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The objective of this study was to determine the temporal trends and factors associated with HIV and syphilis infection among men who have sex with men (MSM) in southern Vietnam. Data from the 2014–2018 national HIV sentinel surveillance of MSM aged 16 years or older were collected from three provinces, including An Giang ( N = 761), Can Tho ( N = 900), and Ho Chi Minh City ( N = 1426), and examined for changes in prevalence rates of HIV and syphilis and risk behaviors over time. Multivariate logistic regression was performed to assess the trends and correlates of HIV and syphilis infections among MSM. There were upward trends for HIV (9.5% in 2014 to 14.2% in 2018, p-trend

BACKGROUND: The extent to which uptake of biomedical HIV prevention strategies has impacted population-level sexual behavior and sexually transmitted infections (STI) among men who have sex with men (MSM) is not well understood. METHODS: We collected data as part of routine care from MSM attending the municipal STI clinic in Seattle, Washington, 2002–2018. MSM were asked about condom use in the prior 12 months. We classified behaviors into four mutually exclusive categories: no anal sex; consistent condom use for anal sex; serosorting (condomless anal sex [CAS] only with HIV-concordant partners); and CAS with serodiscordant/unknown-status partners. STI/HIV testing was performed per routine clinic protocol. RESULTS: There were 45,656 and 6,987 visits by MSM without HIV and MSM with HIV, respectively. Use of antiretroviral therapy and pre-exposure prophylaxis increased substantially during the study period, to 94% and 50%, respectively, by 2018. CAS with serodiscordant/unknown-status partners decreased through 2013 but increased thereafter (to 40% among MSM without HIV; 68% among MSM with HIV). Serosorting increased among MSM without HIV, but declined after 2013 among MSM with HIV. Consistent condom use declined for all MSM (from 35% to 11% among MSM without HIV; from 20% to 5% among MSM with HIV). HIV test positivity declined substantially (3.5% to 0.5%) while STI test positivity increased over time. CONCLUSIONS: Since 2013, CAS with HIV-discordant/unknown-status partners increased substantially concurrent with declining HIV test positivity and increasing STI test positivity. This highlights the success of biomedical HIV prevention strategies to reduce HIV incidence while affirming the need for new approaches to STI prevention.

To test the ACE-Plus curriculum, a two-session program that teaches males in foster care and/or preventive services about correct and consistent condom use, and engagement with female partners to o...

BackgroundConsistent condom use in women, defined as the self-reported usage of male condom in every sexual encounter of the respondent with her most recent partner in the last 12 months, had been perennially low in the Philippines. This is despite consistent condom use being a tested and proven public health intervention to prevent unwanted pregnancy and sexually transmitted infections. Considering the high fertility rate, teenage pregnancy rate, and the rapidly increasing incidence of HIV in the country, we identified the determinants of consistent condom use in the Philippines.MethodsWe used data from the individual recode of the 2017 Philippine National Demographic and Health Survey. We used logistic regression for survey data to identify factors associated with consistent condom use.ResultsOut of 25,074 respondents, only 261 (1.13%) have used condoms consistently with their most recent partner. Reach of information and education campaigns on contraceptive use via different media ranged from 62% via television to 7% via short messaging service. After adjusting for confounders, those who were able to ask their partners to use condoms during sexual intercourse have 6.18 times (adjusted odds ratio (aOR): 6.18; 95% Confidence Interval (95% CI): 2.02. 18.94) greater odds of consistent condom use than those who were unable to ask their partners to use condoms during sexual intercourse. Meanwhile, HIV knowledge (aOR: 1.16; 95% CI: 0.98, 1.38) and hearing about contraception in television (aOR: 1.54; 95% CI: 1.00, 2.38) have weaker associations with consistent condom use.ConclusionsThe low percentage of those who use condoms consistently, together with the low reach of information and education campaigns, highlight the need to implement multi-faceted and context-specific interventions to promote sexual agency and/or consistent condom use to address the burden of unwanted pregnancies and HIV in the Philippines.

