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Background: One of the biggest problems faced by the homosexual population is the high prevalence of sexually transmitted diseases including human immunodeficiency virus which can be attributed to inconsistent and incorrect use of condom. Condom usage among homosexuals is affected by many factors which may have a positive or negative impact on it. This study aimed to find out the different sociodemographic determinants that were associated with consistent and correct condom use among homosexual males aged 18–24 years. Materials and Methods: This descriptive cross-sectional study was conducted among 240 homosexual (including bisexual) males aged 18–24 years living in the Metropolitan city for minimum 1-year duration at the outreach sites of an NGO. Data pertaining to sociodemographic variables and consistent and correct condom use were obtained and analyzed in SPSS using the Chi-square test to find out the association between condom use and sociodemographic profile. Results: Only 43.3% of participants were using condoms consistently and correctly. Consistent and correct use of condom was observed among participants who were younger (p =<0.001), more educated (p =<0.001), belonging to a higher socioeconomic class (p =<0.001) with a high per-capita income (p =<0.001), living in a nuclear family (P = 0.004), unmarried (P = 0.0071), and staying with the family (p =<0.001). Conclusion: Sociodemographic determinants do have an impact and play a vital role in the consistent and correct use of condoms among homosexual males. [ABSTRACT FROM AUTHOR]

Ghanaian adolescents face considerable sexual and reproductive health challenges that can disrupt human capital formation. However, a positive and healthy transition from adolescence to adulthood can be achieved by increasing access to sexual and reproductive health information, education, and services. This paper documents emerging findings from an adolescent girls' programme delivered in 56 districts of Ghana. Data were collected from girls and young women aged 10–24 years who participated in the programme as part of a larger study that included in-school and out-of-school participants. In-depth interviews (IDI) [N = 49] and focus-group discussions (FGDs) [N = 13] were conducted in November 2021 and November 2022. An abductive approach was used to develop key themes from the data. The analysis revealed that the programme showed promise in changing the attitudes of beneficiaries towards safe sexual practices through condom use, in increasing assertiveness towards sexual and gender-based violence, and in real-life application of the knowledge and skills gained for health and social wellbeing. Out-of-school sexuality education programmes such as the one described here can be important catalysts for developing and maintaining meaningful relationships with others through the provision of information and education, and service delivery. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) dramatically reduces HIV transmission risk. PrEP is underutilized among men who have sex with men who use substances (SU-MSM) in the Southern U.S., for whom there is limited research and high PrEP need. Using cross-sectional data from the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) 0082 study, we explored factors associated with PrEP awareness and use among 225 SU-MSM in the Southern U.S. Participants were recruited from community-based sexually transmitted infection clinics, syringe services programs and outpatient substance use treatment programs in eight cities across five Southern states with high HIV incidence. Multinomial logistic regressions examined PrEP awareness and use relative to sociodemographic factors, sexual behaviors and substance use. Results demonstrated overall high awareness, yet limited uptake of PrEP. Younger age, higher education, condomless anal sex and more frequent popper use were associated with greater odds of PrEP awareness. Higher education, condomless anal sex and more frequent popper use were associated with greater odds of PrEP use. Results highlight the need for innovative PrEP outreach to Southern SU-MSM that accounts for age, education and substances used. [ABSTRACT FROM AUTHOR]

The article examines sexual and reproductive health (SRH) care utilization among youth experiencing homelessness (YEH) through a brief intervention at an emergency shelter. Topics discussed include SRH risks and behaviors among YEH, barriers to accessing SRH services, and the effectiveness of interventions to improve service utilization and address SRH disparities in this vulnerable population.

Background. Adverse gender norms within the health care system are detrimental to the sexual and reproductive health of young people. This study assessed the attitudes of health workers toward adverse gender norms related to intimate partner relationships across three domains: intimate partner violence (IPV); sexuality; and reproductive health behavior. Methods. A cross-sectional quantitative survey was conducted among 255 health workers in youth-friendly primary health centers in Ebonyi State, Nigeria. Attitudes to gender norm statements were assessed on a 3-point scale of agree (3 points), partially agree (2 points), and disagree (1 point). Mean attitude scores were estimated for each statement and the predictors of attitudes were determined through multiple linear regression analysis with p -value set at.05. Results. Majority of the health workers held gender biases regarding male control over sexual decision-making, men's higher desire and value for sex, and the woman's responsibility to prevent pregnancy. Over 40% of the respondents associated women carrying condoms with promiscuity, and 39.6% believed that only men have the "social" rights to purchase condoms. Urban residence predicted health workers' attitudes to adverse gender norms related to sexuality (β = −.179, p =.003). Conclusions. Findings from this study provide a basis for in-service training programs that are designed to change the attitudes of health workers to adverse gender norms and transform their practices. [ABSTRACT FROM AUTHOR]

Introduction: Although the Government of Nepal has developed strategies to integrate contraceptive services with abortion care to better meet the contraceptive needs of women, data indicate that significant gaps in services remain. This paper assessed post-abortion contraceptive use, trends over 36 -months, and factors influencing usage. Methods: Data from this paper came from an ongoing cohort study of 1831 women who sought an abortion from one of the sampled 22 government-approved health facilities across Nepal. Women were interviewed eight times over 36 months between April 2019 to Dec 2023. Bivariate and multivariate analysis were used to analyze the data. Results: Results show that after abortion, 59% of women used modern contraception, with injection being the most prevalent method, followed by condoms, pills, implants, and IUD. The hazard model showed that discontinuation of modern contraception was significantly higher among women desiring additional children (aHR 0.62) and lower among literate (aHR − 0.15) and those with existing children (aHR − 0.30). Women's age, ethnicity, cohabitation with husband, household's income and autonomy were not associated with continuation. Conclusion: After having an abortion, we found that just slightly more than half of women used modern methods of contraception; this percentage did not increase significantly over the course of three years. [ABSTRACT FROM AUTHOR]

Background In 2023, Tennessee replaced $6.2 M in US Centers for Disease Control and Prevention (CDC) human immunodeficiency virus (HIV) prevention funding with state funds to redirect support away from men who have sex with men (MSM), transgender women (TGW), and heterosexual Black women (HSBW) and to prioritize instead first responders (FR), pregnant people (PP), and survivors of sex trafficking (SST). Methods We used a simulation model of HIV disease to compare the clinical impact of Current, the present allocation of condoms, preexposure prophylaxis (PrEP), and HIV testing to CDC priority risk groups (MSM/TGW/HSBW); with Reallocation , funding instead increased HIV testing and linkage of Tennessee-determined priority populations (FR/PP/SST). Key model inputs included baseline condom use (45%–49%), PrEP provision (0.1%–8%), HIV testing frequency (every 2.5–4.8 years), and 30-day HIV care linkage (57%–65%). We assumed Reallocation would reduce condom use (−4%), PrEP provision (−26%), and HIV testing (−47%) in MSM/TGW/HSBW, whereas it would increase HIV testing among FR (+47%) and HIV care linkage (to 100%/90%) among PP/SST. Results Reallocation would lead to 166 additional HIV transmissions, 190 additional deaths, and 843 life-years lost over 10 years. HIV testing reductions were most influential in sensitivity analysis; even a 24% reduction would result in 287 more deaths compared to Current. With pessimistic assumptions, we projected 1359 additional HIV transmissions, 712 additional deaths, and 2778 life-years lost over 10 years. Conclusions Redirecting HIV prevention funding in Tennessee would greatly harm CDC priority populations while conferring minimal benefits to new priority populations. [ABSTRACT FROM AUTHOR]

