A comparative study of sexual behavior, dysfunction, satisfaction, relationship, and sexual quality of life amongst treatment-naïve and abstinent men (buprenorphine-maintained) with Opioid (heroin) dependence syndrome.

Background: Association between opioid use and sexual functioning is well-known. However, data evaluating the influence of treatment on different aspects of sexuality are lacking. Aim: To compare sexual behavior, functioning, relationship, satisfaction, and sexual quality of life (sQoL) among treatment naïve patients (GROUP-I) with Opioid (heroin) dependence syndrome (ODS-H) with those maintained on buprenorphine (GROUP-II). Methods: Married adult males diagnosed with ODS-H, currently sexually active, and living with their partner were recruited. They were assessed for their sexual practices and high-risk sexual behavior (HRSB) through a semi-structured questionnaire and sexual functioning, relationships, satisfaction, and sQoL through structured questionnaires. Results: A total of 112 individuals (GROUP-I: 63; GROUP-II: 49) were recruited from the outpatient settings. Mean age and employment in GROUP-II were higher (p < 0.05) than in GROUP-I (37 vs 32 years; 94% vs 70%, respectively). Other sociodemographic variables and the age of onset of heroin use were comparable. The current practice of HRSB (e.g., engaging in casual partner sex, sex with commercial sex workers, and sex under intoxication) was higher in GROUP-I while almost no differences were seen in lifetime HRSB. The frequency of erectile dysfunction and premature ejaculation in the two groups were: 78% vs 39% (p < 0.001), and 30% vs 6% (p = 0.001), respectively. GROUP-II had significantly higher scores in all the scales (p < 0.05) as compared to GROUP-I, indicating better sexual satisfaction, quality of life, and sexual relationship. Conclusion: Heroin use is associated with HRSB, poorer sexual functioning, overall satisfaction, and sQoL. Maintenance of Buprenorphine helps with improvement in all these parameters. Comprehensive management for substance use should target sexual problems as well.

Low Behavioral Intention to Use Any Type of HIV Testing and HIV Self-Testing among Migrant Male Factory Workers Who Are at High Risk of HIV Infection in China: A Secondary Data Analysis.

This study investigated the prevalence of and factors associated with behavioral intention to take up any type of HIV testing and HIV self-testing (HIVST) in the next six months among male migrant workers, who were at high risk of HIV infection, in Shenzhen, China. This was a secondary data analysis. A total of 363 subjects who had sexual intercourse with non-regular female sex partners and/or female sex workers in the past six months were selected. Logistic regression models were fitted for data analysis. About 16.5% of participants reported having used HIV testing in their lifetime and 12.7% for HIVST. Among the participants, 25.6% and 23.7% intended to take up any type of HIV testing and HIVST in the next six months, respectively. Significant factors associated with the behavioral intention to take up HIV testing and HIVST included individual-level factors based of the Health Belief Model (e.g., perceived benefit, perceived cue to action, perceived self-efficacy) and interpersonal-level factors (e.g., frequency of exposure to health-related content or HIV and STI-related content on short video apps). This study provided practical implications for designing interventions to increase the uptake of HIV testing and HIVST among migrant workers.

A Cross-Sectional Clinical Investigation of Organisms Causing Vaginal Discharge in Patients in Rural Tamil Nadu, India.

Background and aims Abnormal vaginal discharge is a prevailing gynecological problem among women in the reproductive age group. Vaginal discharges have multiple etiologies, and the present study was conducted with the objective of determining the prevalence of common organisms causing vaginal discharge and correlating with its various types of clinical presentations in those women attending a rural health centre of a medical college in Tamil Nadu, India. Materials and methods The study was a cross-sectional descriptive study, conducted in a rural health center of a teaching hospital in Tamil Nadu, India, from February 2022 to July 2022. All the patients clinically having the symptoms of vaginitis and with a discharge were included in this study, and postmenopausal women and pregnant women were excluded. Data was collected from a total of 175 patients. Results The mean (SD) age of the study population was 34.8 (6.9) years. Almost half, 91 (52%), of the study participants were in the age group of 31-40 years. Bacterial vaginosis was found in 74 (42.3%) and was the most common cause of abnormal vaginal discharge in our study participants, followed by vulvovaginal candidiasis, 34 (19.4%). There were significant associations between high-risk sexual behavior and the presence of co-morbidities with abnormal vaginal discharge. Conclusion The most common causes of abnormal vaginal discharge were found to be bacterial vaginosis followed by vulvovaginal candidiasis. The study results help to initiate early appropriate treatment for effective management of a community health problem.