Online dating provides emerging adults with a way of connecting with others more frequently and efficiently than traditional courtship. Online dating sites pose opportunities for relationships and sexual encounters, which may be accompanied by engagement in sexual risk behaviors, such as lack of condom use. The present study used the theory of planned behavior to explore psychosocial cognitions (i.e. constructs) about condom use among online daters. The sample size consisted of N = 156 emerging adults (Mage = 20.6) who participated in an online survey of health behaviors and sexual risk. Using attitudes, subjective norms, and self-efficacy about condom use, latent class analysis identified four latent classes: Consistent Condom Users (17%), Inconsistent Condom Users with Low Dating Site Usage (23%), Inconsistent Condom Users with High Dating Site Usage (40%), and Consistent Condom Non-Users (20%). Consistent Condom Non-Users had the highest probability of utilizing dating sites 2+ hours per day, the highest probability of low self-efficacy and low subjective norms about condom use, and a zero probability of using a condom. Inconsistent Condom Users with Low Dating Site Usage and Inconsistent Condom Users with High Dating Site Usage varied in their attitudes and self-efficacy toward condom use. Consistent Condom Users were low on dating site usage, high on all psychosocial constructs, and had a 100% probability of using a condom. Results highlight the need to further explore interventions throughout college campuses and online within dating sites, to strengthen attitudes, subjective norms, and self-efficacy toward condom use among online dating emerging adults.

The goal of this study was to assess awareness of, interest in, and sources of knowledge about pre-exposure prophylaxis (PrEP) among 1,464 HIV-uninfected patients from public STD clinics in Baltimore. Logistic regression analyses were conducted to examine factors associated with PrEP awareness and interest. Results suggest PrEP awareness and interest in knowing more about PrEP was highest among men who reported sex with men or with both men and women. White patients were more likely to be aware of PrEP than African American patients, and those reporting consistent condom use were more likely to have heard about PrEP than those who never used condoms. The major source of knowledge about PrEP was health care providers. Findings can inform future prioritization of locally targeted PrEP programs to enhance access to and uptake of PrEP among those most at risk for HIV transmission.

OBJECTIVES To assess trends in HIV prevention strategies among Australian gay and bisexual men (GBM) since the introduction of preexposure prophylaxis (PrEP), the level of net prevention coverage (the use of safe strategies), and the characteristics of HIV-negative and untested GBM who remain at risk of HIV. DESIGN Repeated behavioural surveillance of GBM recruited from venues, events and online in seven Australian states and territories. METHODS Participants with casual male partners were included. Trends in sexual practices, prevention strategies, net prevention coverage and the characteristics of 'at risk' participants were assessed with binary and multivariate logistic regression. RESULTS A total of 32 048 survey responses (2014-2019) were included. The proportion of participants who reported consistent condom use declined (44.6-23.2%). The proportion who reported any condomless anal intercourse with casual partners increased (37.4-62.0%) but net prevention coverage also increased (68.1-74.9%), with higher levels of undetectable viral load among HIV-positive participants and rapidly increasing PrEP use by HIV-negative participants. PrEP became the most commonly reported prevention strategy in 2019 (31.1%). The analysis of 'at risk' participants showed that they became more likely to report frequent condomless anal intercourse with casual partners but had fewer partners and more partners with undetectable viral load or on PrEP. 'At risk' participants became more likely to identify as bisexual and to be born overseas. CONCLUSION There has been a rapid, historic shift in HIV prevention among GBM in Australia. Net prevention coverage has increased among GBM and 'at risk' GBM have become less at risk of HIV, facilitating reductions in HIV transmission.

Unprotected sexual intercourse places young women in multiple partnerships at great risk for sexually transmitted infections in Haiti. While the most effective means of preventing these infections is consistent condom use, little is known about the factors that influence its use. This study sought to analyze high-risk sexual behavior among young Haitian women with multiple sex partners and to identify and understand factors that influence condom use among these young women. Data were drawn from the 2017 Haiti Demographic and Health survey. Explanatory analysis was used to test for associations between condom use and the selected sociodemographic factors using Pearson’s chi square test. Then, multiple logistic regression was fitted to the data to assess the effects of sociodemographic characteristics of young women in multiple partnerships on condom use. The study revealed significant differences between sociodemographic factors and condom use among young women in multiple partnerships. A young woman’s age, age at sexual debut, level of education, marital status, and household wealth predicted condom use. The paper highlights the importance of reinforcing sexuality education among young women in Haiti.