Background: Risky sexual practices among taxi drivers pose a significant threat to public health, contributing to the spread of sexually transmitted infections (STIs) and HIV/AIDS. The nature of their profession often exposes taxi drivers to factors that increase their vulnerability to engaging in risky sexual practices. Although research on sexual health in general is readily available, studies specifically focused on this population are limited. Understanding the contributing factors behind risky sexual practices among taxi drivers is crucial to developing targeted interventions that address their unique needs and vulnerabilities. Objectives: To assess the prevalence and associated factors of risky sexual practices among taxi drivers in Finoteselam town, northwest Ethiopia, 2023. Methods: A cross-sectional study was conducted among 359 taxi drivers in the Finoteselam town. Data were collected using pre-tested questionnaires and analyzed using SPSS. Bivariate and multivariable analyses were performed to identify factors associated with risky sexual practices. In the bivariate analysis, a p -value ≤ 0.25 at 95% CI was used to consider the variables in the multivariate analysis. Finally, statistical significance was declared with a p -value of less than 0.05 with a 95% CI. Results: The prevalence of risky sexual practices among taxi drivers was 32.9 (95% CI: 28.01, 38.7). Living alone (AOR = 3.47, 95% CI: 1.86, 6.48), taxi ownership (AOR = 2.08, 95% CI: 1.01, 4.25), neglecting the discussion of the SRH issue (AOR = 2.05, 95% CI: 1.08, 4.00), substance use (AOR = 1.56, 95% CI: 1.04, 2.09), attending night clubs (AOR = 6.04, 95% CI: 1.97, 18.55) and watching pornographic materials (AOR = 4.44, 95% CI: 2.14, 9.19) were significantly associated with risky sexual practices. Conclusions and recommendation: This study revealed a high prevalence of risky sexual practices among taxi drivers in Finoteselam town. Therefore, a comprehensive approach involving different stakeholders is required for reducing risky sexual practices. Information dissemination, awareness creation (about risks of attending nightclubs, substance use, and watching pornography), and encouraging knowledge sharing about sexual health are some of the interventions required to reduce risky sexual practices among taxi drivers. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents face unique challenges in accessing appropriate information and services regarding sexuality and reproductive health (SRH). This poor access can lead to sexual behaviours that could put them at risk of unintended pregnancies and sexually transmitted infections. Adolescents living with HIV (ALHIV) have specific SRH needs that remain unmet. We explored the SRH knowledge, practices and needs of ALHIV in Abidjan, Côte d'Ivoire. Methods: Between April and September 2023, a qualitative study using semi-structured individual interviews was conducted with nine male and nine female ALHIV without previous pregnancies, and eight ALHIV who became pregnant. All consented and were ALHIV acquired perinatally, aged 15–19 years, informed of their HIV status, and followed in three paediatric HIV care centres in Abidjan. participating in the paediatric IeDEA West African Cohort and enrolled in the ANRS12390 OPTIMISE-AO project aimed at improving HIV disclosure process and adherence to antiretroviral treatment. A focus group discussion was conducted with five peer-educators, aged 23–31 years, participating in the OPTIMISE-AO project to gather their perspectives on adolescent SRH. Interviews were conducted in French, and a thematic analysis was performed. Results: All participants expressed difficulty in talking about SRH with their parents or health professionals and turned to their friends for advice. All feared transmitting HIV. One-third of female participants reported having experienced non-consensual sex and sexual violence. Participants reported low levels of condom use, despite having good knowledge of its purpose. Reasons for not using condoms included difficulties in negotiating for girls, as well as having an undetectable viral load, which was seen by adolescents as a condition for waiving condom use. As hormonal contraceptives were subject to many negative beliefs justifying their non-use, alternative methods, such as emergency contraceptive pills or traditional plants, were used to prevent pregnancy. Conclusion: ALHIV reported unmet SRH needs, particularly in terms of accessing reliable information and appropriate support. Integrating SRH care into paediatric HIV care, organising SRH discussion groups led by peer-educators, and improving access to a range of contraceptives may address these needs to enhance SRH outcomes for ALHIV. Summary: Adolescents lack access to appropriate information and services on sexuality and reproductive health (SRH), which could lead to unintended pregnancies and the spread of sexually transmitted infections. In this study, we aimed to explore the SRH knowledge, practices and needs of adolescents living with HIV (ALHIV) living in Abidjan, Côte d'Ivoire. Between April and September 2023, we conducted qualitative interviews with adolescents (9 males, 9 females, and 8 females who experienced pregnancy) aged 15–19 years. All were born with HIV and were informed of their HIV status. A group discussion was also conducted with five peer-educators, aged 23–31 years, to gather their perspectives. All participants expressed difficulty talking about SRH with their parents and health professionals and turned to their friends. A third of girls reported having experienced sexual violence. Despite having good knowledge of how and why to use a condom, most participants reported poor condom use. The main reasons were difficulties negotiating with their partner for girls, and having an undetectable viral load (being undetectable means that the virus is at such low concentrations in the blood that it cannot be transmitted). Many negative beliefs around hormonal contraception were reported. Alternative methods, such as emergency contraceptive pills, or traditional plants were used instead to prevent pregnancy. To summarize, ALHIV reported difficulties in accessing reliable information and appropriate support on SRH. Better integration of SRH care into paediatric HIV care, and better access to contraceptives, with the support of peer-educators, are urgently needed for ALHIV. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) can be transmitted through vertical route from the mother to her child during the period of pregnancy, process of childbirth, or through the breastfeeding. This is still a worldwide health issue, especially in environments with low resources. Without intervention, the transmission rate ranges from 15 to 45%, influenced by breastfeeding practices. Effective interventions, including antiretroviral therapy (ART), can reduce the transmission likelihood to about 2% with breastfeeding and 1% without breastfeeding. A further expansion of access to prevention of mother-to-child transmission of HIV (PMTCT) services was made possible by the year 2011 through the Global Plan toward the Elimination of New HIV Infections among Children and Keeping their Mothers Alive. By 2022, there were 130,000 new HIV infections in children under five, down from 310,000 in 2010. Nevertheless, the Joint United Nations Programme on HIV/AIDS (UNAIDS) Global Strategy to End AIDS's 2025 targets cannot be met with the current level of progress. To prevent new infections in children, pregnant and breastfeeding women with HIV must receive faster medical attention. This position paper discusses the primary prevention of HIV and the healthcare system's role in providing comprehensive care to HIV-positive women and their families. The continuum of care includes antenatal, intrapartum, post-delivery, and pediatric services, addressing the unique needs of each woman and her family. Individual-level interventions highlight the importance of partner selection, consistent condom use, avoiding needle sharing, and reducing risky sexual behaviors. Overcoming barriers to medication adherence, such as stigma and discrimination, is crucial for effective prevention and treatment. Community-level interventions are equally important in reducing stigma and discrimination and fostering healthcare-seeking behavior. The paper emphasizes a multi-faceted approach, involving healthcare systems, individuals, and communities, to accomplish the objective of an HIV-free generation by stopping HIV from spreading through the vertical route. Collaboration across these levels is essential to realizing this vision and ensuring optimal health outcomes for HIV-infected individuals, their children, and families. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) in sub-Saharan Africa (SSA) are disproportionately affected by the human immunodeficiency virus (HIV) compared to adult men in the general population. Unprotected anal sexual intercourse is a high-risk behavior for HIV infection. This makes the correct and consistent use of condoms with condom-compatible lubricants crucial in reducing further HIV acquisition amongst the MSM population in SSA. However, consolidated data on the scope of the consistency of condom use with lubricants among MSM in SSA is lacking. In this regard, it was necessary to consolidate existing evidence on consistent condom usage with lubricants, as well as associated context-specific factors among the MSM population in SSA. A systematic review was conceptualized and registered with the International Prospective Register of Systematic Reviews (registration number: CRD42023437904). It was compiled following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) principles and guidelines between July 2023 and June 2024. We searched PubMed, Scopus, ScienceDirect, Google Scholar, and governmental and non-governmental institutions to find published and gray literature relevant to the review objectives from 2005 to June 2024. Studies conducted in SSA, published in English, focusing on MSM aged ≥15 years and also reported condom and lubricant use were considered for this review. Following the removal of duplicates and ineligible articles, 40 studies out of 202 reviewed were selected for the study. The most common study designs were cross-sectional surveys (n = 32) followed by prospective cohorts (n = 4), integrated bio-behavioral surveillance surveys (n = 3), and intervention studies (n = 1). Of the 40 eligible studies included in this review, half (n = 20) reported consistent use of condoms but without lubricants, three reported consistent use of condoms with lubricants but did not specify the lubricant type, six reported consistent condom use with water-based condom-compatible lubricants, and 11 reported only condom use but not consistent usage. Factors linked to consistent condom use with lubricants among MSM from various studies included higher educational level, knowing one's HIV status, accessibility challenges, and older age. Having a high level of self-worth and HIV risk-reduction counseling was also associated with a consistency of condom use amongst MSM who engaged in receptive anal sex. This review indicates that only a few studies reported consistent condom use with lubricants and water-based compatible lubricants. [ABSTRACT FROM AUTHOR]

