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We examined the impact of past-year intimate partner violence (IPV) on HIV outcomes among women living with HIV (WLHIV) in Durban, South Africa. We assessed past-year IPV using the WHO Violence Against Women Questionnaire. We conducted logistic regression to assess associations between demographic variables and IPV at baseline, and between IPV at baseline and longitudinal HIV outcomes. Among 235 WLHIV, 17% reported past-year emotional, physical, or sexual IPV. At baseline, HIV-disclosure to partner was associated with 4.35-fold odds of past-year IPV (95% CI 1.17-16.10) after controlling for children, education, and harmful alcohol use. In the prospective analysis, IPV was associated with not achieving the co-primary outcome of retention in care and viral suppression in univariate (OR = 2.32, 95% CI 1.04-5.18), but not in the multivariate model. In the context of rapid treatment scale-up, the high burden of IPV among WLHIV needs to be prioritized, with an emphasis on disclosure support.

BACKGROUND: HIV partner notification services can help people living with HIV (PLHIV) to identify, locate, and inform their sexual and injecting partners who are exposed to HIV and refer them for proper and timely counseling and testing. To what extent these services were used by PLHIV and what are the related barriers and facilitators in southeast Iran are not known. So, this study aimed to explore HIV notification and its barriers and facilitators among PLHIV in Iran. METHODS: In this qualitative study, the number of 23 participants were recruited from November 2022 to February 2023 including PLHIV (N = 12), sexual partners of PLHIV (N = 5), and staff members (N = 6) of a Voluntary Counseling and Testing (VCT) center in Kerman located in the southeast of Iran. Our data collection included purposive sampling to increase variation. The content analysis was conducted using the Graneheim and Lundman approach. The analysis yielded 221 (out of 322) related codes related to HIV notification, its barriers, and its facilitators. These codes were further categorized into one main category with three categories and nine sub-categories. RESULTS: The main category was HIV notification approaches, HIV notification barriers, and facilitators. HIV notification approaches were notification through clear, and direct conversation, notification through gradual preparation and reassurance, notification due to being with PLHIV, notification through suspicious talking of the physician, and notification due to the behavior of others. Also, the barriers were classified into individual, social, and environmental, and healthcare system barriers and the facilitators were at PLHIV, healthcare staff, and community levels. Stigma was a barrier mentioned by most participants. Also, the main facilitator of HIV notification was social support, especially from the family side. CONCLUSIONS: The findings highlighted the multidimensionality of HIV notification emphasizing the importance of tailored support and education to enhance the notification process for PLHIV and their networks. Also, our results show that despite all the efforts to reduce stigma and discrimination in recent years, stigma still exists as a main obstacle to disclosing HIV status and other barriers are the product of stigma. It seems that all programs should be directed towards destigmatization.

Work shows that sexually-diverse individuals face high rates of early life adversity and in turn increased engagement in behavioral outcomes traditionally associated with adversity, such as sexual risk taking. Recent theoretical work suggests that these associations may be attributable to heightened sexual reward sensitivity among adversity-exposed women. We aimed to test these claims using a combination of self-report and EEG measures to test the relationship between early adversity, sexual reward sensitivity (both self-reported and EEG measured) and sexual risk taking in a sexually diverse sample of cis-gender women (N = 208) (Mage = 27.17, SD = 6.36). Results showed that childhood SES predicted self-reported sexual reward sensitivity which in turn predicted numbers of male and female sexual partners. In contrast we found that perceived childhood unpredictability predicted neurobiological sexual reward sensitivity as measured by EEG which in turn predicted male sexual partner number. The results presented here provide support for the notion that heightened sexual reward sensitivity may be a pathway through which early life adversity augments future sexual behavior, and underscores the importance of including greater attention to the dynamics of pleasure and reward in sexual health promotion.

Unhealthy alcohol use, which encompasses heavy episodic drinking to alcohol use disorder, has been identified as a modifiable barrier to optimal HIV care continuum outcomes. Despite the demonstrated efficacy of couples-based interventions for addressing unhealthy alcohol use, there are no existing couples-based alcohol interventions designed specifically for people living with HIV. This study presents the development and refinement of a three-session couples-based motivational intervention (ReACH2Gether) to address unhealthy alcohol use among a sample of 17 sexual minority men living with HIV and their partners living in the United States. To increase potential population reach, the intervention was delivered entirely remotely. Throughout an original and a modified version, results indicated that the ReACH2Gether intervention was acceptable and there were no reports of intimate partner violence or adverse events. Session engagement and retention were high. In pre-post-test analyses, the ReACH2Gether intervention showed trends in reducing Alcohol Use Disorder Identification Test scores and increasing relationship-promoting dynamics, such as positive support behaviors and goal congruence around alcohol use. Results support the need for continued work to evaluate the ReACH2Gether intervention.

BACKGROUND: Prior research has consistently shown that the involvement of families plays a vital role in reducing risk behaviors, such as engaging in condomless sex, and promoting HIV prevention behaviors among young Black men who have sex with men (YBMSM). With the aim of expanding the existing knowledge, this study aimed to examine the specific influence of families and other supportive adults in facilitating casual condom use, partner condom use, HIV testing, and preexposure prophylaxis (PrEP) utilization among young Black MSM. METHODS: A sample of YBMSM aged 18-29 years (N = 400) was collected online. We used a path analysis to examine the influence of family factors on PrEP stigma and PrEP use. Respondents were recruited from December 1, 2021, to January 31, 2022. We used a path analysis to examine the direct and indirect effects of family factors on PrEP use through HIV testing and encouraging condom use. RESULTS: Among BMSM, other adult support was positive and directly associated with condom use by both casual partners (β = 0.04, p

ObjectivesThis study investigates primary peer-referral engagement (PRE) strategies to assess which strategy results in engaging higher numbers of people with HIV (PWH) who are virally unsuppressed.DesignWe develop a modeling study that simulates an HIV epidemic (transmission, disease progression, and viral evolution) over 6 years using an agent-based model followed by simulating PRE strategies. We investigate two PRE strategies where referrals are based on social network strategies (SNS) or sexual partner contact tracing (SPCT).MethodsWe parameterize, calibrate, and validate our study using data from Chicago on Black sexual minority men to assess these strategies for a population with high incidence and prevalence of HIV. For each strategy, we calculate the number of PWH recruited who are undiagnosed or out-of-care (OoC) and the number of direct or indirect transmissions.ResultsSNS and SPCT identified 256.5 [95% confidence interval (CI) 234-279] and 15 (95% CI 7-27) PWH, respectively. Of these, SNS identified 159 (95% CI 142-177) PWH OoC and 32 (95% CI 21-43) PWH undiagnosed compared with 9 (95% CI 3-18) and 2 (95% CI 0-5) for SPCT. SNS identified 15.5 (95% CI 6-25) and 7.5 (95% CI 2-11) indirect and direct transmission pairs, whereas SPCT identified 6 (95% CI 0-8) and 5 (95% CI 0-8), respectively.ConclusionWith no testing constraints, SNS is the more effective strategy to identify undiagnosed and OoC PWH. Neither strategy is successful at identifying sufficient indirect or direct transmission pairs to investigate transmission networks.