Objective. The Chinese men who have sex with men (MSM) population is suffering from a high HIV infection rate owing to unprotected anal sex. The Health Belief Model (HBM) has been proven to be an effective frame associated with behavior maintenance. Based on HBM, we analyzed the beliefs associated with consistent condom use behavior with regular and nonregular partners among MSM to better provide targeted interventions and services. Methods. A study was conducted in Sichuan Province, China, from November 2018 to April 2019, and 801 eligible participants were recruited by snowball sampling. Sociodemographic characteristics, AIDS-related characteristics, sexual behaviors, condom use behavior, and dimensions of HBM were investigated. Univariate, single multivariate, and summary multivariate models were employed to analyze the factors associated with consistent condom use. Results. Of all participants, 39.1% and 53.6% had had anal sex with regular and nonregular partners in the last six months, respectively. Only 56.5% of them had used condoms consistently with regular partners, and only 60% of them had used condoms consistently with nonregular partners. When taking consistent condoms use with regular partners as the dependent variable, the dimensions of perceived threats ( ORM = 1.28 , 95% CI: 1.10, 1.49), perceived barriers ( ORM = 0.70 , 95% CI: 0.60, 0.82), self-efficacy ( ORM = 1.23 , 95% CI: 1.14, 1.32), and cues to action ( ORM = 1.21 , 95% CI: 1.02, 1.43) showed significant associations with the dependent variable. When taking consistent condoms use with nonregular partners as the dependent variable, the dimensions of perceived barriers ( ORM = 0.77 , 95% CI: 0.67, 0.89), self-efficacy ( ORM = 1.22 , 95% CI: 1.13, 1.32), and cues to action ( ORM = 1.53 , 95% CI: 1.30, 1.80) showed significant associations with the dependent variable. Conclusions. More attention should be focused on how to decrease the obstructive factors of condom use, how to improve the confidence of condom use, and how to layout more cues to action to promote consistent condom use behavior with regular and nonregular partners during anal sex among Chinese MSM.

During the last decade in Costa Rica, the number of newly diagnosed HIV infections has increased. As in many countries across the globe, men who have sex with men (MSM) have been disproportionally affected. Given the need for a knowledge base for interventions, this study focussed on the HIV-protection behaviour of young MSM and predictors of condom use. Specifically, the aim of the study was a) to identify the personal HIV protection strategies which had been adopted by young MSM aged 18-24 living in Costa Rica, b) to assess the consistency of condom use of young MSM when having sex with casual partners, and c) to test the explanatory power of the Information-Motivation-Behavioural skills (IMB) model regarding the condom use of MSM with casual partners. For our data collection, we conducted standardized personal interviews with an availability sample of 238 young MSM aged 18-24. Data were analyzed using descriptive statistics and multivariate analyses. The IMB model was tested using structural equation modelling. The 119 participants who had sex with casual partners had adopted a wide range of personal HIV protection strategies. Only 5.6% of the respondents reported that they had not adopted a strategy to consciously prevent an HIV infection. Among those MSM who had had anal sex with casual partners in the six previous months, 13.4% reported consistent condom use. The test of the IMB model showed that the consistency of condom use was predicted by the personal HIV protection strategy and the perceived severity of an HIV infection. Thus, the data did not fully confirm the IMB model. This study provides insights into condom use of young MSM with casual partners and, thus, adds to the knowledge base needed for the development of prevention offers. It demonstrates the impact of personal HIV protection strategies as well as situational and partner-related barriers to condom use. The findings offer an incentive to further develop and extend the IMB model.

The abundance of social networking platforms has increased the frequency and the availability for which individuals communicate with one another. The feasibility and accessibility to go online to find sexual partners pose opportunity for contracting sexually transmitted infections (STI) in the absence of safe sexual practices. Low condom use has been reported among young adults who seek sexual partners online. African American young adults have some of the highest rates of infection for certain STIs. In order to mitigate the incidence and prevalence of STIs in at-risk populations, sexually active young adults must use condoms consistently and correctly during sexual activities. The present study sought to uncover the heterogeneity within African American young adults regarding their online networking utilization, STI knowledge, and sexual risk behavior. African American young adults (N = 236), ages 18 - 23, completed private online survey administration. Using latent class analysis, three classes were identified: Social Network Communicators (43%; N = 101), Social Networking Daters (36%; N = 83), and Media Sharers (21%; N = 52). Social Networking Daters exhibited the highest probability of using online dating sites daily, low STI knowledge, and a zero probability of consistent condom use. All three groups exhibited relatively low STI knowledge. Furthermore, having a history of STI increased the likelihood of being classified into the Social Networking Daters class relative to the other classes. Findings highlight the need to capitalize upon online platforms for African American young adults who utilize online dating sites and other online environments.