Sexual health and well-being are important components of overall well-being and quality of life. Yet, little is known about autistic persons' self-reported sexual health and well-being in Canada. In the current study, 3,551 youth aged 16–24 from across Canada were surveyed, including 419 youth who reported an autism diagnosis or self-identified as autistic. We examined demographic and sexual health data from autistic youth and assessed differences/similarities with non-autistic youth on key indicators. A significantly greater percentage of autistic youth reported a transgender identity (22.5% vs. 1.9%), an asexual identity (7.0% vs. 2.7%), and an LGBQ+ sexual orientation (55.6% vs. 22.3%), compared to non-autistic youth. Autistic youth were just as likely as non-autistic youth to value sexual pleasure. On average, autistic youth rated their sexual health as "good," and many were happy with their sexual lives. Half were in a committed relationship, and autistic youth in relationships were generally sexually and emotionally satisfied in their relationships. Many had engaged in partnered sexual behaviours (e.g., touching genitals, oral sex, penis–vagina sex), with a higher percentage of autistic youth reporting that they had ever had penis–anal sex (30.8% vs. 22.6%). Autistic youth and non-autistic youth reported similar condom/barrier use for most sexual behaviours. The implications of these findings for sexual health promotion with autistic youth are discussed. [ABSTRACT FROM AUTHOR]

Condoms are safe and effective at preventing the risk of sexually transmitted infections (STIs) and pregnancy (Hatcher, 2007; Holmes et al., 2004). However, when an individual enters a committed relationship, their condom use decreases significantly (Copen, 2017; Lehmiller et al., 2014; Matser et al., 2014; Weitzman et al., 2019). We surveyed 219 heterosexual individuals in committed relationships and 87 in noncommitted sexual relationships to determine differences in their condom use patterns. We collected data on individual psychometric characteristics (condom use attitudes, sexual narcissism, perceived invulnerability, concern for sexual pleasure, condom use self-efficacy, and concern for pregnancy and STIs), individual sexual behaviors (birth control usage, type of sexual activity, number of partners, number of sexual encounters), and couple characteristics (commitment and exclusivity). We modeled the predictors using hierarchical regressions. Our model for coupled participants was significant, F(3, 150) = 10.12, p = .002, R2 = .36, and included birth control, pregnancy, and condom use attitudes as significant predictors. Our model for single individuals was also significant, F(3, 82) = 18.02, p < .001, R2 = .38, and included STI concern, pregnancy concern, and condom use attitudes as significant predictors. Understanding predictors of when college-aged individuals in committed and casual relationships chose to use condoms may allow researchers to be able to create better, targeted tactics to promote condom use in the future. [ABSTRACT FROM AUTHOR]

The objectives were to assess the self-efficacy and consistent condom use by people living with HIV (PLHIV). A cross-sectional, comparative study was carried out in outpatient clinics in Ceará State, Brazil, with a sample of 190 PLHIV, 95 serodiscordant and 95 seroconcordant. Interviews were conducted using the Socio-Demographic, Clinical, Epidemiological and Vulnerability Form and the Condom Use Self-Efficacy Scale. Descriptive analysis, associations between variables, odds ratio and 95% confidence interval were determined. P < 0.05 was considered statistically significant. Of the sample, 43.1% consistently used condoms (50.5% serodiscordant and 35.7% seroconcordant). Serodiscordant PLHIV without guidance on HIV prevention (P = 0.027) and without access to testing (P = 0.002) had lower self-efficacy and 11.5 times more chances for inconsistent condom use (P = 0.006), while those satisfied with follow-up in health were less likely to use condoms inconsistently (P = 0.011). We conclude that there is low consistent use of condoms among PLHIV, which increases the risk of HIV transmission and the acquisition of other sexually transmitted infections. Consistent condom use was greater among serodiscordant individuals, although there was no difference in self-efficacy in condom use between the groups. [ABSTRACT FROM AUTHOR]

This study investigates the predictors of consistent condom use among male construction workers in South Africa who reported concurrent sexual relationships with regular partners, casual partners, and sex workers over a 3-month period. A cross-sectional survey was used to collect data from a convenience sample of 450 male workers across 18 construction work sites in the Western Cape province. Of these, 245 (54%) indicated that they had engaged in sex with all three partner types during the 3-month study period. Hierarchical multiple linear regression was then used to assess consistent condom use as a function of demographic, experiential, behavioural and cognitive characteristics. Three statistically significant predictors of consistent condom use were identified: perceived control over condom use (β = 0.252, p < 0.001), positive attitude toward condom use (β = 0.154, p < 0.05) and fear of HIV infection (β = 0.121, p < 0.05). These findings highlight the high prevalence of sexual concurrency among study participants. It also suggests that amid declining condom use, interventions which focus on enhancing an individuals' condom application skills and efficacy, that foster positive attitudes toward condom use and that strategically incorporate fear-based messaging within a multilevel framework may potentially increase condom use among individuals in concurrent sexual relationships. [ABSTRACT FROM AUTHOR]

Improving communication between American Indian caregivers and their youth has been suggested as an Indigenous-forward strategy to help alleviate the sexual and reproductive health (SRH) disparities faced by American Indian youth as a result of the legacy of colonial violence against American Indian communities. Studies with non-American Indian and American Indian populations suggest that effective communication about SRH between parents and youth plays a role in reducing sexual risk behaviors among youth. There is limited research that examines youth sexual risk behaviors in relation to communication patterns separately assessed in caregivers and youth. The current study aimed to examine the association between caregiver-youth communication patterns and engagement in sex, age at sexual debut, and condom use among American Indian youth in the United States. The study draws on baseline caregiver and youth data collected from Nen ŨnkUmbi/EdaHiYedo, a stepped wedge design trial with American Indian youth living on the Fort Peck Reservation in Montana. 113 caregiver responses were matched to 145 youth for the current study. Caregiver-youth communication patterns were examined in relation to youth engagement in sex, age at sexual debut, and number of protected acts of vaginal and/or anal sex. Multivariable models were used to adjust for confounders and to examine relationships between caregiver-youth communication and youth sexual risk outcomes. An increase in overall level of self-reported youth communication with caregivers about sexual and reproductive health topics was significantly associated with a greater likelihood of youth ever having engaged in sex. A significant interaction effect between youth communication and convergence with caregiver response was observed for the number of protected acts of vaginal and/or anal sex, where caregiver communication (regardless of self-reported youth communication with caregivers) was associated with a greater number of protected sex acts. This study fills a gap in the extant literature by reporting on relationships between communication about SRH, assessed separately in caregivers and youth, and youth sexual risk behaviors. Findings emphasize the importance of involving American Indian caregivers in SRH interventions to improve SRH outcomes among American Indian youth, and inform future experimental research that will evaluate how changes in caregiver communication potentially impact youth SRH. [ABSTRACT FROM AUTHOR]

Introduction: Consensual sexual choking has become prevalent among young United States (US) adults. In sex between women and men, women are overwhelmingly the ones choked, perhaps reproducing traditional heteronormative power dynamics. No research has examined the relationship between being choked during consensual sex and the use of external condoms and other contraceptives. Methods: We administered a cross‐sectional campus‐representative survey to 4989 undergraduate students at a large public Midwestern US university. Results: Half of respondents (n = 1803) had ever been choked during sex. Having been choked was associated with a significantly lower likelihood of event‐level condom use (OR = 0.32 [0.19, 0.54] for >5 times lifetime choking among men and OR = 0.35 [0.27, 0.45] for >5 times lifetime choking among women compared to those with no choking experiences) and in the past 6 months (OR = 0.42 [0.24, 0.72] for >5 times lifetime choking among men and OR = 0.59 [0.43, 0.81] for >5 times lifetime choking among women compared to those with no choking experiences). Also, having ever been choked was associated with a significantly greater likelihood of having used an implant/intra‐uterine device in the past 6 months (OR = 1.85 [1.28, 2.68] for >5 times lifetime choking compared to those with no choking experiences). Conclusion: Recognition that sexual choking is prevalent among young people has only recently emerged and educational programs are lacking. Study findings could be used to engage people in discussions about choking in relation to gender, power, and reproductive health agency. [ABSTRACT FROM AUTHOR]

