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In this paper, I reflect on past papers published in the British Journal of Social Psychology (BJSP) that have played a role in the development of the theory of reasoned action (TRA) and the theory of planned behaviour (TPB). I focus on seven papers that fall into five categories: (1) those that critique the TRA/TPB for taking insufficient account of social factors; (2) those that critique the models on the grounds that many social behaviours are 'habitual'; (3) those that critically examine the construct of perceived behavioural control; (4) those that argue for the importance of affective factors, which appear to be overlooked in the TRA/TPB; and (5) those that argue for the importance of studying the role of moderating factors and interaction effects in the TRA/TPB. I conclude that BJSP's traditional focus on criticism and theory development is one that benefits the journal and the field. [ABSTRACT FROM AUTHOR]

At the same time, most programs focus more on indicators that measure health status, service provision or utilization, or the success of reproductive health interventions at the subnational level (WHO, [40]). Data for these indicators come from nationally representative surveys such as the Demographic and Health Surveys and Multiple Indicator Cluster Surveys, but not all countries conduct these surveys on a regular basis or conduct them using the same population (e.g., exclusion of unmarried youth), and there are limitations to the measures derived from them (e.g., the fixed age range). In August of 2021, the Editorial Committee of I Studies in Family Planning i put out a call for abstracts for a special issue focused on indicators in sexual and reproductive health and rights. Another prevalent theme in the papers in this special issue involves the need for better measurement of psychosocial and socioecological factors that influence sexual and reproductive health-related behaviors. [Extracted from the article]

New medicines can transform routines and priorities in clinical practice, but how do clinicians think and feel about these changes, and how does it affect their work? In Australia, the HIV prevention regimen pre‐exposure prophylaxis (PrEP) has been rapidly rolled out, transforming the sexual cultures and practices of users, but less attention has been given to the ways PrEP has reconfigured clinical practice. This paper draws on 28 qualitative semi‐structured interviews conducted between 2019 and 2020 with PrEP‐providing doctors and nurses in Australia to consider how they have affectively engaged with PrEP and put it into practice. Through a reflexive thematic analysis, we explore how clinicians adapted to PrEP, how the field of HIV prevention has been transformed, and how these developments have changed how clinicians approach patients. While the introduction of PrEP was initially received with uncertainty and shock, clinicians described PrEP as enjoyable to prescribe, and better aligned with the moral duties of sexual health consultations than existing HIV prevention strategies like condoms. Through approaching clinical work as an 'affective practice', we argue for attending not only to how new interventions change expectations and practices, but also how these changes are felt and valued by clinicians. [ABSTRACT FROM AUTHOR]

Aim Despite advances in surgical technique, parastomal herniation is common. This systematic review aims to assess the efficacy of prophylactic mesh at primary operation in reducing the incidence of parastomal hernia. Method Medline, EMBASE and CENTRAL were searched for relevant publications between January 1980 and January 2010. The search strategy included text terms and MESH headings for parastomal hernia, mesh and prevention and/or prophylaxis of hernia. No language restrictions were applied. Bibliographies from the papers requested in full were manually checked. All randomized controlled trials were included regardless of the language of publication. Results were extracted from the papers by two observers independently on a predefined data sheet. Disagreements were resolved by discussion. REVMAN 5 was used for statistical analysis. Results Of 27 possible studies three randomized controlled trials fulfilled the criteria for systematic review, with a total of 128 patients (mesh 64, no mesh 64). The two study groups were well matched demographically. The incidence of parastomal hernia in the mesh group was 12.5% (8/64) compared with 53% (34/64) in the control group ( P < 0.0001). There was no difference in mesh related morbidity in the two groups. Conclusion Although only three trials with 128 patients fulfilled the criteria for this systematic review, the data suggest that the use of prophylactic prosthetic mesh at the time of primary stoma formation reduces the incidence of parastomal hernia. [ABSTRACT FROM AUTHOR]

Introduction: Female sex workers (FSW) who use drugs are a key population at risk of HIV in Kazakhstan, and face multiple structural barriers to HIV prevention. More research is needed on the role of structural interventions such as microfinance (MF) in reducing HIV risk. This paper describes the results of a cluster‐randomized controlled trial to test the efficacy of a combination HIVRR + MF intervention in reducing biologically confirmed STIs and HIV risk behaviours. Methods: This study took place from May 2015 to October 2018 in two cities in Kazakhstan. We screened 763 participants for eligibility and enrolled 354 FSW who use drugs. Participants were randomized in cohorts to receive either a four‐session HIVRR intervention, or that same intervention plus 30 additional sessions of financial literacy training, vocational training and asset‐building through a matched‐savings programme. Repeated behavioural and biological assessments were conducted at baseline, 3‐, 6‐ and 12‐months post‐intervention. Biological and behavioural primary outcomes included HIV/STI incidence, sexual risk behaviours and drug use risk behaviours, evaluated over the 12‐month period. Results: Over the 12‐month follow‐up period, few differences in study outcomes were noted between arms. There was only one newly‐detected HIV case, and study arms did not significantly differ on any STI incidence. At post‐intervention assessments compared to baseline, both HIVRR and HIVRR + MF participants significantly reduced sexual and drug use risk behaviours, and showed improvements in financial outcomes, condom use attitudes and self‐efficacy, social support, and access to medical care. In addition, HIVRR + MF participants showed a 72% greater reduction in the number of unprotected sex acts with paying partners at the six‐month assessment (IRR = IRR = 0.28, 95% CI = 0.08, 0.92), and a 10% greater reduction in the proportion of income from sex work at the three‐month assessment (b = −0.10, 95% CI = −0.17, −0.02) than HIVRR participants did. HIVRR + MF participants also showed significantly improved performance on financial self‐efficacy compared to HIVRR over the 12‐month follow‐up period. Conclusions: Compared to a combination HIVRR + MF intervention, a robust HIVRR intervention alone may be sufficient to reduce sexual and drug risk behaviours among FSW who use drugs. There may be structural limitations to the promise of microfinance for HIV risk reduction among this population. [ABSTRACT FROM AUTHOR]

Objectives: Australian aged care policy is wholly focused on individual "consumers" and consequently neglects the needs of dyadic partners. This paper highlights partnered baby boomers' attitudes to maintaining sexual and intimate relationships in residential care. Methods: In 2016, cross‐sectional data were collected using an online survey of partnered baby boomers recruited using social media. Qualitative data were analysed using word frequency, keywords‐in‐context and thematic analysis. Descriptive statistics were generated from quantitative data. Results: There were 168 participants (85% female), aged 51‐71 years. Many reported that remaining together and continuing physical and sexual contact were important in aged care contexts—necessitating private couple's suites, shared beds, access to condoms, lubricants and sexual health professionals. Conclusions: Considerable cultural change will be required to raise residential aged care to the standard expected by some partnered baby boomers. Shifting to a more couple‐centred approach may benefit partnered residents' health and well‐being. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a literature review to explore issues influencing condom use in heterosexual adolescents and young people. Background. Sexually transmitted infections (STIs) are a major international health issue and adolescents and young people are particularly vulnerable. Efforts to address the rapid spread of STIs have largely focused on promoting the use of condoms as a protective 'safer sex' measure. However, use of the male condom is still inconsistent and the incidence of STIs continues to increase. Method. A search of the literature using EBSCO Host databases was undertaken in 2006, with a focus on women, young people, condoms and STIs. Papers published in English from 1992 to 2006 were sought. Only research papers are included in this review. Results. Factors impeding decisions to use protection by young people include lack of knowledge about prevalence of STIs, ambiguity around contraception and safer sex practices, and the difficulty faced by young women in particular in negotiating safer sex. The notion of romantic love confounds the assessment of risk and can render young people, particularly young women, ineffective in negotiating safer sex practices. Conclusion. Adolescents and young adults are particularly vulnerable in relation to STIs. There is a need to ensure that accurate messages are delivered about safer sex and contraception to this very vulnerable group. Furthermore, it is important to recognize that romantic love comprises strong emotions that have a role in decisionmaking and options for reducing personal-health risk during sexual activity. [ABSTRACT FROM AUTHOR]