International audience; Observing sexual behaviour change over time could help develop behavioural HIV prevention interventions for female sex workers in Zambia, where these interventions are lacking. We investigated the evolution of consistent condom use among female sex workers and their clients and steady partners. Participants were recruited into an HIV incidence cohort from 2012 to 2017. At each visit, women received HIV counselling and testing, screening for sexually transmitted infections (STIs) and free condoms. Our outcome was reported consistent (100%) condom use in the previous month with steady partners, repeat clients, and non-repeat clients. Consistent condom use at baseline was highest with non-repeat clients (36%) followed by repeat clients (27%) and steady partners (17%). Consistent condom use between baseline and Month 42 increased by 35% with steady partners, 39% with repeat clients and 41% with non-repeat clients. Access to condoms, HIV/STI counselling and testing promoted positive sexual behaviour change.

We examined condom use throughout pregnancy during the Zika outbreak in Puerto Rico during 2016. Overall

ObjectivesTo assess risk and protective factors associated with bacterial vaginosis (BV) chronicity ascertained by Nugent score criteria.MethodsA longitudinal cohort study included 255 sexually experienced, postmenarcheal women who provided weekly self-collected vaginal swabs for up to 2 years. Vaginal swabs were scored using Nugent criteria and classified as normal (≤3), intermediate (4–6) and Nugent-BV (≥7). Detailed behavioural/health information were assessed every 6 months. A per-woman longitudinal summary measure of BV chronicity was defined as the percentage of each woman’s weekly vaginal assessments scored as Nugent-BV over a 6-month interval. Risk and protective factors associated with BV chronicity were assessed using multiple linear regression with generalised estimating equations.ResultsAverage BV chronicity was 39% across all follow-up periods. After adjustment, factors associated with BV chronicity included baseline Nugent-BV (β=35.3, 95% CI 28.6 to 42.0) compared with normal baseline Nugent scores and use of unprotected water for bathing (ie, rainwater, pond, lake/stream) (β=12.0, 95% CI 3.4 to 20.5) compared with protected water sources (ie, well, tap, borehole). Women had fewer BV occurrences if they were currently pregnant (β=−6.6, 95% CI −12.1 to 1.1), reported consistent condom use (β=−7.7, 95% CI −14.2 to 1.3) or their partner was circumcised (β=−5.8, 95% CI −11.3 to 0.3).ConclusionsFactors associated with higher and lower values of BV chronicity were multifactorial. Notably, higher values of BV chronicity were associated with potentially contaminated bathing water. Future studies should examine the role of waterborne microbial agents in the pathogenesis of BV.

Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.

Attitudes toward condoms and self-control are reliable predictors of consistent condom use. However, safer sex behaviors depend on whether people are single or romantically involved. For th...

High transmission probability of HIV during condomless anal sex puts men who have sex with men (MSM), transgender, and nonbinary individuals at increased risk of infection. This analysis aims to examine the socioeconomic, biological, and behavioral factors that are associated with consistent condom use (CCU) during insertive/receptive anal sex among MSM in the last month in the cities of Lomé and Kara, Togo. A total of 683 MSM ≥18 years of age were surveyed using respondent-driven sampling (RDS) for a cross-sectional survey in Lomé (n = 354; 51.8%) and Kara (n = 329; 48.2%). Participants completed a structured questionnaire and were tested for HIV and syphilis. Statistical analyses included RDS-weighted proportions, bootstrapped confidence intervals (CIs), and logistic regression models. When compared with Lomé, MSM in Kara had lower odds of CCU [adjusted odds ratio (aOR) = 0.29, 95% CI = 0.19–0.44]. Other factors associated with lower CCU were having an income of 2,000 Communaute Financiere Africaine (CFA)–12,000 CFA (aOR = 0.53, 95% CI = 0.36–0.77) or above 12,000 CFA (aOR = 0.34, 95% CI = 0.20–0.57), transgender women (aOR = 0.47, 95% CI = 0.25–0.92), and intersex gender (aOR = 0.42, 95% CI = 0.24–0.73), and ever being forced to have sex (aOR = 0.42, 95% CI = 0.21–0.82). Factors associated with CCU were identified in this study including older age (aOR = 1.49, 95% CI = 1.04–2.14) and having easy access to condoms (aOR = 2.70, 95% CI = 1.23–5.94) and very easy access to condoms (aOR = 2.73, 95% CI = 1.20–6.16). Reported condom use in this study was low, and several factors associated with CCU were identified including older age and access to condoms. This study highlights multiple barriers to preventive services experienced by MSM in Togo and therefore leveraging strategies to address these barriers may improve prevention of HIV and syphilis.

