generating such a situation in migratory animals.

Unhealthy weight control behaviors among youth: Sex of sexual partner is linked to important differences.

PubMed

Watson, Ryan J; VanKim, Nicole A; Rose, Hilary A; Porta, Carolyn M; Gahagan, Jacqueline; Eisenberg, Marla E

2018-03-30

Unhealthy weight control behaviors (UWCBs) have been decreasing for most youth over time, yet little is known whether these behaviors have changed for sexual minority (e.g., non-heterosexual) youth. This is important because many studies have found that sexual minorities report some of the highest rates of UWCBs. To determine whether or not these behaviors have changed over time, given the extreme changes in social contexts over the past two decades, we utilised three waves of the Minnesota Student Survey (N = 55,597, M age  = 17). In doing so, we report trends, disparities, and changes in disparities of UWCBs. Overall, the prevalence of UWCBs has declined from 1999 to 2010 for all youth, but there are alarming disparities by sex of sexual partner. We found that both- and same-sex partnered male youth were more likely to fast, use diet pills, and vomit on purpose to lose weight compared to their opposite-sex partnered counterparts in all three survey years; specifically, both-sex partnered boys were up to 5.5× as likely to vomit on purpose compared to their opposite-sex partnered counterparts. Likewise, both-sex partnered girls were more likely to use diet pills and vomit on purpose to lose weight compared to opposite-sex partnered girls in all three survey years. Additionally, the disparity in fasting to lose weight widened for the same-sex partnered females compared to the opposite-sex partnered females from 1998 to 2004. This has implications for UWCB interventions and preventions targeted specifically towards sexual minorities.

Sexual Knowledge, Attitudes and Practices of Female Undergraduate Students in Wuhan, China: The Only-Child versus Students with Siblings

PubMed Central

Li, Shiyue; Chen, Rucheng; Cao, Yue; Li, Jingjing; Zuo, Dan; Yan, Hong

2013-01-01

Objectives This study explored sexual knowledge, attitudes and practices of female only-child undergraduates and made a comparison with students with siblings. Methods Anonymously completed questionnaires were received from 4,769 female undergraduates, recruited using randomized cluster sampling by type of university and students' major and grade. Multivariate logistic regression was used to assess the effects of only-child on sexual knowledge, attitudes and practices among female undergraduates. Results Of 4,769 female undergraduate students, 41.0% were only-child and 59.0% were students with siblings. Compared with students with siblings, only-child students scored higher on sex-related knowledge, were more inclined to agree with premarital sex, multiple sex partners, one-night stands, extramarital lovers and homosexuality, and were more likely to have a boyfriend and experience sexual intercourse (73.6% vs. 61.4%; 24.0% vs. 14.0%). Only-children were less likely to experience coercion at first sex and have first sexual intercourse with men not their “boyfriends” than children with siblings (3.3% vs. 6.4%; 20.7% vs. 28.8%). There were no significant differences on other risky sexual behaviors (e.g. multiple sex partners and inconsistent condom use) between the only-child students and students with siblings. Conclusions Sexual knowledge, attitudes and some practices of only-child female undergraduates were different from students with siblings. Intervention should be designed according to different requirements of only-children and non-only-children. PMID:24023905

Disco funerals, a risk situation for HIV infection among youth in Kisumu, Kenya

PubMed Central

Njue, Carolyne; Voeten, Helene ACM; Remes, Pieter

2009-01-01

Objective We investigated the so called ‘disco funeral’ phenomenon in Kisumu, Kenya, whereby community members including adolescents congregate at the home of the deceased for several days, accompanied by music and dancing. We explored whether disco funerals are a risk situation for HIV/STI infection among youth. Design Cross-sectional qualitative study. Methods We conducted 44 in-depth interviews with male and female adolescents aged 15 to 20 in Kisumu municipality in Nyanza Province, Kenya. We also made observations during 6 disco funerals. Results Disco funerals were an important place for young people to hang out; they increased the opportunities to meet and engage in (risky) sexual activities. Many adolescents reported having casual sex on these occasions, sometimes with multiple partners, and mostly without condoms. Some girls were forced into sex, and there were several accounts of gang rape. Sex in exchange for money was reported frequently. Drugs and alcohol seemed to facilitate unprotected, multiple-partner, coerced, and transactional sex. Conclusions In Kisumu, a town with a generalized HIV/AIDS epidemic, the high AIDS mortality leads to frequent disco funerals. Because many adolescents are having unprotected, transactional, or coerced sex at these occasions, disco funerals might contribute to the high HIV prevalence among youth, especially among adolescent girls. HIV interventions urgently need to include outreach actions to youth who hang out at disco funerals, and link up with parents and funeral organizers to reduce risk situations. PMID:19165086

Sexual knowledge, attitudes and practices of female undergraduate students in Wuhan, China: the only-child versus students with siblings.

PubMed

Li, Shiyue; Chen, Rucheng; Cao, Yue; Li, Jingjing; Zuo, Dan; Yan, Hong

2013-01-01

This study explored sexual knowledge, attitudes and practices of female only-child undergraduates and made a comparison with students with siblings. Anonymously completed questionnaires were received from 4,769 female undergraduates, recruited using randomized cluster sampling by type of university and students' major and grade. Multivariate logistic regression was used to assess the effects of only-child on sexual knowledge, attitudes and practices among female undergraduates. Of 4,769 female undergraduate students, 41.0% were only-child and 59.0% were students with siblings. Compared with students with siblings, only-child students scored higher on sex-related knowledge, were more inclined to agree with premarital sex, multiple sex partners, one-night stands, extramarital lovers and homosexuality, and were more likely to have a boyfriend and experience sexual intercourse (73.6% vs. 61.4%; 24.0% vs. 14.0%). Only-children were less likely to experience coercion at first sex and have first sexual intercourse with men not their "boyfriends" than children with siblings (3.3% vs. 6.4%; 20.7% vs. 28.8%). There were no significant differences on other risky sexual behaviors (e.g. multiple sex partners and inconsistent condom use) between the only-child students and students with siblings. Sexual knowledge, attitudes and some practices of only-child female undergraduates were different from students with siblings. Intervention should be designed according to different requirements of only-children and non-only-children.

Women's land ownership and risk of HIV infection in Kenya.

PubMed

Muchomba, Felix M; Wang, Julia Shu-Huah; Agosta, Laura Maria

2014-08-01

Theory predicts that land ownership empowers women to avoid HIV acquisition by reducing their reliance on risky survival sex and enhancing their ability to negotiate safer sex. However, this prediction has not been tested empirically. Using a sample of 5511 women working in the agricultural sector from the 1998, 2003 and 2008-09 Kenya Demographic and Health Surveys, we examined the relationship between women's land ownership and participation in transactional sex, multiple sexual partnerships and unprotected sex, and HIV infection status. We controlled for demographic characteristics and household wealth, using negative binomial and logistic regression models. Women's land ownership was associated with fewer sexual partners in the past year (incidence rate ratio, 0.98; 95% confidence interval [CI], 0.95-1.00) and lower likelihood of engaging in transactional sex (odds ratio [OR], 0.67; 95% CI: 0.46-0.99), indicators of reduced survival sex, but was not associated with unprotected sex with casual partners (OR, 0.64; 95% CI, 0.35-1.18) or with unprotected sex with any partner among women with high self-perceived HIV risk (OR, 1.02; 95% CI, 0.57-1.84), indicating no difference in safer sex negotiation. Land ownership was also associated with reduced HIV infection among women most likely to engage in survival sex, i.e., women not under the household headship of a husband (OR, 0.40; 95% CI, 0.18-0.89), but not among women living in husband-headed households, for whom increased negotiation for safer sex would be more relevant (OR, 1.74; 95% CI, 0.92-3.29). These findings suggest that reinforcing women's land rights may reduce reliance on survival sex and serve as a viable structural approach to HIV prevention, particularly for women not in a husband's household, including unmarried women and female household heads. Copyright © 2014 Elsevier Ltd. All rights reserved.

77 FR 42903 - Change in Definitions; Evacuation Pay and the Separate Maintenance Allowance at Johnston Island

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... same-sex domestic partners of Federal employees and the children of such domestic partners have access... ``Extension of Benefits to Same-Sex Domestic Partners of Federal Employees.'' DATES: This rule is effective... same-sex domestic partners of Federal employees and the children of such domestic partners have the...

Working, sex partner age differences, and sexual behavior among African American youth.

PubMed

Bauermeister, José A; Zimmerman, Marc; Xue, Yange; Gee, Gilbert C; Caldwell, Cleopatra H

2009-10-01

Participation in the workplace has been proposed as a potential structural-level HIV/STI prevention strategy for youth. Only a few cross-sectional studies have explored the effect of work during adolescence and young adulthood on sexual behavior and their results have been mixed. This study builds on this literature by exploring whether work influences youths' sexual behavior in a cohort of African American youth (N = 562; 45% males; M = 14.5 years, SD = 0.6) followed from adolescence to young adulthood (ages 13-25 years). Using growth curve modeling, we tested whether working was associated with older sex partners. Then, we explored the association between sex partner age differences and sexual behaviors (i.e., number of sex partners, condom use, and frequency of sexual intercourse). Finally, we tested whether the relationship between sex partner age differences and sexual behaviors was confounded by working. Working greater number of hours was not significantly associated with having older sex partners. Sex partner age differences was associated with number of partners, condom use, and higher sex frequency. These associations were larger for females. Working was associated with higher sex frequency, after accounting for age differences. We discuss the implications of these findings for future research and program planning, particularly in the context of youth development programs.

Working, Sex Partner Age Differences, and Sexual Behavior among African American Youth

PubMed Central

Bauermeister, José A.; Zimmerman, Marc; Xue, Yange; Gee, Gilbert C.; Caldwell, Cleopatra H.

2009-01-01

Participation in the workplace has been proposed as a potential structural-level HIV/STI prevention strategy for youth. Only a few cross-sectional studies have explored the effect of work during adolescence and young adulthood on sexual behavior and their results have been mixed. This study builds on this literature by exploring whether work influences youths’ sexual behavior in a cohort of African American youth [N = 562; 45% males; M = 14.5 years, SD = 0.6] followed from adolescence to young adulthood (ages 13 to 25). Using growth curve modeling, we tested whether working was associated with older sex partners. Then, we explored the association between sex partner age differences and sexual behaviors (i.e., number of sex partners, condom use, and frequency of sexual intercourse). Finally, we tested whether the relationship between sex partner age differences and sexual behaviors was confounded by working. Working greater number of hours was not significantly associated with having older sex partners. Sex partner age differences was associated with number of partners, condom use, and and higher sex frequency. These associations were larger for females. Working was associated with higher sex frequency, after accounting for age differences. We discuss the implications of these findings for future research and program planning, particularly in the context of youth development programs. PMID:18574686

Measures of Attitudes Toward and Communication about Condom Use: Their Relationships With Sexual Risk Behavior Among Young Black MSM

PubMed Central

Crosby, Richard A.; Graham, Cynthia A.; Yarber, William L.; Sanders, Stephanie A.; Milhausen, Robin R.; Mena, Leandro

2015-01-01

Objective To construct and test measures of psychosocial mediators that could be used in intervention studies seeking to promote safer sex behavior among young Black men who have sex with men (YBMSM). Methods YBMSM (N=400), ages 18–29 years, were recruited from an STI clinic, in the Southern U.S. All men had engaged in penile-anal sex with a male as a “top” in the past 6 months. Men completed an audio-computer assisted self-interview and provided specimens used for NAAT testing to detect Chlamydia and gonorrhea. Four measures were constructed and tested for criterion validity (Safer Sex Communication, Condom Turn-Offs, Condom Pleasure Scale, and a single item assessing frequency of condom use discussions before sexual arousal). Results With the exception of Safer Sex Communication, all of the measures showed criterion validity for both unprotected anal insertive, and unprotected anal receptive sex. With the exception of the Condom Turn-Offs, the three other measures were supported by criterion validity for oral sex. Both the Condom Turn-Offs and Condom Pleasure Scale were significantly related to whether or not men reported multiple partners as a “top” but only the Condom Pleasure Scale was associated with reports of multiple partners as a “bottom.” Only the Condom Turn-Offs Scale was positively associated with having been diagnosed with either Chlamydia or gonorrhea. Conclusion Findings provide three brief scales and a single item that can be used in intervention studies targeting YBMSM. Perceptions about condoms a turn off and about condoms enhancing pleasure showed strong association with sexual risk behaviors. PMID:26766525

Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood.

PubMed

Green, Kerry M; Musci, Rashelle J; Matson, Pamela A; Johnson, Renee M; Reboussin, Beth A; Ialongo, Nicholas S

2017-02-01

Urban populations disproportionately experience poor sexual outcomes, including high rates of teenage pregnancy and sexually transmitted infections. However, the contribution of substance use across adolescence to poor sexual outcomes in young adulthood has not been investigated in depth, despite offering opportunities for more targeted prevention. This study aimed to estimate joint trajectories of adolescent alcohol and marijuana use to determine if they relate differently to four sexual outcomes: multiple sexual partners, sex without a condom, teenage pregnancy, and contraction of a sexually transmitted infection in young adulthood (by age 25). Data came from a longitudinal study of urban youth followed from age 6 to age 25, with annual assessments during adolescence and young adulthood (n = 608). The sample showed high levels of sexual risk, with young adults on average having sex without a condom once in the past month, 28.5% having multiple sexual partners in the past month, one quarter having contracted a sexually transmitted infection, and over 60% of the women being pregnant as a teenager and 36% of the men having gotten a partner pregnant. Applying longitudinal latent profile analysis to estimate joint trajectories of alcohol and marijuana use from grades 8-12, we identified four classes representing high dual use, moderate alcohol use, moderate alcohol use with increasing marijuana use, and non-use. Class membership differently predicted all four outcomes investigated with high dual users having the highest level of teenage pregnancy and the increasing marijuana trajectory having the highest risk of engaging with multiple sexual partners in the past month. Results suggest implications for both sexual risk and substance use prevention for urban youth.

Club drug use among young men who have sex with men in NYC: a preliminary epidemiological profile.

PubMed

Clatts, Michael C; Goldsamt, Lloyd A; Yi, Huso

2005-01-01

This paper describes findings from a study of young men who have sex with men (YMSM) in New York City. Using a cross-sectional design and a community-based targeted sampling approach, a total of 569 YMSM were recruited during 2000 and 2001 for a structured survey interview. High rates of lifetime exposure to a variety of club drugs (including methamphetamine, ketamine, and MDMA) are observed in the overall sample. Among those who use club drugs on a chronic basis (N=145), we found high rates of a prior suicide attempt (including high rates of multiple suicide attempts), high rates of lifetime exposure to multiple types of drugs, high rates of current poly drug use (including multiple types of club drugs), and high rates of current depressive symptoms. Chronic club drug users had a mean CES-D score of 8.5 and nearly two-thirds had a score of 7 or more. Although high rates of condom use are reported in some types of sexual exchanges, data show multiple types of sexual risk among chronic club drug users, including high rates of unprotected anal intercourse (UAI) with most frequent partners and comorbid drug use among both YMSM and their sexual partners.

Club Drug Use Among Young Men Who Have Sex with Men in NYC: A Preliminary Epidemiological Profile

PubMed Central

CLATTS, MICHAEL C.; GOLDSAMT, LLOYD A.; YI, HUSO

2009-01-01

This paper describes findings from a study of young men who have sex with men (YMSM) in New York City. Using a cross-sectional design and a community-based targeted sampling approach, a total of 569 YMSM were recruited during 2000 and 2001 for a structured survey interview. High rates of lifetime exposure to a variety of club drugs (including methamphetamine, ketamine, and MDMA) are observed in the overall sample. Among those who use club drugs on a chronic basis (N = 145), we found high rates of a prior suicide attempt (including high rates of multiple suicide attempts), high rates of lifetime exposure to multiple types of drugs, high rates of current poly drug use (including multiple types of club drugs), and high rates of current depressive symptoms. Chronic club drug users had a mean CES-D score of 8.5 and nearly two-thirds had a score of 7 or more. Although high rates of condom use are reported in some types of sexual exchanges, data show multiple types of sexual risk among chronic club drug users, including high rates of unprotected anal intercourse (UAI) with most frequent partners and comorbid drug use among both YMSM and their sexual partners. PMID:16048819

Men who have sex with men’s attitudes toward using color-coded wristbands to facilitate sexual communication at sex parties

PubMed Central

Grov, Christian; Cruz, Jackeline; Parsons, Jeffrey T.

2014-01-01

Sex parties are environments where men who have sex with men (MSM) have the opportunity to have sex with multiple partners over a brief period of time. Dim lighting and non-verbal communication are characteristics of sex parties that make sexual communication more challenging. We report on qualitative data from 47 MSM who attended sex parties in New York City. Participants responded to distinct hypothetical scenarios involving the use of color-coded wristbands to communicate (1) condom use preferences, (2) sexual position (e.g., top, bottom) and (3) HIV status at sex parties. The majority had positive-to-neutral attitudes toward color-coded wristbands to indicate (1) condom use preference and (2) sexual position (70.8%, 75.0% HIV-positive; 63.6%, 81.8%, HIV-negative respectively). These men cited that wristbands would facilitate the process of pursuing partners with similar interests while also avoiding the discomforts of verbal communication. In contrast, 41.7% of HIV-positive and 50.0% of HIV-negative men expressed unfavorable attitudes to using wristbands to communicate HIV status. These men cited the potential for HIV-status discrimination as well as suspicions around dishonest disclosure. Although participants were receptive to utilizing color-coded wristbands at sex parties to convey certain information, it may be unfeasible to use wristbands to communicate HIV status. PMID:24659929

Differences in Sexual Practices, Sexual Behavior and HIV Risk Profile between Adolescents and Young Persons in Rural and Urban Nigeria.

PubMed

Folayan, Morenike Oluwatoyin; Adebajo, Sylvia; Adeyemi, Adedayo; Ogungbemi, Kayode Micheal

2015-01-01

We aimed to determine differences in sexual practices, HIV sexual risk behaviors, and HIV risk profile of adolescents and young persons' in rural and urban Nigeria. We recruited 772 participants 15 to 24 years old from urban and rural townships in Nigeria through a household survey. Information on participants' socio-demographic profile (age sex, residential area, number of meals taken per day), sexual practices (vagina, oral and anal sex; heterosexual and homosexual sex; sex with spouse, casual acquaintances, boy/girlfriend and commercial sex workers), sexual behavior (age of sexual debut, use of condom, multiple sex partners, transactional sex and age of sexual partner), and other HIV risk factors (use of alcohol and psychoactive substances, reason for sexual debut, knowledge of HIV prevention and HIV transmission, report of STI symptoms) were collected through an interviewer administered questionnaire. Differences in sexual behavior and sexual practices of adolescents and HIV risk profile of adolescents and young persons resident in urban and rural areas were determined. More than half (53.5%) of the respondents were sexually active, with more residing in the rural than urban areas (64.9% vs 44.1%; p<0.001) and more resident in the rural area reporting having more than one sexual partner (29.5% vs 20.4%; p = 0.04). Also, 97.3% of sexually active respondents reported having vaginal sex, 8.7% reported oral sex and 1.9% reported anal sex. More male than female respondents in the urban area used condoms during the last vaginal sexual intercourse (69.1% vs 51.9%; p = 0.02), and reported sex with casual partners (7.0% vs 15.3%; p = 0.007). More female than male respondents residing in the rural area engaged in transactional sex (1.0% vs 6.7%; p = 0.005). More females than males in both rural (3.6% vs 10.2%; p = 0.04) and urban (4.7% vs 26.6%; p<0.001) areas self-reported a history of discharge. More females than males in both rural (1.4% vs 17.0%; p = 0.04) and urban (15.0% vs 29.1%; p<0.001) areas self-reported a history of itching. There are differences in the sexual behavior and practices of adolescents and young persons' residing in the urban and rural area with implication for HIV prevention programming.

Risk Comparison among Youth Who Report Sex with Same-Sex versus Both-Sex Partners

ERIC Educational Resources Information Center

Moon, Martha W.; Fornili, Katherine; O'Briant, Amanda L.

2007-01-01

This article examines risk behavior among youth attending support groups for sexual minority youth in Richmond, Virginia, using a structured survey, with particular attention to partner selection and its relationship to risk. Within this generally high-risk group, youth reporting sex partners of both sexes had significantly higher risk profiles,…

Strong propensity for HIV transmission among men who have sex with men in Vietnam: behavioural data and sexual network modelling.

PubMed

Bengtsson, Linus; Lu, Xin; Liljeros, Fredrik; Thanh, Hoang Huy; Thorson, Anna

2014-01-15

Survey data from men who have sex with men (MSM) in Asian cities indicate ongoing and drastic increases in HIV prevalence. It is unknown which behavioural factors are most important in driving these epidemics. We aimed to analyse detailed sexual behaviour data among MSM in Vietnam and to model HIV transmission using improved assumptions on sexual network structure. Vietnam. Internet-using men who had ever had sex (any type) with a man, aged ≥18 years and living in Vietnam. The study was cross-sectional, population-based and performed in 2012, using online respondent-driven sampling. The Internet-based survey instrument was completed by 982 participants, of which 857 were eligible. Questions included sociodemography and retrospective sexual behaviour, including number of unprotected anal sex (UAS) acts per partner. Estimated basic reproductive number over 3 months as a function of transmission risk per UAS act; frequency distributions of number of UAS partners and UAS acts during last 3 months. 36% (CI 32% to 42%) reported UAS at least once during the last 3 months. 36% (CI 32% to 41%) had ever taken an HIV test and received the result. UAS partner numbers and number of UAS acts were both highly skewed and positively correlated. Using a weighted configuration model, taking into account partner numbers, frequency of UAS and their correlations, we estimated the basic reproductive number (R0) over 3 months. The results indicated rapid transmission over a wide range of values of per-act transmissibility. Men with multiple partners had unexpectedly high UAS frequency per partner, paired with low HIV testing rates. The study highlights the importance of collecting data on frequency of UAS acts and indicates the need to rapidly scale-up HIV prevention services and testing opportunities for MSM in Vietnam.

Partnering Patterns and Sexual Behavior Among Korean Men Who Have Sex With Men.

PubMed

Jung, Minsoo

2016-01-01

This qualitative study investigates the different methods for selecting sex partners by Korean homosexuals considering factors related to homosexual identity and sexual behavior. We take the approach of the grounded theory to examine the issue of sexual partnering of men who have sex with men (MSM). In-depth interviews of urban MSM and bisexual men were conducted. The snowball sampled through a MSM portal web site. Three key informants from the several areas were collected through a MSM portal website, and then, participants were gradually recruited with the snowball samplings in South Korea, 2011 (n=32). The results of coding the interviews based on the grounded theory approach identified three types of partnering: 1) MSM who do not prefer anal intercourse, but pursue safe sex in long-term relationships with fixed partners; 2) those who have fixed partners and perform anal sex, a category into which both MSM and bisexuals fall; and 3) those engaged in anal sex, but enjoy a concurrent sexual relationship without having fixed partners, which was common among bisexuals. The findings from this study elucidate several MSM and bisexual partnering types practice safe sex. This diversity in MSM partnering may increase the vulnerability of some MSM to HIV infection as safe-sex practices remain a matter of individual choice. Changes in Korean societal policies are necessary to enhance capacity building and encourage the practice of safe sex at the community level.

Alcohol Behaviors and Deviant Behaviors among Adolescents in a Rural State.

ERIC Educational Resources Information Center

Nagy, Stephen; Dunn, Michael S.

1999-01-01

Study provides a descriptive profile of alcohol consumption patterns of adolescents in a southern state from four time periods over the past decade. Also examines the relationship between alcohol initiation and binge drinking behaviors and sexual initiation, pregnancy, multiple sex partners, and violence. Regression analyses showed very modest…

HIV status differences in venues where highly sexually active gay and bisexual men meet sex partners: results from a pilot study.

PubMed

Grov, Christian; Golub, Sarit A; Parsons, Jeffrey T

2010-12-01

Highly sexually active men who have sex with men (MSM) are a critical population in which to provide HIV prevention and education. To inform the tailoring and placement of such services, this study reports on HIV status differences in nine venues where 50 highly sexually active MSM (defined as those who had nine or more male partners in the past 90 days) met recent male sex partners. HIV-positive men (95%) were significantly more likely than HIV-negative/unknown status men (68%) to have used the Internet to meet partners but were less likely to meet partners in bars/clubs (37% vs. 71%). Although both HIV-positive and HIV-negative/unknown status men reported a sizable portion of their total partners from the Internet (55% and 29%, respectively), HIV-positive MSM also gravitated toward meeting partners through sexual networks (private sex parties and via other sex partners), whereas HIV-negative/unknown status also gravitated toward gay bars/clubs and public cruising. Overall, HIV-positive men were more likely to report unprotected anal sex than to HIV-negative/unknown status men. Among HIV-negative/unknown status men, the highest rates of unprotected sex were with men they met online (20% of online partners) and through other sex partners (25% of these partners). Efforts targeted toward highly sexually active HIV-negative/unknown status men might be best positioned online and in gay bars/clubs, whereas those tailored for highly sexually active HIV-positive men may consider targeting the Internet and peers/sexual networks.

Sexual activity, substance use, and HIV/STD knowledge among detained male adolescents with multiple versus first admissions.

PubMed

Harwell, T S; Trino, R; Rudy, B; Yorkman, S; Gollub, E L

1999-05-01

Incarcerated and detained youth are at high risk for sexually transmitted diseases (STD), including human immunodeficiency virus (HIV). To compare the level of sexual activity and substance use-related risk and knowledge regarding HIV/STD among male adolescents with multiple (YMA) versus first admissions (YFA) to a detention facility as a basis for the development of specific intervention strategies. Sexual and substance use histories, HIV/STD knowledge, and perceived risk were collected through structured interviews of a consecutive sample of detained youth. Human immunodeficiency virus antibody seroprevalence was determined using a blind study of discarded blood. Overall, these youth (N = 486) reported high levels of noninjection drug use, sexual risk activities, and knowledge regarding HIV/STD prevention. Furthermore, most of these youth reported that their risk for HIV infection was low (68%). Eighty-one percent of all youth reported recent (past 6 months) vaginal sex, and 14% reported insertive anal sex. Controlling for age, YMA were more likely to initiate sex at age 13 or younger (OR 1.38; 95% CI, 1.11-1.70), to report eight or more lifetime sex partners (OR 1.36; 95% CI, 1.13-1.63), and to have ever exchanged drugs or money for sex (OR 1.54; 95% CI, 1.08-2.19). However, these youth were less likely to report condom use with their last sex partner (OR 0.74; 95% CI, 0.60-0.93). More than one third (34%) of all youth felt that consistent use of condoms would not provide a high level of protection against HIV. Youth with multiple versus first admissions are at higher risk of HIV/STD infections through their lifetime and recent sexual activities. Interventions targeted to this population will need to address the barriers to and facilitators of condom use, strategies to promote positive attitudes toward condoms, and strategies to reduce the high level of alcohol and substance use.

Characterization of juvenile play in rats: importance of sex of self and sex of partner.

PubMed

Argue, Kathryn J; McCarthy, Margaret M

2015-01-01

Juvenile social play is observed in many mammalian species, and its disruption in several neuropsychiatric disorders has greatly increased interest in understanding the origins and sources of variability in this behavior. We quantified social play behavior in juvenile rats and investigated the impact of sex and familiarity of the play partner. Sex differences in play behavior were investigated by comparing males and females from either same- or mixed-sex pairs with data pooled over 12 days of analysis. Whether play was altered based on the sex of the play partner was assessed using a paired analysis to compare play with a same- or opposite-sex play partner for both males and females. Additionally, a repeated measures design was utilized to determine whether play changed with increasing age. On postnatal day 33, a novel play partner was introduced. We used a repeated measures analysis to compare postnatal day 33 with the previous day. These approaches were used to assess the effects of age, sex, sex of partner, and familiarity of partner on total social play behavior as well as how play was broken down into components, such as pouncing, pinning, chasing, and boxing. There were sex differences in total frequency of play, and specific parameters of play behavior, such as chasing, pouncing, pinning, and boxing. Additionally, males significantly altered their play behavior in response to the sex of their play partner, whereas females were more sensitive to the familiarity of the play partner. This study provides critical groundwork for uncovering factors that regulate social play behavior and can be used to guide future mechanistic based work.

The other side of the bridge: exploring the sexual relationships of men who have sex with men and their female partners in Mumbai, India

PubMed Central

Closson, Elizabeth F.; Sivasubramanian, Murugesan; Mayer, Kenneth H.; Srivastava, Ankur; Safren, Steven A.; Anand, Vivek Raj; Gangakhedkar, Raman

2014-01-01

Behaviourally bisexual men have been identified as a ‘bridge’ population of HIV transmission to heterosexual women in India. Little is known about the sexual relationships that these men have with their female sex partners. The primary objective of this study was to explore the sexual practices and relationship dynamics between married and unmarried behaviourally bisexual men and their female sex partners in Mumbai, India. In 2009, semi-structured qualitative interviews were conducted with 32 men who reported sex with men and women. Participants discussed a variety of sexual practices and arrangements with female sex partners. Irrespective of marital status and sexual identity, many said that they had satisfying sexual experiences and feelings of affection for female sex partners. However, sexual incompatibility between married partners was also reported. Explanations of bisexual concurrency were discussed in terms of both sexual satisfaction and sexual preference. Self-perceived HIV risk related to same-sex sexual behaviour motivated many men to use condoms with female partners. Expectations of unprotected marital sex and perceptions of partner risk were barriers to condom use. HIV prevention programmes for this population may benefit from tailored risk reduction counselling that attend to the variations of these sexual and social relationship dynamics. PMID:24815724

The Influence of Substance Use, Social Sexual Environment, Psychosocial Factors, and Partner Characteristics on High-Risk Sexual Behavior Among Young Black and Latino Men Who Have Sex with Men Living with HIV: A Qualitative Study

PubMed Central

Duncan, Alexandra; Burrell-Piggott, Tiphani; Bleakley, Amy; Birnbaum, Jeffrey; Siegel, Karolynn; Lekas, Helen-Marie; Schrimshaw, Eric; Cohall, Alwyn; Ramjohn, Destiny

2011-01-01

Abstract Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16–24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions. PMID:21235387

Demographics, Behaviors, and Sexual Health Characteristics of High Risk Men Who Have Sex With Men and Transgender Women Who Use Social Media to Meet Sex Partners in Lima, Peru.

PubMed

Chow, Jeremy Y; Konda, Kelika A; Calvo, Gino M; Klausner, Jeffrey D; Cáceres, Carlos F

2017-03-01

Men who have sex with men (MSM) and transgender women (TW) in Peru bear a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). In a context of quickly expanding communication technology, increasing numbers of MSM and TW are using social media applications to seek sex partners. Understanding social media users and their sex partnering practices is needed to update HIV and STI prevention programming. In Lima, Peru, 312 MSM and 89 TW from 2 STI clinics underwent HIV and STI testing and participated in a survey of demographics, behaviors, sexual health, and social media practices. χ, t tests, and Wilcoxon Mann-Whitney tests were used to compare those with and without recent social media sex partners. Men who have sex with men with social media sex partners were younger, more educated, and more likely to identify as gay. They were significantly more likely to report greater numbers of sex partners, including anonymous sex partners; sex in higher-risk venues, orgies, and have rectal Neisseria gonorrhoeae or Chlamydia trachomatis infection. Transgender women with social media sex partners were also younger, more likely to participate in sex work, and have a lower rate of rapid plasma reagin positivity or history of syphilis. Participants reported using several social media sites including sexual hook-up applications, websites for gay men, pornographic websites, and chat sites, but the most common was Facebook. Prevention strategies targeting Peruvian MSM and TW who use social media are needed to address higher-risk sexual behavior and the high burden of STIs.

Condom use among criminally-involved adolescents.

PubMed

Magura, S; Shapiro, J L; Kang, S Y

1994-01-01

Condom use was studied for 421 sexually active, minority male adolescents who were currently in jail in New York City. Over three-quarters of the youths were users of alcohol and marijuana and about one-quarter were users of cocaine or crack, but drug injectors were rare. In the six months before arrest they had multiple sexual partners and about one-third had engaged in anal intercourse. Inconsistent condom use was the norm, with 17% reporting that they never used condoms and only 15% reporting that they used condoms every time for insertive sex. In multivariate analysis, more frequent condom use was independently predicted by gay/bisexual preference, greater acceptability and accessibility of condoms, partners' receptivity to use, self-initiation of use, and self-efficacy of avoiding AIDS. Condoms were used less frequently with steady than with causual partners, and rarely for anal or oral sex. AIDS prevention curricula addressing these factors should be delivered to high risk adolescents while they are temporarily accessible in jail.

Egocentric Network and Condom Use Among Mid-Age Female Sex Workers in China: A Multilevel Modeling Analysis.

PubMed

Liu, Hongjie

2016-04-01

The epidemics of sexually transmitted infections (STIs) have spread among older adults in the world, including China. This study addresses the deficiency of studies about the multiple contextual influences on condom use among mid-age female sex workers (FSWs) over 35 years old. A combination of an egocentric network design and multilevel modeling was used to investigate factors of condom use over mid-age FSWs (egos) particular relationships with sexual partners (alters). Of the 1245 mid-age FSWs interviewed, 73% (907) reported having at least one sexual partner who would provide social support to egos. This generated a total of 1300 ego-alter sex ties in egos' support networks. Condoms were consistently used among one-third of sex ties. At the ego level, condoms were more likely to be used consistently if egos received a middle school education or above, had stronger perceived behavioral control for condom use, or consistently used condoms with other sex clients who were not in their support networks. At the alter level, condoms were not consistently used over spousal ties compared to other ties. Condoms were less likely to be used among alters whom ego trusted and provided emotional support. Cross-level factors (egos' attitudes toward condom use and emotional support from alters) documented a significant positive interaction on consistent condom use. Given the low frequency of condom use, future interventions should focus on mid-age FSWs and their partners within and beyond their support networks.

Egocentric Network and Condom Use Among Mid-Age Female Sex Workers in China: A Multilevel Modeling Analysis

PubMed Central

2016-01-01

Abstract The epidemics of sexually transmitted infections (STIs) have spread among older adults in the world, including China. This study addresses the deficiency of studies about the multiple contextual influences on condom use among mid-age female sex workers (FSWs) over 35 years old. A combination of an egocentric network design and multilevel modeling was used to investigate factors of condom use over mid-age FSWs (egos) particular relationships with sexual partners (alters). Of the 1245 mid-age FSWs interviewed, 73% (907) reported having at least one sexual partner who would provide social support to egos. This generated a total of 1300 ego–alter sex ties in egos' support networks. Condoms were consistently used among one-third of sex ties. At the ego level, condoms were more likely to be used consistently if egos received a middle school education or above, had stronger perceived behavioral control for condom use, or consistently used condoms with other sex clients who were not in their support networks. At the alter level, condoms were not consistently used over spousal ties compared to other ties. Condoms were less likely to be used among alters whom ego trusted and provided emotional support. Cross-level factors (egos' attitudes toward condom use and emotional support from alters) documented a significant positive interaction on consistent condom use. Given the low frequency of condom use, future interventions should focus on mid-age FSWs and their partners within and beyond their support networks. PMID:27028182

Perpetrators of Intimate Partner Sexual Violence: Are There Unique Characteristics Associated With Making Partners Have Sex Without a Condom?

PubMed Central

Purdie, Michele Parkhill; Abbey, Antonia; Jacques-Tiura, Angela J.

2015-01-01

This study examined correlates of making an intimate partner engage in unprotected sex among perpetrators of sexual violence. Based on the Confluence Model, we hypothesized that power and impersonal sex motives would be higher among perpetrators who made a dating partner have unprotected sex. Among a subsample of 78 male college students, significant differences were found for acceptance of verbal pressure, positive attitudes about casual sex, frequency of sexual intercourse, and physical injuries to dating partners. These findings highlight the importance of integrating theories and interventions directed at sexual assault and sexual risk reduction. PMID:20980229

Oral sex and oropharyngeal cancer: The role of the primary care physicians.

PubMed

Nguyen, Nam P; Nguyen, Ly M; Thomas, Sroka; Hong-Ly, Bevan; Chi, Alexander; Vos, Paul; Karlsson, Ulf; Vinh-Hung, Vincent

2016-07-01

We aimed to study the prevalence of oral sex and its possible association with human papillomavirus (HPV) 16 infection in the development of oropharyngeal cancer in the US population for possible prevention. We conduct a systemic review on the prevalence of oral sex among Americans among different age groups, the prevalence of HPV 16 infection reported in oropharyngeal cancer, and correlation between oral sex and oropharyngeal cancer. Oral sex is prevalent among adolescents and sexually active adults. Sixty percent of oropharyngeal cancer reported in the United States is associated with HPV 16 infections. Individuals who practiced oral sex with multiple partners are at risk for developing oropharyngeal cancer and need to be informed about practicing safe sex or getting vaccination. Family physicians will play a key role in prevention and educating the public about the risk of oral sex.

Sexual risk history and condom use among people living with HIV/AIDS in Ogun State, Nigeria.

PubMed

Amoran, Olorunfemi; Ladi-Akinyemi, Temitope

2012-04-01

The majority of human immunodeficiency virus (HIV) infections are acquired through unprotected sex between partners; only male or female condoms can reduce the chances of infection with HIV during a sexual act. This study was therefore designed to describe sexual risk history and identify factors associated with condom use among people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHAs) in Ogun State, Nigeria. Main outcome measures are sexual and HIV risk history, safe sex practices, and condom use. This study is an analytical cross-sectional study. A total sample of all people living with HIV/AIDS attending secondary health facilities in Ogun State were recruited into the study. A total of 637 were interviewed; median age at first sexual intercourse among the study participants was 19 years (mean age = 18.95, standard deviation [SD] = 4.148) with a median of two lifetime sexual partners (mean = 3.22, SD = 3.57). Majority (71.4%) of the respondents had not been diagnosed with a sexually transmitted infection other than HIV. Precisely 47.7% of men and 52.3% of women had two or more sexual partners in the last 6 months. Men were statistically significantly more likely to have multiple sexual partners when compared with women (P = 0.00). Significantly more women (69.8%) than men (30%) had sexual partners whose HIV status they did not know (P = 0.006). Predictors of condom use were individuals who had multiple sexual partners (odds ratio [OR] = 1.41, confidence interval [CI] = 1.05-1.83) and married (OR = 3.13, CI = 1.15-8.51) with higher level of education (OR = 2.78, CI = 1.39-5.79), with knowledge of partner's serostatus (OR = 2.53, CI = 1.50-4.28), and awareness of reinfection (OR = 1.90, CI = 1.22-2.95). The study indicates that the establishment of effective safe sex practices and condom use behavior among PLWHAs in low-income countries such as the study population requires adequate health education on the transmission of HIV/AIDS and the understanding of the dynamics of family life and gender issues. © 2011 International Society for Sexual Medicine.

76 FR 45204 - Noncompetitive Appointment of Certain Former Overseas Employees

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... Management (OPM) is issuing proposed regulations to clarify that an employee's same-sex domestic partner...-sex domestic partners with the same employment opportunities that opposite-sex spouses of Federal... that an employee's same-sex domestic partner qualifies, and should be treated as, a family member for...

75 FR 32247 - Extension of Benefits to Same-Sex Domestic

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... Benefits to Same-Sex Domestic Partners of Federal Employees Memorandum for the Heads of Executive..., consistent with existing law, in order to extend benefits to the same-sex domestic partners of Federal employees, and, where applicable, to the children of same-sex domestic partners of Federal employees: (a...

What Leads to Sex? Adolescent Preferred Partners and Reasons for Sex.

ERIC Educational Resources Information Center

Eyre, Stephen L.; Millstein, Susan G.

1999-01-01

Examined perceived antecedents of sex and preferred partner qualities in African-American and White late adolescents. Found that African Americans mentioned "nice body" as criterion for partner attractiveness; Whites did not. Males identified sexual arousal as a reason for sex; females did not. African-American males associated sexual…

Household and community income, economic shocks and risky sexual behavior of young adults: evidence from the Cape Area Panel Study 2002 and 2005.

PubMed

Dinkelman, Taryn; Lam, David; Leibbrandt, Murray

2007-11-01

To describe recent trends in adolescent sexual behavior in Cape Town, South Africa, and to determine whether household and community poverty and negative economic shocks predict risky sexual behavior. Matched survey data on 2993 African and coloured youth from the Cape Area Panel Study 2002 and 2005. Sexual debut, multiple sexual partners in past year, condom use at last sex, measured in 2002 and 2005. We tested for changes over time in reported sexual behavior and estimate multivariate probit models to measure the association between 2002 individual, household and community characteristics and 2005 sexual behavior. There was a statistically significant increase in condom use and a decrease in the incidence of multiple sexual partners between 2002 and 2005 for young women aged 17-22 years. Young women in households with 10% higher income were 0.53% less likely to debut sexually by 2005; young men in communities with a 10% higher poverty rate were 5% less likely to report condom use at last sex. Negative economic shocks are associated with a 0.04% increase in the probability of multiple partnerships for young women. Education is positively correlated with sexual debut for young women and with multiple partnerships for both sexes. Trends in sexual behavior between 2002 and 2005 indicate significant shifts towards safer practices. There is little evidence of a relationship between negative economic shocks, household and community poverty, and risky behavior. We hypothesize that the unexpected positive relationship between education and sexual debut may be driven by peer effects in schools with substantial age mixing.

Sexual Decision-Making in HIV-Positive Men Who Have Sex with Men: How Moral Concerns and Sexual Motives Guide Intended Condom Use with Steady and Casual Sex Partners

PubMed Central

Hospers, Harm J.; van Empelen, Pepijn; Breukelen, Gerard van; Kok, Gerjo

2007-01-01

Determinants of intended condom use with steady and casual sex partners were examined among Dutch HIV-positive men who have sex with men (MSM) (N = 296). Given the proposition that safer sex behavior among HIV-positive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior with Schwartz’s norm-activation theory and tested the assumption that personal norms would mediate the effects of other psychosocial factors on intended condom use for anal sex. In addition, it was hypothesized that, depending on the context in which sex occurs, specific motives for unprotected anal sex may have a negative influence on intended condom use and, as such, undermine a prosocial tendency to practice safer sex. Therefore, we also investigated the influence of sexual motives for unprotected anal sex on intended condom use with steady and casual sex partners. Results indicated that the Theory of Planned Behavior adequately predicted condom use intentions (for casual sex partners and steady sex partners, the explained variance was 52% and 53%, respectively). However, our proposed model of sexual decision-making significantly improved the prediction of behavioral intentions. For steady and casual sex partners, the assumption of the mediating role of personal norms on condom use intention was confirmed empirically. Additionally, sexual motives for unprotected anal sex exerted, as expected, a direct, negative effect on condom use intention with casual sex partners. The implications of the findings for future research and the development of HIV-prevention programs for HIV-positive MSM are discussed. PMID:17333328

Drug Use and High-Risk Sexual Behaviors Among African American Men Who Have Sex With Men and Men Who Have Sex With Women

PubMed Central

Clubb, Patricia A.; Wang, Yan; Wagner, Fernando

2009-01-01

Objectives. We investigated covariates related to risky sexual behaviors among young African American men enrolled at historically Black colleges and universities (HBCUs). Methods. Analyses were based on data gathered from 1837 male freshmen enrolled at 34 HBCUs who participated in the 2001 HBCU Substance Use Survey. The covariates of risky sexual behavior assessed included condom nonuse, engaging in sexual activity with multiple partners, and history of a sexually transmitted disease. Results. Young Black men who had sex with men were more likely to engage in risky sexual behaviors than were young men who had sex with women. Two additional factors, early onset of sexual activity and consumption of alcohol or drugs before sexual activity, were independently associated with modestly higher odds of sexual risk behaviors. Conclusions. Services focusing on prevention of sexually transmitted diseases should be provided to all male college students, regardless of the gender of their sexual partners. Such a general approach should also address drug and alcohol use before sexual activity. PMID:19372526

Dangerous subtlety: relationship-related determinants of consistency of condom use among female sex workers and their regular, non-commercial partners in Hai Phong, Viet Nam.

PubMed

Hoffman, Leah; Nguyen, Ha Thi Thu; Kershaw, Trace S; Niccolai, Linda M

2011-10-01

Research indicates female sex workers use condoms more consistently with their clients than with regular, non-commercial partners (partners). The purpose of this study was to better understand the relationship between couple communication and HIV risk behavior by examining (1) sex worker-partner divergence on communication measures and (2) the association between intra-couple communication divergence and consistent condom use. In this cross-sectional study, 50 sex workers and their partners in Hai Phong, Viet Nam were separately asked about their relationships and condom use. When asked about HIV risk communication in their relationship, sex workers reported significantly higher HIV communication content than their partners (p < 0.001). Higher communication divergence between partners was associated with a decreased likelihood of consistent condom use (OR 0.54 95% CI 0.30, 0.97). Sex workers urgently need interventions that build their communication skills and address their risk behavior in non-commercial relationships.

Vulnerability to sexual violence and participation in sex work among high-end entertainment centre workers in Hunan Province, China.

PubMed

Kelvin, Elizabeth A; Sun, Xiaoming; Mantell, Joanne E; Zhou, Jianfang; Mao, Jingshu; Peng, Yanhui

2013-11-01

China has seen a proliferation of entertainment centres that are frequented by business people. Employees at these centres often are young, female rural-to-urban migrants who may be vulnerable to sexual violence and exploitation. Data for this study were collected using a self-administered survey among male and female employees in two high-end entertainment centres in Changsha, Hunan Province, China. We used logistic regression to examine predictors of violent and potentially exploitative experiences (partner violence, forced sex and transactional sex). Predictors included gender, ever having a same-sex partner, migration variables and employment characteristics. Participants reported high levels of partner violence (16.0% ever and 9.0% in the past 3 months) and forced sex (13.9% ever and 5.5% in the past 3 months). Nineteen percent reported sex work in the past 3 months. In the multivariate regressions, ever having had a same-sex partner was associated with higher odds of ever having experienced partner violence (odds ratio (OR)=7.8, P<0.001), partner violence in the past 3 months (OR=9.0, P<0.001), ever having had transactional sex (OR=6.0, P<0.001) and transactional sex in the past 3 months (OR=5.2, P=0.001). After adjusting for transactional sex, the association between having had a same-sex partner and partner violence remained significant. Neither gender nor migration status was associated with any of the outcomes. High-end entertainment centre workers in China are at risk for sexual violence and should be targeted with employment-based interventions.

Love, power, resilience and vulnerability: relationship dynamics between female sex workers in Ghana and their intimate partners.

PubMed

Onyango, Monica Adhiambo; Adu-Sarkodie, Yaw; Adjei, Rose Odotei; Agyarko-Poku, Thomas; Kopelman, Carol Hunsberger; Green, Kimberly; Wambugu, Samuel; Clement, Nana Fosua; Wondergem, Peter; Beard, Jennifer

2018-04-19

Little is known about female sex workers' daily lives or emotional relationships. Using relational-cultural theory, this study explored the relationship dynamics between sex workers and their intimate partners in Kumasi, Ghana. We collected qualitative data from 37 male intimate partners through 24 in-depth interviews and two focus group discussions (FGDs) with 13 male partners. We also conducted three FGDs with 20 women involved in sex work. Relationships between sex workers and their intimate partners were mutual, reciprocal and transactional. Male partners provided protection for financial support, a place to sleep and intimacy. Both men and women described their relationships in terms of friendship, love and a hopeful future. Women were reluctant to quit sex work because they depended on it for income. Most respondents did not use condoms in these romantic relationships, citing trust, love, faithfulness and commitment. Both men and women described high levels of violence in their relationships. The context of sex work heightens vulnerability but also appears to facilitate resilience and creative coping strategies. The relational dynamics between sex workers and their intimate partners in Ghana merit further exploration to examine the extent to which women involved in sex work hold and exert power within these relationships.

Power and Inequality: Intimate Partner Violence Against Bisexual and Non-Monosexual Women in the United States.

PubMed

Coston, Bethany M

2017-08-01

While just over one in three heterosexual women will experience intimate partner violence (IPV) in her lifetime, 61% of bisexual women and 78% of non-monosexual women will. Combining previous research and theories on power, social resources, binegativity, and gender-based violence, this article analyzes the role of power and inequality in non-monosexual women's IPV victimization. Using data from the National Intimate Partner and Sexual Violence Survey, this article first examines rates of IPV victimization for statistically significant differences between monosexual (e.g., only have dating, romantic, and sexual partners of one sex/gender) and non-monosexual (e.g., have dating, romantic, and sexual partners of multiple sexes/genders) women in the United States and, second, introduces theoretically important variables to logistic regression analyses to determine the correlates of IPV victimization among non-monosexual women (age, race ethnicity, income, education, immigration status, and indigeneity; partner gender; sexual identity). Findings indicate that non-monosexual women are more likely to experience sexual, emotional, and psychological/control violence, and intimate stalking, but have an equivalent risk of experiencing physical violence. Moreover, having an abusive partner who is a man, having a lot of relative social power, and self-identifying as "bisexual" are all significant factors in violence victimization. Importantly, this is the first study using nationally representative data that confirms non-monosexual women are particularly at risk for sexual identity-based violence at the hands of their male/man partners, suggesting binegativity and biphobia may indeed be linked to hegemonic masculinity. Suggestions for moving research forward include improving data collection efforts such that we can disentangle gender from sex and individual aggregate power from relationship inequalities, as well as more adequately account for the timing of sexual identity disclosures within relationships, relative to the timing of violent episodes.