A Study on the Association Between Family Support and High-Risk Sexual Behavior of Elderly Men in Rural China.

Our study aimed to understand the relationship between the status of high-risk sexual behaviors of male ≥50 years old (elderly men) and their family support in a rural county-level city in Chengdu. Multi-stage sampling was used to select rural elderly men from six towns to conduct an interview questionnaire survey. Ordinal logistic regression was used to analyze the relationship between high-risk sexual behavior and family factors. A total of 790 samples were included, and the prevalence of high-risk sexual behavior was 16.2%. Two-hundred thirty-nine men (30.3%) had three close family members. More than half of the men (n = 397) had never been provided financial support by family members (50.3%). More than half of men (n = 406) never communicate deeply with family members (51.4%). Logistic analysis reported that 50-59 years old (odds ratio [OR] = 1.928, 95% confidence interval [CI] = [1.070, 3.477]), unmarried, divorced/widowed, married and separated (OR = 8.232, 95% CI = [2.640, 25.673]; OR = 3.589, 95% CI = [1.713, 7.520]; OR = 3.003, 95% CI = [1.238, 7.280]) elderly men were more likely to be involved in commercial sex. Meanwhile, either never or often family financial support (OR = 0.435, 95% CI = [0.228, 0.830]; OR = 0.288, 95% CI = [0.095, 0.876]) helped elderly men to avoid commercial sex. This study predicts family factors may be affected by loneliness, life satisfaction, disposable economic condition, family responsibilities as the middle path, thus affect high-risk sexual behaviors in elderly men.

Analysis of carcinogenic virus infection in HIV-infected patients / 上海预防医学

Objective To investigate the status of carcinogenic infection in people infected with HIV and those with negative HIV test results in VCT clinics. To analyze the epidemiological characteristics and provide scientific basis for more targeted disease prevention and control strategies. Methods The serum levels of Epstein-Barr virus （EBV）， human herpesvirus type 8 （HHV-8） and human T-lymphotropic virus type Ⅰ （HTLV-Ⅰ） antibodies were detected by ELISA method in 224 HIV-infected patients and 480 HIV-negative visitors treated in VCT clinics during the same period from 2014 to 2017， to compare the differences in the infection rates of this virus between HIV-infected and HIV-negative individuals and to systematically analyze the correlation between viral infections and high-risk sexual behavior. Results Among the 224 HIV-infected patients， 79 were positive for EBV antibody， with the infection rate of 35.27%； 151 were positive for HHV-8 antibody， with the infection rate of 67.41%； and 95 were positive for HTLV-Ⅰ， with the infection rate of 42.41%. A total of 480 HIV negative visitors were tested. 7 patients were positive for EBV antibody， with the infection rate of 1.46%. 26 patients were infected with positive HHV-8 antibody， with the infection rate of 5.41%. 9 patients had positive HTIV-Ⅰ antibody， with the infection rate of 1.86%. The infection rates of the three carcinogenic viruses in HIV-infected patients were all higher than those in HIV-negative groups， and the differences were statistically significant （ P <0.05）. Conclusion There is a high prevalence of three highly carcinogenic viruses in HIV-infected patients and serious co-infection. It is necessary to improve the education of safe sex among HIV-infected patients and people with high risk of infection in order to curb the epidemic of HIV and other infectious diseases.

