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The SAVA syndemic is frequently used to describe the co-occurrence of HIV, gender-based violence (GBV), and substance use. In this study we determine the extent to which the typologies of the SAVA syndemic can be described and utilized for intervention strategies among youth living in the slums of Kampala, Uganda. We analyzed the "Kampala Youth Survey 2014," a cross-sectional survey conducted in the spring of 2014, consisting of a convenience sample (N = 1134) of urban youth (12-18years of age). Descriptive statistics were computed for hypothesized risk factors and demographic variables among the 8 typologies of GBV, HIV, and alcohol use. Multinomial logistic regression was conducted to determine statistically significant correlates with each typology. The overall prevalence of GBV was 31.7%, whereas the overall prevalence of alcohol use in the past 12months was 31.2%. HIV-Positive youth comprised 10.5% of the total sample. Females comprised the majority of the typology with no SAVA components compared to males (55% vs. 45%, respectively), as well as the SAVA syndemic typology (GBV + HIV + ALC +) (58% vs. 42%, respectively). Engaging in commercial sex work (36%), witnessing parental abuse (61%), and depression/suicidality (81%) were all highly prevalent among youth in the SAVA syndemic typology (GBV, HIV, and alcohol use). Sex work and observing parental abuse were associated with the SAVA syndemic typology in the multivariable model. In our study, alcohol rarely coexisted without GBV among the typologies. Therefore, prevention efforts including structural interventions may be particularly warranted in vulnerable populations to address alcohol use, which may directly or indirectly impact GBV and HIV.

To determine whether college men’s perceptions of campus drinking norms, aggregated at the institution-level, predicted heavy episodic drinking and sexual violence perpetration. Participants: Data ...

The school-to-prison pipeline (STPP), a framework which describes mechanisms and pathways within the education system that drive students toward involvement in the criminal-legal system, has seen increasing attention from youth researchers, professionals, and advocates in recent years. However, the experiences of transgender individuals and trans-related policies in schools have largely been absent from explorations of the STPP. To begin addressing this gap, this study explores the relationship between anti-trans experiences in school and adverse criminal-legal system outcomes among a sample of 138 Black/African American transgender women (ages 18–65). Data were derived from a life course survey of transgender women in Atlanta and Chicago conducted between August 2014 and September 2017. Only participants who were Black/African American were included in the analytic sample (n = 138). Bivariate and logistic regression analyses were conducted to explore the relationship between education factors (high school/GED completion, anti-trans school victimization, anti-trans school expulsion/denial of enrollment, and denial of gender-appropriate facilities) and criminal-legal system factors (incarceration, anti-trans police mistreatment, and discomfort seeking police assistance). Analyses were conducted for both the full sample and youth subsample of 83 participants (age 30 or younger). Among the overall sample, logistic regression models revealed that anti-trans school expulsion/denial of enrollment was associated with a greater odds of anti-trans mistreatment by police (p = .026, OR = 5.091). Denial of gender-appropriate facilities in school was also associated with anti-trans mistreatment by police (p = .034, OR = 3.873). Among the youth subsample, anti-trans victimization in school was associated with a greater odds of incarceration (p = .021, OR = 3.717). Anti-trans school expulsion/denial of enrollment was also associated with a greater odds of incarceration (p = .046, OR = 9.460). These associations suggest that anti-trans school experiences warrant consideration as factors in the school-to-prison pipeline. Future research that traces the pathways between anti-trans school environments and outcomes in the criminal-legal system would be valuable. Policy interventions that combat anti-trans school victimization and institutional discrimination may be critical to disrupting the STPP for Black/African American transgender women.