HIV Disclosure and Sexual Transmission Behaviors among an Internet Sample of HIV-positive Men Who Have Sex with Men in Asia: Implications for Prevention with Positives

PubMed Central

Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E.; Koe, Stuart

2012-01-01

The relationship between HIV disclosure and sexual transmission behaviors, and factors that influence disclosure are unknown among HIV-positive men who have sex with men (MSM) in Asia. We describe disclosure practices and sexual transmission behaviors, and correlates of disclosure among this group of MSM in Asia. A cross-sectional multi-country online survey was conducted among 416 HIV-positive MSM. Data on disclosure status, HIV-related risk behaviors, disease status, and other characteristics were collected. Multivariable logistic regression was used to identify significant correlates of disclosure. Only 7.0% reported having disclosed their HIV status to all partners while 67.3% did not disclose to any. The majority (86.5%) of non-disclosing participants had multiple partners and unprotected insertive or receptive anal intercourse with their partners (67.5%). Non-disclosure was significantly associated with non-disclosure from partners (AOR = 37.13, 95% CI: 17.22, 80.07), having casual partners only (AOR = 1.91, 95% CI: 1.03, 3.53), drug use before sex on a weekly basis (AOR: 6.48, 95% CI: 0.99, 42.50), being diagnosed with HIV between 1–5 years ago (AOR = 2.23, 95% CI: 1.05, 4.74), and not knowing one’s viral load (AOR = 2.80, 95% CI: 1.00, 7.83). Given the high HIV prevalence and incidence among MSM in Asia, it is imperative to include Prevention with Positives for MSM. Interventions on disclosure should not solely focus on HIV-positive men but also need to include their sexual partners and HIV-negative men. PMID:22198313

Stability of Self-Reported Same-Sex and Both-Sex Attraction from Adolescence to Young Adulthood.

PubMed

Hu, Yueqin; Xu, Yishan; Tornello, Samantha L

2016-04-01

This study examined how sexual attraction varied across age, gender of participant, and gender of romantic partner, from adolescence to early adulthood. Comparisons between same-sex and both-sex attracted individuals were of particular interest. Using the National Longitudinal Study of Adolescent Health (AddHealth), we examined the responses of participants who reported experiencing same-sex attractions or both-sex attractions at least once within four waves (n = 1889). Results indicated that same-sex attractions became more stable over time, whereas both-sex attraction remained unstable even into adulthood. Compared with males, females were less stable in same-sex attraction, but more stable in both-sex attraction. The majority of people who reported same-sex attraction did not report having a same-sex romantic partner before they entered adulthood, and those who reported a same-sex romantic partner were more likely to maintain their same-sex attraction than those who did not. As males got older, the gender of their romantic partner tended to become more consistent with their sexual attraction. However, for females, the consistency between the gender of their romantic partner and sexual attraction did not change over time.

High Rates of Sex with Men among High-Risk, Heterosexually-Identified Men in Low-Income, Coastal Peru

PubMed Central

Lescano, Andres G.; Leontsini, Elli; Fernandez, Percy; Klausner, Jeffrey D.; Coates, Thomas J.; Cáceres, Carlos F.

2011-01-01

In this paper we describe sex with men, including the frequency of sex and unprotected sex, among high-risk, heterosexually-identified men in urban, low-income, coastal Peru. During 2001–2002, a random community-based sample of these men was administered an epidemiologic survey collecting sexual risk behavior data. Among the 924 high-risk heterosexually-identified men, 131 (14.2%) reported at least one male partner in the past 6 months. Of these, 113 (86.3%) reported male and female partners and among those with partners of both sexes, 84.2% and 57.0% of sex acts with female and male partners, respectively, were unprotected, (RR 1.48, 95% CI = 1.31–1.68). We observed a high rate of recent bisexual behavior compared to past studies showing frequent, unprotected sex with male and female partners. This population has substantial potential to act as a bridge population between and their male and female partners and should be addressed by prevention programs. PMID:17377837

Alcohol use, stigmatizing/discriminatory attitudes, and HIV high-risk sexual behaviors among men who have sex with men in China.

PubMed

Liao, Meizhen; Kang, Dianmin; Tao, Xiaorun; Bouey, Jennifer Huang; Aliyu, Muktar H; Qian, Yuesheng; Wang, Guoyong; Sun, Xiaoguang; Lin, Bin; Bi, Zhenqiang; Jia, Yujiang

2014-01-01

This research was conducted to assess the correlates of alcohol consumption and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Shandong province, China. A cross-sectional survey provided demographics, sexual behaviors, illicit drug use, alcohol consumptions, and service utilization. Of 1,230 participants, 82.8% were single, 85.7% aged <35 years, 47.2% had college or higher education, and 11.7% drank alcohol >3 times per week in the past six months. The average total score of stigmatizing and discriminatory attitude was 37.4 ± 4.4. More frequent episodes of alcohol use were independently associated with higher levels of HIV/AIDS-related stigma and discrimination, unprotected anal sex, bisexual identity, multiple male sex partners, drug use, and lower levels of education. Expressing higher levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with alcohol use, unprotected male anal sex, bisexuals, more male sex partners, commercial sex with men, and non-receipt of peer education in the past year. HIV/AIDS-related stigmatizing and discriminatory attitudes are common and associated with alcohol use and unprotected sex among MSM. The finding highlights the needs to develop programs that would reduce HIV/AIDS-related stigmatizing and discriminatory attitudes and strengthen alcohol use prevention and risk reduction initiatives among MSM.

Frequency of Sexual Activity With Most Recent Male Partner Among Young, Internet-Using Men Who Have Sex With Men in the United States

PubMed Central

WALL, KRISTIN M.; STEPHENSON, ROBERT; SULLIVAN, PATRICK S.

2015-01-01

Sex frequency, defined here as the number of oral or anal sex acts with the most recent partner in the past year, is a potential driver of risk for sexually transmitted infections. However, few data on sex frequency have been reported for men who have sex with men (MSM). Data from an Internet survey of MSM were used to describe sex frequency with most recent main and casual male partners and to estimate factors associated with higher sex frequency. Among 5,193 MSM, higher sex frequency was associated with younger age, shorter relationship duration, and reporting a main (vs. casual) partner; and lower sex frequency with male partners was associated with heterosexual or bisexual (vs. homosexual) identity or Black race (vs. non-Hispanic White). Secondary analyses of estimates of sex frequency from 2 publicly available nationally representative datasets comprised of primarily heterosexual survey respondents (the 2008 General Social Survey and the 1992 National Health and Social Life Survey) were performed. Sex frequency among MSM respondents was similar to that reported by heterosexuals. PMID:24059971

An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study.

PubMed

Yang, Cui; Latkin, Carl; Tobin, Karin; Seal, David; Koblin, Beryl; Chander, Geetanjali; Siconolfi, Daniel; Flores, Stephen; Spikes, Pilgrim

2018-05-19

Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.

Love, Lust, and the Emotional Context of Concurrent Sexual Partnerships among Young Swazi Adults

PubMed Central

Ruark, Allison; Dlamini, Lunga; Mazibuko, Nonhlanhla; Green, Edward C.; Kennedy, Caitlin; Nunn, Amy; Flanigan, Timothy; Surkan, Pamela J.

2014-01-01

Men and women in Swaziland who are engaged in multiple or concurrent sexual partnerships, or who have sexual partners with concurrent partners, face a very high risk of HIV infection. Ninety-four in-depth interviews were conducted with 28 Swazi men and women (14 of each sex) between the ages of 20 and 39 in order to explore participants’ sexual partnership histories, including motivations for sexual relationships which carried high HIV risk. Concurrency was normative, with most men and women having had at least one concurrent sexual partnership, and all women reporting having had at least one partner who had a concurrent partner. Men distinguished sexual partnerships that were just for sex from those that were considered to be “real relationships”, while women represented the majority of their relationships, even those which included significant financial support, as being based on love. Besides being motivated by love, concurrent sexual partnerships were described as motivated by a lack of sexual satisfaction, a desire for emotional support and/or as a means to exact revenge against a cheating partner. Social and structural factors were also found to play a role in creating an enabling environment for high-risk sexual partnerships, and these factors included social pressure and norms, a lack of social trust, poverty and a desire for material goods, and geographical separation of partners. PMID:25174630

Will Gay Sex-Seeking Mobile Phone Applications Facilitate Group Sex? A Cross-Sectional Online Survey among Men Who Have Sex with Men in China.

PubMed

Tang, Weiming; Tang, Songyuan; Qin, Yilu; Zhang, Ye; Zhang, Wei; Liu, Chuncheng; Tso, Lai Sze; Wei, Chongyi; Yang, Ligang; Huang, Shujie; Yang, Bin; Tucker, Joseph

2016-01-01

China is amidst a sexual revolution, with changing sexual practices and behaviors. Sex-seeking mobile phone applications (gay apps) that allow multiple people to meet up quickly may facilitate group sex. This study was therefore undertaken to evaluate group sex among Chinese MSM and to better understand factors associated with group sex. An online survey was conducted from September-October 2014, collecting data on socio-demographics, sexual behaviors, use of gay apps and occurrence of group sex among Chinese MSM. Univariate and multivariable logistic regressions were used to compare group sex and non-group sex participants. Of the 1,424 MSM, the majority were under 30 years old (77.5%), unmarried (83.9%), and were gay apps users (57.9%). Overall, 141 (9.9%) participants engaged in group sex in the last 12 months. Multivariate analyses showed that men living with HIV, engaged in condomless anal intercourse with men, and used gay apps were more likely to engage in group sex, with adjusted ORs of 3.74 (95% CI 1.92-7.28), 2.88 (95% CI 2.00-4.16) and 1.46 (95% CI: 1.00-2.13), respectively. Among gay app users, the likelihood of group sex increases with the number of sex partners and the number of sex acts with partners met through a gay app. Chinese MSM who engage in group sex are also more likely to engage in other risky sexual behaviors, and gay app use may facilitate group sex. Further research is needed among MSM who engage in group sex in order to target interventions and surveillance.

"Amar te Duele" ("love hurts"): sexual relationship power, intimate partner violence, depression symptoms and HIV risk among female sex workers who use drugs and their non-commercial, steady partners in Mexico.

PubMed

Ulibarri, Monica D; Roesch, Scott; Rangel, M Gudelia; Staines, Hugo; Amaro, Hortensia; Strathdee, Steffanie A

2015-01-01

A significant body of research among female sex workers (FSWs) has focused on individual-level HIV risk factors. Comparatively little is known about their non-commercial, steady partners who may heavily influence their behavior and HIV risk. This cross-sectional study of 214 FSWs who use drugs and their male steady partners aged ≥18 in two Mexico-U.S. border cities utilized a path-analytic model for dyadic data based upon the Actor-Partner Interdependence Model to examine relationships between sexual relationship power, intimate partner violence (IPV), depression symptoms, and unprotected sex. FSWs' relationship power, IPV perpetration and victimization were significantly associated with unprotected sex within the relationship. Male partners' depression symptoms were significantly associated with unprotected sex within the relationship. Future HIV prevention interventions for FSWs and their male partners should address issues of sexual relationship power, IPV, and mental health both individually and in the context of their relationship.

Intact Marriages in which One Partner Dis-Identifies with Experiences of Same-Sex Attraction.

ERIC Educational Resources Information Center

Yarhouse, Mark A.; Pawlowski, Lisa M.; Tan, Erica S. N.

2003-01-01

This study is of heterosexually married couples in which one partner reports having experienced same-sex attraction and both partners report satisfaction with their marriage despite facing such constraints. Analysis suggested a number of themes related to how spouses learned about their partners' experiences of same-sex attraction, motivations for…

Are adolescent girls with Chlamydia infection notifying their partners?

PubMed

Lim, Sylvia W; Coupey, Susan M

2005-02-01

(1) To determine the proportion of inner-city adolescent girls diagnosed with chlamydial cervicitis who notify their sex partners; (2) to examine girls' attitudes and perceptions about partner notification and treatment; and (3) to assess whether or not girls knew if their partners were treated for chlamydia infection. Adolescent girls who had a positive DNA hybridization test for chlamydial cervicitis from March 2000 to May 2002 completed a 37-item self-administered survey assessing sexual behavior and partner notification, as well as the Rosenberg self esteem scale. Subjects completed the survey 1-3 months after the diagnosis of chlamydia infection. Fifty-five adolescent girls (46% Hispanic, 36% African American) aged 13-21 years (mean 18.3 years) completed the survey. The median age at first intercourse was 14 (SD = 1.6); median number of lifetime sex partners was 4. Forty-one subjects (75%) notified their sex partners. The most common reasons for partner notification were"I did not want my sex partner to give the infection back to me"and"I wanted to let my sex partner know that he/she had given me the infection". There was a trend toward increased notification if the girls were 18 years of age or older (P = 0.07) or had only one lifetime sex partner (P = 0.08). Of the 41 subjects who notified their partners, 22 (54%) reported that the partners were treated; 16 did not know, and three knew that partners were not treated. The majority of inner-city girls in this study notified their partners about chlamydia infection. Self-protection from re-infection was an important reason given for notification and suggests that girls in committed ongoing relationships might be more likely to notify partners.

Effects of polygamy on the activity/rest rhythm of male fruit flies Drosophila melanogaster

NASA Astrophysics Data System (ADS)

Vartak, Vivek Rohidas; Varma, Vishwanath; Sharma, Vijay Kumar

2015-02-01

Although polygamy is common in insects, its extent varies enormously among natural populations. Mating systems influence the evolution of reproductive traits and the difference in extent of polygamy between males and females may be a key factor in determining traits which come under the influence of sexual selection. Fruit flies Drosophila melanogaster are promiscuous as both males and females mate with multiple partners. Mating has severe consequences on the physiology and behaviour of flies, and it affects their activity/rest rhythm in a sex-specific manner. In this study, we attempted to discern the effects of mating with multiple partners as opposed to a single partner, or of remaining unmated, on the activity/rest rhythm of flies under cyclic semi-natural (SN) and constant dark (DD) conditions. The results revealed that while evening activity of mated flies was significantly reduced compared to virgins, polygamous males showed a more severe reduction compared to monogamous males. In contrast, though mated females showed reduction in evening activity compared to virgins, activity levels were not different between polygamous and monogamous females. Although there was no detectable effect of mating on clock period, power of the activity/rest rhythm was significantly reduced in mated females with no difference seen between polygamous and monogamous individuals. These results suggest that courtship motivation, represented by evening activity, is successively reduced in males due to mating with one or more partners, while in females, it does not depend on the number of mating partners. Based on these results we conclude that polygamy affects the activity/rest rhythm of fruit flies D. melanogaster in a sex-dependent manner.

Factors associated with recent HIV testing among younger gay and bisexual men in New Zealand, 2006-2011.

PubMed

Lachowsky, Nathan J; Saxton, Peter J W; Dickson, Nigel P; Hughes, Anthony J; Summerlee, Alastair J S; Dewey, Cate E

2014-03-31

Understanding HIV testing behaviour is vital to developing evidence-based policy and programming that supports optimal HIV care, support, and prevention. This has not been investigated among younger gay, bisexual, and other men who have sex with men (YMSM, aged 16-29) in New Zealand. National HIV sociobehavioural surveillance data from 2006, 2008, and 2011 was pooled to determine the prevalence of recent HIV testing (in the last 12 months) among YMSM. Factors associated with recent testing were determined using manual backward stepwise multivariate logistic regression. Of 3,352 eligible YMSM, 1,338 (39.9%) reported a recent HIV test. In the final adjusted model, the odds of having a recent HIV test were higher for YMSM who were older, spent more time with other gay men, reported multiple sex partners, had a regular partner for 6-12 months, reported high condom use with casual partners, and disagreed that HIV is a less serious threat nowadays and that an HIV-positive man would disclose before sex. The odds of having a recent HIV test were lower for YMSM who were bisexual, recruited online, reported Pacific Islander or Asian ethnicities, reported no regular partner or one for >3 years, were insertive-only during anal intercourse with a regular partner, and who had less HIV-related knowledge. A priority for HIV management should be connecting YMSM at risk of infection, but unlikely to test with appropriate testing services. New generations of YMSM require targeted, culturally relevant health promotion that provides accurate understandings about HIV transmission and prevention.

Alcohol Use as a Determinant of HIV Risk Behaviors Among Recent Latino Immigrants in South Florida

PubMed Central

Rojas, Patria; Dillon, Frank R.; Cyrus, Elena; Ravelo, Gira J.; Malow, Robert M.; De La Rosa, Mario

2013-01-01

Information on the association between alcohol use and Latino sexual risk behavior prior to immigrating to the United States is scarce. Given this population's rapid growth, documenting the influence of alcohol use on Recent Latino Immigrants’ (RLI) sexual risk behaviors is essential. Data prior to immigration were retrospectively collected from 527 RLI ages 18-39. Quantity and frequency of alcohol use during the 90 days prior to immigration and pre-immigration sexual risk behaviors were measured. Structural equation modeling was used to examine the relationships. Males, single participants, and participants with higher incomes reported more alcohol use. Higher alcohol use was associated with lower condom use frequency, having sex under the influence, and more sexual partners among all participants. Results point to the importance of creating interventions targeting adult RLI men, given their likelihood to engage in alcohol consumption, sex under the influence of alcohol, and sex with multiple partners without condoms. PMID:23706771

Conflicting discourses of church youths on masculinity and sexuality in the context of HIV in Kinshasa, Democratic Republic of Congo.

PubMed

Lusey, Hendrew; San Sebastian, Miguel; Christianson, Monica; Dahlgren, Lars; Edin, Kerstin E

2014-01-01

Masculinity studies are fairly new and young churchgoers are an under-researched group in the current Congolese church context. In response to this knowledge gap, this paper attempts to explore discourses of young churchgoers from deprived areas of Kinshasa regarding masculinity and sexuality in the era of HIV. A series of 16 semi-structured interviews were conducted with unmarried young churchgoers from the Salvation Army, Protestant and Revival churches. The interviews were tape-recorded, transcribed verbatim and analysed using discourse analysis. Five main discourses emerged: 'we are aware of the church message on sex', 'young men need sex', 'young women need money', 'to use or not to use condoms' and 'we trust in the church message'. Although all informants knew and heard church messages against premarital sex, many of them were sexually active. The perception was that young men were engaged in sexual activities with multiple partners as a result of sexual motivations surrounding masculinity and sexual potency, while young women sought multiple partners through transactional and intergenerational sex for economic reasons. These sexual practices of young people conflicted with church messages on sexual abstinence and faithfulness. However, a small number of participants challenged current gender norms and suggested alternative ways of being a man or a woman. To elucidate these alternatives, we suggest that church youths and church leaders might take concrete actions to deconstruct misconceptions about being men. In this way, they can possibly enhance a frank and fruitful dialogue on sex, sexuality and gender to promote positive masculinities and constructive partnerships to prevent HIV.

Concurrent sexual partnerships among female sex workers and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico.

PubMed

Robertson, Angela Marie; Syvertsen, Jennifer L; Rangel, M Gudelia; Staines, Hugo S; Morris, Martina; Patterson, Thomas L; Ulibarri, Monica D; Strathdee, Steffanie A

2013-06-01

To investigate the prevalence and correlates of concurrent (overlapping) sexual partnerships among female sex workers (FSWs) and their non-commercial male partners in two Mexico-US border cities. A cross-sectional survey of FSWs and their non-commercial male partners was conducted in Tijuana and Ciudad Juárez, Mexico (2010-2011). Eligible FSWs and verified non-commercial partners were aged ≥18 years; FSWs had ever used hard drugs (lifetime) and recently exchanged sex for money, drugs or other goods (past month). Participants underwent baseline questionnaires obtaining dates of sex and condom use with ≤5 other recurring partners, including FSWs' regular clients. These dates were compared with dates of sex with enrolled study partners to determine overlap (ie, 'recurring' concurrency). Bivariate probit regression identified recurring concurrency correlates. Among 428 individuals (214 couples), past-year recurring concurrency prevalence was 16% and was higher among women than their non-commercial male partners (26% vs 6%). In 10 couples (5%), both partners reported recurring concurrency. The majority of couples (64%) always had unprotected sex, and most of the individuals (70%) with recurring concurrency 'sometimes' or 'never' used condoms with their concurrent partners. Recurring concurrency was positively associated with FSWs' income, men's caballerismo (a form of traditional masculinity) and men's belief that their FSW partners had sexually transmitted infections (STIs). Recurring concurrency, representing sustained periods of overlapping partnerships in which unprotected sex was common, should be addressed by couple-based STI prevention interventions.

Gender inequality increases women's risk of hiv infection in Moshi, Tanzania.

PubMed

Sa, Zhihong; Larsen, Ulla

2008-07-01

This study examined the hypothesis that multiple dimensions of gender inequality increase women's risk for HIV infection using a population-based survey of 1418 women aged 20 to 44 in Moshi, Tanzania. Three forms of HIV exposures were assessed reflecting gender power imbalance: economic exposures (age difference between partners and partner's contributions to children's expenses), physical exposures (coerced first sex and intimate partner violence) and social exposures (ever had problems conceiving). Behavioural risk factors included number of sexual partners for women in the last three years, partner had other wives or girlfriends, non-use of condom and alcohol use at least once a week in the last 12 months. Multivariate logistic regression analysis showed that a woman had a significantly elevated risk for HIV if she had a partner more than 10 years older (OR=2.5), her partner made low financial contributions to children's expenses (OR=1.7), or she experienced coerced first sex before age 18 years (OR=2.0) even after taking into account the effects of risk behaviour factors. The association between ever had problem conceiving and HIV infection was explained away by risk behaviour factors. The findings lend support to the hypothesis that economic deprivation and experience of sexual violence increase women's vulnerability to HIV, providing further evidence for extending the behavioural approach to HIV interventions to incorporate women's economic empowerment, elimination of gender-based violence and promotion of changing attitudes and behaviours among men.

Vulnerability to sexual violence and participation in sex work among high-end entertainment centre workers in Hunan Province, China

PubMed Central

Kelvin, Elizabeth A.; Sun, Xiaoming; Mantell, Joanne E.; Zhou, Jianfang; Mao, Jingshu; Peng, Yanhui

2013-01-01

Background China has seen a proliferation of entertainment centres that are frequented by business people. Employees at these centres often are young, female rural-to-urban migrants who may be vulnerable to sexual violence and exploitation. Methods Data for this study were collected using a self-administered survey among male and female employees in two high-end entertainment centres in Changsha, Hunan Province, China. We used logistic regression to examine predictors of violent and potentially exploitative experiences (partner violence, forced sex and transactional sex). Predictors included gender, ever having a same-sex partner, migration variables and employment characteristics. Results Participants reported high levels of partner violence (16.0% ever and 9.0% in the past 3 months) and forced sex (13.9% ever and 5.5% in the past 3 months). Nineteen percent reported sex work in the past 3 months. In the multivariate regressions, ever having had a same-sex partner was associated with higher odds of ever having experienced partner violence (odds ratio (OR) = 7.8, P < 0.001), partner violence in the past 3 months (OR = 9.0, P < 0.001), ever having had transactional sex (OR = 6.0, P < 0.001) and transactional sex in the past 3 months (OR = 5.2, P = 0.001). After adjusting for transactional sex, the association between having had a same-sex partner and partner violence remained significant. Neither gender nor migration status was associated with any of the outcomes. Conclusion High-end entertainment centre workers in China are at risk for sexual violence and should be targeted with employment-based interventions. PMID:23809910

3 CFR - Extension of Benefits to Same-Sex Domestic Partners of Federal Employees

Code of Federal Regulations, 2011 CFR

2011-01-01

... 3 The President 1 2011-01-01 2011-01-01 false Extension of Benefits to Same-Sex Domestic Partners... Extension of Benefits to Same-Sex Domestic Partners of Federal Employees Memorandum for the Heads of... the following actions, consistent with existing law, in order to extend benefits to the same-sex...

The Contribution of Emotional Partners to Sexual Risk Taking and Violence among Female Sex Workers in Mombasa, Kenya: A Cohort Study

PubMed Central

Bosire, Wilkister; Nelson, Gill; Kingola, Nzioki; Zhang, Xu-Dong; Temmerman, Marleen; Chersich, Matthew F.

2013-01-01

Objectives To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described. Design Cohort study with quarterly follow-up visit over 12-months. Methods Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing. Results Four or more unprotected sex acts in the past week were reported by 21.3% of women during sex with emotional partners, compared to 5.8% with regular and 4.8% with casual clients (P<0.001). Total number of unprotected sex acts per week was 5–6-fold higher with emotional partners (603 acts with 259 partners) than with regular or casual clients (125 acts with 456, and 98 acts with 632 clients, respectively; P<0.001). Mostly, perceptions of “trust” underscored unprotected sex with emotional partners. Low control over these relationships, common to many women (36.9%), was linked with higher partner numbers, inconsistent condom use, and being physically forced to have sex by their emotional partners. Half experienced sexual or physical violence in the past year, similarly associated with partner numbers and inconsistent condom use. Conclusions High-risk sexual behaviour, low control and frequent violence in relationships with emotional partners heighten FSWs' vulnerability and high HIV risk, requiring targeted interventions that also encompass emotional partners. PMID:23950879

Triple Threat: HIV/AIDS, Tuberculosis, Malaria, and the Impact on Military Forces in Sub-Saharan Africa

DTIC Science & Technology

2010-03-01

cultural practices, multiple sex partners, and the presence of other STIs (syphilis, gonorrhea ). In 1998, UNAIDS estimated that sexually transmitted...Although there are 20 diseases that normally fall under the heading of “STD,” the ones usually used as markers are gonorrhea , syphilis, chlamydia

Adolescent maltreatment in the child welfare system and developmental patterns of sexual risk behaviors.

PubMed

Fowler, Patrick J; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John

2015-02-01

In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M = 15.5, SD = 1.49) at baseline (n = 714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare-involved adolescents and inform practices to promote positive transitions within the system. © The Author(s) 2014.

It takes 2: partner attributes associated with sexually transmitted infections among adolescents.

PubMed

Swartzendruber, Andrea; Zenilman, Jonathan M; Niccolai, Linda M; Kershaw, Trace S; Brown, Jennifer L; Diclemente, Ralph J; Sales, Jessica M

2013-05-01

The aims of this study were to identify partner attributes associated with sexually transmitted infections (STIs) among adolescents and to summarize implications for research and prevention. The design of this study was systematic review. We identified peer-reviewed studies published in 1990 through 2010 that assessed 1 or more partner attributes in relation to a biologically confirmed STI among adolescents (15-24 years) by searching MEDLINE and included articles. Studies that included adolescents but more than 50% of the sample or with mean or median age of 25 years or greater were excluded. Sixty-four studies met the eligibility criteria; 61% were conducted in high-income countries; 80% were cross sectional; and 91% enrolled females and 42% enrolled males. There was no standard "partner" definition. Partner attributes assessed most frequently included the following: age, race/ethnicity, multiple sex partners, and STI symptoms. Older partners were associated with prevalent STIs but largely unrelated to incidence. Black race was associated with STIs but not uniformly. Partners with multiple partners and STI symptoms seem to be associated with STIs predominantly among females. Although significant associations were reported, weaker evidence exists for the following: other partner sociodemographics, sexual and other behaviors (sexual concurrency, intimate partner violence, substance use, travel), and STI history. There were no apparent differences by STI. Partner attributes are independently associated with STIs among male and female adolescents worldwide. These findings reinforce the importance of assessing partner attributes when determining STI risk. Prevention efforts should continue to promote and address barriers to condom use. Increased efforts are needed to screen and treat STIs and reduce risky behavior among men. A standard partner definition would facilitate the interpretation of findings in future studies.

Perceived Neighborhood Partner Availability, Partner Selection And Risk For Sexually Transmitted Infections Within A Cohort Of Adolescent Females

PubMed Central

Matson, Pamela A.; Chung, Shang-en; Ellen, Jonathan M.

2014-01-01

Purpose This research examined the association between a novel measure of perceived partner availability and discordance between ideal and actual partner characteristics as well as trajectories of ideal partner preferences and perceptions of partner availability over time. Methods A clinic recruited cohort of adolescent females (N = 92), aged 16 -19, were interviewed quarterly for 12 months using audio computer-assisted self-interview. Participants ranked the importance of characteristics for their ideal main sex partner and then reported on these characteristics for their current main partner. Participants reported on perceptions of availability of ideal sex partners in their neighborhood. Paired t-tests examined discordance between ideal and actual partner characteristics. Random-intercept regression models examined repeated measures. Results Actual partner ratings were lower than ideal partner preferences for fidelity, equaled ideal preferences for emotional support and exceed ideal preferences for social/economic status and physical attractiveness. Discordance on emotional support and social/economic status was associated with sex partner concurrency. Participants perceived low availability of ideal sex partners. Those who perceived more availability were less likely to be ideal/actual discordant on fidelity [OR = 0.88, 95%CI: 0.78,1.0]. Neither ideal partner preferences nor perceptions of partner availability changed over 12 months. Conclusions Current main sex partners met or exceeded ideal partner preferences in all domains except fidelity. If emotional needs are met, adolescents may tolerate partner concurrency in areas of limited partner pools. Urban adolescent females who perceive low availability may be at increased risk for STI as they may be more likely to have non-monogamous partners. PMID:24393545

Perceived neighborhood partner availability, partner selection, and risk for sexually transmitted infections within a cohort of adolescent females.

PubMed

Matson, Pamela A; Chung, Shang-En; Ellen, Jonathan M

2014-07-01

This research examined the association between a novel measure of perceived partner availability and discordance between ideal and actual partner characteristics as well as trajectories of ideal partner preferences and perceptions of partner availability over time. A clinic-recruited cohort of adolescent females (N = 92), aged 1619 years, were interviewed quarterly for 12 months using audio computer-assisted self-interview. Participants ranked the importance of characteristics for their ideal main sex partner and then reported on these characteristics for their current main partner. Participants reported on perceptions of availability of ideal sex partners in their neighborhood. Paired t-tests examined discordance between ideal and actual partner characteristics. Random-intercept regression models examined repeated measures. Actual partner ratings were lower than ideal partner preferences for fidelity, equaled ideal preferences for emotional support and exceeded ideal preferences for social/economic status and physical attractiveness. Discordance on emotional support and social/economic status was associated with sex partner concurrency. Participants perceived low availability of ideal sex partners. Those who perceived more availability were less likely to be ideal/actual discordant on fidelity [OR = .88, 95% CI: .78, 1.0]. Neither ideal partner preferences nor perceptions of partner availability changed over 12 months. Current main sex partners met or exceeded ideal partner preferences in all domains except fidelity. If emotional needs are met, adolescents may tolerate partner concurrency in areas of limited partner pools. Urban adolescent females who perceive low availability may be at increased risk for sexually transmitted infection (STI) because they may be more likely to have nonmonogamous partners. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Influence of Partner Status and Sexual Behavior on College Women's Consent Communication and Feelings.

PubMed

Marcantonio, Tiffany; Jozkowski, Kristen N; Wiersma-Mosley, Jackie

2018-05-09

Sexual consent has permeated mainstream discourse as a mechanism used to decrease rates of sexual assault and increase sex-positive communication. Women's external consent behaviors are frequently examined; however, research exploring their internal consent and feelings associated with sexual activity are understudied. The purpose of this study was to understand how partner status and sexual behavior at most recent sexual activity influence women's external/internal consent and feelings during sexual activity. Three-hundred and ninety women completed a survey on consent, partner status, and most recent sexual behavior. Internal and external consent differed by partner status for women who engaged in vaginal-penile sex, but not genital and oral sex. Feelings associated with the sexual act were different within each behavior group and partner status. Women with a serious dating partner reported stronger feelings related to sexual activity, higher internal consent feelings, and increased use of non-verbal external consent cues. Partner status appears to influence factors of interest for vaginal-penile sex, but not genital and oral sex. Findings from this study can inform prevention efforts to increase sex-positive communication around consent.

Work-related violence and inconsistent condom use with non-paying partners among female sex workers in Adama City, Ethiopia.

PubMed

Mooney, Alyssa; Kidanu, Aklilu; Bradley, Heather M; Kumoji, Evelyn Kuor; Kennedy, Caitlin E; Kerrigan, Deanna

2013-08-23

Although reported condom use between female sex workers and their clients is high in Ethiopia, condom use with regular, non-paying partners remains low, posing a substantial risk of HIV infection to sex workers, their partners and the general population. Previous studies have identified the synergistic effects of substance abuse, violence and HIV risk, but few have examined these inter-relationships among female sex workers and their regular, non-paying partners. This study explored the associations between work-related violence, alcohol abuse and inconsistent condom use among establishment-based female sex workers and their regular, non-paying partners in Adama City, Ethiopia. A cross-sectional survey was conducted with 350 establishment-based female sex workers, aged 15-35, at 63 bars, hotels and nightclubs. Multivariate logistic regression analysis was conducted to test the association between work-related violence and condom use with regular, non-paying partners, controlling for age, overall income, education and sex workers' total number of sexual partners in the past week. Alcohol abuse was explored as an effect modifier. Respondents reported a high prevalence of work-related violence (59%) and alcohol abuse (51%). Work-related violence was statistically significantly associated with unprotected sex with regular, non-paying partners among those who abused alcohol (OR: 6.34, 95% CI: 2.43-16.56) and among those who did not (OR: 2.98, 95% CI: 1.36-6.54). Alcohol abuse was not associated with inconsistent condom use within these partnerships, though it may strengthen the effect of work-related violence on unprotected sex. Findings suggest violence against establishment-based female sex workers is associated with HIV risk within regular, non-paying partnerships. Qualitative work is needed to better understand the links between a violent work environment and condom use with regular, non-paying partners and how interventions can be implemented in this context to prevent violence against sex workers and reduce HIV transmission.

Intimate Partner Violence Is As Important As Client violence in Increasing Street-based Female Sex Workers’ Vulnerability to HIV in India

PubMed Central

Panchanadeswaran, Subadra; Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Latkin, Carl; Bentley, Margaret E.; Solomon, Suniti; Go, Vivian F.; Celentano, David

2008-01-01

Objectives There are no studies that examine street-based female sex workers’ vulnerability to HIV from both clients and intimate partners. This study documents street-based female sex workers’ experiences of client and intimate partners, examines the intersections of violence, alcohol use in condom use, and highlights survival strategies used to avert harm. Methods Ethnographic data were collected from 49 female sex workers though focus group discussions and in-depth interviews. Results Female sex workers experienced multifarious forms of severe client and intimate partner violence. Sexual coercion and forced group sex in the context of alcohol use posed formidable barriers for condom use negotiation. Further, traditional gender norms dictated women’s inabilities to negotiate condom-use with intimate partners. However, there was evidence of adoption of successful survival strategies in the face of danger and women’s positive evaluations of the benefits of sex work and their contributions to family well-being. Conclusions Harm reduction efforts with female sex workers need to account for their vulnerability to HIV from intimate partners in addition to clients. HIV prevention programmes need to include male clients in order to reduce harm among street-based female sex workers. There is an urgent need to build on sex workers’ strengths and involve them in designing individual level, community, and structural interventions that could help in reducing women’s vulnerability to intimate partner violence and HIV in India. PMID:18187314

Sexually transmitted infections, sexual risk behavior, and intimate partner violence among African American adolescent females with a male sex partner recently released from incarceration.

PubMed

Swartzendruber, Andrea; Brown, Jennifer L; Sales, Jessica M; Murray, Colleen C; DiClemente, Ralph J

2012-08-01

Social networks directly and indirectly influence sexually transmitted infections (STIs) risk. The objective was to explore associations between sex with a male recently released from incarceration and sexual risk and intimate partner violence (IPV) among African American adolescent females. Sociodemographic, psychosocial, and sexual behavior data were collected at baseline, 6, and 12 months from African American females, aged 15-21 years, participating in an HIV/STI prevention trial. Among 653 participants with ≥1 follow-up assessments, generalized estimating equations tested associations during follow-up between having a recently released partner and STI acquisition, sexual risk behaviors, and IPV, adjusting for age, treatment assignment, and corresponding baseline measure. Eighty-three (13.6%) participants had a recently released partner at 6 months and 56 (9.3%) at 12 months. Participants with a recently released partner were more likely to have the following: vaginal (adjusted odds ratio [AOR]: 5.48), anal (AOR: 2.43), and oral (AOR: 1.51) sex, a casual partner (AOR: 1.66), sex while high/drunk (AOR: 1.57) or with a high/drunk partner (AOR: 2.27); use condoms inconsistently (AOR: .58); acquire Chlamydia (AOR: 1.80), and experience emotional (AOR: 4.09), physical (AOR: 2.59), or sexual abuse (AOR: 4.10) by a boyfriend. They had a greater number of sex partners, lower partner communication and refusal self-efficacy, were high/drunk during sex more frequently, and used condoms during oral sex less frequently. A recently released sex partner is associated with sexual risk and IPV among African American adolescent females. Prevention programs should inform adolescents about potential risks associated with recently released partners as well as provide adolescents with skills to establish and maintain healthy sexual relationships. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Premarital sexual experience and preferred sources of reproductive health information among young men in Kumbotso, northern Nigeria.

PubMed

Iliyasu, Z; Zubairu, I; Abubakar, I S; Isa, S A; Galadanci, H S; Hadiza, S G; Babam Maryam, A; Babam-Maryam, A; Aliyu, M H; Muktar, H A

2012-01-01

Despite well known risks associated with unprotected premarital sex, this phenomenon has not been well explored among young men in rural northern Nigeria. We studied the predictors of premarital sex and preferred sources of sexual and reproductive health information among young unmarried men in Kumbotso, northern Nigeria. A cross section of 400 young men were interviewed using structured questionnaires with mostly closed ended questions. Of the 385 respondents, 39 (10.1%) were sexually experienced. Less than half of respondents (48.7%) used a condom at sexual debut, and an equal proportion reported having multiple sex partners. Only 41.0% of sexually experienced respondents reported subsequent consistent condom use Age (adjusted odds ratio [AOR] = 4.12; 95% confidence interval (CI): 2.24-5.20 and educational attainment [AOR = 3.57; 95% CI (1.49-9.10)] were significant predictors of sexual experience. The current versus preferred sources of sexual and reproductive health information included friends (51.3% vs. 93.3%), Islamic school teachers (41.0% vs. 72.7%) and school teachers (8.8% vs. 15.1%). Although the prevalence of premarital sex among young men in this community in northern Nigeria as low, those that did engage in such activity were likely to not use condoms and to have multiple partners. Preferred and trusted sources of information included peers and religious leaders. The findings in this study could be used to develop innovative strategies for reaching young men with accurate sexual and reproductive health information.

Seeing the partner: a video recall study of emotional behavior in same- and mixed-sex late adolescent romantic couples.

PubMed

Darling, Nancy; Clarke, Sara A

2009-08-01

Fifty-three college-aged same- and mixed-sex romantic couples (83% White, 63% female, mean age, 20.8) engaged in a video recall task in which they rated their own and their partners' behaviors and emotions. Females reported feeling more connected to partners and reported fewer negative behaviors than males. Females with male partners reported the highest feelings of connection and the fewest negative behaviors. Males with male partners reported the lowest connection and most negative behaviors. Behavioral mirroring and empathic accuracy did not vary by sex of the actor or of their partner. Partners' self-reported connection and negative behaviors were similar and they accurately perceived each others' average behavioral and emotional states. The data showed little evidence that partners' behaviors mirrored one another temporally across time segments, however. Results suggest that college-aged same and mixed-sex romantic couples show greater similarities than differences in functioning.

Predictive factors of unprotected sex for female sex workers: first study in French Guiana, the French territory with the highest HIV prevalence.

PubMed

Parriault, Marie-Claire; Basurko, Célia; Melle, Astrid Van; Gaubert-Maréchal, Emilie; Rogier, Stéphanie; Couppié, Pierre; Nacher, Mathieu

2015-07-01

French Guiana is the French territory that is most affected by HIV. AIDS incidence is much higher than in mainland France and sex work seems to be an important driver of the epidemic. The objective of this study was to describe consistent condom use among female sex workers with their clients and their intimate partners and to identify determinants of non-use of condoms. An HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey was conducted in 2009-2010 among sex workers in French Guiana. A total of 477 sex workers were interviewed. Female sex workers were more likely to use condoms with their clients (97%) than with their intimate partners (45%). The factors associated with non-consistent condom use with the intimate partner were having had an abortion, feeling at risk for HIV, not evaluating one's own risk for HIV, living as a couple, being Dominican, and not feeling comfortable asking intimate partners to use condoms. Although a high proportion of female sex workers declared using condoms with commercial partners, there is still room for improvement in the prevention of transmission with both commercial and intimate partners. © The Author(s) 2014.

Concurrent sexual partnerships among female sex workers and their non-commercial male partners in Tijuana and Ciudad Juárez, Mexico

PubMed Central

Robertson, Angela M.; Syvertsen, Jennifer L.; Rangel, M. Gudelia; Staines, Hugo S.; Morris, Martina; Patterson, Thomas L.; Ulibarri, Monica D.; Strathdee, Steffanie A.

2013-01-01

Objectives To investigate the prevalence and correlates of concurrent (overlapping) sexual partnerships among female sex workers (FSWs) and their non-commercial male partners in two Mexico-U.S. border cities. Methods A cross-sectional survey of FSWs and their non-commercial male partners was conducted in Tijuana and Ciudad Juárez, Mexico (2010–2011). Eligible FSWs and verified non-commercial partners were aged ≥18 years; FSWs had ever used hard drugs (lifetime) and recently exchanged sex for money, drugs, or other goods (past month). Participants underwent baseline questionnaires obtaining dates of sex and condom use with ≤5 other recurring partners, including FSWs’ regular clients. These dates were compared to dates of sex with enrolled study partners to determine overlap (i.e., “recurring” concurrency). Bivariate probit regression identified recurring concurrency correlates. Results Among 428 individuals (214 couples), past-year recurring concurrency prevalence was 16% and was higher among women than their non-commercial male partners (26% vs. 6%). In 10 couples (5%), both partners reported recurring concurrency. The majority of couples (64%) always had unprotected sex, and most of the individuals (70%) with recurring concurrency “sometimes” or “never” used condoms with their concurrent partners. Recurring concurrency was positively associated with FSWs’ income, men’s caballerismo (a form of traditional masculinity), and men’s belief that their FSW-partners had STIs. Conclusions Recurring concurrency, representing sustained periods of overlapping partnerships in which unprotected sex was common, should be addressed by couple-based STI prevention interventions. PMID:23172036

A survey of sexual risk behavior for HIV infection in Nakhonsawan, Thailand, 2001.

PubMed

Lertpiriyasuwat, Cheewanan; Plipat, Tanarak; Jenkins, Richard A

2003-09-05

To determine the prevalence of sexual risk behaviors for HIV in the general population aged 15-44 years in Nakhonsawan province, Thailand. Cross-sectional survey. A two-stage cluster sampling technique was used to select 630 participants aged 15-44 years from the general population. Tape-recorders with earphones provided questions to the respondents, who used self-administered answer sheets to record their responses. Most participants were rural, married and educated at the primary school level. The mean age was 31.5 years. Seventy-eight percent of all participants had ever had sexual intercourse. The prevalence of premarital sex among married participants was 41%. In the previous year, 20% of the participants had had sex with commercial or non-regular partners. Sex with non-regular partners occurred more frequently than sex with commercial partners. Sixty-one percent had used condoms the last time they had sex with a commercial partner and 46% had used condoms the last time they had sex with non-regular partners. Consistent condom use with non-regular partners was lower than with commercial partners. Voluntary HIV testing during the previous year was reported by 24% of the participants who had had sex with commercial or non-regular partners. The results suggest that Nakhonsawan needs to strengthen implementation of the 100% condom programme, address condom use with non-commercial partners, promote awareness of personal risk rather than identification of risk groups and increase voluntary HIV testing among people who engage in risky behaviors.

Sexual Perfectionism in Women: Not as Simple as Adaptive or Maladaptive.

PubMed

Kluck, Annette S; Zhuzha, Kseniya; Hughes, Kelly

2016-11-01

According to research and theory, the construct of perfectionism may apply to specific life domains, including being a perfect sexual partner. We extended the research on sexual perfectionism (SP) by examining the relationships between its various dimensions (i.e., self-directed, partner-directed, socially prescribed, partner-prescribed) and communication about sex, sexual functioning, and appearance self-consciousness during sex. Women (N = 208) of ages 19-50 were recruited online to respond to the Multidimensional Sexual Perfectionism Questionnaire and measures of communication about sex, sexual functioning, and physical appearance self-consciousness during sex. Dimensions of SP demonstrated a mixed pattern of relationships with measures of adaptive functioning. Partner-prescribed SP was related to greater appearance self-consciousness during sex, indicating an unfavorable role of this dimension of SP. An indirect effect of socially prescribed and partner-prescribed SP on sexual functioning through poor dyadic communication about sex and greater appearance self-consciousness was also found. Self-directed SP was less clearly problematic and uniquely related to better dyadic communication, whereas partner-directed SP was uniquely related to fewer concerns about the body appearance during sex. In conclusion, with respect to personal functioning, higher standards directed towards sexual partners may be less problematic but perceptions that romantic partners expect one to be a perfect sexual partner may have deleterious effects. Overall, SP may relate to sexual experiences of women beyond the college-age group with some aspects of SP being more problematic than others.

Sexual Behaviour of Men and Women within Age-Disparate Partnerships in South Africa: Implications for Young Women's HIV Risk.

PubMed

Maughan-Brown, Brendan; Evans, Meredith; George, Gavin

2016-01-01

Age-disparate partnerships are hypothesized to increase HIV-risk for young women. However, the evidence base remains mixed. Most studies have focused only on unprotected sex among women in the partnership. Consequently, little is known about other risky behaviours, such as transactional sex, alcohol use, and concurrency, as well as the behaviours of the men who partner with young women. We therefore examined differences in various sexual behaviours of both young women and their male partners by partnership age difference. We used nationally representative data from South Africa (2012) on partnerships reported by 16-24 year old black African women (n = 818) and by black African men in partnerships with 16-24 year old women (n = 985). We compared sexual behaviours in age-disparate partnerships and age-similar partnerships, using multiple logistic regression to control for potential confounders and to assess rural/urban differences. Young women in age-disparate partnerships were more likely to report unprotected sex than young women in similar-aged partnerships (aOR:1.51; p = 0.014; 95%CI:1.09-2.11). Men in partnerships with young women were more likely to report unprotected sex (aOR:1.92; p<0.01; 95%CI:1.31-2.81), transactional sex (aOR:2.73; p<0.01; 95%CI:1.64-4.56), drinking alcohol before sex (aOR:1.60; p = 0.062; 95%CI:0.98-2.61), and concurrency (aOR:1.39; p = 0.097; 95%CI:0.94-2.07) when their partners were five or more years younger. The association between age-disparate partnerships and transactional sex (aOR:4.14; p<0.01; 95%CI: 2.03-8.46) and alcohol use (aOR:2.24; p<0.013; 95%CI:1.20-4.19) was only found in urban areas. Results provide evidence that young women's age-disparate partnerships involve greater sexual risk, particularly through the risky behaviours of their male partners, with the risk amplified for young women in urban areas.

Effects of a school-based sexuality education program on peer educators: the Teen PEP model.

PubMed

Jennings, J M; Howard, S; Perotte, C L

2014-04-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May 2008. The sample consisted of 96 intervention (i.e. Teen PEP peer educators) and 61 comparison students from five high schools in New Jersey. Baseline and 12-month follow-up surveys were conducted. Summary statistics were generated and multiple regression analyses were conducted. In the primary intent-to-treat analyses, and secondary non-intent-to-treat analyses, Teen PEP peer educators (versus comparison students) reported significantly greater opportunities to practice sexual risk reduction skills and higher intentions to talk with friends, parents, and sex partners about sex and birth control, set boundaries with sex partners, and ask a partner to be tested for STIs including HIV. In addition in the secondary analysis, Teen PEP peer educators (as compared with the comparison students) had significantly higher scores on knowledge of sexual health issues and ability to refuse risky sexual situations. School-based sexuality education programs offering comprehensive training to peer educators may improve sexual risk behavior knowledge, attitudes and behaviors among high school students.

Effects of a school-based sexuality education program on peer educators: the Teen PEP model

PubMed Central

Jennings, J. M.; Howard, S.; Perotte, C. L.