High adolescent pregnancy rates in New Zealand (NZ) are influenced by limited access to contraception. In this paper, we discuss using a proactive contraception provision (PCP) model to overcome barriers that prevent effective contraceptive uptake. After outlining steps taken to assess acceptability of PCP in NZ, we cover three issues to consider with PCP: the range of contraceptives that should be offered, the age range that should be approached, and finally whether to include adolescents without uteruses. We conclude that PCP is an approach worth considering in the NZ context and should be piloted to assess feasibility and effectiveness. [ABSTRACT FROM AUTHOR]

The study reported in this paper uses discourse analysis to better understand heterosexual adults' accounts of condom use. It is suggested that discursive constructions of what it means to use a condom in a relationship may constrain or facilitate particular behaviours within particular contexts. Analysis of interview transcripts revealed that respondents framed their accounts of condom use almost exclusive within a marital discourse. This discourse constructs marriage as a condition incompatible with condom use position married respondents in such a way that they feel unable to request safer sex from their spouse. The concept of 'trust' was identified as a key component of the discourse. Respondents' constructions of 'trust' are fundamentally different from those found in AIDS education materials. The paper discusses the implications of these findings for AIDS education. [ABSTRACT FROM AUTHOR]

By examining the relationship between the cultural construction of female sexuality and the lack of potential for many young heterosexual women to be truly sexually healthy this paper submits that messages for women within HIV prevention programmes can be confused, confining and at times dangerous to women's health and well-being. It is suggested that these messages also reinforce a traditional, biologically determined medical understanding of female sexuality that does not take note of social or culturally based research or commentary on female experience or female desire, but rather confines many women to sexual restrictions, doing little to empower women to prevent sexual risk-taking. The ideological basis of the discussion within this paper is informed by the awareness that applications and understandings of 'sexuality' are diverse and contested within sex research traditions and will influence the choice of research concerns. The 'deterministic' explanation of sexuality that 'sexuality' (the abstract noun referring to the quality of being 'sexual', Williams 1983) is your fate or destiny and that biology causes the patterns of sexual life, is abandoned in this paper in favour of a search for a definition of sexuality which brings together a host of different biological and mental possibilities which are given meaning only in social relations. This allows for a framework for the study of sexuality that relates it to other social phenomena, particularly economic, political and social structures (Foucault 1979); in other words, a study of the 'social construction' of sexuality. This paper suggests that health care professionals need to develop an awareness of the diversities within female sexuality and gain insight into their own values and assumptions about female sexuality if these are not to inhibit effective approaches and interventions in the areas of HIV and sexual health. [ABSTRACT FROM AUTHOR]

Black youth account for the largest number of new HIV infections among heterosexual youth. Mental illness and difficulties in emotion regulation contribute to increased reports of HIV/sexually transmitted infection (STI) risk‐related sexual behaviors in this group. Yet limited interventions exist to address this affective component of the sexual decision‐making process. The purpose of this paper was to describe the trial design, research challenges, and baseline characteristics from a study designed to fill this gap. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually‐active Black youth aged 14 to 17 (N = 108). Challenges encountered in the research process warrant further attention in future research (e.g., disagreement among the regulatory bodies on parental permission requirements). The most common mental health diagnoses were Recurrent Major Depressive Disorder (15.7%) and current substance abuse (7.4%). Participants reported higher levels of emotional suppression, and adaptive methods of emotion management, than culturally inappropriate expressions of anger or sadness. They also reported a mean age of 13.6 at first vaginal sex, used condoms 66% of the time for vaginal sex, and had an average of three sexual partners in the past 6 months. More than one‐quarter (26.9%) had sex with more than one person in the same day. These findings indicate intervention is crucial for this population. The forthcoming trial evaluation will indicate the promise of such interventions in reducing HIV/STI infections in this key population. [ABSTRACT FROM AUTHOR]

Abstract: While the fertility effects of improving teenagers’ access to contraception are theoretically ambiguous, most empirical work has shown that access decreases teen fertility. In this paper, we consider the fertility effects of access to condoms—a method of contraception not considered in prior work. We exploit variation across counties and across time in teenagers’ exposure to condom distribution programs in schools. We find that access to condoms in schools increases teen fertility by about 12 percent. The results suggest that the effects of condom access varied significantly across different programs; the positive fertility estimates are driven by communities where condoms are provided without mandated counseling. Programs that mandated counseling have zero or negative fertility effects, but estimates on these counties are less robust across specifications. [ABSTRACT FROM AUTHOR]

The decision whether or not to use condoms was studied among Norwegian adolescents using the theory of reasoned action (TRA). The empirical data stem from a survey of a random sample of 3000 adolescents aged 17–19 (response rate 60.9 per cent). A total of 1172 persons had made their sexual debuts, and thus constituted the material of this paper. TRA is an expectancy-value model of attitude for understanding and changing a behavior, and views condom behavior as a decision based upon consideration of the expected consequences of using or not using condoms. The decision whether or not to use a condom was primarily under normative control, and immediate consequences were more important than long-term consequences, indicating that persuasive communications should pay more attention to social pressure and psychological costs. Most of the effect of prior behavior upon intention was not mediated by attitudes and subjective norm, and by far exceeded the effects of attitudes and subjective norm, raising doubts of the generality of the model. The possible inclusion of a measure of perceived behavioral control is discussed. [ABSTRACT FROM AUTHOR]

This paper discusses a model to predict intended condom use among a sample of British. 16–20 year old virgins (n = 571). This group are of interest as they hold attitudes and have beliefs about condoms and their ability to use them that are not based upon experience of condom use. In particular the paper focuses upon intentions to use condoms despite the possible disadvantages that condoms are perceived by some to have (e.g. lost spontaneity, the need to carry them etc.). The resulting model suggests that perceptions of personal control over sexual relationships and the perceived ability to use condoms whatever the situation can predict intentions to use condoms. Where respondents expect not to have control, either over sexual relationships generally or condom use specifically, they are less likely to intend to use condoms. A willingness to take risks as a general trait of individuals also provides additional predictive power in the model. The results are discussed with reference to Bandura's (1989) theory of self-efficacy and health education policy. [ABSTRACT FROM AUTHOR]

This paper explores the effects of type of sexual partner (customer vs. primary partner) and several social psychological enabling resources (self-esteem, perceived personal risk of HIV infection, and knowledge about AIDS/HIV) on condom use among 141 female commercial sex workers. The data examine condom use during the respondents' most recent sexual activity with a male partner. Logistic regression analysis supports earlier findings that commercial sex workers are significantly more likely to use condom during commercial sex with a customer, rather than relational sex with a spouse or significant other. Subsequent multiple logistic regression analysis indicates that, controlling for type of sexual partner (client vs. primary partner), the odds of condom use are significantly increased by the respondents' knowledge about AIDS, level of self-esteem, and personal sense of risk of AIDS infection. [ABSTRACT FROM AUTHOR]