Background Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation. Methods Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact of gender minority status, and substance use behaviors as potential mediators for the relationship between perceived stigma and suicidal ideation. All models were controlled for age, race, education, and homelessness. Results Suicidal ideation was reported by 33% (N = 30) of the study participants. In multivariable analysis, suicidal ideation was associated with sexual abuse (AOR = 3.17, 95% CI = 1.10–9.30), anxiety (AOR = 1.74, 95% CI = 1.10–2.73), family verbal abuse (AOR = 2.99, 95% CI = 1.10–8.40), stranger verbal abuse (AOR = 3.21, 95% CI = 1.02–10.08), and psychosocial impact of gender minority status (AOR = 3.42, 95% CI = 1.81–6.46). Partner support was found to be the protective factor for suicidal ideation (AOR = 0.34, 95% CI = 0.13–0.90). In the mediation analysis, the psychosocial impact of gender minority status mediated the relationship between perceived stigma and suicidal ideation. The estimated conditional indirect effect was 0.46, (95% CI = 0.12–1.11). Conclusion Interventions that aim to reduce suicidal behaviors among TGW should address stigma, psychosocial impact of gender minority status, and different forms of violence and abuse.

The purpose of this study is to examine the factors associated with intimate partner violence (IPV) among youth living in the slums of Kampala. This analysis is based on a cross-sectional study of youth living in the slums of Kampala conducted in spring 2014 ( N = 1,134). The participants (12–18 years of age) were attending Uganda Youth Development Link centers, which serve youth living on the streets and slums of Kampala. Bivariate and multivariable multinomial analyses were conducted to examine risk factors associated with IPV victimization only, IPV perpetration only, and both IPV victimization and perpetration compared with no IPV victimization or perpetration. Among youth who reported having a boyfriend or girlfriend ( n = 600), 18.3% ( n = 110) reported experiencing both IPV victimization and perpetration, 11.0% ( n = 66) reported IPV perpetration only, 7.7% ( n = 46) reported experiencing IPV victimization only, and 63.0% ( n = 378) reported no IPV experiences. In the multivariable analysis, IPV victimization only was associated with witnessing parental IPV (odds ratio [OR] = 2.78; 95% confidence interval [CI] = [1.42, 5.48]), experiencing parental physical abuse (OR = 2.27; 95% CI = [1.16, 4.46]), and neighborhood cohesiveness (OR = 0.73; 95% CI = [0.31, 1.69]). IPV perpetration was only associated with experiencing parental physical abuse (OR = 2.86; 95% CI = [1.62, 5.07]). Reporting both IPV victimization and perpetration was associated with non-problem drinking (OR = 2.03; 95% CI = [1.15, 3.57]), problem drinking (OR = 2.65; 95% CI = [1.48, 4.74]), witnessing parental IPV (OR = 2.94; 95% CI = [1.80, 4.80]), experiencing parental physical abuse (OR = 2.23; 95% CI = [1.38, 3.60]), and homelessness (OR = 1.90; 95% CI = [1.14, 3.16]). Levels of IPV victimization and perpetration are very high in this population and warrant urgent attention.

This study examined the limited efficacy of a mixed media campaign that promoted bystander intervention as a sexual violence (SV) prevention strategy and aimed to decrease alcohol use. A quasi-experimental design was used to assess the limited efficacy of the Be a Watch Dawg mixed media campaign implemented at a large Southeastern public university in 2017. Social marketing along with social cognitive theory, social norms theory, and theory of planned behavior were utilized as the framework for the campaign. Be a Watch Dawg promoted bystander intervention in SV risk situations and targeted bystanders’ alcohol use via social media (e.g., Facebook, Instagram, and Twitter) and printed materials (e.g., posters, stickers, and handbills). Participants included 244 undergraduate students 18 to 24 years of age. Study outcomes included bystander intervention, intentions to intervene, and alcohol use. Adjusted linear regression and logistic regression models were used to examine differences in outcomes between pre and postcampaign samples as well as associations with campaign exposure. Significant increases in bystander intervention were observed between the pre and postcampaign samples. Campaign exposure was marginally related to intentions to intervene but was not significantly associated with bystander intervention. Social media analytics revealed that the campaign reached 39,466 social media users and received 50,854 impressions and 19,523 views. A mixed media campaign may be a promising and low-resource approach to increase bystander intervention as a strategy to combat campus SV.

