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Objective: To examine the HIV risk behaviours of men who have sex with men only (MSMO) and men who have sex with men and women (MSMW), aged 12-24 years, in five US cities and in San Juan, Puerto Rico. Methods: Data were collected through four annual cross-sectional anonymous surveys at community venues and included questions about sexual partnerships, sexual practices including condom use and substance use. Demographic and risk profiles were summarised for both groups. Results: A total of 1198 men were included in this analysis, including 565 MSMO and 633 MSMW. There were statistically significant differences between the two groups for many risk factors examined in multivariable models. MSMW were more likely to identify as bisexual, be in a long-term relationship, have a history of homelessness, have ever used marijuana, have ever been tested for HIV and to have been tested for HIV within the past 6 months. MSMW may be more likely to ever exchange sex for money and ever have a sexually transmitted infection than MSMO. Conclusions: MSMW were more likely to report several markers of socioeconomic vulnerability or behaviours associated with increased risk for HIV than MSMO. MSMW contribute to HIV prevalence in the USA, and better understanding of the risk profile of this group is essential to understand heterosexual HIV transmission. MSMW, particularly those who identify as bisexual or questioning, may feel uncomfortable participating in programmes that are designed for gay-identified men. Therefore, prevention strategies need to target distinct subgroups that compose the population of MSM. [ABSTRACT FROM AUTHOR]

Objective To examine the HIV risk behaviours of men who have sex with men only (MSMO) and men who have sex with men and women (MSMW), aged 12-24 years, in five US cities and in San Juan, Puerto Rico. Methods Data were collected through four annual cross-sectional anonymous surveys at community venues and included questions about sexual partnerships, sexual practices including condom use and substance use. Demographic and risk profiles were summarised for both groups. Results A total of 1198 men were included in this analysis, including 565 MSMO and 633 MSMW. There were statistically significant differences between the two groups for many risk factors examined in multivariable models. MSMW were more likely to identify as bisexual, be in a long-term relationship, have a history of homelessness, have ever used marijuana, have ever been tested for HIV and to have been tested for HIV within the past 6 months. MSMW may be more likely to ever exchange sex for money and ever have a sexually transmitted infection than MSMO. Conclusions MSMW were more likely to report several markers of socioeconomic vulnerability or behaviours associated with increased risk for HIV than MSMO. MSMW contribute to HIV prevalence in the USA, and better understanding of the risk profile of this group is essential to understand heterosexual HIV transmission. MSMW, particularly those who identify as bisexual or questioning, may feel uncomfortable participating in programmes that are designed for gay-identified men. Therefore, prevention strategies need to target distinct subgroups that compose the population of MSM. [ABSTRACT FROM AUTHOR]

A clear understanding of local transmission dynamics is a prerequisite for the design and implementation of successful HIV prevention programs. There is a tremendous need for such programs geared towards young African-American women living in American cities with syndemic HIV and injection drug use. In some of these American cities, including Baltimore, the HIV prevalence rate among young African-American women is comparable to that in some African nations. High-risk heterosexual sex, i.e., sex with an injection drug user or sex with someone known to have HIV, is the leading risk factor for these young women. Characterizing transmission dynamics among heterosexuals has been hampered by difficulty in identifying HIV cases in these settings. The case identification method described in this paper was designed to address challenges encountered by previous researchers, was based on the Priorities for Local AIDS Cases methodology, and was intended to identify a high number of HIV cases rather than achieve a representative sample (Weir et al., Sex Transm Infect 80(Suppl 2):ii63-8, . Through a three-phase process, 87 venues characterized as heterosexual sex partner meeting sites were selected for participant recruitment in Baltimore, MD. One thousand six hundred forty-one participants were then recruited at these 87 venues, administered a behavioral risk questionnaire, and tested for HIV. The HIV prevalence was 3 % overall, 3 % among males, and 4 % among females and ranged from 1.7 to 22.6 % among high-HIV-risk subgroups. These findings indicate that attributing HIV transmission to high-risk heterosexual sex vs. other high-HIV-risk behaviors would be difficult. Moving beyond individual risk profiles to characterize the risk profile of venues visited by heterosexuals at high risk of HIV acquisition may reveal targets for HIV transmission prevention and should be the focus of future investigations. [ABSTRACT FROM AUTHOR]

The article discusses the benefits that community engagement offers. It notes that the benefits of community engagement can increase both effectiveness and dissemination of new strategies and might improve the participation in trials through community support and community referrals. It also notes that community engagement has two examples, including the Connect to Protect in the U.S. and the South African Studies on HIV in Adolescents project.