2014-01-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May 2008. The sample consisted of 96 intervention (i.e. Teen PEP peer educators) and 61 comparison students from five high schools in New Jersey. Baseline and 12-month follow-up surveys were conducted. Summary statistics were generated and multiple regression analyses were conducted. In the primary intent-to-treat analyses, and secondary non-intent-to-treat analyses, Teen PEP peer educators (versus comparison students) reported significantly greater opportunities to practice sexual risk reduction skills and higher intentions to talk with friends, parents, and sex partners about sex and birth control, set boundaries with sex partners, and ask a partner to be tested for STIs including HIV. In addition in the secondary analysis, Teen PEP peer educators (as compared with the comparison students) had significantly higher scores on knowledge of sexual health issues and ability to refuse risky sexual situations. School-based sexuality education programs offering comprehensive training to peer educators may improve sexual risk behavior knowledge, attitudes and behaviors among high school students. PMID:24488649

Risk Factors for Human Immunodeficiency Virus Infection among Brazilian Blood Donors; a Multicenter Case-Control Study Using Audio Computer-Assisted Structured-Interviews

PubMed Central

de Almeida-Neto, Cesar; Goncalez, Thelma T.; Birch, Rebecca Jeffries; de Carvalho, Silvia Maia F.; Capuani, Ligia; Leão, Silvana Carneiro; Miranda, Carolina; Rocha, Pedro Capuani; Carneiro-Proietti, Anna Barbara; Johnson, Bryce R.; Wright, David J.; Murphy, Edward L.; Custer, Brian

2013-01-01

Background Although risk factors for HIV infection are known, it is important for blood centers to understand local epidemiology and disease transmission patterns. Current risk factors for HIV infection in blood donors in Brazil were assessed. Methods A case-control study was conducted at large public blood centers located in four major cities between April 2009 – March 2011. Cases were persons whose donations were confirmed positive by enzyme immunoassays followed by Western Blot confirmation. Audio computer-assisted structured-interviews (ACASI) were completed by all cases and controls. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs). Results There were 341 cases, including 47 with recently-acquired infection, and 791 controls. Disclosed risk factors for both females and males were sex with an HIV-positive person (adjusted odds ratio (AOR) 11.3, 95% CI [4.1, 31.7]) and being an IVDU or sexual partner of an IVDU (AOR 4.65 [1.8, 11.7]). For female blood donors, additional risk factors were having male sex partners who also are MSM (AOR 13.5 [3.1, 59.8]), and having unprotected sex with multiple sexual partners (AOR 5.19 [2.1, 12.9]). The primary risk factor for male blood donors was MSM activity (AOR 21.6 [8.8, 52.9.]). Behaviors associated with recently-acquired HIV were being a MSM or sex partner of MSM (13.82, [4.7, 40.3]), and IVDU (11.47, [3.0, 43.2]). Conclusion Risk factors in blood donors parallel those in the general population in Brazil. Identified risk factors suggest that donor compliance with selection procedures at the participating blood centers is inadequate. PMID:23517235

Gender Differences in Factors Related to HIV Risk Behaviors among People Who Inject Drugs in North-East India

PubMed Central

McFall, Allison M.; Solomon, Sunil S.; Srikrishnan, Aylur K.; Vasudevan, Canjeevaram K.; Anand, Santhanam; Celentano, David D.; Mehta, Shruti H.; Kumar, Suresh; Lucas, Gregory M.

2017-01-01

People who inject drugs (PWID) in India are at high risk for HIV, with women being at elevated risk. Using a socio-ecological framework, this study assessed whether factors associated with HIV transmission risk behaviors differed across men and women PWID. Data for this cross-sectional study were collected from 6449 PWID in 7 cities in Northeast India. Men (n = 5653) and women (n = 796) PWID were recruited using respondent-driven sampling (RDS). We assessed sex differences in two recent HIV transmission risk behaviors: multiple sex partners and needle/syringe sharing. We used multi-level logistic regression models, which incorporated sampling weights and random intercepts for city, to assess factors associated with these HIV risks, separately among men and women. The prevalence of HIV was significantly higher among women than men (53% vs 18.4%, p<0.01). Nearly 13% of men and 8% of women (p = .30) had multiple partners. Employment in men and relationship status and stigma in women were significantly associated with multiple partners. Approximately 25% of men and 19% of women engaged in needle sharing (p = .16). Younger age in women and depression symptoms in men were significantly associated with increased risk for sharing needles. We found that sexual and drug related risk behaviors were common among PWID in Northeast India, and there were differences between men and women in the socio-ecologic correlates of these behaviors. Contextually-integrated and gender-specific HIV prevention and intervention efforts are needed that consider factors at individual, interpersonal- and community-levels that uniquely impact HIV risks among PWID. PMID:28099458

At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: assessing Pap test use disparities by sex of sexual partners among black, Latina, and white U.S. women.

PubMed

Agénor, Madina; Krieger, Nancy; Austin, S Bryn; Haneuse, Sebastien; Gottlieb, Barbara R

2014-09-01

Understanding how various dimensions of social inequality shape the health of individuals and populations poses a key challenge for public health. Guided by ecosocial theory and intersectionality, we used data from the 2006-2010 National Survey of Family Growth, a national probability sample, to investigate how one dimension of sexual orientation, sex of sexual partners, and race/ethnicity jointly influence Pap test use among black, Latina and white U.S. women aged 21-44 years (N = 8840). We tested for an interaction between sex of sexual partners and race/ethnicity (p = 0.015) and estimated multivariable logistic regression models for each racial/ethnic group, adjusting for socio-demographic factors. The adjusted odds of Pap test use for women with only female sexual partners in the past year were significantly lower than for women with only male sexual partners in the past year among white women (odds ratio [OR] = 0.25, 95% confidence interval [CI]: 0.12,0.52) and may be lower among black women (OR = 0.32, 95% CI: 0.07,1.52); no difference was apparent among Latina women (OR = 1.54, 95% CI: 0.31,7.73). Further, the adjusted odds of Pap test use for women with no sexual partners in the past year were significantly lower than for women with only male sexual partners in the past year among white (OR = 0.30, 95% CI: 0.22,0.41) and black (OR = 0.23, 95% CI: 0.15,0.37) women and marginally lower among Latina women (OR = 0.63, 95% CI: 0.38,1.03). Adding health care indicators to the models completely explained Pap test use disparities for women with only female vs. only male sexual partners among white women and for women with no vs. only male sexual partners among Latina women. Ecosocial theory and intersectionality can be used in tandem to conceptually and operationally elucidate previously unanalyzed health disparities by multiple dimensions of social inequality. Copyright © 2014 Elsevier Ltd. All rights reserved.

Meeting sexual partners online: associated sexual behaviour and prevalent chlamydia infection among adolescents in Norway: a cross-sectional study.

PubMed

Gravningen, Kirsten; Aicken, Catherine Rh; Schirmer, Henrik; Mercer, Catherine H

2016-03-01

Evidence is mixed as to whether meeting sexual partners online ('internet-partners') is associated with risky sexual behaviour and/or sexually transmitted infection transmission. Accordingly, we sought to estimate the prevalence of reporting various online romantic and sexual activities among Norwegian adolescents, including internet-partners, and the reason for meeting them and to examine differences in sexual behaviour, partnership characteristics and chlamydia infection prevalence among those reporting internet-partners versus those reporting only offline partners. Population-based cross-sectional survey among sexually experienced girls and boys, 15-20 years, using electronic questionnaires and collecting urine samples for Chlamydia trachomatis PCR testing (79% provided both, n=1023). We used logistic regression to examine associations, adjusting for potentially confounding variables. Overall, 30% of both genders reported internet-partners (ever). Boys (but not girls) with internet-partners had higher chlamydia prevalence than those reporting meeting sexual partners only offline (8.1%, 95% CI 4.3% to 13.7% vs 1.6%, 0.5% to 3.7%). Two-thirds of girls and 37% of boys reported meeting their most recent internet-partner to start a romantic relationship, while the remainder did so with the specific intention of having sex. Among both genders, reporting sexual (vs romantic) reasons for meeting their most recent internet-partners was associated with reporting several risky sexual behaviours, including multiple recent sex partners (adjusted OR girls: 3.27, boys: 2.48) and three-fold higher chlamydia prevalence. This population-based study suggests that internet-partners are common among adolescents in Norway, and the reason for meeting them was more strongly associated with additionally reporting sexual risk behaviours and prevalent chlamydia infection than the internet itself as a meeting venue. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Pleasure, Affection, and Love Among Black Men Who Have Sex with Men (MSM) versus MSM of Other Races: Countering Dehumanizing Stereotypes via Cross-Race Comparisons of Reported Sexual Experience at Last Sexual Event

PubMed Central

Rosenberger, Joshua G.; Schick, Vanessa R.; Novak, David S.

2015-01-01

Black men have historically been stereotyped as hedonistic, aggressive, and animalistic in their sexual interactions. This study sought to describe pleasure, affection, and love experienced by Black men who have sex with men (MSM) during their last male-partnered sexual event and to examine differences relative to White, Latino, and Asian MSM. A total of 21,696 (793 Black, 18,905 White, 1,451 Latino, and 547 Asian) U. S. men ages 18–87 (MAge = 39) were recruited from social/sexual networking sites targeting MSM in 2010–2011. Participants reported multiple dimensions of sexual experience (pleasure, affection, and love) occurring at their last male-partnered sexual event, partner relationship, and sociodemographic characteristics. Across relationship categories, a sizeable percentage of Black MSM reported pleasure (72–87 % orgasmed, 57–82 % experienced high subjective pleasure) and affection (70–91 % kissed, 47–90 % cuddled). Love was primarily reported for events involving main partners (felt love for partner: 96 %; felt loved by partner: 97 %; verbalized love to partner: 89 %). Latent class analysis with MSM of all races, adjusting for partner relationship and sociodemographic characteristics, revealed three distinct profiles of sexual experience: affection and love (Class 1); affection in the absence of love (Class 2); and neither affection nor love (Class 3). Pleasure was probable across profiles. Some racial differences in profile probability were present, but no overall pattern emerged. Contrary to Black male stereotypes, Black MSM commonly reported pleasure, affection, and love at their last male-partnered sexual event and did not show a meaningful pattern of difference from other-race MSM in their likelihood of experiencing all three. PMID:25604209

Pleasure, affection, and love among Black men who have sex with men (MSM) versus MSM of other races: countering dehumanizing stereotypes via cross-race comparisons of reported sexual experience at last sexual event.

PubMed

Calabrese, Sarah K; Rosenberger, Joshua G; Schick, Vanessa R; Novak, David S

2015-10-01

Black men have historically been stereotyped as hedonistic, aggressive, and animalistic in their sexual interactions. This study sought to describe pleasure, affection, and love experienced by Black men who have sex with men (MSM) during their last male-partnered sexual event and to examine differences relative to White, Latino, and Asian MSM. A total of 21,696 (793 Black, 18,905 White, 1,451 Latino, and 547 Asian) U.S. men ages 18-87 (M Age = 39) were recruited from social/sexual networking sites targeting MSM in 2010-2011. Participants reported multiple dimensions of sexual experience (pleasure, affection, and love) occurring at their last male-partnered sexual event, partner relationship, and sociodemographic characteristics. Across relationship categories, a sizeable percentage of Black MSM reported pleasure (72-87  % orgasmed, 57-82 % experienced high subjective pleasure) and affection (70-91 % kissed, 47-90 % cuddled). Love was primarily reported for events involving main partners (felt love for partner: 96 %; felt loved by partner: 97 %; verbalized love to partner: 89 %). Latent class analysis with MSM of all races, adjusting for partner relationship and sociodemographic characteristics, revealed three distinct profiles of sexual experience: affection and love (Class 1); affection in the absence of love (Class 2); and neither affection nor love (Class 3). Pleasure was probable across profiles. Some racial differences in profile probability were present, but no overall pattern emerged. Contrary to Black male stereotypes, Black MSM commonly reported pleasure, affection, and love at their last male-partnered sexual event and did not show a meaningful pattern of difference from other-race MSM in their likelihood of experiencing all three.

Increased Risks of Needing Long-Term Care Among Older Adults Living With Same-Sex Partners

PubMed Central

Brodoff, Lisa

2013-01-01

Objectives. We examined whether older individuals living with same-sex partners face greater risks of needing long-term care than their counterparts living with different-sex partners or spouses. Methods. With data on older couples (at least 1 individual aged 60 years or older) from the 2009 American Community Survey, we estimated logistic regression models of 2 activity limitations that signal a long-term care need: difficulty dressing or bathing and difficulty doing errands alone. Results. When we controlled for age, race/ethnicity, and education, older women who lived with female partners were statistically significantly more likely than those who lived with male partners or spouses to have difficulty dressing or bathing. Older men who lived with male partners were statistically significantly more likely than those who lived with female spouses or partners to need assistance with errands. Conclusions. Older individuals living with same-sex partners face greater risks of needing long-term care than those living with different-sex partners or spouses, but the role of relationship status differs by gender. These findings suggest more broadly that older gay men and lesbians may face greater risks of needing long-term care than their heterosexual counterparts. PMID:23763396

Sexual behaviors of non-gay identified non-disclosing men who have sex with men and women.

PubMed

Siegel, Karolynn; Schrimshaw, Eric W; Lekas, Helen-Maria; Parsons, Jeffrey T

2008-10-01

The sexual behaviors of non-gay identified men who have sex with men and women (MSMW) who do not disclose their same-sex behavior to their female partners (referred to by some as men "on the down low") were examined, including the potential for these men to serve as a "bisexual bridge" for HIV and STD acquisition and transmission. Self-reported sexual behavior data were collected as part of an exploratory study of an ethnically diverse (41% African American, 35% Latino, 22% White, and 2% Asian) sample of 46 non-gay identified, non-disclosing MSMW in New York City. Men reported significantly more male than female sexual partners, but more frequent sex with females. The prevalence and frequency of unprotected sex did not differ significantly between male and female partners in the past 3 months. Men reported risk behavior more often with steady female and steady male partners (e.g., wives, girlfriends, boyfriends) than with more casual male and female partners (regular uncommitted partners, one-night stands). Men, especially African American/Black men, were significantly less likely to report receptive sexual behaviors with men than insertive behaviors. Unprotected sex was common with male and female partners in the past 3 months (e.g., 35% of anal sex with men; 50% of vaginal sex). Indeed, 22% of the sample (38% of those who had both recent males and female partners) reported both unprotected vaginal sex and unprotected anal sex with a male partner during the past 3 months. Although the study was limited by a small convenience sample, the findings suggest that non-gay identified non-disclosing MSMW are at risk for the acquisition and transmission of HIV and STDs, and may serve as a potential bridge, suggesting the need for further research and intervention targeting this unique population.

76 FR 5222 - Notice of Federal Long Term Care Insurance Program Open Season

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... workforce members, their spouses, and same-sex domestic partners of civilian active workforce members will be subject to abbreviated underwriting. The addition of same-sex domestic partners of civilian active... provided to same-sex domestic partners of Federal employees consistent with Federal law. All other...

77 FR 42901 - Noncompetitive Appointment of Certain Former Overseas Employees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

..., 591, et al. Same-Sex Domestic Partners: Noncompetitive Appointment of Certain Former Overseas... final regulations to establish that an employee's same-sex domestic partner qualifies as a family member... effect of this regulation is to ensure same-sex domestic partners are treated as family members. DATES...

The role of a regular sex partner in sexually transmitted infections and reinfections: results from the study of female entertainment establishment workers in the Philippines.

PubMed

Chiao, Chi; Morisky, Donald E

2007-08-01

The main objective of this study is to understand the association between living with a regular sex partner, risk-taking behaviors, and one's history of sexually transmitted infections (STIs). Data on sexual behavior and STI histories were obtained from 876 Filipina entertainment establishment workers (FEEWs) through a large-scale participatory research survey. About one-third of FEEWs live with a regular sex partner. Single FEEWs are significantly more likely than partnered FEEWs to engage in commercial sex. Being single, engaging in commercial sex, and using condoms inconsistently, in turn, are significantly associated with a positive STI history. These results suggest that living with a regular sex partner is an independent and protective factor against having an initial STI and subsequent reinfection. Programmatic strategies aimed at reducing STIs among entertainment establishment workers through promoting safer sex behaviors could potentially benefit by including a component that addresses sexual networks.

The Role of a Regular Sex Partner in Sexually Transmitted Infections and Reinfections: Results From the Study of Female Entertainment Establishment Workers in the Philippines

PubMed Central

CHIAO, CHI; MORISKY, DONALD E.

2011-01-01

Objective The main objective of this study is to understand the association between living with a regular sex partner, risk-taking behaviors, and one’s history of sexually transmitted infections (STIs). Methods Data on sexual behavior and STI histories were obtained from 876 Filipina entertainment establishment workers (FEEWs) through a large-scale participatory research survey. Results About one-third of FEEWs live with a regular sex partner. Single FEEWs are significantly more likely than partnered FEEWs to engage in commercial sex. Being single, engaging in commercial sex, and using condoms inconsistently, in turn, are significantly associated with a positive STI history. Conclusion These results suggest that living with a regular sex partner is an independent and protective factor against having an initial STI and subsequent reinfection. Programmatic strategies aimed at reducing STIs among entertainment establishment workers through promoting safer sex behaviors could potentially benefit by including a component that addresses sexual networks. PMID:17710751

Associations of unprotected anal intercourse with Grindr-met partners among Grindr-using young men who have sex with men in Los Angeles.

PubMed

Winetrobe, Hailey; Rice, Eric; Bauermeister, Jose; Petering, Robin; Holloway, Ian W

2014-01-01

Grindr, a geosocial smartphone application, is a networking medium for men who have sex with men. Although three quarters of young men who have sex with men (YMSM) Grindr users report having sex with a Grindr-met partner, the correlates of risky sexual behavior with Grindr-met partners are unknown. A randomly selected sample of 18- to 24-year-old, Grindr-using YMSM completed an anonymous online questionnaire assessing patterns of Grindr use and sexual behavior with their last Grindr-met partners. Of the 146 YMSM who reported having sex with Grindr-met partners, 20% had unprotected anal intercourse (UAI) at last sex with their Grindr-met partner. In the multivariable model, YMSM who used Grindr for at least one year showed naked chest/abs in their profile photo, and reported more past month Grindr-met partners were more likely to report UAI. These findings suggest that familiarity with the app was associated with YMSM's UAI with Grindr-met partners. Moreover, sexualized profile photos (i.e., naked chest/abs) may be associated with sexual risk-taking behaviors. HIV prevention interventions delivered or linked through such apps should target individuals who are longer/frequent users and who present sexualized profiles.

Same-sex partner bereavement in older women: an interpretative phenomenological analysis.

PubMed

Ingham, Charlotte F A; Eccles, Fiona J R; Armitage, Jocelyn R; Murray, Craig D

2017-09-01

Due to the lack of existing literature, the current research explored experiences of same-sex partner bereavement in women over the age of 60. Semi-structured interviews were conducted with eight women. Transcripts were analysed using interpretative phenomenological analysis. Three themes were identified which elaborated the experiences of older women who had lost a same-sex partner: (1) being left alone encapsulated feelings of isolation and exclusion; (2) navigating visibility centred on how homophobia led to a lack of recognition of the women's grief; and (3) finding new places to be authentic related women's need for new relationships in which they could be themselves. The findings indicate that existing models of partner bereavement may provide useful frameworks when seeking to understand the experiences of older women who have lost their same-sex partners. The findings indicate that in addition to the experiences of partner bereavement noted in research with heterosexual widows, older women who lose same-sex partners may face particular challenges, which can impact upon psychological well-being and adjustment to loss. These challenges appear to result from past and current homophobic and heterosexist attitudes within the UK culture. A range of interventions at individual, group, health service, and societal levels may be beneficial in improving the psychological well-being of older women who lose a same-sex partner.

Choice-disability and HIV infection: a cross sectional study of HIV status in Botswana, Namibia and Swaziland.

PubMed

Andersson, Neil; Cockcroft, Anne

2012-01-01

Interpersonal power gradients may prevent people implementing HIV prevention decisions. Among 7,464 youth aged 15-29 years in Botswana, Namibia and Swaziland we documented indicators of choice-disability (low education, educational disparity with partner, experience of sexual violence, experience of intimate partner violence (IPV), poverty, partner income disparity, willingness to have sex without a condom despite believing partner at risk of HIV), and risk behaviours like inconsistent use of condoms and multiple partners. In Botswana, Namibia and Swaziland, 22.9, 9.1, and 26.1% women, and 8.3, 2.8, and 9.3% men, were HIV positive. Among both women and men, experience of IPV, IPV interacted with age, and partner income disparity interacted with age were associated with HIV positivity in multivariate analysis. Additional factors were low education (for women) and poverty (for men). Choice disability may be an important driver of the AIDS epidemic. New strategies are needed that favour the choice-disabled.

Factors affecting sexuality in older Australian women: sexual interest, sexual arousal, relationships and sexual distress in older Australian women.

PubMed

Howard, J R; O'Neill, S; Travers, C

2006-10-01

To investigate the sexual behavior, sexual relationships, sexual satisfaction, sexual dysfunction and sexual distress in a population of older urban Australian women. In 2004, 474 women participating in the Longitudinal Assessment of Ageing in Women (LAW) Study completed a series of questionnaires about sexuality. They included the Short Personal Experiences Questionnaire (SPEQ), Relationship Assessment Scale (RAS), Female Sexual Distress Scale (FSDS), questions concerning past sexual abuse based on the Sex in Australia Study, and questions comparing present and past sexual interest and activity. The percentage of women with partners ranged from 83.3% in the 40 - 49-year age group to 46.4% women in the 70 - 79-year age group. The sexual ability of partners diminished markedly with age, with only 4.8% of the partners using medication to enable erections. Only 2.5% of women reported low relationship satisfaction. The incidence of sexual distress was also low, being reported by only 5.7% of women. Younger women and women with partners had higher levels of distress than older women. Indifference to sexual frequency rose from 26.7% in women aged 40 - 49 years to 72.3% in the 70 - 79-year age group. Past sexual abuse was recalled by 22.7% of women and 11.6% recalled multiple episodes of abuse. Women who recalled abuse had lower scores for satisfaction with sexual frequency. It appears from this study that there is a wide range of sexual experience amongst aging women, from never having had a sexual partner, to having solitary sex, to having a relationship with or without sex into the seventh decade. As women age, they experience a decrease in sexual activity, interest in sex, and distress about sex. This may be associated with the loss of intimate relationships as part of separation, divorce or bereavement. Decreased sexual activity with aging may be interpreted as a biological phenomenon (part of the aging process) or as sexual dysfunction, or it may be the result of adapting to changed circumstances.

Same-sex sexual behavior of men in Kenya: Implications for HIV prevention, programs, and policy

PubMed Central

Geibel, S.

2012-01-01

Unprotected anal sex has long been recognized as a risk factor for HIV transmission among men who have sex with men (MSM). In Africa, however, general denial of MSM existence and associated stigma discouraged research. To address this gap in the literature, partners conducted the first behavioral surveys of MSM in Kenya. The first study was to assess HIV risk among MSM in Nairobi, and the second study a pre-post intervention study of male sex workers in Mombasa. The 2004 behavioral survey of 500 men in Mombasa revealed that MSM were having multiple sexual partners and failed to access appropriate prevention counseling and care at Kenya clinics. A 2006 capture-recapture enumeration in Mombasa estimated that over 700 male sex workers were active, after which a pre-intervention baseline survey of 425 male sex workers was conducted. Awareness of unprotected anal sex as an HIV risk behavior and consistent condom use with clients was low, and use of oil-based lubricants high. Based on this information, peer educators were trained in HIV prevention, basic counseling skills, and distribution of condoms and lubricants. To assess impact of the interventions, a follow-up survey of 442 male sex workers was implemented in 2008. Exposure to peer educators was significantly associated with increased consistent condom use, improved HIV knowledge, and increased use of water-based lubricants. These results have provided needed information to the Government of Kenya and have informed HIV prevention interventions. PMID:24753921

Don't ask, don't tell: patterns of HIV disclosure among HIV positive men who have sex with men with recent STI practising high risk behaviour in Los Angeles and Seattle.

PubMed

Gorbach, P M; Galea, J T; Amani, B; Shin, A; Celum, C; Kerndt, P; Golden, M R

2004-12-01

A high incidence of HIV continues among men who have sex with men (MSM) in industrialised nations and research indicates many MSM do not disclose their HIV status to sex partners. Themes as to why MSM attending sexually transmitted infection (STI) clinics in Los Angeles and Seattle do and do not disclose their HIV status are identified. 55 HIV positive MSM (24 in Seattle, 31 in Los Angeles) reporting recent STI or unprotected anal intercourse with a serostatus negative or unknown partner from STI clinics underwent in-depth interviews about their disclosure practices that were tape recorded, transcribed verbatim, coded, and content analysed. HIV disclosure themes fell into a continuum from unlikely to likely. Themes for "unlikely to disclose" were HIV is "nobody's business," being in denial, having a low viral load, fear of rejection, "it's just sex," using drugs, and sex in public places. Themes for "possible disclosure" were type of sex practised and partners asking/disclosing first. Themes for "likely to disclose" were feelings for partner, feeling responsible for partner's health, and fearing arrest. Many reported non-verbal disclosure methods. Some thought partners should ask for HIV status; many assumed if not asked then their partner must be positive. HIV positive MSM's decision to disclose their HIV status to sex partners is complex, and is influenced by a sense of responsibility to partners, acceptance of being HIV positive, the perceived transmission risk, and the context and meaning of sex. Efforts to promote disclosure will need to address these complex issues.

Symptoms of substance dependence and risky sexual behavior in a probability sample of HIV-negative men who have sex with men in Chicago.

PubMed

Mackesy-Amiti, Mary Ellen; Fendrich, Michael; Johnson, Timothy P

2010-07-01

This study examines the relationship between self-reported symptoms of substance dependence and risky sexual behavior among 187 HIV-negative men who have sex with men. In a supplement to a Chicago household survey, using random probability sampling, men who reported consensual sex with other men or who identified as gay or bisexual were selected for interviews. Participants reported on sexual behavior, substance use, and symptoms of substance dependence related to past year use of alcohol, marijuana, cocaine, and sedatives, tranquilizers or pain relievers. Risky sexual behavior was defined as unprotected insertive or receptive anal intercourse plus having multiple partners, casual partners, or a partner who was HIV positive or of unknown serostatus. Risky sexual behavior in the past six months was significantly and positively associated with alcohol dependence symptoms, cocaine dependence symptoms (receptive only), and prescription drug dependence symptoms (insertive only). Confirmatory factor analyses revealed that dependence symptoms loaded on separate factors by substance, which in turn loaded on an overarching dependence symptoms factor. In structural equation models, individual substance factors were not significantly associated with sexual risk behavior, however the higher order dependence symptoms factor was significantly and positively associated with both receptive and insertive risk behavior. MSM with symptoms of multiple substance use dependencies are more likely to be engaged in sexual behavior that places them at risk for acquiring HIV and other sexually transmitted infections. Alcohol and drug abuse treatment providers should be aware of the need for HIV testing and counseling in this population. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Effects of a Social Network HIV/STD Prevention Intervention for Men Who Have Sex with Men in Russia and Hungary: A Randomized Controlled Trial

PubMed Central

Amirkhanian, Yuri A.; Kelly, Jeffrey A.; Takacs, Judit; McAuliffe, Timothy L.; Kuznetsova, Anna V.; Toth, Tamas P.; Mocsonaki, Laszlo; DiFranceisco, Wayne J.; Meylakhs, Anastasia

2015-01-01

Objective To test a novel social network HIV risk reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections. Design A 2-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling. Setting St. Petersburg, Russia and Budapest, Hungary. Participants 18 “seeds” from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen 3-ring sociocentric networks (mean size=35 members, n=626) were recruited. Intervention Empirically-identified network leaders were trained and guided to convey HIV prevention advice to other network members. Main Outcome and Measures Changes in sexual behavior from baseline to 3- and 12-month followup, with composite HIV/STD incidence measured at 12-months to corroborate behavior changes. Results There were significant reductions between baseline, first followup, and second followup in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (P=.04); UAI with a nonmain partner (P=.04); and UAI with multiple partners (P=.002). The mean percentage of unprotected AI acts significantly declined (P=.001), as well as the mean number of UAI acts among men who initially had multiple partners (P=.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Conclusions Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks. PMID:25565495

A cross-sectional study of knowledge of sex partner serostatus among high-risk Peruvian men who have sex with men and transgender women: implications for HIV prevention

PubMed Central

2013-01-01

Background Knowledge of a sex partner’s HIV serostatus can influence sexual behavior and inform harm-reduction strategies. We sought to determine how often Peruvian men who have sex with men (MSM) and transgender women (TW) knew the HIV serostatus of their sex partners, if this knowledge was associated with any predictive factors or unprotected anal intercourse (UAI), and if UAI was associated with partner serostatus. Methods We analyzed data from the 2008 Peruvian MSM Sentinel Surveillance Survey. Data were collected by CASI about each participant’s three most recent male sex partners. Primary outcome was knowledge of a partner's HIV test result. Multivariate analysis assessed the effect of age, education, sexual identity, number of male partners, alcohol use during intercourse, type of partnership and length of partnership using logistic regression. Results 735 participants provided data on 1,643 of their most recent sex partners from the last 3 months. 179/735 (24.4%) of all participants knew HIV test results for at least one of their 3 most recent partners, corresponding to 230/1643 (14.0%) of all sexual partnerships in the last 3 months. In multivariate analysis, casual (OR: 0.27, 95% CI: 0.17-0.42) and exchange sex (OR: 0.31, 95% CI: 0.11-0.88) partners, compared to stable partners, were negatively associated with knowledge of partner serostatus, whereas relationships lasting longer than one night (<3 months OR: 2.20, 95% CI: 1.39-3.51; 3 months to 1 year OR: 3.00, 95% CI: 1.80-5.01; ≥ 1 year OR: 4.13, 95% CI: 2.40-7.10) were positively associated with knowledge of partner serostatus. Knowledge of partner serostatus was not associated with unprotected anal intercourse with that partner. Conclusions Few MSM and TW in Peru know their partners’ HIV serostatus. Our findings suggest that the type and length of partnership influence the likelihood of knowing a partner’s serostatus. Further research should explore the contexts and practices of partner communication, their effect on sexual behavior, and interventions to promote discussion of HIV testing and serostatus as an HIV prevention strategy in this population. PMID:23448153

Can Young Adults Accurately Report Sexual Partnership Dates? Factors Associated with Inter-partner and Dyad Agreement

PubMed Central

Sanchez, Diana Maria; Schoenbach, Victor J.; Harvey, S. Marie; Warren, Jocelyn T.; Poole, Charles; Leone, Peter A.; Adimora, Adaora A.; Agnew, Christopher R.

2016-01-01

Background Sexual partnership dates are critical to STI/HIV research and control programs, though validity is limited by inaccurate recall and reporting. Methods We examined data from 302 heterosexual adults (151 index-partner dyads) to assess reliability of reporting. Dates of first and last sex were collected through individual interviews and joint dyad questionnaires which partners completed together. We compared index- and partner-reported dates to estimate inter-partner agreement (IPA). We used log-linear regression to model associations between inter-partner differences and partnership characteristics. To assess validity, we compared individually-reported dates to those from joint dyad questionnaires. Results Most partnerships (66.2%) were ≤2 years in duration and many (36.2%) were non-monogamous. IPA to within 1-, 30-, and 365-days was, respectively, 5.6%, 43.1% and 81.3% for first sex; and 32.9%, 94.5%, and 100.0% for last sex. In adjusted models: longer relationship duration was associated with disagreement on first sex dates; partnership non-monogamy was associated with disagreement on dates of first and last sex. Within dyads, several participant characteristics were associated with reporting dates closer to joint dyad responses [e.g., for first sex date, female gender (54.7%), having fewer sex partners (58.5%), and greater relationship commitment (57.3%)]. However, percent agreement to within 30, 60, and 90 days was similar for all groups for both first and last sex dates. Conclusions Agreement was high on date of last sex but only moderate on date of first sex. Methods to increase accuracy of reporting of dates of sex may improve STI research. PMID:27100770

Partner Type, Sexual Double Standard Endorsement, and Ambivalence Predict Abdication and Unprotected Sex Intentions in a Community Sample of Young Women

PubMed Central

Danube, Cinnamon L.; Norris, Jeanette; Stappenbeck, Cynthia A.; Davis, Kelly Cue; George, William H.; Zawacki, Tina; Morrison, Diane M.; Abdallah, Devon Alisa

2015-01-01

In-the-moment ambivalence about having sex may influence sexual decisions, but has rarely been examined. We investigated how ambivalence about sex might be related to intentions to abdicate sexual decisions to a male partner and to engage in unprotected sex in a community sample of young women. Predictors of abdication and unprotected sex intentions included partner type (new casual vs. previous relationship), sexual double standard (SDS) endorsement, and two types of ambivalence. After completing a SDS endorsement measure, women (n = 360) projected themselves into a hypothetical sexual situation and completed dependent measures. In the new casual partner condition, SDS endorsement indirectly negatively predicted unprotected sex intentions through its associations with ambivalence and abdication. In both partner conditions SDS endorsement positively predicted abdication, which then positively predicted unprotected sex intentions. Ambivalence indirectly predicted unprotected sex intentions through its negative association with abdication intentions. Results suggest the importance of ambivalence for sexual decisions and the complexity of understanding the sexual decision making processes for women who endorse the SDS. PMID:26421647

Partner Type, Sexual Double Standard Endorsement, and Ambivalence Predict Abdication and Unprotected Sex Intentions in a Community Sample of Young Women.

PubMed

Danube, Cinnamon L; Norris, Jeanette; Stappenbeck, Cynthia A; Cue Davis, Kelly; George, William H; Zawacki, Tina; Morrison, Diane M; Abdallah, Devon Alisa

2016-01-01

In-the-moment ambivalence about having sex may influence sexual decisions but has rarely been examined. We investigated how ambivalence about sex might be related to intentions to abdicate sexual decisions to a male partner and to engage in unprotected sex in a community sample of young women. Predictors of abdication and unprotected sex intentions included partner type (new casual versus previous relationship), sexual double standard (SDS) endorsement, and two types of ambivalence. After completing a SDS endorsement measure, women (N = 360) projected themselves into a hypothetical sexual situation and completed dependent measures. In the new casual partner condition, SDS endorsement indirectly negatively predicted unprotected sex intentions through its associations with ambivalence and abdication. In both partner conditions SDS endorsement positively predicted abdication, which then positively predicted unprotected sex intentions. Ambivalence indirectly predicted unprotected sex intentions through its negative association with abdication intentions. Results suggest the importance of ambivalence for sexual decisions and the complexity of understanding the sexual decision making processes for women who endorse the SDS.

Sexual Partner Typologies among Single Young Men who Have Sex with Men

PubMed Central

Bauermeister, José A.

2014-01-01

Using data from a sample of single YMSM (N=1,359; ages 18-24; 65% White; 93% gay), we examined whether the number of unprotected anal intercourse (UAI) partners with differed across relationship typologies (e.g., friends with benefits, hookups, romantic interests). We then examined how safer sex self-efficacy, decisional balance to forego condoms, ideal relationship attributes (i.e., intimacy, passion and commitment), and limerence were associated with UAI. Different partner types were associated with greater UAI partners; single partner types were associated with fewer UAI partners, irrespective of how they were categorized. UAI partners was associated with decisional balance (OR=1.89; p<.001), passion ideation (OR=1.38; p<.001), and difficulty negotiating safer sex with romantic partners (OR=1.16; p<.001). Odds of UAI partners decreased with higher scores of commitment ideation (OR=.91; p<.05) and difficulty negotiating safer sex with casual partners (OR=.96; p<.05). We discuss the importance of acknowledging how different sexual partnerships, alongside its motivational correlates, influence UAI risk in order to inform HIV-prevention interventions. PMID:25358726

Exploring the Link between Caregiver Affect and Adolescent Sexual Behavior: Does Neighborhood Disadvantage Matter?

ERIC Educational Resources Information Center

Gardner, Margo; Martin, Anne; Brooks-Gunn, Jeanne

2012-01-01

In a sample of urban youth (N = 1,070), we examined the links between primary caregiver affect (i.e., warmth and hostility) and two measures of sexual behavior in adolescence--early sexual initiation and sex with multiple partners. We also examined the extent to which neighborhood disadvantage moderated associations between caregiver affect and…

Top, Bottom, and Versatile Anal Sex Roles in Same-Sex Male Relationships: Implications for Relationship and Sexual Satisfaction.

PubMed

Moskowitz, David A; Garcia, Christopher P

2018-06-01

Across much of the gay and bisexual male research on sexual position self-label (i.e., calling oneself a top, bottom, or versatile), there exist two commonalities: (1) studies tend to focus almost entirely on individual, relationally single androphilic men; (2) studies rarely account for relationships and relationship dynamics. In response, we explored the role of self-label over sexual and relationship satisfaction among gay and bisexual partnered men. Specifically, we looked at whether adopted sexual position identities were consonant or dissonant (i.e., matching or mismatching) with enacted behavior in relationships and how that impacted men's attitudes toward different relational attributes. Through an online survey, we sampled 169 men in same-sex relationships, asking them questions about their ideal penetrative role identities and their reality penetrative roles with their partner. We then asked them to rate their relationship on 10 sexual and interpersonal attributes. Multiple regression modeling suggested ideal-reality penetrative role dissonance was predictive of sexual dissatisfaction among tops who bottomed in their relationships and, to a lesser extent, bottoms who topped. In contrast, penetrative role dissonance was predictive of relationship satisfaction among tops who bottomed in their relationship, but not bottoms who topped. We conclude that a potential reason for this paradox among tops who bottom may be sexual altruism. That is, men may be satisfied with other aspects within their relationships, understand their partner's anal sex preferences, and accommodate that position in response to their initial relationship satisfaction.

Factors associated with HIV testing among male motorbike taxi drivers in urban Vietnam.

PubMed

Huy, Nguyen Van; Khuyen, Le Thi; Ha, Pham Nguyen

2015-01-01

Using the Attitude-Skills-Knowledge (ASK) model, this study examined the prevalence of, and factors associated with, human immunodeficiency virus (HIV) testing among male motorbike taxi drivers (MMTDs). In a cross-sectional design, using quantitative approaches, 291 MMTDs were recruited from 135 sites across 13 districts in Hanoi, Vietnam, for a face-to-face interview. Applying the ASK model modified as a central theory, logistic regression was used to identify determinants of HIV testing. Although many MMTDs engaged in multiple risk behaviours for HIV, only 20.6% had been tested for HIV during the past 12 months. The tested model included one factor of the ASK model, HIV prevention knowledge (adjusted odds ratio [AOR] = 4.76; 95% confidence interval [CI] = 2.12-10.7) and five additional factors: being married (AOR = 3.13; 95% CI = 1.25-4.78), preferring sex with men or with both men and women (AOR = 8.72; 95% CI = 1.48-51.5), having lower number of lifetime sex partners (AOR = 0.66; 95% CI = 0.49-0.88), higher number of past year sex partners (AOR = 2.97: 95% CI = 1.21-7.31) and discussing condom use when having sex with partners (AOR = 0.08; 95% CI = 0.01-7.31). This modified ASK model provided better fit than the ASK model, as it explained more variance in HIV testing (47 vs. 29.8%). Recognising factors associated with HIV testing among MMTDs enables us to create suitable public health intervention strategies.

High prevalence of forced sex among non-brothel based, wine shop centered sex workers in Chennai, India.

PubMed

Go, Vivian F; Srikrishnan, Aylur K; Parker, Corette Breeden; Salter, Megan; Green, Annette M; Sivaram, Sudha; Johnson, Sethulakshmi C; Latkin, Carl; Davis, Wendy; Solomon, Suniti; Celentano, David D

2011-01-01

Sexual violence has been shown to increase women's risk of HIV infection. India is a country where the HIV epidemic is growing among women and intimate partner violence (IPV) is pervasive. This study examined prevalence of and factors associated with forced sex among female sex workers (FSWs) in Chennai, India. We conducted a probability survey among FSWs in 24 slum venues and identified predictive factors for recent forced sex using univariate and multivariable proportional odds models. Among 522 FSWs, 28% reported having forced sex with one partner and 35% with 2+ partners. In the final multivariable model, women who had a high number of partners who had a strong tendency to drink alcohol before sex were more likely to have experienced forced sex, and women who had both unprotected sex with a nonspousal partner and > 20 days of alcohol consumption in the last 30 days were more likely to have experienced forced sex. Discussion about family violence with larger social networks was independently associated with lower odds of forced sex among FSWs. HIV interventions for FSWs and their clients aimed at reducing alcohol consumption and encouraging condom use could be enhanced by violence prevention interventions to facilitate discourse about sexual violence.

High-risk behaviour in young men attending sexually transmitted disease clinics in Pune, India

PubMed Central

BRAHME, R. G.; SAHAY, S.; MALHOTRA-KOHLI, R.; DIVEKAR, A. D.; GANGAKHEDKAR, R. R.; PARKHE, A. P.; KHARAT, M. P.; RISBUD, A. R.; BOLLINGER, R. C.; MEHENDALE, S. M.; PARANJAPE, R. S.

2012-01-01

The present study reports sexual risk factors associated with HIV infection among men attending two sexually transmitted disease (STD) clinics in Pune, India and compares these behaviours between young and older men. Between April 1998 and May 2000, 1,872 STD patients were screened for HIV infection. Data on demographics, medical history and sexual behaviour were collected at baseline. The overall HIV prevalence was 22.2%. HIV risk was associated with being divorced or widowed, less educated, living away from the family, having multiple sexual partners and initiation of sex at an early age. The risk behaviours in younger men were different to older men. Younger men were more likely to report early age of initiation of sex, having friends, acquaintances or commercial sex workers as their regular partners, having premarital sex and bisexual orientation. Young men were more educated and reported condom use more frequently compared with the older men. Similar high HIV prevalence among younger and older men highlights the need for focused targeted interventions aimed at adolescents and young men and also appropriate interventions for older men to reduce the risk of HIV and STD acquisition. PMID:15832886

Neighborhood Crime and Sexual Transmission Risk Behavior among Black Men Living with HIV

PubMed Central

Ojikutu, Bisola O.; Bogart, Laura M.; Klein, David J.; Galvan, Frank H.; Wagner, Glenn J.

2018-01-01

Here, we examined the association of exposure to neighborhood crime with sexual risk-taking behavior among Black men living with HIV. HIV-positive Black men on anti-retroviral therapy in California completed an audio computer-assisted self-interview. Crime risk per census block group was derived from the Federal Bureau of Investigation’s Uniform Crime Report. Among 193 men, the mean (SD) number of sexual partners among those who were sexually active was 2.7 (3.3). 49% reported condomless sex, and 23% reported sex with an HIV-negative or unknown-serostatus partner. In multivariate analysis, illicit drug use ([IRR=1.86; 95%CI: 1.20–2.89] p=.006), depressive symptoms ([IRR=1.59; 95%CI: 1.03–2.44] p=.03), an undetectable viral load ([IRR=1.91; 95%CI: 1.22–3.00] p=.005), and neighborhood total crime risk ([IRR=1.02; 95%CI: 1.01–1.04] p=.007) remained significant. Among Black men living with HIV, exposure to neighborhood crime is associated with having multiple sexual partners whose HIV status was negative or unknown. PMID:29503307

The Skinny on Sexual Risk: The Effects of BMI on STI Incidence and Risk

PubMed Central

Arnold, Anna; Lewis, Jessica B.; Magriples, Urania; Ickovics, Jeannette R.

2011-01-01

Few studies examine the influence of body mass index (BMI) on sexual risk. The purpose of this study was to determine whether BMI among 704 young mothers (ages 14–25) related to STI incidence and sexual risk. We examined the effect of BMI groups (normal weight, overweight, and obese) at 6 months postpartum on STI incidence and risky sex (e.g., unprotected sex, multiple partners, risky and casual partner) at 12 months post-partum. At 6 months postpartum, 31% of participants were overweight and 40% were obese. Overweight women were more likely to have an STI (OR = 1.79, 95% CI = 1.11–2.89, P < .05) and a risky partner (OR = 1.64, 95% CI = 1.01–2.08, P < .05) at 12 months postpartum compared to normal weight women. However, obese women were less likely to have an STI than normal weight women (OR = .57, 95% CI = .34–.96, P < .01). BMI related to STI incidence and sexual risk behavior. Integrated approaches to weight loss and sexual risk prevention should be explored. PMID:20976536

Factors associated with recent HIV testing among younger gay and bisexual men in New Zealand, 2006-2011

PubMed Central

2014-01-01

Background Understanding HIV testing behaviour is vital to developing evidence-based policy and programming that supports optimal HIV care, support, and prevention. This has not been investigated among younger gay, bisexual, and other men who have sex with men (YMSM, aged 16-29) in New Zealand. Methods National HIV sociobehavioural surveillance data from 2006, 2008, and 2011 was pooled to determine the prevalence of recent HIV testing (in the last 12 months) among YMSM. Factors associated with recent testing were determined using manual backward stepwise multivariate logistic regression. Results Of 3,352 eligible YMSM, 1,338 (39.9%) reported a recent HIV test. In the final adjusted model, the odds of having a recent HIV test were higher for YMSM who were older, spent more time with other gay men, reported multiple sex partners, had a regular partner for 6-12 months, reported high condom use with casual partners, and disagreed that HIV is a less serious threat nowadays and that an HIV-positive man would disclose before sex. The odds of having a recent HIV test were lower for YMSM who were bisexual, recruited online, reported Pacific Islander or Asian ethnicities, reported no regular partner or one for >3 years, were insertive-only during anal intercourse with a regular partner, and who had less HIV-related knowledge. Conclusion A priority for HIV management should be connecting YMSM at risk of infection, but unlikely to test with appropriate testing services. New generations of YMSM require targeted, culturally relevant health promotion that provides accurate understandings about HIV transmission and prevention. PMID:24684728

SOCIAL STABILITY AND HIV RISK BEHAVIOR: EVALUATING THE ROLE OF ACCUMULATED VULNERABILITY

PubMed Central

German, Danielle; Latkin, Carl A.

2011-01-01

This study evaluated a cumulative and syndromic relationship among commonly co-occurring vulnerabilites (homelessness, incarceration, low-income, residential transition) in association with HIV-related risk behaviors among 635 low-income women in Baltimore. Analysis included descriptive statistics, logistic regression, latent class analysis and latent class regression. Both methods of assessing multidimensional instability showed significant associations with risk indicators. Risk of multiple partners, sex exchange, and drug use decreased significantly with each additional domain. Higher stability class membership (77%) was associated with decreased likelihood of multiple partners, exchange partners, recent drug use, and recent STI. Multidimensional social vulnerabilities were cumulatively and synergistically linked to HIV risk behavior. Independent instability measures may miss important contextual determinants of risk. Social stability offers a useful framework to understand the synergy of social vulnerabilities that shape sexual risk behavior. Social policies and programs aiming to enhance housing and overall social stability are likely to be beneficial for HIV prevention. PMID:21259043

Remodelling core group theory: the role of sustaining populations in HIV transmission.

PubMed

Watts, Charlotte; Zimmerman, Cathy; Foss, Anna M; Hossain, Mazeda; Cox, Andrew; Vickerman, Peter

2010-12-01

Core group theory describes the central role of groups with high rates of sexual partner change in HIV transmission. Research illustrates the heterogeneous and dynamic nature of commercial sex, and that some men involved in the organisation or policing of sex work regularly have sex with sex workers. These findings are used to explore gaps in core group theory. Evidence from developing countries on the duration that women sell and men buy sex was reviewed. Simple compartmental dynamic models were used to derive analytical expressions for the relative HIV equilibrium levels among sex workers and partners, incorporating partner change rates and duration in commercial sex settings. Simulations explored the degree to which HIV infection can be attributable to men with low partner change rates who remain in sex work settings for long periods, and their influence on the impact of HIV intervention. Partner change rates and duration of time in a setting determine equilibrium HIV levels. Modelling projections suggest that men with low mobility can substantially contribute to HIV prevalence among sex workers, especially in settings with prevalences <50%. This effect may reduce the impact of sex-worker interventions on HIV incidence in certain scenarios by one-third. Reductions in impact diminish at higher sex-worker prevalences. In commercial sex settings, patterns of HIV risk and transmission are influenced by both partner change rates and duration in a setting. The latter is not reflected in classic core group theory. Men who control the sex industry and regular clients may form an important 'sustaining population' that increases infection and undermines the impact of intervention. Intervention activities should include these groups, and examine the social organisation of sex work that underpins many of these relationships.

77 FR 42905 - Agency Use of Appropriated Funds for Child Care Costs for Lower Income Employees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... services for children of same-sex domestic partners of Federal employees; make certain technical....), and June 2, 2010, that agencies consider extending benefits, where possible, to same-sex domestic partners, and OPM's determination to make benefits available to same-sex domestic partners, to the extent...

