Metabolic pathways that mediate the effects of food deprivation on reproductive behavior in female Drosophila melanogaster.

In most species studied, energy deficits inhibit female reproductive behavior, but the location and nature of energy sensors and how they affect behavior are unknown. Progress has been facilitated by using Drosophila melanogaster, a species in which reproduction and food availability are closely linked. Adult males and females were either fed or food deprived (FD) and tested in an arena with a fed, opposite-sex conspecific with no food in the testing arena. Only FD females (not FD males) significantly decreased their copulation rate and increased their copulation latency, and the effects of FD were prevented in females fed either yeast alone or glucose alone, but not sucralose alone, cholesterol alone, or amino acids alone. It is well-known that high-fat diets inhibit copulation rate in this species, and the effects of FD on copulation rate were mimicked by treatment with an inhibitor of glucose but not free fatty acid oxidation. The availability of oxidizable glucose was a necessary condition for copulation rate in females fed either yeast alone or fed a nutritive fly medium, which suggests that the critical component of yeast for female copulation rate is oxidizable glucose. Thus, female copulation rate in D. melanogaster is sensitive to the availability of oxidizable metabolic fuels, particularly the availability of oxidizable glucose or substrates/byproducts of glycolysis.

A review of published studies on virtual reality in sexuality research.

INTRODUCTION: Virtual reality (VR) technology contributes to greater approach of methodological safety to make ecological validity more feasible and a growing interest in sexuality behaviors. OBJECTIVES: The aim of this study was to show VR in the sexuality area by a comprehensive review of outcomes, offer a synthesis of the studies, and make a methodological quality assessment of finding results. A secondary goal was to investigate the effect of immersion on diverse sexual responses outcomes. METHODS: We designed a review based on a systematic review strategy describing types of studies, participants, data collection and outcomes; searched in 4 electronic databases (PubMed, EMBASE, PsycINFO, and SciELO), and made a full-text screening process. RESULTS: The study found 18 articles that met research criteria synthesized within 3 outcome groups: erection measures, level of immersion, and biomarker studies. Synthesis shows a lack of methodological aspects that impair results, such as description of methods from bias protection, randomization, or concealment. The literature still needs to improve its methodology, even though it already shows relevant data for intervention in sexual dysfunction, forensic psychiatry, sexual attraction, orientation, and use of pornography. CONCLUSION: Current methodological issues need better design to highlight relevant issues in sexuality with stronger quality of design, opening boundaries to new diagnostic or interventional technologies to sexual health.

Self-regulatory Sex Motives Scale in Online Dating: Exploratory Factor Analysis and Internal Consistency.

Risky sex behavior is common among online dating users. Understanding the motives behind risky sex behavior might help identify suitable targets for prevention. We developed the Self-regulatory Sex Motives Scale in Online Dating (SSOD) to assess sex motives for casual sex in online dating users. This study evaluated the psychometric properties of the SSOD and examined the relationship between sex motives indexed by the SSOD and risky sex behavior. The new scale showed high internal consistency. Exploratory factor analysis suggested a one-factor solution. Sex motives were related to a higher frequency of having sex on the first date.

The effect of cigarette smoke extract exposure on the size and sexual behaviour of Drosophila melanogaster.

Drosophila melanogaster is a widely used animal model in human diseases and to date it has not been applied to the study of the impact of tobacco use on human sexual function. Hence, this report examines the effects of different concentrations of cigarette smoke extract (CSE) exposure on the size and sexual behavior of D. melanogaster. Wild-type flies were held in vials containing CSE-infused culture media at concentrations of 10%, 25%, and 50% for three days, and their offspring were reared under the same conditions before measuring their body size and mating behavior. CSE exposure during development reduced the tibia length and body mass of emerging adult flies and prolonged the time required for successful courtship copulation success, while courtship behaviors (wing extension, tapping, abdomen bending, attempted copulation) remained largely unchanged. Our findings indicate that CSE exposure negatively affects the development of flies and their subsequent reproductive success. Future experiments should investigate the CSE effect on male female fertility.

A Preliminary Experimental Study of Self-Objectification and Risky Sex Behavior Among a University Sample of Cisgender Women in the U.S.