The article presents a study conducted by Jacky M. Jennings and Jonathan M. Ellen regarding the condition of young people with HIV and their partners who are at risk of acquiring HIV secondary transmission in the U.S. The researchers have divided their 409 HIV-positive young respondents into two subgroups such as men-who-have-sex-with-men and (MSM) and women-who-have-sex-with-men (WSM) ages 13 to 24 years from 15 Adolescent Medicine Trials Network clinical areas. These respondents have undergone Audio Computer-Assisted Self-Interviews (ACASI) survey along with the set of questionnaires regarding their partners. Moreover, research shows that the HIV transmission risk behaviors among young MSM and WSM were high.

The article deals with the experiences of the domestic in relation with the kinds of sentiments about life that includes houses, intimacy and privacy. It provides information on the concept of singularity as lying in the potential for multiple domesticities that emerge at different times which are either conterminous with family or with household members. It traces how intimacy and alienation mark the constant moves from, to, and through households in interstice of the house, the clinic, the prison, and the street.

Talk and ‘telling’ have assumed prominent roles in preventing HIV and promoting life with the disease at the start of the twenty-first century. Our concern in this paper is to show how social structures and circumstances shape the narrative productions of HIV positive patients whose lives are institutionally managed. We consider what ‘telling’ means when young women with few economic resources are encouraged or mandated to talk about themselves by case managers, researchers, therapists, welfare workers, and clinic staff. We organize our analysis around three such ‘autobiographical occasions’: disclosures to intimate partners prompted by agents of the state; employment opportunities in which women are hired to tell others about living with HIV as peer educators or outreach health workers; and research interviews. We argue that storylines about living with HIV have been laid down by powerful social actors whose illness experiences do not reflect those of many poor patients. These formulations constitute an ‘archive’ which organizes institutional practices and discourses. These matter not only because they provide patients with a language through which to render their actions meaningful, but because they shape the everyday experience of HIV outside the clinic, the welfare office, and the therapy session. [ABSTRACT FROM AUTHOR]

The article attempts to determine whether shifts in syphilis epidemic phases are associated with changes between or within high-risk populations, using the data from Baltimore, Maryland. The authors retrospectively define epidemic phases and compare epidemiologic profiles of syphilis cases infected during epidemic phase. Results show that the shift from a decline to growth phase in Baltimore was mostly because of increases in morbidity among non-African American men who have sex with men (MSM) and young, noninjecting drug-using women. They underscore the need for real-time investigation of potential tipping points to ensure interventions are properly focused at the beginning of any potential growth phase.

The article presents an in-depth study of the acceptability of urine chlamydia testing among asymptomatic men and their providers. The study involved asymptomatic men who were offered free nucleic acid amplification testing (NAAT) and characteristics of men who accepted were compared with those who declined. Asymptomatic men are likely to accept testing depending on venue and approach and barriers exist for men and providers.

Goal: The goat of this study was to examine the risk for repeat sexually transmitted infections (STIs) associated with reducing the number of sex partners who come from within the social networks of males 13 to 25 years old in Baltimore, Maryland, and Denver, Colorado. Study: Asymptomatic males diagnosed with chlamydia and/or gonorrhea as part of an asymptomatic chlamydia and gonorrhea male screening project were recruited and interviewed about their sexual behaviors and their perceptions of social characteristics and sexual behaviors of their sex partners. We characterized the sex partners of each participant as belonging to or not belonging to his social network. We examined whether a decrease in percentage of sex partners who were in the participant's social network was associated with repeat infection. Results: There were 47 participants in Baltimore and 92 in Denver. In both cities, there was a trend toward a finding that decreasing the percentage of sex partners belonging to a participant's social network was protective for repeat STI. Conclusion: These data suggest that interventions may need to be designed to reduce the prevalence of infection in the social networks of infected men. [ABSTRACT FROM AUTHOR]

Background: Although physical attributes have been shown to be associated with sexually transmitted disease (SD) rates, there is little information about the association between social attributes and STD rates. Goal: The objective of this study was to determine the association between gonorrhea prevalence and perceptions of social cohesion in impoverished, urban neighborhoods. Study Design: We conducted a street-based survey of 18- to 24year-olds residing in selected census block groups in Baltimore City, Maryland. Census block groups eligible for selection were defined as impoverished (greater than 20% in poverty) and unstable (lowest 25th percentile for stability). From the eligible census block groups, 5 from high gonorrhea rate (greater than the 75th percentile) census block groups and 5 from the lower gonorrhea rate (lowest 25th percentile to equal or greater than the 75th percentile) census block groups were randomly selected. Participants within the 10 selected census block groups were recruited using a street-intercept method. Participants were asked about perceived social cohesion and control. Results: Results showed that for young adults 18 to 24 years of age residing in high gonorrhea census block groups, the mean social cohesion index scores were 1.7 points lower than mean social cohesion index scores of the participants residing in the low gonorrhea census block groups (P <0.01). Conclusion: Future research needs to be conducted to determine the temporal association between gonorrhea prevalence and local social cohesion dynamics. [ABSTRACT FROM AUTHOR]