Analysis of carcinogenic virus infection in HIV-infected patients / 上海预防医学

Objective To investigate the status of carcinogenic infection in people infected with HIV and those with negative HIV test results in VCT clinics. To analyze the epidemiological characteristics and provide scientific basis for more targeted disease prevention and control strategies. Methods The serum levels of Epstein-Barr virus （EBV）， human herpesvirus type 8 （HHV-8） and human T-lymphotropic virus type Ⅰ （HTLV-Ⅰ） antibodies were detected by ELISA method in 224 HIV-infected patients and 480 HIV-negative visitors treated in VCT clinics during the same period from 2014 to 2017， to compare the differences in the infection rates of this virus between HIV-infected and HIV-negative individuals and to systematically analyze the correlation between viral infections and high-risk sexual behavior. Results Among the 224 HIV-infected patients， 79 were positive for EBV antibody， with the infection rate of 35.27%； 151 were positive for HHV-8 antibody， with the infection rate of 67.41%； and 95 were positive for HTLV-Ⅰ， with the infection rate of 42.41%. A total of 480 HIV negative visitors were tested. 7 patients were positive for EBV antibody， with the infection rate of 1.46%. 26 patients were infected with positive HHV-8 antibody， with the infection rate of 5.41%. 9 patients had positive HTIV-Ⅰ antibody， with the infection rate of 1.86%. The infection rates of the three carcinogenic viruses in HIV-infected patients were all higher than those in HIV-negative groups， and the differences were statistically significant （ P <0.05）. Conclusion There is a high prevalence of three highly carcinogenic viruses in HIV-infected patients and serious co-infection. It is necessary to improve the education of safe sex among HIV-infected patients and people with high risk of infection in order to curb the epidemic of HIV and other infectious diseases.

Covariates of Multiplicity of High-Risk Sexual Behavior Among Men in India: Evidence from the Latest Indian Demographic and Health Survey.

Modern Indian society has witnessed rapid sociocultural transformation where loosening of cultural values is observed at all levels. In the era of transition, traditional norms and values are changing where young male individuals are found to be associated with high-risk multi-partner sexual behavior. Findings are based on a nationally representative sample of 45,231 and 65,704 men aged 15-54 during the period 2005-2006 and 2015-2016, respectively. The burden of high-risk sexual behaviors among men aged 15-54 years in India over the last decade remains disproportionately higher among younger, unmarried, and urban men, who are mainly from economically better-off households. Despite tremendous efforts of the government of India as well as various state governments in condom promotion as part of the HIV/AIDS prevention program, the improvements in condom use over the last decade are not impressive as it has not yet reached the desired threshold level. The disparities in high-risk sexual behavior among men aged 15-54 years, coming from rich and poor households, have narrowed. The findings of the study also underline an apparent paradox in the relationship between knowledge of HIV/AIDS and indulgence in high-risk sexual behavior and adopting safe sexual practices. It is recommended that all the HIV prevention programs in India should promote the concept of men as the responsible sexual partner. This concept may be promoted among young and unmarried men by reinforcing the shift from violence to respect and projecting the condom as a sexual stimulus rather than a means of disease prevention.

Synthetic drug use，sexual behavior and associated factors among men who have sex with men in Shanghai / 上海预防医学