Background. The purpose of this paper is to investigate the prevalence and context of alcohol use, problem drinking and alcohol-related harm among boys and girls in the slums of Kampala, Uganda. Methods. The Kampala Youth Survey is a cross-sectional study conducted in 2014 among youth (ages 12&ndash, 18 years) living in the slums of Kampala (n = 1133) who were participating in Uganda Youth Development Link (UYDEL) centers. Chi-square tests were used to determine differences in alcohol use behaviors between 1) gender (boys vs. girls), and 2) alcohol use behaviors between problem drinkers and non-problem drinkers, stratified by gender. Results. Among all participants (n = 1133), the prevalence of any alcohol use in the past 12 months was 31% (n = 346). A higher percentage of girl drinkers reported having sex in the past month, without a condom (57.9%) due to alcohol consumption, compared to boy drinkers (41.9%) ( &nbsp, &chi, 2 = 8.09, df = 1, p = 0.005). For girl and boy drinkers, nearly half (49.5% and 44.1%, respectively) met the criteria for problem drinkers, measured using the Cut-Annoyed-Guilty-Eye-Opener (CAGE) questionnaire. Conclusions. The high prevalence of alcohol use and problem drinking among youth, as well as alcohol-related harm, warrant urgent alcohol prevention and intervention strategies, particularly among these underserved girls.

Purpose: This study tested three psychosocial measures for their potential to serve as counseling goals for promoting ART to transgender women living with HIV (TWLH). Methods: Among 69 TWLH, 17.4% were not taking ART; these volunteers were compared to the remainder using multivariate regression analyses. Results: Only one psychosocial measure achieved significance: Personal Competence (Adjusted Odds Ratio = 0.80, 95% CI = 0.67–0.97, P = 0.02). Because this was a continuous measure, assessed on a 7-point scale, the protective adjusted odds ratio of 0.80 represents a 20% reduction in the odds of not taking ART for each unit of increase in this construct. Conclusion: Findings suggest a potential counseling goal for TWLH not taking ART.

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

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

Objectives: This study examines the relationships between information motivation behavioral skills model constructs and their associations with consistent condom use and condom use problems among young Black men. Methods: The authors use baseline data collected from 702 participants in a randomized controlled trial. Analyses involved path modeling and bootstrapped standard errors to estimate associations. Results: Motivation had the largest association with consistent condom use, whereas condom application skills had the largest association with condom use problems. Conclusion: Motivation is the most important predictor of consistent condom use, whereas condom application skills are the most important predictor of condom use problems.

The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey including sociodemographic and socioeconomic factors, health and well-being, health care utilization, transgender transition-related health care, and transgender-related victimization. Sixty-five transgender women of color (37 = pre-name change group; 28 = post-name change group) completed the survey. Results indicated that the transwomen in the post-name change group were significantly older than the pre-name change group. In age-adjusted analyses, the post-name change group was significantly more likely to have a higher monthly income and stable housing than the pre-name change group. No significant differences were observed for general healthcare utilization; however, a significantly greater percentage of transwomen in the pre-name change group reported postponing medical care due to their gender identity. In addition, a significantly larger proportion of transwomen in the pre-name change group reported using non-prescribed hormones injected by friends and experiencing verbal harassment by family and friends compared to transwomen in the post-name change group. Findings suggest that legal name change may be an important structural intervention for low-income transwomen of color, providing increased socioeconomic stability and improved access to primary and transition-related health care.

This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P

This study tested the reliability of nine scales assessing psychosocial mediators of HIV-risk and protective behaviors of young minority women in New York City. Sixty-nine age-eligible women were approached during clinical sessions, 90% (n = 62) agreed to participate, and 83% (n = 57) completed a web-based survey. With one exception, scale measures were reliable. The exception was the scale assessing frequency of sexual communication with partners. This scale did not demonstrate adequate interitem reliability for Black women. Findings provide program planners with a reliable set of measures that may be useful for preintervention needs assessments of young minority women at-risk of acquiring HIV.

