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In the United States, adolescents (those 13–18 years old) are a key age group of those at risk for and affected by HIV. Although HIV pre-exposure prophylaxis (PrEP), one promising HIV prevention tool, is approved for eligible adolescents to use, adolescent access to PrEP is limited by primary care providers' (PCPs) willingness to prescribe it. This study examined which Theoretical Domains Framework factors are associated with PCPs' intention to prescribe PrEP to sexually active adolescents. A total of 770 licensed PCPs practicing family medicine, internal medicine, or pediatrics in the United States completed an online cross-sectional questionnaire. Participants were recruited through a Qualtrics panel. We used a hierarchical regression to assess the association of demographic characteristics, sexual health care practices, and the 10 Theoretical Domains Framework factors with intention to prescribe PrEP to sexually active adolescents aged 13–18 years old. Although nearly all PCPs had heard about PrEP (90.9%), 30.6% ever prescribed PrEP to an adolescent. Intention to prescribe PrEP to sexually active adolescents was associated with seven out of the 10 Theoretical Domains Framework factors: knowledge, skills, professional role, belief capacity, belief consequence, environmental resource, social influence, and emotion. Our findings demonstrate that the Theoretical Domains Framework can be employed to understand the intrapersonal, interpersonal, and environmental factors associated with PCPs' intention to prescribe sexually active adolescents PrEP. Implementation strategies are needed to implement interventions that improve provider knowledge, attitudes, and skills related to prescribing PrEP to eligible adolescents. [ABSTRACT FROM AUTHOR]

Introduction: The United States (U.S.) has higher rates of sexually transmitted infections (STIs) and adolescent pregnancy than most other industrialized countries. Furthermore, health disparities persist among racial and ethnic minority adolescents (e.g., African American and Latinx) and in counties located along the U.S.--Mexico border region--they demonstrate the highest rates of STIs and unintended pregnancy among adolescents. Methods: Qualitative data were collected as part of formative research for the development of a mobile app that provides gender-inclusive sexual education to adolescents living in the U.S.--Mexico border region. From August 2019 to March 2020, the study team conducted 11 in-depth interviews with healthcare providers and three focus groups with cisgender, heterosexual, and SGM adolescents ages 15-18 (n = 20). Results: Providers and adolescents reported similar barriers to accessing SRH in this region such as transportation, lack of insurance and cost of services or accessing services without their parent's knowledge. However, providers shared that some adolescents in this region face extreme poverty, family separation (i.e., parent has been deported), have a mixed family legal status or are binational and have to travel every day from Mexico to the U.S. for school. These challenges further limit their ability to access SRH. Conclusions: Adolescents in the U.S.-Mexico border region face unique economic and social challenges that further limit their access to SRH care, making them uniquely vulnerable to STIs and unintended pregnancy. The prototype of the app was developed based on the needs expressed by providers and adolescents, including providing comprehensive Sex Ed and mapping of free comprehensive and confidencial SRH services available in the region and is being pilot tested. Our findings provide further evidence for the need for interventions and service delivery, programs tailored for residents in the border region. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) uptake has been suboptimal despite its demonstrated efficacy in reducing the risk of HIV acquisition. Medical education is one distal determinant that shapes medical providers' perceived role in the PrEP care continuum. However, there is limited understanding of how osteopathic medical students and those wanting to practice in rural areas perceive their role in the PrEP care continuum in the domains of PrEP awareness, uptake, and adherence and retention. Twenty-one semistructured interviews were conducted (March 2019–April 2020) to assess what shapes osteopathic medical students' perceived role in the PrEP care continuum. Participants noted a lack of adequate sexual health training, personal perceptions concerning PrEP use, and ambiguity concerning which of the medical specialties should deliver PrEP. Osteopathic medical schools can incorporate more inclusive and holistic sexual health and PrEP curricula to address these barriers and better prepare osteopathic medical students for their future role in the PrEP care continuum. [ABSTRACT FROM AUTHOR]

Facilitators and barriers of Pre-exposure Prophylaxis (PrEP) uptake have been established in prior studies; however, most of these studies comprise samples of MSM from metropolitan cities and hypothetical PrEP use. There is a dearth of literature on the uptake factors among rural U.S. MSM who are prescribed PrEP. Thirty-four rural Midwestern MSM who currently take PrEP participated in semi-structured telephone interviews about their barriers and facilitators to their PrEP use. Interviews were analyzed using an inductive thematic analysis approach. There were four barriers: (1) lack of rural dissemination of PrEP information, (2) concern about side and adverse effects of using PrEP, (3) cost of PrEP uptake and engagement, and (4) lack of access to PrEP care and PrEP care quality. Individual and social facilitators that participants utilized to overcome these barriers are discussed. Findings elevate the importance of multilevel interventions that address PrEP adoption from a patient, provider, and healthcare system perspective. [ABSTRACT FROM AUTHOR]

