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Background: While the existence of a complex variety of casual sexual relationships (CSRs) has been acknowledged, studies rarely describe the prevalence of condom use across these relationships or how their hybrid nature, specifically relationship characteristics, affect condom use. This study aims to describe condom use within committed relationships and various types of casual sexual relationships (CSRs), examining the influence of relationship characteristics on condom use among culturally validated relationship types (committed, friends with benefits, hookups, booty call). Methods: Emerging adults (N = 728, 18–29 years, M = 22.56; SD = 3.01) completed a survey with four blocks: sociodemographics; brief sexual history; relationships over the previous year; and current relationship, assessing relationship type, ten relationship characteristics (e.g., commitment, emotional and sexual exclusivity, partner acquaintance, sexual involvement) and condom use (vaginal, oral, and anal), operationalized by three measures (use at last encounter, likert-type scale and percentage of use). Results: The results showed patterns in condom use by relationship type and illuminated how relationship characteristics—grouped into three factors: commitment, intimacy, and sexuality—mediate condom use. Condom use was more frequent in vaginal than anal and oral sex, and less frequent in committed relationships. No significant differences were found in condom use in vaginal sex between committed relationships and hookups, with condom in these relationships being significantly lower than in booty call. Intimacy mediated between all contrasts tested and condom use in vaginal sex, while sexuality mediated between committed vs. CSRs and condom use in anal and oral sex. Conclusions: Findings point to the need of considering the diversity of CSRs for understanding condom use and highlight the role of intimacy as a relevant mechanism associated with condom use in vaginal sex and of sexuality in oral and anal sex, which should be taken into consideration in the tailoring of health promoting efforts. [ABSTRACT FROM AUTHOR]

Surveys of the Italian population typically assess general sexual behaviors (e.g., oral, vaginal and anal intercourse). However, little is known about other sexual behavior such as rough sexual behaviors, choking and slapping. Thus, an online cross-sectional survey of 4618 Italian participants was conducted. In the past month, the most prevalent sexual behaviors were solo masturbation (93.6%), partner masturbation (80.0%), oral sex (71.4% received, 75.9% performed), penile–vaginal intercourse (75.7%) and anal intercourse (12.5% received, 7.1% performed). Regarding rough sexual behaviors, the most common behaviors performed were spanking (23.3% received, 55.5% performed), choking (13.2% receive, 60.0% performed), slapping (30.1% received, 20.9% performed) and name calling (44.5% received, 37.0% performed). Our results suggest a gender difference where men and transgender/non-binary individuals perform more rough sexual behaviors compared to women. Moreover, regarding the role of consent in behaviors such as choking and slapping, our results highlight the importance of sexual and affective education to implement sexual assertiveness. In conclusion, this study adds knowledge to the limited literature on this topic, especially with respect to the Italian population. [ABSTRACT FROM AUTHOR]

The present study describes changes in young adults' sexual behaviors during the early COVID-19 pandemic. Latent class growth analyses (LCGAs) conducted with four waves of data collected between July 2019 to May 2020 in N = 775 college students (Mage = 18.61, SD = 0.33; 50.3% female, 90.2% White) revealed the presence of high- and low-risk classes in separate models for oral, vaginal, and anal sexual risk taking. As anticipated, vaginal and oral risk taking declined in spring 2020. Membership in high-risk trajectories was attributable to high COVID-19-related financial problems, early sexual debut, low selfcontrol, and being in a romantic relationship. Other COVID-19 factors and demographic control variables were not linked to trajectory membership. Thus, while many young adults' sexual risk taking changed during the early pandemic, their perceptions of and experiences with COVID-19 were not predictive of sexual risk trajectory membership. [ABSTRACT FROM AUTHOR]

This study investigates how cultural differences, gender role priming, partner's sexual preferences, and women's experienced sexual pleasure influence women's likelihood of consenting to their least favorite sexual practices, including oral sex, anal sex, and having sex when not in the mood. We compared predictors of sexual consent of cisgender heterosexual Chinese and American women as well as how traditional versus egalitarian gender role priming influenced sexual consent. 412 participants completed an online survey. The results revealed that women were more likely to consent to than enjoy the sexual practices examined. Women's experienced sexual pleasure and their partner's sexual preferences were positively correlated with women's sexual consent. More specifically, women's sexual consent was more influenced by partner's sexual preferences, and less influenced by experienced sexual pleasure when exposed to traditional marriage priming compared to egalitarian marriage priming. And Chinese women's sexual consent was more influenced by partner's sexual preferences and less influenced by experienced sexual pleasure compared to American women. Traditional gender role priming made women more likely to have sex when not in the mood compared to egalitarian gender role priming, and made Chinese women more likely and American women less likely to consent to anal sex, respectively, compared to egalitarian gender role priming. Overall, cultural and situational differences in gender role expectations significantly influenced the determinants of women's consent to their least favorite sexual practices, despite cross-cultural consistencies. [ABSTRACT FROM AUTHOR]

Background: This study conducted a survey of men who have sex with men (MSM) in Maanshan City of Anhui Province to assess the risk behaviors related to human immunodeficiency virus (HIV) infection. Methods: A cross-sectional survey was conducted from June 2016 to June 2019. The MSM were recruited by a peer-driven sampling method. A face-to-face interview with anonymous questionnaire was used for data collection. The information collected by the survey was summarized and epidemiology described the basic characteristics of MSM, and then the related factors were statistically analyzed. Results: A total of 934 MSM were recruited with a average age was 30.5 (SD = 8.90) years old, including 816 (87.4%) HIV negative participants and 118 (12.6%) HIV positive ones. This study showed that freelancer (OR = 4.02, 95% CI: 1.96–8.23), scope of sexual partners distribution (OR = 1.78, 95% CI: 1.36–2.33), number of male sexual partners (OR = 2.11, 95% CI: 1.47–3.02), role of anal sex with men was receptive (OR = 2.54, 95% CI: 1.25–5.13) and versatile (OR = 2.34, 95% CI: 1.31–4.19) and non-steady sex partners (OR = 2.14, 95% CI: 1.56–2.93) were risk factors for HIV infection, while monthly income (OR = 0.68, 95% CI: 0.57–0.82), education level (OR = 0.79, 95% CI: 0.66–0.95), frequency of condom use (OR = 0.53, 95% CI: 0.35–0.81) and number of oral sex partners (OR = 0.35, 95% CI: 0.24–0.51) in the past 6 months were protective factors for HIV infection. Conclusion: Risk behaviors were common in MSM, and urgent need for targeted and comprehensive interventions to reduce risky sexual behaviour and to prevent HIV infection in MSM. [ABSTRACT FROM AUTHOR]