Self-objectification is associated with a number of negative mental and behavioral outcomes. Though previous research has established associations between self-objectification and risky sex, no study to date has examined whether self-objectification affects propensity to engage in risky sex. The current research employed an experimental design to examine the effect of heightened self-objectification on a laboratory analog of risky sex (n = 181). We observed that when college-attending women experienced a heightened state of self-objectification, they were more likely to engage in sex without a condom and less likely to wait to use a condom with a highly desirable partner. Given the frequency of intended and unintended objectifying messages that young women face, this increase in willingness to engage in risky sex behavior represents a consequential health concern.

Mistimed restricted feeding disrupts circadian rhythms of male mating behavior and female preovulatory LH surges in mice.

In rodents, eating at atypical circadian times, such as during the biological rest phase when feeding is normally minimal, reduces fertility. Prior findings suggest this fertility impairment is due, at least in part, to reduced mating success. However, the physiological and behavioral mechanisms underlying this reproductive suppression are not known. In the present study, we tested the hypothesis that mistimed feeding-induced infertility is due to a disruption in the normal circadian timing of mating behavior and/or the generation of pre-ovulatory luteinizing hormone (LH) surges (estrogen positive feedback). In the first experiment, male+female mouse pairs, acclimated to be food restricted to either the light (mistimed feeding) or dark (control feeding) phase, were scored for mounting frequency and ejaculations over 96 h. Male mounting behavior and ejaculations were distributed much more widely across the day in light-fed mice than in dark-fed controls and fewer light-fed males ejaculated. In the second experiment, the timing of the LH surge, a well characterized circadian event driven by estradiol (E2) and the SCN, was analyzed from serial blood samples taken from ovariectomized and E2-primed female mice that were light-, dark-, or ad-lib-fed. LH concentrations peaked 2 h after lights-off in both dark-fed and ad-lib control females, as expected, but not in light-fed females. Instead, the normally clustered LH surges were distributed widely with high inter-mouse variability in the light-fed group. These data indicate that mistimed feeding disrupts the temporal control of the neural processes underlying both ovulation and mating behavior, contributing to infertility.

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks.

Being strangled, or "choked," by a sexual partner has emerged as a prevalent, often wanted and consensual sexual behavior among adolescent and young adult women, yet the neurological consequences of repeated exposure to this behavior are unknown. The objective of the study was to examine the association between a history of repeated, recent choking/strangling episodes during sex and fMRI activation during working memory tasks in young adult women. This case-control study involved young adult women (18-30 years old) at a large, public university, and consisted of two study groups: a choking group consisting of participants who were recently and frequently choked/strangled during sex by a partner (≥4 times in the past 30 days) and a choking-naïve (control) group who had never been choked/strangled during sex. Participants completed two variations of the N-back (0-back, 1-back, and 2-back) working memory task during functional magnetic resonance imaging (fMRI): verbal and visual N-back tasks. Data from 20 participants per group were available for analysis. Between-group differences for accuracy and reaction time were not significant for either variation of the N-back task. Significant differences in fMRI activation patterns were detected between the choking and the choking-naïve groups for the three contrasts of interest (1-back > 0-back, 2-back > 0-back, and 2-back > 1-back). The choking group exhibited increased activation in multiple clusters relative to the choking-naïve group for the contrasts between the 1-back and 2-back conditions compared to the 0-back conditions (e.g., superior frontal gyrus, corpus callosum). However, the choking-naïve group exhibited increased activation relative to the choking group in several clusters for the 2-back > 1 back contrast (e.g., splenium, middle frontal gyrus). These data indicate that recent, frequent exposure to partnered sexual strangulation is associated with different neural activation patterns during verbal and visual working memory tasks compared to controls, suggesting that being choked/strangled during sex may modify the allocation of neural resources at increasing levels of cognitive load. Further investigation into the neurologic effects of this sexual behavior is warranted, given the prevalence of sexual choking among adolescent and young adult women.

Developmental nicotine exposure and masculinization of the rat preoptic area.

