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This study examined the process by which a web-based sexual violence (SV) prevention program (i.e., RealConsent) prevents SV perpetration and increases bystander behaviors. Data from 743 college men who participated in a randomized controlled trial were analyzed. Simple and multiple-mediation models were estimated, using several theoretical constructs to assess the mechanisms through which RealConsent produced significant effects on SV perpetration and prosocial bystander or intervening behaviors. The results indicated that knowledge of effective consent for sex, hostility toward women, date rape attitudes, and hyper-gender male ideology significantly mediated the effects of RealConsent on SV perpetration in the multiple-mediator model. Furthermore, intentions to intervene significantly mediated the effects of RealConsent on prosocial bystander behaviors in the multiple-mediator model. The results show that the RealConsent program works to prevent SV perpetration and prosocial bystander behaviors via several theoretically proposed mediators central to the development and content of the program. The results also provide strong evidence that SV and bystander education for college men may benefit from including an explicit focus on decreasing negative norms related to women (e.g., hostility, date rape attitudes, hyper-gender ideology) and through increasing college men's knowledge of consent and intentions to intervene.

Objectives: Following changes in federal regulations, the current study was an examination of differences in institutional responses to sexual violence among Georgia colleges and universities during 2013 and 2014., Participants: A total of 24 four-year institutions located in the state of Georgia were included., Method: Data were collected from various sources in phases from March 2013 to December 2015 and included institutional characteristics from each college website, a content analysis of college annual security reports and sexual misconduct policies, and a college administrator online survey., Results: Seventy percent of the institutions were deemed "Clery compliant" in 2013 but only 12%, in 2014. There was substantial variability in definitions used in sexual misconduct policies and with respect to the description of investigation and adjudication procedures., Conclusions: There is extensive variability in institutional responses to sexual violence across universities and colleges despite recent media attention and federal guidance.

Background: Research over the last two decades has highlighted the critical role of Brain-derived neurotrophic factor (BDNF) in brain neuroplasticity. Studies suggest that physical exercise may have a positive impact on the release of BDNF and therefore, brain plasticity. These results in animal and human studies have potential implications for the recovery from damage to the brain and for interventions that aim to facilitate neuroplasticity and, therefore, the rehabilitation process. Purpose: The aim of this study was to carry out a systematic review of the literature investigating how aerobic exercises and functional task training influence BDNF concentrations post-stroke in humans and animal models. Data Sources: Searches were conducted in PubMed (via National Library of Medicine), SCOPUS (Elsevier), CINAHL with Full Text (EBSCO), MEDLINE 1946-present with daily updates (Ovid) and Cochrane. Study Selection: All of the database searches were limited to the period from January, 2004 to May, 2017. Data Extraction: Two reviewers extracted study details and data. The methodological quality of the studies that used animal models was assessed using the ARRIVE Guidelines, and the study that evaluated human BDNF was assessed using the PEDro Scale. Data Synthesis: Twenty-one articles were included in this review. BDNF measurements were performed systemically (serum/plasma) or locally (central nervous system). Only one study evaluated human BDNF concentrations following physical exercise, while 20 studies were experimental studies using a stroke model in animals. A wide variation was observed in the training protocol between studies, although treadmill walking was the most common type of intervention among the studies. Studies were of variable quality: the studies that used animal models scored from 8/20 to 15/20 according to the ARRIVE Guidelines. The only study that evaluated human subjects scored 5/10 according to the PEDro scale and, which indicates a quality classified as "fair". Conclusions: The results of the current systematic review suggest that aerobic exercise promotes changes in central BDNF concentrations post-stroke. On the other hand, BDNF responses following functional exercises, such as reaching training and Constraint Induced Movement Therapy (CIMT), seem to be still controversial. Given the lack of studies evaluating post-stroke BDNF concentration following physical exercise in humans, these conclusions are based on animal work.

Purpose: This study tested three psychosocial measures for their potential to serve as counseling goals for promoting ART to transgender women living with HIV (TWLH). Methods: Among 69 TWLH, 17.4% were not taking ART; these volunteers were compared to the remainder using multivariate regression analyses. Results: Only one psychosocial measure achieved significance: Personal Competence (Adjusted Odds Ratio = 0.80, 95% CI = 0.67-0.97, P  = 0.02). Because this was a continuous measure, assessed on a 7-point scale, the protective adjusted odds ratio of 0.80 represents a 20% reduction in the odds of not taking ART for each unit of increase in this construct. Conclusion: Findings suggest a potential counseling goal for TWLH not taking ART., Competing Interests: No competing financial interests exist.

This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P < .001) and pharyngeal gonorrhea ( P = .04) occurred among YBTWSM; however, both associations were moderated and only significant for HIV-uninfected volunteers. YBTWSM had more oral sex partners and more frequent engagement in oral sex. The number of new sex partners for anal receptive sex was greater in YBTWSM. YBTWSM were more likely to exchange sex for money/drugs ( P < .001), have sex with men recently in prison ( P < .001), who were "anonymous" ( P = .004), or who were "one night stands" ( P < .001). YBTWSM were more likely to depend on sex partners for money food, etc. ( P < .001), to miss meals due to lack of money ( P = .01), and to report having ever being incarcerated ( P = .009). Compared to cisgender YBMSM, YBTWSM experience multiple risk factors relative to the acquisition/transmission of STIs and HIV.

Objective: To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM)., Methods: Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data., Results: Compared with the reference group, human immunodeficiency virus (HIV)-infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23-2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74-2.63, P < 0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed., Conclusions: A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.