The oral transmission of HPV and, consequently, the risk of oral cancer has increased in the last years. Oral sex has often been implicated among the risk factors for oral HPV infections, however, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. The present study aimed to evaluate the coexistence of papilloma virus, at the levels of the oral and genital mucosa, in women with a histologically confirmed HPV lesions (and a positive HPV test) at the genital level and a negative HPV control group. We also evaluated how some risk factors, such as smoking, the number of partners, age, and sexual habits can influence the possible presence of the virus itself in the oropharynx of the same women. In total, 117 unvaccinated women aged between 18 and 52 were enrolled. We found that the prevalence of oral HPV infection was high among the women with concomitant genital HPV infection (22%) compared to the HPV-negative women (0%), and the estimated odds ratio was 17.36 (95% CI: 1.02, 297.04). In none of the women with oral HPV did we find any relevant clinical lesions. The potential risk factors for HPV infections in the oropharynx and genitals were analyzed based on questionnaire responses. A multivariate analysis showed that genital HPV infections were significantly associated with a number of sexual partners > 10 (OR 138.60, 95% CI: 6.04–3181.30, p < 0.001), but the data also referred to having between 3–5 or 6–10 partners as being significant, as were a high level of education (OR 6.24, 95% CI: 1.67–4.23.26 p = 0.003), a frequency of sexual intercourse >10 (OR 91.67 95% CI: 3.20–2623.52, p = 0.004), oral sex (OR 6.16, 95% CI: 1.22–31.19, p = 0.014), and >20 cigarettes/day (OR 6.09 95% CI: 1.21–30.61, p = 0.014). Furthermore, being "separate" and having multiple sexually transmitted diseases were also significantly associated with genital HPV infection. In contrast, oral HPV infections were significantly associated with women aged 36 to 50 years (OR 27.38, 95% CI: 4.37–171.37; p = 0.000202) and oral sex (OR 95.5, 95% CI: 5.13–1782.75, p = 0.001126).Additionally, being separate, being cohabitant, lifetime sexual partners of >10, 3–5 lifetime sexual partners, <20 years of age, >10 sexual intercourse per month, occasional and regular anal sex, >20 cigarettes per day, a history of sexually transmitted disease (herpes and multiple), and having a history of genital warts were significant. Screening and early diagnosis are considered to be practically unfeasible for this category of cancer, given the lack of visible lesions; the 9-valent HPV vaccine remains the only means that could help to successfully counter the growing incidence of oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Background: Not long ago, the National AIDS Control Organization awakened the matter of men who have sex with men (MSM) and incorporated it as the most important group population. Targeted interventions (TI), as projected in the NACP-III, have made dauntless efforts to launch about, that this group demands an urgent and intensive attention, indicating a significant amount of departure from its previous polices. All above-mentioned reasons prompted us to undertake this study on evaluating the risk of MSM for sexually transmitted infections. Methods: A cross sectional descriptive study was conducted and all the acquired data were entered using epi info version 3.5 software and along with proper statistical procedures. Results: In the current study, 156 participants were involved, of which 90% of respondents were male and the remaining were transgender. Majority of the participants in the present study were involved in MSM activity with both regular and nonregular partners (RP)/casual partners. In the present study, 85.3% of the study participants were involved in MSM activity with a regular partner in the last 6 months, which is similar to nonregular partners reflecting high-risk activity. Conclusion: This study offers compelling evidence that MSM is more vulnerable to HIV due to a variety of variables. According to the current studies, about 37% of MSM were married. This brings up additional issues, such as the fact that women often contract HIV, because they are partners of men who are members of the population groups that are most at risk for HIV infection, such as MSM, rather than due to their own sexual behavior.

"Sexting" (electronic transmission of sexual pictures/messages) among early adolescents is associated with early sexual activity, a marker of increased sexual risk. The current study is a secondary analysis that examined the longitudinal relationship between sexting and first-time sex among a sample of early adolescents deemed "at risk" due to behavioral or emotional problems. Adolescents participated in a longitudinal sexual risk prevention trial and completed questionnaires assessing demographics, unsupervised peer time, mental health, and participation in sexting, oral sex, and penetrative sex (vaginal/anal). Analyses included 343 early adolescents (M age = 12.89, 51% female, 77% racial/ethnic minority) with no history of oral or penetrative sex. Those who reported sexting at baseline were more likely to report first-time oral and/or penetrative sex by the 1-year follow-up. Exploratory analyses revealed that sexting predicted those who had engaged in both oral and penetrative sex. These findings highlight the need to address sexting in risk prevention. [ABSTRACT FROM AUTHOR]

Modeling studies suggest that transmission of gonorrhea and chlamydia to multiple anatomic sites within the same person is necessary to reproduce observed high rates of extragenital gonorrhea/chlamydia. Limited empiric behavioral data support this idea. In this cross-sectional study, we enrolled individuals assigned male at birth who reported sex with men (MSM) and denied receptive anal sex (RAS) in the past 2 years. Participants enrolled in-person at the Sexual Health Clinic in Seattle, Washington (December 2019–September 2021) or online (July 2021–September 2021), and completed a sexual history questionnaire that asked about specific sexual acts and sequence of those acts during their last sexual encounter. We enrolled 210 MSM during the 16-month recruiting period. The median number of sex acts reported at last sexual encounter was 4 (interquartile range 3–5). The most commonly reported acts at last sex were: kissing (83%), receiving oral sex (82%), and insertive anal sex (65%). There was substantial variability in the sequence of acts reported; no unique sequence of sex acts was reported by more than 12% of the population. Ninety percent of participants reported sequences of behaviors that could lead to gonorrhea or chlamydia transmission within the same person (respondent or partner); the most common of these combinations was kissing followed by receiving oral sex (64% reporting). Engaging in multiple sex acts within a single sexual encounter is common and may lead to gonorrhea/chlamydia transmission within the same person. This complicates empiric measurements of transmission probabilities needed to estimate population-level transmission. [ABSTRACT FROM AUTHOR]