Nicotine is a neuroteratogenic component of tobacco smoke, e-cigarettes, and other products and can exert sex-specific effects in the developing brain, likely mediated through sex hormones. Estradiol modulates expression of nicotinic acetylcholine receptors in rats, and plays critical roles in neurodevelopmental processes, including sexual differentiation of the brain. Here, we examined the effects of developmental nicotine exposure on the sexual differentiation of the preoptic area (POA), a brain region that normally displays robust structural sexual dimorphisms and controls adult mating behavior in rodents. Using a rat model of gestational exposure, developing pups were exposed to nicotine (2 mg/kg/day) via maternal osmotic minipump (subcutaneously, sc) throughout the critical window for brain sexual differentiation. At postnatal day (PND) 4, a subset of offspring was analyzed for epigenetic effects in the POA. At PND40, all offspring were gonadectomized, implanted with a testosterone-releasing capsule (sc), and assessed for male sexual behavior at PND60. Following sexual behavior assessment, the area of the sexually dimorphic nucleus of the POA (SDN-POA) was measured using immunofluorescent staining techniques. In adults, normal sex differences in male sexual behavior and in the SDN-POA area were eliminated in nicotine-treated animals. Using novel analytical approaches to evaluate overall masculinization of the adult POA, we identified significant masculinization of the nicotine-treated female POA. In neonates (PND4), nicotine exposure induced trending alterations in methylation-dependent masculinizing gene expression and DNA methylation levels at sexually-dimorphic differentially methylated regions, suggesting that developmental nicotine exposure is capable of triggering masculinization of the rat POA via epigenetic mechanisms.

The association of food parenting practices with adolescents' dietary behaviors differ by youth gender, but not by parent gender.

BACKGROUND: Parents affect their adolescents' dietary behaviors through food parenting practices both directly and indirectly through adolescents' cognitive factors (self-efficacy, intrinsic or extrinsic motivation). However, it is not known if mothers and fathers use of different food parenting practices similarly influences boys' and girls' dietary behaviors. This study investigated the direct and indirect associations between food parenting practices and adolescents' dietary behaviors (fruits/vegetables and sugar sweetened beverage (SSB)) and whether these associations differed by adolescents' or parents' gender. METHODS: Data were obtained from the 2014 Family Life, Activity, Sun, Health, and Eating Study. A sample of 1633 American adolescent-parent dyads (73.7% mothers; 50.4% girls) completed the self-reported tools. Models were stratified by adolescents' gender and differences by parent gender were explored as a moderator. RESULTS: Differences did not emerge based on gender of parents. However, associations between food parenting practices and adolescents' dietary behaviors differed by adolescents' gender. Direct associations between autonomy supportive food parenting practices and fruit/vegetable intake (ß = 0.18, p < .05) and intrinsic motivations and SSB consumption (ß = -0.13, p < .05) were detected only among boys. Direct associations, regardless of gender, were also found including structured food parenting practices and adolescent self-efficacy with their dietary behaviors; controlling food parenting practices with SSB intake; as well as intrinsic and extrinsic motivation with fruit/vegetable intake. Findings from the mediation analyses supported these trends with structured parenting practices displaying similar associations on boys' and girls' dietary behaviors. In contrast, controlling and autonomy supportive parenting practices have significant indirect associations on dietary behaviors through motivation for boys only. CONCLUSION: Adolescent boys and girls appear to be affected differently by food parenting practices and accounting for these differences may contribute to more effective dietary interventions.

Same-sex behavior disclosure to health care providers associated with greater awareness of pre-exposure prophylaxis.

BACKGROUND: This study aimed to determine whether the disclosure of same-sex behavior to health care providers (HCPs) is associated with higher rates of prior human immunodeficiency virus (HIV) testing experience and greater awareness of immediate antiretroviral therapy (ART), Undetectable = Untransmittable (U=U), and pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM). METHODS: We conducted a cross-sectional survey among 689 adult males in Chengdu, China who self-reported having had anal intercourse with at least one man in the past 6 months. We measured same-sex behavior disclosure to three types of HCPs (hospital clinicians, community-based organization peer educators, and Center for Disease Control and Prevention public health specialists), and the awareness of immediate ART, U=U, and PrEP. RESULTS: Of the 689 enrolled participants, 31.4% had disclosed their same-sex behavior to some or all of the clinicians, 83.9% had done so to the peer educators, and 56.8% had done so to the public health specialists. Approximately four in five (82.1%) of the participants had ever been tested for HIV. The awareness rate was 84.8% for immediate ART, 20.2% for U=U, and 50.7% for PrEP. After controlling for significant background variables, same-sex behavior disclosure to clinicians was associated with greater awareness of PrEP (adjusted odds ratio [AOR] = 1.64; 95% confidence interval [CI]: 1.08-2.48), but similar findings were not reported regarding disclosure to peer educators or public health specialist. Same-sex behavior disclosure to any types of HCPs was not associated with HIV testing experience, and awareness of immediate ART or U=U. CONCLUSIONS: The rates of same-sex behavior disclosure varied with different types of HCPs. Disclosure to clinicians was associated with greater awareness of PrEP, but not awareness of immediate ART or U=U.