Intimate partner violence is an important public health problem. Cyber dating violence (CDV) is a form of intimate partner violence perpetrated within a dating relationship via new communication technologies. This study investigated the moderating roles of hostile and benevolent sexism in the relationship between problematic pornography use and CDV perpetration. The Cyber Pornography Use Inventory, the Cyber Dating Violence Inventory, and the Ambivalent Sexism Inventory were completed by 421 Italian adolescents (M = 16.53; females = 63.7%). Results indicated that problematic pornography use was positively related to CDV perpetration. In addition, the relationship between problematic pornography use and CDV perpetration was found to be moderated by hostile sexism. In participants with low levels of hostile sexism, the relationship between problematic pornography use and CDV perpetration was not significant. Conversely, in those with high levels of hostile sexism, this relationship was stronger and significant. Benevolent sexism was not found to be a moderator in the relationship between problematic pornography use and CDV perpetration. Thus, hostile sexism could be a risk factor for the relationship between adolescents' problematic pornography use and their engagement in CDV. Conversely, low levels of hostile sexism could be a protective factor. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionLittle is known about the attitudes toward female genitals of men who are attracted to women. This is an important omission because these attitudes may influence men’s own sexual experiences; they may also influence the genital self-image of their female partners if these views are knowingly or unknowingly communicated. Therefore, we examined men’s views of women’s genitals both globally and with respect to specific aspects.Participants were 212 self-identified men who completed an online survey that included scales assessing the men’s views of female genitals, perceptions of women’s satisfaction with their own genitals, sexual experience, and genital feedback provided to female partners. All were attracted to and had sexual experience with women.On average the men’s attitudes toward female genitals were moderately positive, although they ranged from negative to very positive. The men did not rate any of 24 listed specific female genital aspects as extremely important to them. The men believed that the majority of women feel positively about their own genitals. However, a comparison with published data collected from women revealed that men’s estimates of the percentage of women who are satisfied with their genitals were lower than the percentage of women who actually report that they are satisfied with their genitals. This discrepancy was particularly large with respect to genital appearance. A path analysis revealed that men with more positive attitudes toward female genitals reported having more lifetime sexual partners and providing more frequent positive genital feedback and less frequent negative genital feedback to partners.These results suggest that although men generally have moderately positive attitudes toward female genitals, there is considerable variability among men ranging from negative to very positive. The study also provided some evidence that men’s views of female genitals may adversely affect both the men themselves and their female partners. [ABSTRACT FROM AUTHOR]

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

Based on the level of awareness of the population, an HIV/AIDS model is developed, which focused on the first 95% plan developed by UNAIDS. The threshold R0$$ {R}_0 $$ of model and the expressions of the disease‐free equilibrium and the endemic equilibrium are calculated, proving the existence of backward bifurcation. Backward bifurcation is caused by the imperfect protection rate of susceptible population due to education. Using China's actual data for parameter fitting, it is found that new HIV infections are on an upward trend. In response to this phenomenon, publicity and education, condoms, screening, and treatment of infected populations are considered as control measures. It is concluded that publicity and education is the primary strategy. This measure can not only effectively reduce the number of infected populations but also effectively increase the awareness rate of HIV‐infected populations. It is recommended to use condoms and have fewer sexual partners during sexual contact. Numerical simulation verifies that early stage publicity and education are much more important than post‐infection screening and treatment measures. [ABSTRACT FROM AUTHOR]

Our relationships are an important resource for health and well-being in times of need, often buffering the negative effects of stressful situations. Recent research has expanded on these buffering effects, exploring the role of close others in the experience of posttraumatic growth (PTG), or positive personality change that occurs after someone has experienced trauma. In the current review, we examine how much of a role partners play in PTG for individuals, summarizing the existing evidence suggesting that partners can influence the experience of PTG. Additionally, we examine which partner traits or behaviors may facilitate this growth for individuals, discussing relationship-relevant mechanisms, facilitators, and suppressors of PTG. Finally, and perhaps most importantly, we also discuss the quality of existing evidence for the influence of social relationships on PTG, how can we improve the quality of future research, and what is needed for a comprehensive examination of partner-influenced PTG. Public Significance Statement: Many are interested in the phenomenon of posttraumatic growth—the idea that surviving negative events may change people in positive ways. This review article examines the evidence we have for romantic partners' roles in posttraumatic growth. Ultimately, while the evidence we have currently is not strong enough to definitively answer questions like these, the article closes with several suggestions for improving the quality of future research on this topic. [ABSTRACT FROM AUTHOR]

The present study represents a replication and extension of Kivlighan et al.'s (2021) study, focusing on the social microcosm hypothesis, which posits that group members' interpersonal relationships, operationalized by intimate behaviors such as expressing anger or caring, inside the group, mirror their interpersonal relationships outside of the group. We examined the reciprocal associations between a group member's (e.g., actors) and the other group members' (e.g., partners) in-session and intersession intimate behaviors. The participants were 122 Italian graduate students (89.3% identifying as women) participating in eight-session interpersonal growth groups led by six experienced group therapists. Before each session group members completed the Interpersonal Relations Scale Checklist (Shadish, 1984) indicating their intersession intimate behaviors in the previous week. After each session group members completed the Interpersonal Relations Scale Checklist indicating their own in-session intimate behaviors. We used dynamic structural equation modeling to examine the reciprocal, temporal associations among group members' intersession and in-session intimate behaviors. The replication hypotheses were not confirmed. However, when partners engaged in higher than average intersession intimate behaviors in the previous week, then actors engaged in more in-session intimate behaviors in the current session. In addition, when actors and partners engaged in higher than average in-session intimate behaviors in the previous session, then actors engaged in significantly more intersession intimate behaviors in the current week. The results provide partial support for social microcosm theory, which predicts a reciprocal relationship for in-session and intersession intimate behaviors. As described above, there was a reciprocal relationship for partners' but not for actors' intimate behaviors. Public Significance Statement: We examined the reciprocal relationship between a group member's intimate behaviors and the aggregate of other group members' intimate behaviors. If the other members of the group engage in more intimate behaviors, like sharing feelings and expressing anger or caring, in their relationships outside of group during the previous week, then a group member will be more likely to engage in these intimate behaviors in the current group session. In addition, if the group member and the other members of the group learn and practice new intimate behaviors in the previous group session, then the group member will be more likely to engage in these intimate behaviors in their relationships outside of the group during the current week. [ABSTRACT FROM AUTHOR]