In Benin, consistent condom use among men who have sex with men (MSM) is relatively low and providing them with Pre-exposure prophylaxis (PrEP) could be of great relevance. We aimed to describe PrEP knowledge and intention to use it; identify key facilitators and barriers to PrEP; and describe the perceived impact of PrEP on unsafe sexual behavior. MSM, 18 years or older, HIV-negative or of unknown status, were enrolled in five cities of Benin. Intention to use PrEP was assessed through five focus groups (FG). Data were analyzed using manual thematic sorting. Thirty MSM (six per city) participated in the FG. Mean age (standard deviation) was 27.1 (5.0) years. All participants expressed the intention to use PrEP if made available. Facilitators of PrEP use were: availability of medication, safety, absence of constraints as well as freedom to have multiple sex partners and sex with HIV-positive friends. Barriers were: complex procedures for obtaining medication, size and taste of medication, cost of medication, poor PrEP awareness.. Eighteen men admitted that PrEP could lead to decrease in or even abandonment of condom use. In conclusion, MSM showed openness to use PrEP if available, although they recognized that it could lead to risk compensation.

Background In China, high prevalence of risky sexual behaviours and inequity in health services lead to situations in which migrant men who have sex with men face higher risk of contracting the human immunodeficiency virus. Consistent condom use is a primary means of preventing HIV infection during anal sex among MSM. This study aimed to apply the information–motivation–behavioural skills model to examine the predictors of consistent condom use among migrant MSM in Shanghai, and tested the associations between model constructs. Methods A cross-sectional study was conducted among 412 migrant MSM in Shanghai. Data on HIV-related information, motivation, behavioural skills, and behaviours were collected via structured questionnaires. A structural equation model was used to assess the IMB model. Results Of the 412 participants, 4.4% reported HIV-positive status, and prevalence of consistent condom use in the previous 6 months was 44.9%. A restricted IMB model provided an acceptable fit to the data. Behavioural skills were found to directly predict consistent condom use (β = 0.629, P 0.05), but motivation predicted it indirectly and was mediated by behavioural skills. Conclusion The prevalence of consistent condom use was found to be relatively low among migrant MSM in Shanghai. The restricted IMB model was found to be a good predictor of consistent condom use among them. The results of this study indicate that intervention strategies for safer sexual behaviour should not only include information dissemination, but also emphasize motivation and behavioural skills among this population.

The current study evaluates two predictors of adolescent sexual risk-taking, specifically whether impulse control or future expectations predict condom use and casual sex. We examine whether risky sex occurs among youth who tend to act without thinking about the future, or instead, youth who report low future expectations. We consider these relations longitudinally among a sample of sexually active justice-involved adolescent males (N = 752, M age = 15.58) a group at heightened risk for sexual risk-taking. We found that optimistic expectations for the future predict a higher likelihood of engaging in consistent condom use, whereas high impulse control is related to a lower likelihood of casual sex. Implications for intervention and research on positive sexual health are discussed.

This report presents data on pornography consumption, perceptions of pornography, and condom use among a sample of 140 women in South Korea. Three key findings emerged. First, perceiving pornography as a source of sexual information was a more reliable correlate of less consistent condom use than the frequency with which pornography was viewed. Second, consuming pornography more frequently only predicted using condoms less frequently when pornography was perceived as a source of sexual information. Third, the interaction between the rate of pornography consumption and perceiving pornography as a source of sexual information maintained even after adjusting for pertinent demographic characteristics. Taken together, these findings suggest that while perceiving pornography as a source of sexual information in and of itself is a risk-factor for engaging in unprotected sex, the combination of regular pornography consumption and perceiving pornography as a source of sexual information is more problematic in terms of sexual risk than either variable in isolation. Sampling specifics and methodological singularity, however, point to a need for replication studies from other locales and using additional designs.

Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high s...

Female sex workers’ (FSWs) risk for HIV/STIs is influenced by their work environments. While previous research has characterized vulnerability in a single workplace, many FSWs solicit clients from multiple settings. Using latent class analysis (LCA), we examined client solicitation patterns and associated HIV/STI-related behaviors (consistent condom use with clients, asking clients about HIV/STIs, and past 6-month HIV/STI testing) among 385 FSWs in Baltimore, Maryland. The LCA yielded a three-class solution: predominantly street (61.2%), mixed street/venue (23.7%), and multisource (street, venue, and online) (15.1%). Consistent condom use differed significantly (p

The prevalence of HIV among young Thai men stabilized at 0.5% from 2005 to 2011. A cross-sectional study was conducted among the male army conscripts in 2018 at 36 military training units nationwide. All new conscripts in each selected unit were invited to participate in the study. Questionnaires were used to determine risk factors to HIV infection that had been developed from related risk factors studies among young Thai men. Among 4629 participants, 44 (1.0%) HIV positive individuals were identified. The proportion subject reporting a history of sex with another man was 10.1%. The prevalence of HIV infection among men who have sex with men (MSM) was 4.0%. The proportion of consistent condom use with a male partner was 39.7%. The risk factors of HIV infection included having sex with another man, history of sexually transmitted infection and history of sex in exchange for gifts/money. Only 1.4% of MSM used pre-exposure prophylaxis (PrEP). HIV prevention programs including PrEP in Thailand should be emphasized among MSM in both rural and urban settings.