Objective:To understand the status of synthetic drug use， high-risk sexual behavior and associated factors among men who have sex with men （MSM） in Shanghai. Methods:MSM subjects were recruited， by a team of non-governmental organizations （NGO）， at MSM places and voluntary counseling and testing clinics from May to December 2018. The subjects completed a self-administered questionnaire survey on social-demographic， ways to make friends， synthetic drug use， high-risk sexual behavior， and HIV/STD testing history. They also received tests of HIV and syphilis. According to the use of synthetic drugs， they were divided into user group and non-user group. Results:A total of 209 subjects were recruited. Among them， 43.1% （90/209） used at least one synthetic drug. 81.3% （170/209） of MSM used internet dating software. The proportion of synthetic drug use was higher among the subjects in 30-34 age group， residence registered in other provinces， with university degree or above， occupation of cadres and staff members， monthly income of more than 10 000 yuan， making friends through gay bars， and acquaintance with male partners. The registered residence in other provinces （OR=3.006） and making friends through gay bars （OR=3.588） were independent factors. The top three synthetic drugs were Rush （90.0%， 81/90）， Viagra （8.9%， 8/90） and “capsule 0” （7.8%， 7/90）. The proportion of having sex after using synthetic drugs was 89.5% （17/19）. The frequency of high-risk sexual behaviors such as oral sex， anal sex without condom and group sex was once a day per person on average. Conclusion:The use of synthetic drugs is prevalent among MSM， and the frequency of high-risk sexual behaviors after use is high. Warning education on the dangers of synthetic drug use and mobilization for HIV testing should be carried out with the help of new media technology. Special attention should be paid to MSM people in high-income occupations and gay bars.

Application of HIV prevention information transmission model in prevention of high-risk sexual behavior among men who have sex with men. / HIVé¢„é˜²ä¿¡æ¯ä¼ é€’æ¨¡å¼åœ¨ç”·ç”·æ€§è¡Œä¸ºè€ é«˜å±æ€§è¡Œä¸ºé¢„é˜²ä¸­çš„åº”ç”¨.

OBJECTIVES: To explore the effect of HIV prevention information transmission model in the prevention of high-risk sexual behavior among men who have sex with men (MSM). METHODS: To establish the HIV "expert-key informant-MSM" preventive information transmission model and to intervene the MSM high-risk sexual behavior. Before and 3 months after the intervention, MSM was measured by general information questionnaire, AIDS knowledge and sexual behavior questionnaire, MSM Health Belief Scale for HIV Prevention, and Safe Sexual Self-efficacy Scale. RESULTS: AIDS knowledge and sexual behavior scores in MSM after the intervention were significantly higher than those before the intervention (Z=-13.047, P<0.001); the scores of health belief before and after the intervention were significantly higher (Z=-3.272, P=0.001); condom use in MSM after the intervention was more common than that before the intervention (P<0.05), except for commercial sex. CONCLUSIONS: The application of HIV prevention information transmission model can effectively improve AIDS-related knowledge, HIV prevention health beliefs, condom use rate of MSM population, and in turn promote the transformation of their high-risk sexual behavior.

Impact of community subculture on high-risk sexual behavior of men who have sex with men based on health belief model. / åŸºäºŽå¥åº·ä¿¡å¿µæ¨¡åž‹æŽ¢è®¨ç¤¾ç¾¤äºšæ–‡åŒ–å¯¹ç”·ç”·æ€§è¡Œä¸ºè€ é«˜å±æ€§è¡Œä¸ºçš„å½±å“.

OBJECTIVES: To explore the Impact of community subculture of men who have sex with men (MSM) on the occurrence of high-risk sexual behavior based on the health belief model. METHODS: A qualitative research method was used to conduct in-depth interviews with 17 MSM by one-to-one and half-structured way, and thematic analysis was used to analyze the data. RESULTS: There were several factors for high-risk sexual behavior in MSM subculture, such as trust, subjective assessment for partner or personal health status, the role in inserting, awareness of HIV infection among partners, perception of HIV and homosexual discrimination, difficulty in maintaining a fixed partner, family responsibility,and so on. Self-efficacy also affected MSM's high-risk sexual behavior. CONCLUSIONS: High-risk sexual behavior in MSM population is influenced by individual, group, and intra-circle subculture. Cognitive bias for HIV infection in MSMs can be intervened by constructing a preventive intervention model for high-risk sexual behavior.

Food Insecurity and Risk Indicators for Sexually Transmitted Infection Among Sexually Active Persons Aged 15-44, National Survey of Family Growth, 2011-2017.

