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Sexual risk behaviors among Muslim girls differ from those of others due to their unique cultural and lifestyle factors, including early marriages, high rates of young motherhood, some sexually transmitted diseases, and limited educational opportunities. This quasi-experimental study aimed to test the effectiveness of the Sexual Risk Behaviors Prevention Program on self-efficacy for safe sexual behaviors and sexually intimate behaviors in early adolescent Thai Muslim girls. Forty-eight girls in grades 4-6 were recruited, and their mothers or legal guardians were involved in the program. The participants were randomly assigned to an experimental group (n = 23) receiving the program and a control group (n = 24) receiving only routine sex education. Data were collected from June to November 2023 using the Self-efficacy for Safe Sexual Behaviors Questionnaire and the Adolescent Sexual Activity Index. Data were analyzed using independent t-test and one-way repeated measures ANOVA. The results indicated that the mean self-efficacy score in the experimental group was higher than that of the control group at immediate, 12-, and 24-week follow-ups. Sexually intimate behaviors in the experimental group were lower than in the control group at 12 and 24 weeks. The results indicated that this program is useful for preventing sexual risk behaviors in early adolescent Thai Muslim girls. It could be applied to encourage Thai Muslim girls to be safe from sexual risk behaviors. However, further testing in various settings with other samples is needed before it can be widely used. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk). Methods: We followed 2,332 Bahamian adolescents every six months from Grades 10–12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls. Results: We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents' sexual risk behavior. Conclusion: Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes. [ABSTRACT FROM AUTHOR]

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

Background: Combining pathogen reduction technology (PRT) with blood screening may alleviate concerns over the risk of transfusion‐transmitted infections (TTI) and support changes in blood donor selection to potentially increase blood availability. This study aimed to estimate the residual risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) transfusion‐transmission in Canada after implementing PRT, while eliminating deferrals for sexual risk behaviors. Study Design and Methods: A probabilistic approach that combined Bayesian networks with Monte Carlo simulations was used to estimate the risk of transfusing HIV‐, HBV‐, or HCV‐contaminated blood components. Different scenarios were considered to compare the current residual risk after PRT implementation, with and without donor deferral criteria for sexual risk behaviors. Donor profiles and blood component outcomes were simulated based on a literature review including the prevalence and incidence of HIV, HBV, and HCV in the Canadian blood donor population; the use of current blood screening assays; and HIV, HBV, and HCV blood donor viral loads. Results: In the universal PRT scenario (i.e., with PRT/without deferral criteria), the estimated risks of HIV, HBV, and HCV transmission were significantly lower than those in the currently observed scenario (i.e., without PRT/with deferral criteria). Conclusions: This risk model suggests that PRT for platelets and plasma (and eventually for RBCs when available) significantly reduces the residual risks of HIV, HBV and HCV transfusion‐transmission and could enable the removal of blood donor deferral criteria for sexual risk behaviors. [ABSTRACT FROM AUTHOR]

Introduction: The United States has the highest teen pregnancy rate and sexually transmitted infection rates among developed countries. One common approach that has been implemented to reduce these rates is abstinence‐only‐until‐marriage programs that advocate for delaying sexual intercourse until marriage. These programs focus on changing adolescents' beliefs toward abstinence until marriage; however, it is unclear whether adolescents' beliefs about abstinence predict their sexual behavior, including sexual risk behavior (SRB). An alternative approach may be encouraging youth to delay their sexual debut until they reach the age of maturity, but not necessarily until marriage. Methods: To address this question, we compare the longitudinal association between abstinence beliefs (i.e., abstaining completely until marriage) and beliefs about delayed sexual debut with subsequent SRB 24 months later. The harmonized data set included 4620 (58.2% female, Mage = 13.0, SDage = 0.93) participants from three randomized controlled trials attending 44 schools in the southern United States. Negative binomial regressions were employed to examine the association of abstinence until marriage beliefs and beliefs regarding delaying sex with SRB. Results: We identified that beliefs supporting delaying sex until an age of maturity were associated with lower odds of engaging in SRB, such as having multiple sex partners and frequency of condomless sex, for both sexes. However, stronger abstinence beliefs had no significant associations with all SRB outcomes. Conclusions: Findings suggest prevention programming that focuses on encouraging youth to delay sex until an appropriate age of maturity may be more effective at preventing SRB and consequent negative sexual health outcomes. [ABSTRACT FROM AUTHOR]

Background: Family functioning is associated with adolescent drug use, alcohol use, cigarette use, and sexual risk behaviors. Assessing adolescents for family functioning, commonly associated with multiple risk behaviors, may help identify adolescents at risk for adverse health outcomes. This study examined whether a latent family functioning construct, encompassing multiple dimensions of family functioning, was associated with adolescents' substance use and sexual risk behaviors. Method: This study used data harmonization with three intervention trials, including data from 1451 adolescents (M = 13.6, SD = 1.0), to perform a full-information item bifactor analysis on 46 family functioning items from five pre-existing family functioning measures. Regression analysis was used to examine the association between the identified subset of items and the following outcomes: cigarette use, alcohol use, drug use, and condom use. Results: Bifactor analysis identified a 26-item latent family functioning construct. Regression analysis indicated that a 26-item latent family functioning construct was associated negatively with lifetime and past 90-day cigarette use, alcohol use, and drug use. Conclusion: In sum, the multi-dimensional latent family functioning construct may target specific barriers to risk screening in adolescent populations, including time constraint, hesitancy in discussing sensitive health topics, and use culturally appropriate and age-appropriate assessments. [ABSTRACT FROM AUTHOR]

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Background Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk).Methods We followed 2,332 Bahamian adolescents every six months from Grades 10–12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls.Results We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents’ sexual risk behavior.Conclusion Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes.