Purpose: Sexual violence (SV) perpetration on college campuses is a serious and prevalent public health issue in the U.S. In response, incoming male freshmen are mandated to receive SV prevention programming. To provide a more effective response, however, we need to understand the SV behaviors of male freshmen before they arrive on campus and the associated factors that contribute to risk and that afford protection, areas that have received limited attention., Methods: Male freshmen (N = 1,133) across 30 selected 4-year colleges and universities throughout the state of Georgia were recruited for a longitudinal study on SV perpetration. Levels of precollege SV as well as a range of covariates were assessed at baseline. Self-reported SV perpetrators were compared with nonperpetrators on demographic and hypothesized covariates deemed either risk or protective; then risk and protective models were analyzed using binary logistic regression., Results: Weighted analyses revealed that 19.3% self-reported perpetrating SV before college. Before starting college, young men who reported more sexual media consumption, heavy episodic drinking, hypermasculine beliefs, and peers who endorsed SV were more likely to have a history of SV perpetration at college matriculation. Alternatively, men with more knowledge of effective sexual consent and stronger family functioning were less likely to arrive to college with an SV perpetration history., Conclusions: A significant proportion of incoming male freshmen have perpetrated SV previously. Colleges and universities need to assess incoming freshmen for risk behaviors and negative beliefs and to offer both primary and secondary preventions to more effectively reduce further perpetration., (Copyright © 2017 The Society for Adolescent Health and Medicine. All rights reserved.)

Sexual minority (lesbian, gay, and bisexual [LGB]) populations experience disparities in cigarette use, but sparse evidence exists about novel and other alternative tobacco product use. In this study, we compared rates of novel and other alternative tobacco product use, risk perceptions, and worldview between LGB and heterosexual (HET) adults. An online survey administered in 2014-2015, using a weighted probability sample of 11,525 U.S. adults, assessed awareness of tobacco products; ever and current use of e-cigarettes, cigars, little cigars and cigarillos, and hookahs; perceptions of e-cigarettes; and worldview (individualism vs. communitarianism). Bivariate and adjusted multivariable analyses were performed to determine differences between LGB and HET groups. In the adjusted analyses, LGB adults were 1.5 times more likely to have ever used e-cigarettes (95% CI 1.2-1.9) and 1.9 times more likely to have ever used hookahs (95% CI 1.5-2.4) as compared to HET adults. A lower percentage of LGB adults, as compared to HET adults (16.7% vs. 19.2%), believed that exposure to vapors from e-cigarettes was "harmful" and reported that they "did not know" of any harm (35.1% vs. 39.8%). LGB were 20% less likely than were HET adults to endorse an individualistic worldview. These results suggest that a disparity exists, whereby LGB adults are more likely to have used e-cigarettes and hookahs. In addition, although vapor from e-cigarettes contains nicotine and other chemicals, LGB adults are less likely to perceive exposure to secondhand vapor as harmful. Tailored awareness campaigns and interventions are needed to convey the risks and curb use of these products., (Copyright © 2017 Elsevier Inc. All rights reserved.)

This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P < 0.001). HIV-infected transgender women also experienced less trans-related discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.

To combat the high rates of sexual violence on college campuses, prevention programming should be theoretically driven, persuasive, and salient, and should provide messages that counter negative normative beliefs supportive of sexual violence. We describe qualitative formative research that identifies themes as a means to inform messages and content for a Web-based sexual violence prevention program. To illustrate the process, we used qualitative analysis of eight focus groups (N = 48) with male undergraduates from a large urban, public, Southeastern university. Analyses focused on how men interpret sexual interest, the meaning and methods of obtaining effective consent for sex, sexual encounters that involve alcohol, barriers to and facilitators of bystander intervention, and intervening techniques. We demonstrate how positive and negative themes identified in the analysis can be incorporated into programming segments.

Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial ( N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes ( p < .05). Parental monitoring was an effect modifier for the perceived peer norms and lifetime sexual partners association ( p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.

Background: Brain-derived neurotrophic factor (BDNF) plays a critical role in sensorimotor recovery after a stroke. However, few studies have assessed the circulating BDNF levels in post-stroke humans to understand its changes. This study was conducted to measure BDNF serum concentrations in subjects with chronic hemiparesis, as well as to correlate serum concentrations with age, post-stroke time, total score of Stroke Specific Quality of Life Scale (SS-QOL), mobility subscale score, and motor function of SS-QOL., Methods: Seventeen chronic post-stroke subjects matched by age and gender with healthy controls took part in the study. Personal data (age, hemiparesis side, and post-stroke time) were collected, and a physical examination (weight, height, body mass index) and SS-QOL assessment were carried out. On the same day, after the initial evaluation, venous blood samples were collected from the chronic post-stroke subjects and the healthy subjects. The BDNF serum concentrations were measured blindly by enzyme-linked immunosorbent assay., Results: Subjects with chronic hemiparesis presented a decrease in BDNF serum compared with healthy subjects (P < .01). There was no correlation between BDNF serum levels with post-stroke time, age or quality of life, mobility, and the upper extremity motor function (P > .05). BDNF concentrations are related to structural and functional recovery after stroke; thus, this reduction is important to understand the rehabilitation process more clearly. However, more studies are needed considering the genetic variations and other tools to assess motor impairment and functional independence., Conclusion: Chronic post-stroke subjects presented a decrease in BDNF serum concentrations, without a correlation with post-stroke time, age, and quality of life., (Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

This review describes the use of social networking sites (SNS) in the context of primary prevention of HIV. A review was conducted to assess the published literature for HIV interventions using SNS. Sixteen articles describing twelve interventions were included. SNS were instrumental in recruiting hard-to-reach populations within a short amount of time; were able to reach wide audiences beyond the targeted population for HIV prevention campaigns; and helped to significantly reduce sexual risk behaviors and increase HIV testing. SNS are a viable option to recruit hidden populations, engage the target audience, and disseminate HIV prevention messages. Researchers should use SNS to generate sampling frames that can be used to select participants. Practitioners should use SNS to post images of preventive behavior within health promotion campaigns. Researchers should use multiple SNS platforms to engage participants. As more studies are published using SNS for HIV prevention, meta-analyses will be needed.