Examining the Relationship between Gender Contentedness and Sex-Related Experiences among Taiwanese Youth.

Little is known about how gender contentedness is related to sex-related experiences among Taiwanese adolescents. Secondary analysis of data (n = 2624, Mage = 13.3 ± 0.47 years and 51% males) on a longitudinal youth cohort was used to track the evolving development of sex-related experiences such as exposure to sexually explicit media, romantic experiences, and sexual behaviors. Hierarchical multinomial logistic regression analyses were applied to study the effects of gender contentedness on sex-related outcome variables. The results showed that nearly 10% of the subjects were not contented with their gender. As compared to peers, gender-discontented adolescents had a higher likelihood of exposures to sexually explicit media (odds ratio [OR]. = 1.70, 95% confidence interval [CI]. = 1.18-2.46) and risky sex behaviors (OR = 2.22, 95% CI = 1.03-4.81). These results shed light on the impact of self-perceived gender contentedness on sex-related experiences in Taiwanese adolescents. Our findings are helpful for the development of practical guidance on sexual health issues, particularly for those who are discontented with their gender.

Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey.

BACKGROUND: Probability-based surveys of college students typically assess sexual behaviors such as oral, vaginal, and anal sex. Little is known about the broader range of sexual behaviors in which students engage. AIMS: In a random sample survey of undergraduate students, we aimed to: (1) describe how recently participants had engaged in solo and partnered sexual behaviors, (2) examine how frequently participants enacted certain rough sex sexual behaviors (e.g., light spanking, hard spanking, choking, slapping, and others), (3) assess participants' frequency of experiencing certain rough sex behaviors, (4) describe participants' frequency of threesome/group sex, (5) assess the characteristics of participants' experiences with choking during sex; and (6) examine choking and face slapping in regard to consent. METHODS: A confidential, online cross-sectional survey of 4,989 randomly sampled undergraduate students at a large U.S. university. OUTCOMES: Participants reported having engaged in a broad range of solo and partnered sexual activities, including rough sex behaviors. RESULTS: The most prevalent general sexual behaviors were solo masturbation (88.6%), oral sex (79.4% received, 78.4% performed), penile-vaginal intercourse (73.5%), and partnered masturbation (71.1%). Anal intercourse was the least prevalent of these behaviors (16.8% received, 25.3% performed). Among those with any partnered sexual experience, 43.0% had choked a partner, 47.3% had been choked, 59.1% had been lightly spanked and 12.1% had been slapped on the face during sex. CLINICAL TRANSLATION: College health clinicians and educators need to be aware of the diverse and evolving range of solo and partnered sexual behaviors reported by students. In addition to counseling students about pregnancy and sexually transmitted infection risk, clinicians might assess patients' engagement in diverse sexual behaviors, such as choking/strangulation during sex, given the risk for serious outcomes including death. STRENGTHS AND LIMITATIONS: Strengths of our research include the large sample size, use of random sampling, high response rate for college populations, broad range of behaviors assessed, and novel data on choking during sex. Among our limitations, we did not assess to what extent the experiences were wanted, pleasurable, or appealing to participants. Except for in relation to choking and slapping, we also did not assess issues of consent. CONCLUSION: Participants reported engaging in diverse sexual behaviors, some of which have important clinical implications, are understudied, and warrant further research. Herbenick D, Patterson C, Beckmeyer J, et al. Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. J Sex Med 2021;18:1024-1041.

Improving HIV Self-Testing Social Network Interventions: The Role of Sexual Behavior Disclosure Among Chinese Men Who Have Sex with Men.