Background Human immunodeficiency virus (HIV) rates are high in Uganda (6.7%), and rates are especially high among at-risk groups such as youth living in the slums of Kampala, Uganda. The objective of this study was to assess the psychosocial correlates, particularly alcohol use, associated with HIV among youth living in the slums of Kampala, Uganda. Methods Analyses are based on cross-sectional survey data collected in Spring of 2014. Participants comprised a convenience sample (N = 1134) of urban service-seeking youth living on the streets or in the slums, 12–18 years of age who were participating in a Uganda Youth Development Link drop-in center (56.1% female and 43.9% male). Chi-Square Tests were used to determine differences in the proportions of alcohol use patterns between self-reported HIV-positive and HIV-negative youth. Bivariate and multivariable logistic regression were conducted to determine the associated risk factors with self-reported HIV. Institutional Review Board approvals were obtained from the Georgia State University and the Uganda National Council for Science and Technology. Results Among the total sample of youth (N = 1103), 10.5% (n = 116) reported being HIV-positive. There were statistically significant differences between HIV-positive and HIV-negative youth on ever living on the streets (χ 2 =10.14, df = 1, p = 0.002), past 12-month alcohol use (χ 2 =16.38, df = 1, p

Objectives: This study prospectively examined binge drinking's effect on prosocial bystander behavior and indicators of bystander behavior: intentions to intervene, self-efficacy to intervene, and positive outcome expectancies for intervening. Participants: College men were recruited from February to April 2010. Methods: Pre- and posttest surveys were administered as part of a randomized controlled trial (n = 743). Potential confounders were identified using Pearson product-moment correlations. Controlling for covariates, multiple linear regression was used to examine whether binge drinking was predictive of prosocial bystander behavior and indicators of bystander behavior. Results: Binge drinking was related to lower bystander behavior (p

The purpose of this analysis was to examine the associated factors of self-reported HIV/STI co-infection among youth living in the slums of Kampala. The study sample consists of a cross-sectional survey. Participants comprised a convenience sample (N = 1134) of youth living on the streets or in the slums (age 12–18). Multinomial logistic regression analyses were used to determine the association between hypothesized risk factors and levels of HIV/STI co-infection, adjusting for sociodemographic variables. Among the sample of youth who were sexually active (n = 586), 9.9% (n = 58) of youth reported HIV/STI co-infection. Among youth with HIV (13.8%), 71.6% reported a co-infection with another STI. In the multivariable analysis, youth with HIV/STI co-infection were more likely to engage in problem drinking (OR 2.55; 95% CI 1.08, 6.02) and drinking alcohol without problematic alcohol behavior (OR 3.43; 95% CI 1.60, 7.36). HIV/STI co-infection rates are high among youth living in the slums of Kampala and warrant urgent attention.

Leaf curling symptoms have been reported in sweet potato (Ipomoea batatas) plants infected with a geminivirus (1). Leaf curl disease appeared in Peru after the 1997 to 1998 El Niño, when the population and activity of whiteflies (Bemisia tabaci, B. argentifolii, and B. afer) increased. Approximately 6% of plants in farmers' commercial fields in San Ramón, Junín (September 2000) and Cañete, Lima (February 2001) showed typical leaf curling symptoms. Seventeen plants in total were collected from both places, and stem scions from those plants were graft-inoculated to I. setosa, which developed symptoms of leaf curling, interveinal chlorosis, and stunting. Total nucleic acid was obtained from infected sweet potato and I. setosa plants using cetyltrimethylammoniumbromide (CTAB) extraction, and primers PW285-3 (5′-CGT CGT TAG CAG TCT GCA GGC CTC CTC TAG-3′) and PW285-4 (5′ -AAC TGT AAA TAC GGA ACT GCA GTT CGA ATT-3′) for Sweet potato leaf curl virus (SPLCV), developed and provided by R. Valverde and C. Clark of Louisiana State University (2), were used to amplify SPLCV by polymerase chain reaction (PCR). Expected DNA fragments of ca. 900 bp (in all samples) and 2.4 kp (in some samples), characteristic of the subgenomic and genomic DNAs of SPLCV respectively, were obtained from symptomatic but not from symptomless (uninfected) plants. This 2.4-kb fragment was amplified in relatively small amounts compared to the 900-bp fragment. Presence of SPLCV was also confirmed by nucleic acid spot hybridization using a full-length clone of SPLCV-US. Fourteen of 17 plants infected with SPLCV were also infected with Sweet potato chlorotic stunt virus (determined by nitrocellulose membrane enzyme-linked immunosorbent assay serological test), which is also transmitted by whiteflies. These viruses now seem to be common in farmers' fields in San Ramón and Cañete. To our knowledge, this is the first report of SPLCV in Peru. References: (1) P. Lotrakul et al. Plant Dis. 82:1253, 1998. (2) P. Lotrakul and R. A. Valverde. Cloning of a DNA-A like genomic component of sweet potato leaf curl virus: nucleotide sequence and phylogenetic relationships. Molecular Plant Pathology On-Line ( http://www.bspp.org.uk/mppol/1999/0422lotrakul/paper.htm ), 1999.