75 FR 30267 - Federal Long Term Care Insurance Program: Eligibility Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... of ``qualified relative'' is expanded to cover the same-sex domestic partners of eligible Federal and... Personnel Management (OPM) extend certain benefits that can be provided to same-sex domestic partners of... in 5 U.S.C. 9001(5)(D) to include additional individuals who are same-sex domestic partners of a...

The Stability and Consequences of Young Children's Same-Sex Peer Interactions.

ERIC Educational Resources Information Center

Martin, Carol Lynn; Fabes, Richard A.

2001-01-01

Examined whether preschool children's play-partner choices were stable over time and how they influenced behavior. Found that partner preferences were highly sex differentiated and stable over time. Identified two types of consequences of partner choice: a binary effect that influenced differences between the sexes and a social dosage effect that…

77 FR 42909 - Presumption of Insurable Interest for Same-Sex Domestic Partners

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... OFFICE OF PERSONNEL MANAGEMENT 5 CFR Parts 831 and 842 RIN 3206-AM20 Presumption of Insurable Interest for Same-Sex Domestic Partners AGENCY: Office of Personnel Management. ACTION: Final rule. SUMMARY: The Office of Personnel Management (OPM) is amending its regulations to add same-sex domestic partners...

Impact of Intimate Partner Forced Sex on HIV Risk Factors in Physically Abused African American and African Caribbean Women.

PubMed

Draughon, Jessica E; Lucea, Marguerite B; Campbell, Jacquelyn C; Paterno, Mary T; Bertrand, Desiree R; Sharps, Phyllis W; Campbell, Doris W; Stockman, Jamila K

2015-10-01

We examined associations between intimate partner forced sex (IPFS) and HIV sexual risk behaviors among physically abused Black women. Women aged 18-55 in intimate relationships were interviewed in health clinics in Baltimore, MD and St. Thomas and St. Croix, US Virgin Islands (USVI). Of 426 physically abused women, 38% experienced IPFS; (Baltimore = 44 and USVI = 116). USVI women experiencing IPFS were more likely to have 3+ past-year sex partners (AOR 2.06, 95% CI 1.03-4.14), casual sex partners (AOR 2.71, 95% CI 1.42-5.17), and concurrent sex partners (AOR 1.94, 95% CI 1.01-3.73) compared to their counterparts. Baltimore women reporting IPFS were more likely to have exchanged sex (AOR 3.57, 95% CI 1.19-10.75). Women experiencing IPFS were more likely to report their abuser having other sexual partners in Baltimore (AOR 3.30, 95% CI 1.22-8.88) and USVI (AOR 2.03, 95% CI 1.20-3.44). Clinicians should consider the influence of IPFS on individual and partnership HIV sexual risk behaviors.

Condomless anal intercourse among males and females at high risk for heterosexual HIV infection

PubMed Central

German, Danielle; Nguyen, Trang; Ogbue, Christine Powell; Flynn, Colin

2015-01-01

Background Understanding and addressing heterosexual HIV transmission requires attention to the range and context of heterosexual sexual behaviors. We sought to determine population-based prevalence of condomless anal intercourse (CAI) among individuals at increased heterosexual HIV risk in Baltimore and to identify demographic, behavioral, and health related correlates. Methods Data were from a cross-sectional study of 185 males and 198 females at increased heterosexual risk for HIV recruited using respondent driven sampling as part of CDC's National HIV Behavioral Surveillance Project in Baltimore, August-December 2010. Bivariate and multivariate logistic regression examined factors associated with heterosexual CAI. Results The sample was majority African-American, with mean age of 38 among men and 34 among women. Forty-two percent of men (95% C.I.: 30.9, 52.0%) and 38% of women (95% C.I.: 29.4, 47.2%) reported any CAI in the past year, with variance by partner type and gender. Among men, CAI was significantly associated with homelessness, casual and exchange partners, same sex partner in past year, and substance use. Among women, CAI was significantly associated with lower education, casual and exchange partners, same sex partner in past year, multiple partners, and substance use. In adjusted gender-specific models, males and females with increasing numbers of partners were more likely to engage in CAI. Conclusions It is important to recognize the efficiency of transmission of HIV and other STIs through CAI. There is a need to broaden heterosexual sexual health promotion and HIV/STI prevention to adequately and appropriately address risks and prevention strategies for anal intercourse. PMID:25970308

Gender roles and sexual behavior among young women.

PubMed

Lucke, J C

1998-08-01

The associations between gender role orientation and high-risk sex behaviors were explored in a study of 400 sexually active women 16-24 years of age (mean, 20.4 years) recruited from two metropolitan family planning clinics in Queensland, Australia. Three dimensions of gender role orientation were examined: gender role personality traits, gender role attitudes, and gender role dating behavior. It was hypothesized that women with more nontraditional or "masculine" characteristics are more likely than those with traditional or "feminine" characteristics to engage in unsafe sexual behaviors. Only partial support was found for this hypothesis. Although a number of univariate relationships emerged, very few associations between sexual behavior and gender roles remained significant in the multivariate analysis. Logistic regression analysis indicated that women with two or more sexual partners in the year preceding the study were significantly more likely than those with 0-1 sex partners to have masculine personality traits and to be more liberal in their attitudes toward women in society. Nonuse of condoms with the most recent sexual partner was not significantly associated with the gender role variables; however, women who reported masculine dating behaviors were more likely to have used a condom with their most recent nonsteady sexual partner. Similarly, substance use before or during last sexual intercourse was associated with masculine traits when the partner was nonsteady but was not related to gender role orientation when the partner was steady. The association of "masculine" personality traits with multiple partners and substance use indicates that caution should be exercised in assuming that masculine gender role characteristics are beneficial for women in sexual situations.

Environmental injustice and sexual minority health disparities: A national study of inequitable health risks from air pollution among same-sex partners.

PubMed

Collins, Timothy W; Grineski, Sara E; Morales, Danielle X

2017-10-01

Air pollution is deleterious to human health, and numerous studies have documented racial and socioeconomic inequities in air pollution exposures. Despite the marginalized status of lesbian, gay, bisexual, and transgender (LGBT) populations, no national studies have examined if they experience inequitable exposures to air pollution. This cross-sectional study investigated inequities in the exposure of same-sex partner households to hazardous air pollutants (HAPs) in the US. We examined cancer and respiratory risks from HAPs across 71,207 census tracts using National Air Toxics Assessment and US Census data. We calculated population-weighted mean cancer and respiratory risks from HAPs for same-sex male, same-sex female and heterosexual partner households. We used generalized estimating equations (GEEs) to examine multivariate associations between sociodemographics and health risks from HAPs, while focusing on inequities based on the tract composition of same-sex, same-sex male and same-sex female partners. We found that mean cancer and respiratory risks from HAPs for same-sex partners are 12.3% and 23.8% greater, respectively, than for heterosexual partners. GEEs adjusting for racial/ethnic and socioeconomic status, population density, urban location, and geographic clustering show that living in census tracts with high (vs. low) proportions of same-sex partners is associated with significantly greater cancer and respiratory risks from HAPs, and that living in same-sex male partner enclaves is associated with greater risks than living in same-sex female partner enclaves. Results suggest that some health disparities experienced by LGBT populations (e.g. cancer, asthma) may be compounded by environmental exposures. Findings highlight the need to extend the conceptual framework for explaining LGBT health disparities beyond psycho-behavioral mechanisms translating social stress into illness to include environmental mechanisms. Because psycho-behavioral and environmental factors may together exacerbate health disparities, we call for a shift toward interdisciplinary research on LGBT health that takes into account cumulative risks, including the role of environmental exposures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reduced Sexual Risk Behaviors Among Young Men of Color Who Have Sex with Men: Findings from the Community-Based Organization Behavioral Outcomes of Many Men, Many Voices (CBOP-3MV) Project.

PubMed

Stein, Renee; Shapatava, Ekaterine; Williams, Weston; Griffin, Tanesha; Bell, Kelly; Lyons, Bridget; Uhl, Gary

2015-11-01

In 2006, the Centers for Disease Control and Prevention (CDC) funded community-based organizations (CBOs) to deliver Many Men, Many Voices (3MV) to young men of color who have sex with men. Although 3MV, a group-level behavioral intervention designed to reduce human immunodeficiency virus (HIV) risk behaviors of black men who have sex with men (MSM), has shown effectiveness when delivered in a controlled research environment, there is limited evidence that the intervention is associated with similar outcomes in "real world" settings. For the current project, CDC funded three CBOs to conduct outcome monitoring of the 3MV intervention to determine if young MSM of color report changes in HIV risk behaviors postintervention. Using a repeated measures design, risk behaviors were collected at baseline and again at 3 and 6 months postintervention. Changes in risk behaviors were assessed using generalized estimating equations. Participants (n = 337) reported decreases in sexual risk behaviors at both follow-up time points, such as sex without a condom, sex without a condom and multiple partners, and sex without a condom with serodiscordant or status unknown partners. Results suggest that 3MV may be an effective tool for reducing HIV risk behaviors in this critical target population.

Sexual behavior and vulnerability to HIV infection among seasonal migrant laborers in Metema district, northwest Ethiopia: a cross-sectional study.

PubMed

Tiruneh, Kassa; Wasie, Belaynew; Gonzalez, Hector

2015-02-11

Poor socio-economic conditions fuel seasonal migration of adult males from Northwestern Ethiopia, but behavioral and other migration-related changes increase their vulnerability to HIV/AIDS. This study examined risky sexual behaviors and associated factors that may lead to increased HIV infection vulnerability among migrant laborers in Metema District, Ethiopia. A community-based cross-sectional study was conducted from July 8-18, 2013 at farms with migrant laborers. We enrolled 756 participants through multistage random sampling. Data were collected using structured questionnaires and analyzed using EPI Info7; bivariate and multivariate logistic regression analyses were performed using SPSS. 582 (77%) migrant workers had sexual intercourse in their lifetime. 68% (397/582) reported non-marital sexual intercourse in the preceding six months. Of these, 74% reported sexual intercourse with commercial sex workers, 49% reported having transactional sex, 49% reported unprotected sexual intercourse with CSWs, 69% reported multiple sexual partners in the preceding six months (mean = 2.9 ± 0.7). Being aged between 20-29 (AOR = 2.15, 95% CI: 1.16, 3.99) and 30 years or older (AOR = 2.51, 95% CI: 1.1, 5.71), receipt of HIV prevention information in the preceding six months (AOR = 1.74, 95% CI: 1.15, 2.63), and staying longer on the farm (AOR = 2.74, 95% CI: 1.46, 5.14) were factors significantly associated with condom use at last non-marital sexual intercourse. Respondents aged ≤19, not receiving HIV information in the preceding six months, or staying on the farm for ≤2 months were less likely to have used condoms at their last non-marital sexual intercourse. Moreover, having daily income above USD 5.00 (AOR = 2.24, 95% CI: 1.14, 4.41), paying for most recent sexual intercourse (AOR = 2.22, 95% CI: 1.36, 3.61), and drinking alcohol during last sexual intercourse (AOR = 1.69, 95% CI: 1.01, 2.83) were significantly associated with having multiple (≥2) sexual partners during the preceding six months. Seasonal laborers commonly exhibit risky sexual behaviors likely to increase their vulnerability to HIV infection. Unprotected and multiple sex partners in these populations pose transmission risks to seasonal laborers and onward to their wives and future sexual partners. The findings support the need for targeted HIV prevention campaigns designed for seasonal workers and their sexual partners.

Virtual versus physical channel for sex networking in men having sex with men of sauna customers in the City of Hong Kong.

PubMed

Lee, Shui-Shan; Lam, Agnes N S; Lee, Chi-Kei; Wong, Ngai-Sze

2012-01-01

Advances in communication technology may affect networking pattern, thereby influencing the dynamics of sex partnership. The aim of the study is to explore the impacts of partner sourcing through internet and related channels on exposure risk to sexually transmitted infections (STI) including HIV. Using venue-based sampling, a cross-sectional questionnaire survey was conducted at saunas frequented by men having sex with men (MSM) in Hong Kong. Comparison was made between MSM sourcing partners through physical venues alone versus concomitant users of physical and virtual channels, the latter referring to internet and smart-phone applications, using bivariate logistic regression. Over a 7-week study period, 299 MSM were recruited from 9 saunas. Three main types of sex partners were distinguished: steady (46.8%), regular (26.4%) and casual (96.0%) partners. Users of sauna (n = 78) were compared with concomitant users of saunas and virtual channels (n = 179) for partner sourcing. Sauna-visiting virtual channel users were younger and inclined to use selected physical venues for sourcing partners. Smart-phone users (n = 90) were not different from other internet-users in terms of age, education level and single/mixed self-identified body appearance. Classifying respondents into high risk and low risk MSM by their frequency of condom use, concomitant use of both sauna and virtual channels accounted for a higher proportion in the high risk category (71.6% vs. 58.2%, OR = 1.81, p<0.05). In virtual channel users, partner sourcing through smart-phone was not associated with a higher practice of unprotected sex. MSM sauna customers commonly use virtual channels for sex partner sourcing. Unprotected sex is more prevalent in sauna customers who use virtual channel for sex partner sourcing. While the popularity of smart-phone is rising, its use is not associated with increased behavioural risk for HIV/STI transmission.

“Amar te Duele” (“Love Hurts”): Sexual relationship power, intimate partner violence, depression symptoms and HIV risk among female sex workers who use drugs and their non-commercial, steady partners in Mexico

PubMed Central

Ulibarri, Monica D.; Roesch, Scott; Rangel, M. Gudelia; Staines, Hugo; Amaro, Hortensia; Strathdee, Steffanie A.

2014-01-01

A significant body of research among female sex workers (FSWs) has focused on individual-level HIV risk factors. Comparatively little is known about their non-commercial, steady partners who may heavily influence their behavior and HIV risk. This cross-sectional study of 214 FSWs who use drugs and their male steady partners aged ≥18 in two Mexico-U.S. border cities utilized a path-analytic model for dyadic data based upon the Actor-Partner Interdependence Model to examine relationships between sexual relationship power, intimate partner violence (IPV), depression symptoms, and unprotected sex. FSWs’ relationship power, IPV perpetration and victimization were significantly associated with unprotected sex within the relationship. Male partners’ depression symptoms were significantly associated with unprotected sex within the relationship. Future HIV prevention interventions for FSWs and their male partners should address issues of sexual relationship power, IPV, and mental health both individually and in the context of their relationship. PMID:24743959

HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men

PubMed Central

Kalichman, Moira O.; Cherry, Chauncey; Grebler, Tamar

2016-01-01

Abstract Disclosure of HIV-positive status to sex partners is critical to protecting uninfected partners. In addition, people living with HIV often risk criminal prosecution when they do not inform sex partners of their HIV status. The current study examined factors associated with nondisclosure of HIV status by men living with HIV in Atlanta, GA (92% African African, mean age = 43.8), who engage in condomless sex with uninfected sex partners. Sexually active HIV-positive men (N = 538) completed daily electronic sexual behavior assessments over the course of 28 days and completed computerized interviews, drug testing, medication adherence assessments, and HIV viral load retrieved from medical records. Results showed that 166 (30%) men had engaged in condomless vaginal or anal intercourse with an HIV-uninfected or unknown HIV status sex partner to whom they had not disclosed their HIV status. Men who engaged in nondisclosed condomless sex were less adherent to their HIV treatment, more likely to have unsuppressed HIV, demonstrated poorer disclosure self-efficacy, enacted fewer risk reduction communication skills, and held more beliefs that people with HIV are less infectious when treated with antiretroviral therapy. We conclude that undisclosed HIV status is common and related to condomless sex with uninfected partners. Men who engage in nondisclosed condomless sex may also be more infectious given their nonadherence and viral load. Interventions are needed in HIV treatment as prevention contexts that attend to disclosure laws and enhance disclosure self-efficacy, improve risk reduction communication skills, and increase understanding of HIV infectiousness. PMID:27158850

Subsequent Sexual Risks Among Men Who Have Sex with Men May Differ by Sex of First Partner and Age at Sexual Debut: A Cross-Sectional Study in Beijing, China.

PubMed

Liu, Yu; Qian, Han-Zhu; Amico, K Rivet; Liu, Hongjie; Yin, Lu; Ruan, Yuhua; Shao, Yiming; Zhang, Chen; Vermund, Sten H

2017-10-01

Sexual debut experience may influence HIV/sexual risks among men who have sex with men (MSM). We assessed associations between age of sexual debut and sex of debut partner with recent (past-3-month) sexual/HIV/syphilis risks among 3588 community-based Chinese MSM. Sexual debut with women was associated with more recent (condomless) insertive anal sex with men, more recent (condomless) vaginal sex, and more lifetime female partners. Sexual debut with men was associated with more recent (condomless) receptive anal sex with men and more lifetime male partners. All associations were strongest among those having first sex ≤18 years in both groups. Earlier sexual debut was associated with higher HIV/syphilis risk; HIV risk was higher with first sex with a man, but syphilis was higher with first sex with a woman. Earlier age of sexual debut is associated with greater HIV/syphilis and sexual risks, but MSM risk differs with first sex with women versus men.

Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach.

PubMed

Stein, Judith A; Nyamathi, Adeline; Ullman, Jodie B; Bentler, Peter M

2007-01-01

Studies among normative samples generally demonstrate a positive impact of marriage on health behaviors and other related attitudes. In this study, we examine the impact of marriage on HIV/AIDS risk behaviors and attitudes among impoverished, highly stressed, homeless couples, many with severe substance abuse problems. A multilevel analysis of 368 high-risk sexually intimate married and unmarried heterosexual couples assessed individual and couple-level effects on social support, substance use problems, HIV/AIDS knowledge, perceived HIV/AIDS risk, needle-sharing, condom use, multiple sex partners, and HIV/AIDS testing. More variance was explained in the protective and risk variables by couple-level latent variable predictors than by individual latent variable predictors, although some gender effects were found (e.g., more alcohol problems among men). The couple-level variable of marriage predicted lower perceived risk, less deviant social support, and fewer sex partners but predicted more needle-sharing.

Study protocol for the recruitment of female sex workers and their non-commercial partners into couple-based HIV research.

PubMed

Syvertsen, Jennifer L; Robertson, Angela M; Abramovitz, Daniela; Rangel, M Gudelia; Martinez, Gustavo; Patterson, Thomas L; Ulibarri, Monica D; Vera, Alicia; El-Bassel, Nabila; Strathdee, Steffanie A

2012-02-20

Researchers are increasingly recognizing the importance of addressing sexual and drug-related HIV risk within the context of intimate relationships rather than solely focusing on individual behaviors. Practical and effective methods are needed to recruit, screen, and enroll the high risk and hard-to-reach couples who would most benefit from HIV interventions, such as drug-using female sex workers (FSWs) and their intimate, non-commercial partners. This paper outlines a bi-national, multidisciplinary effort to develop and implement a study protocol for research on the social context and epidemiology of HIV, sexually transmitted infections (STI), and high risk behaviors among FSWs and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico. We provide an overview of our study and specifically focus on the sampling, recruitment, screening, and successful enrollment of high risk couples into a public health study in this context. We used targeted and snowball sampling to recruit couples through the female partner first and administered a primary screener to check her initial eligibility. Willing and eligible females then invited their primary male partners for couple-based screening using a couple verification screening (CVS) instrument adapted from previous studies. The CVS rechecked eligibility and separately asked each partner the same questions about their relationship to "test" if the couple was legitimate. We adapted the original protocol to consider issues of gender and power within the local cultural and socioeconomic context and expanded the question pool to create multiple versions of the CVS that were randomly administered to potential couples to determine eligibility and facilitate study enrollment. The protocol successfully enrolled 214 high risk couples into a multi-site public health study. This work suggests the importance of collaborating to construct a study protocol, understanding the local population and context, and drawing on multiple sources of input to determine eligibility and verify the legitimacy of relationships. We provide a practical set of tools that other researchers should find helpful in the study of high risk couples in international settings, with particular relevance to studies of FSWs and their intimate partners.

Study protocol for the recruitment of female sex workers and their non-commercial partners into couple-based HIV research

PubMed Central

2012-01-01

Background Researchers are increasingly recognizing the importance of addressing sexual and drug-related HIV risk within the context of intimate relationships rather than solely focusing on individual behaviors. Practical and effective methods are needed to recruit, screen, and enroll the high risk and hard-to-reach couples who would most benefit from HIV interventions, such as drug-using female sex workers (FSWs) and their intimate, non-commercial partners. This paper outlines a bi-national, multidisciplinary effort to develop and implement a study protocol for research on the social context and epidemiology of HIV, sexually transmitted infections (STI), and high risk behaviors among FSWs and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico. We provide an overview of our study and specifically focus on the sampling, recruitment, screening, and successful enrollment of high risk couples into a public health study in this context. Methods/Design We used targeted and snowball sampling to recruit couples through the female partner first and administered a primary screener to check her initial eligibility. Willing and eligible females then invited their primary male partners for couple-based screening using a couple verification screening (CVS) instrument adapted from previous studies. The CVS rechecked eligibility and separately asked each partner the same questions about their relationship to "test" if the couple was legitimate. We adapted the original protocol to consider issues of gender and power within the local cultural and socioeconomic context and expanded the question pool to create multiple versions of the CVS that were randomly administered to potential couples to determine eligibility and facilitate study enrollment. Discussion The protocol successfully enrolled 214 high risk couples into a multi-site public health study. This work suggests the importance of collaborating to construct a study protocol, understanding the local population and context, and drawing on multiple sources of input to determine eligibility and verify the legitimacy of relationships. We provide a practical set of tools that other researchers should find helpful in the study of high risk couples in international settings, with particular relevance to studies of FSWs and their intimate partners. PMID:22348625

Opportunities for HIV Prevention Communication During Sexual Encounters with Black Men Who Have Sex with Men.

PubMed

Aholou, Tiffiany M; Nanin, Jose; Drumhiller, Kathryn; Sutton, Madeline Y

2017-01-01

Conversations about HIV prevention before engaging in sex may result in safer sex practices and decreased HIV transmission. However, partner communication for HIV prevention has been understudied among black/African American men who have sex with men (BMSM), a group that is disproportionately affected by HIV. We explored and described encounters and perceptions about HIV prevention conversations among BMSM and their sex partner(s) in New York City. We conducted an inductive thematic analysis of semi-structured interviews with BMSM who reported sex with a man in the previous 3 months. Interviews were professionally transcribed; Nvivo was used for data analysis. Twenty-two BMSM were included in this analysis; median age = 29.1 years; 71.4% self-identified as MSM; 85.7% were ever HIV tested; and 52.6% reported no disclosure or discussion about HIV status with their previous sex partner. The main themes were: (1) missed opportunities for HIV prevention conversations (e.g., no HIV prevention conversations or HIV prevention conversations after sex had occurred); (2) barriers to HIV prevention conversations (e.g., being in the moment; not wanting to pause); (3) emotional thoughts after sex (e.g., feeling worried about possible HIV exposure); and (4) rethinking relationships and sexual health (e.g., changed sex practices by asking partners' HIV status before sex; started using condoms). These findings offer insight into HIV prevention conversations by BMSM around the time of or during sexual encounters and may inform and strengthen partner-level HIV prevention communication interventions for BMSM.

Sexual Self-Acceptance, Communication with Partner, and Contraceptive Use among Adolescent Females: A Longitudinal Study.

ERIC Educational Resources Information Center

Tschann, Jeanne M.; Adler, Nancy E.

1997-01-01

Examined relationships among sexual self-acceptance, communication with sexual partners about sex and contraception, and contraceptive use in 201 adolescent females, ages 14 to 19. Found that females with greater sexual self-acceptance communicated more with partners about sex and contraception. Discussion about contraception, but not about sex,…

Consistent Condom Use with Paying and Nonpaying Partners among Female Sex Workers in Iran: Findings of a National Biobehavioral Survey.

PubMed

Karamouzian, Mohammad; Sadeghirad, Behnam; Sharifi, Hamid; Sedaghat, Abbas; Haghdoost, Ali Akbar; Mirzazadeh, Ali

Little is known about the dynamics of condom use among female sex workers (FSWs) in Iran. We investigated the correlates of consistent condom use (CCU) among FSWs, using data from a national biobehavioral surveillance survey in 2010. A total of 872 FSWs were recruited using a facility-based sampling strategy from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews using a standardized questionnaire. Overall, 33.6% and 17.3% of FSWs reported CCU with paying and nonpaying sex partners, respectively. Consistent condom use with paying partners was significantly associated with temporary marriage, accessing family planning services and history of working in brothels. Conversely, temporary marriage or married status, condom rupture/slippage, and HIV seropositivity remained independently significantly associated with CCU with nonpaying sex partners. Our findings indicated the urgent need for scaling up condom promotion interventions catered toward FSWs and their sex partners to practice safe sex consistently.

HIV Status Communication with Sex Partners and Associated Factors Among High-Risk MSM and Transgender Women in Lima, Peru.

PubMed

Konda, Kelika A; Castillo, Rostislav; Leon, Segundo R; Silva-Santisteban, Alfonso; Salazar, Ximena; Klausner, Jeffrey D; Coates, Thomas J; Cáceres, Carlos F

2017-01-01

Men who have sex with men (MSM) and transgender women (TW) are key populations in the HIV epidemic. HIV status communication between sex partners can inform decisions regarding sexual behavior. MSM and TW were asked about HIV status communication with sex partners at baseline, 9- and 18-months. GEE models assessed associations with HIV status communication at baseline using prevalence ratios (PRs) and longitudinally using odds ratios (ORs). At baseline, those who had previously had an HIV test, disclosed their HIV status to 42 % of their sex partners. HIV status communication was associated with knowing their sex partner's HIV status at baseline (aPR 5.20) and longitudinally (aOR 1.86). HIV positivity at baseline was negatively associated with HIV status communication during follow-up (aOR 0.55). All reported aPRs and aORs have p < 0.05. Interventions promoting HIV status communication and more frequent HIV testing should be explored as current efforts are insufficient.

Sexual agreements and perception of HIV prevalence among an online sample of partnered men who have sex with men.

PubMed

Stephenson, Rob; White, Darcy; Mitchell, Jason W

2015-10-01

Stemming from recent evidence that between one- and two-thirds of new HIV transmissions among men who have sex with men (MSM) occur within main partnerships, research and programmatic efforts have begun to recognize the role of the male-male dyad in shaping HIV risk. Central to this new focus has been studies detailing the presence of sexual agreements, which provide guidelines governing permissions around sex with partners outside of the relationship. Using a Facebook-recruited sample of US-partnered MSM (n = 454), this study examines the associations between reporting of sexual agreements and perceptions of HIV prevalence among male sex partners, friends, and local and national MSM populations. Men who perceived that 10-20 % (OR 6.18, 95 % CI 1.28-29.77) and >20 % of their male sex partners were HIV positive (OR 2.68, 95 % CI 1.02-7.08) had significantly higher odds of reporting having an open agreement with their current main partner than men who perceived that less than 10 % of their male sex partners were HIV positive. Partnered men with open sexual agreements may have more sexual partners than those who report monogamy, possibly leading to heightened perceptions of HIV risk, which may result in reporting of perceptions of greater local HIV prevalence. Additionally, men who have made agreements with their partners may have done so due to concerns about HIV risks, and may also be more aware of increased risks of HIV infection, or may have greater knowledge of HIV prevalence through discussions of serostatus with sex partners. Attention is needed to develop prevention efforts, such as toolkits and resources that enable men to form sexual agreements that are based on comprehensive knowledge of the potential risks for acquisition of HIV.

Intimate partner violence and human immunodeficiency virus risk among black and Hispanic women.

PubMed

Morales-Alemán, Mercedes M; Hageman, Kathy; Gaul, Zaneta J; Le, Binh; Paz-Bailey, Gabriela; Sutton, Madeline Y

2014-12-01

Approximately 80% of new HIV infections among U.S. women are among black/African American and Hispanic women. HIV risk may be associated with intimate partner violence (IPV); data regarding IPV for women in high-HIV prevalence areas are scarce. To examine prevalence and correlates of IPV among women. Heterosexual women and their male partners in cities with high HIV prevalence were enrolled. During 2006-2007, participants completed interviews about HIV risk factors and IPV (physical violence or forced sex) experiences. Data were analyzed during 2012-2013 using multivariate logistic regression to identify individual- and partner-level IPV correlates. Of 1,011 female respondents, 985 (97.4%) provided risk factor and demographic data. Most were non-Hispanic black/African American (82.7%); living at or below poverty (86.7%); and tested HIV-negative (96.8%). IPV-physical violence was reported by 29.1%, and IPV-forced sex by 13.7%. Being married/living with a partner (AOR=1.60, 95% CI=1.06, 2.40); non-injection drug use (AOR=1.74, 95% CI=1.22, 2.48); and ever discussing male partners' number of current sex partners (AOR=1.60, 95% CI=1.15, 2.24) were associated with IPV-physical violence. Women reporting concurrent sex partners (AOR=1.80, 95% CI=1.04, 3.13) and ever discussing number of male partners' past sex partners (AOR=1.85, 95% CI=1.13, 3.05) were associated with IPV-forced sex. Feeling comfortable asking a male partner to use condoms was associated with decreased IPV-physical violence (AOR=0.32, 95% CI=0.16,0.64) and -forced sex (AOR=0.37, 95% CI=0.16, 0.85). Prevention interventions that enhance women's skills to decrease HIV and IPV risk are important strategies for decreasing racial/ethnic disparities among women. Published by Elsevier Inc.

Sexual sensation seeking, co-occurring sex and alcohol use, and sexual risk behavior among adolescents in treatment for substance use problems.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Morgan-Lopez, Antonio A; Saavedra, Lissette M; Csizmadia, Annamaria

2013-01-01

This study evaluated relations between sexual sensation seeking, co-occurring sex and alcohol use, and sexual risk behaviors (eg, unprotected intercourse and multiple sex partners) among adolescents receiving treatment for substance abuse problems. The ethnically diverse sample included 394 adolescents recruited from outpatient treatment (280 males; Mage  = 16.33 years, SDage  = 1.15). Structural equation modeling (SEM) was used to test direct and indirect paths between sexual sensation seeking and sexual risk behaviors via the frequency of co-occurring sex and alcohol use. Conditional indirect effects by gender were also tested. Analyses identified significant effects of sexual sensation seeking on co-occurring sex and alcohol use and sexual risk behaviors. The path from co-occurring sex and alcohol use to unprotected intercourse was significantly stronger among adolescent girls, suggesting a mediation effect moderated by gender. No gender difference was found for the indirect path from sexual sensation seeking and number of past year sexual partners via co-occurring sex and alcohol use. Selected prevention efforts are needed to promote HIV risk reduction among adolescents in substance abuse treatment. The documented conditional indirect effect for unprotected intercourse suggests that HIV prevention programs should pay special attention to gender-specific patterns of alcohol use and sexual risk behavior when tailoring program content. (Am J Addict 2013; 22:197-205). Copyright © American Academy of Addiction Psychiatry.

Anonymous sex and HIV risk practices among men using the Internet specifically to find male partners for unprotected sex.

PubMed

Klein, H

2012-06-01

To examine the popularity of anonymous sex practices among men using the Internet to find male partners for unprotected sex, and how anonymous sex relates to involvement in other HIV-related risk behaviours, and to investigate the factors associated with engaging in anonymous sex. Structured telephone interviews were conducted with men who used the Internet specifically to find male partners for unprotected sex. Random sampling from 16 websites was used to obtain a national sample. The data reported in this paper were based on quantitative interviews collected with a cross-sectional study design. Between January 2008 and May 2009, confidential telephone interviews lasting approximately 1-2 h were completed with 332 men. Participants were paid $35 for their participation. Most of the men (67.4%) liked anonymous sex, and slightly more than half (51.2%) had engaged in the behaviour during the month prior to interview. Involvement in anonymous sex was associated with greater involvement in a variety of human immunodeficiency virus (HIV)-related risk practices, such as illegal drug use, number of sex partners, and amount of unprotected sex. Four factors were associated with having vs not having anonymous sex: (1) being HIV positive; (2) answering all of the HIV-related knowledge questions correctly; (3) deriving greater enjoyment from having sex in public places, such as parks, public toilets, or adult book shops; and (4) greater impulsivity. Seven factors were associated with greater vs lesser involvement in anonymous sex among those practising the behaviour: (1) being involved in a relationship with a long-term partner; (2) liking to have sex in public places; (3) using bareback-oriented websites to identify sex partners; (4) greater impulsivity; (5) low level of condom use self-efficacy; (6) greater knowledge about HIV/acquired immunodeficiency syndrome; and either (7a) severe childhood maltreatment or (7b) Caucasian race. Men in this population often sought anonymous sex, and this practice was related to involvement in a variety of risky behaviours, such as illegal drug use and the number of recent sex partners (among others). Interventionists should address anonymous sex practices among Internet-using, risk-seeking men in order to reduce the overall levels of HIV risk involvement. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Love moderates the relationship between partner type and condom use among women engaging in transactional vaginal sex.

PubMed

Roth, Alexis M; Rosenberger, Joshua G; Hensel, Devon J; Wiehe, Sarah E; Fortenberry, J Dennis; Wagner, Karla D

2016-04-01

Background Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behaviour. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex. Twenty-six women engaging in transactional sex were enrolled in a prospective study of their sexual health. They completed diaries about multi-level predictors of condom use during vaginal sex twice, daily. Over 4 weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex on the weekend and at night were associated with lower odds of condom use (all P≤0.05). There was a significant interaction between being in love and using condoms during transactional sex (P<0.01). In paid/traded sexual events with romantic partners, the frequency of condom use was 71.4% (5/7) when women did not report love and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported. Women were less likely to report protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types.

Contextual factors associated with treatment-seeking and higher-risk sexual behaviour in Botswana among men with symptoms of sexually transmitted infections.

PubMed

Langeni, Tabitha

2007-11-01

This study investigates contextual factors associated with treatment-seeking behaviour and higher-risk sexual conduct of men symptomatic of sexually transmitted infections (STIs) in Botswana. Data were drawn from a randomly selected, nationally representative sample of 8 222 men, aged 15-64 years, who had reported having symptoms suggestive of an STI during the previous twelve months. Higher-risk behaviour continues to sustain the HIV epidemic in Botswana. At the heart of Botswana's epidemic lies men's reluctance to seek medical treatment, engaging in unprotected sex, and having sex with multiple partners while symptomatic of an STI. The odds of engaging in unprotected sex while symptomatic of an STI were significantly higher among teenage males and males in urban households. For every year's increase in the age difference between partners there was a 28% increase in the odds of the male having had unprotected sex. Being married and having had more than one sexual partner in the last year multiplied the odds of having unprotected sex while symptomatic of an STI by three times. The longer an infected man remained with symptoms before seeking help, the more likely it was to have unprotected sex while infected and the more likely to seek treatment from a traditional healer. Notably, having sought medical treatment from hospitals, clinics and health workers, as opposed to consulting traditional healers, significantly reduced the odds of having had unprotected sex while infected with an STI by 48%. The results indicate the need to encourage men to utilise public healthcare services. The public health sector in Botswana needs to provide healthcare services that are user-friendly for men. Increasing the number of treatment sites may also contribute to preventing onward transmission of STIs. Special attention needs to be paid to boys' socialisation towards gender norms, and men are to be encouraged to play a responsible role in HIV prevention.

Sex differences amongst dependent heroin users: histories, clinical characteristics and predictors of other substance dependence

PubMed Central

Shand, Fiona L; Degenhardt, Louisa; Slade, Tim; Nelson, Elliot C

2010-01-01

Introduction and aims To examine differences in the characteristics and histories of male and female dependent heroin users, and in the clinical characteristics associated with multiple substance dependence diagnoses. Design and methods 1513 heroin dependent participants underwent an interview covering substance use and dependence, psychiatric history, child maltreatment, family background, adult violence and criminal history. Family background, demographic and clinical characteristics were analysed by sex. Ordinal regression was used to test for a relationship between number of substance dependence diagnoses and other clinical variables. Results Women were more likely to experience most forms of child maltreatment, to first use heroin with a boyfriend or partner, to experience ongoing adult violence at the hands of a partner, and to have a poorer psychiatric history than men. Males had more prevalent lifetime substance dependence diagnoses and criminal histories and were more likely to meet criteria for ASPD. Predictors of multiple substance dependence diagnoses for both sexes were mental health variables, antisocial behaviour, childhood sexual abuse, victim of adult violence, younger age at first cannabis use and overdose. As the number of dependence diagnoses increased, clinical and behavioural problems increased. Childhood emotional neglect was related to increasing dependence diagnoses for females but not males, whereas PTSD was a significant predictor for males but not females. Discussion and conclusions Mental health problems, other substance dependence, childhood and adult trauma were common in this sample, with sex differences indicating different treatment needs and possible different pathways to heroin dependence for men and women. PMID:20833480

A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru.

PubMed

Vagenas, Panagiotis; Brown, Shan-Estelle; Clark, Jesse L; Konda, Kelika A; Lama, Javier R; Sánchez, Jorge; Duerr, Ann C; Altice, Frederick L

2017-06-07

Peruvian men who have sex with men (MSM) and transgender women (TGW) experience the double burden of a highly concentrated HIV epidemic with a high prevalence of alcohol use disorders (AUDs). Recent research has associated both with risky sexual behaviors, including unprotected sex, having multiple sexual partners, engaging in sex work, having recent sexually transmitted infections, and having HIV-infected partners. AUDs have also been associated in MSM/TGW with being unaware of HIV+ status. This study aims to further examine issues associated with alcohol consumption, HIV infection, and risk behaviors in a qualitative analysis of focus groups conducted with MSM/TGW in Peru. A total of 26 MSM/TGW participants with AUDs participated in three semi-structured focus groups in Lima, Peru. Content analysis was facilitated by software, and specific themes were elucidated. Participants described their drinking patterns, including the types of alcoholic drinks they consumed. They depicted drinking frequently and over multiple-day sessions. Problematic drinking behaviors were described, as well as the perceived characteristics of alcohol dependence. Interestingly, HIV-infected participants who were prescribed antiretroviral therapy did not believe that their drinking affected their medication adherence. These insights can aid in the design of future interventions aiming to reduce problematic drinking as well as HIV-related risk behaviors and, subsequently, HIV incidence. Peruvian MSM/TGW exhibit problematic drinking, which may be associated with risky sexual behaviors and HIV transmission. Interest in reducing alcohol consumption was high, suggesting the need for targeted behavioral and pharmacological interventions.

A TWO-WAY ROAD: RATES OF HIV INFECTION AND BEHAVIORAL RISK FACTORS AMONG DEPORTED MEXICAN LABOR MIGRANTS

PubMed Central

Rangel, M. Gudelia; Martinez-Donate, Ana P.; Hovell, Melbourne; Sipan, Carol L.; Zellner, Jennifer A.; Gonzalez-Fagoaga, Eduardo; Kelley, Norma J.; Asadi-Gonzalez, Ahmed; Amuedo-Dorantes, Catalina; Magis-Rodriguez, Carlos

2012-01-01

A large number of Mexican migrants are deported to Mexico and released in the North Mexican border region every year. Despite their volume and high vulnerability, little is known about the level of HIV infection and related risk behaviors among this hard-to-reach population. We conducted a cross-sectional, probability survey with deported Mexican migrants in Tijuana, Mexico (N=693) and estimated levels of HIV infection and behavioral risk factors among this migrant flow. The sample and population estimated rates of HIV for deported males were 1.23% and 0.80%, respectively. No positive cases were found among the female sample. We found high lifetime rates of reported sexually transmitted infections (22.3%) and last 12-months rates of unprotected sex (63.0%), sex with multiple sexual partners (18.1%), casual partners (25.7%), and sex workers (8.6%), compared to U.S. and Mexico adults. HIV prevention, testing, and treatment programs for this large, vulnerable, and transnational population need to be implemented in both the U.S. and Mexico. PMID:22562390

Does age matter? Sexual event-level analysis of age-disparate sexual partners among gay, bisexual and other men who have sex with men (GBM) in Vancouver, Canada.

PubMed

Closson, K; Lachowsky, N J; Cui, Z; Shurgold, S; Sereda, P; Rich, A; Moore, D M; Roth, E A; Hogg, R S

2017-08-01

To determine factors associated with age-disparate sexual partners among Vancouver gay, bisexual and other men who have sex with men (GBM). Sexually active GBM aged ≥16 years were recruited from February 2012 to February 2014. Participants self-completed a questionnaire on demographics, attitudes and sexual behaviour and substance use at last sexual event with five most recent partners. Two generalised linear mixed models identified factors associated with: (1) 'same-age' (referent), 'younger' or 'much-younger' and (2) 'same-age' (referent), 'older' or 'much-older' partners. Statistical interactions between age and HIV status were tested. Participants (n=719) were predominantly gay (85.1%), White (75.0%), HIV-negative/unknown status (72.9%) with median age of 33 years (Q1,Q3: 26,47). A minority of sexual events were reported with much-older/much-younger partners (13.7%). In the multivariable models, GBM reporting older partners were more likely to be Asian or Latino, have greater Escape Motivation scores, report their partner used erectile dysfunction drugs (EDDs) and have received something for sex; compared with condom-protected insertive anal sex, participants with older partners were more likely to report condomless insertive anal sex with a serodiscordant or unknown status partner or no insertive anal sex. GBM reporting older partners were less likely to be bisexual-identified, have given something for sex and report event-level alcohol and EDD use. GBM reporting younger partners were more likely to have annual incomes >$30 000 and have met their partner online. As per significant statistical interactions, age-disparate relations were more common for younger HIV-positive and older HIV-negative GBM. Differences among age-disparate partners highlight important targets for health promotion and future research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Factors associated with syphilis/HIV infection among men who have sex with men in Shenzhen,2011-2016].

PubMed

Cai, Y M; Song, Y J; Liu, H; Hong, F C

2017-11-06

Objective: To investigate the factors associated with syphilis/HIV infection among men who have sex with men (MSM) maintaining a single sexual partner in Shenzhen. Methods: Respondent driven sampling and snowball sampling method were used to recruit MSM receiving voluntary counseling and testing in Shenzhen Rainbow clinic from 2011 to 2016. aged 18 years and above; reported having one or more anal sexual partners in the recent 6 months. A total of 3 109 men who have sex with men (MSM) were involved in the study. Questionnaire-based interviews were conducted on a one-on-one basis. Data were collected including socio-demographic information, human immunodeficiency virus (HIV) testing history, history of blood donation and drug abuse in the recent two years, self-identified sexual orientation, role in homosexual behavior, ever being money boys (MB) and clients of MB, female sexual partners in the recent 6 months. 5 ml blood samples were taken after questionnaires. Syphilis was screened using toluidine red unheated serum test for the antibody of treponema pallidum and then confirmed by treponema pallidum particle assay. The enzyme-linked immunosorbent assay (ELISA) was used for screening HIV and western blot was used to confirm the HIV screening results. The difference of condom use among MSM between female sexual partners and male sexual partners were compared. Multivariate unconditional stepwise logistic regression model was used to analyze factors associated with syphilis infection and HIV positive among MSM. Results: A total of 3 109 eligible participants with mean (SD) age of 31.49 (8.64) years were enrolled in this study. Among them, 565 cases were infected with syphilis (18.17%), 330 cases were infected with HIV (10.61%), and 165 cases (5.31%) were syphilis co-infected with HIV. 791 (25.44%) reported maintaining a single sexual partners in the recent 6 months. Compared to MSM with multiple sexual partners, the prevalence of syphilis and HIV infection among MSM with a single sexual partner were lower, and the OR (95% CI ) were 0.64 (0.51-0.81) and 0.66 (0.49-0.90), respectively. Conclusion: The proportion of fixed single sexual partner was much lower among MSM in Shenzhen. Maintaining a single sexual partners can reduce the risk of syphilis/HIV infection among MSM.

Sexual behaviours and associated factors among students at Bahir Dar University: a cross sectional study.

PubMed

Mulu, Wondemagegn; Yimer, Mulat; Abera, Bayeh

2014-12-06

Sexual behaviour is the core of sexuality matters in adolescents and youths. Their modest or dynamic behaviour vulnerable them to risky sexual behaviours. In Ethiopia, there is scarcity of multicentered representative data on sexual behaviours in students to have a national picture at higher education. This study therefore conducted to assess sexual behaviours and associated factors at Bahir Dar University, Ethiopia. A cross sectional study was conducted among Bahir Dar University students from December to February 2013. Multistage sampling and self administered questionnaires were employed. Descriptive statistics such as frequency and mean were used to describe the study participants in relation to relevant variables. Multivariate analysis was carried for those variables that had a p-value of ≤ 0.2 in the bivariate analysis to identify the predictor variables. Of the 817 study participants, 297 (36.4%) students had ever had sex. The mean age at first sexual practice was 18.6 years. Unprotected sex, having multiple sex partners, sex with commercial sex workers and sex for the exchange of money was practiced by 184 (62%), 126 (42.7%), 22 (7.4%) and 12 (4%) of sexually active students, respectively. The proportion of attending night clubs and watching porn videos was 130 (15.8%) and 534 (65.4%), respectively. Male respondents had significant positive association with watching porn videos (AOR = 4.8, CI = 3.49 - 6.54) and attending night clubs (AOR = 3.9, CI = 2.3 - 6.7). Watching porn videos, attending night clubs, khat chewing and taking alcohol frequently were significantly associated for ever had sex and having multiple sexual partners. Khat chewing practice (AOR = 8.5, CI =1.31 - 55.5) and attending night clubs (AOR = 4.6, CI = 1.8 - 11.77) had statistical significant association with the purpose of sexual intercourse for the sake of money and for having sex with commercial sex workers, respectively. Significant number of students had different risky sexual behaviours. Substance use, attending night clubs and watching porno video were predictor factors for practicing different sexual behaviours. Therefore, preventive intervention programmes should be strengthened, effectively implemented and monitored both in the earlier school and in the universities.

Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents.

PubMed

Toska, Elona; Cluver, Lucie D; Hodes, Rebecca; Kidia, Khameer K

2015-01-01

HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no study has explored the effects of (i) adolescent knowledge of one's HIV-status, (ii) knowledge of partner status and (iii) disclosure to partners, on safer sex behaviour. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. Eight fifty eight HIV-positive adolescents (10-19 years old, 52% female, 68.1% vertically infected) who had ever initiated antiretroviral treatment in 41 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers and their healthcare workers. N = 128 (14.9%) of the total sample had ever had sex, while N = 109 (85.1%) of sexually active adolescents had boy/girlfriend. In total, 68.1% of the sample knew their status, 41.5% of those who were sexually active and in relationships knew their partner's status, and 35.5% had disclosed to their partners. For adolescents, knowing one's status was associated with safer sex (OR = 4.355, CI 1.085-17.474, p = .038). Neither knowing their partner's status, nor disclosing one's HIV-status to a partner, were associated with safer sex. HIV-positive adolescents feared rejection, stigma and public exposure if disclosing to sexual and romantic partners. Counselling by healthcare workers for HIV-positive adolescents focused on benefits of disclosure, but did not address the fears and risks associated with disclosure. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents, who may be ill-equipped to negotiate safer sex. There is a pressing need for effective interventions that mitigate the risks of disclosure and provide HIV-positive adolescents with skills to engage in safe sex.

Women's motivations to have sex in casual and committed relationships with male and female partners.

PubMed

Armstrong, Heather L; Reissing, Elke D

2015-05-01

Women report a wide variety of reasons to have sex (e.g., Meston & Buss, 2010), and while it is reasonable to assume that those reasons may vary based on the context of the relationship, this assumption has not yet been tested. The purpose of this study was to explore how relationship type, sexual attraction, and the gender of one's partner interact and affect the sexual motivations of women. A total of 510 women (361 who reported exclusively other-sex attraction and 149 who reported same-sex/bisexual attraction) completed the YSEX? questionnaire. Participants rated their sexual motivations for casual sex and sex in a committed relationship with male and/or female partners, depending on reported sexual attraction. Results showed that relationship type affected reported motivation for sex: physical motivations were more strongly endorsed for casual sex, whereas emotional motivations were more strongly endorsed for sex in committed relationships. No significant differences in motivation were reported between women who reported same-sex attraction and those who did not. Women who reported bisexual attraction and identified as being lesbian, bisexual, or another sexual minority reported no significant differences in motivation for sex with male or female partners. The results of this study highlight the importance of relationship context when discussing sexual motivation and suggest a high degree of similarity in motivation for women, regardless of sexual orientation or gender of partner.

Social induction of maturation and sex determination in a coral reef fish.

PubMed Central

Hobbs, Jean-Paul A.; Munday, Philip L.; Jones, Geoffrey P.