We assessed if same-sex sexual behavior disclosure of index men who have sex with men (MSM) was related to number of HIV self-testing (HIVST) kits requested by index participants, and number of test results successfully uploaded by alters in a network-based HIVST intervention. Index participants are men who accessed and distributed HIVST kits and alters are index's social contacts who received kits. We analyzed treatment arm data [N = 106, mean age = 27 (SD = 5.3)] of an intervention conducted among MSM in Guangzhou, China, May 2019-December 2019. Index MSM who disclosed sexual behavior to their family tended to request more kits [adjusted incidence rate ratio (aIRR) 1.42, 95% CI 1.06, 1.90, p < .05]. Index men who disclosed sexual behavior to their family (aIRR 2.47, 95% CI 1.17, 5.24, p < .05) tended to yield an increase in number of alter test results uploaded. Findings have implications for the development of network-based interventions for key populations.

Exogenous leptin promotes reproductive behavior during aphagia in red-sided garter snakes (Thamnophis sirtalis parietalis).

Despite the established dichotomy between investment in either reproduction or self-maintenance, a hormonal mechanism that influences an organism's decision to prioritize these behaviors remains elusive. The protein hormone leptin is a likely candidate because it is secreted from adipocytes in proportion to the amount of stored fat in numerous species. Although the majority of studies suggest that leptin stimulates reproduction, the actions of leptin can be context-dependent. Leptin increases sexual behavior in fed individuals, but inhibits sexual behavior in food-restricted individuals. We investigated if exogenous leptin influences sexual behavior in red-sided garter snakes (Thamnophis sirtalis parietalis) experiencing a predictable bout of aphagia during the mating season. We tested two doses of recombinant murine leptin injected for three days. Males were subjected to three mating trials, one on each day of injections, while females were subjected to one mating trial on the last day of injections. Leptin affects male and female snakes similarly by increasing both appetitive (i.e., mating behavior score) and consummatory (i.e., number of copulations, proportion of individuals copulated) sex behavior. We found no evidence to suggest that leptin influenced latency to copulate or duration of copulation. Because leptin promotes reproductive behavior in non-feeding garter snakes, these findings do not align with research on food-restricted mammals. Further investigations into how leptin affects sexual behavior in snakes exposed to food-restriction manipulations would clarify if the role of leptin is evolutionarily divergent.

[Relationship between new-type drug use and high risk sex behavior in men who have sex with men].

Objective: To understand the relationship between new-type drug use and high risk behavior in men who have sex with men (MSM) in Shandong province. Methods: Cross-sectional surveys was conducted to collect the information about demographics, sexual and drug use behaviors of MSM and HIV-related services in MSM in three sentinel surveillance sites in Shandong from April to July in 2019. Blood samples were taken from the MSM for serological tests of HIV antibody and syphilis antibody. Results: A total of 1 203 MSM were included in this study. The average age of the MSM was 30.2±8.9 years. Among these MSM, 67.7% (815) were unmarried; 66.9% (805) had education level of college or above; 62.2% (721/1 160) had unprotected sex behaviors and 16.3% (189/1 160) had group sex behavior in the past six months and 54.2% (652/1 203) ever used new-type drugs. HIV infection and syphilis prevalence rates were 3.1% (37/1 203) and 4.7% (56/1 203), respectively. Multivariable logistic analysis indicated that MSM who had unprotected anal sex in the past six months were more likely to be from Qingdao (aOR=1.59, 95%CI:1.13-2.23), with education level of high school or below (aOR=1.61, 95%CI: 1.20-2.16), with male sex partners from bars/dance halls or other venues (aOR=1.69, 95%CI: 1.06-2.69), with HIV knowledge awareness score <6 (aOR=1.55, 95%CI: 1.01-2.37), with ≥2 sex partner in the past week (aOR=1.48, 95%CI: 1.12-1.95), to have group sex behaviors in the past six months (aOR=2.43, 95%CI:1.61-3.67) and to use new-type drugs (aOR=1.46, 95%CI: 1.11-1.91). MSM who had group sex were more likely to have following features: being from Qingdao (aOR=2.21, 95%CI: 1.45-3.38), non-Shandong residents (aOR=2.13, 95%CI: 1.28-3.55), HIV knowledge awareness score ≥6 (aOR=3.11, 95%CI: 1.55-6.25), ever having unprotected anal sex behaviors (aOR=2.60, 95%CI: 1.71-3.96) and ever having male commercial sex (aOR=3.38, 95%CI: 1.92-5.95) in the past six months, ever using new-type drugs (aOR=2.71, 95%CI: 1.82-4.04), and never having HIV testing in the past year (aOR=2.66, 95%CI: 1.59-4.43). Conclusion: New-type drug use is common in MSM in Shandong. The use of new-type drugs promotes unprotected sex and group sex in MSM. Surveillance and intervention measures targeting this population should be strengthened.