Objective: To assess internalized homophobia (IH) and its relationship to sexual risk behaviors and prevalence of sexually transmitted infection (STIs) in a clinic-based sample of young black men who have sex with men (YBMSM)., Methods: Six hundred YBMSM completed a self-interview and provided specimens for testing. A 7-item scale assessed IH, and 19 sexual risk behaviors were assessed., Results: In adjusted models, compared with men with less IH, those with greater IH were more likely to report: any condomless anal receptive sex (P = 0.01) and sex with women (P < 0.001). Alternatively, men with greater IH were less likely to: discuss acquired immune deficiency syndrome prevention with sex partners (P = 0.009), disclose their same sex sexual behavior to providers (P = 0.01), be tested for human immunodeficiency virus in the past 12 months (P = 0.04), report condomless oral sex (P = 0.049), and test RPR positive (P = 0.01)., Conclusions: With some exceptions, IH among YBMSM attending STI clinics may influence their sexual risk behaviors; however, STI prevalence was not associated with this construct.

Objective: To characterize sensorimotor control and muscle activation in the shoulder of chronic hemiparetic during abduction and flexion in maximal and submaximal isometric contractions. Furthermore, to correlate submaximal sensorimotor control with motor impairment and degree of shoulder subluxation., Methods: Thirteen chronic hemiparetic post-stroke age-gender matched with healthy were included. Isometric torques were assessed using a dynamometer. Electromyographic activity of the anterior and middle deltoid, upper trapezius, pectoralis major and serratus anterior muscles were collected. Variables were calculated for torque: peak, time to target, standard deviation (SD), coefficient of variation (CV), and standard error (RMSE); for muscle activity: maximum and minimum values, range and coefficient of activation. Motor impairment was determined by Fugl-Meyer and shoulder subluxation was measured with a caliper., Results: Paretic and non-paretic limbs reduced peak and muscle activation during maximal isometric contraction. Paretic limb generated lower force when compared with non-paretic and control. Paretic and non-paretic presented higher values of SD, CV, RMSE, and CV for prime mover muscles and minimum values for all muscles during steadiness. No correlation was found between sensorimotor control, motor impairment and shoulder subluxation., Conclusion: Chronic hemiparetic presented bilateral deficits in sensorimotor and muscle control during maximal and submaximal shoulder abduction and flexion., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Purpose: Among black transgender women (transwomen) at high risk of HIV acquisition or already living with HIV/AIDS, the study examined whether medical or socially based gender affirming factors may contribute differentially to selected measures of resiliency, perceived stress, and a scale measure of mental health outcomes. This question has implications for clinical care and counseling of this population. Methods: Seventy-seven black transwomen were recruited to participate in a private, face-to-face structured interview. Two index measures of gender affirmation (GA) were constructed from the data. One comprised medical aspects only and the other comprised social aspects of GA. Assessed outcomes were personal competence and acceptance of self and life (resiliency), perceived stress and recent anxiety, depression, and suicide ideation (mental health). Associations between GA variables and outcomes were first assessed using bivariate level correlations. Significant bivariate associations were then tested in multivariable regression models adjusting for age and HIV status. Results: Mean age of the sample was 34.5 years. More than one-half of the sample (62.3%) indicated being HIV-infected. None of the bivariate or multivariable associations pertaining to GA medical factors were significant. Conversely, the social GA factors were significant and protective with all four outcomes. In the presence of age and HIV status, greater social GA was significantly associated with greater personal competence, acceptance of self and life, and positive mental health outcome. HIV status had an independent effect on personal competence, acceptance of self and life, with HIV-positive transwomen scoring higher on both measures. Conclusion: Among black transwomen at high risk of HIV acquisition or already HIV-infected, study findings suggest the possibility that socially based GA may play a prominent role in strengthening the resiliency and mental health of black transwomen. This same protective effect may not occur as a consequence of gender affirming body modification practices., Competing Interests: No competing financial interests exist.

Purpose. The purpose of this study is to examine the prevalence of and risk factors for engaging in sex work among youth living in Kampala, Uganda. Methods. Analyses are based on a cross-sectional study (N = 1,134) of youth aged 12-18 years, living in the slums of Kampala, conducted in Spring of 2014. The analytic sample consisted of only sexually active youth (n = 590). Youth who reported engaging in sex work were compared to youth who did not report sex work. Multivariable analyses were conducted to examine factors associated with sex work. Results. Among the youth who had ever had sexual intercourse (n = 590), 13.7% (n = 81) reported engaging in sex work. Self-reported HIV prevalence was 13.9% among the total sample (n = 81) and 22.5% (n = 18) among youth engaged in sex work. Engaging in sex work was associated with being female (AOR 10.4; 95% CI: 3.9, 27.4), being an orphan (AOR 3.8; 95% CI: 1.7, 8.4), ever drinking alcohol (AOR 8.3; 95% CI 3.7, 19.0), and experiencing any rape (AOR 5.3; 95% CI: 2.9, 9.5). Discussion. The reported prevalence of sex work is high among youth in the slums of Kampala and is associated with high HIV prevalence, ever drinking alcohol, previously being raped, and being an orphan.