Objectives: To determine the impact of fraternity and sorority membership on condom use during sex. Methods: Utilizing data from The American College Health Association (ACHA) National College Health Assessment from 2016-2018, we estimated a linear probability, logistic, and instrumental variable model to determine the relationship between fraternity and sorority membership and the frequency of condom use during sex. Results: Compared to non-fraternity members, fraternity members experience an increase in sex without a condom for both oral sex (13.5%, 95% ci= 0.048, 0.221) and anal sex (28.5%, 95% ci= 0.174, 0.396). Compared to non-sorority members, sorority members are more likely to engage in oral sex without a condom. This result is not robust to single sorority members. Conclusions: Fraternity membership increases the probability of risky oral and anal sex. Policy Implications: The reduced use of condoms has implications on sexual health including an increased risk of contracting or spreading sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Background: Not long ago, the National AIDS Control Organization awakened the matter of men who have sex with men (MSM) and incorporated it as the most important group population. Targeted interventions (TI), as projected in the NACP-III, have made dauntless efforts to launch about, that this group demands an urgent and intensive attention, indicating a significant amount of departure from its previous polices. All above-mentioned reasons prompted us to undertake this study on evaluating the risk of MSM for sexually transmitted infections. Methods: A cross sectional descriptive study was conducted and all the acquired data were entered using epi info version 3.5 software and along with proper statistical procedures. Results: In the current study, 156 participants were involved, of which 90% of respondents were male and the remaining were transgender. Majority of the participants in the present study were involved in MSM activity with both regular and nonregular partners (RP)/casual partners. In the present study, 85.3% of the study participants were involved in MSM activity with a regular partner in the last 6 months, which is similar to nonregular partners reflecting high-risk activity. Conclusion: This study offers compelling evidence that MSM is more vulnerable to HIV due to a variety of variables. According to the current studies, about 37% of MSM were married. This brings up additional issues, such as the fact that women often contract HIV, because they are partners of men who are members of the population groups that are most at risk for HIV infection, such as MSM, rather than due to their own sexual behavior. [ABSTRACT FROM AUTHOR]

Although heterosexual oral and anal sexual behaviors have been reported in sub-Saharan Africa, little is known about how they are understood and perceived, particularly, in West Africa. We undertook a qualitative exploration of local terminologies and sexual scripts associated with heterosexual oral and anal sex in preparation for a quantitative survey. We held focus group discussions (18) and interviews (44) with younger and middle-aged men and women from the general population and female sex workers (FSWs) in selected communities in Ibadan. Most participants had heard of oral and anal sex. Younger adults aged 18–25 years, particularly male participants and FSWs, appeared more informed than older adults in the general population. Sexually explicit movies were the most cited source of information. Oral and anal sexual behaviors were considered sensitive, with different local names, meanings, and interpretations. Participants advised against the use of slang terms in research. We identified six different scripts employed by participants in discussing oral and anal sex practices: protecting sexual relationship, financial reward, an alternative to vaginal sex, pleasure, male dominance and control, and risk, stigma, and disgust. [ABSTRACT FROM AUTHOR]

Objective: to analyze the factors associated with inconsistent use of male condoms among HIV-negative men who have sex with other men. Method: a cross-sectional, analytical and nationwide study conducted online in all the Brazilian regions in 2020, via networks and in dating websites. Inconsistent condom use was defined as occasional use or as never using it. Descriptive statistical analyses were performed, as well as association and binary logistic regression tests. Results: inconsistent condom use was reported by 1,222 (85%) of all 1,438 participants. The "homosexuals" (ORAdj: 2.03; 95% CI: 1.14-3.59; p=0.016), "having a fixed partner" (ORAdj: 2.19; 95% CI: 1.55-3.09; p<0.001), "oral sex" (ORAdj: 2.41; 95% CI: 1.31-4.43; p=0.005), "insertive anal" (ORAdj: 1.98; 95% CI: 1.10-3.58; p=0.023) and "STI diagnosis" (ORAdj: 1.59; 95% CI: 1.13-2.24; p=0.007) variables were independently associated with inconsistent use of male condoms. The "receiving advice on HIV test from a friend" (ORAdj: 0.71; 95% CI: 0.52-0.96; p=0.028) and "sex worker" (ORAdj: 0.26; 95% CI: 0.11-0.60; p=0.002) variables were protective factors. Conclusion: the variables under study pointed to a strong relationship between steady partners and increased trust and low adherence to condom use, corroborating other studies. [ABSTRACT FROM AUTHOR]

Spina bifida (SB) may differentially impact adults' participation in solo and partnered sexual behaviors, but little research investigates this topic. Describe solo and partnered sexual behaviors among an international sample of adult men and women with SB. Ever participated (no/yes) and recent participation (>1 year ago/within last year) in solo masturbation, cuddled with a partner, held hands with a partner, kissed a partner, touched a partner's genital, had genitals touched by a partner, gave a partner oral sex, received oral sex from a partner, vaginal sex, anal sex, and sex toy use. Data were drawn from a larger cross-sectional, internet-based survey assessing the sexual behaviors of an international sample of men and women with SB. We used logistic regression to examine the impact of background (gender, age, independent living, and relationship status) and health (shunt status, ambulation, and genital sensation) factors on each outcome. The sample consisted of 345 respondents aged 18–73 years from 26 nations. Very few (<3%) had no lifetime experience with any solo or partnered behaviors; 25.0% reported participating in all behaviors at some point in their lives. The median number of past year sexual behaviors (of 16 total) was 7. Lifetime and recent participation were associated with demographic and health factors. Despite impairment, adults with spina bifida do participate in solo and partnered sexual behaviors. Medical personnel who work with this population should include discussions about sexuality as part of routine care. Although this research measured solo and partnered sexual behavior in large international sample of adults with spina bifida, it is limited by its cross-sectional retrospective design and non-clinical convenience sample. Despite disability, many adults with SB participate in solo and partnered sexual behavior. Medical and psychosocial supports are needed to help adults in this population enjoy sexuality in a healthy and safe manner. Hensel DJ, Misseri R, Wiener JS, et al. Solo and Partnered Sexual Behavior Among an International Sample of Adults With Spina Bifida. J Sex Med 2022;19:1766–1777. [ABSTRACT FROM AUTHOR]