[Studies on sexual and childbearing-related stigma against chronic hepatitis B patients in four provinces in China].

Objective: This study intended to explore the current sexual and childbearing stigma, experienced by chronic hepatitis B patients in China, and to develop related preventive strategies. Methods: We used a self-made questionnaire to investigate the sexual and childbearing stigma suffered by chronic hepatitis B patients in four provinces of China. Analysis of variance and chi-square test were used to compare the differences on sexual and childbearing stigma indexes between different demographic variables. Results: We surveyed 797 chronic hepatitis B patients in four provinces. Among them, 4.15% (28/675) of the patients were persuaded not to give birth to children, and 4.67% (10/210) of patients were told to stop pregnancy, by their medical care takers or by members from the family planning institutions. 3.62% (25/690) and 3.48% (24/690) of the patients were not able to enjoy the family planning or reproductive health services as they were stigmatized,suffered, as having HBV infection. Among the male chronic hepatitis B patients, the under 30 years group suffered less sexual and childbearing stigma than those who were aged 31- (P=0.011) or 51 and above year-olds (P=0.009). Among female chronic hepatitis B patients, the 31- year-olds group suffered less sexual and childbearing stigma than those under 30 years group but higher than those aged 41- (P=0.001) or 51 and above ones (P<0.001). Patients with knowledge on route of sexual transmission for HBV, were more likely to practice less related sexual behaviors than those without such knowledge (P=0.022). Patients who were aware or not that condoms could reduce the risk of HBV infection did not show statistically significant difference on sex behaviors (P=0.612). Conclusions: Chronic hepatitis B patients did suffer from sexual and childbearing related stigma, with women aged 31-40 years old the most. It is necessary to advocate on the advantage of condom use for prevention of HBV transmission among pregnant women, both horizontally and vertically. Strategies on protection the rights of patients with hepatitis B should be developed and strengthened.

Pilot Study of a Multilevel Mobile Health App for Substance Use, Sexual Risk Behaviors, and Testing for Sexually Transmitted Infections and HIV Among Youth: Randomized Controlled Trial.

BACKGROUND: Preventing and reducing substance use disorders, sexually transmitted infections (STIs)/HIV, and teen pregnancy, and the associated risk behaviors (ie, substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among the youth. Mobile health (mHealth) apps may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated efficacy in reducing substance use or sexual risk behaviors or improving the uptake of STI/HIV testing among the youth, particularly in clinic settings. OBJECTIVE: This small-scale study aimed to examine the feasibility of conducting a pilot randomized controlled trial (RCT). We evaluated the effects of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, on the potential mechanisms by which behavior change occurs, namely clinician-youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy. We also assessed the ability to measure targeted outcomes of past 30-day substance use (ie, alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use before sex, as well as the uptake of STI/HIV testing. METHODS: Employing community-based participatory research principles, 50 youths aged 13 to 21 years were recruited from a youth-centered community health clinic in Southeast Michigan, randomized sequentially to either S4E or enhanced usual practice, and assessed at baseline, immediately postintervention, and 30 days postintervention. S4E consists of 3 modules, including alcohol and drug use, tobacco, and STI/HIV. RESULTS: Relative to youth in the enhanced usual practice group, S4E participants demonstrated higher youth-clinician risk communication (mean 3.22, SD 1.67) and increases in prevention knowledge (∆ score mean 0.36, SD 0.51) and self-efficacy (∆ score mean 0.16, SD 0.47). In addition, youth in the S4E group showed reductions in the proportions of past 30-day overall substance use (Cohen h=0.71, 95% CI 0.15 to 1.27), as well as past 30-day alcohol (Cohen h=0.71, 95% CI 0.15 to 1.27), tobacco (Cohen h=0.17, 95% CI -0.39 to 0.73), and drug use (Cohen h=1.28, 95% CI 0.72 to 1.84). The results also suggest a reduction in the proportion of youths who reported past 30-day condomless sex (Cohen h=0.18, 95% CI -0.38 to 0.74) and alcohol use before sex (Cohen h=0.44, 95% CI -0.12 to 1.00). Finally, the findings also demonstrated an increase in the proportion of youths who reported STI/HIV testing over time (Cohen h=0.16, 95% CI -0.39 to 0.72). CONCLUSIONS: The findings suggest the feasibility of a small-scale pilot RCT. S4E demonstrated shifts in the hypothesized direction, reducing substance use, sexual risk behaviors, and improving the uptake of STI/HIV testing among youth in a clinic setting. The findings suggest that a larger RCT may be warranted. TRIAL REGISTRATION: ClinicalTrails.gov NCT03855410, https://clinicaltrials.gov/ct2/show/NCT03855410.