Little is known about the implications of cannabis legalization on adolescent health behaviors. This study sought to examine the relationship between recreational cannabis legalization and adolescent sexual risk behaviors. Data on 371,487 respondents who have ever had sexual intercourse from 41 states in the 2005 to 2019 Youth Risk Behavior Survey was linked with data on state-level cannabis policies. Difference-in-differences logistic regression models were conducted. Recreational cannabis legalization was associated with a reduced likelihood of respondents having 2+ sexual partners (adjusted OR [aOR] 0.63, 95% CI [0.47, 0.84]), but had no association with condom use (aOR 0.94, 95% CI [0.80, 1.11]). Changing social norms around cannabis is a potential pathway linking cannabis legalization to a reduction in sexual risk behaviors. [ABSTRACT FROM AUTHOR]

HIV-related stigma is a primary barrier to seeking HIV care. Online social media interventions utilizing peer-led approaches provide an opportunity to revolutionize HIV health behavior change. Secondary analysis of the UCLA HOPE Study (6 waves) was done to examine the effectiveness of an online peer-led intervention in reducing HIV-related internalized stigma (IS), association between IS and sexual risk behaviors (SRB), and associated costs for changing the likelihood of HIV testing. Among 897 participants, an inverse relationship between IS (Discomfort with people with HIV, Stereotypes, Moral Judgment) and SRB (Number of Sexual Partners, Sexual Encounters) factors was identified over time (p <.05). Engagement in stigma conversations increased participant likelihood to request HIV tests (B = 0.02, Wald = 8.10, p =.004) when made in group versus one-on-one contact. Innovative technology has potential to improve HIV-care efforts through expanded reach to at-risk populations, improved communication maintenance, ease of accessibility, and user anonymity. [ABSTRACT FROM AUTHOR]

The present study investigated the moderating effect of adolescent demographic variables in the longitudinal associations among different types of sexting, mental health (i.e., depression, self-harm, subjective health complaints), and sexual risk behaviors. There were 1113 adolescents (ages 14–17 years; Mage = 16.36; SDage =.81; 50% female) from six high schools located in the United States included in this study. Adolescents completed questionnaires on their sexting behaviors, mental health, and sexual risk behaviors during the ninth grade; in tenth grade, they completed questionnaires on mental health and sexual risk behaviors. Non-consensual sexting and pressured sexting were both related positively to each of the mental health variables and sexual risk behaviors. The relationship between non-consensual sexting and depressive symptoms was stronger for girls, ethnic minorities, those adolescents with disabilities, and sexual minorities. Similar patterns were found for pressured sexting, non-suicidal self-harm, and subjective health complaints. The relationships between pressured sexting and sexual risk behaviors were stronger for girls, ethnic minorities, those adolescents with disabilities, and those who identified as sexual minorities. Research focused on the relationships among different types of sexting, mental health, and sexual risk behaviors is important as such research facilitates the development of evidence-based recommendations for sexting harm prevention and sexual education programs. [ABSTRACT FROM AUTHOR]

Our study, examining the Global School-Based Student Health Survey data from 50 countries across four WHO regions, found boys have higher sexual exposure (33.5 vs 17.7%) and risk behaviors – early sexual initiation (55.0 vs. 40.1%), multiple partners (45.2 vs. 26.2%), and condom nonuse (29.2 vs. 26.8%) – than girls. We found that adolescents with parents who understood their problems, monitored academic and leisure-time activities, and respected privacy were less likely to be engaged in sexual activities and risk behaviors. This study highlights the importance of parental involvement and advocates for gender-specific, family-focused interventions to mitigate adolescent sexual risks. [ABSTRACT FROM AUTHOR]

Considering the high levels of female genital mutilation (FGM) in Sierra Leone with over 83% of girls and young women aged 15–24 years having undergone the practice, the study explores the potential influence of FGM on sexual behaviors of adolescent girls and young women (AGYW) in Sierra Leone. Cross-sectional data from the 2019 Demographic Health Survey were utilized to examine the association between FGM and three sexual behaviors; sexual debut before 18 years, child marriage and adolescent motherhood. To model this association, a generalized estimation equation technique was employed, while controlling for socio-demographic characteristics. Additionally, the study corrected for multiple-hypothesis testing using the Benjamini-Hochberg procedure with a specified false discovery rate of 0.05. Finally, percentage predicted probabilities of occurrence of the sexual risk behaviors in the presence of FGM were also calculated. Of the 5524 AGYW, 76% had undergone FGM. FGM was associated with all three sexual risk behaviors. Sexual debut before 18 years had the highest predicted probability increase (+18.00 ppt, 95% CI: 14.41 to −21.59), followed by adolescent motherhood (+13.38 ppt, 95% CI: 10.16–16.60) and child marriage (+12.61 ppt; 95% CI: 10.22–15.01). Education was found to be protective against all three sexual risk behaviors. The findings of this study demonstrate that FGM remains a prevalent practice in Sierra Leone, even among the younger generation. This practice is strongly associated with sexual behaviors that pose a significant risk to the health outcomes of AGYW. Investments in education by removing barriers to access for AGYW could lead to multiple gains. [ABSTRACT FROM AUTHOR]

Pre-coital and sexual behaviors are precarious and may lead adolescents to face higher rates of unwanted pregnancies and sexually transmitted infections. This cross-sectional study aimed to determine the factors predicting pre-coital and sexual behaviors among Muslim adolescents in southernmost Thailand. Seven hundred adolescents were recruited from a vocational college and four schools. Sexual risk behaviors and its related factors questionnaires were employed for data collection. Descriptive statistics were used to describe the demographic characteristics of the participants; binary and ordinal logistic regression was used to examine the factors explaining sexual risk behaviors. The results indicated that increased age was a predicting factor for higher pre-coital and sexual behaviors. For interpersonal factors, knowledge of sexual risk behaviors was a protective factor, while perceived parent and peer approval of sex and perceived peer norms predicted higher pre-coital and sexual behaviors. More parental monitoring was a protective factor for lower pre-coital behaviors. For environmental factors, cultural norms were a significant protective factor, while neighborhood disorganization predicted higher pre-coital behaviors. In conclusion, age, parental approval of sex, and perceived peer norms were predictors of sexual and pre-coital behaviors. These findings provide useful information for healthcare providers, especially nurses, to develop the intervention with the protective factors and predictors of sexual and pre-coital behaviors. We recommend action research that includes all community stakeholders to develop an intervention to prevent sexual risk behaviors among Muslim adolescents. [ABSTRACT FROM AUTHOR]

Objective: We examined gender differences in Sexual Risk Behaviors (SRBs) in Iranian individuals with Substance Use Disorders (SUDs). Methods: A cross-sectional study conducted from late 2018 to the end of 2019 in Tehran province, Iran. Six outpatient drug-free (ODF) and methadone maintenance treatment program (MMTP) centers were selected. A total of 600 eligible participants (300 men; 300 women) were included in the study. Participants were investigated by trained interviewers using a questionnaire to collect information on SRBs. Data were analyzed using SPSS software version 24. Results: Nearly 75% of participants (64% men and 84.3% women) reported at least one lifetime experience of SRBs. Men were 62% less likely than women to have SRBs. Also, 34.7% women and 3% men had reported sexual violence. Twenty-eight percent of women and 22% of men had a history of group sex. Sixty-nine women (23%) and 20 men (6.7%) reported having had sex with intravenous drug use (IDU) partner. During the past year, the majority of participants never consistently used condoms (83%) in their sexual encounters. Conclusions: Iranian women with SUDs are more likely to be involved in SRBs than their men counterparts. The differences highlighted in this study should inform treatment centers to include “safer sex” interventions in their treatment programs. [ABSTRACT FROM AUTHOR]