There is a growing focus on understanding the role of the male microbiome in fertility issues. Although research on the bacterial communities within the male reproductive system is in its initial phases, recent discoveries highlight notable variations in the microbiome's composition and abundance across distinct anatomical regions like the skin, foreskin, urethra, and coronary sulcus. To assess the relationship between male genitourinary microbiome and reproduction, we queried various databases, including MEDLINE (available via PubMed), SCOPUS, and Web of Science to obtain evidence-based data. The literature search was conducted using the following terms "gut/intestines microbiome," "genitourinary system microbiome," "microbiome and female/male infertility," "external genital tract microbiome," "internal genital tract microbiome," and "semen microbiome." Fifty-one relevant papers were analyzed, and eleven were strictly semen quality or male fertility related. The male microbiome, especially in the accessory glands like the prostate, seminal vesicles, and bulbourethral glands, has garnered significant interest because of its potential link to male fertility and reproduction. Studies have also found differences in bacterial diversity present in the testicular tissue of normozoospermic men compared to azoospermic suggesting a possible role of bacterial dysbiosis and reproduction. Correlation between the bacterial taxa in the genital microbiota of sexual partners has also been found, and sexual activity can influence the composition of the urogenital microbiota. Exploring the microbial world within the male reproductive system and its influence on fertility opens doors to developing ways to prevent, diagnose, and treat infertility. The present work emphasizes the importance of using consistent methods, conducting long-term studies, and deepening our understanding of how the reproductive tract microbiome works. This helps make research comparable, pinpoint potential interventions, and smoothly apply microbiome insights to real-world clinical practices. [ABSTRACT FROM AUTHOR]

Individuals involved with community supervision experience multi-level obstacles impacting health outcomes. This is a high-risk period for HIV acquisition due to potential reengagement in unprotected sex and/or unsafe injection drug practices. This study aimed to assess the congruence between actual and perceived HIV risk and the degree to which individual, social, and behavioral factors impact risk perception among individuals on community supervision. While all participants were clinically indicated for PrEP, most participants (81.5%) did not consider themselves at risk for HIV (69.5%) or were not sure of their risk (12.0%). Among those with no or unsure perceived risk, 94% engaged in sexual behaviors that put them at-risk of HIV. Perceived HIV risk was associated with sharing injection equipment (aPR = 1.8, 95% CI [1.02, 3.3]), identifying as a sexual minority (aPR = 2.3, 95% CI [1.3, 3.9]), and having sex with a partner living with HIV (aPR = 2.4, 95% CI [1.3, 4.3]). Having sex with a partner living with HIV was the only sexual risk behavior associated with a perceived risk of HIV. These findings indicate a substantial discrepancy between actual and perceived HIV risk, highlighting the need for targeted interventions to improve risk perception accuracy and enhance risk prevention among individuals on community supervision. [ABSTRACT FROM AUTHOR]

Human matchmaking has existed for millennia and continues to be an important means of relationship initiation. Yet little is known about the matchmaking process or the role of formal intermediaries in mate selection. To begin exploring this topic, a two-part study was conducted using proprietary data from a professional matchmaking company. Study 1 surveyed matchmakers about what makes their services unique and the criteria they use to select partners for their clients. Study 2 used data from couples to understand if matchmakers' preferences align with the characteristics their clients seek in a long-term partner. The results showed that rather than matching according to others' preferences, part of a matchmaker's work is helping their clients discover, and in some cases reassess, what they desire in a mate. These findings provide novel insight into the commercial dating industry at a time when online dating is beginning to automate many of the tasks traditionally associated with human matchmakers. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the association between evaluating a romantic partner as deviating from relationship ideals (i.e., ideal-partner discrepancy) and a widely studied form of self-regulatory behavior in romantic relationships—accommodation (i.e., inhibiting one's own destructive relationship behaviors and enacting constructive behaviors). We also consider the moderating role of relationship commitment. Two studies tested these associations using self-reports (Study 1, N = 450 individuals) and by observing accommodation behaviors in couples (Study 2, N = 116 dyads). Across both studies, a negative-ideal partner discrepancy (i.e., a partner is deemed as falling below ideals) was associated with more accommodation when relationship commitment was high than for when it was low. The findings provide novel insights into understanding accommodation behavior in romantic relationships. [ABSTRACT FROM AUTHOR]

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV. [ABSTRACT FROM AUTHOR]

Pornography use is a common sexual activity for many individuals including those in a romantic relationship. Some studies have shown that violent content depicted in pornography is a risk factor for perpetration of violence in real life. Even if most of these studies examined perpetration of violent behaviors in general, not specifically toward the intimate partner, some studies have shown that pornography use frequency is related to a greater perpetration of intimate partner violence (IPV), while other studies have found that it is not significantly related. However, most previous studies were cross-sectional, sampled individuals rather than couples, and did not include separately forms of IPV (e.g., physical, psychological, and sexual). The present study examined the associations between pornography use frequency and the perpetration of physical and psychological IPV, and sexual coercion among young adult couples. A convenience sample of 113 couples aged between 16 and 29 years old completed self-reported online questionnaires two times over a 2-year period. The results of autoregressive cross-lagged models showed that a person's pornography use frequency at Time 1 was related to their own higher sexual coercion perpetration 2 years later and that a person's sexual coercion perpetration was related to their partner's lower pornography use frequency 2 years later. However, no significant association between pornography use frequency and physical and psychological IPV emerged. In line with previous studies, our results suggest that pornography use represents an important risk factor for the perpetration of sexual coercion. Findings support the need to include education around pornography use in sexual violence prevention programs to avoid that young adults reproduce pornographic scripts in their sexuality. [ABSTRACT FROM AUTHOR]

Sport governing bodies, such as the International Olympic Committee, have recommended youth sport organizations develop policies, procedures, and/or ethical guidelines to prevent and respond to sexual harassment and abuse (SHA) experienced by young athletes. To our knowledge, no studies have investigated SHA policies or procedures in U.S. youth sport programs. The purpose of this exploratory study was to examine U.S. youth sport programs' policies regarding SHA. The results are based on a cross-sectional survey completed by youth sport coaches (n = 200) from various organizations (e.g., public recreation organizations, private nonprofit organizations, and interscholastic sports). Findings suggest that most organizations have several SHA policies, such as education and training requirements, written policies and codes of conduct regarding coach-athlete sexual relationships, and formal complaint and disclosure procedures for investigating SHA. A bivariate analysis suggests that the presence of several SHA policies was associated with an increased number of self-reported SHA incidents. Moreover, youth sport programs located in urban areas had a greater extent of SHA policies compared to those located in suburban or rural areas. These results are discussed with respect to the potential relationships between the presence of policies and increased cases of SHA. Also, we discussed advocating for equitable resources among youth sport programs regardless of geographic and/or demographic factors. Future research should identify social and cultural barriers that inhibit the successful implementation of SHA policies. While developing and implementing SHA policies is a step in the right direction, it may not be used as the only means to address this complex, systematic, and structural issue. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) is a problematic and important social phenomenon (World Health Organization [WHO], 2021) that has been repeatedly linked to attachment insecurities (Velotti et al., 2020). However, the mechanisms linking these two variables remain understudied. This study examines the direct and indirect associations between attachment insecurities (anxiety and avoidance) and perpetration of IPV (psychological, physical, sexual, coercive control) through the use of dysfunctional communication patterns (i.e., demand/demand, I demand/my partner withdraws, my partner demands/I withdraw) and lower relationship satisfaction. Methods: A sample of 613 men and non-binary people who consulted organizations providing help to individuals with relationship or IPV-related difficulties answered online questionnaires. A path analysis was conducted to test the direct and indirect associations between attachment insecurities and perpetrated IPV through communication patterns and relationship satisfaction. Results: The results showed a direct and positive association between attachment anxiety and perpetration of coercive control, and an indirect and positive association between attachment insecurities and psychological violence through the demand/demand pattern. The results also revealed an indirect and positive association between attachment anxiety and psychological violence, sexual violence, and coercive control through the I demand/my partner withdraws pattern. Finally, an indirect and positive association was observed between attachment insecurities and all types of violence studied through lower relationship satisfaction. Conclusions: This study provides key individual and relational correlates of IPV perpetration that can inform prevention and intervention among men and non-binary people. [ABSTRACT FROM AUTHOR]