Determines if there were any demographic, behavioral and clinical differences between clients seen aboard a mobile sexually transmitted disease (STD)/HIV clinic compared with those seen in a traditional municipal STD/HIV health clinic for receipt of STD/HIV services. Key issues of interest; Analysis of pertinent topics and relevant issues; Implications on studies of acquired immune deficiency syndromes.

Determines whether partner-specific measures of perception of risk for sexually transmitted diseases predict partner-specific condom use six months later among high-risk and low-risk youth. Condom self-efficacy; Attitudes about condoms; Behavioral measures.

Inconsistent findings regarding the predictive validity of perceptions of risk for a sexually transmitted disease (STD) and HIV may be related to the use of nonspecific measures. The objective of this study was to determine whether more specific measures of perceptions of risk for STDs and HIV are associated with intentions to use a condom. We interviewed 490 male and female adolescents, 14 to 19 years old, from a free municipal STD clinic. Controlling for whether a condom was used at last sex, the association between perceptions of risk for an STD and HIV with a casual sex partner and intentions to use a condom with a casual sex partner was significant (βHIV = . 14, p < .01, and βSTD = .20, p < .01 ), as was the association between perceptions of risk for an STD and HIV with a main sex partner and intentions to use a condom with a main sex partner (βHIV = .31, p < .001, and βSTD = .32, p < .001). This supports the continued inclusion of this construct in models of sexual and other health-related behaviors. [ABSTRACT FROM AUTHOR]

Individuals' perceptions about their sex partners' sexually transmitted disease (STD) and human immunodeficiency virus (HIV)-related risk behaviors may affect their sexual behavior. The objective of this study was to determine the agreement between individuals' perceptions about their main sex partner' risk behaviors and their main sex partners' self-reported risk behaviors. One hundred individuals and their current main heterosexual partner were recruited from a public STD Clinic. Participants were questioned separately from their main sex partner about their own risk behaviors and about their perceptions of their main sex partner's risk behaviors. Risk behaviors included more than one sex partner in the last three months, ever having had sex with another man (for male partners only), having used crack cocaine in the last three months, and ever having used injection drugs. For most of the risk behaviors, there was fair to moderate agreement between subjects' perceptions and their main sex partners' reported behavior (kappa scores ranged from 0.51 to 0.81). There was poor agreement between females' perceptions and their partners' report of ever having had sex with a man (kappa score=0.24). Furthermore, for most risk behaviors more than one third of participants thought that their partner had not engaged in a risk behavior when, in fact, they had. These findings are worrisome from a health education perspective. Individuals are either not asking about, or are being given false information about their partners' HIV-related risk behaviors and, thus, may not be taking necessary precautions. [ABSTRACT FROM AUTHOR]

The article presents a study which determined how often primary care physicians ask adolescents about smoking in California. A mailed questionnaire was used to survey a stratified random sample of community-based, board-certified, specialists in pediatrics, family practice, and internal medicine who practice in California and spend at least 50% of their patient care time in primary care. The final sample included only physicians who graduated from medical school in the United States from 1970 through 1985. All anaIysis were performed with the use of data weighted by the actual number of male and female providers in each specialty in California. Overall, the rates of screening younger adolescents for reguIar smoking were higher among female than among male physicians during routine visits. Multivariate analyses revealed significant associations between measured physician attitudes and variations in rates of screening for regular smoking during a routine history and physical exam. Rates of screening younger adolescents were highest among physicians who had more positive attitudes towards adolescents and more positive attitudes towards smoking cessation.

Provides information on a study to determine the degree to which racial/ethnic differences in sexual behaviors account for Africa-American adolescents' higher rates of sexually transmitted diseases (STDs). Methodology used to conduct the study; Results of the study; Discussion on the results; Conclusion reached.

Determines whether personal and/or a partner's use of crack cocaine is associated with the diagnosis of early syphilis or gonorrhea independent of high-risk sex behaviors. Suggestion that the use of crack cocaine characterizes sexual networks at risk for syphilis; STD risk-related sexual behaviors.