Sexual risky behaviors among adolescents and young people remain a major public health problem worldwide. This study examined the impact of parent–adolescent communication on adolescents' possibility to engage in risky behaviors. The study used baseline data from the Suubi-Maka Study (2008–2012) implemented in 10 primary schools in Southern Uganda. Binary logistic regression models were conducted to determine the association between parent–adolescent communication and sexual risk possibility. Results indicate that gender [OR 0.220, 95% CI 0.107, 0.455], age [OR 1.891, 95% CI 1.030, 3.471], household size [OR 0.661, 95% CI 0.479, 0.913], and comfort level of family communication [OR 0.944, 95% CI 0.899, 0.990] were significantly associated with lower levels of sexual risk possibility among adolescents. There is a need to build interventions that make it easy and comfortable for adolescents to have open discussion and communication with parents on sexual risk possibility, risky behaviors, and risky situations. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a significant global public health problem that results in high social and economic costs to individuals and communities. Compared to women in the general population, women engaged in sex work (WESW) are more likely to experience physical, emotional, and sexual IPV. This study examines the correlates of IPV among young WESW with their intimate partners in Southern Uganda. We used baseline data from the Kyaterekera project, a 5 year NIH-funded longitudinal study aimed at reducing HIV risks among 542 WESW in Southern Uganda. To examine the factors associated with IPV, we fitted three separate multi-level Poisson regression models for physical, emotional, and sexual IPV, respectively. Average age was 31.4 years, and 54% of the women reported being victims of at least one form of IPV from their intimate partners. Model one assessed correlates of sexual IPV. Being married women (β =.71, 95% CI [0.24, 1.17]), divorced/separated/widowed (β =.52, [0.02, 1.02]), depressed (β =.04, [0.02, 0.05]), and having any sexually transmitted infections (STIs) (β =.58, [0.14, 1.01]) were associated with sexual IPV. Model two assessed correlates of physical IPV. Experience of childhood sexual abuse (β =.12, [0.04, 0.19]) was associated with an increase in physical IPV, and increasing age reduced its occurrence (β = −.02, [−0.04, −0.001]). Finally, model three assessed emotional IPV. Women with higher education (β =.49, [0.14, 0.85]) and symptoms of depression (β =.02, [0.001, 0.04]) had higher risks for emotional IPV. For WESW, IPV presents an additional potential pathway for HIV and STIs acquisition and transmission through a lack of negotiating power for safe sex. Efforts to reduce violence against WESW should be prioritized as a strategy for enhancing the well-being of WESW. [ABSTRACT FROM AUTHOR]

There is strong evidence linking stimulant use, namely methamphetamine use, to sexual risk behavior among sexual minority men (SMM); we do not, however, have a good understanding of this relationship among other at-risk populations. In this study, we systematically reviewed associations between stimulant use (i.e., methamphetamine, crack cocaine, cocaine) and sexual risk behaviors among populations facing elevated risk of HIV transmission and acquisition (i.e., SMM, people who inject drugs (PWID), and people living with HIV/AIDS (PLWH)). Random-effects meta-analyses and sensitivity analyses that included crude and adjusted estimates separately were conducted to evaluate the impact of potential confounding variables. The results showed strong relationships between stimulant use and condomless sex, transactional sex, and multiple sexual partners. Results were broadly consistent when analyses were stratified by type of stimulant (methamphetamine, crack cocaine, and other stimulants) and risk group. Sensitivity analyses with confounding variables did not greatly impact results. The results indicate that stimulant use is associated with numerous sexual risk behaviors regardless of risk group, suggesting prevention efforts focused on reducing methamphetamine-related HIV risk should target a range of at-risk populations. [ABSTRACT FROM AUTHOR]

Different immigrant generations may encounter distinct sexual opportunities with implications for HIV transmission. Yet, few studies have examined how immigrant generational status is associated with sexual risk behaviors among men who have sex with men (MSM). We explored relationships between immigrant generational status, social support, and sexual risk behaviors among English-speaking MSM using data from surveys conducted in Seattle, Washington, in 2014 (n = 323). We compared the sexual risk behaviors and social support of first-generation, second-generation, and third- and higher-generation MSM, and examined whether immigrant generational status and social support were associated with sexual risk behaviors using logistic regression models. Second-generation MSM reported lower friend social support than first- or third- and higher-generation MSM (p < .05). However, immigrant generational status was not associated with sexual risk behavior outcomes, even after accounting for social support. Results suggest that differences in immigration processes such as acculturation may be more predictive of risk behaviors than generational status alone.

Abstract Objective To implement a STI risk behavior reduction program to reduce sexual risk behaviors in university-aged students. Participants Fifty-nine freshman from the university participated in the STI Risk Behavior Reduction program. Methods Pre- and post-test design using descriptive statistics evaluated the STI Risk Behavior Reduction Program. Results The majority of participants were 19 years of age, female, and freshman. Condom use as a pregnancy prevention increased from 18 (before intervention) to 23 participants (after intervention). Retrospective data noted 72 referrals the year before implementation whereas, 148 referrals were made after implementation. Conclusions An increase in referrals to community centers and condom usage was noted after the STI Risk Behavior Reduction Program. This may have been due to the increase in knowledge of risky sexual behaviors and when seeking treatment early by recognizing the signs of sexual transmitted infections. [ABSTRACT FROM AUTHOR]

Among people with HIV, alcohol use is associated with increased prevalence of sexual transmission behaviors. We examined associations between alcohol use in the prior year and sexual behaviors approximately six months later among 1857 women, 6752 men who have sex with men (MSM) and 2685 men who have sex with women (MSW). Any alcohol use was associated with increased risk of unsafe vaginal sex among women; anal sex and =>2 anal sex partners among MSM; and anal sex, =>2 anal or vaginal sex partners, and unsafe vaginal sex among MSW. In particular, among women >7 alcoholic drinks/week and among MSW =>5 alcoholic drinks/drinking day increased the likelihood of certain subsequent sexual behaviors. For all groups, especially women, the risk of sex under the influence of drugs/alcohol markedly increased with increases in quantity and frequency of alcohol consumption. These different patterns of drinking and sexual behaviors indicate the importance of tailored counseling messages to women, MSM and MSW.