2004-01-01

Labile maturation and sex determination should be advantageous where the probability of finding a mating partner is unpredictable. Here we tested the hypothesis that the presence of a potential mating partner induces maturation and sex determination in a coral-dwelling fish, Gobiodon erythrospilus. In natural populations at Lizard Island (Great Barrier Reef), single individuals were less likely to be mature than paired individuals and they matured at a larger size, indicating plasticity in the timing of maturation. By manipulating group structure we demonstrated that both the timing of maturation and the sex of maturing individuals are socially controlled. Single juveniles did not mature, but maturation was rapidly induced by the presence of an adult partner. In addition, sex determination was found to be labile, with juveniles maturing into the opposite sex of the partner encountered. To our knowledge, this is the first experimental demonstration of social induction of maturation in conjunction with labile sex determination at maturation in vertebrates. This flexibility enables individuals to maximize their reproductive success in an environment where the timing of mate acquisition and the sex of their future partner are unpredictable. PMID:15475329

Intimate partner sexual violence: a comparison of foreign- versus US-born physically abused Latinas.

PubMed

Cavanaugh, Courtenay E; Messing, Jill T; Amanor-Boadu, Yvonne; O'Sullivan, Chris O; Webster, Daniel; Campbell, Jacquelyn

2014-02-01

Men's violence against women-particularly intimate partner sexual violence (IPSV)-is associated with the transmission of HIV. Men who physically abuse their female intimate partners often also sexually abuse them. Latinas are one of the fastest growing populations in the USA and at high-risk for contracting HIV, though little is known about IPSV against physically abused Latinas, including whether there is an association between nativity of the victim and the likelihood of sexual violence by intimate partners. This study examined the (1) prevalence of recent (past 6 months) IPSV against 555 physically abused, help-seeking Latinas and (2) relationship of nativity to recent IPSV. This study used data collected in 2002–2003 from participants in one major city on the East Coast and one West Coast county, who were involved in the Risk Assessment Validation (RAVE) Study. The RAVE Study assessed the accuracy of four different methods for predicting risk of future intimate partner violence. IPSV was defined as an abusive male partner physically forcing sex (rape) or making the woman have sex without a condom. Recent IPSV was reported by 38 % of the sample. Among those reporting recent IPSV, multiple assaults were common: 30%of women were raped and 51%were made to have unprotected sex six or more times during the past 6 months. IPSV was significantly associated with nativity. Physically abused Latinas who were foreign born had two times greater odds of reporting recent IPSV than physically abused Latinas born in the USA, after controlling for other demographic covariates. Exploratory post hoc analyses examining all pairwise comparisons of IPSV against Latinas born in the USA, Mexico, Central America, South America, and the Caribbean also revealed some significant differences that warrant further study with larger samples. HIV prevention efforts aimed at reducing IPSV in this population are needed.

Older Sexual Partners and Adolescent Females' Mental Health.

PubMed

Meier, Ann; Erickson, Gina A; McLaughlin, Heather

2016-03-01

The physical health detriments associated with adolescent females' having older romantic partners are well documented. However, little is known about the relationship between having an older partner and females' subsequent mental health. Two waves of data from 1,440 participants in the National Longitudinal Study of Adolescent Health were analyzed. The sample was restricted to females in grades 7-12 who had not had sex at Wave 1 (1994-1995) and reported at least one romantic relationship by Wave 2 (1996). A lagged dependent variable approach with ordinary least-squares regression measured changes in depression and self-esteem associated with sexual and nonsexual relationships with same-age and older partners. Intimate partner violence was tested as a mediator. Compared with respondents reporting a nonsexual relationship with a same-age partner, those reporting a nonsexual relationship with an older partner, sex with a same-age partner or sex with an older partner experienced greater increases in depression between surveys; mean predicted depression levels at Wave 2 ranged from 7.7 to 9.0 across these groups (possible range, 0-27). Intimate partner violence explained one-third of the difference between those who had had sex and those who had not had sex with same-age partners. Fewer associations were found for self-esteem, and differences between groups were small. Health correlates of adolescent sexual behavior go beyond physical health outcomes. Future research should identify mechanisms through which relationships, especially those with older partners, are associated with declines in mental health. Copyright © 2016 by the Guttmacher Institute.

Human Papillomavirus Genital Infections among Men, China, 2007–2009

PubMed Central

He, Zhonghu; Liu, Ying; Sun, Yuan; Xi, Long Fu; Chen, Ke; Zhao, Yiqiang; Gao, Lei; Liu, Fangfang; Pan, Yaqi; Ning, Tao; Zhang, Lixin; Cai, Hong

2013-01-01

To determine prevalence of genital human papillomavirus (HPV) infection among men in rural China, we analyzed genital swab specimens. Among 2,236 male residents of rural Henan Province, HPV infection prevalence was 17.5%. The most common oncogenic and nononcogenic types were HPV-16 and HPV-3, respectively. Infection was associated with younger age and multiple sex partners. PMID:23735236

Assessment of risky sexual behavior and practice among Aksum University students, Shire Campus, Shire Town, Tigray, Ethiopia, 2017.

PubMed

Kebede, Awoke; Molla, Bogale; Gerensea, Hadgu

2018-01-31

Having sex at early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs and unprotected sexual behaviors are the common characteristics of risky sexual behavior which increases risk of individuals to sexuality and reproductive health problems. Risky sexual behavior is the most common problem in adolescents and young adults which may expose individuals for permanent social, economical, psychological and physical problem. So that this study focus on assessment of risk sexual behavior using institution based cross-sectional study design on 287 randomly selected subjects among Aksum University students. Almost 60% students reported to have ever had sexual activity. Of which 86 (83.5%) and 112 (64.4%) reported having inconsistent condom use and multiple sexual partners respectively. Even though more than half of first sexual intercourse (61.5%) starts due to their desire but still peer pressure and alcohol have significant effect. Similarly the study indicated that a significant segment of students have risk sexual behaviors which increase individuals' risk of acquiring HIV/AIDS. Unless appropriate age and institutional targeted interventions exist, certain behaviors can place the university students at greater risk of HIV infection and sexually transmitted disease.

Sexual Behavior Latent Classes Among Men Who Have Sex With Men: Associations With Sexually Transmitted Infections.

PubMed

Rice, Cara E; Norris Turner, Abigail; Lanza, Stephanie T

2017-01-01

Men who have sex with men (MSM) are at disproportionate risk of acquisition of sexually transmitted infections (STIs). We used latent class analysis (LCA) to examine patterns of sexual behavior among MSM and how those patterns are related to STIs. We examined patterns of sexual behavior using behavioral and clinical data from a cross-sectional study of 235 MSM who presented to an urban sexual health clinic for STI testing. Analyzed data were collected using a combination of interviewer- and self-administered surveys and electronic health records. We used LCA to identify underlying subgroups of men based on their sexual behavior, described the demographics of the latent classes, and examined the association between the latent classes and STI status. We identified three latent classes of sexual behavior: Unprotected Anal Intercourse (UAI) Only (67%), Partner Seekers (14%), and Multiple Behaviors (19%). Men in the Multiple Behaviors class had a 67% probability of being STI positive, followed by men in the UAI Only class (27%) and men in the Partner Seekers class (22%). Examining the intersection of a variety of sexual practices indicates particular subgroups of MSM have the highest probability of being STI positive.

Self-efficacy among young men who have sex with men: an exploratory analysis of HIV/AIDS risk behaviors across partner types.

PubMed

Bauermeister, José A; Hickok, Andrew M; Meadowbrooke, Chrysta; Veinot, Tiffany; Loveluck, Jimena

2014-01-01

HIV infection continues to rise among young men who have sex with men (YMSM). We explored whether unprotected receptive anal intercourse (URAI) occasions and partners, respectively, were associated with YMSM's (N = 194; ages 18-24) self-efficacy for safe sex with regular and casual partners. We created four self-efficacy typologies: high self-efficacy with both partner types [HRHC; N = 73(41.7 %)], high self-efficacy with regular partners but low with casual partners [HRLC; N = 24(13.7 %)], low self-efficacy with regular partners but high with casual partners [LRHC; N = 21(12.0 %)], and low with both partner types [LRLC; N = 57(32.6 %)]. YMSM in the LRHC category reported fewer URAI occasions, whereas those in the HRLC group reported more URAI partner and occasions, respectively. YMSM having serodiscordant partners were more likely to report more URAI partners, and be represented in the LRLC category. These findings underscore the importance of addressing differential self-efficacy across partner types, and highlight an urgent need to enhance YMSM's self-efficacy with casual partners.

Sexual Networks and HIV Risk among Black Men Who Have Sex with Men in 6 U.S. Cities.

PubMed

Tieu, Hong-Van; Liu, Ting-Yuan; Hussen, Sophia; Connor, Matthew; Wang, Lei; Buchbinder, Susan; Wilton, Leo; Gorbach, Pamina; Mayer, Kenneth; Griffith, Sam; Kelly, Corey; Elharrar, Vanessa; Phillips, Gregory; Cummings, Vanessa; Koblin, Beryl; Latkin, Carl

2015-01-01

Sexual networks may place U.S. Black men who have sex with men (MSM) at increased HIV risk. Self-reported egocentric sexual network data from the prior six months were collected from 1,349 community-recruited Black MSM in HPTN 061, a multi-component HIV prevention intervention feasibility study. Sexual network composition, size, and density (extent to which members are having sex with one another) were compared by self-reported HIV serostatus and age of the men. GEE models assessed network and other factors associated with having a Black sex partner, having a partner with at least two age category difference (age difference between participant and partner of at least two age group categories), and having serodiscordant/serostatus unknown unprotected anal/vaginal intercourse (SDUI) in the last six months. Over half had exclusively Black partners in the last six months, 46% had a partner of at least two age category difference, 87% had ≤5 partners. Nearly 90% had sex partners who were also part of their social networks. Among HIV-negative men, not having anonymous/exchange/ trade partners and lower density were associated with having a Black partner; larger sexual network size and having non-primary partners were associated with having a partner with at least two age category difference; and having anonymous/exchange/ trade partners was associated with SDUI. Among HIV-positive men, not having non-primary partners was associated with having a Black partner; no sexual network characteristics were associated with having a partner with at least two age category difference and SDUI. Black MSM sexual networks were relatively small and often overlapped with the social networks. Sexual risk was associated with having non-primary partners and larger network size. Network interventions that engage the social networks of Black MSM, such as interventions utilizing peer influence, should be developed to address stable partnerships, number of partners, and serostatus disclosure.

CONDOM USE WITH VARIOUS TYPES OF SEX PARTNERS BY MONEY BOYS IN CHINA

PubMed Central

Liu, Shusen; Chen, Lin; Li, Li; Zhao, Jin; Cai, Wende; Rou, Keming; Wu, Zunyou; Detels, Roger

2012-01-01

Money boys (MBs) who typically sell sex to males have not yet been extensively studied in China. In this 2009 study, 28 venue-based MBs were interviewed. We analyzed their condom use behaviors with various partners, including male and female clients, male and female casual partners, other MBs and female sex workers, and boyfriends and girlfriends. All participants were aware of the need for using condoms; however, usage with different partner types varied. The longer a relationship with a partner, the less frequent was condom use. A major reason for not using condoms was that they or their partners did not like the loss of sensation due to condom use. Other factors included sexual orientation, age, duration in commercial sex, concerns about HIV/AIDS, attractiveness of partners, and support of “mommies” (brothel supervisors). Both individual- and venue-level interventions are needed to promote condom use, and mommies need to be included in intervention strategies. PMID:22468976

A Cohort Effect of the Sexual Revolution May Be Masking an Increase in Human Papillomavirus Detection at Menopause in the United States

PubMed Central

Gravitt, Patti E.; Rositch, Anne F.; Silver, Michelle I.; Marks, Morgan A.; Chang, Kathryn; Burke, Anne E.; Viscidi, Raphael P.

2013-01-01

Background. Cohort effects, new sex partnerships, and human papillomavirus (HPV) reactivation have been posited as explanations for the bimodal age-specific HPV prevalence observed in some populations; no studies have systematically evaluated the reasons for the lack of a second peak in the United States. Methods. A cohort of 843 women aged 35–60 years were enrolled into a 2-year, semiannual follow-up study. Age-specific HPV prevalence was estimated in strata defined by a lower risk of prior infection (<5 self-reported lifetime sex partners) and a higher risk of prior infection (≥5 lifetime sex partners). The interaction between age and lifetime sex partners was tested using likelihood ratio statistics. Population attributable risk (PAR) was estimated using Levin's formula. Results. The age-specific prevalence of 14 high-risk HPV genotypes (HR-HPV) declined with age among women with <5 lifetime sex partners but not among women with ≥5 lifetime sex partners (P = .01 for interaction). The PAR for HR-HPV due to ≥5 lifetime sex partners was higher among older women (87.2%), compared with younger women (28.0%). In contrast, the PAR associated with a new sex partner was 28% among women aged 35–49 years and 7.7% among women aged 50–60 years. Conclusions. A lower cumulative probability of HPV infection among women with a sexual debut before the sexual revolution may be masking an age-related increase in HPV reactivation in the United States. PMID:23242540

75 FR 67629 - Federal Travel Regulation (FTR); Terms and Definitions for “Dependent”, “Domestic Partner...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... partners of Federal employees, and, where applicable, to the children of same- sex domestic partners of... include ``Domestic partner'' and children, dependent parents, and dependent brothers and sisters of the... respective departments and agencies to determine what authority they have to extend such benefits to same-sex...

Knowledge, risk perception of AIDS and reported sexual behaviour among students in secondary schools and colleges in Tanzania.

PubMed

Maswanya, E S; Moji, K; Horiguchi, I; Nagata, K; Aoyagi, K; Honda, S; Takemoto, T

1999-04-01

A questionnaire survey was carried out among 1041 students in secondary schools and colleges in Dar-es-Salaam, Tanzania to evaluate the relationship between HIV-risky sexual behaviour and anti-condom bias, as well as with AIDS-related information, knowledge, perceptions and attitudes. Self-reportedly, 54% of students (75% of the boys and 40% of the girls) were sexually active, 39% had a regular sexual partner and 13% had multiple partners in the previous year. The condom use rate was higher than previous reports. However, 30% of sexually active respondents did not always use condoms (Risk-1 behaviour) and 35% of those with multiple partners in the previous year did not always use condoms (Risk-2 behaviour). Multiple logistic regression analyses indicated that 'sex partner hates condom' had association with both Risk-1 behaviour (OR 2.47; 95% CI 1.58-3.85) and Risk-2 behaviour (OR 2.47; 95% CI 1.10-5.48). 'Use of condom prevents HIV infection' also had association with both Risk-1 behaviour (OR 2.09; 95% CI 1.19-3.67) and Risk-2 behaviour (OR 3.73; 95% CI 1.28-11.03). Students engaging in risky behaviour were aware of the risk, even though they failed to change their behaviour. Reasons for the AIDS epidemic among Tanzanian students and the importance of more effective AIDS education are also discussed.

Sexual Partners of Street-Based Female Sex Workers in St. Petersburg, Russia: A Model of Partnership Characteristics as a Basis for Further Research

PubMed Central

Levina, Olga S.; Heimer, Robert; Odinokova, Veronika; Bodanovskaya, Zinaida; Safiullina, Liliya; Irwin, Kevin S.; Niccolai, Linda M.

2014-01-01

Street-based sex work in Russia, as in many countries, carries with it a high risk for violence and the transmission of infectious diseases. The male partners of female sex workers are both cause and recipient of such risks. Because little is known about the men, we undertook a preliminary study to determine the feasibility of recruiting and interviewing them, develop typologies that describe partners, and derive hypotheses for further study and risk reduction intervention projects. We were able to conduct open-ended, qualitative interviews with street-based sex workers and, largely through these contacts, their male partners. To these data, we added interviews with social work and medical experts who engage with the sex workers. The text of interviews from 37 respondents were analyzed to identify commonly mentioned partner characteristics in five distinct domains: sociodemographics, behavioral patterns of the partners, motivations in seeking sex services, levels of partner engagement with the sex workers, and the social circumstances that moderate the engagement. Four of the five domains (all but sociodemographics) proved useful in identifying typologies that were best described as populated points in a matrix generated from the intersection of the four domains. The data were too limited to specify which of the points in the matrix are most common, but the points populated are useful in generating hypotheses for further study and in identifying potential avenues for risk reduction interventions. PMID:25741032

Sexual Partners of Street-Based Female Sex Workers in St. Petersburg, Russia: A Model of Partnership Characteristics as a Basis for Further Research.

PubMed

Levina, Olga S; Heimer, Robert; Odinokova, Veronika; Bodanovskaya, Zinaida; Safiullina, Liliya; Irwin, Kevin S; Niccolai, Linda M

2012-01-01

Street-based sex work in Russia, as in many countries, carries with it a high risk for violence and the transmission of infectious diseases. The male partners of female sex workers are both cause and recipient of such risks. Because little is known about the men, we undertook a preliminary study to determine the feasibility of recruiting and interviewing them, develop typologies that describe partners, and derive hypotheses for further study and risk reduction intervention projects. We were able to conduct open-ended, qualitative interviews with street-based sex workers and, largely through these contacts, their male partners. To these data, we added interviews with social work and medical experts who engage with the sex workers. The text of interviews from 37 respondents were analyzed to identify commonly mentioned partner characteristics in five distinct domains: sociodemographics, behavioral patterns of the partners, motivations in seeking sex services, levels of partner engagement with the sex workers, and the social circumstances that moderate the engagement. Four of the five domains (all but sociodemographics) proved useful in identifying typologies that were best described as populated points in a matrix generated from the intersection of the four domains. The data were too limited to specify which of the points in the matrix are most common, but the points populated are useful in generating hypotheses for further study and in identifying potential avenues for risk reduction interventions.

Perceived peer engagement in HIV-related sexual risk behaviors and self-reported risk-taking among female sex workers in Guangxi, China.

PubMed

Chen, Yiyun; Li, Xiaoming; Zhou, Yuejiao; Wen, Xiaoqing; Wu, Deren

2013-01-01

Searching for modifiable perceptions that are associated with sexual risk behaviors among female sex workers (FSWs) are considered a priority in HIV/sexually transmitted disease preventions. Perception of peers' involvement in risk behaviors, a key correlate of individual risk behaviors, has barely been studied among FSWs. A self-administered questionnaire was completed by 1022 FSWs in Guangxi, China, a country with rapid growth in both HIV epidemic and commercial sex. Multiple imputation using chained equation (MICE) was applied to handle missing values (1-10%) in the data-set. Regression analysis that focused on relationship between perceived peers' risk involvement and FSWs' risk-taking was performed on full data-sets generated by MICE. FSWs who perceived more peer alcohol use was significantly more likely to have sex under the influence of alcohol. Those who perceived more unprotected sex among peers had a higher likelihood to use condom inconsistently with both stable and casual partners. Perceiving more peers engaging in sex after using alcohol was positively associated with having sex with clients who were intoxicated and/or high on drugs, and with having sex under the influence of alcohol. Perceived peer promiscuity, defined as having sex with any types of clients at any price offered, was positively associated with inconsistent condom use with casual partners, but negatively associated with having sex under the influence of alcohol. These data suggest that the potential for intervention programs to address behavioral change among FSWs through modifying perceptions of peer involvement in sexual risk behaviors. Longitudinal studies are needed to confirm these findings and qualitative researches will be essential for the clarification of mechanisms behind associations found in the current study and for the actual design of effective norm-based interventions among FSWs.

Correlates of Lifetime History of Purchasing Sex Services by Men in Saint Petersburg and Leningrad Oblast, Russia.

PubMed

Girchenko, P; Ompad, D C; Kulchynska, R; Bikmukhametov, D; Dugin, S; Gensburg, L

2015-12-01

Commercial sex workers (CSWs) in the Russian Federation are at high risk of HIV infection and transmission as a result of unsafe sexual and injecting behaviors. Their clients might be at increased risk of acquiring HIV; however, little is known about the population of men purchasing sex services. This study aims to investigate factors associated with a history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation. Data were collected as part of a cross-sectional study offering free anonymous rapid HIV testing in Saint Petersburg and Leningrad Oblast in 2014; in total, 3565 men aged 18 years and older provided information about their behaviors associated with risk of acquiring HIV during face-to-face interviews. Prevalence of CSW use in our study was 23.9%. Multivariable analyses using log-binomial regression were stratified by self-reported HIV testing during the 12 months preceding the study interview. In both strata, older age, multiple sex partners, and a history of sex with an injection drug user (IDU) were associated with an elevated prevalence ratio (PR) for history of purchasing sex services, although the strength of the association differed by strata. Among men who reported recent HIV testing, condom use (PR = 1.22, 90% confidence interval (CI) 1.0, 1.48) was associated with a history of purchasing sex services, and among men who did not report recent HIV testing, having a consistent sex partner was associated with purchasing sex services (PR = 1.23, 90% CI 1.1, 1.37). The high prevalence of CSW service use and associations found in this study raise serious concerns about potential for sexual HIV transmission and should be investigated more closely.

The additive effects of depressive symptoms and polysubstance use on HIV risk among gay, bisexual, and other men who have sex with men.

PubMed

Card, Kiffer G; Lachowsky, Nathan J; Armstrong, Heather L; Cui, Zishan; Wang, Lu; Sereda, Paul; Jollimore, Jody; Patterson, Thomas L; Corneil, Trevor; Hogg, Robert S; Roth, Eric A; Moore, David M

2018-07-01

Among gay, bisexual, and other men who have sex with men (GBM), collinearity between polysubstance use and mental health concerns has obscured their combined effects on HIV risk with multivariable results often highlighting only one or the other. We used mediation and moderation analyses to examine the effects of polysubstance use and depressive symptoms on high-risk sex (i.e., condomless anal sex with serodiscordant/unknown status partner) in a sample of sexually-active GBM, aged ≥16 years, recruited in Metro Vancouver using respondent driven sampling. Hospital Anxiety and Depression Scale scores assessed mental health. Alcohol Use Disorder Identification Test scores assessed alcohol disorders. Poly-use of multiple drug types (e.g., stimulants, sedatives, opiates, hallucinogens) was assessed over the previous six months. Among 719 predominantly white (68.0%), gay-identified (80.7%) GBM, alcohol use was not associated with increased prevalence of high-risk sex. Controlling for demographic factors and partner number, an interaction between polysubstance use and depressive symptoms revealed that the combined effects were additively associated with increased odds for high-risk sex. Mediation models showed that polysubstance use partially mediated the relationship between depressive symptoms and high-risk sex. An interaction effect between polysubstance use (defined by using 3 or more substances in the past six months) and depressive symptoms (defined by HADS scores) revealed that the combination of these factors was associated with increased risk for high-risk sex - supporting a syndemic understanding of the production of HIV risk. Copyright © 2018 Elsevier Ltd. All rights reserved.

Does it really matter which drug you choose? An examination of the influence of type of drug on type of risky sexual behavior.

PubMed

Ritchwood, Tiarney D; DeCoster, Jamie; Metzger, Isha W; Bolland, John M; Danielson, Carla K

2016-09-01

This study investigates whether certain types of substances are differentially related to certain risky sexual behaviors (RSBs) within the same population and determines whether combination substance use (SU) has additive, redundant or antagonistic effects on RSBs. African-American youth aged 9-19 participated in a large, community-based survey assessing substance use and sexual behaviors. Multilevel modeling was used to predict the differential influence of alcohol, marijuana, and cocaine use on condom use measured in the past 90days and at last intercourse, sex while drunk/high, and number of sexual partners. Tests of the within-participant relations showed that participants increasing their SU over time concurrently increased their RSBs, establishing a strong link between the two behaviors (alcohol: condom β=-0.045, sex while drunk/high β=0.138, sex partners β=0.102; marijuana: condom β=-0.081, sex while drunk/high β=0.255, sex partners β=0.166; cocaine: condom β=-0.091, sex while drunk/high β=0.103, sex partners β=0.031; all p's<0.01). Tests of the between-participant relations showed that, generally, youth reporting less SU across their teenage years were also more likely to report fewer RSBs over this period (alcohol: condom β=-0.128, sex while drunk/high β=0.120, sex partners β=0.169; marijuana: condom β=-0.170, sex while drunk/high β=0.638, sex partners β=0.357; cocaine: condom β=-0.353; all p's<0.05). Moreover, the combination of some substances has unique redundant or antagonistic effects on RSB. Such findings support the consideration of type of SU, and particular combinations of substances, on RSBs in intervention development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evolution of mating systems in coral reef gobies and constraints on mating system plasticity

NASA Astrophysics Data System (ADS)

Hernaman, V.; Munday, P. L.

2007-09-01

Social and mating systems can be influenced by the distribution, abundance, and economic defendability of breeding partners and essential resources. Polygyny is predicted where males can economically defend multiple females or essential resources used by females. In contrast, monogamy is predicted where neither sex can monopolise multiple partners, either directly or through resource control, but where one mate is economically defendable. The mating system and reproductive behaviour of five species of coral reef goby were investigated and contrasted with population density and individual mobility. The two most abundant species ( Asterropteryx semipunctatus and Istigobius goldmanni) were polygynous. In contrast, the less populous and more widely dispersed epibenthic species ( Amblygobius bynoensis, Amblygobius phalaena and Valenciennea muralis) were pair forming and monogamous. All five species had low mobility, mostly remaining within metres (3 epibenthic species) or centimetres (2 cryptobenthic species) of a permanent shelter site. Interspecific differences in the mating system may have been shaped by differences in population density and the ability of reproductive individuals to economically defend breeding partners/sites. However, in a test of mating system plasticity, males of the three monogamous species did not mate polygynously when given the opportunity to do so in experimental manipulations of density and sex ratio. Mate guarding and complex spawning characteristics, which have likely co-evolved with the monogamous mating system, could contribute to mating system inflexibility by making polygynous mating unprofitable for individuals of the pair forming species, even when presented with current-day ecological conditions that usually favour polygyny.

Sexual Lifestyle, Risk Factors and Socioeconomic Status of the STD Patients in Bangladesh.

PubMed

Nandi, A K; Hossain, K J; Islam, A S

2017-01-01

Sexually transmitted diseases (STDs) are increasing alarmingly with time among the young-adults in Bangladesh. The objective of the study was to investigate Sexual lifestyle, Risk Factors and Socioeconomic Status of the STD Patients. A total of 205 STD patients were selected following convenient method of sampling consistent with defined selection criteria from outpatient department of Skin and Venereal Disease of Mymensingh Medical College Hospital, Mymensingh. Period of data collection was from July 2014 to June 2015. The research instrument was an interviewer questionnaire and laboratory investigation reports. Results showed that the mean age of the respondents was 27±5.9 years of which 104(50.7%) unmarried and 95(46.3%) married. Level of education, 168(82.0%) of the STD patients were literate. Occupation of the STD patients, 201(98.0%) had specific occupation of which 74(36.1%) were businessmen, 48(23.4%) student, 24(11.7%) technical jobs, 20(9.8%) day labourer, 15(7.3%) household workers, 14(6.8%) service holders and 6(2.9%) were transport workers. Their average monthly income was Tk. 7892±6763. Majority of the STD patients 115((56.1%) expressed that they enjoyed extra-marital sex or illegal sex out of curiosity, 32(15.6%) habitual, 24(11.7%) to test sexual performance, 18(8.8%) inadequate response of the legal sex partners, 8(3.9%) hyper-sexuality and 8(3.9%) family disharmony. Most of the patients 200(97.6%) were heterosexual of which 165(80.5%) visited 1-10 sex partners, 18(8.8%) 11-20 sex partners and 22(10.7%) visited 21-100 sex partners in lifetime. In category of sex partners, 60(29.3%) were hotel-based sex partners, 111(54.1%) brothel-based, 20(9.8%) friends sex partners, 10(4.9%) street sex sellers and 4(2.0%) were residential sex partners respectively. Of them, 132(64.4%) did not use condom during sex, 65(31.7%) use it occasionally and only 8(3.9%) use condom regularly. Most of them 170((82.8%) had been suffering from gonococcal urethritis, 19(9.3%) non-gonococcal urethritis, 12(5.9%) genital herpes, and rest other specific infections. STDs were significantly (p<0.05) associated with category of sex partners and use of condom. Altering sexual lifestyle is still the only applicable way to stop this human catastrophe.

Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men.

PubMed

Tang, Weiming; Liu, Chuncheng; Cao, Bolin; Pan, Stephen W; Zhang, Ye; Ong, Jason; Fu, Hongyun; Ma, Baoli; Fu, Rong; Yang, Bin; Ma, Wei; Wei, Chongyi; Tucker, Joseph D

2018-02-22

HIV serostatus disclosure before sex can facilitate serosorting, condom use and potentially decrease the risk of HIV acquisition. However, few studies have evaluated HIV serostatus disclosure from partners before sex. We examined the rate and correlates of receiving HIV serostatus disclosure from regular and casual male partners before sex among an online sample of men who have sex with men (MSM) in China. An online cross-sectional study was conducted among MSM in eight Chinese cities in July 2016. Participants completed questions covering sociodemographic information, sexual behaviors, HIV testing (including HIV self-testing) history, self-reported HIV status, and post-test violence. In addition, participants were asked whether they received HIV serostatus disclosure from their most recent partners before sex. Overall, 2105 men completed the survey. Among them, 85.9% were never married, and 35.4% had high school or less education. A minority (20.6%, 346/1678; 17.8%, 287/1608) of men received HIV serostatus disclosure from their most recent regular and casual male partners, respectively. Multivariate analysis indicated that participants who ever self-tested for HIV were more likely to have received HIV status disclosure from regular [adjusted OR (aOR) = 1.92, 95% CI 1.50-2.44] and casual (aOR = 2.34, 95% CI 1.80-3.04) male partners compared to never self-tested participants. Compared to participants who had not received HIV status disclosure from regular partners, participants who received disclosure from regular male partners had higher likelihood in experiencing post-test violence (aOR = 5.18, 95% CI 1.53-17.58). Similar results were also found for receiving HIV serostatus disclosure from casual partners. This study showed that HIV serostatus disclosure from partners was uncommon among Chinese MSM. Interventions and further implementation research to facilitate safe disclosure are urgently needed for MSM.

Effect of Physical Violence on Sexually Transmitted Infections and Treatment Seeking Behaviour among Female Sex Workers in Thane District, Maharashtra, India

PubMed Central

Prakash, Ravi; Manthri, Suneedh; Tayyaba, Shaikh; Joy, Anna; Raj, Sunil Saksena; Singh, Devender; Agarwal, Ashok

2016-01-01

Background Violence against sex workers can heighten their vulnerability to HIV and other sexually transmitted infections (STIs). Evidence suggests the risk of acquiring STI/HIV infections among female sex workers (FSWs) who have experienced violence to be almost three-times higher than FSWs, who have not experienced violence. Moreover, an experience of physical and sexual violence makes it difficult for them to negotiate safer sex with their partners and often act as a barrier to utilization of prevention services. Methods This study utilizes data from 2785 FSWs aged 18 years and above who participated in a cross-sectional behavioural study conducted during 2013–14 in Thane district, Maharashtra. A probability-based two-stage cluster sampling method was used for data collection. This study assesses the effect of physical violence on self-reported STI symptoms (any STI and multiple STIs) and treatment seeking for the last STI symptom using propensity score matching method. Results About 18% of sampled FSWs reported physical violence at the time of the survey. The likelihood of experiencing such violence was significantly higher among FSWs who solicited clients at public places, engaged in other economic activities apart from sex work, had savings, and reported high client volume per week. FSWs experiencing violence were also inconsistent condom users while engaging in sex with regular partners and clients. The average adjusted effect of violence clearly depicted an increase in the risk of any STI (11%, p<0.05) and multiple STIs (8%, p<0.10) and reduction in treatment seeking (10%, p<0.05). Conclusions This study demonstrates a significant effect of physical violence on reporting of any STI symptom and treatment seeking. Findings call for the immediate inclusion of strategies aimed to address violence related challenges in HIV prevention program currently being provided at Thane district. Such strategies would further help in enhancing the access to tailored STI prevention and care services among FSWs in the district. PMID:26933884

Porn video shows, local brew, and transactional sex: HIV risk among youth in Kisumu, Kenya

PubMed Central

2011-01-01

Background Kisumu has shown a rising HIV prevalence over the past sentinel surveillance surveys, and most new infections are occurring among youth. We conducted a qualitative study to explore risk situations that can explain the high HIV prevalence among youth in Kisumu town, Kenya Methods We conducted in-depth interviews with 150 adolescents aged 15 to 20, held 4 focus group discussions, and made 48 observations at places where youth spend their free time. Results Porn video shows and local brew dens were identified as popular events where unprotected multipartner, concurrent, coerced and transactional sex occurs between adolescents. Video halls - rooms with a TV and VCR - often show pornography at night for a very small fee, and minors are allowed. Forced sex, gang rape and multiple concurrent relationships characterised the sexual encounters of youth, frequently facilitated by the abuse of alcohol, which is available for minors at low cost in local brew dens. For many sexually active girls, their vulnerability to STI/HIV infection is enhanced due to financial inequality, gender-related power difference and cultural norms. The desire for love and sexual pleasure also contributed to their multiple concurrent partnerships. A substantial number of girls and young women engaged in transactional sex, often with much older working partners. These partners had a stronger socio-economic position than young women, enabling them to use money/gifts as leverage for sex. Condom use was irregular during all types of sexual encounters. Conclusions In Kisumu, local brew dens and porn video halls facilitate risky sexual encounters between youth. These places should be regulated and monitored by the government. Our study strongly points to female vulnerabilities and the role of men in perpetuating the local epidemic. Young men should be targeted in prevention activities, to change their attitudes related to power and control in relationships. Girls should be empowered how to negotiate safe sex, and their poverty should be addressed through income-generating activities. PMID:21824393

Porn video shows, local brew, and transactional sex: HIV risk among youth in Kisumu, Kenya.

PubMed

Njue, Carolyne; Voeten, Helene A C M; Remes, Pieter

2011-08-08

Kisumu has shown a rising HIV prevalence over the past sentinel surveillance surveys, and most new infections are occurring among youth. We conducted a qualitative study to explore risk situations that can explain the high HIV prevalence among youth in Kisumu town, Kenya We conducted in-depth interviews with 150 adolescents aged 15 to 20, held 4 focus group discussions, and made 48 observations at places where youth spend their free time. Porn video shows and local brew dens were identified as popular events where unprotected multipartner, concurrent, coerced and transactional sex occurs between adolescents. Video halls - rooms with a TV and VCR - often show pornography at night for a very small fee, and minors are allowed. Forced sex, gang rape and multiple concurrent relationships characterised the sexual encounters of youth, frequently facilitated by the abuse of alcohol, which is available for minors at low cost in local brew dens. For many sexually active girls, their vulnerability to STI/HIV infection is enhanced due to financial inequality, gender-related power difference and cultural norms. The desire for love and sexual pleasure also contributed to their multiple concurrent partnerships. A substantial number of girls and young women engaged in transactional sex, often with much older working partners. These partners had a stronger socio-economic position than young women, enabling them to use money/gifts as leverage for sex. Condom use was irregular during all types of sexual encounters. In Kisumu, local brew dens and porn video halls facilitate risky sexual encounters between youth. These places should be regulated and monitored by the government. Our study strongly points to female vulnerabilities and the role of men in perpetuating the local epidemic. Young men should be targeted in prevention activities, to change their attitudes related to power and control in relationships. Girls should be empowered how to negotiate safe sex, and their poverty should be addressed through income-generating activities.

Effect of Physical Violence on Sexually Transmitted Infections and Treatment Seeking Behaviour among Female Sex Workers in Thane District, Maharashtra, India.

PubMed

Prakash, Ravi; Manthri, Suneedh; Tayyaba, Shaikh; Joy, Anna; Raj, Sunil Saksena; Singh, Devender; Agarwal, Ashok

2016-01-01

Violence against sex workers can heighten their vulnerability to HIV and other sexually transmitted infections (STIs). Evidence suggests the risk of acquiring STI/HIV infections among female sex workers (FSWs) who have experienced violence to be almost three-times higher than FSWs, who have not experienced violence. Moreover, an experience of physical and sexual violence makes it difficult for them to negotiate safer sex with their partners and often act as a barrier to utilization of prevention services. This study utilizes data from 2785 FSWs aged 18 years and above who participated in a cross-sectional behavioural study conducted during 2013-14 in Thane district, Maharashtra. A probability-based two-stage cluster sampling method was used for data collection. This study assesses the effect of physical violence on self-reported STI symptoms (any STI and multiple STIs) and treatment seeking for the last STI symptom using propensity score matching method. About 18% of sampled FSWs reported physical violence at the time of the survey. The likelihood of experiencing such violence was significantly higher among FSWs who solicited clients at public places, engaged in other economic activities apart from sex work, had savings, and reported high client volume per week. FSWs experiencing violence were also inconsistent condom users while engaging in sex with regular partners and clients. The average adjusted effect of violence clearly depicted an increase in the risk of any STI (11%, p<0.05) and multiple STIs (8%, p<0.10) and reduction in treatment seeking (10%, p<0.05). This study demonstrates a significant effect of physical violence on reporting of any STI symptom and treatment seeking. Findings call for the immediate inclusion of strategies aimed to address violence related challenges in HIV prevention program currently being provided at Thane district. Such strategies would further help in enhancing the access to tailored STI prevention and care services among FSWs in the district.

RELATIONSHIP FORMATION AND STABILITY IN EMERGING ADULTHOOD: DO SEX RATIOS MATTER?

PubMed Central

Warner, Tara D.; Manning, Wendy D.; Giordano, Peggy C.; Longmore, Monica A.

2013-01-01

Research links sex ratios with the likelihood of marriage and divorce. However, whether sex ratios similarly influence precursors to marriage—transitions in and out of dating or cohabiting relationships—is unknown. Utilizing data from the Toledo Adolescent Relationships Study (TARS) and the 2000 census, this study assesses whether sex ratios influence the formation and stability of emerging adults’ romantic relationships. Findings show that relationship formation is unaffected by partner availability, yet the presence of partners increases women’s odds of cohabiting, decreases men’s odds of cohabiting, and increases number of dating partners and cheating among men. It appears that sex ratios influence not only transitions in and out of marriage, but also the process through which individuals search for and evaluate partners prior to marriage. PMID:24265510

Social context, diversity and risk among women who inject drugs in Vietnam: descriptive findings from a cross-sectional survey.

PubMed

Khuat, Oanh T H; Morrow, Martha; Nguyen, Trang N N; Armstrong, Gregory

2015-10-16

Women who inject drugs (WWID) are neglected globally in research and programming yet may be likelier than males to practise sexual and injecting risks and be infected with HIV and more stigmatised but seek fewer services. Little is known about characteristics, practices and nexus between drugs and sex work of WWID in Vietnam, where unsafe injecting has driven HIV transmission, and commercial sex and inconsistent condom use are prevalent. This was the first quantitative investigation of Vietnamese WWID recruited as injecting drug users. This article summarises descriptive findings. A cross-sectional survey was conducted among WWID in Hanoi (n = 203) and Ho Chi Minh City (HCMC) (n = 200) recruited using respondent-driven sampling. Characteristics varied within and between sites. Twenty-two percent in Hanoi and 47.5 % in HCMC had never sold sex. Almost all commenced with smoking heroin, some as children. Most injected frequently, usually alone, although 8 % (Hanoi) and 18 % (HCMC) shared equipment in the previous month. Some had sex--and sold it--as children; most had multiple partners. Condom use was high with clients but very low with intimate partners, often injecting drug users. HIV knowledge was uneven, and large minorities were not tested recently (or ever) for HIV. Nearly all perceived intense gender-related stigma, especially for drug use. This ground-breaking study challenges assumptions about characteristics and risks based on anecdotal evidence and studies among men. Most WWID were vulnerable to sexual HIV transmission from intimate partners. Interventions should incorporate broader sociocultural context to protect this highly stigmatised population.

Emotional intimate partner violence experienced by men in same-sex relationships

PubMed Central

Woodyatt, Cory R.; Stephenson, Rob

2016-01-01

Intimate partner violence research has focused almost exclusively on physical and sexual intimate partner violence in opposite-sex relationships, paying little attention to the intimate partner violence experienced by men in same-sex relationships. Emerging research focusing on intimate partner violence among male-male couples has focused largely on physical and sexual violence, with little consideration of the unique forms of emotional violence experienced by gay men. Ten focus group discussions with gay and bisexual men (n=64) were conducted to examine perceived typologies, antecedents, and experiences of emotional violence that occur between male partners. Participants described emotional violence as the most threatening form of intimate partner violence, driven largely by factors including power differentials, gender roles, and internalised homophobia. Results indicate that gay and bisexual men perceive emotional intimate partner violence to be commonplace. A better understanding of emotional violence within male-male relationships is vital to inform intimate partner violence prevention efforts and the more accurate measurement of intimate partner violence for gay men. PMID:27109769

Do Drinking Episodes Contribute to Sexual Aggression Perpetration in College Men?

PubMed

Testa, Maria; Parks, Kathleen A; Hoffman, Joseph H; Crane, Cory A; Leonard, Kenneth E; Shyhalla, Kathleen

2015-07-01

Survey and experimental analog studies suggest that alcohol consumption contributes to perpetration of sexual aggression. However, few studies have considered the temporal association between naturally occurring episodes of drinking and subsequent sexual aggression. This daily report study was designed to examine whether alcohol consumption increases the odds of aggressive sexual activity within the next 4 hours. First-year male college students (N = 427) completed daily online reports of drinking and sexual activity for up to 56 days. Multilevel modeling was used to determine whether drinking episodes increased the odds of the following outcomes occurring within 4 hours: (a) aggressive sex with a new partner, (b) non-aggressive sex with a new partner, (c) aggressive sex with a previous partner, and (d) non-aggressive sex with a previous partner. Drinking episodes increased the odds of both aggressive and non-aggressive sex with a new partner. In contrast, drinking episodes did not predict aggression involving previous partners and decreased the odds of non-aggressive sex with a previous partner. Contrary to hypotheses, individual difference variables associated with propensity toward sexual aggression (sexual misperception, antisocial behavior, hostility toward women) did not interact with daily alcohol. The complex pattern of results is more consistent with situational as opposed to pharmacological effects of alcohol on sexual aggression and suggests that prevention efforts focus on drinking contexts known to facilitate sexual activity.

Do Drinking Episodes Contribute to Sexual Aggression Perpetration in College Men?

PubMed Central

Testa, Maria; Parks, Kathleen A.; Hoffman, Joseph H.; Crane, Cory A.; Leonard, Kenneth E.; Shyhalla, Kathleen

2015-01-01

Objective: Survey and experimental analog studies suggest that alcohol consumption contributes to perpetration of sexual aggression. However, few studies have considered the temporal association between naturally occurring episodes of drinking and subsequent sexual aggression. This daily report study was designed to examine whether alcohol consumption increases the odds of aggressive sexual activity within the next 4 hours. Method: First-year male college students (N = 427) completed daily online reports of drinking and sexual activity for up to 56 days. Multilevel modeling was used to determine whether drinking episodes increased the odds of the following outcomes occurring within 4 hours: (a) aggressive sex with a new partner, (b) non-aggressive sex with a new partner, (c) aggressive sex with a previous partner, and (d) non-aggressive sex with a previous partner. Results: Drinking episodes increased the odds of both aggressive and non-aggressive sex with a new partner. In contrast, drinking episodes did not predict aggression involving previous partners and decreased the odds of non-aggressive sex with a previous partner. Contrary to hypotheses, individual difference variables associated with propensity toward sexual aggression (sexual misperception, antisocial behavior, hostility toward women) did not interact with daily alcohol. Conclusions: The complex pattern of results is more consistent with situational as opposed to pharmacological effects of alcohol on sexual aggression and suggests that prevention efforts focus on drinking contexts known to facilitate sexual activity. PMID:26098025

The impact of a national poverty reduction program on the characteristics of sex partners among Kenyan adolescents.

PubMed

Rosenberg, Molly; Pettifor, Audrey; Thirumurthy, Harsha; Halpern, Carolyn Tucker; Handa, Sudhanshu

2014-02-01

Cash transfer programs have the potential to prevent the spread of HIV, particularly among adolescents. One mechanism through which these programs may work is by influencing the characteristics of the people adolescents choose as sex partners. We examined the four-year impact of a Kenyan cash transfer program on partner age, partner enrollment in school, and transactional sex-based relationships among 684 adolescents. We found no significant impact of the program on partner characteristics overall, though estimates varied widely by gender, age, schooling, and economic status. Results highlight the importance of context in exploring the potential HIV preventive effects of cash transfers.

Prediction of HIV Sexual Risk Behaviors among Disadvantaged African American Adults using a Syndemic Conceptual Framework

PubMed Central

Nehl, Eric J.; Klein, Hugh; Sterk, Claire E.; Elifson, Kirk W.

2015-01-01

The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1,535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographics, and psychological functioning factors helps explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems. PMID:26188618

Outcome Expectancy and Sexual Compulsivity among Men who have Sex with Men Living with HIV

PubMed Central

Brown, Monique J.; Serovich, Julianne M.; Kimberly, Judy A.

2016-01-01

Sexual compulsivity is operationalized by engaging in repetitive sexual acts, having multiple sexual partners and/or the excessive use of pornography. Outcome expectancy refers to the beliefs about the consequences of engaging in a given behavior. Research examining the relationship between outcome expectancy and sexual compulsivity is limited. The aim of this study was to assess the association between outcome expectancy and sexual compulsivity among men who have sex with men (MSM) living with HIV. Data were obtained from 338 MSM. Simple and multiple linear regression models were used to assess the association between outcome expectancy and sexual compulsivity. After adjusting for age, race/ethnicity, income, education, and employment status, for every one point increase in outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices, there was, on average, an approximate one point decrease in sexual compulsivity score. Prevention and intervention programs geared towards reducing sexual compulsivity among MSM should focus on increasing outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices. PMID:26979416

Male sex workers who sell sex to men also engage in anal intercourse with women: evidence from Mombasa, Kenya.

PubMed

Mannava, Priya; Geibel, Scott; King'ola, Nzioki; Temmerman, Marleen; Luchters, Stanley

2013-01-01

To investigate self-report of heterosexual anal intercourse among male sex workers who sell sex to men, and to identify the socio-demographic characteristics associated with practice of the behavior. Two cross-sectional surveys of male sex workers who sell sex to men in Mombasa, Kenya. Male sex workers selling sex to men were invited to participate in surveys undertaken in 2006 and 2008. A structured questionnaire administered by trained interviewers was used to collect information on socio-demographic characteristics, sexual behaviors, HIV and STI knowledge, and health service usage. Data were analyzed through descriptive and inferential statistics. Bivariate logistic regression, after controlling for year of survey, was used to identify socio-demographic characteristics associated with heterosexual anal intercourse. From a sample of 867 male sex workers, 297 men had sex with a woman during the previous 30 days - of whom 45% did so with a female client and 86% with a non-paying female partner. Within these groups, 66% and 43% of male sex workers had anal intercourse with a female client and non-paying partner respectively. Factors associated with reporting recent heterosexual anal intercourse in bivariate logistic regression after controlling for year of survey participation were being Muslim, ever or currently married, living with wife only, living with a female partner only, living with more than one sexual partner, self-identifying as basha/king/bisexual, having one's own children, and lower education. We found unexpectedly high levels of self-reported anal sex with women by male sex workers, including selling sex to female clients as well as with their own partners. Further investigation among women in Mombasa is needed to understand heterosexual anal sex practices, and how HIV programming may respond.

Intimate relationships of Devadasi sex workers in South India: An exploration of risks of HIV/STI transmission.

PubMed

Ramanaik, Satyanarayana; Thompson, Laura H; du Plessis, Elsabé; Pelto, Pertti; Annigeri, Vinod; Doddamane, Mahesh; Bhattacharjee, Parinita; Shaw, Souradet Y; Deering, Kathleen; Khan, Shamshad; Halli, Shiva S; Lorway, Robert

2014-01-01

Global literature on female sex workers suggests that being in an intimate relationship is associated with barriers to practising safe sex behaviours. Condom use within intimate relationships is often seen as a sign of infidelity and fosters mistrust which could affect longevity, trust and intimacy within partnerships. Using qualitative data from Devadasi sex workers and their intimate male partners in Bagalkot District, Karnataka, India, we examined both partners' perspectives to understand the quality and dynamics of these relationships and the factors that influence condom use in intimate relationships. Our thematic analysis of individual interviews conducted in May 2011 with 20 couples suggests that many Devadasi sex workers and their intimate partners define their relationships as 'like marriage' which reduced their motivation to use condoms. Evidence from this study suggests that active participation in sex workers' collectives (sanghas) can increase condom use, education and family planning services, among other things, and could be helpful for both Devadasis and their intimate partners to better understand and accept safer sexual practices. Our work has direct implications for designing couple-based health interventions for traditional Devadasi sex workers and their intimate partners in India.

Understanding the Impact of Migration on HIV Risk: An Analysis of Mexican Migrants' Sexual Practices, Partners, and Contexts by Migration Phase.