Sexual consent research often focuses on how those who identify as heterosexual communicate consent, with limited research examining how sexual minority (SM) men communicate consent. Factors that influence how people communicate consent – such as the type of sexual behaviour being consented to and the relationship status of those engaged in sexual behaviour – is understudied among SM men. The purpose of this exploratory study was to assess how SM men communicate sexual consent and examine if these factors influence how men consent to sex. SM men (N = 234) were recruited from social media and Qualtrics' panel. Participants completed an open-ended survey assessing how consent was communicated during oral and anal sex and who their partner was during this encounter. Responses were analysed using an inductive coding approach. Six overarching consent cues emerged: Explicit Verbal, Explicit Nonverbal, No-Response, Implicit Nonverbal, Virtual Consent and Implicit Verbal. Sexual consent communication appeared to vary by sexual behaviour and relationship status. Overall, SM men and people who identify as heterosexual appear to communicate sexual consent similarly; however, some new cues emerged for SM men. Consent education initiatives should consider findings from more diverse populations when discussing sexual consent to take a more inclusive approach to sexual health education. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the sexual behavior patterns of student athletes of senior high schools in the Upper East Region of Ghana and to assess the differences in sexual behavior patterns between male and females. A sample of 400 student athletes using a convenience sampling technique from public senior high schools was drawn to complete a self-designed research study. Descriptive statistics and the Chi-square test tool were used to analyze the collected data. The results showed that student athletes practiced various forms of sexual behaviors such as celibacy, foreplay, vaginal-penile sex, sexual fantasy, masturbation, oral sex, and anal sex. The Chi-square analysis showed significant gender differences in prevalence of masturbation (χ2 (1, n = 400) = 4.6962, probability = 0.030) and sexual fantasy (χ2 (1, n = 400) = 6.8477, probability = 0.009), but not vaginal-penile intercourse (χ2 (1, n = 400) = 1.3197, probability = 0.251) and celibacy (χ2, (1, n = 400) = 0.0721, probability = 0.788). The study concludes that student athletes of senior high schools might be vulnerable to unplanned parenthood and are at risk of STIs, including HIV. Regular health promotion campaigns on sexual risk-taking behaviors are required to help reduce the prevalence of student athletes’ indulgence in risky sexual behavior patterns that can harm their health. It is essential to implement gender-specific interventions (e.g., decision-making skills) when addressing the problems of sexual behaviors among the student athletes in the region.

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Background Enteric pathogens are often associated with exposure to food, water, animals, and feces from infected individuals. However, in sexual networks of men who have sex with men (MSM), transmission of enteric pathogens may occur during direct or indirect oral–anal contact. Methods We performed a scoping review of the literature for studies prior to July 2019 with key terms for gastrointestinal syndromes ("proctitis," "enteritis," "proctocolitis"), enteric pathogens or sexually transmitted infections (STIs), and outbreaks using multiple electronic databases. Results We identified 5861 records through database searches, bibliography reviews, and keyword searches, of which 117 references were included in the pathogen-specific reviews. Conclusions The strength of observational data describing enteric pathogens in MSM and possible sexual transmission of enteric pathogens varies by pathogen; however, a robust body of literature describes the sexual transmission of Campylobacter , Giardia lamblia , and Shigella (particularly antimicrobial-resistant strains) in sexual networks of MSM. Providers are encouraged to consider enteritis or proctocolitis in MSM as possibly having been sexually transmitted and encourage targeted STI testing. Risk/harm reduction and prevention messages should also be incorporated, though there is an acknowledged paucity of evidence with regards to effective strategies. Further research is needed to understand the transmission and prevention of enteric pathogens in MSM. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the sexual behavior patterns of student athletes of senior high schools in the Upper East Region of Ghana and to assess the differences in sexual behavior patterns between male and females. A sample of 400 student athletes using a convenience sampling technique from public senior high schools was drawn to complete a self-designed research study. Descriptive statistics and the Chi-square test tool were used to analyze the collected data. The results showed that student athletes practiced various forms of sexual behaviors such as celibacy, foreplay, vaginal-penile sex, sexual fantasy, masturbation, oral sex, and anal sex. The Chi-square analysis showed significant gender differences in prevalence of masturbation (χ2 (1, n = 400) = 4.6962, probability = 0.030) and sexual fantasy (χ2 (1, n = 400) = 6.8477, probability = 0.009), but not vaginal-penile intercourse (χ2 (1, n = 400) = 1.3197, probability = 0.251) and celibacy (χ2, (1, n = 400) = 0.0721, probability = 0.788). The study concludes that student athletes of senior high schools might be vulnerable to unplanned parenthood and are at risk of STIs, including HIV. Regular health promotion campaigns on sexual risk-taking behaviors are required to help reduce the prevalence of student athletes' indulgence in risky sexual behavior patterns that can harm their health. It is essential to implement gender-specific interventions (e.g., decision-making skills) when addressing the problems of sexual behaviors among the student athletes in the region. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Prostate cancer (PCa) is often diagnosed early with prolonged survival, which makes sexual quality of life (QoL) an increasingly important treatment consideration, but existing QoL questionnaires have limited applicability for men who-have-sex-with-men (MSM) beyond penile erections and penetrative sex. Aim: We aimed to create a validated survey instrument for assessing a variety of sexual activities beyond penile insertive sex for MSM after PCa treatment. Methods: Based on our previously published survey findings, we have generated a prototype questionnaire with 13 different domains, reviewed by both healthy MSM and pilot-tested by MSM treated for PCa. Outcomes: We report here on progress in developing the questionnaire and demonstrate the complexity of MSM sexual side effects resulting from PCa treatment(s). Results: Statistical analysis of 204 responses from MSM treated for PCa showed that each domain performed well individually (Cronbach's alpha coefficients ranged from 0.80 to 0.95; item-total correlations ranged from 0.16 to 0.89), with many significant intercorrelations between the domains (ranged from -0.048 to 0.93). Clinical Implications: The questionnaire can contribute to clinical diagnosis and treatment decisions that best fit the preferred sexual practices of individual MSM. Strengths & Limitations: The current questionnaire considers a much broader repertoire of MSM's sexual practices and preferences than other currently available questionnaires. The high intercorrelations between the many parameters demonstrate that problems in one domain can affect other domains. This preliminary analysis warrants further exploration with a larger sample size. Conclusions: Once validated our questionnaire should help develop tailored psychosocial supports for MSM experiencing sexual dysfunction after PCa treatment and help newly diagnosed MSM with PCa make treatment decisions informed by their preferred sexual practices.Wibowo E, Dowsett GW, Nelson CJ, et al. Development of a Sexual Quality of Life Questionnaire for Men-Who-Have-Sex-With-Men With Prostate Cancer. Sex Med 2022;10:100480.