The article explores the systems approach to improve screening of human immunodeficiency virus (HIV) in sexually active youth in urban primary care settings in the U.S. It states that the systems approach is designed to disseminate the revised recommendations of the Centers for Disease Control and Prevention (CDC) for HIV testing in healthcare setting. The authors examine whether the approach would result in increased HIV screening tests performed on sexually active youth.

The article presents a study on the pelvic inflammatory disease (PID) patients' cost of medical care and the factors affecting its increase. It says that the study used the medical record of PID patients with age ranging from 12 to 21 years old from a university hospital in the U.S. The result shows that PID outpatient cost 763 dollars in 2009 while inpatient ranges from 5,817 to 8,117 dollars. It adds that outpatient setting is cost effective than that of emergency department (ED).

The article reports on the evaluation of supplementary cueing as a technique to increase recall of sex partners. It discusses that volunteers at a clinic in Brazil were asked to freely recall all regular and casual sex partners. It infers that the cue technique can improve sexual partners' recall in cultural contexts different than the United States because individuals already reporting several partners before the cue. An overview on the testing in adolescents and young adults receiving sexually transmitted testing in an urban primary care setting.

This paper examines the effect of socioeconomic position on the differences in the 3-year rates (1990 to 1992) of reported cases of gonorrhea and chlamydia between Black and White adolescents, aged 12 to 20 years, residing in San Francisco. The crude relative risks for Blacks were 23.4% (95% confidence interval [CI] = 20.4, 27.8) for gonorrhea and 9.3 (95% CI = 8.3, 10.3) for chlamydia. Adjusting for poverty and occupational status, the relative risks were 28.7 (95% CI = 22.5, 36.1) for gonorrhea and 8.9 (95% CI = 7.4, 10.6) for chlamydia. This study demonstrates that factors other than poverty and occupational status account for the racial/ethnic differences in the rates of gonorrhea and chlamydia among adolescents in San Francisco. [ABSTRACT FROM AUTHOR]

Purpose: To examine how interpersonal factors are associated with family, peer, and partner social support among urban female adolescents in sexual relationships.Design: Secondary data analysis of cross-sectional data.Setting: Two urban health clinics and community sites in Baltimore, Maryland.Participants: One hundred sixteen female adolescents (ages 16-19) with 131 heterosexual relationships from the Perceived Risk of Sexually Transmitted Diseases cohort.Measures: Interpersonal factors included parental monitoring, friend-partner connectedness, and feelings of intimacy for partner. Social support was measured using the Multidimensional Scale of Perceived Social Support with family, peer, and partner subdomains.Analysis: Multivariable linear regression models using baseline data and accounting for clustering of partners.Results: Adolescents perceived high levels of family, peer, and partner support, with the greatest coming from partners (range: 1-5; family mean: 4.0 [95% confidence interval, CI: 3.83-4.18]; peer mean: 4.2 [95% CI: 4.05-4.33]; partner mean: 4.5 [95% CI: 4.36-4.60]). Parental monitoring and friend-partner connectedness were significantly associated with greater family (b = 0.11, standard error [SE] = 0.03, P = 0.001; b = 0.15, SE = 0.06, P = .02) and peer support (b = 0.06, SE = 0.02, P = .01; b = 0.29, SE = 0.07, P < .001). Feelings of intimacy for partner was significantly associated with greater partner support (b = 0.08, SE = 0.03, P = .02).Conclusion: Feeling connected to one's social network and having a connected network is an important contribution to social support for urban female adolescents in sexual relationships. Future research targeting interpersonal factors is warranted, as it may result in increased social support and promote positive sexual health behaviors in an urban female adolescent population. [ABSTRACT FROM AUTHOR]

Youth living with HIV have sub-optimal rates of adherence to antiretroviral therapy (ART). Mindfulness instruction interventions have shown promise for improving medication adherence, but the effects and mechanisms of these interventions are still being explored among people living with HIV, including youth. In the context of a randomized controlled trial of the efficacy of a Mindfulness-Based Stress Reduction (MBSR) program on ART adherence and viral suppression among youth living with HIV, we conducted 44 iterative, semi-structured, in-depth interviews with 20 study participants (13-24 years) recruited from clinics at two academic centers in Baltimore, Maryland. Interviews explored the social context and psychosocial dynamics of ART adherence in the context of the MBSR intervention, compared with those in a control arm. We employed thematic content analysis to systematically code and synthesize textual interview data. Participants’ challenges with ART adherence were often situated within an ongoing process of working to manage HIV as a stigmatized, chronic condition in addition to other intersecting social stigmas, inequalities, and stressors. Participation in the MBSR program and related group support allowed participants to non-judgmentally observe and accept difficult thoughts, feelings, and experiences associated with living with HIV and taking ART, which facilitated greater reported adherence. Mindfulness training may stimulate new perspectives and understanding, including greater self- and illness-acceptance among youth living with HIV, leading to improved HIV outcomes. [ABSTRACT FROM AUTHOR]

The article discusses the use of venue-based sampling in sexually transmitted disease (STD) research. It discusses the results of a study on the prevalence of sexual behaviors and sexually transmitted infections among a sample of youth recruited through venue-based and network sampling approaches form working-class neighborhoods in Atlanta, Georgia.