OBJECTIVES: Food insecurity is linked to poor sexual health outcomes, especially among persons engaged in sexual behaviors that are associated with the risk of acquiring sexually transmitted infections (STIs). We examined this link using nationally representative data. METHODS: We used data on adolescents and adults aged 15-44 who reported sexual activity in the past year from 6 years (September 2011-September 2017) of cross-sectional, weighted public-use data from the National Survey of Family Growth. We compared data on persons who did and did not report food insecurity, accounting for demographic characteristics, markers of poverty, and past-year STI risk indicators (ie, engaged in 1 of 4 high-risk activities or diagnosed with chlamydia or gonorrhea). RESULTS: Respondents who reported at least 1 past-year STI risk indicator were significantly more likely to report food insecurity (females: adjusted risk ratio [ARR] = 1.63; 95% confidence interval [CI], 1.35-1.97; P < .001; males: ARR = 1.46; 95% CI, 1.16-1.85) than respondents who did not report food insecurity. This finding was independent of the association between food insecurity and markers of poverty (≤100% federal poverty level [females: ARR = 1.46; 95% CI, 1.23-1.72; P < .001; males: ARR = 1.81; 95% CI, 1.49-2.20; P < .001]; if the respondent or someone in the household had received Special Supplemental Nutrition Program for Women, Infants, and Children or Supplemental Nutrition Assistance Program benefits in the past year [females: ARR = 3.37; 95% CI, 2.81-4.02; P < .001; males: ARR = 3.27; 95% CI, 2.76-3.87; P < .001]). Sex with opposite- and same-sex partners in the past year was significantly associated with food insecurity (females: ARR = 1.44; 95% CI, 1.11-1.85; P = .01; males: ARR = 1.99; 95% CI, 1.15-3.42; P = .02). CONCLUSIONS: Food insecurity should be considered a social determinant of health independent of poverty, and its effect on persons at highest risk for STIs, including HIV, should be considered when planning interventions designed to decrease engagement in higher-risk sexual behaviors.

Application of HIV prevention information transmission model in prevention of high-risk sexual behavior among men who have sex with men / 中南大学学报(医学版)

OBJECTIVES@#To explore the effect of HIV prevention information transmission model in the prevention of high-risk sexual behavior among men who have sex with men (MSM).@*METHODS@#To establish the HIV "expert-key informant-MSM" preventive information transmission model and to intervene the MSM high-risk sexual behavior. Before and 3 months after the intervention, MSM was measured by general information questionnaire, AIDS knowledge and sexual behavior questionnaire, MSM Health Belief Scale for HIV Prevention, and Safe Sexual Self-efficacy Scale.@*RESULTS@#AIDS knowledge and sexual behavior scores in MSM after the intervention were significantly higher than those before the intervention (=-13.047, <0.001); the scores of health belief before and after the intervention were significantly higher (=-3.272, =0.001); condom use in MSM after the intervention was more common than that before the intervention (<0.05), except for commercial sex.@*CONCLUSIONS@#The application of HIV prevention information transmission model can effectively improve AIDS-related knowledge, HIV prevention health beliefs, condom use rate of MSM population, and in turn promote the transformation of their high-risk sexual behavior.

Impact of community subculture on high-risk sexual behavior of men who have sex with men based on health belief model / 中南大学学报(医学版)

OBJECTIVES@#To explore the Impact of community subculture of men who have sex with men (MSM) on the occurrence of high-risk sexual behavior based on the health belief model.@*METHODS@#A qualitative research method was used to conduct in-depth interviews with 17 MSM by one-to-one and half-structured way, and thematic analysis was used to analyze the data.@*RESULTS@#There were several factors for high-risk sexual behavior in MSM subculture, such as trust, subjective assessment for partner or personal health status, the role in inserting, awareness of HIV infection among partners, perception of HIV and homosexual discrimination, difficulty in maintaining a fixed partner, family responsibility,and so on. Self-efficacy also affected MSM's high-risk sexual behavior.@*CONCLUSIONS@#High-risk sexual behavior in MSM population is influenced by individual, group, and intra-circle subculture. Cognitive bias for HIV infection in MSMs can be intervened by constructing a preventive intervention model for high-risk sexual behavior.