Background. Heterosexual transmission within serodiscordant relationships is the core source of new HIV infections. Although consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples, it has not been extensively studied in Ethiopia. Consequently, the current study looked at the proportion of serodiscordant couples in Ethiopia who used condoms consistently and the factors associated with that. Methods. A cross-sectional was conducted from October 2019 to June 2020. For the quantitative findings to be more robust and reliable, a qualitative design was incorporated. An interviewer-administered questionnaire was used to collect the data. Qualitative data were collected using gender-matched four focus group discussions. Multivariable logistic regression was conducted to identify factors associated with consistent condom use. The statistical significance of the variables was declared at a P value of less than 0.05. Results. This study confirmed that the proportion of consistent condom use was 58.4% [95% CI: 53.1-63.1%]. After controlling for all other variables, unmarried partners, adjusted odds ratio AOR = 0.44 [95% CI: 0.229-0.877] and students and employees, AOR = 0.33 [95% CI: 0.130-0.846] and AOR = 0.39 [95% CI: 0.165-0.939], respectively, were less likely consistently use condoms, whereas couples living together, AOR = 1.86 [95% CI: 1.197-2.195], receiving counseling about condom use, AOR = 1.90 [95% CI: 1.182-3.076], and having more knowledge about HIV, AOR = 1.61 [95% CI: 1.031-2.525] were more likely to use condoms consistently. Conclusion. Despite its importance, the proportion of consistent condom use among serodiscordant couples was significantly low. To improve condom use consistently, planners, policymakers, and health care practitioners should consider the factors listed above when making decisions. There should be an increased focus on student and employee intervention as well.

Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms.Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

Background: Young people in KwaZulu-Natal and Mpumalanga South Africa are at high risk of HIV and other sexually transmitted infections. Therefore, awareness programs are needed to reach these young people and change their knowledge, attitudes, and behaviors. Objective: The objective of this study is to use cross-sectional data from grade 10 female and male learners in randomly assigned intervention and control schools to examine their knowledge, attitudes, and sexual behaviors. Methods: Participants, who were in grade 10 in the 2018 school year and attending schools, were randomly assigned to the intervention and control arms for implementation of the Department of Basic Education’s adapted life orientation curriculum that included scripted lesson plans. The study took place in two high HIV prevalence provinces in South Africa. Participants completed self-administered tablet-based surveys and female participants provided a dried blood spot for HIV testing. Results: Results demonstrate that two-fifths to one-half of male learners reported being sexually experienced and a quarter (KwaZulu-Natal) to a third (Mpumalanga) of the female learners reported the same. A greater percentage of learners in Mpumalanga reported consistent condom use than learners in KwaZulu-Natal. HIV prevalence among female grade 10 learners in both provinces was about 6-7%. No notable differences were observed between intervention and control school learners on the knowledge, attitudes, and behavior outcomes. Conclusion: The findings demonstrate the importance of developing HIV prevention programs for young people in high HIV prevalence provinces since these young people remain at high risk for HIV and other negative outcomes. Trial Registration: This study has been registered at ClinicalTrials.gov. The trial registration number is: NCT04205721. The trial was retrospectively registered on December 18, 2019.

Female sex workers (FSWs) decision to use or not to use condoms depends on several issues, including the decision to trust their client or not, a matter given little attention in previous research. This paper explores the role of trust in consistent condom use among FSWs. We used a cross-sectional survey among FSWs in Bali, Indonesia. The outcome variable for this study was condom use, and independent variables included sociodemographic characteristics, psychosocial factors, social capital dimensions and HIV prevention practices. In total, 406 FSWs participated in the study. Of these, 48% of FSWs used condoms consistently with paying clients over the last month. The following FSWs were less likely to consistently use condoms with clients: FSWs who did not trust that their peer FSWs will use condoms (AOR = 9.3, 95% CI, 3.3–26.2), FSWs who did not feel valued by the people at their location (AOR = 3.9, 95% CI, 1.4–11.6), FSWs who did not graduate from primary or never went to school (AOR = 2.4, 95% CI, 1.03–5.6), and FSWs who have worked more than five years as FSWs (AOR = 5.8, 95% CI, 1.2–29.2). Our results highlight higher rates of inconsistent condom use related to lower trust and feelings of being valued between FSWs, identifying areas for policy and practice attention.