Background Neisseria gonorrhoeae can be cultured from saliva in men with pharyngeal gonorrhoea and could theoretically be transmitted from the pharynx to the urethra when saliva is used as a lubricant for masturbation. In this work, we proposed that saliva use during masturbation may be a potential transmission route of gonorrhoea. Methods We analysed the transmission of Neisseria gonorrhoeae at the oropharynx, urethra and anorectum with mathematical models among men who have sex with men using data from six different studies. Model 1 included transmission routes (oral sex, anal sex, rimming, kissing, and three sequential sex practices). In Model 2, we added saliva use during solo masturbation and mutual masturbation to model 1. Results Model 2 could replicate single site infection at the oropharynx, urethra and anorectum and multi-site infection across six different datasets. However, the calibration of Model 2 was not significantly different from Model 1 across four datasets. Model 2 generated an incidence of gonorrhoea from masturbation of between 5.2% (95% CI: 3.2-10.1) to 10.6% (95% CI: 5.8-17.3) across six data sets. Model 2 also estimated that about one in four cases of urethral gonorrhoea might arise from solo masturbation and mutual masturbation. Conclusions Our models raise the possibility that saliva use during masturbation may play a role in transmitting gonorrhoea. This is an important area to explore because it contributes to the knowledge base about gonorrhoea transmission. [ABSTRACT FROM AUTHOR]

We examined reporting agreement of oral, vaginal, and anal sex in adolescents and young adults living with perinatally-acquired HIV and those perinatally HIV-exposed and uninfected in the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) and AMP Up studies. Agreement between fixed constructs (e.g., age at first sex) and prevalence of logical inconsistencies (e.g., reclaimed virginity status) over time were assessed. Internal consistency was also examined using an attention check question and questions regarding condom use in the prior three months. Those who reported having anal sex in adolescence had a higher proportion of inconsistent responses compared to vaginal and oral sex measures. At their most recent survey, 84% of young adults correctly answered an attention check question and 74% agreed within the survey on condom use in the prior three months. In bivariate analyses, HIV status was not associated with responding inconsistently. Increased time between surveys, male sex, and younger age at first survey were associated with multiple measures of inconsistency over time, while lower cognitive scores, having less than a high school diploma, and negatively answering post-survey acceptability questions were associated with incorrectly answering an attention check question. [ABSTRACT FROM AUTHOR]

Background: This study determined the association between mental health and risky oral health and sexual health behaviours. Methods: A household cross-sectional survey was conducted in Ile-Ife, Nigeria between December 2019 and January 2020. Data were collected from 10 to 19-year-old on the sociodemographic profile (age, sex at birth and socioeconomic status); mental health problems (psychological distress, depressive symptoms and suicidal ideation); and mental (smoking habit, consumption of alcohol, use of psychoactive substances), sexual (history of vaginal or anal sexual intercourse; transactional sex, multiple sex partners, use of condom at last sexual intercourse) and oral (frequency of daily tooth brushing, daily frequency of consumption of refined carbohydrate in-between-meals, frequency of use of dental floss, history of dental service utilization in the last 12 months and dental anxiety) health risk factors. Binary logistic regression analysis was conducted to determine the association between risky oral (neglecting to brush twice daily and frequent consumption of refined carbohydrates in-between-meals), and sexual (neglecting to use condoms during the last sex act and having multiple sex partners) health behaviours as outcome variables, and mental health status as the explanatory variables. An ordinal logistic regression model was also developed where the outcome variable was the number of risky health behaviours. The models were adjusted for the socio-demographic variables and history of dental service utilisation in the last 12 months of the survey. Results: High psychological distress was significantly associated with lower odds of frequent consumption of refined carbohydrates in-between-meals (AOR = 0.32; 95%CI 0.23, 0.47), and having multiple sex partners (AOR = 0.10; 95%CI 0.02, 0.57); but higher odds of having a higher number of risky behaviours (AOR = 3.04; 95%CI 2.13, 4.33). Having depressive symptoms was significantly associated with higher odds of neglecting to use condom at the last sexual intercourse (AOR = 7.20; 95%CI 1.94, 26.76) and having multiple partners (AOR = 95.43; 95%CI 24.55, 370.90). Suicidal ideation was significantly associated with lower odds of neglecting to use condom at the last sexual intercourse (AOR = 0.00; 95%CI 0.00, 0.00) and having multiple sex partners (AOR = 0.00; 95%CI 0.00, 0.00). Conclusion: The associations between psychological distress and oral and sexual health risk behaviours in adolescents seem complex and need to be studied further. [ABSTRACT FROM AUTHOR]