During a 2006 survey for the presence of criniviruses in Peru, large numbers of greenhouse whitefly (Trialeurodes vaporariorum) were observed infesting strawberry (Fragaria × ananassa) fields near Huaral on the central coast of Peru. Plants exhibited a wide range of symptoms including stunting and reddening of leaves. These symptoms are characteristic of those induced by the presence of the criniviruses Beet pseudo-yellows virus (BPYV) and/or Strawberry pallidosis associated virus (SPaV) together with any of a number of different strawberry-infecting viruses (1,3). The virus complex causes older leaves to develop a red color, vein and petiole reddening, roots become stunted, and plants fail to develop. Leaf samples with varying symptoms were collected from 22 plants from 2 fields, each planted with a different cultivar. Total nucleic acid was extracted, spotted onto positively charged nylon membranes, and tested by hybridization with probes specific to the minor coat protein (CPm) gene of BPYV (2) and coat protein (CP) gene of SPaV (4). Results identified the presence of BPYV, SPaV, or both viruses in mixed infections in symptomatic strawberry, while control plants were infected with each virus individually. No signal was detected in virus-free strawberry. Secondary confirmation was obtained using probes specific to the RNA-dependent RNA polymerase (RdRp) genes of SPaV and BPYV. The SPaV probe corresponded to nucleotides 6116–6599 of SPaV RNA1 (GenBank Accession No. NC_005895), whereas the BPYV probe corresponded to nucleotides 6076–6447 of BPYV RNA1 (GenBank Accession No. NC_005209). All probes were generated by reverse-transcription polymerase chain reaction (RT-PCR) amplification using sequence-specific primers, cloning of RT-PCR products into pGEM-T Easy (Promega, Madison, WI), confirmation by sequencing, and expression as digoxygenin-labeled transcript probes (Roche, Indianapolis, IN). Field 1, containing cv. Fern Sancho, had the largest number of symptomatic and infected plants (5 of 12 BPYV, 6 of 12 SPaV, and 4 of 12 with both). Only 1 of 10 plants from field 2 containing cv. Tajo Holandesa was infected, but with both SPaV and BPYV. BPYV and SPaV are transmitted by the greenhouse whitefly (T. vaporariorum), although BPYV is transmitted much more efficiently and has a broader host range than SPaV (4). Movement of these viruses in Peru is likely a result of both propagation by runners and vector transmission. To our knowledge, this is the first report of either virus in Peru. References: R. R Martin and I. E. Tzanetakis. Plant Dis. 90:384, 2006. (2) I. E. Tzanetakis and R. R. Martin. Plant Dis. 88:223, 2004. (3) I. E. Tzanetakis et al. Plant Dis. 87:1398, 2003. (4) I. E. Tzanetakis et al. Plant Dis. 90:1343, 2006.

To assess internalized homophobia (IH) and its relationship to sexual risk behaviors and prevalence of sexually transmitted infection (STIs) in a clinic-based sample of young black men who have sex with men (YBMSM).Six hundred YBMSM completed a self-interview and provided specimens for testing. A 7-item scale assessed IH, and 19 sexual risk behaviors were assessed.In adjusted models, compared with men with less IH, those with greater IH were more likely to report: any condomless anal receptive sex (P = 0.01) and sex with women (P0.001). Alternatively, men with greater IH were less likely to: discuss acquired immune deficiency syndrome prevention with sex partners (P = 0.009), disclose their same sex sexual behavior to providers (P = 0.01), be tested for human immunodeficiency virus in the past 12 months (P = 0.04), report condomless oral sex (P = 0.049), and test RPR positive (P = 0.01).With some exceptions, IH among YBMSM attending STI clinics may influence their sexual risk behaviors; however, STI prevalence was not associated with this construct.