Purpose This study examined the influence of parental marital status, parent-child sexual communication, parent-child closeness on the HIV-related knowledge, safer-sex intentions, and behaviors of late adolescent urban African American males. Design The study employed a cross-sectional design with retrospective recall of salient parental influences and behaviors. Methods Data were collected via paper-and-pencil questionnaire from 134 late adolescent African American males, 18 to 22 years of age, recruited from urban communities in and around Boston, Massachusetts. Data were analyzed using bivariate correlations, paired t tests, and regression modeling. Findings Young men reported greater amounts of sexual communication with mothers than fathers ( p < .001). Parent-child closeness was positively correlated with amount of parent-child sexual communication with both mothers and fathers ( p < .001 for both). Parent-child closeness was, in turn, associated with greater condom use self-efficacy ( p < .01), less permissive sexual attitudes ( p < .001), fewer sexual partners ( p < .01), and less unprotected sex ( p < .01). Greater amounts of parent-child sexual communication were associated with fewer sexual risk behaviors, more consistent condom use, and greater intentions to use condoms in the future. There was evidence that parental influences on sexual risk behaviors and condom use intentions were mediated through young men's condom use self-efficacy, attitudes, and beliefs. Conclusions These findings highlight the importance of the parent-child relationship and the role of parent-child communication between parents and sons. Further studies are needed to better understand the nature of father-son communication and develop strategies to help parents communicate effectively with sons. Clinical Relevance Evidence has shown that African American adolescent males are more likely to engage in high-risk sexual behaviors. Understanding the sexual risk communication between African American adolescent males and their parents is important to developing strategies in reducing sexual risk behavior. [ABSTRACT FROM AUTHOR]

The papers in this section cover a variety of topics, from urodynamics using a noninvasive method, the morbidity associated with long-term urinary catheters and attempts being made to lower this, the use of botulinum toxin in refractory idiopathic detrusor overactivity, and finally, a study into the effect of chronic prostatitis-like symptoms on the quality of life in a relatively large patient sample. OBJECTIVE To test, in an ongoing noninvasive longitudinal study in healthy men, whether the condom catheter method (a noninvasive urodynamic test to assess bladder function and bladder outlet obstruction) inhibits bladder function and whether this affects the reliability of the measured isovolumetric bladder pressure (Pves.iso). SUBJECTS AND METHODS Subjects (754, aged 40–79 years) voided three times, i.e. one free void and two condom measurements. The postvoid residual volume (PVR) was measured after each void using transabdominal ultrasonography. The statistical significance of differences was tested using Wilcoxon rank test and the Mann–Whitney U-test. RESULTS After free voiding the median (interquartile range) PVR was 18 (37) mL, and independent of the amount of fluid intake. In a subgroup of volunteers, when the free void was done last, the PVR was no different ( P = 0.25), suggesting that the bladder did not become exhausted during the protocol. The PVR after two subsequent condom measurements was significantly higher than after free voiding, at 45 (78) and 57 (88) (both P < 0.05), independent of the number of interruptions in voiding. After supplementary fluid intake before the condom measurements, the PVR was double that with a normal fluid intake ( P = 0.03). The median Pves.iso was 3 cmH2O higher in the second condom measurement than in the first ( P < 0.05), although this small difference was not clinically relevant. CONCLUSIONS The condom measurement is associated with a significantly higher PVR, partly caused by supplementary fluid intake. This effect was only temporary and did not affect the measured Pves.iso. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to describe which determinants best predict perceived barriers to condom use during sexual encounters among human immunodeficiency virus human immunodeficiency virus-infected African-American men, middle-aged and older, living in the United States of America. Background. While the global epidemic of acquired immunodeficiency syndrome infection is a well-documented phenomenon with national and international implications, prevalence statistics indicate that middle-aged and older African-American (non-Hispanic) men have not benefited from the prevention efforts implemented during the past two decades. Method. A cross-sectional design using a survey and convenience sampling was adopted between September 2003 and July 2004 to recruit n = 130 middle-aged human immunodeficiency virus-infected African-American men from infectious disease clinics from the Mid-Atlantic region in the United States of America. The survey covered demographics, perceived health beliefs, spiritual well-being and symptoms related to human immunodeficiency virus. Findings. Stepwise multiple regression showed having fewer human immunodeficiency virus-related symptoms associated with the human immunodeficiency virus (P = 0.004) and being single (P = 0.05) were perceived as barriers to condom use during sexual encounters (R2 = 0.029, P = 0.046). Conclusion. Tailored interventions are needed for African-American men, middleaged and older, infected with human immunodeficiency virus nationally and worldwide that are designed to decrease perceived barriers in order to increase condom use. [ABSTRACT FROM AUTHOR]

The detection of DNA is inhibited in cases of sexual assault involving condom use. Trace evidence, including condom lubricant residues, provides crucial associative evidence in such cases. The existing Fourier transform infrared spectroscopy (FTIR) methods for lubricant analysis and detection are limited with regard to sensitivity and discrimination. The aim of this research was to establish a new method as an alternative to FTIR for the analysis of condom lubricant residues. Pyrolysis gas chromatography-mass spectrometry (PyGC-MS) and GC-MS are highly sensitive methods of analysis for a wide range of chemical substances. PyGC-MS and GC-MS were used to analyze condom lubricants in standard solution, from clean swabs and from postcoital swabs. Pyrolysis of polydimethylsiloxane (PDMS) lubricant forms cyclic products known as cyclic dimethyl siloxanes (DMS), which are separated and detected by the GC-MS. The polyethylene glycol (PEG) lubricant can be analyzed by GC-MS directly from solution. The methods of extraction and analysis presented in this paper were shown to be significantly more sensitive than FTIR for the analysis of PDMS and PEG condom lubricants. PDMS was detected as low as 1 μg in standard solution and from clean swabs using the PyGC-MS method. PEG was detected as low as 0.5 μg from standard solution and 50 μg from clean swabs using the GC-MS method. Unfortunately, we were unable to provide further discrimination between condom brands and subbrands. The methods established throughout the research were used successfully to detect condom lubricants from donated postcoital swabs. Lubricants were detected in abundance on swabs 12 h postcoitus. Recommendations are made regarding implementation of new methods for routine analysis of casework samples along with strict pyrolysis interpretation criteria to minimize the possibility of misinterpretation of false positives. [ABSTRACT FROM AUTHOR]

This paper investigates the extent of knowledge about HIV/AIDS among young Yupno women and men. Local understanding of sikAIDS is shaped by cultural, moral and religious concepts and processes that are based on social values and practices. Difficulties these young people face in accessing information about HIV/AIDS and using it to implement preventative measures -- for example by obtaining condoms -- have to be seen in the framework of 'kastom' and a moral discourse coined and influenced by the Lutheran Church. As the research shows, there is an urgent need for a broad and contextually sensitive approach to sexual health, including information about conception, family planning methods, and sexually transmitted diseases when planning awareness campaigns for teenagers in rural regions. [ABSTRACT FROM AUTHOR]

Rugby league is the national sport of Papua New Guinea and the game's huge popularity and international profile has been used in recent condom promotion campaigns in the nation's fight against the HIV/AIDS epidemic. In this paper, I argue that the promotion of condom use through rugby league requires a national campaign strategy that includes understandings of condom use and masculinity at the rural level. I demonstrate this through a study of Gogodala men's understandings of the epidemic and condom use in Western Province. The Gogodala are a Christian-based society and many blame the national condom promotion strategy for an increase in promiscuity and for 'turning sex into a game'. Condom availability in this rural area continues to be restricted to a family planning program that promotes Christian values and excludes unmarried men. I explore the male condom dilemma where young men are more concerned with avoiding accusations that their sexual behaviour puts them at risk of contracting HIV despite acknowledging the preventative value of using condoms. In this context young men disassociate themselves from the disease and condom use through a process of calculated risk or risk minimisation. [ABSTRACT FROM AUTHOR]