Probability-based surveys of college students typically assess sexual behaviors such as oral, vaginal, and anal sex. Little is known about the broader range of sexual behaviors in which students engage. In a random sample survey of undergraduate students, we aimed to: (1) describe how recently participants had engaged in solo and partnered sexual behaviors, (2) examine how frequently participants enacted certain rough sex sexual behaviors (e.g., light spanking, hard spanking, choking, slapping, and others), (3) assess participants' frequency of experiencing certain rough sex behaviors, (4) describe participants' frequency of threesome/group sex, (5) assess the characteristics of participants' experiences with choking during sex; and (6) examine choking and face slapping in regard to consent. A confidential, online cross-sectional survey of 4,989 randomly sampled undergraduate students at a large U.S. university. Participants reported having engaged in a broad range of solo and partnered sexual activities, including rough sex behaviors. The most prevalent general sexual behaviors were solo masturbation (88.6%), oral sex (79.4% received, 78.4% performed), penile-vaginal intercourse (73.5%), and partnered masturbation (71.1%). Anal intercourse was the least prevalent of these behaviors (16.8% received, 25.3% performed). Among those with any partnered sexual experience, 43.0% had choked a partner, 47.3% had been choked, 59.1% had been lightly spanked and 12.1% had been slapped on the face during sex. College health clinicians and educators need to be aware of the diverse and evolving range of solo and partnered sexual behaviors reported by students. In addition to counseling students about pregnancy and sexually transmitted infection risk, clinicians might assess patients' engagement in diverse sexual behaviors, such as choking/strangulation during sex, given the risk for serious outcomes including death. Strengths of our research include the large sample size, use of random sampling, high response rate for college populations, broad range of behaviors assessed, and novel data on choking during sex. Among our limitations, we did not assess to what extent the experiences were wanted, pleasurable, or appealing to participants. Except for in relation to choking and slapping, we also did not assess issues of consent. Participants reported engaging in diverse sexual behaviors, some of which have important clinical implications, are understudied, and warrant further research. Herbenick D, Patterson C, Beckmeyer J, et al. Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. J Sex Med 2021;18:1024–1041. [ABSTRACT FROM AUTHOR]

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This study was conducted to determine sexual experiences and gender differences in sexual behaviour in university students. In this cross-sectional and descriptive study conducted between 1st February and 12th November 2017. A total of 491 volunteer students were selected at a state university in the Mediterranean region of Turkey using a systematic sampling method. Questionnaires were distributed to the students in sealed envelopes and collected on completion. The data were collected using a socio-demographic form and a sexual experiences and sexual health behaviours form. A total of 414 students (78 males; 336 females) were included in this study. The prevalence of sexual intercourse among these was 4.3%, and total oral and anal sex experiences were 35% and 16.7%, respectively. A significantly higher number of female students of those who reported having sexual intercourse (n = 9; 50.0%), oral sex (n = 81; 55.9%) and anal sex (n = 60; 87.0%), also reported not telling anyone about his/her partner (77.2%), not talking about sex (82.4%) and not buying contraceptive products, even when necessary (78.3%). Hidden sexuality was seen to affect female students more often and this may lead to risky sexual behaviours, sexually transmitted diseases, an unhealthy sexual life with multiple partners and even unplanned, unwanted pregnancies. [ABSTRACT FROM AUTHOR]

Tensions between emotional labor, agency, entitlement, and coercion all underlie women's ability or inability to negotiate, consent to, and refuse oral and anal sex. In this study, we analyzed semi-structured interviews with twenty women from a diverse 2014 community sample collected in a large Southwestern U.S. city in order to examine the context around women's negotiations of oral and anal sex, particularly how, when, why, and with whom they engage in, and refuse, such activities. There were three themes in how women negotiated oral and anal sex with their partner(s): (1) not expecting sexual reciprocity; (2) partner pressure; and (3) emotional labor. Implications for how women negotiate sex, and what meanings they bring to these negotiations, are explored. Women's beliefs about (men's) sexual entitlement and cultural expectations for non-vaginal sex further complicate women's negotiations of oral and anal sex as well as their ability to enthusiastically consent to such activities. Clinical practice implications and the importance of clinicians both broadening definitions of sex and openly discussing women's entitlement to refuse sex are discussed. [ABSTRACT FROM AUTHOR]

Aim: To determine the frequency of and identify risk factors associated with sexual practices leading to hepatitis A infection in the population of men who have sex with men in Spain. Background: The increased incidence of hepatitis A as a result of sexual contact among this population is a public health concern and a challenge in controlling sexually transmitted infections. Methods: This cross‐sectional, online survey‐based study included 881 men who have sex with men. Unprotected oro‐anal and insertive‐anal sex are considered to be unsafe sexual practices associated with hepatitis A infection. Results: Of all respondents, 83.4% engaged in insertive‐anal sex and 71.3% in unprotected oro‐anal sex during the previous 12 months. An association was found with sociodemographic factors [living alone (OR = 2; 95%CI = 1.13–3.35)] and contextual factors of sexual behaviour [previous diagnosis of sexually transmitted infection(s) (OR = 1.74; 95%CI = 1.15–2.61) and participating in 'chemsex' (OR = 5.15; 95%CI = 1.05–25.15)]. Conclusion: The frequency of unsafe sexual practices associated with hepatitis A among men who have sex with men in Spain is high. Interventions based on sociodemographic and contextual factors of sexual behaviour should be implemented. Implications for Nursing Management: Nurse managers should update and incorporate the support needs of men who have sex with men and take advantage of the opportunity to implement harm reduction strategies. [ABSTRACT FROM AUTHOR]