To determine whether men's reported desire to father a child or their perception that someone wanted to have their child was associated with elevated rates of unprotected vaginal sex, we studied a sample of young Black men at high risk of sexually transmitted infection acquisition. Data were collected in clinics treating sexually transmitted infections in three southern U.S. cities. Men 15-23 years of age who identified as Black/African American and reported recent (past two months) penile-vaginal sex were eligible (N = 578). Logistic regression was used to examine whether desire to conceive a child (self and perception of partners' desire) predicted condom use, adjusting for age and whether they had previously impregnated someone. Their own level of desire to conceive a child was not significantly associated with unprotected vaginal sex or the proportion of times a condom was used. However, those who perceived higher level of someone wanting to conceive their child were 1.73 times more likely to report unprotected vaginal sex (P = .006) and 1.62 times more likely to report a lower proportion of times condoms were used (P = .019). Young Black men attending sexually transmitted infection clinics in the USA may forego condom use based on a perceived desire of their partners to become pregnant, putting themselves at risk for sexually transmitted infection acquisition and unplanned pregnancy. Findings provide initial support for the relevance of the idea that perceptions of women partners' desire to conceive may be a critical determinant of condomless sex., (© The Author(s) 2015.)

Unlabelled: Background The purpose of this study was to identify unmediated associations of early sexual debut (ESD) on the current safer sex practices of young Black men (YBM)., Methods: A cross-sectional study of YBM (n=697) attending clinics treating sexually transmissible diseases (STIs) in three cities was conducted. ESD was dichotomised at the age of 13 years and under. A series of regression models were used to test the moderating effects of ESD and perceived parental monitoring (PPM). A regression model also tested the effect of years of sexual experience (YSE) on sexual risk behaviours, while controlling for ESD., Results: Mean age of debut was 13.95 years. ESD results varied with significance for pregnancy (P<0.001), sexual partners (P<0.001), and ever having chlamydia (assessed by self report), but this final association was only found for older males (P=0.03). PPM held no moderating effect on any of the sexual risk outcomes. YSE was correlated with an increase in recent unprotected vaginal sex (AOR=1.19, 95%CI=1.10-1.27) and having a pregnant partner at the time of enrolment (AOR=1.30, 95%CI=1.17-1.43)., Conclusions: The findings provide mixed evidence for unmediated associations of ESD among young Black males. The study strongly posits that ESD may actually be a mediating variable rather than a causal explanation for sexual risk. The findings also suggest that advancing YSE foster diminishing vigilance in safer sex practices. These outcomes should be utilised to inform intervention development.

Background: The stroke is the leading cause of adult disability in the world. One of the main complaints of individuals post-stroke refers to the loss of function of the upper limb, as evidenced during the performance of activities of daily living. This difficulty may be related to an important component of sensorimotor control, joint position sense, a submodality of proprioception., Objectives: To investigate whether the proprioception of both shoulders of chronic hemiparetic patients is altered during abduction and flexion., Methods: Thirteen subjects with chronic hemiparesis due to ischemic stroke and 13 healthy subjects matched for gender and age was included. The joint sense position was assessed using a dynamometer. Absolute error for shoulder abduction and flexion at the 30 and 60° was calculated., Results: No difference was found between the paretic and non-paretic limbs in movements at both 30 and 60°. Higher values of absolute error for both paretic and non-paretic limbs compared to the control were observed during abduction at 30 and at 60°., Conclusions: Chronic ischemic post-stroke patients have bilateral proprioceptive deficits in the shoulder during abduction and flexion. But these deficits are dependent on the movement performed and the angle tested. The results demonstrate the need to include bilateral exercises and/or visual feedback in the rehabilitation program.

Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs.

Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.

Purpose: To describe factors associated with racial disparities in HIV (human immunodeficiency virus) incidence among men who have sex with men (MSM) in the United States., Methods: In a longitudinal cohort of black and white HIV-negative MSM in Atlanta, HIV incidence rates were compared by race. Incidence hazard ratios (HRs) between black and white MSM were estimated with an age-scaled Cox proportional hazards model. A change-in-estimate approach was used to understand mediating time-independent and -dependent factors that accounted for the elevated HR., Results: Thirty-two incident HIV infections occurred among 260 black and 302 white MSM during 843 person-years (PY) of follow-up. HIV incidence was higher among black MSM (6.5/100 PY; 95% confidence interval [CI]: 4.2-9.7) than white MSM (1.7/100 PY; CI: 0.7-3.3) and highest among young (18-24 years) black MSM (10.9/100 PY; CI: 6.2-17.6). The unadjusted hazard of HIV infection for black MSM was 2.9 (CI: 1.3-6.4) times that of white MSM; adjustment for health insurance status and partner race explained effectively all of the racial disparity., Conclusions: Relative to white MSM in Atlanta, black MSM, particularly young black MSM, experienced higher HIV incidence that was not attributable to individual risk behaviors. In a setting where partner pool risk is a driver of disparities, it is also important to maximize care and treatment for HIV-positive MSM., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Although region and neighborhood condition's effect on HIV/sexually transmitted infection (STI) risk has been studied separately, there is little research examining their interplay. African American adolescents (n = 1,602) from four matched cities in the Northeastern and Southeastern US completed Audio Computer Assisted Self-Interviews and submitted biospecimen samples to detect Sexually Transmitted Infections (chlamydia, gonorrhea, and trichomonas). Logistic and negative binomial regressions determined HIV/STI risk differences by region, neighborhood stress, and stress-region dyads. Northeastern participants demonstrated lower HIV/STI risk while participants from higher stress neighborhoods exhibited greater risk. Relationships between neighborhood condition and ever having anal sex (p < 0.01), anal condom use (p < 0.05), and number of anal partners (p < 0.05) were significant in the Northeast only. Participants in unstressed Northeastern neighborhoods were less likely to have vaginal sex than those in comparable Southeastern neighborhoods (p < 0.05). Participants in unfavorable Northeastern neighborhoods had fewer anal partners than participants in comparable Southeastern neighborhoods (p < 0.01). In concert, neighborhood and region differentially affect HIV/STI risk.

HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma.

Objective: To test the hypothesis that a brief, clinic-based, single-session programme will reduce the rate of 10 selected condom use errors in a clinical sample of young black men (YBM) ages 15 through 23 years., Methods: Data were collected in clinics treating patients with sexually transmitted infections (STI) in three southern US cities. Males 15-23 years of age who identified as black/African-American, and reported recent (past 2 months) condom use were eligible. Only those also reporting condom use in the 2 months prior to a 6-month follow-up assessment (n=311) were included in this secondary analysis of data from a randomised, controlled trial. Difference scores were used to capture a Group×Time effect., Results: YBM reported 2232 condom use events in the 2 months preceding study enrolment and 2042 in the 2 months preceding the follow-up assessment. Mean baseline error rates were 1.32 and 1.13 for young men randomised to the intervention and control conditions, respectively. Follow-up rates were 1.11 and 3.59 for young men randomised to the intervention and control conditions, respectively. Controlled findings yielded a significant effect for the influence of group assignment on the difference score (baseline to follow-up) in the condom use error rate (β=0.13; p=0.02)., Conclusions: A brief, clinic-based counselling programme produced modest reductions in condom use errors among YBM attending STI clinics in the southern USA Intensified clinic-based intervention that helps YBM improve the quality of their condom use behaviours is warranted., Trial Registration Number: NCT00849823., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objective: This article aimed to review the literature to verify the effect of botulinum toxin type A (BTX-A) on the intrinsic properties of spastic muscles and functionality in children with cerebral palsy (CP)., Methods: A literature search was conducted in the following databases: CINAHL, SCOPUS, Web of Science and PubMed. Database searches were limited to the period from January 1993 to March 2014., Results: A total of 2182 papers were identified, and 17 met the inclusion criteria. Only one study analyzed the effect of the toxin on muscle intrinsic properties and others analyzed the effect on functionality., Conclusion: BTX-A application demonstrated no changes in the passive stiffness of spastic muscle. In relation to functional level, the evidence of BTX-A effect was controversial. These studies showed methodological quality limitations that restrict the interpretation of the results for the entire CP population, which justifies the need for further randomized controlled trials.

Objectives: We tested the efficacy of a brief intervention to promote correct and consistent use of condoms among Black male youths attending sexually transmitted infection (STI) clinics in 3 southern US cities., Methods: In 2010 to 2012, we screened (n = 1102) and enrolled (n = 702) youths aged 15 to 23 years who identified as Black and reported recent (past 2 months) sexual activity and randomized them to a private, brief, interactive intervention (n = 349) or an attention-equivalent control condition (n = 353). Assessments occurred at baseline and 2 and 6 months after the intervention., Results: At 6 months, with adjustment for age and pretest nonequivalence of the outcome variable, an estimated odds ratio (EOR) of 1.63 (95% confidence interval [CI] = 1.07, 2.49; P = .02) indicated efficacy for correct condom use. An adjusted generalized estimating equations model with both 2- and 6-month condom use variables produced an EOR of 1.49 (95% CI = 1.06, 2.08; P = .02). We did not observe significant effects on chlamydia and gonorrhea incidence., Conclusions: This brief intervention, delivered as part of STI clinical care, could help alleviate the disproportionate STI-HIV burden among young Black men.

Background: Lack of human immunodeficiency virus (HIV) infection awareness may be a driver of racial disparities in HIV infection among men who have sex with men (MSM). Lack of awareness is typically measured by comparing HIV test result to self-reported HIV status. This measure may be subject to reporting bias and alternatives are needed., Methods: The InvolveMENt study examined HIV disparities between black and white MSM from Atlanta. Among HIV-positive participants who did not report knowing they were positive, we examined other measures of awareness: HIV viral load (VL) <1000 copies/mL (low VL), antiretroviral (ARV) drugs in blood, and previous HIV case surveillance report., Results: Using self-report only, 32% (62 of 192) of black and 16% (7 of 45) of white MSM were not aware of their HIV infection (P = .03). Using self-report and low VL, 25% (48 of 192) black and 16% (7 of 45) white MSM lacked awareness (P = .18). Using self-report and ARVs, 26% (50 of 192) black and 16% (7 of 45) white MSM lacked awareness (P = .14). Using self-report and surveillance report, 15% (28 of 192) black and 13% (6 of 45) white MSM lacked awareness (P = .83)., Conclusions: Self-report only may overestimate true lack of awareness of HIV status for black MSM. If, as our data suggest, black MSM are not less likely to be aware of their HIV infection than are white MSM, then this factor is not a substantial driver of HIV disparity. Future HIV research that depends on accurate measurement of HIV status awareness should consider including additional laboratory and case surveillance data.