Using latent class analysis to identify money boys at highest risk of HIV infection.

OBJECTIVES: Limited research has been conducted to investigate the characteristics of money boys (MBs) in China. This study was aimed to identify the subgroups of MBs based on sexual behaviors, Net-based venue sex-seeking, and substance abuse. STUDY DESIGN: Cross-sectional study. METHODS: Convenience sampling was used to recruit MBs from December 2014 to June 2015 in Tianjin, China. Face-to-face interviews were conducted for 330 MBs, and trained interviewers collected data. RESULTS: The laboratory-confirmed human immunodeficiency virus (HIV)-positive rate was 11.52% among 330 MBs. Four classes were identified through latent class analysis (LCA) method: 'relatively safe behavior' group, 'higher sexual risk' group, 'multiple sexual-partners' group, and 'unprotected sex and substance abuse' group, and there is a significant difference based on the HIV status. Significant differences were found in original residence, monthly income, duration in sex trade, employment, history of sexually transmitted infection (STI), HIV testing, knowledge of free antiviral treatment policy, and awareness of free AIDS testing between the four latent classes (P < 0.05). MBs who used Net-based venues to seek sexual partners; who have inconsistent condom use, substance abuse, a longer duration in sex trade, multiple sexual clients, and multiple anal sex; and who were full-time employed had the highest risk of HIV infection. CONCLUSIONS: The utility of LCA to identify subgroups based on risky behaviors attributes to formulating targeted intervention strategy.

Optimizing Assessment of Risk and Protection for Diverse Adolescent Outcomes: Do Risk and Protective Factors for Delinquency and Substance Use Also Predict Risky Sexual Behavior?

Assessments of youth risk and protective factors (RPFs) for substance use, delinquency, and violence have been used by communities to identify priorities and target them with prevention interventions. These same RPFs may also predict other youth problems. This study examined the strength and consistency of relationships of 41 ecological RPFs that predict antisocial behavior and substance use with sexual behavior outcomes in a sample of 2150 urban youth in 10th and 12th grade. After adjusting for controls, findings identify significant associations among the majority of community, school, family, peer, and individual risk factors, and family, peer, and individual protective factors, with sexual behavior outcomes, specifying unique associations among multiple factors with risky sex relative to both safe sex and not being sexually active. Prevention programming that targets common predictors for multiple problems may address a broad array of outcomes, including sexual health risk behaviors.

Development and Feasibility Testing of a Videogame Intervention to Reduce High-Risk Sexual Behavior in Black and Hispanic Adolescents.

Objective: Develop and test feasibility of a mobile videogame intervention to decrease high-risk sexual behavior in black and Hispanic adolescents. Materials and Methods: Iterative design to develop intervention in partnership with target audience. Feasibility and preliminary impact data collected at baseline, following 2-3 hours of gameplay and at 8-week follow-up. Results: Twenty-six 15-17-year-olds completed pilot testing: 16 (62%) were male, 20 (77%) black or Hispanic. Pilot testing demonstrated feasibility, including producing a usable videogame prototype, incorporating videogame testing within a high school, and participants' acceptability of the videogame. Participants' gameplay experience reflected that most would play the videogame again (77%), stated that they felt responsible for the choices they made in the videogame (73%), and would tell their friends to play the videogame (58%). Most suggested adding more videogame content to further engage participants. From baseline to follow-up, participants demonstrated improvements in condom and contraception self-efficacy (P = 0.003), risk perceptions (P = 0.009), and high-risk sexual behavior knowledge (P < 0.0001). Among black or Hispanic adolescents, we found improvements in summary measures of intentions (P = 0.04), self-efficacy (P = 0.003), risk perceptions (P = 0.002), and sexual knowledge (P = 0.0002). Adolescents with previous sexual experience showed similar improvements. Conclusion: Pilot testing of an innovative videogame, developed in partnership with the target audience, demonstrated feasibility and preliminary impact with this cohort of black or Hispanic adolescents. We developed a usable videogame prototype and gained important data about how to enhance the next videogame iteration. Future plans include targeting an older age group to maximize our ability to measure potential impact among sexually experienced adolescents.

