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In a sample of men who have sex with men (N = 404), 55 (14%) experienced anodyspareunia, frequent and severe pain during receptive anal sex. Most men with anodyspareunia described their pain as life-long, experienced psychological distress as a result, and avoided anal sex for periods of time. Men with anodyspareunia reported that psychological factors were the primary contributing cause of their pain. The findings contradict the myth that pain is a necessary consequence of receptive anal sex and show that anodyspareunia is similar to dyspareunia in women in terms of prevalence, mental health consequences, and contributing factors. Clinical criteria were developed to assist clinicians in diagnosing anodyspareunia.

This article describes practical lessons learned from an evaluation of a continuum of HIV prevention efforts and is intended to assist other states in strengthening their own HIV prevention evaluation activities. In 1996 Minnesota launched several evaluation activities and began to examine how they could be linked across the HIV prevention continuum. Although each evaluation activity generated its own findings, this article examines the challenges faced and the solutions created when integrating these findings into the original steps of the HIV prevention continuum. Key points are highlighted to guide HIV professionals in their endeavors to develop an integrated approach to evaluation and to establish clear and logical linkages across the HIV prevention continuum.

Virtually no HIV prevention education has specifically targeted the transgender community. To fill this void, a transgender HIV prevention workshop was developed, implemented and evaluated. A 4 h workshop, grounded in the Health Belief Model and the Eroticizing Safer Sex approach, combined lectures, videos, a panel, discussion, roleplay and exercises. Evaluation using a pre-, post- and follow-up test design showed an increase in knowledge and an initial increase in positive attitudes that diminished over time. Due to the small sample size (N = 59) and limited frequency of risk behavior, a significant decrease in unsafe sexual or needle practices could not be demonstrated. However, findings suggested an increase in safer sexual behaviors such as (mutual) masturbation. Peer support improved significantly. Future prevention education should make special efforts to target the more difficult-to-reach, high-risk subgroups of the transgender population.