Background: Bystander intervention approaches offer promise for reducing rates of sexual violence on college campuses. Most interventions are in-person small-group formats, which limit their reach and reduce their overall public health impact., Objective: This study evaluated the efficacy of RealConsent, a Web-based bystander approach to sexual violence prevention, in enhancing prosocial intervening behaviors and preventing sexual violence perpetration., Methods: A random probability sample of 743 male undergraduate students (aged 18 to 24 years) attending a large, urban university located in the southeastern United States was recruited online and randomized to either RealConsent (n=376) or a Web-based general health promotion program (n=367). Participants were surveyed online at baseline, postintervention, and 6-months postintervention. RealConsent was delivered via a password-protected Web portal that contained six 30-minute media-based and interactive modules covering knowledge of informed consent, communication skills regarding sex, the role of alcohol and male socialization in sexual violence, empathy for rape victims, and bystander education. Primary outcomes were self-reported prosocial intervening behaviors and sexual violence perpetration. Secondary outcomes were theoretical mediators (eg, knowledge, attitudes)., Results: At 6-month follow-up RealConsent participants intervened more often (P=.04) and engaged in less sexual violence perpetration (P=.04) compared to controls. In addition, RealConsent participants reported greater legal knowledge of sexual assault (P<.001), greater knowledge of effective consent (P<.001), less rape myths (P<.001), greater empathy for rape victims (P<.001), less negative date rape attitudes (P<.001), less hostility toward women (P=.01), greater intentions to intervene (P=.04), less hyper-gender ideology (P<.001), less positive outcome expectancies for nonconsensual sex (P=.03), more positive outcome expectancies for intervening (P<.001), and less comfort with other men's inappropriate behaviors (P<.001)., Conclusions: Our results support the efficacy of RealConsent. Due to its Web-based format, RealConsent has potential for broad-based dissemination thereby increasing its overall public health impact on sexual violence., Trial Registration: Clinicaltrials.gov: NCT01903876; http://clinicaltrials.gov/show/NCT01903876 (Archived by WebCite at http://www.webcitation.org/6S1PXxWKt).

Background: Recruiting valid samples of men who have sex with men (MSM) is a key component of the US human immunodeficiency virus (HIV) surveillance and of research studies seeking to improve HIV prevention for MSM. Social media, such as Facebook, may present an opportunity to reach broad samples of MSM, but the extent to which those samples are comparable with men recruited from venue-based, time-space sampling (VBTS) is unknown., Objective: The objective of this study was to assess the comparability of MSM recruited via VBTS and Facebook., Methods: HIV-negative and HIV-positive black and white MSM were recruited from June 2010 to December 2012 using VBTS and Facebook in Atlanta, GA. We compared the self-reported venue attendance, demographic characteristics, sexual and risk behaviors, history of HIV-testing, and HIV and sexually transmitted infection (STI) prevalence between Facebook- and VTBS-recruited MSM overall and by race. Multivariate logistic and negative binomial models estimated age/race adjusted ratios. The Kaplan-Meier method was used to assess 24-month retention., Results: We recruited 803 MSM, of whom 110 (34/110, 30.9% black MSM, 76/110, 69.1% white MSM) were recruited via Facebook and 693 (420/693, 60.6% black MSM, 273/693, 39.4% white MSM) were recruited through VTBS. Facebook recruits had high rates of venue attendance in the previous month (26/34, 77% among black and 71/76, 93% among white MSM; between-race P=.01). MSM recruited on Facebook were generally older, with significant age differences among black MSM (P=.02), but not white MSM (P=.14). In adjusted multivariate models, VBTS-recruited MSM had fewer total partners (risk ratio [RR]=0.78, 95% CI 0.64-0.95; P=.01) and unprotected anal intercourse (UAI) partners (RR=0.54, 95% CI 0.40-0.72; P<.001) in the previous 12 months. No significant differences were observed in HIV testing or HIV/STI prevalence. Retention to the 24-month visit varied from 81% for black and 70% for white MSM recruited via Facebook, to 77% for black and 78% for white MSM recruited at venues. There was no statistically significant differences in retention between the four groups (log-rank P=.64)., Conclusions: VBTS and Facebook recruitment methods yielded similar samples of MSM in terms of HIV-testing patterns, and prevalence of HIV/STI, with no differences in study retention. Most Facebook-recruited men also attended venues where VTBS recruitment was conducted. Surveillance and research studies may recruit via Facebook with little evidence of bias, relative to VBTS.

Background: Men who have sex with men (MSM), particularly young black MSM, are disproportionately affected in the United States' HIV epidemic. Drug use may contribute to these disparities, yet previous studies have failed to provide evidence of elevated use among black MSM, relying exclusively on self-reported usage. This study uses biological assays to validate self-reports of drug use and explore the potential for misclassification to distort findings on racial patterns of use in this population., Methods: From an Atlanta-based cohort study of 454 black and 349 white MSM from 2010 to 2012, participants' self-reported drug use was compared to urine drug screening findings. The sensitivity of self-report was calculated as the proportion reporting recent usage among those who screened positive. Multivariable regression models were constructed to examine racial patterns in self-report, urine-detection, and self-report sensitivity of marijuana and cocaine usage, adjusted for socio-demographic factors., Results: In analyses that adjusted for age, education, income, sexual orientation, and history of arrest, black MSM were less likely to report recent use of marijuana (P<0.001) and cocaine (P=0.02), but equally likely to screen positive for either drug. This discrepancy between self-reported and urine-detected drug use was explained by significantly lower sensitivity of self-report for black participants (P<0.001 for marijuana, P<0.05 for cocaine)., Conclusions: The contribution of individual drug-related risk behaviors to the HIV disparities between black and white MSM should be revisited with methods that validate self-reports of illegal drug use., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: The reasons for black/white disparities in HIV epidemics among men who have sex with men have puzzled researchers for decades. Understanding reasons for these disparities requires looking beyond individual-level behavioral risk to a more comprehensive framework., Methods and Findings: From July 2010-December 2012, 803 men (454 black, 349 white) were recruited through venue-based and online sampling; consenting men were provided HIV and STI testing, completed a behavioral survey and a sex partner inventory, and provided place of residence for geocoding. HIV prevalence was higher among black (43%) versus white (13% MSM (prevalence ratio (PR) 3.3, 95% confidence interval (CI): 2.5-4.4). Among HIV-positive men, the median CD4 count was significantly lower for black (490 cells/µL) than white (577 cells/µL) MSM; there was no difference in the HIV RNA viral load by race. Black men were younger, more likely to be bisexual and unemployed, had less educational attainment, and reported fewer male sex partners, fewer unprotected anal sex partners, and less non-injection drug use. Black MSM were significantly more likely than white MSM to have rectal chlamydia and gonorrhea, were more likely to have racially concordant partnerships, more likely to have casual (one-time) partners, and less likely to discuss serostatus with partners. The census tracts where black MSM lived had higher rates of poverty and unemployment, and lower median income. They also had lower proportions of male-male households, lower male to female sex ratios, and lower HIV diagnosis rates., Conclusions: Among black and white MSM in Atlanta, disparities in HIV and STI prevalence by race are comparable to those observed nationally. We identified differences between black and white MSM at the individual, dyadic/sexual network, and community levels. The reasons for black/white disparities in HIV prevalence in Atlanta are complex, and will likely require a multilevel framework to understand comprehensively.