Because early initiation of sexual behavior can lead to negative health outcomes, it is important to understand the influence of family of origin (FOO) on adolescent sexual debut. This brief report explores the relationship between time spent living with both biological parents, overall quality of FOO experience, and various sexual behaviors (vaginal sex, oral sex, anal sex, masturbation, and pornography use) in adolescence and emerging adulthood. We hypothesized that participants reporting higher quality FOO experiences and more time with biological parents would be (a) more likely to delay the debut of these behaviors and (b) less likely to have participated in these behaviors at all. A demographically diverse national sample of 2,556 18–19-year-old U.S. residents was surveyed. Results showed that more time with biological parents was associated with a lower likelihood of experiencing vaginal, oral, and anal sex. Across analyses, higher quality FOO experience was consistently associated with a lower likelihood of pornography access, masturbation, and oral sex and inconsistently associated with a lower likelihood of anal and vaginal sex. Higher quality FOO and more time with biological parents predicted delayed debut of pornography access, masturbation, vaginal sex, and oral sex. Implications for future research and practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Oral sex and its associated factors among low-tier female sex workers (FSWs) have not been documented in the Chinese literature. Here, we report this perspective in this group. Methods: The data were derived from a large cross-sectional study conducted among low-tier FSWs using a structured questionnaire in 21 counties in Zhejiang province, China. The prevalence of oral sex and its associated factors among 2645 low-tier FSWs were analyzed using bivariate and multivariate analysis. Results: Of all participants, 579 (21.9%) had performed oral sex with clients over the previous month. Multivariate analysis revealed that oral sex is related to being unmarried, low income, early initiation of commercial sex, having conducted commercial sex in more counties, longer duration of commercial sex, larger number of clients, ever having engaged in anal sex, less use of condoms and oral contraceptives during the previous month, low rate of adoption for contraception at the present time, and STI-related symptoms during the previous half year. Conclusion: Oral sex practitioners among low-tier FSWs in China are at a higher risk of STI, HIV, and unwanted pregnancy compared to those who did not engage in oral sex. Behavioral interventions carried out among low-tier FSWs should specifically target low-tier FSWs who practice oral sex, should carefully take into account the characteristics of these FSWs, provide risk awareness education and training for condom use negotiation, and promote the availability of condom and reproductive health care, timely diagnosis, and treatment of STIs. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men (MSM) and transgender women (TGW) are at risk for sexually transmitted infections (STIs), including those of the oropharynx. We estimated the prevalence and factors associated with oral sex practices and characterized oropharyngeal STIs among a cohort of MSM and TGW in Nigeria. Methods: From 2013 to 2018, TRUST/RV368 recruited MSM and TGW into HIV/STI diagnosis and treatment at community-based clinics in Nigeria. Participants who completed HIV testing and oral sex questions at enrollment were selected. Cross-sectional analyses with bivariate and multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs). Oropharyngeal swab testing for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) began in 2014 and for those with diagnostic results at enrollment, the unadjusted association of oral sex practices with oropharyngeal STIs was conducted. Results: A total of 1342 participants had a median age of 25 years (interquartile range: 22–29), 58% were living with HIV, and 69% reported oral sex practices. Factors associated with increased odds of engaging in oral sex included living with HIV (adjusted [a]OR: 1.4, 95% CI: 1.1–1.8), self-identifying as a woman (aOR:1.8, 95% CI: 1.1–2.8), mobile phone ownership (aOR:2.3, 95% CI: 1.3–3.9), receptive anal sex (aOR:1.7, 95% CI:1.3–2.3) and multiple male sexual partners (2 to 4 vs. ≤1, aOR:1.5, 95% CI: 1.0–2.2; 5+ vs ≤1, aOR:2.9, 95% CI:1.9–4.3). Oropharyngeal STI prevalence was 7% (52/752) and higher among those who engaged in oral sex compared to those who did not (unadjusted OR: 2.5, 95% CI:1.2–5.3). Conclusions: Oral sex was common and associated with an increased odds of oropharyngeal STIs among MSM and TGW from Nigeria. In the absence of screening and treatment guidelines, condoms continue to be the mainstay for oral STI prevention. A pre-exposure prophylaxis for bacterial STIs would complement current prevention strategies to curb transmission. [ABSTRACT FROM AUTHOR]

Earlier age of first sex has potential direct and indirect health effects later in life. Though there are multiple nationwide general population studies on ages of first sex, there is no such nationwide study of first male-male oral or anal sex among men who have sex with men (MSM). This may be important for understanding racial/ethnic disparities in HIV and sexually transmitted infection acquisition among young racial/ethnic minority MSM. Our study examined the birth cohort and racial/ethnic differences in ages of first male-male oral and anal sex using a diverse 2015 U.S. nationwide sample of 10,217 sexually active MSM. The mean age of first male-male oral sex was 18.0 years. Compared with older birth cohorts, those MSM born 1990-2000 were more likely to have younger age of first male-male oral sex. Compared to white MSM, Hispanic MSM and non-Hispanic black MSM were more likely to have younger age of first male-male oral sex with a man. The mean age of first male-male anal sex was 20.3 years. Compared with older birth cohorts, those MSM born 1990-2000 were more likely to have younger age of first male-male anal sex. Compared to white MSM, MSM of all other racial/ethnic groups were more likely to have younger age of first male-male anal sex. These findings emphasize the need for comprehensive and MSM-inclusive sexual health education for young teens and online sexual health resources for young gay, bisexual, queer, and other MSM. [ABSTRACT FROM AUTHOR]

This Personal View argues for a new framework of gonorrhoea transmission in men who have sex with men in which the oropharynx plays a major role in transmitting gonorrhoea to, or acquiring gonorrhoea from, their partner's oropharynx, penis, or anorectum through either direct contact or via saliva. To avoid preconceived notions of transmission dynamics, we ask readers to imagine that they are investigating a new sexually transmitted infection. On the basis of the existing clinical and epidemiological data for gonorrhoea at the penis, oropharynx, and anorectum site, we develop two models for transmission: the so-called penile model and the so-called oropharyngeal model. We argue that the existing epidemiological data and behavioural data best fit the oropharyngeal model. Our argument rests on the observation that, at the population level, the prevalence of urethral gonorrhoea is too rare to explain the high incidence of oropharynx and anorectum infection. We describe studies of gonorrhoea detection in saliva, saliva use during sex, epidemiological studies of kissing and oropharyngeal gonorrhoea, as well as studies aided by mathematical models. Finally, we argue that the correlation between sexual acts (eg, kissing, oral sex, anal sex, and saliva use) is so high that any epidemiological study that does not measure these factors will be prone to confounding. [ABSTRACT FROM AUTHOR]