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

Background: Many cisgender women in the US who have experienced incarceration are at substantial risk for HIV acquisition after they return to the community. Various network interventions have been leveraged for HIV prevention in this population. The objective of this study was to identify network and relationship determinants of influence on HIV prevention decisions, including PrEP. Methods: We conducted interviews with a network mapping exercise with participants recruited from the social and sexual networks of women who had experienced incarceration. Participants enumerated important individuals in their lives from the past six months and provided demographic and relationship data as well as whether each relationship influenced their HIV prevention decisions. We abstracted network data from the interview transcripts and described the data set using descriptive statistics and network density graphs. To measure associations between characteristics at each level and whether a relationship was considered influential regarding PrEP decision-making, we use multiple logistic regression with random intercepts for each respondent. Results: We interviewed 32 participants, average age 33.5 years (SD = 8.98), majority female (n = 28, 87.5%), white (n = 23, 71.8%), heterosexual/straight (n = 25, 78.1%), and with a personal history of incarceration (n = 29, 90%). They reported 253 relationships (119 family, 116 friend, 18 sexual relationships). Most adult network members had used drugs or alcohol (n = 182, 80.9%), and of those, 30.8% had used them with the participant (n = 53). The mean network size was 7 (SD = 4) and network density was 52.2%. In the full model, significant positive predictors of an influential relationship included participant non-heterosexual identity (OR 27.8), older average age in the network (OR 3.9 per standard deviation), and being a current or prior sexual partner (OR 10.1). Significant negative predictors included relationships with individuals who use or had used drugs (OR 0.28), longer average relationship duration in the network (OR 0.09) and being in a network with at least one sexual partner (OR 0.2). Conclusions: There are significant positive and negative determinants of relationship influence related to PrEP at individual-, dyad-, relationship-, and network-levels. These support using nuanced network approaches to behavior change that respect and leverage the diversity of relationships that comprise the social networks of women who have experienced incarceration. [ABSTRACT FROM AUTHOR]

The use of information and communication technologies (ICTs) has gained relevance since they are a tool for socialization around substance use and sex through the formation of social networks of gay men (GM). This study investigated how and why substance use is related to the use of ICT in GM. Moreover, what social and cultural dynamics characterize the use of ICTs concerning sexualized drug use in Mexican GM? In May 2022, focus groups were held in which 19 GM from Mexico participated. Different types of ICTs used by GM were identified as playing a role in online interactions around substance use and chemsex. It was found that specific platforms, such as mobile geolocation applications, favored access to sexual practices and drugs. In addition, online sexual subcultures destigmatized substance use and non‐normative sexual practices and reinforced social ties, offering caring information about sexualized drug use practices among GM. The findings contribute to understanding the health of GM from a contemporary digital context. [ABSTRACT FROM AUTHOR]

The term blesser has become part of South Africa's contemporary lexicon, replacing the older terminology of 'sugar daddy.' While much recent literature has focused on the blesser phenomenon, the voices of orphaned adolescent girls on their entanglement in blesser relationships have had insufficient attention. Using the theory of gender and power as an analytical lens, this qualitative study analyses the visual and textual data generated by orphaned adolescent girls on their relationships with blessers. To generate data, the participants used photovoice to represent their relationships with older male sexual partners in their resource-poor South African township neighbourhoods. Our analysis reveals a set of factors that render orphaned adolescent girls vulnerable to age-disparate relationships, such as the structural dimensions of their lives, including their status as orphaned girls, heteropatriarchy, age-based hierarchies, and poverty in their households and communities. On the other hand, our analysis explores the less understood area of the relative agency, intentionality, and proactive approach that orphaned girls take to initiating and negotiating blesser relationships. The findings have implications for further research that will expand our understanding of girls' agency—and the structural limits to that agency—in adverse socio-cultural circumstances. Such research holds potential for interventions that might enable orphaned girls to better advocate for themselves in the context of unequal power relations. [ABSTRACT FROM AUTHOR]

Background In Denmark, a girls-only human papillomavirus (HPV) vaccination program was initiated in 2008–2009. The study aim was to assess the HPV prevalence and type distribution in younger men prior to HPV vaccination in men. Methods The study population was younger men who attended information days regarding military service. At random days (2019–2020), 280 men were included. We collected questionnaire data regarding risk factors for HPV infection and a penile swab for HPV testing. We compared results in this study with those from a previous study of young men (2006–2007). Results The majority of participants (94%) were 18–20 years old. The median number of lifetime sexual partners was 4. Altogether, 130 men (46.4%) were HPV positive. No infections with HPV types 6, 11, 16, 18, 31, and 45 were detected. The most frequent type was HPV-51 (detected in 11.1%). Comparison showed that the odds of high-risk HPV type infection were higher in 2019–2020 (prevalence odds ratio [POR], 1.7 [95% confidence interval {CI}, 1.1–2.7]) compared with 2006–2007. In contrast, the odds were lower (POR, 0.3 [95% CI,.1–.6]) for HPV types targeted by the 9-valent HPV vaccine. Conclusions The multicohort girls-only vaccination program has to a large degree protected young men against the HPV types included in the licensed vaccines. This does not speak against gender-neutral vaccination as the HPV prevalence is still high, although consisting largely of less carcinogenic HPV types. [ABSTRACT FROM AUTHOR]

Sexualized drug use (SDU) describes use of any psychoactive substance before or during planned sexual activity to facilitate, intensify, or prolong intercourse. The impact of pain, pleasure, and other mediators on SDU is not well characterized. This study aimed to distinguish the motivations behind different classes and frequencies of substance use during receptive anal intercourse (RAI). Data were from an internet-based survey conducted between July 2022-January 2023. We measured the frequency of SDU for five substances: poppers, alcohol, marijuana, methamphetamine, and nicotine. Satisfaction with pleasurable sensations during RAI and any type of pain bother during RAI were assessed on a 5-point scale. Multivariable logistic regression was performed for 1,119 respondents. Our results showed a strong association between bothersome pain during RAI and frequent alcohol (aOR 2.1), marijuana (aOR 2.4), nicotine (aOR 3.1), and meth (aOR 5.9) use. None of the five substance classes studied was correlated with dissatisfaction with pleasure during RAI. Frequent popper use was associated with increasing lifetime RAI experience and number of sexual partners. The mechanism behind SDU during RAI is substance-specific and multifactorial. Bothersome pain during RAI is highly associated with frequent SDU. Inquiring about pain during RAI may offer avenues for intervention. [ABSTRACT FROM AUTHOR]