We tested a couples HIV testing and counseling (CHTC) intervention with male couples in Atlanta by randomizing eligible couples to receive either CHTC or separate individual voluntary HIV counseling and testing (iVCT). To evaluate the acceptability and safety of CHTC, main outcomes were satisfaction with the intervention and the proportions of couples reporting intimate partner violence (IPV) and relationship dissolution after the service. The results indicated that the service was very acceptable to men (median 7-item index of satisfaction was 34 for CHTC and 35 for iVCT, P = .4). There was no difference in either incident IPV (22% versus 17% for CHTC and iVCT, respectively, P = .6) or relationship dissolution (42% versus 51% for CHTC and iVCT, respectively, P = .5). Based on the preliminary data, CHTC is safe for male couples, and it is equally acceptable to iVCT for men who have main partners.

The current study examined and compared the willingness of young Black men who have sex with men (YBMSM) to accept pre-exposure prophylaxis (PrEP), adult male circumcision, and condoms for reducing their risk of HIV acquisition. The majority (67%) reported unprotected receptive anal sex in the last six months. About three-quarters (71%) would accept using PrEP if it was 100% effective. Cost influenced PrEP acceptance with 19% indicating acceptance at $100 per month co-pay. Of those not circumcised, 50% indicated willingness if circumcision was 100% effective. Acceptance of circumcision decreased markedly to 17% with co-pays of $100. About 73% of men were willing to use condoms if they were 100% effective and 50% indicated a willingness at the cost of $10 per month. The findings suggest that condom use promotion strategies should remain at the forefront of public health efforts to control HIV incidence among YBMSM.

In the United States, a substantial proportion of HIV transmissions among men who have sex with men (MSM) arise from main sex partners. Couples voluntary HIV testing and counseling (CHTC) is used in many parts of the world with male-female couples, but CHTC has historically not been available in the U.S. and few data exist about the extent of HIV serodiscordance among U.S. male couples. We tested partners in 95 Atlanta male couples (190 men) for HIV. Eligible men were in a relationship for ≥3 months and were not known to be HIV-positive. We calculated the prevalence of couples that were seroconcordant HIV-negative, seroconcordant HIV-positive, or HIV serodiscordant. We evaluated differences in the prevalence of HIV serodiscordance by several dyadic characteristics (e.g., duration of relationship, sexual agreements, and history of anal intercourse in the relationship). Overall, among 190 men tested for HIV, 11 % (n = 20) were newly identified as HIV-positive. Among the 95 couples, 81 % (n = 77) were concordant HIV-negative, 17 % (n = 16) were HIV serodiscordant, and 2 % (n = 2) were concordant HIV-positive. Serodiscordance was not significantly associated with any evaluated dyadic characteristic. The prevalence of undiagnosed HIV serodiscordance among male couples in Atlanta is high. Offering testing to male couples may attract men with a high HIV seropositivity rate to utilize testing services. Based on the global evidence base for CHTC with heterosexual couples and the current evidence of substantial undiagnosed HIV serodiscordance among U.S. MSM, we recommend scale-up of CHTC services for MSM, with ongoing evaluation of acceptability and couples' serostatus outcomes.

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15-21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions.

This cross-sectional study identified the prevalence of gender based violence (GBV) and examined its association with sexual risk behavior among female sex workers (FSWs). Among 120 participants between ages 20 and 52, a total of 56.7 % reported lifetime GBV. Multivariate analyses revealed that GBV was significantly associated with inconsistent condom use, unprotected sex, condom misuse, fear of client reaction to requests of condom use, self-reported history of STIs, and earlier age of initiation of sex work. GBV must be considered an urgent public health priority among FSWs in Armenia. Interventions addressing FSWs, in addition to targeting skill-based, sexual risk reduction must also introduce a discourse among FSWs, sexual partners, clients and community members about the role of GBV in HIV-associated risk behaviors and infection. Structural level initiatives must address economic opportunities for women, health-sector policies and responses to FSWs' health needs, law enforcement training and societal norms toward women.

Objectives: Stigma is an important issue for marginalized HIV-infected populations. We describe stigma among HIV-infected women on antiretroviral therapy and associations with access to clinical care, demographic factors, and structural elements of support., Methods: HIV-infected women attending a government-supported clinic in Kolkata, India, were asked about experiences with stigma. Clinical information was abstracted from medical records. We described factors associated with stigma using ordinal logistic regression., Results: Among 198 women, higher levels of stigma were associated with lower CD4 count upon entry into care (aOR = 0.78; 95% confidence interval [CI]: [0.65, 0.94]), district of residence (aOR = 1.9; CI: [1.0, 3.4]), presence of extended family in the household (aOR = 0.57; CI: [0.32, 1.0]), and employment at the time of the interview (aOR = 0.48; CI: [0.26, 0.90]). Stigma was not associated with having missed scheduled HIV care appointments., Conclusion: Stigma is prevalent among Indian women with HIV, should be further explored, and may be important in considering public health interventions for better access to care.