People who inject drugs (PWID) face a significantly increased risk of blood-borne virus (BBV) infections, including HIV and hepatitis C virus (HCV), as well as co-infections. To better understand this issue, bio-behavioral surveillance studies were conducted among PWID attending harm reduction facilities in Catalonia, forming part of the comprehensive Integrated HIV/STI Surveillance System since 2008. The goal of this study was to describe the prevalence of HIV, HCV, and HIV-HCV coinfection and associated socio-demographic and behavioural factors among young PWID in Catalonia by gender and to examine trends over time, from 2008 to 2019. We first estimated the prevalence of HIV, HCV, and their co-infection and sample characteristics, and then, we calculated prevalence ratios (PR) and adjusted prevalence ratios (aPR) to identify the variables associated with HIV infection, HCV infection, and HIV-HCV co-infection. We found that the overall prevalence of HIV, HCV and HIV-HCV co-infection in 2019 was 20.1%, 66.2%, and 16.8%, respectively. In multivariable analysis, we found that being female (aPR: 1.55, 95% CI: 1.05–2.30), age (aPR: 1.09, 95% CI: 1.04–1.14), having born outside of Spain (aPR: 1.67, 95% CI: 1.19–2.34), homelessness (aPR: 1.90, 95% CI: 1.34–2.68), daily injection (aPR: 1.46, 95% CI: 1.04–2.04), sharing needles (aPR: 1.93, 95% CI: 1.32–2.82), involvement in sex work (aPR: 1.82, 95% CI: 1.09–3.03), and imprisonment (aPR: 2.54, 95% CI: 1.75–3.67) was associated with increased prevalence of HIV and HCV co-infection, while being a new injector (aPR: 0.64, 95% CI: 0.43–0.93) was associated with decreased prevalence. Overall, this research provides valuable insights into the risks and determinants of HIV and HCV co-infection among young PWID. The study's findings contribute to the existing body of knowledge on blood-borne virus transmission in this population, informing evidence-based strategies for prevention and harm reduction. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the impacts of use of various contraceptive methods on vaginal microbiome and reproductive tract infections (RTI) in females. A cross-sectional study in Jammu Province of Jammu and Kashmir was conducted in which 796 sexually active married women of reproductive age were recruited as participants. A well-structured questionnaire was used to collect the data and the analysis was performed using linear and binary logistic regression with 95% confidence interval (CI). The p value of < 0.05 was considered as significant. Previous studies have consistently shown that disturbances in the vaginal microbiome can lead to reproductive tract infections in women. The prevalence of contraceptive use and RTI in the studied population was 53.1% (CI 49.6–56.7%) and 44.7% (CI 41.2–48.3%) respectively. Several sociodemographic factors like age, place of residence, educational qualification, religion, and caste of the participant significantly governed the method of contraception used by the females. It was observed from the data obtained that the use of condoms and hormonal oral contraceptives reduced the risk of RTI as they maintain vaginal eubiosis in the females by 1.97-folds (AOR:1.97; CI 1.02–2.86) and 1.68 folds (AOR:1.68; CI 0.78–2.50) respectively. The likelihood of developing RTI increased by 2.31 (AOR:2.31; CI 1.05–3.57), 3.62 (AOR:1.97; CI 1.02–2.86), and 4.97 (AOR:4.97; CI 3.50–6.00) folds in females who opted for IUDs, tubal ligation, and unprotected sex respectively, these methods may interfere with the host vaginal microbiome, alter it and making the female more susceptible to the microbial infections and pathogenic attack. The research proposes that the use of hormonal oral contraceptives and condoms as the means of contraception is a safe method and the females opting for them are less prone to RTI. [ABSTRACT FROM AUTHOR]

Background: Sexual health service engagement is important for the healthy sexual development of young people. Further, as later adolescence and early adulthood are critical periods for relationship development, sexual health needs may vary across this period and be associated with relationship status. Methods: A total of 468 participants, aged 16–25 years (mean age: 19.7 years) and living in the United Kingdom, completed an anonymous, online survey about their sexual health service use. To explore how relationship status is associated with engagement for five different sexual health services, we conducted chi-squared and multivariable logistic regression analyses. Results: In general, engagement with sexual health services was low: 28.2% reported accessing free condoms, 21.4% reported STI testing, and 9.4% had used relationship advice services. Among women only, 57.2% had accessed services to start the pill and 19.6% had done so for pregnancy testing. Among all participants, those in relationships were more likely to have accessed sexual health services for free condoms (aOR: 1.71, 95% CI: 1.13, 2.59). Among female participants, those in relationships were more likely to have accessed sexual health services to start the pill (aOR: 2.21, 95% CI: 1.45, 3.36) and for pregnancy testing (aOR: 3.86, 95% CI: 2.20, 6.78). There were no differences by relationship status for accessing sexual health services for STI testing or relationship advice. Conclusions: Health care providers and relationship and sexual education providers should encourage all young people to engage with sexual health services, while also recognising that sexual health needs are likely to vary depending on relationship status. Sexual health service engagement among young people is important and needs may vary depending on relationship status. We explored use of five different sexual health services and found that, in general, engagement was low and those in relationships were more likely to have used services for free condoms, to start the pill, and for pregnancy testing. Healthcare and relationship and sexual education providers should encourage all young people to engage with sexual health services, whatever their relationship status. [ABSTRACT FROM AUTHOR]

Purpose: Using a community-engaged approach, we adapted a human immunodeficiency virus (HIV) prevention smartphone app, Transpire, to meet the HIV and sexually transmitted infection (STI) prevention needs of transgender men and other transmasculine people. We conducted a pilot study to assess the feasibility and acceptability of the app among participants in two cities in the southeastern United States. Methods: Participants were recruited online and through community partners. Eligible and consenting participants used the Transpire app for 3 months and completed surveys at the beginning and end of the follow-up period. Transpire gave participants access to HIV and STI prevention information; the ability to order HIV and STI at-home self-test kits, condoms, and lube; and mental health and substance use resources. The primary feasibility outcome was the System Usability Scale (SUS), which measures the usability of technology-based products. Results: Sixty participants were enrolled. Most were 18–24 years old (n=33, 55%) and identified as non-Hispanic white (n=46, 77%). The mean SUS score was 72.4, which meets established criteria for acceptability. Fifteen (32%) participants conducted an HIV test during the 3-month follow-up period and 2 (4%) initiated pre-exposure prophylaxis. Conclusions: Following a community-engaged adaptation process, the Transpire app was found to be acceptable in a pilot study conducted among transmasculine participants. These pilot data indicate that app-based interventions have the potential to increase awareness of and access to sexual health resources for transmasculine people. Additional studies will be needed to assess the efficacy of Transpire or similar apps to improve sexual health outcomes. [ABSTRACT FROM AUTHOR]

Effective contraception consultations are essential to delivering high-quality perimenopause care and reducing unplanned pregnancies. Contraception can be used independently, or in conjunction with hormone replacement therapy (HRT). Newer contraception options provide enhanced opportunities to individualise perimenopause care. This paper provides case based contraception options, which reduce unplanned pregnancies, erratic perimenopausal bleeding patterns and estrogen deficiency symptoms. Clinicians must also be aware of the potential impact of vaginal preparations which may affect condom integrity. Formulary updates should enable a wide range of options for contraception choices in all settings and provider updates should include this vital topic. [ABSTRACT FROM AUTHOR]