Editorial. Comments on several articles about sexually transmitted disease (STD). Sex behavior of a birth cohort of women and men; Disease rates; STD prevention.

Editorial. Focuses on the prevention efforts of the government to curb the incidence of sexually transmitted diseases (STD) in incarcerated adolescent girls. Estimation on the annual cost for the treatment of pelvic inflammatory disease; Risk among the adolescent girls for STD complications; Rates of gonorrhea among the population of women.

Editorial. Comments on the consideration of age in the study of sexuality among adolescents. Reasons for lack of data on developmental changes in sex; Comparison between within-subject analysis to cross-sectional data analyses; Inclusion on matters related to sexual coercion among younger adolescents.

HIV-infected youth experience many stressors, including stress related to their illness, which can negatively impact their mental and physical health. Therefore, there is a significant need to identify potentially effective interventions to improve stress management, coping, and self-regulation. The object of the study was to assess the effect of a mindfulness-based stress reduction (MBSR) program compared to an active control group on psychological symptoms and HIV disease management in youth utilizing a randomized controlled trial. Seventy-two HIV-infected adolescents, ages 14-22 (mean age 18.71 years), were enrolled from two urban clinics and randomized to MBSR or an active control. Data were collected on mindfulness, stress, self-regulation, psychological symptoms, medication adherence, and cognitive flexibility at baseline, post-program, and 3-month follow-up. CD4+ T lymphocyte and HIV viral load (HIV VL) counts were also pulled from medical records. HIV-infected youth in the MBSR group reported higher levels of mindfulness (P = .03), problem-solving coping (P = .03), and life satisfaction (P = .047), and lower aggression (P = .002) than those in the control group at the 3-month follow-up. At post-program, MBSR participants had higher cognitive accuracy when faced with negative emotion stimuli (P = .02). Also, those in the MBSR study arm were more likely to have or maintain reductions in HIV VL at 3-month follow-up than those in the control group (P = .04). In our sample, MBSR instruction proved beneficial for important psychological and HIV-disease outcomes, even when compared with an active control condition. Lower HIV VL levels suggest improved HIV disease control, possibly due to higher levels of HIV medication adherence, which is of great significance in both HIV treatment and prevention. Additional research is needed to explore further the role of MBSR for improving the psychological and physical health of HIV-positive youth. [ABSTRACT FROM AUTHOR]

Background: Young men who have been involved with the criminal justice system are more likely to have concurrent sexual partners, a key driver of sexually transmitted infections. The value men place on having sexual relationships to validate themselves may play an important role in understanding this association.Methods: Data were from a household survey. Young men (N = 132), aged 16 to 24 years, self-reported whether they ever spent time in jail or juvenile detention and if they had sexual partnerships that overlapped in time. A novel scale, "Validation through Sex and Sexual Relationships" (VTSSR) assessed the importance young men place on sex and sexual relationships (α = 0.91). Weighted logistic regression accounted for the sampling design.Results: The mean (SD) VTSSR score was 23.7 (8.8) with no differences by race. Both criminal justice involvement (CJI) (odds ratio [OR], 3.69; 95% confidence interval [CI], 1.12-12.1) and sexual validation (OR, 1.10; 95% CI, 1.04-1.16) were associated with an increased odds of concurrency; however, CJI did not remain associated with concurrency in the fully adjusted model. There was effect modification, CJI was associated with concurrency among those who scored high on sexual validation (OR, 9.18; 95% CI, 1.73-48.6]; however, there was no association among those who scored low on sexual validation. Racial differences were observed between CJI and concurrency, but not between sexual validation and concurrency.Conclusions: Sexual validation may be an important driver of concurrency for men who have been involved with the criminal justice system. Study findings have important implications on how sexual validation may explain racial differences in rates of concurrency. [ABSTRACT FROM AUTHOR]