The purpose of this study was to develop and assess the psychometric properties of several scales that measure dyadic constructs derived from an integrated model of interdependence theory and communal coping perspectives. The scales are specific to HIV risk and men who have sex with men who are in an intimate relationship. These scales are newly developed measures of perceived severity of HIV, preferences for sexual health outcomes, outcome and couple efficacy to avoid HIV, and communal coping strategies. Scale items were created based on theoretical definitions and results from six focus groups with men who have sex with men. Face and content validity of the scales were assessed with a panel of six experts in the field of HIV prevention. Revised scales were subsequently administered to an online sample of 638 men who have sex with men, who indicated being in a relationship for at least three months. All scales showed adequate reliability, and evidence for construct validity was obtained for all scales, except for perceived severity of HIV. The results indicate that these dyadic scales are psychometrically sound and can be used in future HIV prevention research and practice with men who have sex with men couples.

Objectives: We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents., Methods: We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009-December 2010) after the intervention began (August 2006-January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events., Results: All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases., Conclusions: Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended.

This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infections among detained African American female adolescents. A cross-sectional survey was conducted among 123 African American female adolescents within eight detention facilities in Georgia. Using audio-computer assisted self-interviewing technology, data were collected on demographics, ethnic identity, laboratory-confirmed Chlamydia and Gonorrhea, and other known correlates for sexually transmitted infections (STIs), such as socioeconomic status, parental monitoring, and risky sexual behaviors. Rates of Chlamydia and Gonorrhea testing yielded incidence rates of 22.6% and 4.3%, respectively. Findings indicated that, controlling for STI correlates, participants who indicated high ethnic identity were 4.3 times more likely to test positive for an STI compared to those scoring low on the measure of ethnic identity.

Introduction: Entomological studies conducted in large hydroelectric infrastructure projects are a tool for the prevention and control of vector-borne diseases. These diseases emerge as a consequence of changes made to the terrain that often increase the natural and artificial mosquito larval habitats. Many of these insects are of public health importance and population increases result in an increased risk of disease transmission., Objective: The culicine (mosquito) and phlebotomine (sand fly) populations were characterized in the area of the Porce II and Porce III hydroelectric projects of Antioquia between 1990 to 2009., Materials and Methods: Periodical entomological samplings were made in the area of impact, in the workers camps, and construction sites. Adult specimens were captured with nets, Shannon light traps, CDC light traps, and protected human bait., Results: Mosquito larvae of the following species were identified: Culex coronator, Culex nigripalpus, Culex corniger, Culex quinquefasciatus and Limatus durhami. The most frequently identifiers of larval habitats were low tanks, waste cans, tires, and aquatic plants. Aedes aegypti specimens were captured in only two rural locations from two municipalities within the area of influence. Specimens from the following mosquito genera were captured in forest areas: Aedes, Mansonia, Culex, Psorophora, Wyeomyia, Phonyomyia, Uranotaenia, Haemagogus and Sabethes. The most important mosquito found was Haemogogus janthinomis, an efficient yellow fever vector in Colombia. The area has been endemic for leishmaniasis and in the current study, 20 species of Lutzomyia sand flies, potential vectors, were identified. Among malaria vectors, the most important species found in the area were Anopheles nuneztovari and Anopheles pseudopunctipennis., Conclusion: A wide variety of vectors were discovered in the area of the Porce II and Porce III hydroelectric projects, and many of these were relevant for public health. Further monitoring will be necessary to minimize disease transmission risks among the workers and the inhabitants of the surrounding areas.

Purpose: To identify significant factors that distinguish African American girls who have high sexually transmitted infection (STI) prevention knowledge from those lacking such knowledge., Methods: We recruited a sample of 715 African American girls from three public health clinics in downtown Atlanta. Using audio computer-assisted self-interviewing (A-CASI) technology, we assessed for age, self-mastery, employment status, attendance at sex education classes, socioeconomic status, and STI prevention knowledge., Results: Slightly more than one-third of the girls did not know that females are more susceptible to STI infections than males; and that having an STI increases the risk of contracting HIV. Almost half of the girls did not know if a man has an STI he will not have noticeable symptoms; and that most people who have AIDS look healthy. Logistic regression findings indicated that being older, having greater self-mastery, and being employed significantly predicted high STI knowledge., Conclusions: Health educators may especially target African American girls who are younger, unemployed, and experiencing low self-mastery for more tailored STI heath education., (Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

This study examined correlates of the discordance between sexual behavior self-reports and Incident Sexually Transmitted Infections. African American adolescent females (N = 964) from four U.S. cities were recruited for an HIV/STI prevention trial. Self-reported sexual behaviors, demographics, and hypothesized psychosocial antecedents of sexual risk behavior were collected at baseline, 6-, 12-, and 18-month follow-up assessments. Urine specimens were collected and tested for three prevalent STIs (chlamydia, gonorrhea, trichomonas) at each assessment. Seventeen percent of participants with a laboratory-confirmed STI reported either lifetime abstinence or recent abstinence from vaginal sex (discordant self-report). Lower STI knowledge, belief that fewer peers were engaging in sex, and belief that more peers will wait until marriage to have sex were associated with discordant reports. Discordance between self-reported abstinence and incident STIs was marked among African American female adolescents. Lack of STI knowledge and sexual behavior peer norms may result in underreporting of sexual behaviors.

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.