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Interventions aimed at preventing IIIV transmission include avoidance behaviors like condom use and reduced partner acquisition. In turn, engagement in such activities might also entail changed patterns of travel to evade contact with infected individuals. One method of estimating the effects of these actions on the observed distribution of HIV/AIDS involves the specification of space-time models that imitate the epidemic process. This paper presents an application of this procedure where prevention is construed as a continuous population response to the evolving distribution of IIIV and AIDS. This task entails the construction of models with time-dependent parameters adapted to predicted prevalence or incidence measures to represent the effects of specific avoidance behaviors. In this respect, a multiregion model is described that serves as a baseline for analyzing the impact of preventative actions on the HIV/AIDS epidemic in Western Europe. A series of adaptation functions are derived within this system for imitating both changed rates of partner acquisition and altered travel behaviors. The results elicit modifications to the behavior of the baseline epidemic thai are generated by each of these functions. Then, the conditions supporting space-lime variations in rates of survival between core countries (relatively low) and those in the periphery (relatively high) are investigated. The discussion considers the implications of these results for health policies that promote avoidance behaviors. [ABSTRACT FROM AUTHOR]

A sample of 582 injecting drug users were interviewed as part of an evaluation of an AIDS prevention programme for drug users. This paper examines the biographic and predispositional determinants of five HIV preventive behaviours--equipment sharing (not receiving and not giving) and and condom use (with regular partners, casual partners and sex clients). A two-stage sequential approach was adopted for a logistic regression analysis. Initially, to model each of the five preventive behaviours, biographical and drug use variables were entered. In a second set of models, behavioural predisposition factors were included. Age, drug use and prison experience correlate with variables in both models, although not consistently in the same direction. While a predisposition to reject sharing correlates with safer rejecting and condom use, the predisposition to safer sex only correlates with condom use. Needle exchange programmes that only target the individual would seem to be inadequate. To enhance targeted interventions changes in public and agency policy that create a social environment conductive to behaviour change are required.

Based on extensive formative research in the three Eastern Caribbean countries of St. Lucia, St. Vincent and the Grenadines, and Grenada (Fishbein, Middlestadt, & Trafimow, 1993; Fishbein, Trafimow, et al., 1993), a three-nation, mass media, condom use campaign was developed. In order to assess the impact of the campaign, a follow-up survey was conducted in St. Vincent and the Grenadines. This paper examines the effectiveness of the campaign by comparing responses on this survey by respondents who were or were not exposed to the campaign. A statistically significant impact of exposure to the campaign was obtained, indicating that a well-designed, empirically based, mass media campaign can be an effective tool in the battle to prevent the spread of AIDS. [ABSTRACT FROM AUTHOR]

This paper uses the AIDS Risk Reduction Model (ARRM) to examine psychosocial factors involved in adopting safer sex practices in a sample of Los Angeles injection drug users (IDUs; n = 161) who reported having more than one sex partner in the year preceding the interview. The ARRM hypothesizes that behavior change is a process occurring in three stages: (a) labeling one's behavior as problematic, (b) making a commitment to behavior change, and (c) taking action to accomplish that change. We test the first two stages of the model using a measure of perceived risk of HIV infection (Stage 1), and intentions to use condoms always during vaginal or anal sex in the next year (Stage 2). We examine differences in the predictive value of the ARRM between IDUs who reported using condoms in the year prior to the interview and those who reported not using them. We identify leverage points in the model-- factors which appear to have a major influence on intentions to use condoms and which may be amenable to change through educational or other types of intervention. For both condom users and non-users, susceptibility to AIDS predicted perceived infection risk (Stage 1). For condom users, knowledge about AIDS also predicted perceived risk. For both groups, self efficacy, peer norms concerning condom use, and the perceived pleasure of using condoms predicted intentions to use condoms (Stage 2). Our findings do not support either direct or indirect relationships between the Stage 1 and Stage 2 outcome variables for either group. [ABSTRACT FROM AUTHOR]

The article assesses the intentions of college women to tell their partners to use condoms by examining the applicability of the theory of reasoned action and the additional prediction contributed by perceived behavioral control and the emotional reaction variables. In this study, researchers examined the applicability of the theory of reasoned action (TORA) as a framework for developing such interventions. More specifically, in this paper authors will attempt to understand and predict college women's intentions to tell their partners to use condoms every time they have sexual intercourse. Although there are empirical studies supporting the applicability of TORA to condom-using behavior, there are some theoretical issues authors would like to address. According to TORA, the immediate antecedent of any given behavior is the person's intention (BI) to perform that behavior. The theory also specifies two conceptually independent determinants of BI, one personal in nature and the other reflecting social influence. The personal factor is the individual's positive or negative feelings with respect to his or her performing that behavior: the attitude toward the behavior.

In the National Spinal Injuries Unit at Stoke Mandeville Hospital, rubber condom urinals, kept on the penis with a medical adhesive, are used for incontinent male patients where possible. However, contact allergy to rubber condoms and/or the adhesives is a common problem and can cause considerable morbidity in paralysed patients. This paper investigates the rubber chemicals and adhesives most commonly implicated in causing contact allergy. The survey was divided into two parts: 1. Patch testing symptomatic inpatients 2. A questionnaire sent to new patients from January 1974 to ascertain the overall incidence of contact allergy. It was found that allergy to mercaptobenzthiazole (MBT)- and thiuram-containing condoms was relatively common and that latex/petroleum tube medical adhesives most commonly caused adhesive allergy. It is suggested that a condom made of the least allergenic rubber and an adhesive causing the least number of allergic reactions should be used from the outset for paralysed patients requiring a condom urinal. [ABSTRACT FROM AUTHOR]

This paper focuses upon HIV-related risk behaviours of 51 female drug injecting prostitutes, interviewed as part of a serial cross-sectional study of injecting drug users in Glasgow. Forty-five per cent injected with used needles and syringes in the 6 months prior to interview. Condom use in private sexual relations was low with only 9% of those with primary partners and 22% of those with casual partners reporting consistent use of condoms with these partners. In contrast, use of condoms for all commercial sexual encounters was almost universal Prevalence of HIV was 2.2%. Despite this low prevalence, we conclude that the level of injecting-related and private sexual risk behaviours reported here requires the continuing monitoring of drug injecting prostitutes in Glasgow. [ABSTRACT FROM AUTHOR]