Introduction: In Japan, syphilis notifications have increased. Men who have sex with men (MSM) in Tokyo have contributed substantially to the increase in syphilis notifications. We thus aimed to determine the correlates of incident syphilis among them. Methods: MSM who attended a Tokyo clinic that serves sexual minorities were recruited in a case-control study in 2015. A case was seropositive for primary/secondary/asymptomatic syphilis at enrolment visit and seronegative at prior visit or had oral ulcers positive for Treponema pallidum DNA at enrolment. For each case, two controls seronegative at enrolment and prior visit were selected. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to assess for correlates of case status. Results: Among 35 cases, the median age was 37 (range = 21-63) years and was similar to the 71 controls. Among HIV-positive participants (26 cases and 67 controls), cases were independently associated with higher frequency of anal or oral sex (OR = 3.4; 95% CI = 1.4-8.6; increase per category from < 1/month, ≥ 1/month but < 1/week, to ≥ 1/week) and no or inconsistent condom use during anal or oral sex (OR = 3.0; 95% CI = 1.1-8.3; increase per category from using every time, occasionally, to never), adjusted for residency and time between visits. Discussion: Modifiable behaviours were associated with incident syphilis, and dissemination of prevention messages are needed. [ABSTRACT FROM AUTHOR]

Given that different generations of gay, bisexual, and other men who have sex with men (gbMSM) have been influenced by substantially different life course events and cultural contexts, we explored differences in sexual behaviour between millennials, Gen-Xers, and baby boomers. Sexually active gbMSM from Metro Vancouver, ≥ 16 years, were recruited using respondent-driven sampling between 2012–2015 and completed computer-assisted self-interviews every 6 months, up to 2017. To explore differences between generations (millennials born ≥ 1987, Gen-Xers born 1962–1986, baby boomers born < 1962) we used multivariable logistic regression models using baseline, RDS-weighted data. We also examined 6-month trends, stratified by generation, in partner number, prevalence of high-risk sex, and relationship status using hierarchical mixed-effects models. Among 774 gbMSM (190 millennials, 469 Gen-Xers, 115 baby boomers), median age of first anal sex with a male partner decreased from 20 (aQ1,aQ3:17,25) among baby boomers to 18 (aQ1,aQ3: 16,20) among millennials (x2 (DF = 2, N = 764) = 12.920, p = 0.002). After controlling for relevant demographics, differences were observed for some sexual behaviours (i.e., anal sex positioning, giving oral sex, sex toys, masturbation, sexual app/website use, transactional sex) but not others (i.e., receiving oral sex, rimming, fisting, watersports, group sex). At baseline, millennials reported less high-risk sex than other generations but all trended toward less high-risk sex, fewer partners, and regular partnering over the course of the study. While there was notable similarity across generations, millennial gbMSM reported earlier age at first anal intercourse and less high-risk sex. However, all generations trended towards less high-risk sex, fewer partners, and regular partnering over time. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors. Methods: OKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15–59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data. Results: Among 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting “not” having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors. Conclusions: Oral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa. [ABSTRACT FROM AUTHOR]

Student nurses should be aware of their sexual myths to be able to offer holistic nursing care to their patients. The aim of this study is to determine the opinions of student nurses about sexuality and sexual myths. The study population included fourth-year student nurses of a nursing department of a university (N = 160). The purposeful sampling method was used to explore the sexual myths of the student nurses. The study sample consisted of 31 student nurses. Data were collected by asking the participants a total of three questions in the individual in-depth interview form. After transcribing the audio-recorded interviews, the transcripts were combined with observation notes and then raw data were processed in computer. Finally, a content analysis was performed. As a result of the content analysis, two main themes with 13 subthemes emerged in the study: “Thoughts/Judgments About Sexuality” and “Thoughts/Judgments About Sexual Myths”. The student nurses stated that sexuality is seen as a taboo subject in the society they live in, there should be no sexual activity in old age, and they had difficulty in explaining what sexual myths mean. Also, the participants stated they thought that only men can masturbate, but married individuals and women should not masturbate, and watching pornographic films is wrong behavior. This paper is crucial to determine student nurses’ level of awareness of their own sexual myths and those in their own society and to determine their opinions and thoughts on sexual myths. [ABSTRACT FROM AUTHOR]

Objectives: ‘Get an early check – chrysanthemum tea’ was a multimedia campaign promoting HIV testing targeting Chinese‐speaking men who have sex with men (MSM) in Hong Kong, China. It ran from October to December 2015. This study was carried out to investigate the level of campaign exposure among Chinese‐speaking MSM in Hong Kong and the association between uptake of HIV testing in the last 6 months and campaign exposure. Methods: A cross‐sectional survey was conducted 6 months after the campaign was launched. Participants were Hong Kong Chinese‐speaking men aged ≥18 years who had had anal or oral sex with at least one man in their lifetime. A total of 153 eligible participants completed the anonymous self‐administered questionnaire. Results: Among the participants, 45.8% had been exposed to the campaign and 43.1% had taken up HIV testing in the last 6 months. In multivariate logistic regression analysis, exposure to the campaign [multivariate odds ratio (ORm) 2.55; 95% confidence interval (CI) 1.25, 5.19] and having had anal intercourse with a nonregular sex partner (ORm 2.36; 95% CI 1.05, 5.31) in the last 6 months were significantly associated with uptake of HIV testing in the last 6 months. Conclusions: The campaign had relatively good reach in the target population and may have been useful to encourage them to take up HIV testing. Future campaigns promoting HIV testing among MSM in Hong Kong are still needed. Such programmes should consider making use of viral videos, having a longer project duration and developing culturally sensitive materials for non‐Chinese‐speaking MSM. [ABSTRACT FROM AUTHOR]