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Since few researchers have analyzed sexting behaviors in nonuniversity-based adult samples, we sought to determine if sexting is associated with negative psychological correlates and risky sexual behaviors in this population. Analysis of individuals who indicated having vaginal or anal sex in the past 12 months and who identified as single (n = 377) showed that condomless sex is independent of sexting behaviors. Results for those in committed relationships (n = 374) and having had vaginal or anal sex in the past 12 months also demonstrated condomless sex and sexting behaviors were not related. Furthermore, alcohol consumption and relational health were predictive of sexting behaviors in adults in committed relationships. These findings demonstrate that while risky sexual behavior and negative psychological correlates are associated with sexting and younger populations, the same might not be true for a nonuniversity-based, older adult sample. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To understand the comparative concerns and perceptions of veterinary and medical health professionals regarding antimicrobial resistance (AMR) and its effects on their clinical practices. SAMPLE: 17 Doctors of medicine and veterinary medicine and 1 nurse practitioner were interviewed to collect qualitative-based data regarding their clinical experience with AMR. METHODS: The interviews from the health professionals were transcribed and thematically coded to reveal 3 overarching themes and 7 corresponding subthemes. RESULTS: Both veterinary and human medical health professionals share concerns about antimicrobial resistance, specifically regarding the development of "superbugs" and increased difficulty in treating disease. However, there were some unique differences in the clinical effects of AMR between the professions in relation to client demand and satisfaction, ability to track/test trends, and approaches to therapy. Both professions also discussed the possible one-health implications of AMR and its transmission. CLINICAL RELEVANCE: There are several barriers to veterinarians that prevent them from using best-practice methods with antimicrobials that were not shared with human medical personnel, who can use antibiotic stewardship principles and readily access necessary testing. However, many veterinarians possessed a unique one-health-based understanding of how antimicrobial resistance can affect the wider community across species and globally that many human medical professionals had not previously considered. This demonstrates an increased need for one-health understanding within human medical professionals and a need for veterinarians to have access to necessary tools to comply with stewardship guidelines, such as culture and sensitivity testing and antibiograms, to have the ability to limit their contribution to antibiotic resistance. [ABSTRACT FROM AUTHOR]

Introduction: Given the large number of individuals who are released from detention in correctional facilities every year, the process of reentry and its associated physical, mental, social, sexual, and other health challenges position recently incarcerated men as a priority population for public health research and practice. The aim of this exploratory study was to assess the prevalence of a range of comprehensive health issues among a community-based sample of recently incarcerated men in metropolitan Indianapolis, Indiana. Methods: Under the auspices of an academic-community coalition, our study team engaged in a series of formative steps to determine the most relevant and feasible pilot study that would match the needs of the local community. Based on this guidance, we employed a variety of recruitment strategies to engage a sample of recently incarcerated men in a venue-based computerized survey. We collected a range of data in terms of their sexual health and behaviors as well as a wide range of comprehensive health concerns. Results: Complete baseline data were collected from a diverse sample of 18 adult men who had been released from incarceration during the past 30 days. As with other populations, recently incarcerated men reported a wide range of lifetime sexual experiences. Despite previous studies suggesting high rates of sexual risk behavior immediately following release from incarceration, reports of recent sexual risk behavior (i.e., within the past 30 days) in our sample were relatively low. The majority of participants had been screened for HIV/STI during the past year. Approximately half of the participants reported using drugs at least once over the past year. Although rates of use of most illicit substances were relatively low, a high proportion of men (67%) smoked cigarettes. Employment concerns following release from incarceration were clearly significant among the participants, including stigma and associated stress. Conclusions: Using a community-informed research process, we were able to elicit a wide range of health-related information from a diverse group of men currently in the process of reentry following incarceration. Rates of sexual risk behavior were lower than anticipated and rates of recent HIV/STI screening were relatively high. Additionally, drug use did not appear to be a major concern for most participants. However, employment-related issues were perhaps the most significant challenge for men during the process of reentry. Future health promotion strategies aimed at men during the reentry process would likely be enhanced by focusing on mechanisms for coping with stress and other difficulties related to the reality of stigma and discrimination faced by individuals who are released from incarceration. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) who reside in predominantly mixed rural and rural areas remain at risk for HIV and STI acquisition; however, few studies have researched the sexual behavior of this population. Sexual health interventions geared toward MSM are often developed with urban and suburban populations, with a focus on community development and diffusion of health information. Such approaches may not account for the unique social context of residing in a mixed rural or rural area, with smaller numbers of open sexual minority individuals and lower HIV/STI prevalence rates. To address the sexual health needs of this diverse population, a community-academic partnership was developed to inform research. MSM (N = 282) residing within south central Indiana were recruited to complete an anonymous online questionnaire regarding sexual behavior, community identity, and community connectedness. Results demonstrate the need for innovative HIV/STI prevention programs geared to reach MSM residing in rural and mixed rural areas. [ABSTRACT FROM AUTHOR]