Introduction: Risky sexual behavior has been explored in women living with HIV (WLHIV) internationally but is not well studied in WLHIV in the United States (U.S.). This merits further investigation due to the negative reproductive and HIV health outcomes associated with risky sexual behavior, such as the increased risk for HIV transmission and infertility from sexually transmitted infections (STIs). The aims of this study are to (1) describe sexual behaviors in a cohort of WLHIV in Florida, (2) determine whether demographic characteristics, substance use, and mental health symptoms are associated with risky sexual behavior in a cohort of WLHIV in Florida, and (3) explore whether the relationship between substance use and mental health symptoms and risky sexual behavior differs in reproductive‐age (age 18–49), compared to non‐reproductive‐age WLHIV (age 50+). Design: This was a cross‐sectional analysis of data from a multisite cohort study done in Florida. Methods: Data were collected from a sample of 304 participants who were recruited into the Florida Cohort Study from 9 clinical and community sites in Florida between 2014 to 2017. The predictor variables of interest were mental health symptoms, substance use, and demographic variables. The outcome variable of interest was risky sexual behavior which was defined as reporting ≥1 of the following: (1) at least one STI diagnosis in the past 12 months, (2) two or more sexual partners in the past 12 months, or (3) any inconsistent condom use in the past 12 months. Descriptive statistics, bivariate analysis, and logistic regression (p < 0.1) were conducted on the variables of interest. Results: The mean age of the sample was 47.8 years, and approximately half (51.6%) of the sample was of reproductive‐age. Reporting ≥1 risky sexual behavior was reported in over half (51.6%) of the reproductive‐age WLHIV in the sample and 32% of the non‐reproductive‐age WLHIV in the sample. Binge drinking, alcohol‐related problems, marijuana use, and age were all significantly associated with self‐reporting ≥1 risky sexual behaviors in all WLHIV. Self‐reporting binge drinking, marijuana use, and a high alcohol‐related problems score respectively were associated with increased odds of self‐reporting ≥1 risky sexual behavior in all WLHIV. Neither mental health symptoms nor race/ethnicity or education were significantly associated with self‐reporting ≥1 risky sexual behavior in all WLHIV. Self‐reporting severe anxiety symptoms and high alcohol‐related problems scores respectively were associated with increased odds of self‐reporting ≥1 risky sexual behavior only in reproductive‐age WLHIV from the sample. Conclusion: Marijuana use, binge drinking, and alcohol‐related problems appear to have a relationship with risky sexual behavior in WLHIV regardless of age. Reproductive‐age also appears to influence risky sexual behavior in WLHIV, and specific reporting severe anxiety symptoms and high alcohol‐related problems in reproductive‐age WLHIV increases the odds of engaging in risky sexual behavior. Clinical Significance: This study holds clinical significance for nurses and other clinicians working in reproductive health settings and clinics with WLHIV. Results indicate that it could be beneficial to do more screening for mental health symptoms (particularly anxiety) and alcohol use in younger reproductive‐age WLHIV. [ABSTRACT FROM AUTHOR]

Background: Blood operators screen donors to reduce the risk of transfusion‐transmitted infections (TTIs). Many are evolving screening procedures from those that defer all who have had a sexual interaction with gay, bisexual, or other men who have sex with men (gbMSM) to an approach that assesses individual donors' recent sexual risk behavior with any partner. Study Design and Methods: A representative sample of current blood donors (N = 1194) was recruited online and randomized to complete either the existing (at the time of the study) Canadian Blood Services' donor questionnaire (DQ) that screens out those with recent gbMSM sexual experience, a modified donor questionnaire (MDQ) that assesses individuals' recent sexual behavior with any partner, or an MDQ that assesses individual sexual behavior with any partner and explains why these questions are asked. Respondents were asked for their perceptions concerning difficulty, comfort, and acceptability of these screening questionnaires. Results: Across experimental conditions, current donors regarded screening questionnaire difficulty to be low; discomfort in responding was minimal; screening questionnaires were perceived to be relatively inoffensive and justified, and very few donors would cease donating if the screening questionnaire they responded to became the one in general use. Some minor sex differences were observed, and in some cases, perceptions of the MDQ with explanation were somewhat more positive than those of the DQ and MDQ without explanation. Discussion: An individual risk behavior screening approach appears to be acceptable to current blood donors as an alternative to screening out all who have recently engaged in gbMSM sexual interactions. [ABSTRACT FROM AUTHOR]

Introduction: Penile and genital surgery for congenital or acquired conditions is daily practice in reconstructive urology. These procedures, which carry the risk of disrupting nerves and blood vessels, may impair the genital sensation, and affect the capacity for sexual pleasure. Self‐reported tools are needed to systematically assess the male genitalia before and after reconstructive surgeries in terms of genital sensation and sexual experience. Aim: This study validated the Dutch translation of the "self‐assessment of genital anatomy and sexual functioning in male" (SAGASF‐M) questionnaire and investigated the perceptions of healthy men regarding their genital anatomy and sensory function. Methods: Eight hundred and eight sexually active men with a median age of 39 years (18–79 years) and no history of genital procedures other than circumcision filled out an online version of the questionnaire. Twenty‐four participants were randomly recruited to confirm the responses of the "self‐assessment of genital anatomy and sexual functioning in male" questionnaire by a clinical evaluation. Main outcome measures: The "self‐assessment of genital anatomy and sexual functioning in male" questionnaire comprises of multiple‐choice questions and clarifying illustrations asking men to rate their genital appearance, overall sexual sensitivity, and pain perception as well as the intensity and the effort to reach orgasm. Prespecified regions of the glans, penile shaft, scrotum, perineum, and anus are evaluated through this questionnaire. Results: Only slight variability in anatomical ratings was observed. Overall discrimination between different genital areas in terms of genital sensation was significant. The bottom of the glans or frenular area was rated the highest contributor to "sexual pleasure," followed by the other regions of the glans and shaft. The same distribution was found for "orgasm intensity" and "orgasm effort." The anal region was generally rated the lowest. "Discomfort/pain" was rated lower than any of the other sensory function indicators and the top of the glans and anal region were rated most likely to perceive this unpleasant sensation. Participants reported significantly more sexual pleasure and intense orgasms when stimulated by a sexual partner than self‐stimulation. Homosexual and bisexual men reported a higher contribution of the perineal and anal regions in sexual pleasure and orgasm. No significant difference between circumcised and uncircumcised individuals regarding overall genital sensation could be found. Conclusion: The Dutch translation of the SAGASF‐M questionnaire is a valuable and reliable tool for self‐assessment of genital anatomy and sensation, providing a site‐specific attribution of a patient's perceived sexual function. Further prospective research with this questionnaire could aid in the patient‐centered improvement of genital surgery. [ABSTRACT FROM AUTHOR]