Sexually Transmitted Infections (STI’s) continue to negatively affect young people in the United States, ages 15-24 years old, specifically impacting young woman at a disproportionately high rate. STI infection rates among young Black females are significantly higher than among their white counterparts, and this group continues to be identified as an at-risk population. Condom use has been assessed and encouraged as a prevention strategy for both STI's and unintended pregnancies. Previous research has identified a number of factors that influence condom use in adolescent females, however not enough research has focused on the impact of relational factors on condom use. The aim of this study was to assess interpersonal relational factors and their influence on consistent condom use among sexually active adolescent females. Additionally, this study can begin to fill a gap in research regarding the relational experiences of urban, adolescent females and their condom use behavior. This study assessed how relational factors: relationship duration, sexual relationship duration, relationship status, and perceived power and control were related to consistent condom use. The sample included 831 sexually active, adolescent females, ages 14-17 years old. Results suggest that both relationship duration and sexual relation duration have a significant association with stage of condom use. Relationship status (steady/not) did not show a significant association with stage of condom use, in this sample. Perceived relational power/control over condom use was significantly associated with stage of condom use These results are consistent with the literature in suggesting that as relationship duration increases, the perceived risk for STI prevention may decrease, explaining the increase in risky sex associated with longer relationships. Further research is needed to continue to assess the dynamics of adolescent relationships along with the influence of interpersonal relational characteristics on consistent condom use within this population.

Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18-24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.

The overwhelming majority of infection with the Human Immunodeficiency Virus (HIV) is acquired worldwide through sexual contacts. Risk of transmission is higher through anal sex, in presence of ulcerative genital lesion and when the source has high HIV viremia. Conversely, it is reduced by male circumcision, consistent condom use and it is virtually zero when the infected persons in under antiretroviral therapy and has undetectable viremia.

Chlamydia trachomatis infection is the most common sexually transmitted bacterial infection among women. In Brazil, there is no organized screening program for C. trachomatis, and the actual prevalence of infection is unknown. This study aimed to determine the prevalence of C. trachomatis infection in women living in riverside communities in the Amazon, using self-collection employing the Evalyn® Brush and polymerase chain reaction. A total of 299 riverine women aged 18–81 years, mean age 35.7 (±12.8) years, predominantly agricultural workers, with low schooling and living with a partner, participated in this study. The prevalence of C. trachomatis infection was found to be 3.7% (95% CI 1.8–6.5), most of them being symptomatic. The mean age of the first sexual intercourse reported by women was 15.2 (±2.3) years, and the majority reported having had none or only one partner in the last 12 months, with very low adherence to consistent condom use (15.4%). Most women (98.3%) reported having approved using the vaginal self-collecting brush, and only 4.7% reported having difficulty in handling the brush. We consider that a vaginal self-collecting device is adequate for diagnosing C. trachomatis infection in women living in remote, hard-to-reach areas.

Men's involvement in sexual and reproductive health is under-researched in South Africa despite evidence to suggest that men are key decision-makers in various household matters. Against this background, this study aimed to explore men's perspectives on contraceptive use in a South African township with a focus on motivations for contraception use and the challenges men face in using contraceptives. In-depth interviews were conducted with a sample of 20 men. Findings suggest that awareness of contraception among men is high and attitudes towards contraceptives are generally favourable. Contraceptive use is strongly influenced by the perceived risk of unplanned pregnancy and HIV infection. Condoms are the most commonly known and used method of contraception by men. Men complained that there are limited contraceptive options for them and consistent condom use remains difficult. To increase the uptake and use of contraceptives, sexual and reproductive programmes should fully include men in design and delivery. In the longer term, investment in the development of a wider range of contraceptive methods will increase options for men.