A large body of research has identified peer exposure as a key factor driving adolescent substance use. However, findings on the role of sex partners are less robust and mixed. This study aims to fill this gap by examining the independent contribution of close friends' and sex partners' alcohol and marijuana use on adolescents' use of these substances. A secondary data analysis of social network data collected in 2000–2002 from a household sample of African American youth (14–19 years old) in the Bayview and Hunter's Point neighborhoods of San Francisco was conducted. Index participants and their nominated close friends and romantic sex partners (N = 104 triads) self-reported recent alcohol and marijuana use (defined as any use in the past 3 months). Generalized estimated equations were used to estimate the independent association between adolescent's recent substance use and their friend's and sex partner's use. Adolescents with a marijuana-using romantic sex partner had a nearly six-fold higher odds of using marijuana compared to adolescents with a non-using partner, controlling for close friend's marijuana use and other confounders [OR:5.69, 95%CI: 1.94, 16.7]; no association with close friend's marijuana use was found. A similar pattern was observed for alcohol use. Adolescents with an alcohol-using romantic sex partner had increased odds of using alcohol compared to adolescents with a non-using partner, controlling for close friend's alcohol use and other confounders [OR:2.40, 95%CI: 1.02, 5.63]; no association with close friend's alcohol use was found. Romantic sex partners may play a unique and significant role in adolescent substance use. Peer-focused interventions may be more effective if they consider romantic sex partners. Future research should consider the role of romantic sex partners in changing social context related to substance use from adolescence to young adulthood. [ABSTRACT FROM AUTHOR]

Adolescents and young adults (AYA) 13–24 years old make up a disproportionate 21% of new HIV diagnoses. Unfortunately, they are less likely to treat HIV effectively, with only 30% achieving viral suppression, limiting efforts to interrupt HIV transmission. Previous work with mindfulness-based stress reduction (MBSR) has shown promise for improving treatment in AYA living with HIV (AYALH). This randomized controlled trial compared MBSR with general health education (HT). Seventy-four 13–24-year-old AYALH conducted baseline data collection and were randomized to nine sessions of MBSR or HT. Data were collected at baseline, post-program (3 months), 6 and 12 months on mindfulness and HIV management [medication adherence (MA), HIV viral load (HIV VL), and CD4]. Longitudinal analyses were conducted. The MBSR arm reported higher mindfulness at baseline. Participants were average 20.5 years old, 92% non-Hispanic Black, 51% male, 46% female, and 3% transgender. Post-program, MBSR participants had greater increases than HT in MA (p = 0.001) and decreased HIV VL (p = 0.052). MBSR participants showed decreased mindfulness at follow-up. Given the significant challenges related to HIV treatment in AYALH, these findings suggest that MBSR may play a role in improving HIV MA and decreasing HIV VL. Additional research is merited to investigate MBSR further for this important population. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented where the author discusses various reports published within the issues, including on the program Connect to Protect® to prevent the spread of HIV, one on root cause analysis for the spread of HIV and one on community mobilization to prevent HIV.

The article discusses a research study on the reciprocity of heterosexual relationships among adolescents, concordance in partner types and reciprocal dyads. Obtained were data for examining sexually transmitted infections (STI) risk behaviour prevalence and transmission patterns from July 2000 to October 2001. Results showed that of 782 unique heterosexual relationships, 211 reciprocal dyads were reported by 179 males and 198 females and less than one-third were nominated heterosexual dyads.

The article presents a study which examines the association between relationship characteristics and condom uses among heterosexual Latino adolescents and young adults in the U.S. It notes the greater risk of sexually transmitted infection among Latino youth in the country compared with non-Hispanic white youth. It states that heterosexual young Latinos aged 16 to 22 were taken for interviews. Moreover, it also mentions that the increasing affection and the decline in condom use between youth might induce the transmission of sexually transmitted infections.

CONTEXT: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. [ABSTRACT FROM AUTHOR]

The article presents a case study that evaluates the impact of sexual mixing and concurrency levels on the spread of a persistent sexually transmitted infection through the use of a stochastic model. Results shows that among 1,050 respondents, mixing patterns had a greater impact on the prevalence of infection whereas concurrency was significant for only the lowest activity group. It reveals that mixing patterns had moderated the extent of concurrency's impact on secondary transmission.

Background: Traditional syphilis control tools could be limited in high-risk groups in which the disease is concentrated. Novel programmatic methods such as tracking and targeting sex partner meeting venues could be valuable.Goal: The goals of this study were to determine if syphilis cases' sex partner meeting venues are geographically different than their residences and to determine the characteristics of identified meeting places.Results: For cases diagnosed from September 2001 to December 2002 with geocodable data, only 9% of meetings took place in the same census block group as residence, and mean and median distance from residence to meeting place was 1.73 and 1.03 miles. The most common meeting location type overall was a street or corner, but differed by risk behaviors.Conclusion: Baltimore syphilis cases in general met sex partners outside their immediate neighborhoods. Meeting locations could provide new targets for syphilis control interventions. [ABSTRACT FROM AUTHOR]