Background: Adolescent girls and young women (AGYW), aged 15–24 years, are disproportionately affected by HIV and other sexual and reproductive health (SRH) risks due to varying social, cultural, and economic factors that affect their choices and shape their knowledge, understanding, and practices with regard to their health. Socio‐Behavioral Change Communication (SBCC) interventions targeted at strengthening the capabilities of individuals and their networks have supported the demand and uptake of prevention services and participation in biomedical research. However, despite growing global recognition of the domain, high‐quality evidence on the effectiveness of SBCC remains scattered. This evidence and gap map (EGM) report characterizes the evidence base on SBCC interventions for strengthening HIV Prevention and Research among AGYW in low‐ and middle‐income countries (LMICs), identifying evidence gaps and outlining the scope of future research and program design. Objectives: The objectives of the proposed EGM are to: (a) identify and map existing EGMs in the use of diverse SBCC strategies to strengthen the adoption of HIV prevention measures and participation in research among AGYW in LMICs and (b) identify areas where more interventions and evidence are needed to inform the design of future SBCC strategies and programs for AGYW engagement in HIV prevention and research. Methods: This EGM is based on a comprehensive search of systematic reviews and impact evaluations corresponding to a range of interventions and outcomes—aimed at engaging AGYW in HIV prevention and research ‐ that were published in LMICs from January 2000 to April 2021. Based on guidance for producing a Campbell Collaboration EGM, the intervention and outcome framework was designed in consultation with a group of experts. These interventions were categorized across four broad intervention themes: mass‐media, community‐based, interpersonal, and Information Communication and Technology (ICT)/Digital Media‐based interventions. They were further sub‐categorized into 15 intervention categories. Included studies looked at 23 unique behavioral and health outcomes such as knowledge attitude and skills, relationship dynamics, household dynamics, health care services, and health outcomes and research engagement. The EGM is presented as a matrix in which the rows are intervention categories/sub‐categories, and the columns are outcome domains/subdomains. Each cell is mapped to an intervention targeted at outcomes. Additional filters like region, country, study design, age group, funding agency, influencers, population group, publication status, study confidence, setting, and year of publication have been added. Selection Criteria: To be eligible, studies must have tested the effectiveness of SBCC interventions at engaging AGYW in LMICs in HIV prevention and research. The study sample must have consisted of AGYW between the ages of 15–24, as defined by UNAIDS. Both experimental (random assignment) and quasi‐experimental studies that included a comparison group were eligible. Relevant outcomes included those at the individual, influencer, and institutional levels, along with those targeting research engagement and prevention‐related outcomes. Results: This EGM comprises 415 impact evaluations and 43 systematic reviews. Interventions like peer‐led interactions, counseling, and community dialogues were the most dominant intervention sub‐types. Despite increased digital penetration use of media and technology‐driven interventions are relatively less studied. Most of the interventions were delivered by peers, health care providers, and educators, largely in school‐based settings, and in many cases are part of sex‐education curricula. Evidence across geographies was mostly concentrated in Sub‐Saharan Africa (70%). Most measured outcomes focused on disease‐related knowledge dissemination and enhancing awareness of available prevention options/strategies. These included messaging around consistent condom use, limiting sexual partners, routine testing, and awareness. Very few studies were able to include psychographic, social, and contextual factors influencing AGYW health behaviors and decisions, especially those measuring the impact of social and gender norms, relationship dynamics, and household dynamics‐related outcomes. Outcomes related to engagement in the research were least studied. Conclusion: This EGM highlights that evidence is heavily concentrated within the awareness‐intent spectrum of behavior change and gets lean for outcomes situated within the intent‐action and the action‐habit formation spectrum of the behavior change continuum. Most of the evidence was concentrated on increasing awareness, knowledge, and building risk perception around SRH domains, however, fewer studies focused on strengthening the agency and self‐efficacy of individuals. Similarly, evidence on extrinsic factors—such as strengthening social and community norms, relationships, and household dynamics—that determine individual thought and action such as negotiation and life skills were also found to be less populated. Few studies explore the effectiveness of these interventions across diverse AGYW identities, like pregnant women and new mothers, sex workers, and people living with HIV, leading to limited understanding of the use of these interventions across multiple user segments including key influencers such as young men, partners, families, religious leaders, and community elders was relatively low. There is a need for better quality evidence that accounts for the diversity of experiences within these populations to understand what interventions work, for whom, and toward what outcome. Further, the evidence for use of digital and mass‐media tools remains poorly populated. Given the increasing penetration of these tools and growing media literacy on one end, with widening gender‐based gaps on the other, it is imperative to gather more high‐quality evidence on their effectiveness. Timely evidence generation can help leverage these platforms appropriately and enable intervention designs that are responsive to changing communication ecologies of AGYW. SBCC can play a critical role in helping researchers meaningfully engage and collaborate with communities as equal stakeholders, however, this remains poorly evidenced and calls for investigation and investment. A full list of abbreviations and acronyms are available in Supporting Information: Appendix F. [ABSTRACT FROM AUTHOR]

Background: Dating apps for men who have sex with men (MSM) have favored unprotected sexual encounters; other unsafe practices, including drug use, are widespread. No evidence is available from the perspective of the structure of their relationships, a personal aspect included in all nursing meta‐paradigms. Aim: To study the structure of MSM networks through dating and contact applications and this relationship to risky sexual activities such as condom use, chemsex (sex while using drug), and group sex. Design: Descriptive cross‐sectional study. Sample: A total of 32 MSM participants from Madrid (Spain). Measurements: Socio‐demographic and structural variables with Social Network Analysis (SNA) metrics. Data on condom use, drug use during encounters, and group sex were included. Results: Twenty‐five percent of respondents practiced chemsex, and 75% of these used poppers. MSM with higher socioeconomic status participated in group sex sessions more frequently than those with lower socioeconomics. Within the network analysis, the relationships strong showed greater ease in having unprotected anal intercourse. Conclusion: SNA can be effective in the study of MSM sexual networks and their risk behaviors for community nurses to improve their interventions in sexual health promotion. [ABSTRACT FROM AUTHOR]

The author proposes that particular oedipal dynamics in individuals suffering with compulsive sexual behaviours tend to be characterized by imbalance between maternal and paternal functions. The maternal object is experienced as overwhelming and potentially annihilating. The paternal object is relatively weak and incapable of moderating fear of symbiosis. There is failure to develop a triangular space within the mind to enable the capacity to apprehend psychic reality and to relate. Compulsive sexual behaviours are defined as a series of compelling sexualized enactments, which function as a 'curative device' to prevent psychic collapse. Due to a lack of adequate internalized paternal function, perverse enactments signify premature attempts to structure reality. Enactment mitigates emotional contact and manifests within the here‐and‐now of treatment. The psychotherapist has to contend with enticements and pressures to act, sometimes in a retaliatory way. The setting or frame, representing the paternal function, is an arena for these dynamics to be manifest. There is an inducement to be drawn towards 'management' rather than the 'being with' of the maternal function. [ABSTRACT FROM AUTHOR]

ARV-based HIV prevention methods available in pill, gel or ring formulations (broadly referred to as microbicides) offer the possibility of protection against HIV for women who find it difficult because they cannot ask their partners to use condoms or even refuse sex. Partial efficacy of ARV-based medications has been demonstrated in a number of clinical trials around the world among various populations, building the evidence that ARV-based technologies will contribute to reducing the AIDS epidemic worldwide. Disappointing results, however, from two trials in sub-Saharan Africa, where poor adherence contributed to study closure due to futility, have raised questions about whether women at the centre of the epidemic are able to effectively use products that require routine use. Also, there are fears by some of risk compensation by decreased condom use because of the availability of microbicides when only partial efficacy has been demonstrated in microbicide trials to date. Of note, sub-analyses of biologic measures of adherence in trials where this was possible have shown a strong correlation between good adherence and efficacy, reinforcing the necessity of good adherence. Research conducted in conjunction with clinical trials and post-trials in advance of possible rollout of ARV-based products have examined social and cultural factors, gender-related and otherwise, influencing adherence and other aspects of women's use of products. These include HIV stigma, women's perception of risk, partner and community influences and the differing needs of women in various stages of life and in different circumstances. It is the purpose of this supplement to give voice to the needs of women who can benefit from woman-initiated methods by presenting research results and commentary to contribute to the global conversation about optimizing women's experience with ARV-based prevention. [ABSTRACT FROM AUTHOR]

Introduction: Antiretroviral‐based pre‐exposure prophylaxis (PrEP) is today an established, effective and safe method of HIV prevention used in multiple countries worldwide by a broad range of populations at risk of HIV infection. Biomedical innovations are critical in supporting the primary prevention of HIV; however, their potential can only be maximized if end‐user challenges are recognized, described and used to develop next‐generation models. Discussion: First‐generation PrEP, a daily oral pill, is highly efficacious, discreet and affords users the ability to commence and conclude treatment rapidly. However, consistent daily adherence and persistence is challenging, especially among younger populations, due in part to side effects, the risk of stock‐outs and a lack of pill storage options. Second‐generation PrEP, longer acting agents that require less frequent dosing, could overcome such challenges. Agents that have shown efficacy in clinical trials include a monthly vaginal ring and PrEP injectables to be administered every 8 weeks, while products in development include 6 monthly injectables, oral therapy that uses monthly rather than daily pills, implants and the potential for long‐acting passive immunization. Conclusions: Second‐generation PrEP agents will have the potential to offer improved adherence and less frequent reminders once they have undergone further development and the delivery systems that will best support them have been established. In order to pursue global UNAIDS targets of reducing new HIV infections to fewer than 500,000 annually by 2025, and to ensure that all people have access to prevention options that meet their specific prevention needs, both early and next‐generation PrEP options are needed. [ABSTRACT FROM AUTHOR]