Purpose – The purpose of this paper is to investigate the intention to prevent sexual risk behaviors and associated factors among the youth in Yangon, Myanmar. Design/methodology/approach – A cross-sectional descriptive research was undertaken among 192 youths. Participants included the youth residing in the study area and participated in the youth development program. Bivariate and multivariate logistic regressions were applied to identify an association. Findings – The findings indicated that the proportion of a high level of intention to prevent sexual risk behaviors was 53.6%. The factors associated with the intention to prevent sexual risk behaviors were: belief strength on sexual risk behaviors (aOR = 2.84; 95% CI: 1.06–7.26), normative belief on the prevention of sexual risk behaviors (aOR = 2.03; 95% CI: 3.03–6.23), motivation to comply with preventing sexual risk behaviors (aOR = 4.72; 95% CI: 3.11–6.23), decision-making (aOR = 2.46; 95% CI: 2.22–5.41) and negotiation (aOR = 6.3; 95% CI: 2.37–10.23) Research limitations/implications – The study was a cross-sectional study and cannot establish causal relationships. These results can be a guideline for implementation for the youth but may limit the generalization of results to other age groups in Myanmar. Practical implications – Findings can be used as a local and national public health guideline for developing interventions to prevent sexual risk behaviors. Originality/value – Sexual risk behavior is considered taboo and puts Myanmar youths at risk of health and social problems. It is important for prevention efforts to determine factors related to sexual intentions to prevent the consequence of these problems.

To explore the relationship between sexual orientation and specific sexual and risk behaviors, compare the number of sexual behaviors and attitudes among people of different sexual orientations, and test the mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors. A total of 2288 participants completed a checklist of sexual behaviors, indicators of sexual risk behaviors, and a scale of attitudes toward sexual behaviors. Bisexual women engaged in a greater number of sexual behaviors and had more positive attitudes toward sexual behaviors than heterosexual women. Homosexual men engaged in a greater number of sexual behaviors than heterosexual men, and homosexual and bisexual men had more positive attitudes toward sexual behaviors than heterosexuals. Finally, we show the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors engaged in. The importance of considering sexual orientation when analyzing sexual behaviors and attitudes is highlighted. [ABSTRACT FROM AUTHOR]

Previous studies have established that individual characteristics such as violent behavior, substance use, and high-risk sexual behavior, as well as negative relationships with parents and friends, are all risk factors for intimate partner violence (IPV). In this longitudinal prospective study, we investigated whether violent behavior, substance use, and high-risk sexual behavior in early adulthood (ages 22–23 years) mediated the link between family conflict and coercive relationship talk with friends in adolescence (ages 16–17 years) and dyadic IPV in adulthood (ages 28–30 years). A total of 998 individuals participated in multimethod assessments, including observations of interactions with parents and friends. Data from multiple reporters were used for variables of interest including court records, parental and self-reports of violence, self-reports of high-sexual-risk behaviors and substance use, and self- and romantic partner-reports of IPV. Longitudinal mediation analyses showed that violent behavior during early adulthood mediated the link between coercive relationship talk with friends in adolescence and dyadic IPV in adulthood. No other mediation paths were found and there was no evidence of gender differences. Results are discussed with attention to the interpersonal socialization processes by which IPV emerges relative to individual risk factors. [ABSTRACT FROM AUTHOR]

HIV self-testing (HIVST) increases testing frequency among men who have sex with men (MSM). However, its impact on sexual risk behaviors is unclear. In a randomized controlled trial conducted in Hunan Province, China, HIV-negative MSM were randomized to receive one of two interventions for one year: (1) facility-based HIV testing, or (2) facility-based HIV testing augmented with free HIVST. From April to June 2018, 230 MSM were enrolled. They self-reported sexual behaviors every 3 months for 12 months. Among 216 MSM with follow-ups (intervention: 110; control: 106), adjusting for potential confounders in Generalized Estimating Equation models, there were no statistically significant differences in consistent condom use with male partners (regular/casual) or female partners, nor on number of male or female sexual partners. Provision of free HIVST kits does not increase risky sex and should be included in comprehensive HIV prevention packages, particularly for sexual minority men in China. [ABSTRACT FROM AUTHOR]

Sexual risk behaviors often co-occur. Understanding the heterogeneity in patterns of sexual behavior among youth and how context of majority and minoritized status may be related to these behaviors can inform targeted STIs/HIV interventions. Data are from the Boricua Youth Study, a longitudinal study of two probability samples of Puerto Rican youth recruited in the South Bronx (SBx) and the metropolitan area in Puerto Rico (PR). We identified patterns of sexual behaviors among young adults (ages 15–24) with sexual experience (N = 1,203) using latent class analysis. Analyses examined context differences and the prospective relationship between adverse childhood experiences (ACEs) (childhood maltreatment/violence, family/parental dysfunction) and patterns of sexual behaviors (age at first sex, number of sex partners, sex with a high-risk partner, condom use, sex while intoxicated, oral sex, anal sex). We identified five classes of sexual behaviors: (1) currently inactive (16.51%); (2) single partner, low activity (13.49%); (3) single partner, inconsistent condom use (32.19%); (4) single partner, sex without a condom (27.65%); and (5) multirisk (10.16%). Young adults from the SBx (minoritized context), those who identified as male, and those with higher child maltreatment/violence ACEs were more likely to be in the multi-risk class relative to the single partner, inconsistent condom use class. Those from the SBx were also more likely to be in the single partner, sex without condom class, relative to the single partner, inconsistent condom use class. Differences in young adults' patterns of sexual behaviors between the two contexts, one representing the minoritized context (SBx) contrasted to the majority context (PR), were not explained by ACEs. Findings highlight the heterogeneity in the patterns of sexual behaviors among Puerto Rican young adults as well as how such patterns vary based on sociocultural contexts. Exposure to child maltreatment/violence ACEs was related to the riskier patterns; however, they did not explain why riskier patterns of sexual behaviors were found in the SBx compared to PR. Results underscore the need for tailored interventions and more in-depth examination of differences across contexts. [ABSTRACT FROM AUTHOR]