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The introduction of the undetectable equals untransmittable (U = U) statement significantly reduces HIV stigma and provides an empirical basis for achieving "zero transmission." U = U messaging has gained increasing support and is well-developed in several countries. However, the current status of accurate knowledge of U = U and its associated factors among men who have sex with men (MSM) in China remians unclear. We conducted a cross-sectional survey among MSM recruited in Chengdu, China, from March to May 2022 to investigate the percentage of those who knew U = U accurately and to explore associations between sexual risk behaviors, HIV testing, socio-behavioral measures, and accurate knowledge of U = U. Of 497 MSM included in our study, 23.4% (116/497) had accurate knowledge of U = U. More than half of the participants (63.2%, 314/497) reported multiple sexual partnerships, 15.7% (78/497) used substance during sex, 37.4% (186/497) reported inconsistent condom use, and 76.1% (378/497) took HIV testing in the past six months. Factors associated with accurate knowledge of U = U among MSM included substance use during sex (multivariate odds ratios ORm = 1.96; 95%CI: 1.13–3.41), HIV status tested in the last six months (ORm = 2.07; 95%CI: 1.14–3.77), HIV-related literacy (ORm = 1.41; 95%CI: 1.14–1.74) and perceived higher risk of HIV infection (ORm = 1.11; 95%CI: 1.02–1.21). The findings indicate that great challenges need to be conquered for U = U achievement among the MSM population in Chengdu, China. Intervention strategies should be prioritized in health education on high-risk behaviors such as group sex and substance use, information provision and counseling of U = U in HIV testing services, and encouraging U = U knowledge sharing among MSM with their partners in China. Resumen: La introducción de la declaración "indetectable es igual a intransmisible" (Singla en inglés: U = U) reduce significativamente el estigma asociado al VIH y proporciona una base empírica para lograr la "transmisión cero." Los mensajes de U = U han ganado cada vez más apoyo y están bien desarrollados en varios países. Sin embargo, el estado actual del conocimiento preciso sobre U = U y sus factores asociados entre los hombres que tienen sexo con hombres (HSH) en China sigue siendo incierto. Realizamos una encuesta transversal entre HSH reclutados en Chengdu, China, de marzo a mayo de 2022, para investigar el porcentaje de participantes que conocían U = U con precisión y explorar las asociaciones entre comportamientos sexuales de riesgo, pruebas de VIH, medidas socio-comportamentales y el conocimiento preciso de U = U. De los 497 HSH incluidos en nuestro estudio, 23.4% (116/497) tenían un conocimiento preciso de U = U. Más de la mitad de los participantes (63.2%, 314/497) informaron tener múltiples parejas sexuales, el 15.7% (78/497) usaron sustancias durante el sexo, el 37.4% (186/497) informaron un uso inconsistente de condones, y el 76.1% (378/497) se realizaron pruebas de VIH en los últimos seis meses. Los factores asociados con el conocimiento preciso de U = U entre los HSH incluyeron el uso de sustancias durante el sexo (razones de probabilidad multivariadas ORm = 1.96; IC95%: 1.13–3.41), pruebas recientes de VIH (ORm = 2.07; IC95%: 1.14–3.77), la alfabetización relacionada con el VIH (ORm = 1.41; IC95%: 1.14–1.74) y la percepción de un mayor riesgo de infección por VIH (ORm = 1.11; IC95%: 1.02–1.21). Estos hallazgos destacan que se deben superar grandes desafíos para lograr el objetivo de U = U entre la población HSH en Chengdu, China. Las estrategias de intervención deben priorizarse en la educación sanitaria sobre comportamientos de alto riesgo, como el sexo grupal y el uso de sustancias, la provisión de información y el asesoramiento sobre U = U en los servicios de pruebas de VIH, y fomentar la difusión del conocimiento de U = U entre los HSH y sus parejas en China. [ABSTRACT FROM AUTHOR]

Despite advances in prevention and treatment, the transmission of human immunodeficiency virus remains a significant problem in the United States, especially among men who have sex with men (MSM). Alcohol use can promote risky sexual decisions, and alcohol expectancies may influence the role of alcohol in decision making. The present secondary analysis tests the moderating role of sexual alcohol expectancies (SAEs) in the relation between daily alcohol intoxication and sexual behavior in a sample of 248 moderate- to heavy-drinking MSM. SAEs were assessed with the Sexual Alcohol Expectancies Questionnaire at baseline, followed by two 23-day bursts of ecological momentary assessment including self-initiated morning assessments of sexual behavior and the prior night's perceived intoxication, as well as nine daily random alcohol assessments. Multilevel modeling showed that SAEs moderated a curvilinear association between intoxication and anal intercourse with a condom such that the relation between daily intoxication and anal intercourse with a condom is a more pronounced inverted u-shape among individuals with strong SAEs, and this moderation effect was not seen for condomless anal intercourse (CAI). While SAEs do appear to influence the association between intoxication and sexual behavior in MSM, they do not appear to moderate the association between alcohol intoxication and CAI. [ABSTRACT FROM AUTHOR]

The current research advances understanding of how consumers respond to embarrassing service encounters. Across a combination of field and online studies, the authors provide evidence that (1) consumers prefer self-service to human services when purchasing embarrassing products or services; (2) when self-service is not available, consumers respond more positively to a mechanistic service provider than to a personable service provider; and (3) if consumers must engage in embarrassing social interactions, they dehumanize service providers, perceiving them as more mechanistic and less capable of emotional reactions than when engaging in nonembarrassing service interactions. The authors also examine consumers' familiarity with the service provider as a boundary condition for the effect. Collectively, the results provide converging evidence for the proposed framework and have substantive implications for service management. [ABSTRACT FROM AUTHOR]

Background: University campus clinics provide crucial sexual health services to students, including STI/HIV screening, testing, contraception, and counseling. These clinics are essential for engaging young adults who may lack access to primary care or have difficulty reaching off-campus services. Dating apps are widely used by young adults, yet there is a lack of studies on how they affect sexual practices. This study aimed to evaluate the use of dating apps, engagement in condomless sexual activity, and the prevalence of STIs among young adult college students in Northern Texas. Methods: A cross-sectional survey was conducted from August to December 2022 among undergraduate and graduate students aged 18–35 at a large university in Northern Texas. A total of 122 eligible participants completed the survey, which assessed demographics, sexual behaviors, dating app use, and STI/HIV testing practices. Descriptive statistics, bivariate analyses, and multivariate Poisson regression analyses with robust variance were performed to identify factors associated with dating app use and condomless sexual activity. Results: Two-thirds of participants reported using dating apps. Significant differences were found between app users and non-users regarding demographic factors and unprotected sexual behaviors. Dating app users were more likely to report multiple sexual partners, inconsistent condom use, and a higher likelihood of engaging in unprotected sex. Poisson regression analysis indicated that app use was associated with residing in large urban areas, frequent use of campus STI/HIV screening services, and having multiple sexual partners (p < 0.05). Conclusion: The study highlights a significant association between dating app use and engagement in condomless sexual activity among college students. University health clinics play a critical role in providing sexual health services and can enhance their impact by expanding access to testing, contraception, and inclusive, sex-positive education. Future research should explore the long-term effects of dating app use on sexual health and evaluate the effectiveness of app-based interventions in promoting safer sexual practices. [ABSTRACT FROM AUTHOR]