This study investigated the intersectionality of adverse childhood experiences (ACEs) among subgroups of sex, race/ethnicity, and sexual orientation. Using data from the Behavioral Risk Factor Surveillance Survey across 34 states (N=116,712) from 2009 to 2018, authors stratified subgroups of sex (male/female), race/ethnicity (White/Hispanic/Black/multiracial/other), and sexual orientation (heterosexual/bisexual/gay) to investigate the number of ACEs across groups. Analyses were conducted in 2022. Stratification resulted in 30 distinct subgroups (e.g., bisexual Black females, straight multiracial males) with significant post hoc differences per group. Generally, those identifying as sexual minority individuals had the highest number of ACEs (the top 14 of 30 subgroups), whereas seven of the top ten subgroups were female. Surprisingly, no clear patterns emerged by race/ethnicity, although the two largest groups (straight White females and straight White males) were 27th and 28th of 30, respectively. Although studies have examined ACEs by individual demographic variables, less is known about the extent to which ACEs are present in stratified subgroups. Sexual minority subgroups (particularly female bisexual subgroups) trend toward a higher number of ACEs, whereas heterosexual subgroups (regardless of sex) comprised the lowest 6 groups with respect to ACEs. Implications include further examination of bisexual and female subgroups (including specific ACE domain investigations) to identify the vulnerable population. [ABSTRACT FROM AUTHOR]

Although HIV pre-exposure prophylaxis (PrEP) effectively and safely prevents HIV among adolescents, uptake of PrEP is low. Adolescents must have primary care providers (PCPs) prescribe them PrEP, making PCPs critical actors in PrEP delivery. However, research has primarily investigated determinants of PCPs' intention to prescribe adolescents PrEP rather than the determinants of performing the behavior itself. We examined the demographic, clinical practice, and implementation determinants of PCPs previously prescribing PrEP to adolescents. PCPs were recruited from a national Qualtrics panel of licensed medical providers in the United States from July 15-August 19, 2022. The Theoretical Domains Framework informed the implementation determinants measured. A multivariable logistic regression was used. PCPs who were more knowledgeable of the CDC guidelines (aOR 2.97, 95% CI 2.16-4.10), who were assigned male at birth (aOR 1.64, 95% CI 1.03-2.59), and who practiced in the Western region (aOR 1.85, 95% CI 1.04-3.30) had greater odds of prior prescribing adolescents PrEP. Provider-based educational interventions should be designed, implemented, and tested to encourage PCPs to prescribe PrEP to eligible adolescents., (© 2023. Springer Nature Limited.)

Purpose: Parents' attitudes toward contraceptive delivery methods have been shown to impact their adolescents' use of contraceptive methods. However, little is known about the HIV pre-exposure prophylaxis (PrEP) delivery method attitudes of parents of sexual and gender minority (SGM) adolescents assigned male at birth (AMAB). This exploratory, mixed-method formative study examined the PrEP delivery method preferences among a convenience sample of 33 parents of SGM adolescents AMAB who live in Texas., Methods: Participants completed an online survey, where they selected their preferred PrEP method for their SGM adolescent AMAB to use: PrEP as a daily oral pill, a bimonthly injectable, or a yearly implant. Parents answered an open-ended question about their reasons for choosing their preferred method. We analyzed data through descriptive statistics and inductive content analysis., Results: Findings from this convenience sample suggest that there is not one PrEP delivery method that parents of SGM adolescents AMAB prefer: one third of parents (33.3%) selected PrEP as a daily oral pill, 45.5% selected PrEP as a bimonthly injectable, and 21.2% selected PrEP as an annual implant. Parents cited multiple reasons for selecting a delivery method over another, with the most prevalent reasons being adherence (57.6%), access or cost (21.2%), and generic convenience or ease (21.2%)., Discussion: Findings from this formative exploratory study sets the stage for future research and intervention development in increasing parental knowledge, preferences, and preference motivations for PrEP delivery methods., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Few studies have examined the role adverse childhood experiences (ACEs) have on specific diet patterns. This study assessed the association between ACEs and daily fruit and vegetable intake (FVI). Data were derived from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) which surveys 50 states and three U.S. territories. Participants who completed the ACEs module were included in the analyses (N = 106,967). Total ACEs included the summed responses from the domains of abuse, household challenges, and neglect. FVI was reported by number of times consumed per day. The two fruit items included fruit (fresh, frozen, and canned) and fruit juice. The four vegetable items included leafy greens, fried potatoes, non-fried potatoes, and other vegetables. All fruit and vegetable items were analyzed separately to see which specific items drove the relationship between total ACEs and total FVI, equaling a total of 8 regression models. Every model controlled for poor mental health days, sex, age, ethnicity, income, body mass index, and physical activity. Total ACEs were positively associated with daily intake of fried potatoes (β = 0.008, p =.025), other potatoes (β = 0.008, p =.049), and other vegetables (β = 0.024, p <.001). Total ACEs were negatively associated with daily intake of fruit (β = -0.016, p <.001). ACEs had non-significant relationships with leafy greens and fruit juice. Findings suggests that those with increased ACEs scores report increased consumption of fried potatoes, non-fried potatoes, and other vegetables, and less of fruit. Findings highlight the need for understanding food context and preparation when analyzing the relationship between ACEs and diet intake., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Inc.)