PubMed

Zhang, Xiao; Rhoads, Natalie; Rangel, Maria Gudelia; Hovell, Melbourne F; Magis-Rodriguez, Carlos; Sipan, Carol L; Gonzalez-Fagoaga, J Eduardo; Martínez-Donate, Ana P

2017-03-01

HIV risk among Mexican migrants varies across migration phases (pre-departure, transit, destination, interception, and return), but there is limited knowledge about specific sexual behaviors, characteristics of sexual partners, and sexual contexts at different migration stages. To fill the gap, we used data from a cross-sectional population-based survey conducted in Tijuana, Mexico. Information on migration phase and last sexual encounter was collected from 1219 male migrants. Our findings suggest that compared to pre-departure migrants, repeat migrants returning from communities of origin were more likely to have sex with male partners, use substances before sex, and not use condoms; migrants in the transit phase in the Mexican border were more likely to have sex with casual partners and sex workers; and migrants in the interception phase were more likely to engage in anal sex and use substances before sex. Sexual behaviors, partners, and contexts vary significantly among migrants at different migration phases. Tailored HIV prevention programs targeting Mexican migrants need to be developed and implemented at all migration phases.

Understanding the Impact of Migration on HIV Risk: An Analysis of Mexican Migrants’ Sexual Practices, Partners, and Contexts by Migration Phase

PubMed Central

Zhang, Xiao; Rhoads, Natalie; Rangel, Maria Gudelia; Hovell, Melbourne F.; Magis-Rodriguez, Carlos; Sipan, Carol L.; Gonzalez-Fagoaga, J. Eduardo; Martínez-Donate, Ana P.

2018-01-01

HIV risk among Mexican migrants varies across migration phases (pre-departure, transit, destination, interception, and return), but there is limited knowledge about specific sexual behaviors, characteristics of sexual partners, and sexual contexts at different migration stages. To fill the gap, we used data from a cross-sectional population-based survey conducted in Tijuana, Mexico. Information on migration phase and last sexual encounter was collected from 1,219 male migrants. Our findings suggested that compared to pre-departure migrants, repeat migrants returning from communities of origin were more likely to have sex with male partners, use substances before sex, and not use condoms; migrants with a recent stay in the Mexican border were more likely to have sex with casual partners and sex workers; and migrants in the interception phase were more likely to engage in anal sex and use substances before sex. Sexual behaviors, partners, and contexts vary significantly among migrants at different migration phases. Tailored HIV prevention programs targeting Mexican migrants need to be developed and implemented at all migration phases. PMID:27888370

The dynamics of condom use with regular and casual partners: analysis of the 2006 National Sexual Behavior Survey of Thailand.

PubMed

Chamratrithirong, Aphichat; Kaiser, Paulina

2012-01-01

This study aims to determine factors associated with levels of condom use among heterosexual Thai males in sex with regular partners and in sex with casual partners. The data used in this study are from the national probability sample of the 2006 National Sexual Behavior Study, the third nationally representative cross-sectional survey in Thailand. A subtotal of 2,281 men were analyzed in the study, including young (18-24) and older (25-59) adults who were residents of rural areas of Thailand, non-Bangkok urban areas, and Bangkok. Two outcomes of interest for this analysis are reported condom use in the past 12 months by males in relationships with the most recent regular and casual partners who were not sex workers. Chi-square statistics, bivariate regressions and the proportional odds regression models are used in the analysis. Condom use for men with their regular partner is revealed to be positively related to education, knowledge of condom effectiveness, and pro-condom strategy, and negatively related to non-professional employment, status of registered marriage, and short relationship duration. Condom use with casual partner is positively determined by education, condom knowledge, non-professional occupation, short relationship duration, and lack of history of paid sex. The national survey emphasized the importance of risk perceptions and condom motivations variables in explaining condom use among men in Thailand. These factors include not only education and knowledge of condom effectiveness and pro-condom strategy but also types of partners and their relationship context and characteristics. Program intervention to promote condom use in Thailand in this new era of predominant casual sex rather than sex with sex workers has to take into account more dynamic partner-based strategies than in the past history of the epidemics in Thailand.

Sexual partnership characteristics of African American women who have sex with women; impact on sexually transmitted infection risk.

PubMed

Muzny, Christina A; Austin, Erika L; Harbison, Hanne S; Hook, Edward W

2014-10-01

African American women who have sex with women (WSW) are emerging as a population at risk for sexually transmitted infections (STIs). The objectives of this study were to explore partnership characteristics for a cohort of African American WSW and evaluate those characteristics as potential risk factors for STIs. In addition, we aimed to determine STI diagnoses and identify predictors of STI infection. Women who have sex with women presenting to a sexually transmitted disease clinic in Birmingham, AL, completed a questionnaire and were tested for bacterial vaginosis, trichomoniasis, chlamydia, gonorrhea, Mycoplasma genitalium, syphilis, HIV, and herpes simplex virus type 2. A total of 163 women were enrolled: 78 WSW and 85 women who have sex with women and men (WSWM) (based on report of past year sexual behavior). Both WSW and WSWM reported similar numbers of female partners over the lifetime, past year, and past month; however, WSWM reported significantly more lifetime male partners, thus having a higher overall number of sexual partners. Women who have sex with women and men were more likely to report new or casual partner(s), group sex, history of STIs, and sex with partner(s) known to have STIs. Overall, WSWM were more likely to have a current diagnosis of bacterial vaginosis, a current diagnosis of a curable STI, or a diagnosis of a noncurable STI (85% vs. 56%, P < 0.01). African American WSW are not a homogeneous group, and their sexual health may be directly or indirectly influenced by male partners. A better understanding of the distinctions and differences between African American WSW and WSWM will enable health care providers to improve the quality of care provided.

The moderating role of love in the relationship between partner type and condom use among women engaging in paid vaginal sex

PubMed Central

Roth, Alexis M.; Rosenberger, Joshua G.; Hensel, Devon J.; Wiehe, Sarah E.; Fortenberry, J. Dennis; Wagner, Karla D.

2017-01-01

Background Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behavior. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex. Methods We enrolled twenty-six women engaging in transactional sex in a prospective study and collected information about their paid/traded sexual experiences twice daily on cell phones. Results Over 4-weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex and on the weekend were associated with lower odds of condom use (all p=<.05). There was a significant interaction between being in love and using condoms during transactional sex (p<0.01). In paid/traded sexual events with romantic partners, the frequency of condom use was 71.4% (5/7) when women did not report love and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported. Conclusions Women were less likely to reported protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types. PMID:26615499

The protective value of parental sex education: a clinic-based exploratory study of adolescent females.

PubMed

Crosby, Richard A; Hanson, Amy; Rager, Kristin

2009-06-01

This exploratory study compared the impact of sex education provided by parents to female adolescents against the same education provided in formal settings to female adolescents. Females, 16-24 years old, attending an adolescent medicine clinic in an urban area of the South were recruited prior to examination. Each patient completed an anonymous self-administered questionnaire. Data from 110 respondents were analyzed to compare those indicating they had learned about each of four topics from parents to those not indicating learning about all four topics from a parent. The same process was repeated relative to learning about the four topics in formal educational settings. In controlled, multivariate, analyses, adolescents not communicating with parents on all four topics were nearly five times more likely to report having multiple sex partners in the past three months. Further, these adolescents were 3.5 times more likely to have low self-efficacy for condom negotiation, 2.7 times more likely to report ever using alcohol or drugs before sex, and about 70% less likely to have ever talked about HIV prevention with a partner before engaging in sex. Differences relative to learning about the four topics in formal settings were not found. Findings suggest that teen females (attending teen clinics) may experience a protective benefit based on communication with parents. This protective effect was not observed for education delivered in formal settings.

Divorce and infidelity are associated with skewed adult sex ratios in birds.

PubMed

Liker, András; Freckleton, Robert P; Székely, Tamás

2014-04-14

Adult sex ratio (ASR) is a fundamental concept in population demography, and recent theory suggests that ASR plays a central role in social behavior, mating systems, and parental care. Unbalanced ASRs are predicted to influence pair-bond and mating behavior, since the rarer sex in the population has more potential partners to mate with than the more common sex. Here we use phylogenetic comparative analyses to test whether ASR is related to three major aspects of mating behavior: divorce, social polygamy, and pair-bond infidelity. ASR is strongly correlated with long-term pair bonds, since the divorce rate is higher in species with a female-biased sex ratio, indicating that mate change by pair members and/or breaking of pair bonds by unmated individuals is more frequent when females outnumber males. Short-term pair bonds are also associated with unbalanced ASRs: males are more commonly polygamous when females outnumber males, and conversely, females are more polygamous when males outnumber females. Furthermore, infidelity increases with male-biased ASR in socially monogamous birds, suggesting that male coercion and/or female willingness to cheat the partner are facilitated by male-biased ASR. Our results provide the first comprehensive support for the proposition that ASR influences multiple aspects of pair-bond and mating behavior in wild populations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Eroding gains in safe sex behavior, HIV/AIDS knowledge, and risk perceptions among royal Thai Navy conscripts after 28 years of the AIDS epidemic in Thailand.

PubMed

Yuntadilok, Nuntawun; Timmuang, Rattana; Timsard, Somkid; Guadamuz, Thomas E; Heylen, Elsa; Mandel, Jeffrey; Ekstrand, Maria L

2014-01-01

Despite extensive early prevention efforts, recent surveys suggest that sexual risk taking may again be on the rise in Thailand. The present cross-sectional study surveyed 3,299 recruits in the Thai Navy in 2010, to examine their rates and correlates of consistent condom use. Most participants were aged 21-22 years, unmarried, and had a secondary education. Almost half were employed in labor/agriculture. Only 17 % of sexually experienced recruits were consistent condom users, and 53 % reported multiple sex partners in the past 3 months. In multiple logistic regression, residence in the Northeast (AOR 1.47), age (AOR 1.43), being single (AOR 2.13), non-MSM status (AOR 1.41), voluntary testing (AOR 1.24), and condom use at first sex (AOR 4.29) were significantly associated with consistent condom use. These findings suggest gaps in Thailand's condom campaign targeting both sexually experienced and inexperienced youth. Interventions targeting naval recruits may benefit from including sex education in the training curriculum, building drillmasters' capacities to facilitate sex education/counseling, and creating a supportive environment with better access to condoms.

Analysis of risk factors for persistent infection of asymptomatic women with high-risk human papilloma virus.

PubMed

Shi, Nianmin; Lu, Qiang; Zhang, Jiao; Li, Li; Zhang, Junnan; Zhang, Fanglei; Dong, Yanhong; Zhang, Xinyue; Zhang, Zheng; Gao, Wenhui

2017-06-03

This study aims to prevent persistentinfection, reduce the incidence of cervical cancer, and improve women's health by understanding the theoretical basis of the risk factors for continuous infection of asymptomatic women with high-risk human papilloma virus (HPV) strains via information collected, which includes the persistent infection rate and the most prevalent HPV strain types of high risk to asymptomatic women in the high-risk area of cervical cancer in Linfen, Shanxi Province. Based on the method of cluster sampling, locations were chosen from the industrial county and agricultural county of Linfen, Shanxi Province, namely the Xiangfen and Quwo counties. Use of the convenience sampling (CS) method enables the identification of women who have sex but without symptoms of abnormal cervix for analyzing risk factors of HPV-DNA detection and performing a retrospective questionnaire survey in these 2 counties. Firstly, cervical exfoliated cell samples were collected for thin-layer liquid-based cytology test (TCT), and simultaneously testing high-risk type HPV DNA, then samples with positive testing results were retested to identify the infected HPV types. The 6-month period of testing was done to derive the 6-month persistent infection rate. The retrospective survey included concepts addressed in the questionnaire: basic situation of the research objects, menstrual history, marital status, pregnancy history, sexual habits and other aspects. The questionnaire was divided into a case group and a comparison group, which are based on the high-risk HPV-DNA testing result to ascertain whether or not there is persistent infection. Statistical analysis employed Epidate3.1 software for date entry, SPSS17.0 for date statistical analysis. Select statistic charts, Chi-Square Analysis, single-factor analysis and multivariate Logistic regression analysis to analyze the protective factors and risk factors of high-risk HPV infection. Risk factors are predicted by using the classification tree. 3000 women participated in the study. The high-risk type HPV infection rate was 8.7%, the persistent infection rate was 7.5%. The persistent infection rates for the 2 age groups (ages 18-26 and 27-30) were 6.9% and 8.7%. The persistent infection rates of Xiangfen county were 7.4% and 7.4% respectively, and those of Quwo county were 7.8% and 11.6% respectively; there was no significant difference between each pair of groups. Single risk-factor analysis showed that first-time sex at age under 20, high school/technical secondary school education or above, multiple sexual partners, having more than 2 sexual partners in the past 6 months, oral sex, and colitis are the risk factors of high-risk type HPV infection. Multivariate analysis showed that the number of sexual partners, smoking and oral sex had an effect on HPV infection. The risk of HPV infection from smoking was 5.0-fold higher, and the risk of HPV infection from oral sex was 6.1-fold higher. Having more than 2 sexual partners increase the risk of HPV infection. By the predicated model analysis, the probability of HPV conveyed by oral sex was 14.8%; if the sexual companion number was zero or more than 2 without oral sex, the probability of HPV infection was 12.1%; if there was one sexual partner who smokes without oral sex, the probability of infection was 18.6%; if there was one sexual partner who does not smoke and without oral sex, the probability of infection was 3.6%. The persistent infection rate of asymptomatic women for high-risk type HPV is lower than those women in all ages. High-risk type HPV infection risk factors include the number of sexual partners, oral sex and smoking. Thus, young women may be able to reduce the risk of infection with high-risk type HPV by reducing the number of sexual partners, forming a correct sexual life habit, and avoiding smoking.

'He's not my pimp': toward an understanding of intimate male partner involvement in female sex work at the Mexico-US border.

PubMed

Mittal, María Luisa; Bazzi, Angela Robertson; Rangel, María Gudelia; Staines, Hugo; Yotebieng, Kelly; Strathdee, Steffanie A; Syvertsen, Jennifer L

2017-11-24

Female sex work is often perceived as women being controlled by men. We used surveys and qualitative interviews with female sex workers and their intimate partners in two Northern Mexico cities to examine couples' own perceptions of their relationships and male partners' involvement in sex work. Among 214 couples, the median age was 34 and relationship duration was approximately 3 years. Only 10 women in the survey reported having a pimp, and the majority reported sole control over sex work decisions. Qualitative analyses revealed that while most men avoided direct involvement in sex work, they offered advice that was largely driven by concern for their partner's well-being. Our discussion of these results considers the broader socio-political context surrounding these relationships and how changing gender roles, economic insecurity and stigma shape couples' everyday social interactions. Assumptions that all sex workers' relationships are coercive and commercial marginalises these couples while leaving their health concerns unaddressed.

Differences in relationship characteristics between HIV-negative male couples who used and did not use substances with sex

PubMed Central

Mitchell, Jason W.

2015-01-01

Although substance use is linked to HIV seroconversion, little is known about male couples substance use with sex. The present study sought to: describe whether neither, one, or both partners in the couple used a particular substance with sex within or outside their relationship; assess, by substance type used with sex, whether relationship factors differed between these groups of couples. Dyadic data from 83 behaviorally non-monogamous HIV-negative male couples were used with multinomial regression models. Those who used with sex within the relationship varied by substance type; outside the relationship, most only had one partner who used with sex. Couples with one or both partners who used substances with sex within or outside the relationship were more likely to have higher commitment to their relationship yet less likely to trust their main partner; mixed results were found regarding communication. Further research is warranted toward the need for preventive intervention development. PMID:26223222

Trends in Sexual Behavior Among Men Who have Sex with Men (MSM) in High-Income Countries, 1990-2013: A Systematic Review.

PubMed

Hess, Kristen L; Crepaz, Nicole; Rose, Charles; Purcell, David; Paz-Bailey, Gabriela

2017-10-01

HIV diagnoses among men who have sex with men (MSM) have been increasing in several high-income countries. A better understanding of the sexual behavior trends among MSM can be useful for informing HIV prevention. We conducted a systematic review of studies that examined behavioral trends (1990-2013) in any condomless anal sex, condomless anal sex with an HIV-discordant partner, and number of partners. Studies included come from the United States, Europe, and Australia. We found increasing trends in condomless anal sex and condomless anal sex with an HIV-discordant partner, and a decreasing trend in number of partners. The increase in condomless anal sex may help to explain the increase in HIV infections. More explanatory research is needed to provide insight into factors that contribute to these behavior trends. Continuous monitoring of HIV, risk behaviors, and use of prevention and treatment is needed to evaluate prevention efforts and monitor HIV transmission risk.

Limiting options: Sex ratios, incarceration rates and sexual risk behavior among people on probation and parole

PubMed Central

Green, Traci C.; Pouget, Enrique R.; Harrington, Magdalena; Taxman, Faye S.; Rhodes, Anne G.; O’Connell, Daniel; Martin, Steven S.; Prendergast, Michael; Friedmann, Peter D.

2012-01-01

Background To investigate how incarceration may affect risk of acquiring HIV and other sexually transmitted infections, we tested associations of ex-offenders’ sexual risk behavior with the male-female sex ratio and the male incarceration rate. Methods Longitudinal data from 1287 drug-involved persons on probation and parole as part of the Criminal Justice Drug Abuse Treatment Studies were matched by county of residence with population factors, and stratified by race/ethnicity and gender. Generalized estimating equations assessed associations of having unprotected sex with a partner who had HIV risk factors, and having more than 1 sex partner in the past month. Results Among non-Hispanic Black men and women, low sex ratios were associated with greater risk of having unprotected sex with a risky partner (Adjusted relative risk (ARR) = 1.76, 95% confidence interval (CI) = 1.29, 2.42; ARR = 2.48, 95% CI = 1.31, 4.73, respectively). Among non-Hispanic Black and non-Hispanic White women, low sex ratios were associated with having more than 1 sex partner (ARR = 2.00, 95% CI = 1.02, 3.94; ARR = 1.71, 95% CI = 1.06, 2.75, respectively). High incarceration rates were associated with greater risk of having a risky partner for all men (non-Hispanic Black: ARR= 2.14, 95% CI=1.39, 3.30; non-Hispanic White: ARR= 1.39, 95% CI: 1.05, 1.85; Hispanic: ARR = 3.99, 95% CI =1.55, 10.26) and having more than one partner among non-Hispanic White men (ARR= 1.92, 95% CI = 1.40, 2.64). Conclusions Low sex ratios and high incarceration rates may influence the number and risk characteristics of sex partners of ex-offenders. HIV-prevention policies and programs for ex-offenders could be improved by addressing structural barriers to safer sexual behavior. PMID:22592827

Contextual Factors and Sexual Risk Behaviors Among Young, Black Men.

PubMed

Jones, Jamal; Salazar, Laura F; Crosby, Richard

2017-05-01

Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial ( N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes ( p < .05). Parental monitoring was an effect modifier for the perceived peer norms and lifetime sexual partners association ( p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.

Adult romantic relationships as contexts of human development: a multimethod comparison of same-sex couples with opposite-sex dating, engaged, and married dyads.

PubMed

Roisman, Glenn I; Clausell, Eric; Holland, Ashley; Fortuna, Keren; Elieff, Chryle

2008-01-01

This article presents a multimethod, multi-informant comparison of community samples of committed gay male (n=30) and lesbian (n=30) couples with both committed (n=50 young engaged and n=40 older married) and noncommitted (n=109 exclusively dating) heterosexual pairs. Specifically, in this study the quality of same- and opposite-sex relationships was examined at multiple levels of analysis via self-reports and partner reports, laboratory observations, and measures of physiological reactivity during dyadic interactions. Additionally, individuals in same-sex, engaged, and marital relationships were compared with one another on adult attachment security as assessed through the coherence of participants' narratives about their childhood experiences. Results indicated that individuals in committed same-sex relationships were generally not distinguishable from their committed heterosexual counterparts, with one exception--lesbians were especially effective at working together harmoniously in laboratory observations. Copyright (c) 2008 APA.

Shall we marry? Legal marriage as a commitment event in same-sex relationships.

PubMed

Schecter, Ellen; Tracy, Allison J; Page, Konjit V; Luong, Gloria

2008-01-01

This study is a part of an exploratory study of 50 married and unmarried same-sex couples in Massachusetts conducted by the Wellesley Centers for Women following legalization of same-sex marriage in Massachusetts in 2004. This article examines whether and how legalization of same-sex marriage impacted same-sex partners' commitment to one another, presentation to others as a couple, and treatment as a couple by others. Roughly one-quarter of the couples studied chose not to mark their commitment with ceremonies of any kind, while nearly three-fourths of the couples had either commitment (non-legal) ceremonies, legal weddings, or both. While decisions to legally marry largely were based on gaining legal protections, unforeseen impacts on self and relationships with family, friends, and the larger society revealed multiple layers of meaning. Implications of the study for public policy and social change are discussed.

Sexual sensation seeking, transactional sex, and rural African American cocaine users

PubMed Central

Gullette, Donna; Booth, Brenda M.; Wright, Patricia B.; Montgomery, Brooke E. E.; Stewart, Katharine E.

2014-01-01

The purpose of this study was to explore correlates of sexual sensation seeking (SSS) in a sample of rural African American cocaine users. Respondent-driven sampling was used to recruit 251 participants from two impoverished rural counties in eastern Arkansas. Consistent with previous investigations, SSS scores were associated with being younger, being male, having more sexual partners, and having more unprotected sexual encounters in the previous 30 days. Multiple regression revealed SSS was correlated with number of oral sex acts, transactional sex (exchanging sex for food, shelter, drugs, money, or other commodities), and Addiction Severity Index (ASI) drug composite. SSS continues to demonstrate a strong association with sexual risk behaviors in diverse populations, including vulnerable groups like this community. Interventions to reduce unsafe sexual behaviors among high-risk groups, including drug users and individuals who engage in transactional sex, should incorporate approaches that include high sensation seekers' needs for novelty and variety. PMID:24070647

HIV-risk behaviours of American spring break vacationers: a case of situational disinhibition?

PubMed

Apostolopoulos, Y; Sönmez, S; Yu, C H

2002-11-01

Young adults are at high risk for acquiring STDs/HIV due primarily to multiple sex partners, unprotected sex, and substance use combined with sexual activity. Contranormative settings--such as the annual spring break vacation--provide ideal conditions for the potentially lethal interaction between alcohol, drugs, and sexual risk-taking. As a steadily growing form of youth travel and characterized by binge drinking, illicit drug use, and unsafe sexual practices, spring break has become a North American institution involving large numbers of travellers. In this study, the theory of interpersonal behaviour was used to explain college students' health-risk behaviours in the context of spring break and pre- and post-spring break surveys were used to examine casual sex and condom use behaviours. Multivariate analyses revealed peer influences, prior experiences with casual sex, alcohol consumption prior to sex, and impulsivity to be significant predictors of casual sex, while impulsivity and condom availability were significant predictors of students' use of condoms during casual sex.

78 FR 64873 - Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

.... Thus, the availability of same-sex marriage in a particular state was not relevant to our determination... same-sex domestic partners living in states that do not allow same-sex couples to marry to be covered... for the children of same- sex domestic partners is limited to those states in which same-sex couples...

Substance Use, Depression and Sociodemographic Determinants of HIV Sexual Risk Behavior in Outpatient Substance Abuse Treatment Patients.

PubMed

Tross, Susan; Feaster, Daniel J; Thorens, Gabriel; Duan, Rui; Gomez, Zoilyn; Pavlicova, Martina; Hu, Mei Chen; Kyle, Tiffany; Erickson, Sarah; Spector, Anya; Haynes, Louise; Metsch, Lisa R

2015-01-01

The NIDA Clinical Trials Network trial of rapid HIV testing/counseling in 1281 patients was a unique opportunity to examine relationships among substance use, depressive symptoms, and sex risk behavior. Past 6-month substance use; substance use severity (Drug Abuse Screening Test - 10); depressive symptoms (Quick Inventory of Depressive Symptomatology); and three types of sex risk behavior (unprotected sex occasions [USOs] with primary partners; USOs with nonprimary partners; and USOs while high/drunk) were assessed. Zero-inflated negative binomial analyses provided: probability and rate of sex risk behavior (in risk behavior subsample). Levels of sexual risk behavior were high, while variable across the three types of sex risk behaviors. Among the patients, 50.4% had engaged in USOs with primary partners, 42% in sex while drunk or high, and 23.8% in USOs with nonprimary partners. Similar factors were significantly associated with all three types of sex risk behaviors. For all types, problem drinking, cocaine use, and substance use severity had an exacerbating effect. Older age was associated with lower risk behavior; other relationship categories (eg, married, separated/divorced, cohabitating) were associated with greater risk behavior than was single status. Depressive symptoms were associated with decreased likelihood of USOs with a primary partner. Sexual risk behavior is common among individuals in outpatient substance abuse treatment. Results highlight problem drinking (eg, up to three-fold) and cocaine (eg, up to twice) in increasing sex risk behavior. They demonstrate the utility of distinguishing between partner types and presence/absence of alcohol/drugs during sex. Findings argue for the need to integrate sex risk reduction into drug treatment.

Alcohol Use Problems and Sexual Risk among Young Adult African American Mothers

PubMed Central

Swartzendruber, Andrea; Sales, Jessica M.; Rose, Eve S.; DiClemente, Ralph J.

2015-01-01

Studies have documented high levels of alcohol use and sexual risk among young mothers. We examined parenting satisfaction and self-efficacy in relation to alcohol use problems and sexual risk among 346 young African American women enrolled in an HIV prevention trial, 41% (n=141) of whom were mothers. Among mothers, greater parenting satisfaction was associated with a reduced likelihood of problematic alcohol use, having multiple sex partners, and testing positive for Trichomonas vaginalis. Relative to non-parenting women, mothers reported lower condom use. Compared to non-parenting women, mothers with the highest parenting satisfaction reported fewer alcohol use problems; mothers with the lowest parenting satisfaction reported lower condom use and were more likely to have multiple partners and test positive for T. vaginalis. Parenting self-efficacy was not associated with the outcomes examined. Future research investigating relationships between parenting satisfaction, alcohol use and sexual risk may be useful for improving multiple maternal health outcomes. PMID:26499334

Disclosure of newly diagnosed HIV infection and condom use at first sex after diagnosis: a study of young Black men who have sex with men.

PubMed

Crosby, Richard A; Mena, Leandro; Arnold, Trisha

2017-08-01

Background The first purpose of the present study was to determine whether young Black men who have sex with men (YBMSM) disclose their newly diagnosed HIV infection to a male or female partner, and to determine whether this disclosure is related to condom use; the second was to identify correlates of disclosing newly diagnosed HIV infection to male sex partners, including a measure of partner-related barriers to condom use. A sample of 125 HIV-infected YBMSM (age 15-29 years) provided cross-sectional data used for both study purposes. Recruitment occurred in a mid-size city in the southern US experiencing inordinately high prevalence and incidence rates of HIV among YBMSM. Significance was defined by an α level of <0.05. Eighty-eight YBMSM (70.4%) indicated disclosing their newly diagnosed HIV status to the first male partner they had sex with after being diagnosed. Of these, nine (9.1%) reported that condoms were not used during ensuing sex with that partner. However, of the men not disclosing, 27.0% reported not using condoms for ensuing sex (P=0.009). Similar findings were observed relative to sex with females (P=0.057). Regarding the second study purpose, in addition to a protective effect of advancing age, men scoring at or above the median on a measure of partner-related barriers to condom use were 2.4-fold more likely to not disclose compared with men scoring below the median (P=0.04). For YBMSM, a beneficial counselling objective relative to disclosing newly diagnosed HIV may be to help men resolve perceptions of partner-related barriers to condom use.

Prevalence and correlates of intimate partner violence in HIV-positive women engaged in transactional sex in Mombasa, Kenya

PubMed Central

Wilson, Kate S; Deya, Ruth; Masese, Linnet; Simoni, Jane M; Stoep, Ann Vander; Shafi, Juma; Jaoko, Walter; Hughes, James P; McClelland, R Scott

2016-01-01

We evaluated the prevalence and correlates of intimate partner violence in the past year by a regular male partner in HIV-positive female sex workers in Mombasa, Kenya. This cross-sectional study included HIV-positive women ≥ 18 years old who reported engagement in transactional sex at the time of enrolment in the parent cohort. We asked 13 questions adapted from the World Health Organization survey on violence against women about physical, sexual, or emotional violence in the past year by the current or most recent emotional partner (index partner). We used standardised instruments to assess socio-demographic and behavioural characteristics as possible correlates of intimate partner violence. Associations between intimate partner violence and these correlates were evaluated using univariate and multivariate logistic regression. Overall, 286/357 women (80.4%) had an index partner, and 52/357 (14.6%, 95% confidence interval 10.9%–18.2%) reported intimate partner violence by that partner in the past year. In multivariate analysis, women with severe alcohol problems (adjusted odds ratio 4.39, 1.16–16.61) and those experiencing controlling behaviours by the index partner (adjusted odds ratio 4.98, 2.31–10.74) were significantly more likely to report recent intimate partner violence. Recent intimate partner violence was common in HIV-positive female sex workers. Interventions targeting risk factors for intimate partner violence, including alcohol problems and partner controlling behaviours, could help to reduce recurrent violence and negative health outcomes in this key population. PMID:26464502

Men who have sex with men and women in Bangalore, South India, and potential impact on the HIV epidemic.

PubMed

Phillips, A E; Lowndes, C M; Boily, M C; Garnett, G P; Gurav, K; Ramesh, B M; Anthony, J; Moses, S; Alary, M

2010-06-01

The aim of this study was to quantify differences in patterns of sexual behaviour among men who have sex with men and women (MSMW) compared with men who have sex with men only (MSMO), and to examine the extent to which bisexual behaviour may act as a bridge for introducing HIV infection into the general population. A cross-sectional survey in Bangalore city in 2006, which sampled men seeking sex with men in public places and hammams (bath houses where transgender individuals sell sex to men). Among a sample of 357 men reporting same-sex behaviour; 41% also reported sex with a woman in the past year and 14% were currently married to a woman, only two of whom had informed their wives about having sex with men. Condom use was very inconsistent with all male partners, while 98% reported unprotected vaginal sex with their wives. MSMW reported lower rates of risky behaviour with other men than MSMO: fewer reported selling sex (17% vs 58%), or receptive anal sex with known (28% vs 70%) or unknown (30% vs 59%) non-commercial partners. Bisexual behaviour was common among men seeking sex with men sampled in this survey. Although MSMW reported lower rates of risky sexual behaviour with male partners than MSMO, inconsistent condom use with both male and female partners indicates a potential means of HIV transmission into the general population. HIV prevention programmes and services should reach bisexual men who potentially expose their male and female partners to HIV.

Sex Trade Behavior Among Heterosexually Active Homeless Men

PubMed Central

Tucker, Joan S.; Wenzel, Suzanne L.; Kennedy, David P.; Golinelli, Daniela; Ewing, Brett

2013-01-01

Sex trade behavior is fairly common among homeless adults and may contribute to higher rates of HIV/AIDS in this population. This study provides a detailed examination of the sex trade-related attitudes and behaviors of homeless men by: (1) determining the prevalence of sex trade-related behaviors, including sex with female sex workers (FSWs); (2) identifying risk factors for having sex with FSWs; and (3) comparing men's relationships with FSWs and non-FSWs in terms of relationship qualities and HIV-related risk behaviors, such as condom use. Structured interviews were conducted with a probability sample of 305 heterosexually active homeless men recruited from meal lines in Los Angeles. Recent sex with a FSW was reported by 26% of men, and more likely among those who were older, used crack cocaine, had more sex partners, believed that sometimes men just need to have sex no matter what, and were embedded in networks that were denser and where risky sex was more normative. Compared to non-FSW partners, men with FSW partners felt less emotionally close to them, were more likely to believe the partner had never been tested for HIV, and were more likely to have sex with them under the influence of drugs or alcohol; however, they were not more likely to talk about using condoms or to use condoms with FSWs. Whether the relationship was considered “serious” was a stronger correlate of condom use than whether the partner was a FSW. Implications of these findings for HIV prevention efforts among homeless adults are discussed. PMID:23720137

Community Cultural Norms, Stigma and Disclosure to Sexual Partners among Women Living with HIV in Thailand, Brazil and Zambia (HPTN 063)

PubMed Central

Ojikutu, Bisola O.; Pathak, Subash; Srithanaviboonchai, Kriengkrai; Limbada, Mohammed; Friedman, Ruth; Li, Shuying; Mimiaga, Matthew J.; Mayer, Kenneth H.; Safren, Steven A.

2016-01-01

Background Serostatus disclosure may facilitate decreased HIV transmission between serodiscordant partners by raising risk awareness and heightening the need for prevention. For women living with HIV (WLWH), the decision to disclose may be influenced by culturally determined, community-level stigma and norms. Understanding the impact of community HIV stigma and gender norms on disclosure among WLWH in different countries may inform intervention development. Methods HPTN063 was a longitudinal, observational study of sexually active HIV-infected individuals, including heterosexual women, in care in Zambia, Thailand and Brazil. At baseline, a questionnaire measuring community HIV stigma and gender norms, anticipated stigma, demographic, partner/relationship characteristics, and intimate partner violence was administered. Longitudinal HIV disclosure to sexual partners was determined via audio-computer assisted self-interview (ACASI) at the baseline and quarterly during the one year following up. Logistic regression was conducted to identify the predictors of disclosure. Results Almost half (45%) of women living with HIV acknowledged perceived community HIV stigma (the belief that in their community HIV infection among women is associated with sex work and multiple sexual partners). Many women (42.9%) also acknowledged perceived community gender norms (the belief that traditional gender norms such as submissiveness to husbands/male sexual partners is necessary and that social status is lost if one does not procreate). HIV disclosure to current sex partners was reported by 67% of women. In multivariate analysis, among all women, those who were older [OR 0.16, 95%CI(0.06,0.48)], reported symptoms of severe depression [OR 0.53, 95%CI(0.31, 0.90)], endorsed anticipated stigma [OR 0.30, 95%CI(0.18, 0.50)], and were unmarried [OR 0.43, 95%CI(0.26,0.71)] were less likely to disclose to current partners. In an analysis stratified by marital status and cohabitation, unmarried [OR 0.41, 95%CI(0.20,0.82)] and non-cohabiting women [OR 0.31, 95%CI(0.13,0.73)] who perceived community HIV stigma were less likely to disclose to their sex partners. Conclusions Perceived community level HIV stigma, along with individual level factors such as anticipated stigma, depressive symptoms, and older age, predict non-disclosure of HIV status to sexual partners among WLWH in diverse geographic settings. Interventions to promote disclosure among women in serodiscordant relationships should incorporate community-level interventions to reduce stigma and promote gender equality. PMID:27152618

Collateral consequences: implications of male incarceration rates, imbalanced sex ratios and partner availability for heterosexual Black women.

PubMed

Dauria, Emily F; Oakley, Lisa; Arriola, Kimberly Jacob; Elifson, Kirk; Wingood, Gina; Cooper, Hannah L F

2015-01-01

While studies have found correlations between rates of incarceration and sexually transmitted infections (STIs), few studies have explored the mechanisms linking these phenomena. This qualitative study examines how male incarceration rates and sex ratios influence perceived partner availability and sexual partnerships for heterosexual Black women. Semi-structured interviews were conducted with 33 Black women living in two US neighbourhoods, one with a high male incarceration rate and an imbalanced sex ratio (referred to as 'Allentown') and one with a low male incarceration rate and an equitable sex ratio (referred to as 'Blackrock'). Data were analysed using grounded theory. In Allentown, male incarceration reduced the number of available men, and participants largely viewed men available for partnerships as being of an undesirable quality. The number and desirability of men impacted on the nature of partnerships such that they were shorter, focused on sexual activity and may be with higher-risk sexual partners (e.g. transactional sex partners). In Blackrock, marriage rates contributed to the shortage of desirable male partners. By highlighting the role that the quantity and quality of male partners has on shaping sexual partnerships, this study advances current understandings of how incarceration and sex ratios shape HIV- and STI-related risk.

Talking the talk, walking the walk: social network norms, communication patterns, and condom use among the male partners of female sex workers in La Romana, Dominican Republic.

PubMed

Barrington, Clare; Latkin, Carl; Sweat, Michael D; Moreno, Luis; Ellen, Jonathan; Kerrigan, Deanna

2009-06-01

Male partners of female sex workers are rarely targeted by HIV prevention interventions in the commercial sex industry, despite recognition of their central role and power in condom use negotiation. Social networks offer a naturally existing social structure to increase male participation in preventing HIV. The purpose of this study was to explore the relationship between social network norms and condom use among male partners of female sex workers in La Romana, Dominican Republic. Male partners (N =318) were recruited from 36 sex establishments to participate in a personal network survey. Measures of social network norms included 1) perceived condom use by male social network members and 2) encouragement to use condoms from social network members. Other social network characteristics included composition, density, social support, and communication. The primary behavioral outcome was consistent condom use by male partners with their most recent female sex worker partner during the last 3 months. In general, men reported small, dense networks with high levels of communication about condoms and consistent condom use. Multivariate logistic regression revealed consistent condom use was significantly more likely among male partners who perceived that some or all of their male social network members used condoms consistently. Perceived condom use was, in turn, significantly associated with dense networks, expressing dislike for condoms, and encouragement to use condoms from social network members. Findings suggest that the tight social networks of male partners may help to explain the high level of condom use and could provide an entry point for HIV prevention efforts with men. Such efforts should tap into existing social dynamics and patterns of communication to promote pro-condom norms and reduce HIV-related vulnerability among men and their sexual partners.

78 FR 54633 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

.../Dissolution of a Same-Sex Domestic Partnership for DEERS Enrollment; DD x653 and DD x654; OMB Control Number 0704-TBD. Needs and Uses: Benefits shall be extended to same-sex domestic partners and, where applicable, children of same-sex domestic partners, once the DoD civilian and his/her same-sex domestic...

[Analysis of HIV/AIDS related risk behaviors and their impact factors among out-of-school adolescents in outflow areas].

PubMed

Sun, Xiao; Zhu, Guang-rong; Ji, Cheng-ye; Wang, Zhen-zhen

2012-06-18

To analyze HIV/AIDS related risk behaviors among unmarried outside school adolescents and the impact factors in outflow areas, in order to provide basis for related health education. Using cluster sampling method, we investigated a vocational training center for all 15- to 24-year-old unmarried outside school youths in one county. The structured questionnaire based on the Theory of Reasoned Action was anonymous, which filled envelopes on the spot. A total of 1 800 questionnaires were recovered, and 1 712 questionnaires were valid. Epidata 3.0 was used for establishing a database and SPSS 13.0 for statistical analysis. (1) The incidence of HIV/AIDS risk behaviors of the outside school adolescents was high: 18.0% of the respondents had sexual behavior, 27.3% had never used condom when sexed in the past three months, 31.0% had multiple sexual partners, and 9.7% had drug abuse experience; the rate of HIV/AIDS-related knowledge was only 25.1%; peer environment of respondents was poor. (2) The use of condoms was correlated with those who had higher score of AIDS knowledge, and who could talk about condoms in sexual intercourse; The multiple sexual partners' behavior was correlated with age, friends who were themselves multiple sexual partners, high score of the attitude, and the subjective norm; The commercial sex was correlated with the family address, high score of the HIV/AIDS-related knowledge, friends who had commercial sex, the subjective norm and the intention of behavior, The drug abuse behavior was correlated with age, high score of the HIV/AIDS-related knowledge, drug abuse among their friends, the subjective norm, and the intention of behavior. (3) Subjective norms and behavioral intentions could better predict the occurrence of HIV/AIDS risk behaviors. The outside school adolescents are at risk in lack of HIV/AIDS-related knowledge and coping skills of negative peer pressure, so providing the related health education before they go and work outside their home is the "critical period".

The characterisation of sexual behaviour in Chinese male university students who have sex with other men: A cross-sectional study

PubMed Central

Cong, Liming; Ono-Kihara, Masako; Xu, Guozhang; Ma, Qiaoqin; Pan, Xiaohong; Zhang, Dandan; Homma, Takayuki; Kihara, Masahiro

2008-01-01

Background The risks for Chinese male university students who have sex with other men (MSM) have not been compared with those for non-MSM students. This information is important for the development of targeted HIV prevention programmes for this population. Methods Sexually active MSM and non-MSM students were compared for demographic characteristics, sexual behaviour, and related psychosocial variables using bivariate analyses. The data were a subset drawn from a large-scale cross-sectional questionnaire survey of sexually active male students conducted at two universities in a large city in Zhejiang Province, China, in 2003. Results Of 1824 sexually active male students, 68 (3.7%) reported having had sex with a man at least once; 33.8% of these 68 men had also had female partners. Compared with non-MSM students, MSM students were 3–6.5 times more likely to have had sexual encounters with casual or commercial sex partners and were three times less likely to have protected sex in the past year or during their lifetime. They were three to five times more likely to have had multiple partners and 15 times more likely to have had a sexually transmitted disease (STD). In addition, the MSM students knew half as much about HIV and had less condom-decision than did non-MSM students and were two times more accepting of commercial sex. However, the MSM students were twice as aware of the risks for HIV infection. Conclusion MSM composed 3–4% of the male sexually active university student population studied and was found to be at greater risk than non-MSM students for STD/HIV infection. There is an urgent need for STD/HIV programmes in university health services that take into consideration the sexuality and psychosocial issues of MSM students. PMID:18647381

Premarital sexual behavior among male college students of Kathmandu, Nepal.

PubMed

Adhikari, Ramesh; Tamang, Jyotsna

2009-07-15

In Nepal, as in other Asian countries, the issue of sexuality still remains a taboo. Despite this fact, an increasing number of sexual activities is being reported by Nepalese students. This trend warrants serious and timely attention. Due to the sensitivity of the topic of premarital sexuality, youth receive inadequate education, guidance and services on reproductive health. The main objectives of this paper are to explore the sexual behavior especially focusing on prevalence of premarital sex among college men and to investigate the factors surrounding premarital sexual behavior. A cross-sectional survey of college students was conducted in April-May 2006. A self-administered questionnaire was completed by 573 male students. Association between premarital sex and the explanatory variables was assessed in bivariate analysis using Chi-square tests. The associations were further explored using multivariate logistic analysis. Despite the religious and cultural restrictions, about two-fifths of survey respondents (39%) reported that they have had premarital sex. The study has also shown that substantial proportions of students indulge in sexual activities as well as risky sexual behavior. Sex with commercial sex workers, multiple sex partners, and inconsistence use of condom with non-regular partner was common among the students. Less than two in five male students (57%) had used condom at the first sexual intercourse.The prevalence of premarital sex varied on different settings. Older students aged 20 and above were more likely to have premarital sex compared with younger students aged 15-19. Men who had liberal attitude towards male virginity at marriage were almost two times more likely to have engaged in premarital sex compared to their counterparts who have conservative attitude towards male virginity at marriage. Moreover, those students who believe in Hindu religion were more than two times (OR = 2.5) more likely to have premarital sex compared with those who follow other religions. Furthermore, those men who have close unmarried friends who have experienced premarital sexual intercourse were eight times (OR = 8.4) more likely to be sexually active compared to those who did not have such sexually active friends. Prevalence of premarital sexual intercourse and risky sexual behavior are not uncommon in Nepal. Young people are exposed to health hazards due to their sexual behavior; hence sex education should be provided. School or college based sexuality education could benefit even out-of-school youths, because their partners often are students.

Potential predictors of risk sexual behavior among private college students in Mekelle City, North Ethiopia.

PubMed

Gebresllasie, Fanna; Tsadik, Mache; Berhane, Eyoel

2017-01-01

Risk sexual practice among students from public universities/colleges is common in Ethiopia. However, little has been known about risk sexual behavior of students in private colleges where more students are potentially enrolled. Therefore, this study aimed to assess the magnitude of risky sexual behaviors and predictors among students of Private Colleges in Mekelle City. A mixed design of both quantitative and qualitative methods was used among 627 randomly selected students of private colleges from February to march 2013. Self administered questionnaire and focus group discussion was used to collect data. A thematic content analysis was used for the qualitative part. For the quantitative study, Univariate, Bivariate and multivariable analysis was made using SPSS version 16 statistical package and p value less than 0.05 was used as cut off point for a statistical significance. Among the total 590 respondents, 151 (29.1%) have ever had sex. Among the sexually active students, 30.5% reported having had multiple sexual partners and consistent condom use was nearly 39%. In multivariable logistic regression analysis, variables such as sex, age group, sex last twelve months and condom use last twelve months was found significantly associated with risky sexual behavior. The findings of qualitative and quantitative study showed consistency in presence of risk factors. Finding of this study showed sexual risk behaviors is high among private colleges such as multiple sexual partners and substance use. So that colleges should emphasis on promoting healthy sexual and reproductive health programs.

Female homosexual behavior and inter-sexual mate competition in Japanese macaques: possible implications for sexual selection theory.

PubMed

Vasey, Paul L; Leca, Jean-Baptiste; Gunst, Noëlle; VanderLaan, Doug P

2014-10-01

In this paper, we review research related to female homosexual behavior in Japanese macaques (Macaca fuscata), including our 20-year program of research on this species. Multiple lines of evidence indicate that female homosexual behavior in this species is sexually motivated. In contrast, many sociosexual hypotheses have been tested in relation to female homosexual behavior in Japanese macaques, but none have been supported. Female Japanese macaques sometimes engage in same-sex sexual activity even when motivated opposite-sex alternatives are available. Within this context of mate choice, males compete inter-sexually for opportunities to copulate with females above and beyond any intra-sexual competition that is required. Anecdotal evidence suggests that inter-sexual competition for female sexual partners has been observed in a number of other species, including humans. At present it is unclear whether inter-sexual competition for sexual partners influences patterns of reproduction. Our understanding of sexual selection and the evolution of mating systems may be improved by investigating whether inter-sexual mate competition influences the acquisition and maintenance of reproductive partners in those species in which such interactions occur. Copyright © 2014 Elsevier Ltd. All rights reserved.

Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.

PubMed

Park, Brian Y; Wilson, Gary; Berger, Jonathan; Christman, Matthew; Reina, Bryn; Bishop, Frank; Klam, Warren P; Doan, Andrew P

2016-08-05

Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.

Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru.

PubMed

Satcher, Milan F; Segura, Eddy R; Silva-Santisteban, Alfonso; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2017-08-01

Condomless anal intercourse among transgender women (TW) in Peru has been shown to vary by the type of partner involved (e.g. primary vs. casual vs. transactional sex partner), but no previous studies have explored variations in partner-level patterns of condom use according to type of anal intercourse. We evaluated the relationship between partnership characteristics and condom use during insertive (IAI) versus receptive anal intercourse (RAI) among TW with recent, non-female partners. Condomless IAI was more common with transactional and casual sex partners and by TW who self-reported HIV-uninfected serostatus (p < 0.05), alcohol use disorders, or substance use before sex. Condomless RAI was more common with primary partners and by TW who described their HIV serostatus as unknown (p < 0.05). Examining partner-level differences between condomless IAI and RAI reveals distinct patterns of HIV/STI risk among TW, suggesting a need for HIV prevention strategies tailored to the specific contexts of partners, practices, and networks.

Gender and Casual Sexual Activity From Adolescence to Emerging Adulthood: Social and Life Course Correlates

PubMed Central

Lyons, Heidi A.; Manning, Wendy D.; Longmore, Monica A.; Giordano, Peggy C.

2015-01-01

The prevalence of casual sexual activity among teens and emerging adults has led to much public attention. Yet limited research has investigated whether the number of casual sexual partners per year changes as heterosexual men and women transition from adolescence into emerging adulthood. We considered the influence of social context and life course factors on the number of casual sex partners. We examined four waves of interviews from the Toledo Adolescent Relationships Study (TARS) and used negative binomial growth curve models to investigate patterns of change in the number of casual sex partners (N = 1,196) ages 15 to 22. Men and women both reported increases in the number of casual sex partners over time and did not differ from each other in the rate of change over time. In all, 40% of respondents reported a recent casual sex partner at age 22. Number of prior dating relationships, education status, substance use, and perceptions of peer sexual behavior significantly influenced the number of casual sex partners. Emerging adults who did not complete high school, compared to those enrolled in four-year degree programs, reported significantly more partners. The findings contribute to research on intimate relationships and provide insights for programs targeting emerging adults. PMID:24992285

Transactional sex and economic exchange with partners among young South African men in the rural Eastern Cape: prevalence, predictors, and associations with gender-based violence

PubMed Central

Dunkle, Kristin L; Jewkes, Rachel; Nduna, Mzikazi; Jama, Nwabisa; Levin, Jonathan; Sikweyiya, Yandisa; Koss, Mary P

2009-01-01

We explored the prevalence and predictors of transactional sex with casual partners and main girlfriends among 1,288 men aged 15-26 from 70 villages in the rural Eastern Cape province of South Africa. Data were collected through face-to-face interviews with young men enrolling in the Stepping Stones HIV prevention trial. A total of 17.7% of participants reported giving material resources or money to casual sex partners and 6.6% received resources from a casual partner. Transactionally motivated relationships with main girlfriends were more balanced between giving (14.9%) and getting (14.3%). We constructed multivariable models to identify the predictors for giving and for getting material resources in casual and in main relationships. Each model resulted in remarkably similar predictors. All four types of exchange were associated with higher socio-economic status, more adverse childhood experiences, more lifetime sexual partners, and alcohol use. Men who were more resistant to peer pressure to have sex were less likely to report transactional sex with casual partners, and men who reported more equitable gender attitudes were less likely to report main partnerships underpinned by exchange. The most consistent predictor of all four types of transaction was the perpetration of intimate partner violence and rape against women other than a main partner. The strong and consistent association between perpetration of gender-based violence and both giving and getting material goods from female partners suggests that transactional sex in both main and casual relationships can be viewed within a broader continuum of men's exercise of gendered power and control. HIV prevention interventions need to explicitly address transactional sex in the context of ideas about masculinity which place a high emphasis on heterosexual success with, and control of, women. PMID:17560702

Individual and Partner-Level Factors Associated with Condom Non-Use Among African American STI Clinic Attendees in the Deep South: An Event-Level Analysis.