Rates of sexual assault and sexual violence among college-aged adults are much higher than the national rates of sexual assault and sexual violence. Therefore, reduction and prevention of sexual violence among university students is critical and is consistent with national public health priorities. Often times, messages to students focus only on sexual assault and omit larger notions of sexual health. Four focus groups with a total of 24 participants (nine men, 15 women) highlighted three main perceptions about the sexual assault programming offered at this large university: themes of resistance to traditional programming, a need for holistic sexual health programming, and a desire to have an environment, which normalizes conversations surrounding sex, sexuality, and sexual health. [ABSTRACT FROM AUTHOR]

Background: One well documented reason that individuals use alcohol and drugs is the belief that these substances will increase satisfaction of a sexual experience or somehow otherwise enhance the sexual experience. However, the unique experiences of MSM residing in rural areas are not well represented in the scientific literature. Methods: We conducted 40 interviews with individuals who identified as a man who has sex with men and lived in rural areas in Oklahoma, a primarily rural and socio-politically conservative state in the United States. Data collection continued until thematic saturation was reached. Results: Three main substances (and themes) were identified by participants: 1) marijuana (focus on the experience/person), alcohol (more open/playful and reduces anxiety), and methamphetamines (stamina and arousal). Conclusions: While the themes for alcohol and methamphetamines were in line with previous research, this is one of the first studies to identify the sex expectancies of marijuana of increasing the ability to focus on the sexual experience and/or the partner. Taken together, participants endorsed some type of positive substance use sex expectancies. These results highlight the importance of accounting for substance use sex expectancies when developing interventions to reduce substance use and risky sexual behaviors. [ABSTRACT FROM AUTHOR]

Sexting, defined as the sending and receiving of sexually suggestive or sexually explicit text or photos, has been growing in prevalence. Recent studies have demonstrated that over half of individuals sampled over 17 and regardless of gender participate in some type of sexting behavior. Most studies on sexting behaviors, including those looking at men who have sex with men (MSM) focus on emerging adult or university-based populations. The goal of the current study was to sample a nonuniversity-based MSM adult population to determine the prevalence of sexting behavior and the odds that a person engages in sexting behaviors based on certain sexual behaviors. The sample consisted of 213 MSM (mean age = 34.8 years, standard deviation [STD] = 12.1) who reside in Oklahoma. The majority of participants (133, 62.4 percent) participated in sexting behaviors. Logistic regression indicated that individuals had 10 times higher odds to engage in sexting if they had participated in a hookup (odds ratio [OR] = 10.44, 95% CI = [4.16-26.25]) and individuals who are married or in a committed relationship had 71 percent lower odds that they had sent a sext message (OR = 0.29, 95% CI = [0.12-0.71]). Sexting behaviors were not associated with condom use. Implications, including using third-party geolocation mobile application (such as Grindr) to deliver sexual health information, are discussed. [ABSTRACT FROM AUTHOR]

Unlabelled: Background There is a lack of research that examines event-level lubricant use and outcomes among gay and bisexual men, with the majority of current research addressing lubricant use within the context of sexual risk. Most studies examining sexual health among gay and bisexual men have relied on convenience sampling strategies for participant recruitment.Methods: Data were collected from the 2012 wave of the National Survey of Sexual Health and Behaviour (NSSHB), which involved the administration of an online questionnaire to a nationally representative probability sample of women and men in the United States aged 18 years and older, including an oversampling of self-identified gay and bisexual men and women. The findings from gay (n=307) and bisexual (n=25) participants who reported sexual behaviours with other male partners during their last sexual encounter are included in this paper. Post-stratification data weights were applied to the data to maximise the generalisability of the findings.Results: Men who reported lubricant use during their last sexual event with a male partner (n=163) were significantly more likely to be non-White, Hispanic and between 30 and 39 years old. Bisexual men had lower odds of using lubricant than gay-identified men. The majority of men reported using lubricant during anal intercourse, along with lower numbers with a range of other sexual behaviours.Conclusion: Public health promotion specialists should consider recommending continued lubricant use as a part of comprehensive sexual health promotion efforts for gay and bisexual men, including that it reduces pain and maximises pleasure. [ABSTRACT FROM AUTHOR]