Women who experience gender-based violence (GBV) are at increased risk for HIV. To better understand causal mechanisms, qualitative interviews were conducted with 48 African American women, who reported recent GBV and who were recruited from areas in Atlanta, GA, deemed high risk for HIV infection. Women were tested for Chlamydia (9.4%), gonorrhea (7.5%), and trichomoniasis (28.3%). Key themes were history of abuse, stereotypical gender roles, concurrency, and social support. HIV prevention programs need to address societ al, cultural, and relational influences that play a role in men perpetrating GBV while also addressing risk and protective factors for women to engage in safer sex.

Purpose: Among black transgender women (transwomen) at high risk of HIV acquisition or already living with HIV/AIDS, the study examined whether medical or socially based gender affirming factors may contribute differentially to selected measures of resiliency, perceived stress, and a scale measure of mental health outcomes. This question has implications for clinical care and counseling of this population. Methods: Seventy-seven black transwomen were recruited to participate in a private, face-to-face structured interview. Two index measures of gender affirmation (GA) were constructed from the data. One comprised medical aspects only and the other comprised social aspects of GA. Assessed outcomes were personal competence and acceptance of self and life (resiliency), perceived stress and recent anxiety, depression, and suicide ideation (mental health). Associations between GA variables and outcomes were first assessed using bivariate level correlations. Significant bivariate associations were then tested in multivariable regression models adjusting for age and HIV status. Results: Mean age of the sample was 34.5 years. More than one-half of the sample (62.3%) indicated being HIV-infected. None of the bivariate or multivariable associations pertaining to GA medical factors were significant. Conversely, the social GA factors were significant and protective with all four outcomes. In the presence of age and HIV status, greater social GA was significantly associated with greater personal competence, acceptance of self and life, and positive mental health outcome. HIV status had an independent effect on personal competence, acceptance of self and life, with HIV-positive transwomen scoring higher on both measures. Conclusion: Among black transwomen at high risk of HIV acquisition or already HIV-infected, study findings suggest the possibility that socially based GA may play a prominent role in strengthening the resiliency and mental health of black transwomen. This same protective effect may not occur as a consequence of gender affirming body modification practices.

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

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

To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM).Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data.Compared with the reference group, human immunodeficiency virus (HIV)-infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23-2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74-2.63, P0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed.A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.

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

This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P

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

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

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

OBJECTIVES To examine the associations of homophobia, racism, and resiliency with differences in prevalent HIV infection in black and white men who have sex with men (MSM). METHODS The Involve[ment]t study is a cohort of black and white MSM aged 18-39 years in Atlanta, GA, designed to evaluate individual, dyadic, and community level factors that might explain racial disparities in HIV prevalence. Participants were recruited irrespective of HIV serostatus from community-based venues and from Internet advertisements and were tested for HIV. We assessed respondents' demographics, whether they had engaged in unprotected anal intercourse (UAI) within the past 6 months, and attitudes about perceived homophobia, perceived racism, and personal resiliency. RESULTS Compared with white MSM, black MSM were less likely to report UAI in the past 6 months [odds ratio (OR): 0.59, confidence interval (CI): 0.44 to 0.80], more likely to be HIV positive (OR: 5.05, CI: 3.52 to 7.25), and--among those HIV positive--more likely to report not being aware of their HIV infection (OR: 2.58, CI: 1.18 to 5.65). Greater perceived racism was associated with UAI in the black sample (partial odds ratio: 1.48, CI: 1.10 to 1.99). Overall, perceived homophobia, perceived racism, and resilience were not associated with prevalent HIV infection in our samples. Greater resilience was associated with less perceived homophobia in both black and white samples (Spearman r = -0.27, P < 0.001, for both). CONCLUSION Future studies of social discrimination at the institutional and network level, than at the individual level, may explain differences in HIV infection in black and white MSM.