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

Background: The phenomenon of the māhū and raerae of French Polynesia represents a long-standing historical recognition of a third gender status that makes space for a level of respect and integration within a broader society. Raerae is a more recent type of māhū who more overtly express themselves as women in society. Aim: This article describes the gender identity, gender expression, sexual behavior, and sexual orientation of gender diverse individuals in French Polynesia, including the Society, Tuamotus, and the Marquesas Islands. By studying cultures with protective factors, this research seeks to contribute to the development of effective approaches to sexual and gender health promotion, including HIV/STI prevention. Method: Our analysis is based on ethnographic work, field observation, in depth interviews, and survey data. The focus of this study was specifically on the māhū and raerae (gender diverse individuals). Results: We collected data from ten islands in French Polynesia and included 47 participants. The results include demographics, information about self-identification, gender identity development and family and social acceptance, current gender identity, expression, early and current sexual experiences, relationships, involvement in sex work, and health status, including HIV risk and status. Conclusion: While not a utopia for gender variant individuals living in French Polynesia, this cultural recognition serves as a protective factor as compared to other cultures that greatly stigmatize transgender and gender diverse individuals or those who transgress socially defined roles for men. [ABSTRACT FROM AUTHOR]

Background: Studies have shown insufficient utilization of care for patients with erectile dysfunction (ED) after radical prostatectomy (RP). Aim: The aim of this study was to evaluate variables associated with barriers to seeking and receiving ED treatment. Methods: In this multicenter prospective cross-sectional study, the functional outcomes of 936 patients were assessed 10 to 15 years after RP. A total of 525 patients with ED or incontinence were asked about their treatment experiences or lack thereof. The data were analyzed using the chi-square test, t test, and multivariate logistic analyses. Outcomes: Patients answered validated questionnaires regarding information sources, communication with their partner and urologist, and barriers to ED treatment. Results: Of the 525 patients, 80 were not available to survey. A total of 304 patients answered the survey (response: 68.0%). A total of 246 patients had ED and were included in this study. The mean age at surgery was 64.4 ± 6.1 years, and the mean age at the time of this survey was 77.1 ± 6.2 years. The mean follow-up duration was 12.7 ± 1.5 years. Forty-six percent (n = 114 of 246) of the patients had never received ED treatment. The most important conversation partners regarding the ED were the partner (69% [n = 169 of 246]) and the urologist (48% [n = 118 of 246]). Patients who never received ED treatment were less likely to have conversations with their urologist (34% vs 60%; P <.001), had less support (51% vs 68%; P =.01), and had less interest in sex from their partner (20% vs 40%; P =.001). Communication with other groups (general practitioners, other physicians, family, friends, and the Internet) had no influence on ED treatment utilization. The most relevant barrier to receiving ED treatment was the belief that treatment would not help (65%). No interest in sex from their partner (odds ratio, 3.9) and no conversation with their urologist about ED (odds ratio, 2.9) were found to be independent predictors of not receiving ED treatment. Clinical Implications: Urologists should have enhanced awareness of how to approach patients directly about their ED and actively offer them treatment options. Strengths and Limitations: These results should be further validated in a multicenter, prospective study. Response bias may have affected the results. Furthermore, the current cohort was relatively old. Conclusion: This study revealed that no interest in sex from one's partner and insufficient communication with a urologist were relevant barriers to insufficient utilization of ED treatment after RP. [ABSTRACT FROM AUTHOR]

Background: The primary reasons for labiaplasty usually revolve around aesthetic, sexual, and functional concerns. Upon delving deeper into these issues, it becomes apparent that sexual partners play a controversial role in influencing women's decisions to undergo surgery. Aim: This study aimed to investigate the impact of sexual partners on women's choices to pursue labiaplasty. Methods: A comprehensive search was conducted across electronic databases covering the period from January 2000 to February 2024. After removing duplicates, a total of 931 articles were retrieved by searching keywords in titles and abstracts. Outcomes: The meta-analysis revealed that 36.7% of women who sought labiaplasty cited their partners' negative comments as a factor influencing their decision. Results: After applying the eligibility criteria and excluding irrelevant articles, a total of 12 articles involving 962 participants were included in the analysis. With the exception of 2 articles, the majority of the studies suggested a discernible influence of male partners on women's decisions to seek labiaplasty. Frequently, sexual partners are not the primary decision makers, nor do they exert significant pressure when it comes to seeking labiaplasty. In certain instances, women seeking labiaplasty acknowledged that their sexual partners did influence their decisions, either by making disparaging comments about their genitalia or by directly pressuring or requesting them to undergo labiaplasty. Additionally, women might opt for labiaplasty out of fear of their partner's negative remarks or to enhance sexual pleasure for their partners. For a more accurate result, a meta-analysis was conducted noting a considerable heterogeneity. Clinical Implications: The findings of this study can be applied in prelabiaplasty counseling sessions to acknowledge and explore the role of the sexual partner in women's decision making. Strengths and Limitations: This study stands as the inaugural systematic review examining the impact of sexual partners on women seeking labiaplasty, encompassing all original studies exploring the role of the sexual partner. However, a notable limitation lies in the varied interpretations of the sexual partner's role, that the heterogeneous nature of these interpretations poses a challenge to providing a more precise answer through meta-analysis. Conclusion: Based on the findings of this systematic review, it is evident that sexual partners exert multifaceted influences on women's decisions to seek labiaplasty. While not serving as the primary decision makers, women opt for labiaplasty with the aim of enhancing attractiveness in sexual relationships and mitigating potential negative comments from their partners. [ABSTRACT FROM AUTHOR]

Background: Currently in Australia, men are deferred from donating blood if they have had sex with another man within the past 3 months. However, a proposed gender‐neutral assessment (GNA) process will ask all donors questions about sex with new or multiple recent partners, with deferral based on responses to a question about anal sex. Understanding the acceptability of such questions among existing and potential blood donors is paramount for successful implementation of GNA. Study Design and Methods: We used data from a nationally representative survey to estimate the levels of comfort with the proposed GNA questions among the Australian population and subgroups, defined by self‐reported ethnicity and religion. Respondents were aged over 18 and living in Australia. Results were weighted to represent the population. Results: Most of the 5178 respondents described themselves as comfortable with answering questions about new partners (73.1%) or anal sex (64.0%) to donate blood. However, 2.2% and 4.5% indicated that questions about new sex partners and anal sex, respectively, would stop them from donating, and 4.4% and 7.7% respectively, said they were "completely uncomfortable." By religion, the least comfortable were Muslim or Eastern Orthodox respondents, and by country of birth, the least comfortable were those born in the Middle East, followed by those born in Southern Europe and Asia. Discussion: GNA appears to be broadly acceptable in the Australian context, but our findings suggest that key GNA questions are less acceptable in some population subgroups, indicating a need for targeted campaigns that consider cultural sensitivities. [ABSTRACT FROM AUTHOR]

This case study focuses on the therapeutic change process, highlighting the crucial role of therapists in facilitating it. Rooted in constructivist epistemology, we employed an integrative systemic model. Our exploration centers on the presence or absence of system restructuring within the therapeutic process. We delve into the differing perceptions of change between the therapist and the client, particularly regarding the criteria for therapy discharge. A significant aspect of our analysis is the discussion on the authenticity of change. We examine the dual role of therapists as expert observers and participants in the therapy, navigating between "objective" and subjective perspectives in their interventions. This includes assessing various levels of change, first and second order. We highlight the client's autonomy in defining the reality and authenticity of change, advocating for a balance between the therapist's guidance and the client's agency. Additionally, we emphasize the therapist's need for self-reflection and adherence to ethical practices. Our study contributes to systemic therapy literature by demonstrating the effective application of an integrative approach. It reinforces the importance of collaboration in therapeutic change, offering insights into how therapists can navigate complex therapeutic dynamics. [ABSTRACT FROM AUTHOR]