Economic hardship is a driver of entry into sex work, which is associated with high HIV risk. Yet, little is known about economic abuse in women employed by sex work (WESW) and its relationship to uptake of HIV prevention and financial support services. This study used cross-sectional baseline data from a multisite, longitudinal clinical trial that tests the efficacy of adding economic empowerment to traditional HIV risk reduction education on HIV incidence in 542 WESW. Mixed effects logistic and linear regressions were used to examine associations in reported economic abuse by demographic characteristics, sexual behaviors, HIV care-seeking, and financial care-seeking. Mean age was 31.4 years. Most WESW were unmarried (74%) and had less than primary school education (64%). 48% had savings, and 72% had debt. 93% reported at least one economic abuse incident. Common incidents included being forced to ask for money (80%), having financial information kept from them (61%), and being forced to disclose how money was spent (56%). WESW also reported partners/relatives spending money needed for bills (45%), not paying bills (38%), threatening them to quit their job(s) (38%), and using physical violence when earning income (24%). Married/partnered WESW (OR = 2.68, 95% CI:1.60–4.48), those with debt (OR = 1.70, 95% CI:1.04–2.77), and those with sex-work bosses (OR = 1.90, 95% CI:1.07–3.38) had higher economic abuse. Condomless sex (β = +4.43, p <.05) was higher among WESW experiencing economic abuse, who also had lower odds of initiating PrEP (OR =.39, 95% CI:.17–.89). WESW experiencing economic abuse were also more likely to ask for cash among relatives (OR = 2.36, 95% CI:1.13–4.94) or banks (OR = 2.12, 95% CI:1.11–4.03). The high prevalence of HIV and economic abuse in WESW underscores the importance of integrating financial empowerment in HIV risk reduction interventions for WESW, including education about economic abuse and strategies to address it. Programs focusing on violence against women should also consider economic barriers to accessing HIV prevention services. [ABSTRACT FROM AUTHOR]

This study adopts a socio-ecological framework and examines school- and district-level influences on sexual behaviors among high school students from 16 school districts that were federally funded to conduct a school-based, multilevel sexual health program. We drew cross-sectional data from the 2015 and 2017 Youth Risk Behavior Survey from funded school districts containing 648 schools and 101,728 students. We used multilevel modeling to determine the percentage of variance in sexual health outcomes explained at school and district levels, overall and by race/ethnicity and biological sex. We found protective behaviors such as using hormonal birth control had considerable district-level variance (10.1%) while sexual risk behaviors such as having multiple sex partners showed considerable school-level variance (12.7%). We also found significant subgroup heterogeneity in the variance. Findings indicate school-based interventions should address all levels of influences of the educational system to effectively improve a myriad of student sexual health outcomes. [ABSTRACT FROM AUTHOR]

Little is known about HIV treatment optimism and risk behaviors among Black men who have sex with men (BMSM). Using longitudinal data from BMSM in the HPTN 061 study, we examined participants' self-reported comfort with having condomless sex due to optimistic beliefs regarding HIV treatment. We assessed correlates of treatment optimism and its association with subsequent risk behaviors for HIV acquisition or transmission using multivariable logistic regression with generalized estimating equations. Independent correlates of treatment optimism included age ≥35 years, annual household income

There is limited research examining the sexual health and well-being of older women living with HIV (OWLH). Most studies focus on sexual dysfunction, leaving aside the richer context of sexuality and sexual health, including the effect of age-related psychosocial and interpersonal changes on sexual health behaviors. Guided by the integrative biopsychosocial model and the sexual health model, this study explored the importance of sex and sexuality among OWLH to identify their sexual health and HIV prevention needs for program planning. A purposive sample (n = 50) of OWLH was selected from a parent study (n = 2052). We conducted 8 focus groups and 41 in-depth interviews with 50 African American and Latina OWLH aged 50-69 years old in three U.S. cities. The triangulation approach was used to synthesize the data. Six salient themes emerged: sexual pleasure changes due to age, sexual freedom as women age, the role of relationships in sexual pleasure, changes in sexual ability and sexual health needs, sexual risk behaviors, and ageist assumptions about older women's sexuality. We found that sexual pleasure and the need for intimacy continue to be important for OWLH, but that changing sexual abilities and sexual health needs, such as the reduction of sexual desire, as well as increased painful intercourse due to menopause-associated vaginal drying, were persistent barriers to sexual fulfillment and satisfaction. Particular interpersonal dynamics, including low perceptions of the risk of HIV transmission as related to gender, viral suppression, and habitual condomless sex with long-term partners without HIV transmission have resulted in abandoning safer sex practices with serodiscordant partners. These findings suggest that HIV prevention for OWLH should focus on how sexual function and satisfaction intersect with sexual risk. HIV prevention for OWLH should promote ways to maintain satisfying and safe sex lives among aging women.

Confirmed HIV/AIDS cases are increasing year by year. HIV is mainly transmitted through sexual risk behaviors and other associated behavioral factors such as perceived HIV risk, sexual self-concept, and attitude toward condom use, among others. Given that new HIV cases are concentrated in northern Chile, the purpose of this study was to characterize behaviors associated with HIV exposure in a sample of young people and young adults from the Norte Grande region of Chile using a cross-sectional, descriptive design, with non-probabilistic accidental sampling by quotas (sex, educational level, and city of residence). A total of 1037 young people and adults from the 5 main cities of Chile's Norte Grande (Arica, Iquique, Alto Hospicio, Antofagasta, and Calama) were surveyed. Data were collected using 6 scales relating to behaviors associated with HIV exposure. Detailed item-level descriptions showed that inadequate condom use, mainly with non-penetrative genital contact, multiple sexual partners, and the use of alcohol and drugs as an active agent in sexual encounters are common practices. Most participants perceive themselves as susceptible to acquiring HIV, consider that condom use reduces sexual pleasure, manifest conservative tendencies in terms of sexual motivation, and report being satisfied with typically monogamous sexual practices. Finally, limitations are discussed, and it is recommended to use these results in the design of sexual health programs and the identification of target populations. [ABSTRACT FROM AUTHOR]

This cross-sectional study sought to identify factors associated with sexual intentions among a sample of 252 African American high school adolescents who participated in a teen pregnancy prevention program in a large urban city. Participants completed surveys that included measures of youth assets and knowledge of HIV-related sexual risk behaviors. A series of data analyses included descriptive statistical analyses, t-tests, chi-square, and ordinal regression. Study results demonstrate that older age, male gender, and lower levels of youth assets predicted intentions to have sex in the future. Findings also suggest youth assets may serve as a protective factor against the transmission of HIV for African American adolescents in the context of theory regarding intentions to have sex. Surprisingly, more accurate knowledge about HIV-related sexual risk behaviors was associated with intentions to engage in sexual intercourse within the next six months, calling into question subjects' confidence in or perceived self-efficacy about safely engaging in sexual activity. [ABSTRACT FROM AUTHOR]