Introduction: COVID-19 vaccination is widely recommended as a prevention strategy; however, vaccine uptake is disproportionately lower among rural Americans compared to their urban counterparts. Development of public health activities to address the rural-urban vaccine gap requires an understanding of determinants of vaccine hesitation. The present study explores perceptions of and barriers to COVID-19 vaccination among rural Oklahomans., Methods: Between March and May 2021, 222 residents, unvaccinated for COVID-19, within rural Oklahoma counties completed a cross-sectional, online questionnaire to qualitatively assess perceptions, benefits, and concerns regarding getting vaccinated for COVID-19., Results: Approximately two-fifths of rural respondents in the present study were hesitant to get vaccinated, even when a vaccine was made available to them. Major factors included limited knowledge and understanding about the vaccine, including potential side-effects and long-term complications, as well as skepticism surrounding COVID-19 vaccine development and efficacy. Among the potential perceived benefits of vaccination were protecting the health of vulnerable individuals and the ability to return to normal day-to-day activities., Conclusion: Increases in COVID-19 cases and deaths in rural areas are expected to continue as new variants are introduced within communities. The present findings highlight the need for the development of culturally tailored vaccine information, to be disseminated by local leaders within rural communities.

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., (© 2022. The Author(s).)

Public health literature often neglects populations from rural communities, particularly with men who have sex with men (MSM). Although HIV/STI infections are decreasing slightly, there is an increase within rural MSM, thus opening the door for further research on condom use behavior in a rural context. In-depth interviews were conducted with 40 MSM in rural Oklahoma regarding their condom use and sexual behaviors. A qualitative analysis revealed five themes with respect to condom usage: physical discomfort of condoms, relationship trust, usage based on the type of sexual act, substance use, and knowledge of a partner's HIV/STI status. A sixth theme within the context of rural Oklahoma revealed participants' fear of physical/verbal abuse, hesitations seeking medical help due to confidentially issues, and general acknowledgment of the lack of education and resources available. Implications include increasing mobile testing locations and a push for marketing greater confidentially within health service providers.

This study highlights the experiences of gay and bisexual men who live in Oklahoma with formalized sex education. Open-ended prompts were provided to individuals ( N = 112) who completed an online questionnaire assessing their experience with sex education and what they would like to see offered. The majority of participants did not receive a formalized sex education and they want to see a comprehensive sex education program provided in public schools. A need exists for a more comprehensive and inclusive formalized sex education program to be provided in socio-politically conservative areas like Oklahoma.

Research investigating the health care experiences of men who have sex with men (MSM) predominately concerns urban populations. This study examines the health care experiences of MSM residing in rural Oklahoma. A total of 40 MSM (aged 21 through 66) living in rural areas were interviewed. Data were analyzed using a qualitative approach to identify emerging concepts. Three themes emerged from the data: First, participants cited cultural differences related to religious conservative ideologies as a central motif of health care experiences. Next, doctor-patient relationship quality was a contributing factor to health care experiences. Last, health care experiences were predicated on the idea of doctors' knowledge of lesbian, gay, bisexual and transgender (LGBT) health issues. Certain health care aspects regarding the rural experiences of MSM that were identified differed between rural and urban MSM. Implications include support for programs that bridge the gap between practitioners and patients, while better informing both MSM and health care providers of current LGBT health issues.

Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men's patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population.