Intimate Relationships and Sexual Behavior in Young Women withDepression.

PURPOSE: To better understand links between depressive symptoms and high-risk sexual behavior in young women. METHODS: We conducted semistructured interviews with young women from three primary care clinics who reported clinically significant depressive symptoms, had penile-vaginal sexual intercourse within the past 6 months, and met at least one sexual risk criterion (N = 16, age 16-23years, racially/ethnically diverse). We transcribed the interview recordings, organized and coded the data, and conducted a directed content analysis. RESULTS: Participants described a complex interrelation between depression and intimate relationships and sexual behavior. Depression had negative effects on relationships, sexual motives and experiences (including safety), and feelings about oneself in sexual situations. Participants reported difficulty in developing and maintaining intimate relationships. Although many participants reported less interest in and emotional energy for sex, several were having sex frequently to manage depressive symptoms. Generally, the young women described sex as unsafe (e.g., no condom) owing to impaired judgment, increased impulsivity, apathy, and alcohol. As a result, sometimes their efforts to feel better by having sex led them to feeling worse (e.g., ashamed and worthless). CONCLUSIONS: Depressed young women may limit intimate relationships, yet engage in frequent and unsafe sex to cope with their symptoms. Their efforts to feel better may provide only temporary relief or result in feeling worse. Depressed young women would benefit from tailored interventions that identify and counter unhealthy thoughts, attitudes, behaviors, and patterns related to sexual relationships and behavior; minimize factors that impair healthy decision-making; and foster development of alternative affect regulation strategies.

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept.

Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18-24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61-0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05-1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85-2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08-1.36), and marriage (aOR 1.55; 95% CI 1.37-1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18-24 vs. 25-32 years).

Review of high-risk sexual behaviors in men who have sex with men: influencing factors and theoretical models / 上海交通大学学报（医学版）

The disproportionately high prevalence of HIV among men who have sex with men (MSM) is associated with the prevalence of unprotected anal intercourse (UAI), which has been the predominant high-risk behavior of HIV acquisition and transmission. MSM have become a target population for HIV prevention. The aspects affecting the high-risk sexual behaviors of MSM mainly include personal factors, environmental factors, and social psychological factors. Currently widely applied models of acquired immunodeficiency syndrome (AIDS) behavioral intervention include KABP (knowledge, attitude, belief, and practice) model, health belief model, theory of reasoned action, social network theory, and so on. These theories provide a reference for studying various influential factors and elaborating the occurrence of high-risk sexual behaviors of MSM. Exploring and building the comprehensive model and integrating the influencing factors of high-risk sexual behaviors of MSM can help us to predict their ultimate actions in the future. Similarly, it will also provide ideas for the further preventions and interventions in MSM.

Reducing the risk of HIV transmission among men who have sex with men: A feasibility study of the motivational interviewing counseling method.

HIV prevalence among Chinese men who have sex with men has rapidly increased in recent years. In this randomized, controlled study, we tested the feasibility and efficacy of motivational interviewing to reduce high-risk sexual behaviors among this population in Changsha, China. Eighty men who have sex with men were randomly assigned to either the intervention group, in which participants received a three-session motivational interviewing intervention over 4 weeks, or the control group, in which participants received usual counseling from peer educators. High-risk behavior indicators and HIV knowledge level were evaluated at baseline and 3 months after the intervention. Motivational interviewing significantly improved consistent anal condom use. However, there was no significant change in consistent condom use for oral sex or in the number of sexual partners over time. HIV knowledge scores improved equally in both groups. This study demonstrated that an intervention using motivational interviewing is feasible and results in increased condom use during anal sex for Chinese men who have sex with men. However, further work must be done to increase the use of condoms during oral sexual encounters.