We aimed to explore the sexual health of young adults with perinatally acquired human immunodeficiency virus (PHIV). Eighteen to 25 years old PHIV participants were recruited in two tertiary care units in Paris. Sexually transmitted HIV was an exclusion criterion. Individual interviews were conducted. Transcripts were analyzed using a semio-pragmatic phenomenological method. Twenty-five participants were interviewed from March 2022 to September 2022. Some of them renounced being in any romantic relationship. Those who disclosed their HIV status to their romantic partner reported that dating was more complex and those who did not disclose reported that keeping HIV a secret was a significant mental burden. Young men tended to disclose their HIV status to their romantic partner whereas young women did not consider doing so before marriage. Many participants had to educate themselves about sexuality, through school or websites. Identified interlocutors for sexuality varied across participants. All participants were aware of U = U (Undetectable = Untransmittable) slogan. Despite that, participants remained worried about transmitting HIV to their sexual partners. That hindered their sexual satisfaction. In addition, they neglected the risk of unwanted pregnancies or sexually transmitted diseases (STDs). In our study, knowing the U = U slogan did not provide reassurance to PHIV participants regarding the risk of onward HIV transmission. Further, they showed very little concern for protecting themselves from their partner's STD. [ABSTRACT FROM AUTHOR]

Background: Positive health behaviors (e.g., exercise, healthy eating habits, good sleep hygiene, treatment adherence) are important in ensuring optimal symptom management and health outcomes among individuals living with Parkinson's disease (PD). While multiple factors may influence engagement in health behaviors, little is known about the occurrence of social control, or relationship partners' attempts to influence and regulate another's behavior, and its potential role in the adoption of health behaviors among individuals with PD. Methods: To better understand the types of social control attempts employed and begin to explore the association between social control attempts and behavioral responses (e.g., engage in the targeted health behavior, hide the behavior) to those attempts, survey data were drawn from a cross-sectional, pilot study of married/partnered Veterans diagnosed with idiopathic PD (n = 25). Participants completed self-reported measures of sociodemographics, physical and mental well-being, relationship functioning, and both the frequency of and behavioral responses to positive and negative social control attempts. Results: Although the majority of individuals reported their partners engaged in positive social control attempts, half also reported negative attempts. Bivariate analyses revealed more frequent positive social control attempts from one's partner were related to both positive and negative behavioral responses, and negative social control attempts were related to negative behavioral responses. However, when adjusting for covariates, positive social control attempts were related to positive behavioral responses, while negative social exchanges with one's partner (e.g., general conflict), rather than exposure to negative social control attempts, were related to negative behavioral responses. Conclusions: Findings lend preliminary evidence of the relationship between social control and exchanges and health behavior that may inform future, adequately powered observational and intervention studies that target interpersonal processes and health behaviors among individuals living with PD and their relationship partners. [ABSTRACT FROM AUTHOR]

Within romantic relationships, secret-keeping has been related to negative outcomes whereas self-disclosure has been related to positive outcomes. Exploring young adult women's pornography use disclosures to their romantic partners can provide further avenues for understanding aspects of sexual and relational health. Using an open-ended survey informed by the Revelation Risk Model (RRM), this study explored young adult women's reasons and perceived relational outcomes of disclosing their pornography use to their romantic partners. Data from 32 young adult women (M = 20.8 years old), were thematically analyzed. Women in our sample reported disclosing for three main reasons: disclosed to be close, disclosed because we are intimate, and speaking our minds. They also reported that their disclosures resulted in emotional, sexual, or no relational changes. Further, we found that women who engaged in more in-depth conversations following their pornography disclosures perceived there to be more positive relational changes in comparison to women who had surface-level conversations following their pornography disclosures. [ABSTRACT FROM AUTHOR]

Gaslighting, a form of psychological abuse, has received increasing attention in recent years. The current research provides reliability and validity evidence for a new 11-item measure of exposure to gaslighting by a romantic partner: The Gaslighting Relationship Exposure Inventory (GREI). Two studies were conducted with Israeli (N = 509) and American (N = 395) community samples. Participants were involved in a romantic relationship and completed an online questionnaire that included measures of intimate partner violence (IPV) victimization, depression, and relationship satisfaction. In both studies, the GREI items loaded onto a single factor of relationship gaslighting exposure. The scale demonstrated metric gender invariance and was reliable in both men and women. Relationship gaslighting exposure was strongly linked with psychological abuse victimization and weakly linked with other forms of IPV victimization, thus showing strong convergent and discriminant validity. Moreover, relationship gaslighting exposure was associated with greater depression and lower relationship quality, above and beyond other forms of IPV victimization. The results support the reliability and validity of the GREI in both men and women, as well as its utility for the study of gaslighting exposure within relationships. The current research highlights that gaslighting is a distinct form of psychological abuse with unique implications for personal and relational well-being. [ABSTRACT FROM AUTHOR]

The ability to form strong relationships is viewed as central to mental health recovery. Few studies have explored the experiences of people with mental health problems in forming or maintaining romantic relationships. Our study addressed this gap through conducting focus groups with ten people with mental health problems, six carers and six professionals. All three participant groups considered romantic relationships to be important aspects of wellbeing and lamented this gap in the lives of people with mental health problems. Service users and carers perceived the physicality and outward trappings of 'being mentally ill,' including treatment side effects and unemployment to impact negatively on romantic relationships. Service users reported self and societal stigma as a major barrier to relationships. Carers and professionals focused on vulnerability and risks. Professionals stated that they rarely supported people with mental health problems with their romantic relationships and were uneasy about discussing sexual intimacy. Points of interest: This research used focus groups with people with mental health problems, family carers and mental health professionals. It explored how people with mental health problems experience romantic relationships and what support they might need. People with mental health problems said that they struggled to form and maintain romantic relationships. This was due to mental health symptoms, medication side-effects, stigma, a lack of confidence and worries about telling others about their mental health problems. Carers felt that romantic relationships were valuable but worried about their relatives being vulnerable or the relationship being stressful. They felt support should be provided by existing mental health services. Mental health professionals reported that they rarely provided support around romantic relationships. They were also reluctant to discuss sexual intimacy with the people they were working with. The study shows the need for staff training to enable better support in this area. [ABSTRACT FROM AUTHOR]