Desorption electrospray ionization mass spectrometry (DESI-MS) is employed in the forensic analysis of chemical components present in condoms and imaging of latent fingerprints as circumstantial evidence of sexual assault. Polymers such as nonoxynol-9, polyethylene glycol, and polydimethylsiloxane, as well as small molecules additives such as N-methylmorpholine, N-octylamine, N, N-dibutyl formamide, and isonox 132, commonly used in lubricated condom formulations, were successfully characterized by DESI. The results suggest that DESI-MS is useful for identification of this type of evidence, and it has advantages over conventional extractive techniques, in terms of speed of analysis and ease of use. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The global COVID‐19 pandemic poses new challenges for communities built around certain sexual practices, and some of which have responded by using their previous experiences of HIV. In this article, we undertake an online ethnography of a popular Anglo‐American barebackers' forum to understand how HIV and COVID‐19 converge and how these men negotiate COVID‐19 risk by adapting previous sexual and disease prevention strategies. Barebackers, aka gay men who eroticise condomless anal intercourse, provide a relevant group to consider given their longstanding negotiation of HIV. We explore processes of responsibility, risk management and pleasure during the COVID‐19 pandemic. We suggest that their experiences of both the AIDS crisis and the current context of HIV frame their decisions around COVID‐19. We focus on how responsibility and desire shape discussions of bathhouses and the survival of barebackers' sexual practices during and after COVID‐19. [ABSTRACT FROM AUTHOR]

Qualitative data from a Western Australian study of sexual behaviour in young people were used to describe difficulties experienced in carrying and using condoms. Both men and women were concerned for their sexual reputation if they carried condoms, although this was more of a problem for the women than the men. However, these fears were not matched by the attitudes of the opposite gender: in general, there was less negativity about condom-carrying than was feared. Many of those who described using condoms had experienced condom failure and other difficulties, and it appeared that they were unfamiliar with the correct way to use condoms. It is suggested that many of these barriers to condom use can be removed with appropriate education and information strategies. [ABSTRACT FROM AUTHOR]

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BACKGROUND Teen pregnancy continues to burden families, communities, and society. Programs continue to educate and impower youth and young adults to make positive behavioral decisions. METHODS: We evaluated a program aimed at high‐risk youth in after‐school programs. The goal of the program was to instill a sense of community and empathy, as well as sexual health decision‐making. The evaluation was a multiyear evaluation from external evaluators. RESULTS: There were statistically significant changes in empathy toward others in the community and a feeling of safety at school. Other positive changes noted were that students felt empowered to use condoms, other barriers, or birth control in the future when having sexual relations. The program noted a positive direction in students feeling they develop plans or goals and stick to them. CONCLUSIONS: These programs serve to instill a sense of empowerment, community, and responsibility in students. Evaluation data can serve as a metric of the merit of these programs and the impact on school health programs and communities. [ABSTRACT FROM AUTHOR]

Objectives: Despite being a key population in whom to initiate pre‐exposure prophylaxis (PrEP), the awareness of and willingness to use PrEP are still unclear in Chinese young men who have sex with men (YMSM). We report factors associated with PrEP awareness and willingness in the population. Methods: From 1 August to 31 December 2018, 495 participants aged 15–24 years were included in a cross‐sectional study about awareness of and willingness to use PrEP among YMSM. Logistic regression models were used to identify factors associated with two outcomes: awareness of PrEP; and willingness to use PrEP. Results: Among 495 eligible participants, 129 participants (26.1%) knew about PrEP. PrEP awareness among YMSM was associated with higher education level [adjusted odds ratio (aOR) = 1.812, 95% CI: 1.113–2.951] and previous HIV testing (aOR = 3.507, 95% CI: 1.261–9.752). YMSM with shorter local residence time (aOR = 0.317, 95% CI: 0.101–0.992) and internet‐based partner‐seeking (aOR = 0.171, 95% CI: 0.096–0.305) were less likely to be aware of PrEP. In those with previous knowledge of PrEP, 36 (27.9%) conveyed their willingness to use it. PrEP willingness was associated with internet‐based partner‐seeking (aOR = 9.593, 95% CI: 1.965–46.844). The main barriers influencing those who knew about PrEP but refused to use it were the high price of PrEP (69.9%), the need to use condoms consistently (52.7%), and concerns about side effects (39.8%) and effectiveness of prevention (22.6%). Conclusions: Chinese YMSM have low awareness of and willingness to use PrEP. Adequate PrEP promotions should be implemented, especially on the Internet and dating software. [ABSTRACT FROM AUTHOR]

CONTEXT: Transgender and gender‐diverse youth experience significant health disparities across numerous domains of health, including sexual health. Among general populations, parent connectedness has been strongly associated with youth sexual health. METHODS: The relationships between parent connectedness and sexual health indicators were investigated among 2,168 transgender and gender‐diverse youth who participated in the 2016 Minnesota Student Survey, a statewide population‐based survey of ninth‐ and 11th‐grade students. Multivariate logistic regression models, stratified by sex assigned at birth, tested associations between parent connectedness—youth's perceptions of parent caring and parent–youth communication—and eight sexual health indicators: ever having had sex, having multiple sexual partners in the past year, pregnancy involvement, substance use at last sex, partner communication about STI prevention, partner communication about pregnancy prevention, condom use at last sex and pregnancy prevention methods at last sex. RESULTS: The level of parent connectedness was inversely associated with ever having had sex, regardless of sex assigned at birth (odds ratios, 0.6–0.8). Although level of connectedness was inversely associated with having multiple sexual partners in the past year and pregnancy involvement among transgender and gender‐diverse youth assigned male at birth (0.6–0.7), these relationships were nonsignificant among transgender and gender‐diverse youth assigned female at birth. Further differences in associations between parent connectedness and four sexual risk–reduction behaviors were found between youth assigned male at birth and those assigned female. CONCLUSIONS: As with other populations, parent connectedness promotes sexual health among transgender and gender‐diverse youth and may provide a point of intervention. [ABSTRACT FROM AUTHOR]

CONTEXT: Little is known about whether adolescents' risk‐taking in areas other than sex is associated with the effectiveness of their contraceptive method use, or whether any such associations vary by race and ethnicity. METHODS: Data from the 2011, 2013 and 2015 National Youth Risk Behavior Surveys were used to examine nonsexual risk behaviors and contraceptive method choice among 5,971 sexually active females aged 13–18. Risk‐taking profiles for White, Black and Hispanic adolescents were identified using latent class analysis. Multinomial logistic regression was used to estimate the associations between these risk profiles and use of less‐ or more‐effective contraceptive methods at last sexual intercourse. RESULTS: Three distinct risk‐taking profiles were identified for White and Hispanic adolescents and two for Black adolescents. Compared with their counterparts in the low‐risk "abstainer" group, White adolescents in the "high substance use and violence" group were less likely to use condoms alone (relative risk, 0.4) or a prescription contraceptive paired with condoms (0.3) rather than no contraceptive at all, and more likely to use withdrawal or no method rather than condoms alone (2.4 each). However, higher risk‐taking among Whites was positively associated with using prescription contraceptives rather than condoms (1.9). Among Black and Hispanic females, lower risk‐taking was associated only with more condom use. CONCLUSIONS: Future studies should examine whether interventions designed to reduce adolescent risk‐taking improve the effectiveness of contraceptive use, particularly among White females. However, efforts to increase Black and Hispanic adolescents' use of more‐effective contraceptives should target barriers other than risk‐proneness. Perspectives on Sexual and Reproductive Health, 2020, 52(4):TK, doi:10.1363/psrh.12165 [ABSTRACT FROM AUTHOR]