[Behavior and influencing factors of HIV infection among men who have sex with men only and men who have sex with both men and women in Shandong province].

Objective: This study aimed to examine the demographic characteristics, HIV related knowledge and behavior, correlates of bisexual behavior and status of HIV infection among men who have sex with men only (MSMO) and men who have sex with both men and women (MSMW) in Shandong province. Methods: According to the requirements from "National HIV/AIDS sentinel surveillance program" , a cross-sectional survey was conducted to collect information on demographics, sexual and drug use behaviors, and HIV-related services among MSM in nine sentinel surveillance sites from April to July in 2018. Blood samples were drawn for serological tests on both HIV and syphilis antibodies. Results: A total of 3 474 participants were included in this study. Related information on these participants would include: average age as (31.66±9.01) years; 35.06% (1 218) married or cohabiting with a woman, 50.52% (1 755) had college or higher education, 80.11% (2 783) self-identified as gays and 14.22% (494) self-identified as bisexual men,16.87% (586) ever having sex with woman in the past 6 months, 10.51% (365) ever using drugs. HIV and syphilis prevalence rates were 2.99% (104/3 474) and 2.76%(96/3 474). Through multivariable logistic models, MSMW were more likely to be ≥35 years of age, local residents, self-identified as heterosexual/bisexual/uncertain, ever having commercial sex with man but less likely to consistently use condoms in the past 6 months, less using internet/dating software to find male sex partners and less using drugs. There was no significant differences noticed in the following areas: number of sexual partners in the last week, condom use in the last six months with commercial sex partners, with HIV or syphilis infection and self-reported history of STD in the past year between MSMO and MSMW (P>0.05). HIV-infected MSM were more likely to have the following features, ≥45 years of age, non-local residents, finding male sex partners from the bothhouses, park/toilets or from the internet/dating software, also less likely to consistently use condoms in the past 6 months, using drugs or with syphilis infection. Conclusions: High prevalence of bisexual behavior as well as higher risk of HIV infection were noticed among MSM in Shandong province. It is important to strengthen related surveillance and effective intervention programs for MSM with different characteristics in Shandong province.

Behavioral Interventions to Increase Condom Use Among College Students in the United States: A Systematic Review.

Background. Traditional undergraduate college students in the United States are in the age range that experiences the highest rate of sexually transmitted infections (STIs) and are vulnerable to contracting STIs. Increasing condom use among college students is a prevention strategy to reduce the spread of STIs. Aim. The purpose of this systematic review of the literature was to identify behavioral interventions that increased condom use behaviors and/or intentions among college students. Method. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed in systematically searching, extracting, appraising, and synthesizing the evidence. A quality assessment was also conducted with the tool provided by the Effective Public Health Practice Project. Results. The initial search yielded 715 records. After critical appraisal, seven articles remained for review. Discussion. Four of the interventions were developed using the three constructs of the information, motivation, and behavioral skills model, and all four found significant increases in condom use or condom use intentions. Additionally, interventions that included modules to increase self-efficacy for condom use, taught participants where to get condoms and how to negotiate condom use with partners, or elicited positive associations (feels) toward condoms saw increased condom use or intention to use condoms.