Background Objectives Search Strategy Selection Criteria Data Collection and Analysis Main Results Conclusion Given the high incidence of ectopic pregnancy (EP) in the general population and the high maternal morbidity and mortality rates associated with it, determining risk factors for the occurrence of EP is essential for directing attention and care to risk groups, aiming for early diagnosis, favorable outcomes, and the development of prevention strategies.The aim of this study was to identify risk factors for the occurrence of EP.A systematic review with meta‐analysis was performed on the electronic databases MEDLINE/PubMed, LILACS, The Cochrane Library, and Virtual Health Library (VHL), searching the following terms "Ectopic Pregnancy" or "Ectopic Gestation" and "Risk Factors" or "Predisposing Factors".The inclusion criteria were observational studies published in English and Portuguese. We excluded studies with undefined methodology and those published before the year 2000.The authors independently read the titles, abstracts, and full texts, using pre‐defined inclusion and exclusion criteria, and discussed any differences. Data extraction and assessment of methodological quality were performed by each author in a standardized way. Sixteen risk factors were evaluated. The meta‐analysis calculations were performed using the Reviewer Manager 5.3 software (RevMan 5.3).The study found 715 studies, of which 11 were selected for review. The surveys were conducted between 2003 and 2019 and included 25 051 patients. The study revealed that several factors were strongly associated with the occurrence of EP. These included EP history (OR 9.03; 95% CI: 7.18–11.35; I2 = 67%), pelvic inflammatory disease (OR 4.00; 95% CI: 3.46–4.61; I2 = 0%), infertility (OR 3.70; 95% CI: 3.23–4.23; I2 = 48%), abdominal and pelvic surgeries (OR 5.60; 95% CI: 4.83–6.49; I2 = 81%), and previous tubal ligation (OR 5.59; 95% CI: 2.49–12.55; I2 = 0%). Furthermore, the study showed that advanced maternal age, smoking, number of partners exceeding one, history of spontaneous and induced abortion, previous use of emergency contraception, and intrauterine device, demonstrated a slightly increased risk. Advanced maternal age within the range of 30–34 years (OR 1.13; 95% CI: 1.03–1.24; I1 = 11%) and ≥ 40 years (OR 1.46; 95% CI: 1.19–1.78; I1 = 88%), marital status (OR 1.19; 95% CI: 1.03–1.37; I2 = 88%), and the use of oral contraceptives (OR 0.77; 95% CI: 0.66–0.90; I2 = 86%) were also found to be associated with a slightly increased or decreased risk of EP, respectively. The impact of condom use on the occurrence of EP seems to be very limited (OR 0.93; 95% CI: 0.83–1.05; I2 = 83%).Based on the study findings, it is suggested that the presence of strong risk factors warrants the implementation of a screening policy for EP among these women. [ABSTRACT FROM AUTHOR]

This review examines the critical unmet needs for pre-exposure prophylaxis (PrEP) among female sexual workers in Tanzania, highlighting key barriers to uptake and key actions for improvement. Key findings reveal that lack of awareness and knowledge, stigma and discrimination, and accessibility and affordability challenges hinder PrEP utilization. Perspectives from both female sex workers and healthcare providers reveal complex individual, community, and systemic factors contributing to the persistent gap in PrEP utilization. Addressing the unmet PrEP needs requires a multi-faceted approach involving improving awareness and knowledge, tackling stigma and discrimination, enhancing affordability and accessibility, and strengthening healthcare provider capacity. The implications of addressing these challenges extend to reducing HIV transmission rates and advancing the goal of ending the AIDS epidemic among marginalized populations in Tanzania. [ABSTRACT FROM AUTHOR]

Background/Objectives: Adolescence represents a period of heightened vulnerability to risky sexual behaviours. In Portugal, adolescents are initiating sexual activity at increasingly younger ages, making it relevant to characterise their knowledge about sexually transmitted diseases and prevention methods at an earlier stage of their development. Methods: A cross-sectional observational study was conducted involving the application of a questionnaire to 750 ninth-grade students from Vila Nova de Gaia, Porto, Portugal. The questionnaire covered topics such as perceptions of sexuality, knowledge of sexuality and STIs, methods of transmission prevention, and sources of information. Results: The mean age was 14.4 years, with 19.9% reporting having already initiated sexual activity. Overall, the knowledge about sexually transmitted infections was low, with a score of 7.08 out of a maximum score of 18. Condoms and immunisation were well-recognised preventive measures, but many misconceptions persisted. Better knowledge is associated with better attitudes regarding the likelihood of having sexual intercourse. Conclusions: This study reveals adolescents' limited knowledge about sexually transmitted infections, misconceptions about prevention, and reliance on peers and the internet over trusted sources, highlighting the need for comprehensive sexual education in middle school. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) who use dating applications (apps) have higher rates of engaging in condomless anal sex than those who do not. Therefore, we conducted a two-arm randomized controlled trial to evaluate the effectiveness of an interactive web-based intervention in promoting safer sex among this population. The intervention was guided by the Theory of Planned Behavior and co-designed by researchers, healthcare providers, and MSM participants. The primary outcome was the frequency of condomless anal sex in past three months. Secondary outcomes included five other behavioral outcomes and two psychological outcomes. This trial was registered on ISRCTN (ISRCTN16681863) on 2020/04/28. A total of 480 MSM were enrolled and randomly assigned to the intervention or control group. Our findings indicate that the intervention significantly reduced condomless anal sex behaviors by enhancing self-efficacy and attitudes toward condom use among MSM dating app users, with the effects sustained at both three and six months. [ABSTRACT FROM AUTHOR]

The present study uses latent class analysis to explore patterns of family communication about health-related topics during early adolescence. Directed parent–child communication is important for early adolescents to make informed health risk decisions, yet not all families discuss all health issues, especially surrounding sensitive topics such as sex and substance use. Participants were 182 seventh-grade students from a rural, low-income county in the Southeastern U.S. (M age = 12; 49% girls, 48% boys, 2% transgender or another gender; 49% lower socioeconomic status; 34% Latine, 33% White, 23% Black/African American, 2% Asian, 8% another race/ethnicity). Participants self-reported if they had ever discussed 10 health risk topics with their parents: alcohol, cigarettes, e-cigarettes/vaping, marijuana, sex, sexting, condoms/birth control, bullying, sleep, and time spent online. Four latent classes emerged: those who were unlikely to have discussed any topics ("Low—All Topics", 38.7%); those who were likely to have discussed all topics ("High—All Topics", 25.2%); those whose communication selectively excluded discussions of sex ("Everything but Sex", 18.1%); and those who selectively excluded discussions of substance use ("Moderate—Low Substance", 18.1%). Adolescents' gender and sexual experience were related to class membership; their socioeconomic status and substance use experience were not. Results highlight that health risk family communication patterns are not one-size-fits-all. Understanding pluralistic patterns of parent-child health risk communication can inform interventions to promote effective parent communication. Highlights: Latent class analysis determined four profiles of parent–child communication about 10 health risk topics during early adolescence. Most families discussed (1) no or (2) all topics, some selectively excluded (3) sex and (4) substance use topics. Early adolescents' gender and sexual experience (but not SES or prior substance use) were related to class membership. [ABSTRACT FROM AUTHOR]