This study examined the potential mediating roles of relationship satisfaction and dual-career lifestyle satisfaction in the association between investments and commitment to a relationship. The participants comprise 213 Turkish dual-career married couples (N = 426) between the ages of 19–60, who have been married for at least seven months. Two models were proposed, and the Actor-Partner Interdependence Mediation Model (APIMeM) was conducted to test these models. The results revealed that the associations of both past and planned intangible investments to commitment were partially mediated through relationship satisfaction for both wives and husbands. This study provided support for the dyadic nature of the association between intangible investments and commitment via relationship satisfaction in Turkish dual-career married couples and discussed the findings in relation to the relevant literature. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of sexual partners' HIV serostatus awareness on the HIV acquisition among men who have sex with men (MSM) in Guangzhou, China. A nested case–control study was conducted based on a prospective cohort of MSM in Guangzhou. Within the cohort, individuals who underwent HIV seroconversion were identified as the case group, and each case was matched with four controls from the non-seroconverted participants. Information regarding the awareness of sexual partners' HIV serostatus over the preceding 6 months was gathered. Of the 161 participants, 36.0% were aware of the HIV serostatus of all their sexual partners. The practice of engaging in condomless anal sex with partners of unknown HIV serostatus and being aware of the HIV serostatus of only some casual partners were positively correlated with an elevated risk of acquiring HIV. Conversely, being fully aware of the HIV serostatus of all sexual partners, including regular ones, was associated with a diminished risk of HIV incidence. Regular communication with sexual partners regarding HIV testing outcomes, honest disclosure of one's own HIV serostatus, and refusal of sexual contact with partners of unknown HIV serostatus can potentially mitigate the risk of acquiring HIV among MSM. [ABSTRACT FROM AUTHOR]

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

The disclosure of HIV status poses challenges, and women living with HIV often face intimate partner violence as a result of revealing their HIV status. This study aims to investigate the prevalence of intimate partner violence and HIV status disclosure among women living with HIV in Indonesia, as well as the factors associated with disclosure. A total of 283 women with HIV participated in an online survey, and descriptive and logistic regression analyses were performed. The findings revealed that women reported experiencing physical (9.54%), sexual (6.01%), mental (23.67%), and economic (14.49%) abuse. HIV status disclosure varied among different individuals, with higher rates observed for partners (71.2%), other family members (65.02%), close friends (37.10%), and lower rates for health workers (1.77%). Factors such as employment status and partner's HIV status influenced disclosure to partners, while the duration of knowing one's HIV status, experiences of intimate partner violence, and perceived barriers influenced disclosure to both family and non-family members. To mitigate the negative consequences of HIV status disclosure, targeted health promotion efforts should prioritize partners, family members, and non-family members, focusing on enhancing knowledge and awareness about HIV, including the impact of violence. [ABSTRACT FROM AUTHOR]

Background. Mouthwash is a commonly used product with the potential to prevent STIs. This study aimed to determine the association between mouthwash use frequency with sexual behaviours and STIs among Chinese men who have sex with men (MSM). Methods. A cross-sectional study was conducted among MSM in Xi'an, China, from January to September 2022. Participants were categorised into non-mouthwash users, occasional (used it less than once every week) and frequent (used it more than once every week) mouthwash users. Multinomial logistic regression was performed to identify the association between mouthwash use frequency with sexual behaviours. Results. Of 838 MSM included in the analysis, 621 (74.11%) reported never using mouthwash, whereas 47 (5.60%) used it occasionally and 170 (20.29%) used it frequently. Frequent mouthwash users had a lower prevalence of chlamydia compared with occasional users (8.33% vs 23.93%, P < 0.05). In comparison with participants who consistently used condoms, those who used condoms occasionally and never used condoms were 1.8 (adjusted odds ratio (aOR) 1.838, 95% confidence interval (CI) 1.011-3.375) and 4.5 (aOR 4.538, 95% CI 1.259-16.362) times more likely to be frequent mouthwash users, respectively. Participants with more sexual partners who engaged in kissing (aOR 1.060, 95% CI 1.019-1.103), receptive oral sex (aOR 1.065, 95% CI 1.024-1.108), insertive oral sex (aOR 1.043, 95% CI 1.014-1.072) and receptive anal sex (aOR 1.076, 95% CI 1.027-1.127) were more likely to be frequent mouthwash users. Conclusion. MSM with more sexual partners or lower condom use frequency were more likely to be frequent mouthwash users. However, frequent mouthwash users had a lower chlamydia prevalence. [ABSTRACT FROM AUTHOR]

Background. The patterns of sexually transmitted infections (STIs) in populations may be influenced by the sexual mixing within the population. We aimed to investigate the assortative sexual mixing pattern by bisexuality in male-male partnerships. Methods. This was a retrospective repeated crosssectional study of men with mostly regular male partners attending the Melbourne Sexual Health Centre between 2011 and 2019. Data on sexual practices, including their sexual practices, presence of other male/female sex partners and the gender of sexual partners in the previous 3 and 12 months, were collected using computer-assisted self-interview. We calculated the proportion of male partnerships where at least one man in the partnership reported a female sex partner. Results. A total of 2056 male-male partnerships (i.e. 4112 individuals) with a median age of 29 years (IQR 25 to 35) were included. Overall, in 94.4% (1941/2056) of male-male partnerships both men had male partners only; however, in 5.5% (113/2056) of partnerships, one man had both male and female partners, and in 0.1% (2/2056) partnerships, both men had both male and female partners. No assortative relationship was found on the sexual mixing by bisexuality in male-male partnerships due to the low assortativity coefficient (r = 0.006, 95% CI: -0.004 to 0.016). Conclusion. One in 20male-male partnerships had at least one man who had both male and female partners within the preceding year. Individuals were not selective by bisexuality, suggesting that partnerships of bisexual individuals are mixed proportionately to the distribution of their characteristics. Still, these sexual mixing practices may affect STI transmission dynamics. [ABSTRACT FROM AUTHOR]

Bagwell-Gray et al. developed a taxonomy of intimate partner sexual violence (IPSV) focusing on type of force (physical or nonphysical) and type of sexual activity (penetration or no penetration). The current secondary descriptive qualitative analysis of interviews with 89 Canadian women IPV victims assessed IPSV that fit Bagwell-Gray's taxonomy. About half (46 or 51.7%) described sexual violence, most commonly sexual abuse (26 or 29.2%), sexual assaults (17 or 19%), and sexual coercion (16 or 17.9%), with overlap across categories. Forced sexual activity was seldom mentioned (3 or 3.4%). Implications for service providers and researchers are provided. [ABSTRACT FROM AUTHOR]

We contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger. [ABSTRACT FROM AUTHOR]

Background: Assisted partner services (APS) is a recommended public health approach to promote HIV testing for sexual partners of individuals diagnosed with HIV. We evaluated the cost and cost-effectiveness of integrating oral HIV self-testing (HIVST) into existing APS programs. Methods: Within the APS-HIVST study conducted in western Kenya (2021–2022), we conducted micro-costing, time-and-motion, and provider surveys to determine incremental HIVST distribution cost (2022 USD). Using a decision tree model, we estimated the incremental cost per new diagnosis (ICND) for HIVST incorporated into APS, compared to APS with provider-delivered testing only. Scenario, parameter and probabilistic sensitivity analyses were conducted to explore influential assumptions. Results: The cost per HIVST distributed within APS was USD 8.97, largest component costs were testing supplies (38%) and personnel (30%). Under conditions of a facility-based testing uptake of <91%, or HIVST utilization rates of <27%, HIVST integration into APS is potentially cost-effective. At a willing-to-pay threshold of USD 1000, the net monetary benefit was sensitive to the effectiveness of HIVST in increasing testing rates, phone call rates, HIVST sensitivity, HIV prevalence, cost of HIVST, space allocation at facilities, and personnel time during facility-based testing. In a best-case scenario, the HIVST option was cheaper by USD 3037 and diagnosed 11 more cases (ICND = 265.82). Conclusions: Implementers and policy makers should ensure that HIVST programs are implemented under conditions that guarantee efficiency by focusing on facilities with low uptake for provider-delivered facility-based testing, while deliberately targeting HIVST utilization among the few likely to benefit from remote testing. Additional measures should focus on minimizing costs relating to personnel and testing supplies. [ABSTRACT FROM AUTHOR]