Background: Beliefs regarding responsibility for preventing HIV transmission may differ between individuals and their sexual partners. We assessed HIV prevention responsibility beliefs among men who have sex with men (MSM) participating in the 2017 National HIV Behavioral Surveillance survey. Methods: MSM were recruited using time-location sampling at clubs, bars, and street locations in San Francisco. HIV prevention responsibility beliefs were assessed on a four-point scale (1 = strongly disagree to 4 = strongly agree). Associations were assessed using generalizing estimating equations to adjust for behaviors within multiple partnerships. Results: A total of 316 HIV-negative men and 76 HIV-positive men reported on 1336 partnerships. HIV-negative compared with HIV-positive men had higher endorsement of mutual responsibility (mean 3.7 vs. 3.5; P < 0.01). Both groups had similar levels of endorsing responsibility on the HIV-negative or HIV-positive partner. HIV-positive men endorsing equal responsibility were more likely to know their partner's HIV status (P < 0.01) and less likely to have serodiscordant condomless anal intercourse (CAI) (P < 0.01) than men who did not endorse equal responsibility. HIV-negative men in partnerships with pre-exposure prophylaxis (PrEP) use were more likely to know their partner's HIV status (P = 0.02) and have serodiscordant CAI (P = 0.04) than men not in partnerships with PrEP use. Conclusions: HIV-negative and HIV-positive men accept responsibility for preventing HIV. The finding that HIV-negative men in partnerships with PrEP use who engage in serodiscordant CAI is concerning because they are still at risk for other sexually transmitted infections, which are presently at elevated levels in San Francisco and other US cities. [ABSTRACT FROM AUTHOR]

Previous research has identified several factors, including sexual risk behaviors, alcohol consumption, sexual refusal assertiveness, impulse control difficulties, drinking to cope, and sex to cope, as being associated with sexual assault victimization. Data were collected from 465 adult, undergraduate women, and analyzed using structural equation modeling to determine how these variables related to one another. Results showed that together, these factors predicted 17.1% of the variance in victimization frequency. These findings may help future researchers better understand the etiology of sexual assault victimization on college campuses and prove crucial to the development of future intervention programs which reduce victimization. [ABSTRACT FROM AUTHOR]

An examination of the sexual attitudes, knowledge, and behaviors post-incarceration was conducted in the current study. Further, factors linked to sexual health (i.e., age, race, education, length imprisoned), as well as pornography consumption, and infidelity, were examined. Data were collected from 100 heterosexual men released from incarceration in the last 36 months. The prevalence of risky sexual behaviors and correlations among all sexual behavior, attitude, and knowledge items were analyzed. A series of multivariate regression models examined the moderating effect of certain demographic factors between condom use and STI/HIV testing. The most notable results revealed that a vast majority of participants engaged in inconsistent condom use during vaginal (77%), oral (92%), and anal (71%) sex. Most participants (70%) tested for STIs infrequently after engaging in unprotected sex. Consistent with this, most participants lacked knowledge about STIs, as demonstrated by the fact that, on average, they answered 37% of questions assessing knowledge on STIs correctly. Research about individuals' sexual health risks post-incarceration commonly focuses on those diagnosed with HIV/AIDS despite most men being HIV-seronegative post-incarceration. Empirical research that directly assesses men's sexual attitudes, knowledge and behaviors post-incarceration more generally is warranted and, therefore, the current study's primary objective. Further, little but existing literature contends that a lack of sexual health knowledge and education are closely linked to safe sex practices post-incarceration. The current study examined these relationships further. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men (MSM) residing outside of large urban areas are underrepresented in research on online partner seeking and sexual behaviors related to transmission of HIV. Objective: We aimed to determine associations between the use of the internet or social networking apps (online tools) to meet partners for sex, dating, or for both purposes (online partner seeking) and sexual behaviors among MSM residing in small and midsized towns in Kentucky, United States. Methods: Using peer-referral sampling and online self-administered questionnaires, data were collected from 252 men, aged 18 to 34 years, who had recently (past 6 months) engaged in anal sex with another man and resided in Central Kentucky. Using multivariable logistic regression models, we assessed associations of online partner seeking and HIV-related sexual behaviors. Results: Most (181/252, 71.8%) of the participants reported using online tools for partner seeking. Of these 181 respondents, 166 (91.7%) had used online tools to meet partners for sex (n=45, 27.1% for sex only; and n=121, 72.9% for sex and dating) and 136 (75.1%) had used online tools to meet partners for dating (n=15, 11% for dating only; and n=121, 89% for sex and dating). Adjusted analyses revealed that MSM who had engaged in condomless insertive and receptive anal intercourse were less likely to report online partner seeking (adjusted odds ratio [aOR] 0.22, 95% CI 0.07-0.68; P=.009 and aOR 0.25, 95% CI 0.10-0.66; P=.005, respectively). Increased number of insertive and receptive anal sex partners and substance use before or during sex were associated with higher odds of online partner seeking (aOR 1.31, 95% CI 1.11-1.55; P=.001; aOR 1.20, 95% CI 1.05-1.39; P=.008; and aOR 2.50, 95% CI 1.41-4.44; P=.002, respectively). Conclusions: Among MSM who reside outside of large urban areas and practice online partner seeking, HIV risk-reduction interventions should address safer sex practices, including the risks for HIV transmission associated with alcohol or drug use before or during sex. MSM who do not practice online partner seeking are in need of continued outreach to reduce condomless anal sex. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore patterns of drug use and sexual risk behaviors among people who inject drugs (PWID) in Iran. We surveyed 500 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, and drug-related risk behaviors in the month prior to study. We used latent class analysis (LCA) to establish a baseline model of risk profiles and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Three classes of multiple HIV risk were identified. The probability of membership in the high-risk class was 0.33, compared to 0.26 and 0.40 for the low- and moderate-risk classes, respectively. Compared to members in the lowest-risk class (reference group), the highest-risk class members had higher odds of being homeless (OR = 4.5, CI: 1.44-8.22; p = 0.001) in the past 12 months. Members of the high-risk class had lower odds of regularly visiting a needle and syringe exchange program as compared to the lowest-risk class members (AOR = 0.42, CI: 0.2-0.81; p = 0.01). Findings show the sexual and drug-related HIV risk clusters among PWID in Iran, and emphasize the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug use related.