This study draws on social normative and social learning theories to examine the masspersonal safer sex communication (i.e., Facebook posts about safer sex) and safer sex behavior (i.e., condom use) in a cohort of Black sexual minority men (BSMM) (N = 340), with an eye toward understanding their relationship with the safer sex communication and behaviors of their BSMM Facebook friends. Using linear network autocorrelation regression models, results showed that BSMM's safer sex communication and condom use behavior were each associated with the communication and behavior of their online peers. Specifically, BSMM's condom use was positively associated with their friends' condom use and friends' safer sex communication, and BSMMs' safer sex communication was positively associated with friends' safer sex communication. Moreover, contrary to prior research, BSSM's safer sex communication and condom use were not related to one another, suggesting that talking about safer sex on social media should not be interpreted to be an indication of engageDment in safer sex behavior. These findings underscore an opportunity to leverage peer influence in social media networks, particularly in the form of masspersonal communication, to encourage cascades of safer sex messaging among peers and adoption of safer sex behavior. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare viral load suppression levels among men who have sex with men (MSM) living with HIV who were put on risk reduction interventions versus a control group in Mvita sub-county, Mombasa County, Kenya between December 2020 and June 2021. Methodology: A quasi-experimental study design using quantitative methods was conducted among MSM living with HIV from December 2020 to June 2021. The study involved a questionnaire and various laboratory investigations. The respondent-driven sampling (RDS) was used to obtain the sample of respondents. A total of 114 HIV positive MSM completed the study and were all subjected to a battery of tests. Blood was drawn for alcohol, syphilis, hepatitis B, and viral load tests, while urine was used to screen for drugs and gonorrhoea. Half (57) of the HIV positive MSM were actively followed and risk reduction interventions such as adherence to ARVs, general counselling, and HIV prevention measures such as prompt treatment of STI/OI and condom use were offered after every 2 months. The control group (57) received no risk reduction interventions. Thereafter, both groups were asked to respond to a questionnaire. Since the study was carried out during COVID-19, the risk reduction interventions were conducted over the phone to minimize transmission. Log-binomial univariate and the multivariate regression analysis model was used to identify the variables which were associated with undetectable viral load. Undetectable viral load was defined as having an HIV viral load of less than 50 copies/ml. Data generated from the questionnaires were collected, cleaned, coded and analysed using STATA software, Version 17. Level of significance was fixed at 5% (95% confidence interval). Findings: Majority of MSM living with HIV were between 19-20 years and 49% were actively followed by the researcher and received risk reduction interventions while 54% were in the control group. However, the baseline demographic characteristics were not significantly different (all p>0.05). MSM in the control group who were neither Christian nor Muslim (11%) and had a lower income (35%), were likely to have detectable viral load. However, MSM who had a higher income in both groups (1.8%), were likely to have undetectable viral load. MSM in the control group, who reported ever use of PEP/PrEP (44%), were likely to have detectable viral load while MSM who received interventions, who reported condom break more than once during anal sex (61%), who had more than one regular anal sex partner (61% both groups), and those who drunk more than 2 bottles of beer (33% both groups) were likely to have undetectable viral load. However, MSM who received interventions but used nonprescribed injectables drugs 1 to 2 times in a week (15%), were likely to have detectable viral load. MSM in the control group who reported being always high on alcohol during anal sex (19%), were likely to have detectable viral load but those chewing muguka (type of khat) (79%) were likely to have undetectable viral load. MSM who received interventions who reported feeling uneasy while seeking health services (75%), had detectable viral load while those in the control group who attended private clinics (42%), had undetectable viral load. Overall, after six months, the proportion of MSM achieving viral load suppression was significantly higher in the intervention group as compared to control group by 60% (95% CI 49-70)), p-value < 0.001. Unique contribution to theory, practice, and policy: The study found out that majority of HIV positive MSM who received risk reduction intervention, had undetectable viral load as compared to those in the control group. HIV viral suppression is the desirable outcome for MSM on ART, since once achieved, MSM cannot transmit the virus to their sex partners. The Government/NGO should encourage peer-led HIV services to run the HIV programmes involving MSM with other stakeholders. Thus, many MSM will be able to access the HIV services where their needs will be addressed and supported in a non-judgemental environment. [ABSTRACT FROM AUTHOR]

Contraception is freely available in the UK from the NHS through pharmacies or private providers, such as Brook clinics. Despite wider societal acceptance of contraception, practical, psychological and social barriers remain to access for a range of groups. A first consultation to assess contraceptive needs will require a longer appointment as there are many issues to discuss alongside those pertaining directly to contraceptive use, such as emergency contraception, safeguarding and sexually transmitted infection risk. Health professionals must consider consent and confidentiality in any consultation and be aware of groups who are at higher risk of abuse, such as vulnerable adults and those from the LGBTQ+ community. This article discusses contraception use, and forms of available contraception in the UK, including common risks and benefits, barriers to accessing contraception and emergency contraception. [ABSTRACT FROM AUTHOR]

To end the HIV epidemic, there is need for targeted strategies to reduce HIV incidence for those most vulnerable, including an HIV vaccine. This study seeks to understand the perceptions that non-PrEP using gay and bisexual men and other men who have sex with men (GBMSM) have about a potential HIV vaccine, while contextualizing their perspectives within the context of heightened vaccine hesitancy that has emerged since the COVID-19 pandemic. Between March and May of 2022, GBMSM (N = 20) participated in in-depth interviews, which assessed their perceptions about an HIV vaccine. Interviews were analysed using a codebook approach to thematic analysis. We oversampled for those unvaccinated against COVID-19 as a proxy for vaccine hesitation. Participants expressed a range of enthusiastic support, cautious optimism and skepticism when presented with the possibility of an HIV vaccine. Factors that drove willingness to receive an HIV vaccine included community-oriented altruism, individualized risk-benefit assessment, and/or the perception that a vaccine could provide a beneficial shift in sexual experiences. Participants also expressed hesitations about receiving an HIV vaccine, including concerns about potential side-effects and efficacy, as well as mistrust in the vaccine development process. Notably, participants often evaluated the vaccine in comparison to PrEP and condoms. Participants offered specific insights into information they would like to receive about an HIV and where/how they would like to receive it. Our findings can help inform future HIV vaccine implementation efforts by offering insights into the factors that motivate and deter GBMSM to receive an HIV vaccine. [ABSTRACT FROM AUTHOR]

Condoms continue to be used by many gay, bisexual, and other men who have sex with men (GBM) to reduce the risk of HIV transmission. However this is impacted by condom failure events, defined here as condom breakage and slippage. In a prospective, observational cohort study of 343 HIV serodiscordant male couples recruited through high HIV caseload clinics and hospitals between 2012 and 2016 in Australia, Brazil, and Thailand, condom failure rates and associated factors were analysed, including with the study partner versus other sexual partners. There were 717 reported instances of condom failure from an estimated total of 25,831 sex acts with condoms, from over 588.4 participant years of follow up. Of the HIV-negative partners (n = 343) in the study, more than a third (n = 117, 36.7%) reported at least one instance of condom failure with any partner type during study follow-up. Condom failure with their study partner was reported by 91/343 (26.5%) HIV-negative partners, compared with 43/343 (12.5%) who reported condom failure with other partners. In total, there were 86 events where the HIV-negative partner experienced ano-receptive condom failure with ejaculation, representing 12.0% of all failure events. In multivariable analysis, compared to Australia, HIV-negative men in Brazil reported a higher incidence risk rate of condom failure (IRR = 1.64, 95%CI 1.01–2.68, p = 0.046) and HIV-negative men who reported anal sex with other partners reported an increased risk of condom failure compared with men who only had sex with their study partner (IRR = 1.89, 95%CI 1.08–3.33, p = 0.025). Although at least one event of condom failure was reported by a significant proportion of participants, overall condom failure events represented a small proportion of the total condom protected sex acts. [ABSTRACT FROM AUTHOR]

Background: In sub-Saharan African countries, including Ethiopia, the utilization of sexual and reproductive health information during adolescence is considered to be low. The aim of this study was to assess the level of sexual and reproductive health literacy among adolescents in Ethiopia as well as the factors associated with sexual and reproductive health literacy in this population. Methods: An institutional-based cross-sectional study design was employed. Systematic sampling methods were used to select 909 study participants. A validated scale was used, consisting of 31 questions with a 5-point Likert scale. A total score was computed, ranging from 31 (minimum score) to 155 (maximum score), which was finally categorized into limited and adequate sexual and reproductive health literacy. A multivariate linear regression model was fitted to determine the factors influencing adolescents' sexual and reproductive health literacy. Results: The percentage of adolescents with slightly adequate and excellent sexual and reproductive health literacy was 38.9% and 6.3%, respectively. On the other hand, 677 (74.5%) participants overall had limited sexual and reproductive literacy. Healthcare workers and reading books were the preferred sources of sexual and reproductive health information that were associated with higher sexual and reproductive health literacy by 6.42 (95% CI 1.62-11.22) and 6.57 (95% CI 1.62-11.22), respectively. Adolescents' ability to pay for their healthcare was associated with better sexual and reproductive health literacy by 13.76 times (95% CI 8.21-19.32). Conclusion: More than three-quarters of the adolescents had limited sexual and reproductive health literacy. Sources of sexual and reproductive health information, including healthcare workers, books, and the Internet, were significantly associated with adolescents' sexual and reproductive health literacy. Hence, primary stakeholders need to incorporate sexual and reproductive health into the curriculum at high schools. [ABSTRACT FROM AUTHOR]

The United States Preventive Services Task Force recommends pre-exposure chemoprophylaxis for persons at high risk of HIV exposure. The optimal screening strategy for at-risk individuals in primary care is not known. We evaluated the strategy of universal screening and discussed challenges to the implementation of this recommendation in primary care. Around 430 of 500 (86%) screening surveys were completed. Mutual monogamy was common but monogamous partners with recent negative HIV testing were uncommon. Likewise, among heterosexually active men and women, inconsistent condom use was common. Such individuals would be on guideline for HIV pre-exposure prophylaxis (PrEP) if their partner was at risk for HIV exposure. None of these potentially at-risk individuals met the criteria for PrEP, but 13% lacked knowledge of their partners' sexual and behavioral risk factors, preventing a clear decision on whether PrEP should be used. Our screen identified no individuals who clearly met the guideline criteria for HIV PrEP. We conclude that universal screening for HIV PrEP in primary care is unlikely to be an efficient strategy; targeted screening is likely more appropriate. Moreover, the 2019 guidelines for heterosexually active men and women rely on information that is often unknown to the patient, which makes these guidelines difficult to implement. Future guidelines should address these problems. [ABSTRACT FROM AUTHOR]