PubMed

Marshall, Brandon D L; Perez-Brumer, Amaya G; MacCarthy, Sarah; Mena, Leandro; Chan, Philip A; Towey, Caitlin; Barnett, Nancy; Parker, Sharon; Barnes, Arti; Brinkley-Rubinstein, Lauren; Rose, Jennifer S; Nunn, Amy S

2016-06-01

The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determinants that result in partner dependency and sexual risk behavior.

Heterosexual Partnerships and the Need for HIV Prevention and Testing for Men Who Have Sex With Men and Women in China: A Qualitative Study.

PubMed

Wang, Sijia; Song, Dandan; Huang, Wen; He, Huan; Wang, Min; Manning, David; Zaller, Nickolas; Zhang, Hongbo; Operario, Don

2015-04-01

Previous studies have reported that approximately 30% of men who have sex with men (MSM) in China have concurrent female partners. Men who have sex with men and women (MSMW) might "bridge" HIV transmission to their female sex partners. This study aimed to explore (a) motivations for why MSMW in China engage in relationships and sexual behaviors with female partners; (b) patterns of sexual behaviors and condom use between MSMW and their female partners; and (c) barriers to and strategies for encouraging MSMW and their female partners to undergo HIV testing. The authors conducted in-depth interviews with 30 MSMW in two urban cities in China, Guangzhou and Chengdu, and used thematic analysis methods to code and interpret the data. MSMW described family, social, and workplace pressures to have a female partner, and expressed futility about their ability to form stable same-sex relationships. Although participants reported concern about the risk of personally acquiring and transmitting HIV or other sexually transmitted infections (STIs) to their female partners, they described the challenges to using condoms with female partners. HIV-positive participants described how stigma restricted their ability to disclose their HIV status to female partners, and HIV-negative participants displayed less immediate concern about the need for female partners to undergo HIV testing. Participants described a range of possible strategies to encourage HIV testing among female partners. These findings highlight the urgent need for HIV risk reduction and testing interventions for Chinese MSMW in the context of heterosexual partnerships, and they also underscore the additional need for privacy and cultural sensitivity when designing future studies.

HETEROSEXUAL PARTNERSHIPS AND THE NEED FOR HIV PREVENTION AND TESTING FOR MEN WHO HAVE SEX WITH MEN AND WOMEN IN CHINA: A QUALITATIVE STUDY

PubMed Central

Wang, Sijia; Song, Dandan; Huang, Wen; He, Huan; Wang, Min; Manning, David; Zaller, Nickolas; Zhang, Hongbo; Operario, Don

2016-01-01

Previous studies have reported that approximately 30% of men who have sex with men (MSM) in China have concurrent female partners. Men who have sex with men and women (MSMW) might “bridge” HIV transmission to their female sex partners. This study aimed to explore (a) motivations for why MSMW in China engage in relationships and sexual behaviors with female partners; (b) patterns of sexual behaviors and condom use between MSMW and their female partners; and (c) barriers to and strategies for encouraging MSMW and their female partners to undergo HIV testing. The authors conducted in-depth interviews with 30 MSMW in two urban cities in China, Guangzhou and Chengdu, and used thematic analysis methods to code and interpret the data. MSMW described family, social, and workplace pressures to have a female partner, and expressed futility about their ability to form stable same-sex relationships. Although participants reported concern about the risk of personally acquiring and transmitting HIV or other sexually transmitted infections (STIs) to their female partners, they described the challenges to using condoms with female partners. HIV-positive participants described how stigma restricted their ability to disclose their HIV status to female partners, and HIV-negative participants displayed less immediate concern about the need for female partners to undergo HIV testing. Participants described a range of possible strategies to encourage HIV testing among female partners. These findings highlight the urgent need for HIV risk reduction and testing interventions for Chinese MSMW in the context of heterosexual partnerships, and they also under-score the additional need for privacy and cultural sensitivity when designing future studies. PMID:25915698

Patient-Reported Expedited Partner Therapy for Gonorrhea in the United States: Findings of the STD Surveillance Network 2010-2012.

PubMed

Stenger, Mark R; Kerani, Roxanne P; Bauer, Heidi M; Burghardt, Nicole; Anschuetz, Greta L; Klingler, Ellen; Schumacher, Christina M; Simon, Julie; Golden, Matthew

2015-09-01

Expedited partner therapy (EPT) has been shown to prevent reinfection in persons with gonorrhea and to plausibly reduce incidence. The Centers for Disease Control and Prevention recommends EPT as an option for treating sex partners of heterosexual patients. Few studies that examine how the reported use of this valuable intervention differs by patient and provider characteristics and by geography across multiple jurisdictions in the United States are currently available. Case and patient interview data were obtained for a random sample of reported cases from 7 geographically disparate US jurisdictions participating in the Sexually Transmitted Disease (STD) Surveillance Network. These data were weighted to be representative of all reported gonorrhea cases in the 7 study sites. Patient receipt of EPT was estimated, and multivariate models were constructed separately to examine factors associated with receipt of EPT for heterosexuals and for men who have sex with men. Overall, 5.4% of patients diagnosed and reported as having gonorrhea reported receiving EPT to treat their sex partners. Heterosexual patients were more likely to have received EPT than men who have sex with men at 6.6% and 2.6% of patients, respectively. Receipt of EPT did not vary significantly by race, Hispanic ethnicity, or age for either group, although significant variation was observed in different provider settings, with patients from family planning/reproductive health and STD clinic settings more likely to report receiving EPT. Jurisdiction variations were also observed with heterosexual patients in Washington State most likely (35.5%), and those in New York City, Connecticut, and Philadelphia least likely to report receiving EPT (<2%). With the exception of one jurisdiction in the STD Surveillance Network actively promoting EPT use, patient-reported receipt of the intervention remains suboptimal across the network. Additional efforts to promote EPT, especially for patients diagnosed in private provider and hospital settings, are needed to realize the full potential of this valuable gonorrhea control intervention.

Partner management for gonococcal and chlamydial infection: expansion of public health services to the private sector and expedited sex partner treatment through a partnership with commercial pharmacies.

PubMed

Golden, M R; Whittington, W L; Handsfield, H H; Malinski, C; Clark, A; Hughes, J P; Gorbach, P M; Holmes, K K

2001-11-01

Public health partner notification (PN) services currently affect only a small minority of patients with gonorrhea or chlamydial infection and new approaches to PN are needed. To expand PN for gonorrhea and chlamydial infection to private sector patients and to assess the feasibility of treating sex partners through commercial pharmacies. Selected patients were offered PN assistance and were randomly offered medication to deliver to their partners. Providers permitted the health department to contact 3613 (91%) of 3972 potentially eligible patients, and 1693 (67%) of 2531 successfully contacted patients consented to interview. Of these, 1095 (65%) reported at least one untreated partner. Most patients (90%) wished to notify partners themselves. Patients were more likely to have partners who had not yet been treated and to request PN assistance if they had more than one sex partner in the preceding 60 days or a partner they did not anticipate having sex with in the future. These two factors characterized 49% of all patients interviewed, 70% of those with a partner that was untreated 7 or more days after index patient treatment, and 83% of those accepting PN assistance. Among 458 randomly selected patients with untreated partners at time of study interview, 346 (76%) agreed to deliver treatment to a partner. Of these, most (266) chose to obtain medication for a partner at a pharmacy, of whom 223 (84%) successfully did so. A substantial minority of private sector patients have untreated partners more than 7 days after their own treatment; some need help with PN, but most will agree to deliver medication to partners themselves.

Developing a Video-Based eHealth Intervention for HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men: Study Protocol for a Randomized Controlled Trial.

PubMed

Hirshfield, Sabina; Downing, Martin J; Parsons, Jeffrey T; Grov, Christian; Gordon, Rachel J; Houang, Steven T; Scheinmann, Roberta; Sullivan, Patrick S; Yoon, Irene S; Anderson, Ian; Chiasson, Mary Ann

2016-06-17

Gay, bisexual, and other men who have sex with men (GBMSM) accounted for 67% of new US human immunodeficiency virus (HIV) infections in 2012; however, less than 40% of HIV-positive GBMSM are virally suppressed. Preventing transmission from virally unsuppressed men who have condomless anal sex (CAS) with serodiscordant partners is a public health imperative. New HIV infections in GBMSM are attributed in part to online access to sex partners; therefore, low-cost eHealth interventions are a unique opportunity to reach men where they meet partners. To describe the protocol of a randomized controlled trial evaluating whether video-based messaging delivered online may lead to reductions in serodiscordant CAS and increased HIV disclosure. Sex Positive!([+]) is a two-arm, phase III, video-based randomized controlled trial delivered online to GBMSM living with HIV. Participants in the intervention arm receive 10 video vignettes grounded in social learning and social cognitive theories that are designed to elicit critical thinking around issues of HIV transmission and disclosure. Participants in the attention control arm receive 10 video vignettes that focus on healthy living. All videos are optimized for mobile viewing. The study protocol includes five online assessments conducted over a 1-year period among 1500 US white, black, or Hispanic/Latino GBMSM living with HIV who report suboptimal antiretroviral therapy (ART) adherence or a detectable viral load in the past 12 months and recent CAS (past 6 months) with HIV-negative or unknown status male partners. Compared to the control arm, we hypothesize that men who watch the intervention videos will report at 12-month follow-up significantly fewer serodiscordant CAS partners, increased HIV disclosure, and improved social cognition (eg, condom use self-efficacy, perceived responsibility). Participant recruitment began in June 2015 and ended in December 2015. This protocol describes the underlying theoretical framework and measures, study design, recruitment challenges, and antifraud measures for an online, video-based randomized controlled trial that has the potential to decrease HIV transmission risk behaviors among HIV-positive GBMSM who struggle with ART adherence. The Sex Positive!([+]) intervention allows for participation through multiple Internet-based mediums and has the potential to reach and engage a broader population of HIV-positive GBMSM who are virally unsuppressed. ClinicalTrials.gov NCT02023580; https://clinicaltrials.gov/ct2/show/NCT02023580 (Archived by WebCite at http://www.webcitation.org/6iHzA8wRG).

Developing a Video-Based eHealth Intervention for HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men: Study Protocol for a Randomized Controlled Trial

PubMed Central

Downing Jr, Martin J; Parsons, Jeffrey T; Grov, Christian; Gordon, Rachel J; Houang, Steven T; Scheinmann, Roberta; Sullivan, Patrick S; Yoon, Irene S; Anderson, Ian; Chiasson, Mary Ann

2016-01-01

Background Gay, bisexual, and other men who have sex with men (GBMSM) accounted for 67% of new US human immunodeficiency virus (HIV) infections in 2012; however, less than 40% of HIV-positive GBMSM are virally suppressed. Preventing transmission from virally unsuppressed men who have condomless anal sex (CAS) with serodiscordant partners is a public health imperative. New HIV infections in GBMSM are attributed in part to online access to sex partners; therefore, low-cost eHealth interventions are a unique opportunity to reach men where they meet partners. Objective To describe the protocol of a randomized controlled trial evaluating whether video-based messaging delivered online may lead to reductions in serodiscordant CAS and increased HIV disclosure. Methods Sex Positive![+] is a two-arm, phase III, video-based randomized controlled trial delivered online to GBMSM living with HIV. Participants in the intervention arm receive 10 video vignettes grounded in social learning and social cognitive theories that are designed to elicit critical thinking around issues of HIV transmission and disclosure. Participants in the attention control arm receive 10 video vignettes that focus on healthy living. All videos are optimized for mobile viewing. The study protocol includes five online assessments conducted over a 1-year period among 1500 US white, black, or Hispanic/Latino GBMSM living with HIV who report suboptimal antiretroviral therapy (ART) adherence or a detectable viral load in the past 12 months and recent CAS (past 6 months) with HIV-negative or unknown status male partners. Compared to the control arm, we hypothesize that men who watch the intervention videos will report at 12-month follow-up significantly fewer serodiscordant CAS partners, increased HIV disclosure, and improved social cognition (eg, condom use self-efficacy, perceived responsibility). Results Participant recruitment began in June 2015 and ended in December 2015. Conclusions This protocol describes the underlying theoretical framework and measures, study design, recruitment challenges, and antifraud measures for an online, video-based randomized controlled trial that has the potential to decrease HIV transmission risk behaviors among HIV-positive GBMSM who struggle with ART adherence. The Sex Positive![+] intervention allows for participation through multiple Internet-based mediums and has the potential to reach and engage a broader population of HIV-positive GBMSM who are virally unsuppressed. ClinicalTrial ClinicalTrials.gov NCT02023580; https://clinicaltrials.gov/ct2/show/NCT02023580 (Archived by WebCite at http://www.webcitation.org/6iHzA8wRG) PMID:27315764

Indirect genetic effects and sexual conflicts: Partner genotype influences multiple morphological and behavioral reproductive traits in a flatworm.

PubMed

Marie-Orleach, Lucas; Vogt-Burri, Nadja; Mouginot, Pierick; Schlatter, Aline; Vizoso, Dita B; Bailey, Nathan W; Schärer, Lukas

2017-05-01

The expression of an individual's phenotypic traits can be influenced by genes expressed in its social partners. Theoretical models predict that such indirect genetic effects (IGEs) on reproductive traits should play an important role in determining the evolutionary outcome of sexual conflict. However, empirical tests of (i) whether reproductive IGEs exist, (ii) how they vary among genotypes, and (iii) whether they are uniform for different types of reproductive traits are largely lacking. We addressed this in a series of experiments in the simultaneously hermaphroditic flatworm Macrostomum lignano. We found strong evidence for IGEs on both morphological and behavioral reproductive traits. Partner genotype had a significant impact on the testis size of focal individuals-varying up to 2.4-fold-suggesting that IGEs could mediate sexual conflicts that target the male sex function. We also found that time to first copulation was affected by a genotype × genotype interaction between mating partners, and that partner genotype affected the propensity to copulate and perform the postcopulatory suck behavior, which may mediate conflicts over the fate of received ejaculate components. These findings provide clear empirical evidence for IGEs on multiple behavioral and morphological reproductive traits, which suggests that the evolutionary dynamics of these traits could be altered by genes contained in the social environment. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

Sexual risk-taking behaviors, gambling, and heavy drinking among U.S. College athletes.

PubMed

Huang, Jiun-Hau; Jacobs, Durand F; Derevensky, Jeffrey L

2010-06-01

The purpose of this study was to empirically examine the prevalence patterns of sexual risk-taking behaviors (i.e., unprotected sex and having multiple sex partners) in relation to levels of gambling problems and heavy episodic drinking (HED) status among U.S. college athletes. Data from a representative national sample of 20,739 U.S. college athletes were derived from the first National Collegiate Athletic Association national survey of problem gambling and health-risk behaviors. Among college athletes who were sexually active during the past year, males reported significantly higher prevalence of unprotected sex (10.2%) and multiple sex partners (14.6%) than females (7.9% and 9.3%, respectively). Using the DSM-IV Gambling Screen classification, as the level of gambling severity increased, the prevalence of sexual risk-taking behaviors also increased among female athletes, but decreased among male athletes. As regards the effect of heavy drinking, while both male and female HED athletes reported elevated sexual risk-taking, the effect of HED was twice as large in females as in males. It is important to note that the definitions of sexual risk behaviors in this study took into account committed sexual relationship status; hence, the results of this study need to be interpreted with the refined sexual risk measures in mind. Further investigations are warranted to help us better understand and explicate the interrelationships of sexual risk-taking behaviors, gambling, and heavy drinking among these college athletes. Findings from this exploratory study suggest new directions for future research and practice and also highlight the importance of a more inclusive multi-component approach to address these co-occurring youth risk behaviors.

Development and Evaluation of the Brief Sexual Openness Scale—A Construal Level Theory Based Approach

PubMed Central

Chen, Xinguang; Wang, Yan; Li, Fang; Gong, Jie; Yan, Yaqiong

2015-01-01

Obtaining reliable and valid data on sensitive questions represents a longstanding challenge for public health, particularly HIV research. To overcome the challenge, we assessed a construal level theory (CLT)-based novel method. The method was previously established and pilot-tested using the Brief Sexual Openness Scale (BSOS). This scale consists of five items assessing attitudes toward premarital sex, multiple sexual partners, homosexuality, extramarital sex, and commercial sex, all rated on a standard 5-point Likert scale. In addition to self-assessment, the participants were asked to assess rural residents, urban residents, and foreigners. The self-assessment plus the assessment of the three other groups were all used as subconstructs of one latent construct: sexual openness. The method was validated with data from 1,132 rural-to-urban migrants (mean age = 32.5, SD = 7.9; 49.6% female) recruited in China. Consistent with CLT, the Cronbach alpha of the BSOS as a conventional tool increased with social distance, from .81 for self-assessment to .97 for assessing foreigners. In addition to a satisfactory fit of the data to a one-factor model (CFI = .94, TLI = .93, RMSEA = .08), a common factor was separated from the four perspective factors (i.e., migrants’ self-perspective and their perspectives of rural residents, urban residents and foreigners) through a trifactor modeling analysis (CFI = .95, TLI = .94, RMSEA = .08). Relative to its conventional form, CTL-based BSOS was more reliable (alpha: .96 vs .81) and valid in predicting sexual desire, frequency of dating, age of first sex, multiple sexual partners and STD history. This novel technique can be used to assess sexual openness, and possibly other sensitive questions among Chinese domestic migrants. PMID:26308336

Local differences in human immunodeficiency virus prevalence: a comparison of social venue patrons, antenatal patients, and sexually transmitted infection patients in eastern kinshasa.

PubMed

Mwandagalirwa, Kashamuka; Jackson, Elizabeth F; McClamroch, Kristi; Bollinger, Robert; Ryder, Robert W; Weir, Sharon S

2009-07-01

This study compares the sexual behavior and HIV prevalence of men and women at social venues where people meet new sexual partners in Eastern Kinshasa with that of sexually transmitted infection (STI) treatment and antenatal clinic (ANC) patients in the same area. ANC patients, STI clinic patients, and social venue patrons were interviewed, asked to provide a blood sample on-site, and provided with information about obtaining test results. Every patron at identified social venues in the study area was invited to participate. One thousand one hundred sixteen pregnant women; 66 male and 229 female STI clinic patients; and 952 male and 247 female patrons of social venues were interviewed and tested for HIV. HIV prevalence differed by group: ANC patients (4%); female venue patrons (12%); female STI patients (16%); male venue patrons (2%); and male STI patients (23%). HIV prevalence among sex workers at social venues (29%) was higher than HIV prevalence among other female patrons with new or multiple partnerships in the past four weeks (19%) and higher than HIV prevalence among female patrons denying sex work (6%). However, the absolute number of infected women was higher among women reporting recent new or multiple partnerships than among the smaller group of sex workers (23 vs. 18). Two-thirds of the infected female STI patients (24/36) reported no more than one and no new sexual partner in the past year. Improving prevention programs in Kinshasa is essential. Prevention efforts should not neglect women at social venues who do not self-identify as sex workers but who have high rates of new sexual partnership formation.

The evolution of monogamy in response to partner scarcity

PubMed Central

Schacht, Ryan; Bell, Adrian V.

2016-01-01

The evolution of monogamy and paternal care in humans is often argued to have resulted from the needs of our expensive offspring. Recent research challenges this claim, however, contending that promiscuous male competitors and the risk of cuckoldry limit the scope for the evolution of male investment. So how did monogamy first evolve? Links between mating strategies and partner availability may offer resolution. While studies of sex roles commonly assume that optimal mating rates for males are higher, fitness payoffs to monogamy and the maintenance of a single partner can be greater when partners are rare. Thus, partner availability is increasingly recognized as a key variable structuring mating behavior. To apply these recent insights to human evolution, we model three male strategies – multiple mating, mate guarding and paternal care – in response to partner availability. Under assumed ancestral human conditions, we find that male mate guarding, rather than paternal care, drives the evolution of monogamy, as it secures a partner and ensures paternity certainty in the face of more promiscuous competitors. Accordingly, we argue that while paternal investment may be common across human societies, current patterns should not be confused with the reason pairing first evolved. PMID:27600189

The evolution of monogamy in response to partner scarcity.

PubMed

Schacht, Ryan; Bell, Adrian V

2016-09-07

The evolution of monogamy and paternal care in humans is often argued to have resulted from the needs of our expensive offspring. Recent research challenges this claim, however, contending that promiscuous male competitors and the risk of cuckoldry limit the scope for the evolution of male investment. So how did monogamy first evolve? Links between mating strategies and partner availability may offer resolution. While studies of sex roles commonly assume that optimal mating rates for males are higher, fitness payoffs to monogamy and the maintenance of a single partner can be greater when partners are rare. Thus, partner availability is increasingly recognized as a key variable structuring mating behavior. To apply these recent insights to human evolution, we model three male strategies - multiple mating, mate guarding and paternal care - in response to partner availability. Under assumed ancestral human conditions, we find that male mate guarding, rather than paternal care, drives the evolution of monogamy, as it secures a partner and ensures paternity certainty in the face of more promiscuous competitors. Accordingly, we argue that while paternal investment may be common across human societies, current patterns should not be confused with the reason pairing first evolved.

The challenge of promoting safe sex at sites where persons meet new sex partners in Jamaica: results of the Kingston PLACE randomized controlled trial.

PubMed

Figueroa, J Peter; Weir, Sharon S; Byfield, Lovette; Hall, Alison; Cummings, Stirling M; Suchindran, Chirayath M

2010-08-01

To determine whether a site-based Priorities for Local AIDS Control Efforts (PLACE) HIV prevention intervention in Kingston, Jamaica increased condom use among persons with new or multiple sex partners. A total of 147 sites where persons go to meet new sex partners were grouped into 50 geographic clusters and randomized to receive or not receive a multilevel PLACE prevention intervention. Baseline cross-sectional surveys of sites and patrons at sites were conducted in 2005 to determine the nature of social activities at sites to better plan the intervention and to ensure that the two arms of the trial were similar. The intervention was delivered by 50 trained outreach workers between January and June 2006. After the intervention two cross-sectional surveys were conducted to assess the extent of intervention implementation and to estimate the proportion of patrons at sites with recent new or concurrent partnerships and inconsistent condom use. Characteristics of sites and patrons were similar for most variables at intervention and control sites at both baseline and post-intervention. A total of 1535 patrons (723 men, 812 women) were interviewed at intervention sites and 1324 patrons (661 men, 663 women) at control sites 6-9 months after the intervention. There were no significant differences between intervention and control groups in the proportions of men (37.8% and 31.6%) and women (24.6% and 22.6%) who reported new or multiple relationships in the past year and inconsistent condom use. There was no significant difference in the proportion of men or women showing a condom at interview, having a HIV test in the past 12 months or being exposed to the intervention. An intent-to-treat analysis did not show any intervention effect. This was probably because of difficulty in implementing the intervention, the extent of patron mixing among sites, the intensity of national education campaigns, delay in conducting the post-intervention survey and evidence of other interventions at some control sites.

The prevalence of, and factors associated with, paying for sex among men resident in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

PubMed Central

Jones, Kyle G; Johnson, Anne M; Wellings, Kaye; Sonnenberg, Pam; Field, Nigel; Tanton, Clare; Erens, Bob; Clifton, Soazig; Datta, Jessica; Mitchell, Kirstin R; Prah, Phillip; Mercer, Catherine H

2015-01-01

Objectives Men who pay for sex (MPS) are considered a bridging population for sexually transmitted infections (STI). However, the extent, characteristics and role of MPS in transmission is poorly understood. We investigate these questions using data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Methods We performed complex survey analyses of data from 6293 men aged 16–74 years resident in Britain who completed Natsal-3, a probability sample survey undertaken during 2010–2012, using computer-assisted personal interviewing and computer-assisted self-interview. Results 11.0% (95% CI10.1% to 11.9%) of all men reported ever paying for sex. Among MPS, 18.4% (95% CI 18.2% to 18.7%) of their lifetime sexual partners were paid. 3.6% (95% CI 3.1% to 4.2%) of men had paid for sex in the past 5 years. Partners of MPS constitute 14.7% of all reported partners and MPS report 15.6% of all reported STI diagnoses in the past 5 years. Paying for sex in the past 5 years was strongly associated with reporting larger numbers of sexual partners (adjusted OR, AOR for 5+ partners, past 5 years, 31.50, 95% CI 18.69 to 53.09). After adjusting for partner numbers, paying for sex remained strongly associated with reporting new foreign partners outside the UK (AOR 7.96; 95% CI 4.97 to 12.73) and STI diagnosis/es (AOR 2.34; 95% CI 1.44 to 3.81), all in the past 5 years. Among men ever paying for sex, 62.6% (95% CI 58.3% to 66.8%) reported paying for sex outside the UK, most often in Europe and Asia. Conclusions MPS in Britain remain at greater risk of STI acquisition and onward transmission than men who do not. They report high numbers of partners, but the minority are paid partners. They are an important core group in STI transmission. PMID:25404706

Hookup App Use, Sexual Behavior, and Sexual Health Among Adolescent Men Who Have Sex With Men in the United States.

PubMed

Macapagal, Kathryn; Moskowitz, David A; Li, Dennis H; Carrión, Andrés; Bettin, Emily; Fisher, Celia B; Mustanski, Brian

2018-06-01

Geosocial networking applications (e.g., "hookup apps") are widely used among adult men who have sex with men (MSM). Little is known about adolescent MSM's (AMSM) use of these apps. Exploratory research is needed as AMSM's app use poses various ethical, legal, and sexual health concerns. This article examined AMSM's app use patterns and its associations with their sexual health and behavior. Two hundred sexually experienced AMSM in the United States (M age = 16.6, 49% racial/ethnic minority) completed online survey questions assessing their use of apps specific to MSM and not specific to MSM to meet partners for dating and sex, as well as their sexual behavior and HIV risk. Overall, 52.5% of participants (n = 105) reported using MSM-specific apps to meet partners for sex. Of these, most participants reported having oral (75.7%, n = 78) and anal sex (62.1%, n = 64) with those partners. Of those who reported having anal sex, 78.1% (n = 50) had sex with those partners more than once, and only 25.0% (n = 16) always used condoms with those partners. Relative to those who used only non-MSM-specific apps, MSM-specific app users reported more sex partners and condomless anal sex partners, greater perceived risk of HIV, more engagement in sexual health services, and greater odds of HIV testing. Use of MSM-specific apps was not uncommon among this sample of AMSM. Patterns of risk behavior and HIV testing were similar to samples of adult MSM app users. Further research should investigate AMSM's app-related sexual and HIV/sexually transmitted infection prevention decision-making to guide sexual health education efforts for AMSM. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Happiness and Sexual Minority Status

PubMed Central

Thomeer, Mieke Beth; Reczek, Corinne

2017-01-01

We used logistic regression on nationally representative data (General Social Survey, N = 10,668 and N = 6,680) to examine how sexual minority status related to happiness. We considered two central dimensions of sexual minority status—sexual behavior and sexual identity. We distinguished between same-sex, both-sex, and different-sex oriented participants. Because individuals transition between sexual behavior categories over the life course (e.g., from both-sex partners to only same-sex partners) and changes in sexual minority status have theoretical associations with well-being, we also tested the effects of transitions on happiness. Results showed that identifying as bisexual, gay, or lesbian, having both male and female partners since age 18, or transitioning to only different-sex partners was negatively related to happiness. Those with only same-sex partners since age 18 or in the past five years had similar levels of happiness as those with only different-sex partners since age 18. Additional tests showed that the majority of these happiness differences became non-significant when economic and social resources were included, indicating that the lower happiness was a product of structural and societal forces. Our findings clearly and robustly underscored the importance of taking a multi-faceted approach to understanding sexuality and well-being, demonstrating that not all sexual minority groups experience disadvantaged happiness. Our study calls for more attention to positive aspects of well-being such as happiness in examinations of sexual minorities and suggests that positive psychology and other happiness subfields should consider the role of sexual minority status in shaping happiness. PMID:27102605

Happiness and Sexual Minority Status.

PubMed

Thomeer, Mieke Beth; Reczek, Corinne

2016-10-01

We used logistic regression on nationally representative data (General Social Survey, N = 10,668 and N = 6680) to examine how sexual minority status related to happiness. We considered two central dimensions of sexual minority status-sexual behavior and sexual identity. We distinguished between same-sex, both-sex, and different-sex-oriented participants. Because individuals transition between sexual behavior categories over the life course (e.g., from both-sex partners to only same-sex partners) and changes in sexual minority status have theoretical associations with well-being, we also tested the associations of transitions with happiness. Results showed that identifying as bisexual, gay, or lesbian, having both male and female partners since age 18, or transitioning to only different-sex partners was negatively related to happiness. Those with only same-sex partners since age 18 or in the past 5 years had similar levels of happiness as those with only different-sex partners since age 18. Additional tests showed that the majority of these happiness differences became non-significant when economic and social resources were included, indicating that the lower happiness was a product of structural and societal forces. Our findings clearly and robustly underscored the importance of taking a multi-faceted approach to understanding sexuality and well-being, demonstrating that not all sexual minority groups experience disadvantaged happiness. Our study calls for more attention to positive aspects of well-being such as happiness in examinations of sexual minorities and suggests that positive psychology and other happiness subfields should consider the role of sexual minority status in shaping happiness.

Self-concept and adolescents' refusal of unprotected sex: a test of mediating mechanisms among African American girls.

PubMed

Salazar, Laura F; DiClemente, Ralph J; Wingood, Gina M; Crosby, Richard A; Harrington, Kathy; Davies, Susan; Hook, Edward W; Oh, M Kim

2004-09-01

During adolescence, girls form self-concepts that facilitate the transition to adulthood. This process may entail engaging in risky sexual behaviors resulting in STD infection and pregnancy. This study assessed the relation between self-concept and unwanted, unprotected sex refusal among 335 African American adolescent girls. The second aim was to determine whether attributes of partner communication about sex would act as a mediating mechanism on this hypothesized relationship. These assessments were made within the context of several theoretical models (social cognitive theory and theory of gender and power). Self-concept was composed of self-esteem, ethnic identity, and body image, whereas attributes of partner communication about sex was conceptualized as frequency of communication, fear of condom use negotiation, and self-efficacy of condom use negotiation. Structural equation modeling was used to analyze data. The results showed that self-concept was associated with partner communication attributes about sex, which in turn, was associated with frequency of unprotected sex refusal. The hypothesized mediating role of partner communication was also supported. STD-HIV preventive interventions for this population may be more effective if they target self-concept as opposed to only self-esteem, incorporate an Afrocentric approach, and focus on enhancing several attributes of partner communication about sex.

Multi-level risk factors associated with sex trading among women living with HIV in Kazakhstan: A neglected key population.

PubMed

Davis, Alissa; Jiwatram-Negrón, Tina; Primbetova, Sholpan; Terlikbayeva, Assel; Bilokon, Yelena; Chubukova, Lyubov; El-Bassel, Nabila

2017-12-01

Little is known about the prevalence and risk factors associated with sex trading among HIV-positive women. A total of 242 HIV-positive women were recruited in five regions in Kazakhstan. These women completed a survey containing items on socio-demographics, HIV stigma, intimate partner violence, and partner risk behaviors. Multivariate regression was used to examine associations between risk factors and sex trading after controlling for socio-demographic factors. Fifty-six (23.1%) women reported trading sex in the past 90 days. Women who reported recent sex trading were more likely than women who did not trade sex in the past 90 days to experience intimate partner violence (adjusted odds ratio [AOR]: 2.25; 95% confidence interval [CI]: 1.08-4.73), to have been homeless in the past 90 days (AOR: 4.12; 95% CI: 1.19-14.29), and to know or suspect a male partner had a sexually transmitted infection (AOR: 2.20; 95% CI: 1.07-4.53), had sex with another partner (AOR: 4.53; 95% CI: 2.25-9.14), or injected drugs in the past year (AOR: 3.31; 95% CI: 1.64-6.65). These findings underscore the need for comprehensive HIV prevention and intervention programs that address the multi-level risk factors associated with sex trading for women infected with HIV.

Perception of partner sexual history: Effects on safe-sex intentions.

PubMed

Cornelius, Talea; Kershaw, Trace

2017-07-01

Sexual intercourse is a dyadic activity, and intentions to engage in safe sex vary across partners. Because pregnant and newly parenting adolescents and young adults are at high risk for sexually transmitted infections (STIs), it is important to understand sexual decision-making in this population. This cross-sectional study examined how participants' own risk behavior and their partners' risk behavior influence perceptions of partner risk, and the impact of risk perceptions on condom use intentions and monogamy intentions in 296 pregnant adolescent and young adult couples (MAgeFemale = 18.71 years; MAgeMale = 21.33 years). Participants' behavior and their partners' behavior both related to increased perceptions of partner risk. Male participants' perceptions were more strongly influenced by female partners' behavior than participants' own behavior. Perceiving a partner as having a history of more risk behaviors trended toward a negative relationship with condom use intentions and monogamy intentions. For females, more previous sex partners related negatively to condom use intentions and positively to monogamy intentions. Having a male partner with more previous sex partners related positively to condom use intentions and monogamy intentions. Perceptions of partner risk did not significantly relate to condom use intentions and monogamy intentions, however, trends suggest that risk perception could reflect similarity bias and ongoing risk engagement. Differences in partner perception by gender suggest that females may communicate more openly about risks. Interventions to reduce STI transmission in couples should work to interrupt trajectories of risky behavior and enhance risk communication. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Migrant Workers in Kazakhstan: Gender Differences in HIV Knowledge and Sexual Risk Behaviors.

PubMed

Zhussupov, Baurzhan; McNutt, Louise-Anne; Gilbert, Louisa; Terlikbayeva, Assel; El-Bassel, Nabila

2015-07-01

This study compares sexual risk behaviors among male and female migrant market vendors in Almaty, Kazakhstan. From the Barakholka Market, 209 male and 213 female market vendors were randomly recruited. Self-reported data were collected through standardized face-to-face interviews. Dry blood spot was used as specimen for syphilis testing. Propensity score stratification was used to estimate adjusted prevalence or rate ratios by gender. Compared to male migrant workers, females had lower HIV knowledge and were less likely to have multiple sexual partners. There was no evidence of a gender difference for prevalence of syphilis, condom use with unsteady partners, and safe sex communication between couples. Associations between mobility patterns and engagement in multiple sexual partnerships were stronger among women than men. Efforts should be made to mitigate the gender differential in HIV knowledge among migrants, especially women. Such efforts need to be implemented in both home and host countries.

Seeing the Partner: A Video Recall Study of Emotional Behavior in Same- and Mixed-Sex Late Adolescent Romantic Couples

ERIC Educational Resources Information Center

Darling, Nancy; Clarke, Sara A.

2009-01-01

Fifty-three college-aged same- and mixed-sex romantic couples (83% White, 63% female, mean age, 20.8) engaged in a video recall task in which they rated their own and their partners' behaviors and emotions. Females reported feeling more connected to partners and reported fewer negative behaviors than males. Females with male partners reported the…

Gender Role Conflict, Interest in Casual Sex, and Relationship Satisfaction Among Gay Men

PubMed Central

Sanchez, Fráncisco J.; Bocklandt, Sven; Vilain, Eric

2010-01-01

This study compared single (n = 129) and partnered gay men (n = 114) to determine if they differed in their concerns over traditional masculine roles and interest in casual sex, and to measure the relationship between concerns over masculine roles and interest in casual sex. Additionally, a regression model to predict relationship satisfaction was tested. Participants were recruited at two Southern California Gay Pride festivals. Group comparisons showed single men were more restrictive in their affectionate behavior with other men (effect-size r = .14) and were more interested in casual sex than partnered men (effect-size r = .13); and partnered men were more concerned with being successful, powerful, and competitive than single men (effect-size r = .20). Different masculine roles were predictive of interest in casual sex among the two groups of men. Finally, a hierarchical regression analysis found that interest in casual sex and the length of one’s current relationship served as unique predictors of relationship satisfaction among the partnered gay men (Cohen’s f2 = .52). PMID:20721305

Differences in Gay Male Couples' Use of Drugs and Alcohol With Sex by Relationship HIV Status.

PubMed

Mitchell, Jason W

2016-07-01

Prior studies with men who have sex with men have documented a strong association between substance use with sex and risk for acquisition of HIV. However, few studies have been conducted about gay male couples' use of substances with sex, despite the fact that between one third and two thirds of men who have sex with men acquire HIV from their relationship partners. The present study sought to (1) describe whether one or both partners in the male couple uses substances with sex-by substance type-within and/or outside of their relationship, and (2) assess whether differences exist in those who use substances with sex within and outside the relationship by the couples' HIV status. Dyadic data for this analysis were collected in the United States from a nation-wide cross-sectional Internet study about male couples' relationships and behaviors. Couple-level descriptive and comparative analyses were employed with 361 male couples. Except for alcohol, most couples did not use substances with sex. Of those who did, rates of who used it with sex and substance type within the relationship varied; most couples only had one partner who used substances with sex outside the relationship. Significantly higher proportions of concordantly HIV-negative and HIV-positive couples had both partners who used substances (all types) with sex within their relationship over discordant couples. Most couples had one partner who used outside the relationship; only marijuana and erectile dysfunction medication use with sex significantly differed by couples' HIV status. Findings indicate the need to conduct additional research for prevention development. © The Author(s) 2014.

In Peru, reporting male sex partners imparts significant risk of incident HIV/sexually transmitted infection: all men Engaging in same-sex behavior need prevention services.

PubMed

Konda, Kelika A; Lescano, Andres G; Celentano, David D; Hall, Eric; Montano, Silvia M; Kochel, Tadeusz J; Coates, Thomas J; Cáceres, Carlos F

2013-07-01

Detailed information on the sexual behavior of bisexual, non-gay-identified men and the relationship between same-sex behavior and HIV/sexually transmitted infection (STI) incidence is limited. This study provides information on the sexual behavior with male partners of non-gay-identified men in urban, coastal Peru and the relationship of this behavior with HIV/STI incidence. We analyzed data from 2146 non-gay-identified men with a baseline and then 2 years of annual follow-up, including detailed information on sexual behavior with up to 5 sex partners, to determine the characteristics associated with bisexual behavior. Discrete time proportional hazards models were used to determine the effect of self-reported sex with men on subsequent HIV/STI incidence. Over the 3 study visits, sex with a man was reported by 18.9% of men, 90% of whom also reported sex with a female partner. At baseline, reported bisexual behavior was associated with other sexual risk behaviors such as exchanging sex for money and increased risk of HIV, herpes simplex virus type 2, and gonorrhea. The number of study visits in which recent sex with men was reported was positively correlated with risk of other sexual risk behaviors and incident HIV, herpes simplex virus type 2, and gonorrhea. Recent sex with a man was associated with increased HIV/STI incidence (hazard ratio, 1.79; confidence interval, 1.19-2.70), after adjusting for sociodemographics and other sexual risk behaviors. Given the prevalence of recent sex with men and the relationship of this behavior with HIV/STI incidence, interventions with non-gay-identified men who have sex with men and their partners are warranted.

Excessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students

PubMed Central

Agius, Paul; Taft, Angela; Hemphill, Sheryl; Toumbourou, John; McMorris, Barbara

2015-01-01

Objective Estimate the prevalence of sexual behaviour and alcohol use and examine the association between excessive alcohol use and risky sexual behaviour in late secondary students in Victoria, Australia. Method The sample of Year 11 students from government and independent schools participating in the 2008 International Youth Development Study (n=450) was representative of the Victorian school population. Logistic regression analyses examined the associations between sexual behaviour, binge and compulsive drinking, adjusting for socio-demographic, school and family factors. Results Under half (44%) the students had experienced sex in the past year, half (50%) had engaged in binge drinking in the past two weeks and 26% reported compulsive drinking in the past year. Of those who reported sex in the past year (n=197), 34% had sex without a condom at the last sexual encounter and 28% later regretted sex due to alcohol. The likelihood of experiencing sex was increased by binge (OR=2.44, 95%CI 1.44–4.12) and compulsive drinking (OR=2.15, 95%CI 1.29–3.60). For those sexually active, binge drinking increased the risk of having three or more sexual partners (OR=3.37, 95%CI 1.11–10.26) and compulsive drinking increased the likelihood of regretted sex due to alcohol (OR=4.43, 95%CI 2.10–9.31). Excessive drinking was not associated with condom non-use. Conclusion and implications Risky sex – multiple sexual partners and regretted sex due to alcohol – and excessive drinking are highly prevalent and co-associated among Victorian late secondary students. PMID:23379810

Do Love Styles Predict Lifetime Number of Sex Partners?

ERIC Educational Resources Information Center

Hans, Jason D.

2008-01-01

The relationship between love styles and lifetime number of sexual partners was explored using survey data from 507 college students. Love styles significantly (p less than 0.001) contributed to the prediction of number of lifetime sex partners after controlling for demographic characteristics and attitudes toward sexually transmitted infections.…

Factors associated with partner notification of STIs in men who have sex with men on PrEP in France: a cross-sectional substudy of the ANRS-IPERGAY trial.

PubMed

Suzan-Monti, Marie; Cotte, Laurent; Fressard, Lisa; Cua, Eric; Capitant, Catherine; Meyer, Laurence; Pialoux, Gilles; Molina, Jean-Michel; Spire, Bruno

2018-01-29

Partner notification (PN) is a useful public health approach to enhance targeted testing of people at high risk of HIV and other STIs, and subsequent linkage to care for those diagnosed. In France, no specific PN guidelines exist and information about current practices is scarce. We used the ANRS-IPERGAY PrEP trial to investigate PN in HIV-negative men who have sex with men (MSM) reporting a bacterial STI. This substudy included 275 participants who completed a specific online PN questionnaire during the open-label extension study of the ANRS-Intervention Préventive de l'Exposition aux Risques avec et pour les Gays (IPERGAY) trial. Variables used as proxies of at-risk practices were defined using data collected at the previous follow-up visit about participants' most recent sexual encounter and preventive behaviours. χ 2 or Fisher's exact test helped select variables eligible for multiple logistic models. Of the 275 participants, 250 reported at least one previous STI. Among the latter, 172 (68.8%) had informed their partner(s) of their most recent STI. Of these, 138 (80.2%) and 83 (48.3%) had notified their casual and main partners, respectively. Participants were less likely to notify their main partner when their most recent sexual encounter involved unsafe anal sex with a casual partner (adjusted OR (aOR) (95% CI) 0.18 (0.06 to 0.54), P=0.02). Older participants were less likely to inform casual partners (aOR (95% CI) 0.44 (0.21 to 0.94), P=0.03), while those practising chemsex during their most recent sexual encounter were more likely to inform their casual partners (aOR (95% CI) 2.56 (1.07 to 6.09), P=0.03). Unsafe sexual encounters with people other than main partners and street drugs use were two sociobehavioural factors identified, respectively, as a barrier to main PN and a motivator for casual PN, in a sample of high-risk MSM. These results provide an insight into current PN practices regarding STI in France and might inform future decisions about how to define feasible and acceptable PN programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample.

PubMed

Rojas, Patria; Huang, Hui; Li, Tan; Ravelo, Gira J; Sanchez, Mariana; Dawson, Christyl; Brook, Judith; Kanamori, Mariano; De La Rosa, Mario

2016-11-23

Few studies have examined the sociocultural determinants of risky sexual behavior trajectories among adult Latinas. To longitudinally examine the link between sociocultural determinants of risky sexual behaviors, we followed a sample of adult Latina mother-daughter dyads ( n = 267) across a 10-year span through four waves of data collection. The present study investigates how risky sexual behavior (operationalized as sex under the influence of alcohol or other drugs, sex without a condom, or multiple sex partners) is affected by: (a) socioeconomic conditions; (b) mental health; (c) medical health; (d) acculturation to U.S. culture; (e) interpersonal support; (f) relationship stress; (g) mother-daughter attachment; (h) intimate partner violence; (i) religious involvement; and (j) criminal justice involvement. Results indicate the following factors are negatively associated with risky sexual behavior: drug and alcohol use, treating a physical problem with prescription drugs, religious involvement, and mother-daughter attachment. The following factors are positively associated with risky sexual behavior: higher number of mental health symptoms, being U.S.-born, and criminal justice involvement. We discuss implications for the future development of culturally relevant interventions based on the study findings.

Women, drugs and HIV.

PubMed

Azim, Tasnim; Bontell, Irene; Strathdee, Steffanie A

2015-02-01

Women who use drugs, irrespective of whether these are injected or not, are faced with multiple issues which enhance their vulnerability to HIV. In this commentary, we explore the HIV risks and vulnerabilities of women who use drugs as well as the interventions that have been shown to reduce their susceptibility to HIV infection. Women who inject drugs are among the most vulnerable to HIV through both unsafe injections and unprotected sex. They are also among the most hidden affected populations, as they are more stigmatized than their male counterparts. Many sell sex to finance their own and their partner's drug habit and often their partner exerts a significant amount of control over their sex work, condom use and injection practices. Women who use drugs all over the world face many different barriers to HIV service access including police harassment, judgmental health personnel and a fear of losing their children. In order to enable these women to access life-saving services including needle-syringe and condom programs, opioid substitution therapy and HIV testing and treatment, it is essential to create a conducive environment and provide tailor-made services that are adapted to their specific needs. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Understanding the psychosocial aspects of HIV / AIDS prevention for northern Thai single adolescent migratory women workers.

PubMed

Cash, K; Anansuchatkul, B; Busayawong, W

1999-04-01

This study describes formative research about sex, sexuality, and sexual relationships of northern Thai single female migratory laborers. Methodologies included focus group discussions, observation, and in-depth individual interviews. Findings revealed that these women were sexually active, although the actual number of girls who were or had been sexually active could not be determined. It was also found that serial partners were much common than multiple partner relationships. And that these young women did not practice safe sex which can be considered as a potential social consequences of negotiating safe sex often outweigh health consequences. Furthermore, respondents reported that condoms were "men's business" and that there are irreconcilable social costs if a single woman talks about condoms or AIDS. From these findings, it is suggested that these young women and girls, regardless of their occupation or marital status or age, need HIV/AIDS education. Condoms need to be brought out of the disease spectrum and into the family planning and contraceptive spectrum. Educational interventions and material should address young people's emotional and relational needs including their desire to be modern and acceptable to peers.

Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample

PubMed Central

Rojas, Patria; Huang, Hui; Li, Tan; Ravelo, Gira J.; Sanchez, Mariana; Dawson, Christyl; Brook, Judith; Kanamori, Mariano; De La Rosa, Mario

2016-01-01

Few studies have examined the sociocultural determinants of risky sexual behavior trajectories among adult Latinas. To longitudinally examine the link between sociocultural determinants of risky sexual behaviors, we followed a sample of adult Latina mother-daughter dyads (n = 267) across a 10-year span through four waves of data collection. The present study investigates how risky sexual behavior (operationalized as sex under the influence of alcohol or other drugs, sex without a condom, or multiple sex partners) is affected by: (a) socioeconomic conditions; (b) mental health; (c) medical health; (d) acculturation to U.S. culture; (e) interpersonal support; (f) relationship stress; (g) mother-daughter attachment; (h) intimate partner violence; (i) religious involvement; and (j) criminal justice involvement. Results indicate the following factors are negatively associated with risky sexual behavior: drug and alcohol use, treating a physical problem with prescription drugs, religious involvement, and mother–daughter attachment. The following factors are positively associated with risky sexual behavior: higher number of mental health symptoms, being U.S.-born, and criminal justice involvement. We discuss implications for the future development of culturally relevant interventions based on the study findings. PMID:27886095

Associations Between Alcohol Use and Intimate Partner Violence Among Men Who Have Sex with Men.