The initiation and escalation of substance use and sex behaviors is prevalent during adolescence. School-based health centers (SBHCs) are well-equipped to provide interventions for risky behaviors and offer sexually transmitted infection (STI) testing services. This study examined receipt of STI testing following brief intervention (BI) among sexually active adolescents. This is a secondary analysis of data from a randomized trial comparing computer versus nurse practitioner–delivered BI approaches among adolescents (ages 14–18) with risky alcohol and/or cannabis use at two SBHCs within two urban high schools. Associations were examined among receipt of STI testing and participant characteristics, BI format, site, and frequency of substance use/sexual behaviors. Among sexually active participants (N = 254), 64.2% received STI testing at their SBHC within 6 months of receiving a BI. Participants receiving nurse practitioner–delivered BI had higher odds of getting STI testing than participants receiving computer-delivered BI (adjusted odds ratio 2.51, 95% confidence interval 1.41–4.47, p =.002). Other variables associated with STI testing in multivariable logistic regression included female sex (p =.001), being in a serious relationship (p =.018), and SBHC site (p <.001). Frequency of substance use and sexual risk behaviors were not independently associated with receipt of STI testing services. Sexually active adolescents who received in-person BI from a nurse practitioner were more likely to get STI testing than adolescents who received BI via computer. Nurse practitioners working in SBHCs can successfully engage adolescents in additional sexual health services subsequent to BI for risky behaviors. [ABSTRACT FROM AUTHOR]

Abstract Background Acceptability is a critical requisite in establishing feasibility when planning a larger effectiveness trial. This study assessed the acceptability of conducting a feasibility randomized clinical trial of a 20-week microenterprise intervention for economically-vulnerable African-American young adults, aged 18 to 24, in Baltimore, Maryland. Engaging MicroenterprisE for Resource Generation and Health Empowerment (EMERGE) aimed to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. Methods Thirty-eight participants were randomized to experimental (n = 19) or comparison group (n = 19). The experimental group received text messages on job openings plus educational sessions, mentoring, a start-up grant, and business and HIV prevention text messages. The comparison group received text messages on job openings only. Qualitative and quantitative post-intervention, in-person interviews were used in addition to process documentation of study methods. Results Our results found that the study design and interventions showed promise for being acceptable to economically-vulnerable African-American young adults. The largely positive endorsement suggested that factors contributing to acceptability included perceived economic potential, sexual health education, convenience, incentives, and encouraging, personalized feedback to participants. Barriers to acceptability for some participants included low cell phone connectivity, perceived payment delays, small cohort size, and disappointment with one’s randomization assignment to comparison group. Use of peer referral, network, or wait-list designs, in addition to online options may enhance acceptability in a future definitive trial. Expanding administrative and mentoring support may improve overall experience. Conclusion Microenterprise interventions are acceptable ways of providing young adults with important financial and sexual health content to address HIV risks associated with economic vulnerability. Trial registration ClinicalTrials.gov. NCT03766165 . Registered 04 December 2018.

Abstract Background Men who have sex with men (MSM) bear a disproportionate burden of HIV in Malawi. Early prevention efforts in Malawi have been largely focused on preventing heterosexual and vertical transmission of HIV, and MSM have rarely been the specific benefactors of these efforts, despite facing both higher prevalence of HIV coupled with multiple barriers to prevention and care. To better facilitate the design of culturally relevant HIV prevention programs and prioritize resources among MSM in resource limited settings, the objective of this analysis was to estimate the relationship between social factors and HIV related risk behaviors and mental health. Methods 338 MSM were recruited using respondent-driven sampling in Blantyre, Malawi from April 2011 to March 2012. Structural equation models were built to test the association between six latent factors: participation in social activities, social support, stigma and human rights violations, depression symptomatology, condom use, and sexual risk behaviors, including concurrent sexual partnerships and total number of partners. Results The mean age of participants was 25 years old. Almost 50% (158/338) of the participants were unemployed and 11% (37/338) were married or cohabiting with women. More than 30% (120/338) of the participants reported sexual behavior stigma and 30% (102/338) reported depression symptomatology. Almost 50% (153/338) of the participants reported any kind of HIV-related risk behaviors and 30% (110/338) participated in one of the recorded social activities. Significant associations were identified between stigma and risk behaviors (β = 0.14, p = 0.03); stigma and depression symptomatology (β = 0.62, p = 0.01); participation in social activities and depression symptomatology (β = 0.17, p = 0.01). Conclusion Results suggest MSM reporting stigma are more likely to report sexual risk practices associated with HIV/STI transmission and depressive symptoms, while those reporting participation in social activities related to HIV education are less likely to be depressed. Furthermore, interventions at the community level to support group empowerment and engagement may further reduce risks of HIV transmission and improve mental health outcomes. Taken together, these results suggest the potential additive benefits of mental health services integrated within comprehensive HIV prevention packages to optimize both HIV-related outcomes and general quality of life among MSM in Malawi.

Abstract Background Justice-involved youth have higher rates of sexually transmitted infections (STIs), and a higher prevalence of the associated sexual risk behaviors. Sexual risk behaviors are also associated with alcohol and drug use. Research suggests that a history of trauma is an important predictor of alcohol and drug use in youth offenders, and therefore is a likely contributor to sexual risk behavior in this population. The objective of this analysis is to determine the association of trauma, specifically, domestic violence and forced sex, to six sexual risk behaviors and a history of chlamydia among detained youth. Methods The analysis uses data from a convenience sample of detainees assenting to HIV testing conducted December 2016 – August 2017 using the state-certified Voluntary Counseling Testing and Referral (VCTR) process. Results Of the 379 youth that received VCTR at the facility, 308 (81.3%) were used in this analysis. Report of domestic violence was significantly associated with sex under the influence of alcohol and was also significantly associated with sex under the influence of marijuana. Forced sex was associated with a sexual partner of unknown HIV status. Conclusions Traumatic experiences were related to sexual risk behaviors in this analysis, and substance use was strongly implicated in the association. Trauma is known to be a catalyst to sexual risk behaviors, substance use, and delinquency in adolescence. Results support the findings of other investigators and re-iterate the need for trauma-informed interventions that can improve the life trajectories of detained youth.