This paper is concerned with how disclosure becomes self-production for young adults within the setting of the sexually transmitted disease (STD) clinic. The STD clinic is a special medical environment where the process of disclosure is not just a way of accessing treatment; it is also a process through which illness, sexuality, and social experience become entangled in telling. Illness according to medical categories is reshaped in the social world, bringing a different set of criteria to bear on the definition of illness. The concern we raise regards how meaning is secured simultaneously through the experience of illness and social relations. Using data from a series of clinic-based ethnographic interviews, we examine the narratives of three young men. Together, the narratives demonstrate the interrelatedness of illness and self-production in various forms. In one case the tension between interpersonal violence and self-preservation is central. In another, the place of knowledge in family relationships renders the entire picture of the social unstable. The paper signals a number of issues absent in clinical and epidemiological depictions of vulnerability, particularly in the context of the urban United States. [ABSTRACT FROM AUTHOR]

Background: In sexual networks, bridge members engaging in discordant partnering play key roles in maintaining and transmitting sexually transmitted infections (STIs) within a population. Goal: The goal was to characterize adolescents likely to engage in discordant sexual relationships with main and casual sex partners. Study Design: Egocentric data about adolescents and their most recent sex partner(s) collected over 6 months were analyzed with use of logistic regression. Results: History of STI, drug use, and meeting venue were significantly associated with discordant sexual partnering among high-risk adolescents. Participants with histories of high-risk behavior, e.g., hard drug use or STI, were more likely to have had a recent, dissimilar partner than those with lower-risk profiles. Particular meeting venues, such as clubs and street locations, were more likely to be associated with age-discordant, race-discordant, and drug use-discordant partnerships for females. Conclusion: Bridge members of adolescent sexual networks were more likely to have a history of STI, hard drug use, or meeting their sex partner through particular venues. [ABSTRACT FROM AUTHOR]

Abstract. Study objectives. To identify the sociodemographic and Health Belief Model predictors of follow-up appointment-keeping behavior. Design. Prospective observational study. Settings. General adolescent medical clinic. Patients and measurements. Sequential sample of 166 adolescents (aged 12 to 20 years, mean = 15.9 years) enrolled in the clinic. The population was 75% female; the racial-ethnic distribution of the sample was 37.9% black, 29.8% white, 11.2% Asian, 14.3% Hispanic, and 6.8% "other" background. Subjects' social class was primarily lower-middle (60.5%) and middle class (28.6%). A sub-sample was randomly assigned to be interviewed about their beliefs concerning their follow-up appointment and the constructs of the Health Belief Model. Results. Forty-eight percent of the total sample failed to keep their follow-up appointment. There was a significant positive correlation between social class and appointment keeping (F = 5.07; df = 5,110; P = .026). Neither race-ethnicity nor who made the appointment were found to be associated with follow-up appointment-keeping. The only construct of the Health Belief Model found to be significantly associated with appointment keeping was the number of potential negative outcomes resulting from noncompliance perceived by the subject (F = 6.85; df = 1,74; P = .011). Conclusions. Clinicians must work with adolescents to improve their understanding of the potential negative outcomes associated with noncompliance to improve appointment-keeping behavior. [ABSTRACT FROM AUTHOR]

In the United States, youth aged 13–24 comprised approximately 21% of new HIV infections in 2017; 13% of these infections occurred among women, the majority of whom (86%) acquired HIV through heterosexual contact (Centers for Disease Control and Prevention. 2019a. HIV and youth. Retrieved from , Centers for Disease Control and Prevention. 2019b. HIV among women. Retrieved from https://www.cdc.gov/hiv/group/gender/women/index.html). We fit and validated a developmentally appropriate empirical model of Connell's Theory of Gender and Power (Connell, R. W. 1987. Gender and power: Society, the person and sexual politics. Stanford, CA: Stanford University Press, Connell, R. W. 2013. Gender and power: Society, the person and sexual politics. Hoboken, NJ: John Wiley & Sons) in a sample of young women and assessed whether gendered powerlessness reflected a multidimensional higher-order latent factor, as the theory implies. Anonymous computer-assisted interviews were administered to at-risk, sexually active young women (N = 1,101). Factor analyses and structural equation modeling were used to determine the dimensionality of gendered powerlessness. Associations with condom use were examined to validate the model. We fit a three-component model of gendered powerlessness, but not a higher-order latent factor. We observed that high scores on two dimensions of gendered powerlessness – cathexis and sexual division of power — were associated with lower likelihood of condom use. Our three-component model helps elucidate the role that components of gendered powerlessness play in young women's health behaviors and underscores the need for measures tailored to young women at high risk of contracting HIV. [ABSTRACT FROM AUTHOR]

Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.Results: Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)).Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust. [ABSTRACT FROM AUTHOR]

Generalized perceived powerlessness is an important psychosocial construct that determines a wide range of health behaviors and outcomes. This study has two aims: (1) examine the structure of the newly developed perceived powerlessness scale using exploratory and confirmatory factor analyses and (2) assess the scale's invariance across key demographic variables using multi-group confirmatory factor analysis among a random household sample of African American and White youth (aged 15–24 years) residing in Baltimore, MD. Our study results demonstrated that the powerlessness scale is valid among a demographically diverse sample of urban youth, showing promise for use in future health behavior and outcome studies. [ABSTRACT FROM AUTHOR]

Venue-based strategies offer effective means of targeting men who have sex with men. Few studies have sought to focus on where younger men congregate and understand risk behaviors that may occur at lower (i.e., community centers) versus higher risk venues. Data from 1,311 young men who have sex with men (YMSM) aged 12- to 24-years-old recruited from publicly accessible venues was used to examine the association between venue type (bar/club, community center, mixed [adjacent to bar/club, including parking lot/alley]) and HIV-related risk factors. YMSM recruited from community venues were more likely than those from bars/clubs to report more partners in last year, receive money in exchange for sex, and to be tested for HIV in prior 6 months, whereas YMSM from mixed-use venues were more likely to have ever received money in exchange for sex, and injected drugs. Community and mixed venues may be key access points for YMSM. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined whether adolescents' perceived risk for sexually transmitted disease (STD) is correlated with perceptions about partners' STD-related risk behaviors. Most adolescents perceived their partners to be involved in drug and alcohol use during the course of their relationships. More than two third of participants reported that they thought their partner had gotten and HIV test.

A distal psychosocial factor, perceived powerlessness, has been found to predict various sexual risk behaviors among youth, yet no studies have assessed mediators or moderators in this relationship. Using a demographically diverse, longitudinal sample of urban youth (N = 257), this study assessed whether the need for sexual validation mediates the relationship between perceived powerlessness and sexual risk behaviors and to assess whether this mediated pathway is moderated by socioeconomic status and gender. The mean age of the participants was 21 years old (range: 15–24) and the majority of the sample identified as Black (65%) and female (62%). The results of structural equation modeling showed that the need for sexual validation mediated perceived powerlessness and condomless sex at last sex among Black youth. The need for sexual validation mediated perceived powerlessness and concurrent sexual partnerships among White youth and depended on levels of socioeconomic status. Sexual risk behavior interventions should provide youth with increased opportunities that encourage feelings of validation from other personal achievements in addition to sex while simultaneously addressing the structural conditions that drive young people to feel powerless. [ABSTRACT FROM AUTHOR]

To compare clinician perspectives for the treatment of pelvic inflammatory disease (PID) with those of adolescent patients and parents. Cross-sectional study. Urban academic pediatric and adolescent medicine practices and school-based health clinics in a large urban community with a high prevalence of sexually transmitted infections and a national sample of adolescent-serving clinicians. Female patients aged 12-19 years, parents raising an adolescent older than the age of 12 years in the urban community, and clinicians who serve adolescents recruited from regional and national listservs. None. Visual analogue scale scores on a scale of 0-10 corresponding to preferences on patient disposition in 17 clinical scenarios for a hypothetical patient with PID. Compared with adolescents, clinicians were significantly more likely to endorse hospitalizations when patients presented with severe or complicated illness (β = 0.9; standard error [SE], 0.22; P <.001), possible surgical emergency (β = 0.83; SE, 0.2; P <.001), concurrent pregnancy (β = 0.59; SE, 0.3; P =.046), or failure of outpatient treatment (β = 0.58; SE, 0.29; P =.045). Compared with clinicians, adolescents were significantly more likely to endorse hospitalizations when patients presented at a young age (β = 1.36; SE, 0.38; P <.001), were homeless (β = 0.88; SE, 0.32; P =.007), were afraid to inform a partner (β = 1.66; SE, 0.40; P <.001), or had unaware parents (β = 2.86; SE, 0.39; P <.001). Clinicians were more likely to recommend hospitalization when doing so adhered to national guidelines on PID treatment. Adolescents opted for hospitalization more often than clinicians in scenarios in which patients exhibited social vulnerability. Clinicians should engage with adolescents in shared disposition planning and use a more nuanced approach to PID management for adolescents who might not be able to tolerate an outpatient regimen. [ABSTRACT FROM AUTHOR]