Black and African American men who have sex with men (Black MSM) experience the greatest proportion of new HIV infections in the United States. To address this challenge, a better understanding of the HIV environment riskscape including both risk and resilience factors is warranted among Black MSM. Research indicates that stress is associated with increased HIV sexual risk behaviors. Further, behavioral factors such as serosorting and community level factors including social support and community connection are resilience factors that protect against risk behaviors. The present study examines whether everyday stress is associated with HIV sexual risk behavior, as well as the role of risk and resilience factors among 125 Black MSM recruited in the Real Talk study. The Real Talk project examined the relationships between resilience, HIV risk behaviors, and HIV prevention strategy among a sample of Black MSM. Using generalized estimating equations, our results indicate a positive association between everyday stress and engaging in condomless anal intercourse only after adjusting for risk, resilience, and correlate variables. Similarly, having multiple sex partners and using substances during sex also show positive associations with condomless anal intercourse. Resilience factors of engaging in serosorting and being connected to both the Black and gay communities were negatively associated with condomless anal intercourse. Future prevention research and programming should focus on both risk and resilience factors to mitigate new HIV infections among Black MSM. [ABSTRACT FROM AUTHOR]

Background: Traditional and new media use links to young people's sexual risk behaviour. The social contexts of young people's daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people's sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa. Methods: Age-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15–24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people's sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections. Results: Socio-contextual factors attenuated the association between media use and young people's sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40–2.56), p <.001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26–2.15), p <.001)]. Young people in Angola (aOR = 0.68 (0.56–0.83), p <.001), Cameroon [(aOR = 0.66 (0.51–0.84), p <.001)], Nigeria [(aOR = 0.72 (0.56–0.93), p =.01)], and South Africa [(aOR = 0.69 (0.49–0.98), p =.03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29–0.70), p <.001). Traditional media use was significantly associated with transactional sex in many countries. Conclusions: Media use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural–urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media. Plain language summary: In addition to television, radio, magazines, and newspapers, young people in Sub-Saharan Africa are increasingly using their phones and the Internet to connect with their peers. However, these media sources can lead to sexual risk behaviour because of access to inappropriate and inaccurate information. Social environmental factors in Sub-Saharan Africa, such as gender, place of residence, and socio-economic status influence young people's access to and use of these media sources. However, many studies that consider the influence of these social factors on the use of media among young people evaluate each of them and fail to consider that these social forces jointly influence young people's access to the internet, and ability to own phones, watch television, or read newspapers. Our study considered these combined social factors and their influence on the link between the use of media and sexual risk behaviour among young people. We found that considering these social environmental factors reduced the association between media use and young people's sexual risk behaviour but those who did not have access to these media sources were more likely to use unreliable methods to prevent pregnancy or sexually transmitted diseases. Those who listened to the radio, or read newspapers and magazines were more likely to give or receive cash or other gifts in exchange for sex. In contrast, young people who never owned phones or lacked access to the internet were less likely to have had multiple sexual partners. Our findings stress the need to consider social contexts and media use in promoting young people's sexual health. [ABSTRACT FROM AUTHOR]

Background: Apart from HIV acquisition, men who have sex with men are at a higher risk of sexually transmitted infections, especially syphilis. Although the intersection between syphilis and HIV poses a formidable challenge among key populations who are known to be vulnerable to many health threats, there is little known about syphilis infection among MSM living with HIV in Ghana. This study seeks to investigate the burden of syphilis and address the existing knowledge gap by exploring behavioral, healthcare access, and structural factors influencing the syphilis burden within the HIV-positive MSM population. Method: This study was conducted in 2023 as part of the bio-behavioral survey (BBS) among men who have sex with men (MSM) in Ghana. A cross-sectional survey that used a respondent-driven sampling (RDS) approach was conducted in the old ten regions of Ghana. Data was collected on 3,420 participants, however, 857 HIV-positive MSM were included in this study since it focused on syphilis among HIV-positive MSM in Ghana. The study estimated the prevalence of syphilis among MSM living with HIV and provided a 95% confidence interval across different categories of explanatory variables. Bivariate and multivariable logistic regression models were used to identify factors associated with overall syphilis prevalence. All other analyses were weighted due to the complex design of the study. Results: The overall prevalence of syphilis was 23.83% (95% CI: 20.44, 27.58). HIV-positive men who only had sex with men had a 29.77% (95% CI: 23.90, 36.40) prevalence of syphilis compared to a prevalence of 9.50% (95% CI: 2.56, 29.53) recorded by HIV-positive MSM who were attracted to mostly females. Participants who ever had receptive anal sex recorded a higher prevalence 26.79% (95% CI: 22.78, 31.23) than those who never had receptive anal sex 12.86% (95% CI: 8.02, 19.99). The odds of syphilis among HIV-positive MSM who never used condoms with regular sex partners in the last 6 months were 41.08 (aOR: 41.08 at 95% CI 1.24–136.42; p = 0.038). Conclusion: There is a high prevalence of syphilis among HIV-positive men who have sex with men in Ghana, especially among those who engage in unprotected anal sex and have multiple sexual partners. Our findings underscore the dire need for targeted interventions to address the dual brunt of HIV and syphilis among the MSM population in Ghana. [ABSTRACT FROM AUTHOR]

Sexting has emerged as a prevalent avenue for individuals to express their sexuality and desires. To explore the diverse motivations to engage in sexting a comprehensive review of existing literature and analysis of survey data from 109 individuals from the United States (collected online 2019, mean age of 29.0 years, 56% identified as female) we employ Latent Profile Analysis (LPA) to identify distinct profiles of sexting motivations. Three primary profiles emerge: those who sext primarily for sexual purposes, individuals who sext to alleviate relational anxiety and those engaging in sexting for ulterior motives such as body image reinforcement or instrumental/aggressive reasons. Notably, each profile exhibits unique patterns of attachment styles and motivations for engaging in sexting behaviours. While the largest number of participants sext to initiate sexual encounters with their partner(s) (n = 44, 40.4%), a significant subset sexts as a coping mechanism for relational insecurities (n = 34, 31.2%) or with manipulative intentions (n = 31, 28.4%). These findings underscore the complexity of sexting behaviours and highlight the need for tailored interventions and awareness campaigns to promote healthy sexual communication and relationship dynamics. Understanding these diverse motivations is crucial for clinicians, educators and policymakers aiming to address the multifaceted implications of sexting in contemporary society. [ABSTRACT FROM AUTHOR]