BackgroundYoung men who have sex with men (YMSM) are at high risk of HIV infection that accounts for an increasing proportion of new human immunodeficiency virus (HIV) infections in China. However, little is known about the trajectories of sexual risk behaviors in this population. The study aimed to investigate longitudinal patterns of sexual risk behaviors among YMSM in China.MethodsStudy data were collected from a prospective cohort study among 460 YMSM from 2017 to 2020. Based on the predicted HIV infection risk scores, distinct sexual risk behaviors trajectories of YMSM were estimated and plotted using the group-based censored normal model to identify the predictors of trajectories change over time.ResultsThree sexual risk behaviors trajectories were identified: a decreasing low-risk group (7.6%), an intermediate-risk group (67.4%), and an ascending high-risk group (25.0%).Compared to the decreasing low-risk group, intermediate-risk group membership was associated with being from rural areas, current smoker and higher depressive symptoms; ascending high-risk group membership was associated with an education level of high school or lower, being from rural areas, younger age at sex debut with a man, current smoker, higher depressive symptoms and sexual minority stress.ConclusionsSexual risk behaviors among YMSM changed over time within different trajectories. Identifying YMSM belonging to high-risk trajectories before HIV infection is vital for the intervention and may reduce HIV transmission.

Little is known about how HIV risk varies among trans women of different ages. From January 2010 to February 2021, 2,242 trans women were assessed via outreach encounters consisting of health education and risk reduction information, and queries of recent sexual behaviors. Generalized linear models provide adjusted rates of engagement in condomless anal intercourse (CAI), in exchange sex, and CAI with exchange partners in the past 30 days for each year from age 18 to 60. Most participants identified as Hispanic/Latina (52%) and most were HIV negative (80%). Engagement in exchange sex remained prevalent from participants' early 20s through their mid-40s, though CAI with such partners never exceeded an average estimated prevalence of 15%. Condomless behaviors with non-exchange partners was more common, with at least 20% reporting engagement in non-exchange CAI regardless of age. The need for trans-specific sexual risk reduction interventions that take age into account is underscored. [ABSTRACT FROM AUTHOR]

To describe individual, interpersonal, and environmental factors and sexual risk behaviors among Thai Muslim adolescents. We recruited adolescents from four schools and one vocational college on the Southern border of Thailand during October 2018 to January 2019. We used password-protected online questionnaires for each respondent to protect their privacy. We recruited N = 700 participants of which 9% were sexually experienced. Of those participants, many had never used a condom (41.3%) or considered taking contraceptive pills (71.4%). Moreover, 54% of them have had sexual intercourse more than once. Some had been infected with an STI (17.5%), and (14.3%) became pregnant more than once. Adolescents reported individual factors such as high religiosity (58.7%), and (47.6%) practiced Islam daily with no differences between boys and girls. Girls had significantly higher refusal of sex self-efficiency than boys (96 vs. 119.5, p < 0.05). In the interpersonal factors, boys had more uninvolved parenting style, lower parental monitoring, higher parental approval of sex, and higher perceived peer norm than girls. The environmental factors besides cultural norms impacted girls and boys equally. We showed low rates of sexual activity, but in those adolescents who were sexually active we showed high rates of lack of knowledge and higher rates of sexual risk behaviors. Individual, interpersonal, and environmental factors all influenced sexual risk behaviors. We recommend comprehensive sexuality education that includes Islamic context for adolescents and their parents embedded in policy, religious, and community cultural practices. [ABSTRACT FROM AUTHOR]

Young adolescents in Sub-Saharan Africa (SSA) are at high risk of involvement in sexual risk behaviors; and curable sexually transmitted infections (STI), herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and unintended pregnancies remain persistently high in this population. Evidence based strategies are urgently needed to improve these outcomes. The aim of this systematic review was to synthesize the evidence from randomized controlled trials (RCT) to determine whether school-based interventions promote safe sex behaviors, reduce sexual risk behaviors and risk of curable STIs, HSV-2, HIV and unintended pregnancies among young adolescents aged 9–19 years in SSA. Electronic databases were searched for published studies and manual searches were conducted through reviewing of references of cited literature in the English language up to December 2019. Two independent reviewers screened and abstracted the data. We identified 428 articles and data from nine RCTs (N = 14,426 secondary school students) that fulfilled the selection criteria were analysed. Two studies measured pregnancy as an outcome and showed significant declines in unintended pregnancies. Of the five studies that measured HIV/AIDS related-knowledge, condom-use outcomes (normative beliefs, knowledge, and self-efficacy) and attitudes to HIV testing, four showed significant improvements. Of the six studies that measured sexual debut, four reported moderate but non-significant declines and in two studies sexual debut information was either incomplete or unreliable. One study measured curable STIs and found no significant declines; whilst the second study that measured HSV-2 and HIV, no significant declines were observed. This review highlights the need to undertake well-designed research studies to provide evidence on the impact of interventions on curable STIs, HSV-2 and HIV, critical to improving the health of young adolescents. [ABSTRACT FROM AUTHOR]

Social networking technologies have emerged as potential platforms to reach HIV(+) MSM in HIV interventions. This study sought to compare use of online social networking sites (SNSs) and sexual risk behaviors between HIV(+) and HIV(-) individuals among a sample of predominately African American and Latino SNS-using MSM. A total of 112 MSM Facebook users were recruited online and offline and completed an online survey. We performed regression models to assess the association between HIV status, SNS use, and sexual risk behaviors. After adjusting for age, race, and employment status, being HIV positive was significantly associated with a greater number of sexual partners (ARR = 2.84, p = 0.0017) and lower comfort levels of discussing HIV/STI status on SNSs (AOR: 0.23, p = 0.011). Findings suggest that HIV status is associated with sexual risk behaviors and SNS use among SNS-using MSM. We discuss the implications for online HIV prevention.

We assessed changes in self-reported sexual activity (SA) over 13 years among HIV-infected and uninfected women. The impact of aging and menopause on SA and unprotected anal or vaginal intercourse (UAVI) was examined among women in the Women's Interagency HIV Study (WIHS), stratifying by HIV status and detectable viral load among HIV-infected women. Generalized mixed linear models were fitted for each outcome, adjusted for relevant covariates. HIV-uninfected women evidenced higher levels of SA and UAVI than HIV-infected. The odds of SA declined by 62-64 % per decade of age. The odds of SA in a 6-month interval for women aged 40-57 declined by 18-22 % post-menopause (controlling for age). Among HIV+/detectable women only, the odds of any UAVI decreased by 17 % per decade of age; the odds of UAVI were unchanged pre-menopause, and then decreased by 28 % post-menopause. Elucidating the factors accounting for ongoing unprotected sex among older women should inform interventions.