Introduction: Learning one's HIV status through HIV testing services (HTS) is an essential step toward accessing treatment and linking to preventive services for those at high HIV risk. HTS may impact subsequent sexual behaviour, but the degree to which this varies by population or is true in the setting of contemporary HIV prevention activities is largely unknown. As part of the 2019 World Health Organization Consolidated Guidelines on HTS, we undertook a systematic review and meta‐analysis to determine the effect of HTS on sexual behaviour. Methods: We searched nine electronic databases for studies published between July 2010 and December 2019. We included studies that reported on at least one outcome (condom use [defined as the frequency of condom use or condom‐protected sex], number of sex partners, HIV incidence, STI incidence/prevalence). We included studies that prospectively assessed outcomes and that fit into one of three categories: (1) those evaluating more versus less‐intensive HTS, (2) those of populations receiving HTS versus not and (3) those evaluating outcomes after versus before HTS. We conducted meta‐analyses using random‐effects models. Results and discussion: Of 29 980 studies screened, 76 studies were included. Thirty‐eight studies were randomized controlled trials, 36 were cohort studies, one was quasi‐experimental and one was a serial cross‐sectional study. There was no significant difference in condom use among individuals receiving more‐intensive HTS compared to less‐intensive HTS (relative risk [RR]=1.03; 95% CI: 0.99 to 1.07). Condom use was significantly higher after receiving HTS compared to before HTS for individuals newly diagnosed with HIV (RR = 1.65; 95% CI: 1.36 to 1.99) and marginally significantly higher for individuals receiving an HIV‐negative diagnosis (RR = 1.63; 95% CI: 1.01 to 2.62). Individuals receiving more‐intensive HTS reported fewer sex partners at follow‐up than those receiving less‐intensive HTS, but the finding was not statistically significant (mean difference = −0.28; 95% CI: −3.66, 3.10). Conclusions: Our findings highlight the importance of using limited resources towards HTS strategies that focus on early HIV diagnosis, treatment and prevention services rather than resources dedicated to supplementing or enhancing HTS with additional counselling or other interventions. [ABSTRACT FROM AUTHOR]

Objectives: We report the frequency of previous HIV testing at baseline in men who have sex with men (MSM) who enrolled in an HIV self‐testing (HIVST) randomized controlled trial [an HIV self‐testing public health intervention (SELPHI)]. Methods: Criteria for enrolment were age ≥ 16 years, being a man (including trans men) who ever had anal intercourse (AI) with a man, not being known to be HIV positive and having consented to national HIV database linkage. Using online survey baseline data (2017–2018), we assessed associations with never having tested for HIV and not testing in the previous 6 months, among men who reported at least two recent condomless AI (CAI) partners. Results: A total of 10 111 men were randomized; the median age was 33 years [interquartile range (IQR) 26–44 years], 89% were white, 20% were born outside the UK, 0.8% were trans men, 47% were degree educated, and 8% and 4% had ever used and were currently using pre‐exposure prophylaxis (PrEP), respectively. In the previous 3 months, 89% reported AI and 72% reported CAI with at least one male partner. Overall, 17%, 33%, 54%, and 72% had tested for HIV in the last 3 months, 6 months, 12 months and 2 years, respectively; 13% had tested more than 2 years ago and 15% had never tested. Among 3972 men reporting at least two recent CAI partners, only 22% had tested in the previous 3 months. Region of residence and education level were independently associated with recent HIV testing. Among current PrEP users, 15% had not tested in the previous 6 months. Conclusions: Most men in SELPHI, particularly those reporting at least two CAI partners and current PrEP users, were not testing in line with current UK recommendations. The results of the trial will inform whether online promotion of HIVST addresses ongoing testing barriers. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the effect of antiretroviral therapy (ART) with or without condom use on the risk of sexual transmission of HIV. Methods: A search of the literature was conducted in the PubMed, Web of Science, Cochrane, SCOPUS and EMBASE databases for studies dating back to 2008. The results were summarized as relative risks and incidence rates with 95% confidence intervals (CIs). The effect sizes were pooled using random‐effects models and heterogeneity was evaluated using the Cochrane Q test and I2. Results: Of the 1424 studies retrieved in the initial search, 10 met the eligibility requirements. ART was associated with a 52% reduction in transmission risk compared to no ART, with a relative risk of 0.48 (95% CI 0.439–0.525) (Q = 0.524; I2 = 0.0%; overall effect Z = 15.99, P < 0.0001). ART vs. no ART caused a reduction in the risk from 5.6 person‐years (95% CI 3.26–9.62 person‐years) (Q = 0.771; I2 = 0.0%; overall effect Z = 6.25, P < 0.0001) in the untreated group to 0.85 person‐years (95% CI 0.28–2.99 person‐years) (Q = 0.038; I2 = 76.7%; overall effect Z = 0.11, P = 0.772) in the treated group, but not significantly so, which is equivalent to an 84% reduction in the risk of sexual transmission. In accordance with the Swiss National AIDS Commission declaration, ART with suppressed viral loads was associated with a minimal risk of transmission, with a median time at risk of 0.00 person‐years (95% CI 0.00–0.00 person‐years) (Q = 1.00; I2 = 0.0%; overall effect Z = 6.80, P < 0.0001). Conclusions: ART and condom use were found to cause a significant reduction in the risk of sexual transmission of HIV in both homosexual and heterosexual populations, based on previous systematic reviews and meta‐analyses. [ABSTRACT FROM AUTHOR]

Introduction: East African cross‐border areas are visited by mobile and vulnerable populations, such as men, female sex workers, men who have sex with men, truck drivers, fisher folks and young women. These groups may not benefit from traditional HIV prevention interventions available at the health facilities where they live, but may benefit from services offered at public venues identified as places where people meet new sexual partners (e.g. bars, nightclubs, transportation hubs and guest houses). The goal of this analysis was to estimate availability, access and uptake of prevention services by populations who visit these venues. Methods: We collected cross‐sectional data using the Priorities for Local AIDS Control Efforts sampling method at cross‐border locations near or along the land and lake borders of Kenya, Rwanda, Tanzania and Uganda from June 2016–February 2017. This bio‐behavioural survey captured information from a probability sample of 11,428 individuals at 833 venues across all areas. Data were weighted using survey sampling weights and analysed using methods to account for the complex sampling design. Results: Among the 85.6% of persons who had access to condoms, 60.5% did not use a condom at their last anal or vaginal sexual encounter. Venues visited by high percentages of persons living with HIV were not more likely than other venues to offer condoms. In 12 of the 22 cross‐border areas, male or female condoms were available at less than 33% of the venues visited by persons having difficulty accessing condoms. In 17 of the 22 cross‐border areas, education outreach visits in the preceding six months occurred at less than 50% of the venues where participants had low effective use of condoms. Conclusions: Individuals visiting venues in cross‐border areas report poor access to and low effective use of condoms and other prevention services. Availability of HIV prevention services differed by venue and population type and cross‐border area, suggesting opportunities for more granular targeting of HIV prevention interventions and transnational coordination of HIV programming. [ABSTRACT FROM AUTHOR]