L’infection a VIH en Cote d’Ivoire constitue une epidemie generalisee. En 2017 la prevalence etait estimee a 2.8% et les nouvelles infections atteignaient le nombre de 29800. La transmission heterosexuelle est de loin la plus importante. Les facteurs associes a la pratique du sexe sans condom sont nombreux. A l’oppose, on ne connait pas les facteurs qui favorisent l’usage regulier du preservatif dans le foyer conjugal. L’objectif de cette etude etait de decrire les facteurs associes a l’usage regulier du preservatif dans la sexualite intraconjugale chez les patients infectes par le VIH et sous traitement ARV. Une enquete quantitative transversale descriptive a ete menee sur 6 mois continus du 1er decembre 2017 au 31 mai 2018 a l’INHP. Etaient enrolees a tout venant, les personnes vivant avec le VIH suivies sur le site et ayant donne leur consentement ecrit. Les variables etudiees ont ete reparties en groupes de caracteristiques individuelles, de situation matrimoniale, de reproduction, de duree de suivi, de divulgation du statut, de comportement sexuel dans le foyer, d’acceptabilite du preservatif. L’analyse des donnees a ete faite avec le logiciel EPI INFO Version 3.5.4/2012. Les frequences et les proportions des variables ont ete calculees et le degre de signification a ete determine. 102 personnes de la file active sous traitement ARV ont ete enrolees. La moyenne d’âge etait 40 ans avec un âge median de 39 ans. 55,9% des patients etaient en union dont 63,6% vivaient toujours avec leur meme partenaire depuis leur depistage. 61,8% des patients ont partage leur statut a leur partenaire sexuel. Les couples serodifferents representaient 39%. Dans le foyer, les rapports sexuels continuent d’etre pratiques chez 72% des personnes. Le preservatif etait utilise regulierement chez 53,5% durant les 6 derniers mois. Le fait d’etre celibataire ou d’etre informe du statut partenaire ou d’avoir une difference de statut etait plus associe a l’utilisation constante du preservatif ; cependant aucune variable n’est significativement liee a un usage regulier du preservatif. Les PVVIH qui sont eduquees au port de preservatif, l’introduisent dans leur relation sexuelle intraconjugale. L’usage du preservatif serait plutot determine par les problemes et les besoins des individus qui l’utilisent. La difficulte de son utilisation reguliere resulterait de la complexite et de la variabilite de ces problemes et besoins vecus ou ressentis par les usagers. HIV infection in Cote d'Ivoire is a generalized epidemic. In 2017 the prevalence was estimated at 2.8% and new infections were 29,800. Heterosexual transmission is by far the most important. In contrast, the factors that promote regular condom use in the marital home are not known.The objective of this study was to describe the factors associated with consistent condom use in intramarital sexuality among PLWH infection and ARV treatment. A descriptive cross-sectional quantitative survey was conducted over 6 consecutive months from December 1st, 2017 to May 31st, 2018 at the INHP. All PLWH who had been followed up and gave their written consent were enrolled. The variables studied were divided into groups of individual characteristics, marital status, children’s needs, duration of follow-up, disclosure of status, sexual behaviour in the home, condom acceptability. The data analysis was done with the software Epi Info 3.5.4/2012. Frequencies and proportions of the variables were determined and the degree of significance have been determined. 102 PLWHIV treated with ARV were enrolled. The average age was 40 years with a median age of 39 years. 55.9% of patients were in a relationship, 63.6% of whom were still living with their same partner since their screening. 61.8% of people shared their status with their sexual partner. Serodiscordant couples accounted for 39%. In the household, sexual intercourse continues to be practised in 72% of people. The condom was used regularly in 53.5% during the last 6 months. The condom was used regularly in 53.5%. Being single or being informed of partner status or having a status difference was more associated with consistent condom use; however, no variable is significantly related to consistent condom use. People living with HIV who are educated to condom use, introduce it into their intramarital sex. But its regular use is peppered with many difficulties. . Condom use would rather be determined by the problems and needs of the individuals who use it. The difficulty of its regular use would result from the complexity and variability of these problems and needs experienced or felt by the users.

Condom use with steady heterosexual partners has been insufficiently addressed in Brazil, because, in this setting, most studies are on the population of men who have sex with men or sex workers. Besides that, the literature on this topic regarding traditional communities is even scarcer. Therefore, the objective of the present study was to identify which factors are related to the consistent use of condoms with steady partners in Quilombola communities in the northeast region of Brazil. A total of 367 individuals from 14 communities were enrolled from September 2016 to June 2017. Logistic regression models for predicting the consistent use of condoms with steady partners were developed. Most of the study participants (90.73%) had steady partners. Regarding personal vulnerability to not using condoms, only 9.91% of those who had steady partners engaged in protected sexual intercourse with the partners. Provision of sexual health information and receiving condoms showed statistical significance (OR = 4.38; CI = 1.7–11.09; p = 0.002), with approximately four times greater probability of consistent condom use with steady partners, pointing to a vulnerability in relation to those who do not receive these resources. It should also be emphasized that low socioeconomic levels and geographic distance of health units can have a negative impact on access to information and condoms.