Adolescents' sexual and reproductive health challenges are of global public health concern and good quality sexual and reproductive health (SRH) education has an important role to play in addressing these negative sexual health outcomes. Yet in most Sub-Saharan African countries including Ghana, there is limited implementation of SRH education. Several environmental factors hinder the implementation of SRH education with the attitudes expressed by religious leaders having a major impact. We conducted semi-structured interviews with 15 Christian leaders in Bolgatanga, Ghana, to explore the factors influencing their decision to adopt and implement SRH education. Findings show that although Christian leaders were aware of (unsafe) sexual practices among adolescents, they held a conservative position on SRH education. While leaders were open to educating adolescents about sexual health, most held the opinion that SRH education for adolescents should be limited to abstinence-only and not acknowledge sexual activity or promote contraceptive use. Beliefs related to sexual morality, the perceived cause(s) of teenage pregnancy, and perceived responsibility for SRH education influenced Christian leaders' thinking about SRH education. Implementing SRH education programmes to address young people's sexual behaviour will require intervention programmes to change Christian leaders' beliefs and attitudes towards SRH education. [ABSTRACT FROM AUTHOR]

Reproductive medicine has made significant advancements over the last 70 years, much of it in the way of female contraception. Reliable male contraception continues to be restricted to condoms and vasectomy. The purpose of this narrative review is to provide an overview of the contemporary usage of male contraceptive methods, including ethical and political standpoints, as well as to summarize current and future studies being done on male hormonal and non-hormonal contraceptive options. [ABSTRACT FROM AUTHOR]

There is a dearth of HIV prevention behavioral interventions for transgender Latinas, despite this population's HIV risk. ChiCAS (Chicas Creando Acceso a la Salud) is an intervention to increase PrEP, condom, and gender-affirming hormone therapy (GAHT) use among transgender Latinas. To inform future work, semistructured interviews were conducted postintervention with 28 ChiCAS participants. Thematic analysis with inductive coding was used. Six themes emerged: (1) health-related priorities include sexual health and avoiding discrimination; (2) safe and collaborative community is of high importance; (3) interactive education with time for sharing stories and discussion was valued; (4) PrEP uptake was facilitated through awareness and health care navigation; (5) accessing GAHT depends on cost, clinic location, and individual goals; (6) ChiCAS could be improved with more PrEP/GAHT details and social connection. Interventions with goals similar to those of ChiCAS should prioritize building community, PrEP and GAHT education tailored to participants' needs, and emphasize health care options available locally. [ABSTRACT FROM AUTHOR]

Background: The consequences of engaging in risky sexual behaviours (RSB) can lead to HIV infection, sexually transmitted diseases and unintended pregnancy. The relationship between neighbourhood characteristics and youth involvement in RSB such as early sexual debut and multiple sexual partnerships has been of great concern to government, researchers and policymakers. However, there are very few empirical studies using demographic and health surveys to unpack the nature of this relationship in Rwanda, Ghana and South Africa. The objective of this study was to estimate the prevalence and determinants of early sexual debut and condom use, and to explore the neighbourhood factors associated with early sexual debut and condom use in Rwanda, Ghana and South Africa. Methods: This was a cross-sectional study using the most recent Demographic and Health Survey Data (DHS 2014–2016) from Ghana, Rwanda and South Africa to investigate the relationship between neighbourhood characteristics and risky sexual behaviour among the youth. Results: The prevalence of risky sexual behaviour in the three countries ranges from 56% (South Africa), 30% (Ghana) and 12% (Rwanda). Male youth in the 20-to-24-year-old category had increased odds of engaging in multiple sexual partnerships for the three countries (AOR 4.58; 95% CI 3.40–6.16), Rwanda (AOR 2.72; 95% CI 2.04–3.68) and South Africa (AOR 4.56; 95% CI 3.33–6.24). Meanwhile, at the community level, community education significantly increased the odds of age sexual debut among female adolescents by 50% (South Africa), and 46% (Ghana), while in Rwanda, this factor had decreased odds with higher community education. Conclusion: To lower the incidence of risky sexual behaviour in the community, programmes aimed at appropriate policy options must be intensified. The implications of these findings is helpful for a developmental approach aimed at reaching Africa's long-term development goal of eliminating STIs among young people. [ABSTRACT FROM AUTHOR]

Women engaged in sex work (WESW) are at increased risk for exposure to work setting violence. This phenomenological study examines the experience of work setting violence and strategies utilized to maintain safety for WESW in Republic of Barbados in the Caribbean. In-depth, semi-structured interviews were conducted with 30 cis-gender WESW in Barbados. This study found participants experienced work-related violence that includes physical assault, rape, robbery, kidnapping, and attempted murder. Participants were actively engaged in strategies for maintaining safety that were central to their business practices. Moreover, local HIV prevention intervention efforts including condom assertiveness training, free condom distribution, and rapid, accessible STI testing further enabled participants to assert and enforce safe business practices. Unfortunately, poor economic conditions at the time of the study, which reduced the market of available customers who were willing to pay full price while increasing the number of WESW, diminished the participants' power to insist on safe business practices. This has implications for interventions to prevent and counteract gender-based violence, as well as gender-based social and economic development efforts. [ABSTRACT FROM AUTHOR]

Background: Currently, approximately half of all pregnancies worldwide are unintended. Contraceptive use significantly reduces the risk of unintended pregnancy; however, options for men are particularly limited. Consequently, efforts are underway to develop novel, safe, and effective male contraceptives. Results: This review discusses research into emerging male contraceptive methods that either inhibit sperm production or impair sperm function. It focuses on those in the preclinical or early clinical stages of development. [ABSTRACT FROM AUTHOR]

Objectives: We explored participants' experiences in a randomized controlled trial that evaluated the Home-Based Intervention Strategy (HIS-UK) to improve male condom use skills/experiences. Methods: 25 men (18–25 years) who had reached the first 6 months of the intervention were interviewed. We used a codebook approach to thematic analysis to analyze the data. Results: Four themes were identified: Perceived benefits of online versus in-clinic recruitment; Perceptions of the educational content; Benefits of the condom kit; Acceptability of condom testing and monthly questionnaire. Conclusion: Participants valued the intervention, especially the condom kit that provided a range of different condoms and lubricants. [ABSTRACT FROM AUTHOR]

Objectives: We tested whether social activities and interactions as part of a condom campaign strengthened young adults' condom-use intentions and normative perceptions of condoms compared to simple exposure to campaign information. Method: Data from 3,041 young adults collected after four annual condom campaigns were analyzed and combined into a meta-analysis. Results: Interaction about the campaign and engagement in campaign-related activities was associated with higher condom use intention and more positive pro-condom norms. Conclusions: The authors call for a greater emphasis on social influence in youth-aimed sexual health campaigns. Implications for the research are discussed. [ABSTRACT FROM AUTHOR]

CHOICES-TEEN is a bundled intervention aimed at reducing the risks of unintended pregnancy, sexually transmitted infections, and alcohol- and tobacco-exposed pregnancies for adolescent girls involved in the juvenile justice system. We examined youths' (N = 22) elicited pros and cons concerning alcohol, tobacco, condom, and contraception use to inform future iterations of CHOICES-TEEN and other prevention programming during a one-arm pilot study. Content analysis was used to identify recurring themes elicited and recorded during a decisional balance exercise with a counselor. The most recurrent pros and cons were factors that directly affected these adolescents, with more immediate consequences. The results provide insight into motivations for engaging in substance use and risky sexual behaviors for these youth, as well as barriers to change. [ABSTRACT FROM AUTHOR]