PubMed

Davis, Alissa; Kaighobadi, Farnaz; Stephenson, Rob; Rael, Christine; Sandfort, Theodorus

2016-12-01

Intimate partner violence (IPV) research among men who have sex with men (MSM) has primarily focused on the prevalence of IPV victimization and perpetration. Although alcohol use is a known trigger of IPV in opposite sex relationships, less is known about alcohol use and IPV perpetration and victimization in same-sex couples. The aim of this study was to examine associations between alcohol use and different types of IPV victimization and perpetration among MSM. MSM in New York City were recruited at gay-friendly venues and events to participate in an online survey assessing sociodemographics, alcohol use, and victimization/perpetration of IPV with both regular and casual sex partners. Logistic regression was used to examine associations between alcohol use and different types of IPV victimization and perpetration. Among 189 participants, 103 (54.5%) reported experiencing at least one incidence of IPV perpetrated by a regular partner and 92 (48.7%) reported having perpetrated IPV against a regular partner in the past 12 months. Higher levels of alcohol use were significantly associated with (1) physical/sexual and HIV-related IPV victimization by a regular partner, (2) physical/sexual, monitoring, and controlling IPV victimization by a casual partner, (3) physical/sexual, emotional, controlling, and HIV-related IPV perpetration against a regular partner, and (4) physical/sexual and emotional IPV perpetration against a casual partner. The association of high levels of alcohol use with different types of IPV perpetration and IPV victimization suggests a need for targeted services that address the co-occurring issues of alcohol use and IPV.

Associations Between Neighborhood Characteristics, Social Cohesion, and Perceived Sex Partner Risk and Non-Monogamy Among HIV-Seropositive and HIV-Seronegative Women in the Southern U.S.

PubMed

Haley, Danielle F; Wingood, Gina M; Kramer, Michael R; Haardörfer, Regine; Adimora, Adaora A; Rubtsova, Anna; Edmonds, Andrew; Goswami, Neela D; Ludema, Christina; Hickson, DeMarc A; Ramirez, Catalina; Ross, Zev; Bolivar, Hector; Cooper, Hannah L F

2018-07-01

Neighborhood social and physical factors shape sexual network characteristics in HIV-seronegative adults in the U.S. This multilevel analysis evaluated whether these relationships also exist in a predominantly HIV-seropositive cohort of women. This cross-sectional multilevel analysis included data from 734 women enrolled in the Women's Interagency HIV Study's sites in the U.S. South. Census tract-level contextual data captured socioeconomic disadvantage (e.g., tract poverty), number of alcohol outlets, and number of non-profits in the census tracts where women lived; participant-level data, including perceived neighborhood cohesion, were gathered via survey. We used hierarchical generalized linear models to evaluate relationships between tract characteristics and two outcomes: perceived main sex partner risk level (e.g., partner substance use) and perceived main sex partner non-monogamy. We tested whether these relationships varied by women's HIV status. Greater tract-level socioeconomic disadvantage was associated with greater sex partner risk (OR 1.29, 95% CI 1.06-1.58) among HIV-seropositive women and less partner non-monogamy among HIV-seronegative women (OR 0.69, 95% CI 0.51-0.92). Perceived neighborhood trust and cohesion was associated with lower partner risk (OR 0.83, 95% CI 0.69-1.00) for HIV-seropositive and HIV-seronegative women. The tract-level number of alcohol outlets and non-profits were not associated with partner risk characteristics. Neighborhood characteristics are associated with perceived sex partner risk and non-monogamy among women in the South; these relationships vary by HIV status. Future studies should examine causal relationships and explore the pathways through which neighborhoods influence partner selection and risk characteristics.

Prevalence and patterns of victimization and polyvictimization among female sex workers in Soweto, a South African township: a cross-sectional, respondent-driven sampling study

PubMed Central

Coetzee, J.; Gray, G. E.; Jewkes, R.

2017-01-01

ABSTRACT Background: Female sex workers (FSWs) are disproportionately affected by violence from multiple partner categories. This increases their vulnerability to HIV. Objectives: To describe patterns of violence and polyvictimization among female SWs in Soweto. Methods: A respondent-driven sampling (RDS) recruitment methodology was used to enrol 508 Soweto-based FSWs using a survey instrument. Raw and RDS adjusted data were descriptively analysed, Spearman’s correlation and chi2 test of association were used to show associations. Polyvictimization patterns are shown within a modified Venn diagram. Results: The median age of FSWs in Soweto was 31 years, and most had an incomplete education (74.2%). The prevalence of exposure to physical/sexual intimate partner violence (IPV) in the past year was 53.8%, 46.8% by clients, and 18.5% by police. Past year prevalence of sexual/physical violence by any perpetrator category was 70.8% and lifetime exposure was 76.0%. Childhood sexual violence was reported by 44.3%. Lifetime non-partner rape was 55.5% and all rape exposure was 62.4%. As a result of engaging in sex work in the past year, 65.2% women had been discriminated against. Client, police, IPV, and childhood trauma were all significantly associated with one another, with IPV being the most common co-occurrence. Polyvictimization was seen in almost two-thirds of FSWs, and increased with exposure to discrimination. Conclusion: In Soweto, FSWs are exposed to high rates of violence in multiple forms across their lifetime. Our findings show that violence continues unabated into adulthood at levels far higher than in the general population and overall at higher levels than previously recorded among SWs in South Africa. We argue that violence against FSWs is rooted in discrimination. The disparate burden of violence on FSWs requires urgent interventions to proactively address and reframe the normalisation of violence against all women. PMID:29211633

Prevalence and patterns of victimization and polyvictimization among female sex workers in Soweto, a South African township: a cross-sectional, respondent-driven sampling study.

PubMed

Coetzee, J; Gray, G E; Jewkes, R

2017-01-01

Female sex workers (FSWs) are disproportionately affected by violence from multiple partner categories. This increases their vulnerability to HIV. To describe patterns of violence and polyvictimization among female SWs in Soweto. A respondent-driven sampling (RDS) recruitment methodology was used to enrol 508 Soweto-based FSWs using a survey instrument. Raw and RDS adjusted data were descriptively analysed, Spearman's correlation and chi 2 test of association were used to show associations. Polyvictimization patterns are shown within a modified Venn diagram. The median age of FSWs in Soweto was 31 years, and most had an incomplete education (74.2%). The prevalence of exposure to physical/sexual intimate partner violence (IPV) in the past year was 53.8%, 46.8% by clients, and 18.5% by police. Past year prevalence of sexual/physical violence by any perpetrator category was 70.8% and lifetime exposure was 76.0%. Childhood sexual violence was reported by 44.3%. Lifetime non-partner rape was 55.5% and all rape exposure was 62.4%. As a result of engaging in sex work in the past year, 65.2% women had been discriminated against. Client, police, IPV, and childhood trauma were all significantly associated with one another, with IPV being the most common co-occurrence. Polyvictimization was seen in almost two-thirds of FSWs, and increased with exposure to discrimination. In Soweto, FSWs are exposed to high rates of violence in multiple forms across their lifetime. Our findings show that violence continues unabated into adulthood at levels far higher than in the general population and overall at higher levels than previously recorded among SWs in South Africa. We argue that violence against FSWs is rooted in discrimination. The disparate burden of violence on FSWs requires urgent interventions to proactively address and reframe the normalisation of violence against all women.

Actual versus perceived peer sexual risk behavior in online youth social networks.

PubMed

Black, Sandra R; Schmiege, Sarah; Bull, Sheana

2013-09-01

Perception of peer behaviors is an important predictor of actual risk behaviors among youth. However, we lack understanding of peer influence through social media and of actual and perceived peer behavior concordance. The purpose of this research is to document the relationship between individual perception of and actual peer sexual risk behavior using online social networks. The data are a result of a secondary analysis of baseline self-reported and peer-reported sexual risk behavior from a cluster randomized trial including 1,029 persons from 162 virtual networks. Individuals (seeds) recruited up to three friends who then recruited additional friends, extending three waves from the seed. ANOVA models compared network means of actual participant behavior across categories of perceived behavior. Concordance varied between reported and perceived behavior, with higher concordance between perceived and reported condom use, multiple partners, concurrent partners, sexual pressure, and drug and alcohol use during sex. Individuals significantly over-reported risk and under-reported protective peer behaviors related to sex.

Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique

PubMed Central

Figueroa, Maria Elena; Poppe, Patricia; Carrasco, Maria; Pinho, Maria Dirce; Massingue, Felisberto; Tanque, Maria; Kwizera, Amata

2016-01-01

Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009–2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions, the program sparked critical thinking and open dialogue among participants. This article measures the program’s effectiveness based on a sample of 462 participants and 453 nonparticipants. The results show that the program was successful in producing changes in three of the underlying structural factors of HIV: gender attitudes, gender roles, and HIV stigma. The program was also successful in changing other factors associated with HIV infection, including HIV prevention knowledge, discussion of HIV between sex partners, and having multiple sex partners. PMID:27123984

Normative influence on condom use in the personal networks of female cocaine smokers.

PubMed

Richard, A J; Bell, D C; Montoya, I D

2000-08-01

Attitudes-norms research (the theories of planned behavior and reasoned action) has been successful in accounting for many types of behavior change. One of the strengths of this approach has been to combine individual beliefs and normative influences in the explanation of behavior change. However, the conceptualization of normative influence in these theories makes very strong assumptions about self-awareness in the selection of normative referents. These assumptions are particularly problematic when applied to female cocaine smokers, who report frequent sex while under duress or while cognitively impaired. In this study the original conceptualization of normative influence and two alternatives (assuming emotion-based and interaction-based selection of normative referents) are operationalized to evaluate stage of change for condom use among women who are heavy crack cocaine users with multiple sex partners. Results show that stage of change for use of condoms with nonmain partners is best accounted for by interaction-based selection of normative referents.

Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique.

PubMed

Figueroa, Maria Elena; Poppe, Patricia; Carrasco, Maria; Pinho, Maria Dirce; Massingue, Felisberto; Tanque, Maria; Kwizera, Amata

2016-05-01

Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009-2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions, the program sparked critical thinking and open dialogue among participants. This article measures the program's effectiveness based on a sample of 462 participants and 453 nonparticipants. The results show that the program was successful in producing changes in three of the underlying structural factors of HIV: gender attitudes, gender roles, and HIV stigma. The program was also successful in changing other factors associated with HIV infection, including HIV prevention knowledge, discussion of HIV between sex partners, and having multiple sex partners.

Association Between Enacted Stigma and HIV-Related Risk Behavior Among MSM, National HIV Behavioral Surveillance System, 2011.

PubMed

Balaji, Alexandra B; Bowles, Kristina E; Hess, Kristen L; Smith, Justin C; Paz-Bailey, Gabriela

2017-01-01

MSM bear a disproportionate burden of the HIV epidemic. Enacted stigma (overt negative actions) against sexual minorities may play an important role in increasing HIV risk among this population. Using data from the 2011 National HIV Behavioral Surveillance system, MSM cycle, we examined the independent associations between three measures of enacted stigma (verbal harassment, discrimination, physical assault) and engagement in each of four HIV-related risk behaviors as outcomes: condomless anal intercourse (CAI) at last sex with a male partner of HIV discordant or unknown status and, in the past 12 months, CAI with a male partner, ≥4 male sex partners, and exchange sex. Of 9819 MSM, 32% experienced verbal harassment in the past 12 months, 23% experienced discrimination, and 8% experienced physical assault. Discordant CAI at last sex with a male partner was associated with previous discrimination and physical assault. Past 12 month CAI with a male partner, ≥4 male sex partners, and exchange sex were each associated with verbal harassment, discrimination, and physical assault. These findings indicate that a sizable proportion of MSM report occurrences of past 12 month enacted stigma and suggest that these experiences may be associated with HIV-related risk behavior. Addressing stigma towards sexual minorities must involve an integrated, multi-faceted approach, including interventions at the individual, community, and societal level.

Predictors of HIV-protection behaviour in HIV-positive men who have sex with casual male partners: a test of the explanatory power of an extended Information-Motivation-Behavioural Skills model.

PubMed

Nideröst, Sibylle; Gredig, Daniel; Roulin, Christophe; Rickenbach, Martin

2011-07-01

This prospective study applies an extended Information-Motivation-Behavioural Skills (IMB) model to establish predictors of HIV-protection behaviour among HIV-positive men who have sex with men (MSM) during sex with casual partners. Data have been collected from anonymous, self-administered questionnaires and analysed by using descriptive and backward elimination regression analyses. In a sample of 165 HIV-positive MSM, 82 participants between the ages of 23 and 78 (M=46.4, SD=9.0) had sex with casual partners during the three-month period under investigation. About 62% (n=51) have always used a condom when having sex with casual partners. From the original IMB model, only subjective norm predicted condom use. More important predictors that increased condom use were low consumption of psychotropics, high satisfaction with sexuality, numerous changes in sexual behaviour after diagnosis, low social support from friends, alcohol use before sex and habitualised condom use with casual partner(s). The explanatory power of the calculated regression model was 49% (p<0.001). The study reveals the importance of personal and social resources and of routines for condom use, and provides information for the research-based conceptualisation of prevention offers addressing especially people living with HIV ("positive prevention").

Participation in online and offline HIV prevention among men who have sex with men who use the internet to meet sex partners in New York City.

PubMed

Navejas, Michael; Neaigus, Alan; Torian, Lucia; Murrill, Christopher

2012-02-01

This report presents data on participation in online or offline prevention activities among a sample of New York City men who have sex with men (MSM) recruited online between April-August of 2007 who use the Internet to meet sex partners. The analysis focuses on the 1,124 men who reported sex with a main or casual partner in the past 12 months. Over half (53%) of the MSM reported unprotected anal intercourse (UAI) in the past year. Data from our multivariate analysis indicate that MSM who participate in online or offline prevention activities were less likely to engage in UAI.

Relationship characteristics and sexual risk-taking in young men who have sex with men.

PubMed

Mustanski, Brian; Newcomb, Michael E; Clerkin, Elise M

2011-09-01

Young men who have sex with men (MSM), particularly young men of color, are experiencing the largest increase in HIV incidence of any risk group in the United States Epidemiological research suggests that the majority of transmissions among MSM are occurring in the context of primary partnerships, but little research has been done on the processes within these dyads that increase HIV risk behaviors. The aim of this study was to use longitudinal partnership-level data to explore the effects of partner and relationship characteristics on the frequency of unprotected sex within young MSM relationships. One hundred twenty-two young MSM (age 16-20 at baseline) were assessed at three time-points six months apart, with 91% retention at the 12-month follow-up wave. Over 80% were racial/ethnic minorities. At each wave, participants reported on characteristics of the relationships and partners for up to three sexual partners. Hierarchical linear modeling was used for analyses. The largest effect was for considering the relationship to be serious, which was associated with nearly an eightfold increase in the rate of unprotected sex. Other factors that increased risk behaviors included older partners, drug use prior to sex, physical violence, forced sex, and partnership lasting more than six months. Partners met online were not associated with significantly more sexual risk. These data provide insight into the relationship processes that should be addressed in prevention programs targeted at young MSM. Relationships may serve as a promising unit for HIV prevention interventions, although more formative research will be required to address potential logistical obstacles to implementing such interventions. The partner-by-partner analytic approach (i.e., evaluating situational variables associated with several partners for a given participant) holds promise for future HIV behavioral research.

Relationship characteristics and sexual risk-taking in young men who have sex with men

PubMed Central

Mustanski, Brian; Newcomb, Michael E.; Clerkin, Elise M.

2011-01-01

Objective Young MSM (men who have sex with men), particularly young men of color, are experiencing the largest increase in HIV incidence of any risk group in the U.S. Epidemiological research suggests that the majority of transmissions among MSM are occurring in the context of primary partnerships, but little research has been done on the processes within these dyads that increase HIV risk behaviors. The aim of this study was to use longitudinal partnership-level data to explore the effects of partner and relationship characteristics on the frequency of unprotected sex within young MSM relationships. Methods One hundred twenty-two young MSM (age 16-20 at baseline) were assessed at three time-points six months apart, with 91% retention at the 12-month follow-up wave. Over 80% were racial/ethnic minorities. At each wave, participants reported on characteristics of the relationship and partner for up to three sexual partners. Hierarchical linear modeling was used for analyses. Results The largest effect was for considering the relationship to be serious, which was associated with nearly an eight-fold increase in the rate of unprotected sex. Other factors that increased risk behaviors included: older partners, drug use prior to sex, physical violence, forced sex, and partnership lasting more than 6 months. Partners met online were not associated with significantly more sexual risk. Conclusions These data provide insight into the relationship processes that should be addressed in prevention programs targeted at young MSM. Relationships may serve as a promising unit for HIV prevention interventions, although more formative research will be required to address potential logistical obstacles to implementing such interventions. The partner-by-partner analytic approach (i.e., evaluating situational variables associated with several partners for a given participant) holds promise for future HIV behavioral research. PMID:21604883

Sexual partnerships and considerations for HIV antiretroviral pre-exposure prophylaxis utilization among high-risk substance using men who have sex with men.

PubMed

Mimiaga, Matthew J; Closson, Elizabeth F; Kothary, Vishesh; Mitty, Jennifer A

2014-01-01

Men who have sex with men (MSM) remain at great risk of HIV in the United States, representing 65 % of incident HIV infections. One factor contributing to the high rate of HIV infection among MSM is use of "recreational" drugs that are highly associated with unprotected anal sex. Pre-exposure chemoprophylaxis (PrEP) is a novel biomedical HIV prevention strategy that has the potential to reduce HIV transmission in MSM. Main and casual sex partners play a role in HIV prevention efforts for MSM. The study aimed to qualitatively explore the perceived influences of sexual relationships on promoting and inhibiting PrEP use among high-risk MSM who report regular drug use. Semi-structured qualitative interviews were conducted with 40 participants recruited in Boston, Massachusetts. Data were analyzed using descriptive qualitative analysis. Casual partners presented a distinct set of concerns from primary partnerships. MSM generally viewed main partners as a potential source of support for taking PrEP. Given their informal and often temporary nature, PrEP disclosure to casual partners was considered unnecessary. HIV-related stigma and substance use were also perceived as barriers to discussing PrEP use with casual partners. MSM articulated a high degree of personal agency regarding their ability to take PrEP. Findings suggest that behavioral interventions to improve PrEP utilization and adherence for high-risk MSM should be tailored to sex partner type and the parameters established between sex partners. Approaches to PrEP disclosure and partner engagement should be informed by the relative benefits and limitations characterized by these different types of relationships.

Sexual Behavior and STI/HIV Status Among Adolescents in Rural Malawi: An Evaluation of the Effect of Interview Mode on Reporting

PubMed Central

Mensch, Barbara S.; Hewett, Paul C.; Gregory, Richard; Helleringer, Stephane

2008-01-01

This study investigates the reporting of premarital sex in rural southern Malawi. It summarizes the results of an interview-mode experiment conducted with unmarried young women aged 15–21 in which respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. In addition, biomarkers were collected for HIV and three STIs: gonorrhea, chlamydia, and trichomoniasis. Prior to collecting the biomarkers, nurses conducted a short face-to-face interview in which they repeated questions about sexual behavior. The study builds on earlier research among adolescents in Kenya where we first investigated the feasibility and effectiveness of ACASI. In both Malawi and Kenya, the mode of interviewing and questions about types of sexual partners affect the reporting of sexual activity. Yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode. When we ask about other partners as well as multiple lifetime partners, however, the reporting is consistently higher with ACASI, in many cases significantly so. The FTF mode produced more consistent reporting of sexual activity between the main interview and a subsequent interview. The association between infection status and reporting of sexual behavior is stronger in the FTF mode, although in both modes a number of young women who denied ever having sex test positive for STIs/HIV. PMID:19248718

Potential impact and acceptability of Internet partner notification for men who have sex with men and transgender women recently diagnosed as having sexually transmitted disease in Lima, Peru.

PubMed

Clark, Jesse L; Segura, Eddy R; Perez-Brumer, Amaya G; Reisner, Sari L; Peinado, Jesus; Salvatierra, Hector J; Sanchez, Jorge; Lama, Javier R

2014-01-01

We assessed the potential impact of Internet partner notification among men who have sex with men and transgender women in Peru recently diagnosed as having sexually transmitted disease. Use of Internet partner notification was anticipated for 55.9% of recent partners, including 43.0% of partners not currently expected to be notified, a 20.6% increase in anticipated notification outcomes.

Verbal compliments as a differential source of mate poaching threat for men and women.

PubMed

Brown, Christina M; Daniels, Emily R; Lustgraaf, Christopher J N; Sacco, Donald F

2014-08-18

Two studies tested whether people feel threatened by another individual verbally complimenting their romantic partner. Such compliments may indicate that the other person is a potential rival who will try to "poach" their mate. Across two studies, women were more threatened than men when imagining another person complimenting their partner's physical appearance. There were no sex differences in response to imagining another person complimenting their partner's sense of humor. When another person compliments one's partner's physical appearance, this indicates that they may be sexually attracted to the partner. Mediation analyses revealed that the sex difference occurs because women believe men are more open to casual sex, and therefore more vulnerable to mate poaching when another person expresses sexual interest in them.

Love grows with sex: teenagers negotiating sex and gender in the context of HIV and the implications for sex education.

PubMed

Bhana, Deevia

2017-03-01

How do teenagers located in the KwaZulu-Natal province of South Africa, the epicentre of the HIV pandemic, give meaning to sexuality? This paper examines teenage black Africans investments in sex and sexuality and the gendered dynamics through which sexuality is articulated. Whilst unequal gender relations of power continue to feature prominently within relationship dynamics fuelling the gendering of HIV, attention to the micro-processes through which relationships are forged remain significant in illustrating the complex connections between love, sex and gender. Drawing on empirical findings with teenagers between the ages of 16 and 17 years old, the paper shows how relationships are conceptualised based on discourses of love. Love is inextricably bound up with sex and when teenagers talk about love and sex they also talk about condom use, multiple sexual partners and gender inequalities. What teenagers were interested in for their sexual relationships was not raised in sex education programmes at school. Implications for addressing teenage constructions of sexuality are discussed in the conclusion.

Neural bases of human mate choice: multiple value dimensions, sex difference, and self-assessment system.

PubMed

Funayama, Risa; Sugiura, Motoaki; Sassa, Yuko; Jeong, Hyeonjeong; Wakusawa, Keisuke; Horie, Kaoru; Sato, Shigeru; Kawashima, Ryuta

2012-01-01

Mate choice is an example of sophisticated daily decision making supported by multiple componential processes. In mate-choice literature, different characteristics of the value dimensions, including the sex difference in the value dimensions, and the involvement of self-assessment due to the mutual nature of the choice, have been suggested. We examined whether the brain-activation pattern during virtual mate choice would be congruent with these characteristics in terms of stimulus selectivity and activated brain regions. In measuring brain activity, young men and women were shown two pictures of either faces or behaviors, and they indicated which person they would choose either as a spouse or as a friend. Activation selective to spouse choice was observed face-selectively in men's amygdala and behavior-selectively in women's motor system. During both partner-choice conditions, behavior-selective activation was observed in the temporoparietal regions. Taking the available knowledge of these regions into account, these results are congruent with the suggested characteristics of value dimensions for physical attractiveness, parenting resources, and beneficial personality traits for a long-lasting relationship, respectively. The medial prefrontal and posterior cingulate cortices were nonselectively activated during the partner choices, suggesting the involvement of a self-assessment process. The results thus provide neuroscientific support for the multi-component mate-choice mechanism.

Workplace and HIV-related sexual behaviours and perceptions among female migrant workers.

PubMed

Yang, H; Li, X; Stanton, B; Fang, X; Lin, D; Mao, R; Liu, H; Chen, X; Severson, R

2005-10-01

Data from 1,543 female migrants working in eight occupational clusters in Beijing and Nanjing, China were analysed to examine the association of workplace with HIV-related behaviours and perceptions. For sexually experienced women (n = 666, 43.2%), those working in entertainment establishments or personal service (e.g., nightclubs, dancing halls, barbershops, beauty salons, massage parlours, etc.) engaged in risky sexual practices twice as frequently as those working in non-entertainment establishments (e.g. restaurants, stalls, domestic service, factories, etc.). About 10% of women in the entertainment establishments reported having sold sex, 30% having multiple sexual partners and 40% having sex with men with multiple sexual partners. The rate of consistent condom use was less than 15%. They also tended to have a higher level of perceptions of both peer risk involvement and positive expectancy of risk behaviours, and lower perceptions of severity of STDs and HIV. For women who were not sexually experienced, those working in 'stalls' or 'domestic service' tended to perceive higher peer risk involvement, less severity of HIV infection, and less effectiveness of protective behaviour. The occupational pattern of sexual risk behaviours and perceptions observed in the current study indicates employment conditions are associated with HIV risk. Intervention strategies should be tailored to address occupational-related factors.

Marijuana use and sex with multiple partners among lesbian, gay and bisexual youth: results from a national sample.

PubMed

Zhang, Xiaoyun; Wu, Li-Tzy

2017-01-05

Sex with multiple partners (SMP) is one of the important contributing factors for contracting sexually transmitted infections (STIs) among adolescents and young adults, especially among Lesbian, Gay, and Bisexual (LGB) youth. Past studies mainly focus on examining associations of alcohol or club drugs use with unprotected sexual behaviors among adult homo/bisexual men, while little is known about the temporal association between marijuana use (MU) and SMP among LGB youth. This study examined the relationship between MU and SMP among LGB adolescents and young adults. Generalized estimating equations (GEE) logistic regression analyses were utilized to analyze four waves' public-use Add Health data (N = 694, youth who reported a homo/bisexual status at any wave; Wave 1: aged 11-21; Wave 4: aged 24-32). After adjusting for other substance use, current depression, mother-child relationship quality at Wave 1, and socioeconomic variables, past-year MU was both concurrently and prospectively associated with past-year SMP. The moderating effect of age was not found. MU is concurrently and prospectively associated with increased odds of SMP in the adolescent sample and in the young adult sample. Findings imply that prevention/intervention on HIV risk behaviors may benefit from MU reduction not only in LGB adolescents but also in young adults.

The association between stress, coping, and sexual risk behaviors over 24 months among African-American female adolescents.

PubMed

Hulland, Erin N; Brown, Jennifer L; Swartzendruber, Andrea L; Sales, Jessica M; Rose, Eve S; DiClemente, Ralph J

2015-01-01

Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African-American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6, 12, 18, and 24 months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p = .018), inconsistent condom use (p = .011), and not using a condom at last sex (p = .002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population.

Workplace and HIV-related sexual behaviours and perceptions among female migrant workers

PubMed Central

YANG, H.; LI, X.; STANTON, B.; FANG, X.; LIN, D.; MAO, R.; LIU, H.; CHEN, X.; SEVERSON, R.

2007-01-01

Data from 1,543 female migrants working in eight occupational clusters in Beijing and Nanjing, China were analysed to examine the association of workplace with HIV-related behaviours and perceptions. For sexually experienced women (n = 666, 43.2%), those working in entertainment establishments or personal service (e.g., nightclubs, dancing halls, barbershops, beauty salons, massage parlours, etc.) engaged in risky sexual practices twice as frequently as those working in non-entertainment establishments (e.g. restaurants, stalls, domestic service, factories, etc.). About 10% of women in the entertainment establishments reported having sold sex, 30% having multiple sexual partners and 40% having sex with men with multiple sexual partners. The rate of consistent condom use was less than 15%. They also tended to have a higher level of perceptions of both peer risk involvement and positive expectancy of risk behaviours, and lower perceptions of severity of STDs and HIV. For women who were not sexually experienced, those working in ‘stalls’ or ‘domestic service’ tended to perceive higher peer risk involvement, less severity of HIV infection, and less effectiveness of protective behaviour. The occupational pattern of sexual risk behaviours and perceptions observed in the current study indicates employment conditions are associated with HIV risk. Intervention strategies should be tailored to address occupational-related factors. PMID:16120499

The association between stress, coping, and sexual risk behaviors over 24-months among African American female adolescents

PubMed Central

Hulland, Erin N.; Brown, Jennifer L.; Swartzendruber, Andrea L.; Sales, Jessica M.; Rose, Eve S.; DiClemente, Ralph J.

2014-01-01

Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6-, 12-, 18-, and 24-months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p=0.018), inconsistent condom use (p=0.011), and not using a condom at last sex (p=0.002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population. PMID:25159332

Preventing HIV Transmission among Partners of HIV-Positive Male Sex Workers in Mexico City: A Modeling Study

PubMed Central

Monteiro, João Filipe G.; Marshall, Brandon D.L.; Escudero, Daniel; Sosa-Rubí, Sandra G.; González, Andrea; Flanigan, Timothy; Operario, Don; Mayer, Kenneth H.; Lurie, Mark N.; Galárraga, Omar

2015-01-01

Mexico has a concentrated HIV epidemic, with male sex workers constituting a key affected population. We estimated annual HIV cumulative incidence among male sex workers’ partners, and then compared incidence under three hypothetical intervention scenarios: improving condom use; and scaling up HIV treatment as prevention, considering current viral suppression rates (CVS, 60.7%) or full viral suppression among those treated (FVS, 100%). Clinical and behavioral data to inform model parameterization were derived from a sample (n=79) of male sex workers recruited from street locations and Clínica Condesa, an HIV clinic in Mexico City. We estimated annual HIV incidence among male sex workers’ partners to be 8.0% (95% CI: 7.3–8.7). Simulation models demonstrated that increasing condom use by 10%, and scaling up HIV treatment initiation by 50% (from baseline values) would decrease the male sex workers-attributable annual incidence to 5.2%, 4.4% (CVS) and 3.2% (FVS), respectively. Scaling up the number of male sex workers on ART and implementing interventions to ensure adherence is urgently required to decrease HIV incidence among male sex workers’ partners in Mexico City. PMID:25307025

Preventing HIV Transmission Among Partners of HIV-Positive Male Sex Workers in Mexico City: A Modeling Study.

PubMed

Monteiro, João Filipe G; Marshall, Brandon D L; Escudero, Daniel; Sosa-Rubí, Sandra G; González, Andrea; Flanigan, Timothy; Operario, Don; Mayer, Kenneth H; Lurie, Mark N; Galárraga, Omar

2015-09-01

Mexico has a concentrated HIV epidemic, with male sex workers constituting a key affected population. We estimated annual HIV cumulative incidence among male sex workers' partners, and then compared incidence under three hypothetical intervention scenarios: improving condom use; and scaling up HIV treatment as prevention, considering current viral suppression rates (CVS, 60.7 %) or full viral suppression among those treated (FVS, 100 %). Clinical and behavioral data to inform model parameterization were derived from a sample (n = 79) of male sex workers recruited from street locations and Clínica Condesa, an HIV clinic in Mexico City. We estimated annual HIV incidence among male sex workers' partners to be 8.0 % (95 % CI: 7.3-8.7). Simulation models demonstrated that increasing condom use by 10 %, and scaling up HIV treatment initiation by 50 % (from baseline values) would decrease the male sex workers-attributable annual incidence to 5.2, 4.4 % (CVS) and 3.2 % (FVS), respectively. Scaling up the number of male sex workers on ART and implementing interventions to ensure adherence is urgently required to decrease HIV incidence among male sex workers' partners in Mexico City.

Geosocial-Networking App Usage Patterns of Gay, Bisexual, and Other Men Who Have Sex With Men: Survey Among Users of Grindr, A Mobile Dating App.

PubMed

Goedel, William C; Duncan, Dustin T

2015-01-01

Geosocial-networking apps like Grindr have been used increasingly among men who have sex with men (MSM) to meet anonymous partners. These mobile dating apps employ global positioning system technology to facilitate connections with other users based on their current location. These new technologies have generated quicker and easier modes for men who have sex with men to meet potential partners based on attraction and physical proximity. The aim of this study is to describe geosocial-networking app use and recent sexual behaviors of MSM in the Atlanta metropolitan statistical area. Our sample was recruited from Grindr, the most commonly used of these mobile apps among MSM, using broadcast advertising. Advertisements were displayed over the course of a 72-hour period and participants were directed to a Web-based survey. In total, 604 men clicked through the advertisement, and 92 users completed the survey. One-third (38.0%) of the men reported using these mobile apps to meet new sexual partners, and one-fifth (18.5%) used them to "kill time" when bored. Men reporting currently being in a relationship were less likely to report using these mobile apps to meet other MSM to date or to find a boyfriend or romantic partner, but more likely to report using these mobile apps to meet other MSM to have sex, X (2) 24=12.1, P=.016. Respondents had current accounts on 3.11 mobile apps (SD 1.84) on average, with Grindr being the most common (100%), followed by Scruff (52.5%), and Jack'd (45.7%). Most men were most active in the late night (40.2%), and on weekdays (64.1%). Each day, on average, men reported opening these mobile apps 8.38 times (SD 8.10) and spent 1.31 hours (SD 1.15) on these mobile apps. The age respondents began using these mobile apps was associated with the age at their first instance of insertive anal sex (r80=.527, P<.001) and receptive anal sex (r76=.527, P<.001). These findings suggest that MSM use multiple mobile apps and spend significant time on them. For these reasons, HIV prevention interventions could be delivered on these mobile apps.

Geosocial-Networking App Usage Patterns of Gay, Bisexual, and Other Men Who Have Sex With Men: Survey Among Users of Grindr, A Mobile Dating App

PubMed Central

2015-01-01

Background Geosocial-networking apps like Grindr have been used increasingly among men who have sex with men (MSM) to meet anonymous partners. These mobile dating apps employ global positioning system technology to facilitate connections with other users based on their current location. These new technologies have generated quicker and easier modes for men who have sex with men to meet potential partners based on attraction and physical proximity. Objective The aim of this study is to describe geosocial-networking app use and recent sexual behaviors of MSM in the Atlanta metropolitan statistical area. Methods Our sample was recruited from Grindr, the most commonly used of these mobile apps among MSM, using broadcast advertising. Advertisements were displayed over the course of a 72-hour period and participants were directed to a Web-based survey. Results In total, 604 men clicked through the advertisement, and 92 users completed the survey. One-third (38.0%) of the men reported using these mobile apps to meet new sexual partners, and one-fifth (18.5%) used them to “kill time” when bored. Men reporting currently being in a relationship were less likely to report using these mobile apps to meet other MSM to date or to find a boyfriend or romantic partner, but more likely to report using these mobile apps to meet other MSM to have sex, X 2 24=12.1, P=.016. Respondents had current accounts on 3.11 mobile apps (SD 1.84) on average, with Grindr being the most common (100%), followed by Scruff (52.5%), and Jack’d (45.7%). Most men were most active in the late night (40.2%), and on weekdays (64.1%). Each day, on average, men reported opening these mobile apps 8.38 times (SD 8.10) and spent 1.31 hours (SD 1.15) on these mobile apps. The age respondents began using these mobile apps was associated with the age at their first instance of insertive anal sex (r80=.527, P<.001) and receptive anal sex (r76=.527, P<.001). Conclusions These findings suggest that MSM use multiple mobile apps and spend significant time on them. For these reasons, HIV prevention interventions could be delivered on these mobile apps. PMID:27227127

Acceptability and intention to seek medical care after hypothetical receipt of patient-delivered partner therapy or electronic partner notification postcards among men who have sex with men: the partner's perspective.

PubMed

Kerani, Roxanne Pieper; Fleming, Mark; Golden, Matthew Robert

2013-02-01

Little is known about how men who have sex with men (MSM) exposed to a sexually transmitted infection respond to receiving patient-delivered partner therapy (PDPT) or electronic partner notification postcards (e-cards). We anonymously surveyed MSM in a sexually transmitted disease (STD) clinic and a private medical practice. Three scenarios were presented in which participants had oral or anal sex with a new partner and were subsequently notified of a chlamydia or gonorrhea exposure and offered PDPT by the partner. A fourth scenario described partner notification via an anonymous inSPOT e-card. We asked participants if they would see a doctor, test for HIV/STD, and/or notify other partners in each situation. Among 198 MSM, the percentage indicating that they would seek a medical evaluation was higher when scenarios described proctitis (97%-98%) versus pharyngitis (84%) or no symptoms (84%-89%). In the absence of symptoms, men indicated that they would be less likely to seek care (62% vs. 84%-88%, P < 0.0001) and notify partners (85% vs. 69%, P < 0.0001) if notified via an anonymous e-card than if notified directly by a partner. Approximately half reported that they would use PDPT provided by a partner. In the absence of symptoms, men who indicated that they would use PDPT reported that they would seek medical care less frequently than men who indicated that they would not take PDPT (74% vs. 92% [P = 0.0007 for oral sex exposure] 82% vs. 94%-94% [P = 0.01 or unprotected anal sex exposure]). Although many MSM express interest in using PDPT and anonymous e-cards, these methods may result in missed opportunities to test for HIV and other STDs.

The number of recent sex partners among bisexual men in the United States.

PubMed

Jeffries, William L

2011-09-01

Little is known regarding bisexual men's number of recent sex partners, a risk factor for HIV and other STDs. Furthermore, it is unclear if bisexual men have more partners than heterosexual or homosexual men, and whether partner number varies by measures of sexual behavior, identity and attraction. Sexual orientation-defined separately by sexual behavior during the past year, identity and attraction-was assessed for 3,875 sexually active men aged 15-44 who had participated in the 2002 National Survey of Family Growth. Chi-square and t tests examined differences in background characteristics, behavioral risk factors and number of past-year sex partners by sexual orientation according to each definition. Multivariate ordinary least-squares regression was used to assess predictors of the number of partners. When sexual identity and attraction were controlled for, behaviorally bisexual men were predicted to have had 3.1 more past-year partners than behaviorally heterosexual men and 2.6 more than behaviorally homosexual men. After controlling for sexual identity and behavior, bisexual-attracted men had had 0.7 fewer partners than homosexual-attracted men. In a model including background characteristics and behavioral risk factors, behaviorally bisexual men were predicted to have had 2.5-2.6 more partners than others. Neither bisexual identity nor bisexual attraction independently predicted the number of recent partners. The way in which bisexuality relates to men's number of recent sex partners depends on how sexual orientation is measured. Interventions to reduce behaviorally bisexual men's number of partners will likely lessen their risk for HIV and other STDs. Copyright © 2011 by the Guttmacher Institute.

Sex partnerships, health, and social risks of young men leaving jail: analyzing data from a randomized controlled trial.

PubMed

Ramaswamy, Megha; Freudenberg, Nicholas

2010-11-10

Young men involved in the criminal justice system face disproportionately high rates of sexual risk behavior, drug, use, and violence. Little is known about how their involvement in sex partnerships might mitigate their unique health and social risks. This study explores whether sex partner experience protects against harmful sexual behaviors, drug problems, violence, and recidivism in 16-18-year-old Black and Latino men leaving a US jail. Data were drawn from the Returning Educated African-American and Latino Men to Enriched Neighborhoods (REAL MEN) study conducted between 2003-2007, which tracked 552 adolescents during their time in a New York City jail and 397 of them one year after their release. Logistic regression was used to examine the relationship between sex partner experience and sex behavior, drug use, violence, and recidivism. This study indicates that young men who have long-term sex partners prior to incarceration are less likely to be inconsistent condom users (OR = 0.50, p ≤ 0.01), have sex while high on drugs/alcohol (OR = 0.14, p ≤ 0.001), use marijuana daily (OR = 0.45, p ≤ 0.001), and carry weapons during illegal activity (OR = 0.58, p ≤ 0.05), especially compared with peers who simultaneously are involved with long-term and casual "short-term" sex partners. However, the positive effects of having a long-term sex partner generally do not apply over time - in this case, one year after being released from jail. Aside from sexual partners, factors such as employment and housing stability predict whether these young men will experience positive or negative outcomes post-incarceration. This study highlights the importance and potential benefits of health interventions that engage young Black and Latino men who are involved in the criminal justice system in the US, as well as their sex partners, in health promotion programs. The study also confirms the need for programs that address the employment and housing needs of young men after they leave correctional facilities.

Alcohol intoxication and sexual risk behaviors among rural-to-urban migrants in China

PubMed Central

Lin, Danhua; Li, Xiaoming; Yang, Hongmei; Fang, Xiaoyi; Stanton, Bonita; Chen, Xinguang; Abbey, Antonia; Liu, Hongjie

2007-01-01

Background The migrant population in China is at high risk for sexual risk behavior and alcohol intoxication. Information about the prevalence of alcohol intoxication and its association with sexual risk behavior among migrants is needed for designing effective intervention prevention programs for reduction in alcohol abuse and HIV infection. Methods Cross-sectional data were collected from 2153 sexually experienced young rural-to-urban migrants in Beijing and Nanjing, China, in 2002. Results Approximately one-third of the participants had been intoxicated with alcohol at least once during the previous month, with more males than females reporting intoxication (40.2% versus 23.7%, p < 0.001). Compared to non-intoxicated participants, respondents with alcohol intoxication in previous 30 days reported more psychological problems, including higher depression scores, lower levels of satisfaction with life and work, and higher perception of peer involvement in risk behavior. Intoxicated respondents were more likely to engage in premarital sex than non-intoxicated respondents (76% versus 60.2%, p < 0.001), have multiple sexual partners (13.4% versus 5.2%, p < 0.001), purchase sex (12.6% versus 4.9%, p < 0.001), and sell sex (10.1% versus 3.7%, p < 0.001). However, there was no association between alcohol intoxication and inconsistent/non-use of condoms. Multivariate analysis controlling for depression, peer risk involvement, age, gender, and other socio-demographic variables indicated that alcohol intoxication was independently correlated with premarital sex, multiple sexual partners, and buying and selling sex. Conclusions Compared to the general Chinese population, levels of intoxication were elevated among Chinese rural-to-urban migrants. Alcohol intoxication was associated with sexual risk behaviors. HIV/AIDS prevention and intervention efforts should include components of alcohol use/abuse prevention for an effective reduction of sexual risk among young rural-to-urban migrants in China. PMID:15943949

Substance use and risky sexual behaviours among street connected children and youth in Accra, Ghana.

PubMed

Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

2014-11-27

Research on street children and youth has shown that this population is at high risk for substance use. Though risky sexual behaviours have been investigated and widely reported among street youth in resource constrained-settings, few studies have explored the relationship between substance use and other risk behaviours. This study was therefore conducted to examine the association between substance use and risky sexual behaviours among homeless youth in Ghana. A cross-sectional survey of a convenient sample of 227 (122 male and 105 female) street connected children and youth was conducted in Ghana in 2012. Using self-report measures, the relationship between substance use and risky sexual behaviours was examined using logistic regression. Substance use was relatively high as 12% and 16.2% reported daily use of alcohol and marijuana respectively. There were age and sex differences in substance use among the sample. As compared to males, more females had smoked cigarettes, used alcohol and marijuana. While alcohol use decrease with age, marijuana use on the other hand increases with age. Results from multivariate analysis revealed that having ever drunk alcohol and alcohol use in the past one month were independently associated with all the four indices of risky sexual behaviour (ever had sex, non-condom use, multiple sexual partners and survival sex). Both marijuana use and smoking of cigarettes were associated with having ever had sex, multiple sexual partners and survival sex. Other drug use was independently associated with non-condom use. Substance use seems to serve as a possible risk factor for sexual risk behaviours among homeless youth. Harm reduction interventions are needed to prevent street children and youth from engaging in substance use and risky sexual behaviours. Such programmes should pay special attention to females and younger children who are highly susceptible to the adverse conditions on the street.

The Dynamics of Condom Use with Regular and Casual Partners: Analysis of the 2006 National Sexual Behavior Survey of Thailand

PubMed Central

Chamratrithirong, Aphichat; Kaiser, Paulina

2012-01-01

Objective This study aims to determine factors associated with levels of condom use among heterosexual Thai males in sex with regular partners and in sex with casual partners. Methods The data used in this study are from the national probability sample of the 2006 National Sexual Behavior Study, the third nationally representative cross-sectional survey in Thailand. A subtotal of 2,281 men were analyzed in the study, including young (18–24) and older (25–59) adults who were residents of rural areas of Thailand, non-Bangkok urban areas, and Bangkok. Two outcomes of interest for this analysis are reported condom use in the past 12 months by males in relationships with the most recent regular and casual partners who were not sex workers. Chi-square statistics, bivariate regressions and the proportional odds regression models are used in the analysis. Results Condom use for men with their regular partner is revealed to be positively related to education, knowledge of condom effectiveness, and pro-condom strategy, and negatively related to non-professional employment, status of registered marriage, and short relationship duration. Condom use with casual partner is positively determined by education, condom knowledge, non-professional occupation, short relationship duration, and lack of history of paid sex. Conclusion The national survey emphasized the importance of risk perceptions and condom motivations variables in explaining condom use among men in Thailand. These factors include not only education and knowledge of condom effectiveness and pro-condom strategy but also types of partners and their relationship context and characteristics. Program intervention to promote condom use in Thailand in this new era of predominant casual sex rather than sex with sex workers has to take into account more dynamic partner-based strategies than in the past history of the epidemics in Thailand. PMID:22860047

"Come on Baby. You Know I Love You": African American Women's Experiences of Communication with Male Partners and Disclosure in the Context of Unwanted Sex.

PubMed

Gutzmer, Kyle; Ludwig-Barron, Natasha T; Wyatt, Gail E; Hamilton, Alison B; Stockman, Jamila K

2016-05-01

We examined African American women's experiences of communication with their male intimate partners a couple of hours before and after an incident of unwanted sex. We also examined women's experiences of disclosure following an incident of unwanted sex. Semi-structured qualitative interviews were conducted with a community-based sample of sexually active African American women (n = 19) reporting at least one incident of sexual coercion (i.e., being pressured into unwanted sex without consent) by an intimate male partner since the age of 18. Our analysis was guided by "the sexual division of power" from Connell's (1987) theory of gender and power. Data were analyzed inductively by examining the interviews for common themes in the following domains: communication before the unwanted sex, communication after the unwanted sex, and disclosure to others. Men pressured partners for unwanted sex through verbal and non-verbal tactics, ranging from pestering and blunt requests for sex to verbal bullying and violence. Many women responded by clearly saying no. However, many women also described eventually ceasing to resist their partners and engaging in unwanted sex. After the unwanted sex, men actively and passively avoided discussing the incident. Although many women discussed the unwanted sex with family and friends, less women disclosed to trained professionals. In some cases, women did not discuss the incident with anyone at all. These findings indicate that, when addressing sexual violence against women, there is a need to target men as well as the norms of masculinity that underpin physical and sexual violence against women.

“Come on baby. You know I love you”: African American Women's Experiences of Communication with Male Partners and Disclosure in the Context of Unwanted Sex

PubMed Central

Gutzmer, Kyle; Ludwig-Barron, Natasha T.; Wyatt, Gail E.; Hamilton, Alison B.; Stockman, Jamila K.

2016-01-01

We examined African American women's experiences of communication with their male intimate partners a couple of hours before and after an incident of unwanted sex. We also examined women's experiences of disclosure following an incident of unwanted sex. Semi-structured qualitative interviews were conducted with a community-based sample of sexually active African American women (n=19) reporting at least one incident of sexual coercion (i.e., being pressured into unwanted sex without consent) by an intimate male partner since the age of 18. Our analysis was guided by “the sexual division of power” from the Theory of Gender and Power. Data were analyzed inductively by examining the interviews for common themes in the following domains: communication before the unwanted sex, communication after the unwanted sex, and disclosure to others. Men pressured partners for unwanted sex through verbal and nonverbal tactics, ranging from pestering and blunt requests for sex to verbal bullying and violence. Many women responded by clearly saying no. However, many women also described eventually ceasing to resist their partners and engaging in unwanted sex. After the unwanted sex, men actively and passively avoided discussing the incident. Although many women discussed the unwanted sex with family and friends, less women disclosed to trained professionals. In some cases, women did not discuss the incident with anyone at all. These findings indicate that, when addressing sexual violence against women, there is a need to target men as well as the norms of masculinity that underpin physical and sexual violence against women. PMID:26892099

The "Rod and Fran Test": relationship priming influences cognitive-perceptual performance.

PubMed

Baldwin, Mark W; Bagust, Jeff; Docherty, Sharon; Browman, Alexander S; Jackson, Joshua C

2014-01-01

We theorized that interpersonal relationships can provide structures for experience. In particular, we tested whether primes of same-sex versus mixed-sex relationships could foster cognitive-perceptual processing styles known to be associated with independence versus interdependence respectively. Seventy-two participants visualized either a same-sex or other-sex relationship partner and then performed two measures of cognitive-perceptual style. On a computerized Rod and Frame Test, individuals were more field-dependent after visualizing a mixed-sex versus same-sex relationship partner. On a measure involving perceptions of group behavior, participants demonstrated more holistic/contextually based perception after being primed with a female versus male relationship partner. These findings support the hypothesis that activated cognitive structures representing interpersonal relationships can shape individuals' cognitive-perceptual performance.

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

PubMed

Saggurti, Niranjan; Mahapatra, Bidhubhusan; Swain, Suvakanta N; Jain, Anrudh K

2011-12-29

Recent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India. A cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes. The average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex. Findings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants' destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations.