Sexual Debut in Early Adolescence and Individual, School, and Neighborhood Social Capital.

PURPOSE: Sexual debut in early adolescence is associated with poor health outcomes in adulthood. We examined the associations of social capital within families, schools, and neighborhoods with early sexual debut. METHODS: Using data from the Healthy Passages cohort, a longitudinal multilevel study of adolescents, we performed a series of cross-classified multilevel logistic regression models to examine (1) the relative contribution of schools and neighborhoods to the variance and (2) the association of markers of social cohesion/social capital in families, schools, and neighborhoods with sexual debut by 10th grade. RESULTS: There were 4,001 youth participants nested in 115 schools and 751 neighborhoods, with a high degree of cross-classification (1,340 unique combinations of school and neighborhoods). In models adjusting for individual demographics, neighborhoods contributed more to the variance (log odds U [95% confidence interval {CI}] [intra class correlation {ICC}%]) in sexual debut than schools: Uneighborhoods = 0.11 (0.02, 0.23) [3.2%] versus Uschools = 0.07 (0.01, 0.16) [2%]. Restriction of dating and family cohesion, markers of family social capital, were associated with reduced odds of sexual debut by 10th grade (odds ratio = 0.45 95% CI: 0.41-0.49 and 0.93, 95% CI: 0.86, 1.00). Neighborhood cohesion and education level were associated with early debut. Although reduced, there remained significant, unexplained variance in both the school and neighborhood level in the fully adjusted model (Uschool = 0.08 [0.01, 0.17] [2.3%], Uneighborhood = 0.08 [0.02, 0.17] [2.2%]). DISCUSSION: Markers of social capital at the family and neighborhood levels were associated with sexual debut by 10th grade. Developers of public health programs aiming to delay sexual debut should consider family-focused and neighborhood-focused interventions.

Sociodemographics, behaviour and knowledge of first South African HPV-vaccine recipients.

BACKGROUND:  Infection with the human papillomavirus (HPV) is a necessary cause of cervical cancer and is one of the most prevalent sexually transmitted infections worldwide. Primary prevention strategies target reducing HPV acquisition through vaccination, limiting exposure (e.g. delayed sexual debut, barrier contraception) and health education focusing on sexual behaviour and tobacco use. METHODS:  The ImmunoVACCS study, conducted from 2019 to 2022 in two provinces in South Africa, examined sociodemographic characteristics, sexual practices, and knowledge of cervical cancer and the HPV vaccine among young female vaccine recipients. It encompassed participants from the previously conducted vaccine implementation trials, VACCS 1 and VACCS 2 (2011-2014). Recruitment involved telephonic contact with eligible potential participants. Data were collected through self-administered questionnaires. RESULTS:  One hundred and eleven participants took part in the current study (median age: 20 years; age range: 16-22 years). Most sexually active participants had their first engagement in secondary school (96.2%), and 77.2% used contraception during their last sexual activity. Knowledge gaps were evident, with only 13.5% recognising cervical cancer's cervix origin and 3.6% attributing it to a virus. Despite this, 70.3% had heard of a vaccine for cervical cancer. Less than half knew about the importance of regular Pap smears (49.5%), vaccine protection (44.1%) or condom use (20.7%) against HPV and cervical cancer. CONCLUSION:  The current study demonstrates that young women still lack complete information on cervical cancer and its risk factors even after receiving health education linked with vaccination.Contribution: This study underscores the necessity of ongoing education about HPV, its risks and preventive measures among young women to combat cervical cancer.

Italian women who have sex with women: prevalence and co-occurrence of sexual practices.

Background: Sexuality research on the sexual practices of women who have sex with women (WSW) has thus far mostly centered on risk factors and addressed a limited number of practices, with a focus on oral sex and insertive vaginal sex. Aim: This study arises from the need to fill such a significant gap, which prevents researchers, clinicians, and policy makers from being adequately up-to-date on the sexual habits and tendencies of this population. Methods: A multiple-choice questionnaire was completed by 723 WSW with a mean (SD) age of 29.14 (6.94) years. Outcomes: The survey included closed questions on sexual practices, including genital and oral sex, but also nongenital sexual contact (petting and intercrural sex), anal sex, and kinky practices. Results: The most common sexual practices were self-masturbation (99.03%), oral sex (performed or received, 98.20%), and insertive genital sex (performed or received, 89.07%). Half of our sample had tried kinky practices at least once in a lifetime (51.31%). Respondents tended to experiment sexually more with stable partners rather than with casual ones. Comparisons among practices in the lesbian and bisexual population are presented. Clinical Implications: Providers should be aware that sexual orientations have their own specificities, including sexuality and practices, which should increase their knowledge and comfort in working with sexual minorities. Strengths and Limitations: The novel topic of the study addresses the gap in sexuality research among WSW. Strengths include the sex-positive approach, the inclusion of an array of sexual practices, and the consideration of the specificities of the group. Limitations in the generalization of the results are the cross-sectional design and the explicit topic, which may have kept some persons from responding. Conclusion: We propose the framing of sex as going beyond genital contact, and we invite clinicians and researchers who come into contact with WSW to be aware that sexual orientation can be associated with specificities regarding sexuality and sexual practices.

Assessing high-risk sexual practices associated with human immunodeficiency virus infection among young female sex workers in Lubumbashi, Democratic Republic of the Congo: a cross-sectional study.

INTRODUCTION: Young female sex workers (YFSWs) face a higher risk of HIV infection compared to older workers, but there is a lack of comprehensive data on their sexual practices and HIV infection risks, which may present unique challenges and vulnerabilities. The study aimed to identify high-risk sexual practices associated with HIV infection among YFSWs in Lubumbashi. METHODS: We conducted an analytical cross-sectional study and used a comprehensive sample of all YFSWs who presented to the HIV/Sexually Transmitted Infections Screening and Treatment Center in Lubumbashi between April 2016 and December 2017. We collected data on socio-demographic characteristics and behavioral risk factors of female sex workers were collected using a structured questionnaire. Using STATA version 16, multivariate logistic regression was fitted and the results were presented as adjusted odds ratios (aORs) with their 95% confidence intervals (95% CIs). RESULTS: A total of 572 YFSWs were included in the study, 19 of whom were HIV-positive (3.3%; 95% CI: 2.1-5.1%). Participants who were forced to have sex (aOR = 12.2; 95% CI: 3.2-46.4; p < 0.0001), those who did not use condoms systematically (aOR = 4.1; 95% CI: 1.3-13.0; p = 0.018), and those who had anal sex (aOR = 23.8; 95% CI: 6.9-82.4; p < 0.0001) were more likely to be HIV-positive. CONCLUSION: The study reveals a concerning trend of higher hospital HIV prevalence among YFSWs compared to the general Congolese population. It also highlights a significant link between high-risk sexual practices and HIV infection, highlighting the need for urgent interventions.

Relationship between Bacterial Vaginosis and Sexually Transmitted Infections: Coincidence, Consequence or Co-Transmission?

Sexually transmitted infections (STIs) are a serious global problem, causing disease, suffering, and death. Although bacterial vaginosis (BV) is not considered to be an STI, it may be associated with an increased risk of contracting a wide range of STIs. We sought to assess the link between the different microorganisms involved in STIs and BV. A total of 290 vaginal swabs from 290 women sent for diagnostic purposes to the clinical microbiology laboratory of the Marseille University Public Hospitals were tested by specific qPCR targeting STI-causing microorganisms and BV. Of these 290 swabs, 15.2% (44/290) were diagnosed with at least one STI-causing microorganism and 17.2% (50/290) with BV. The prevalence of STIs was significantly higher in women with BV (28%, 14/50) than in those without (20.4%, 51/240). The prevalence of co-infections involving two STI-causing microorganisms was significantly more frequent in women with BV than in those without (18% [8/50] vs. 2% [5/250]; p < 0.001). The prevalence of monoinfections and polyinfections with STI-causing microorganisms was lower in women without BV than in those with (8.8% [21/240] vs. 28% [14/50]), p < 0.001 and 2% (5/240) vs. 8% (4/50), p = 0.05, respectively). Our data suggest that a correlation between BV and STI may exist, with a higher prevalence of both monoinfections and polyinfections involving STI-causing microorganisms in women with BV. Further research is needed to better understand BV and its links to STIs.

Sexual self-concept, functioning, and practices of women with binge eating episodes.

PURPOSE: Positive sexuality has received little empirical attention in relation to eating disorders. Two tendencies related to sexuality have been identified among women with anorexia nervosa (avoidance) and bulimia nervosa (disinhibition), but it is unclear if they also apply to women with binge eating episodes without compensatory behaviors. This study aimed at (1) exploring the sexual self-concept, functioning, and practices of women with binge eating episodes with or without comorbid restrictive and/or compensatory behaviors, considering past experiences of violence, and (2) verifying the presence of distinct profiles of sexual dispositions among this population. METHODS: In total, 253 women reporting recurrent episodes of loss of control related to food intake in the past 5 years, completed a web-based questionnaire. Descriptive and correlational analyses were conducted to outline participants' sexual self-concept, functioning, and practices and to examine the relationship between these factors. A two-step cluster analysis was also performed to determine whether participants presented distinct profiles of sexual dispositions. RESULTS: Participants were generally characterized by a negative sexual self-concept and poor sexual functioning. While a first subgroup of participants displayed a pattern of sexual difficulties and avoidance, a second subgroup had a positive sexual self-concept, better sexual functioning and a wider range of sexual practices. Subgroups did not differ relative to binge eating. CONCLUSIONS: Sexuality offers a platform for positive embodiment, which can lead to the improvement of body image and mind-body connection and may thus constitute an essential clinical target to improve treatment related to binge eating episodes. LEVEL OF EVIDENCE: Level II: The experimental study is a non-randomized controlled trial.

Telehealth as a potential tool for outreach among women in Puerto Rico.

BACKGROUND: Access to the full spectrum of healthcare should be available to all individuals. After the revocation of the constitutional right to abortion, women have fewer alternatives to unplanned pregnancy. Telehealth provides an additional option for such pregnancies through its remote provision of services. This could benefit women of all social strata. However, data regarding telehealth among underserved populations are limited. OBJECTIVE: This study aimed to evaluate the use of contraception, awareness of abortion services, and receptiveness to telehealth among women in Puerto Rico, a Spanish-speaking minority population. STUDY DESIGN: This was a cross-sectional study of women living in Puerto Rico aged between 21 and 65 years. Data were collected with a self-administered survey via SurveyMonkey from March to December of 2021. Recruitment was done through social media and at the gynecology clinics of the University of Puerto Rico, Medical Sciences Campus and San Juan City Hospital. Analysis was done with Stata, version 14.2. Chi-square and Cochran-Armitage tests were used to evaluate the unadjusted relationship between variables. A P value ≤.05 was considered statistically significant. RESULTS: A total of 286 women were recruited. Of these, 73.3% (189/258) were sexually active, 89.1% (229/257) were heterosexual, and 62.7% (163/260) were not using contraception. In addition, 63.3% (157/248) knew about emergency contraception, yet 42.4% (103/243) were unaware of any sources of access to it; 76.6% (197/257) were unaware of nearby abortion services. A higher education level was associated with knowing about emergency contraception (P<.05) and awareness of sources of access to it (P<.05). However, no significant association was found between a higher education level and awareness of nearby abortion services (P=.799). Regarding telehealth, 65.2% (176/270) were willing to use the service for future gynecologic visits, yet only 18.9% (51/269) were offered telehealth services. No association was found between previous telehealth experiences and willingness to use telehealth for future gynecologic visits (P=.325). CONCLUSION: The lack of contraceptive use and unawareness of nearby abortion services place women at increased risk of unplanned pregnancy and unsafe practices. The gap between knowledge about and access to emergency contraception also calls for action. Telehealth may be of benefit given that most women showed interest in using it, and could be used for educating and providing women in Puerto Rico with contraception and medical abortions, further increasing their access to reproductive healthcare. Clarifying misconceptions and instructing women about safe practices is essential to our role as physicians. Ensuring women's access to adequate services is also vital for upholding their rights to healthcare.

A Sexologia e Seus Especialistas na Mídia Durante a Pandemia da Covid-19 / Sexology and Its Media Experts During the Covid-19 Pandemic / Sexología y Sus Expertos en Medios Durante la Pandemia del Covid-19

No escopo de uma pesquisa de abrangência nacional sobre práticas sexuais e gestão de risco, nos chamou atenção, na procura por materiais de mídia relacionando sexo e sexualidades com a pandemia de Covid-19, a presença majoritária de um grupo de "especialistas" ligados ao campo heterogêneo da Sexologia, tais como psicólogas, psiquiatras, urologistas, sexólogas, educadoras sexuais, associadas/os aos infectologistas. Por meio da pesquisa de palavras-chave, via buscador do Google, inventariamos um número de 44 matérias oriundas de sites de grupos jornalísticos grandes e alternativos, bem como de clínicas, associações profissionais e blogs particulares, publicadas entre março de 2020 a julho de 2021. Dessas, concentramos nossa análise em 30 matérias correspondentes àquelas veiculadas pelos grupos jornalísticos grandes e alternativos. A leitura realizada foi inspirada pela problemática da produção de objetos via práticas enunciativas e materiais, mediante as quais associações entre elementos diversos, perguntas e respostas explicitadas vão estabilizando não só os sentidos, mas os próprios objetos em disputa, no caso aqui observado, as práticas sexuais. Ao final de nosso estudo, percebeu-se que o sexo e a sexualidade produzidos pelos "especialistas" através dos canais de mídia tendem à generalização dos corpos e a descontextualização das práticas.

In the scope of a nationwide survey on sexual practices and risk management, what caught our attention, in the search for media materials relating sex and sexualities to the Covid-19 pandemic, the majority presence of a group of "specialists" linked to the heterogeneous field of Sexology, such as psychologists, psychiatrists, urologists, sexologists, sex educators, associated with infectologists. Through keyword research, via google search, we inventoried a number of 44 articles from large and alternative journalistic groups websites, as well as clinics, professional associations and private blogs, published between March 2020 and July 2021. From these, we focused our analysis on 30 articles corresponding to those published by large and alternative journalistic groups. The reading performed was inspired by the problematic of the production of objects via enunciative and material practices, through which associations between different elements, questions and explicit answers, stabilize not only the senses, but the objects in dispute, in the case observed here, sexual practices. At the end of our study, it was noticed that the sex and sexuality produced by the "specialists" through the media channels tends to the generalization of bodies and the decontextualization of practices.

En el ámbito de una encuesta a nivel nacional sobre prácticas sexuales y gestión de riesgos, lo que llamó nuestra atención, en la búsqueda de materiales mediáticos que relacionan el sexo con la pandemia de la Covid-19, destaca la presencia mayoritaria de un grupo de especialistas vinculados al heterogéneo campo de la Sexología, como psicólogos, psiquiatras, urólogos, sexólogos, y otra. A través de una investigación de palabras clave, a través de una búsqueda en Google, inventariamos una serie de 44 artículos de sitios web de grupos periodísticos grandes y alternativos, así como clínicas, asociaciones profesionales y blogs privados, publicados entre marzo de 2020 y julio de 2021. Enfocamos nuestro análisis en 30 artículos publicados por grandes y alternativos grupos periodísticos. La lectura realizada se inspiró en el problema de la producción de objetos a través de prácticas enunciativas y materiales, a través de las cuales asociaciones entre diferentes elementos, preguntas y respuestas explícitas, estabilizan no sólo los sentidos, sino los objetos en disputa, en el caso, prácticas sexuales. Al final de nuestro estudio, se percibió que el sexo y la sexualidad producidos por los especialistas tienden a la generalización de los cuerpos ya la descontextualización de las prácticas.

A cross-sectional study to assess the pre-marital sexual practices among Panjab University students, Chandigarh, India.

Background: In India, premarital partnerships whether involving sex or not are widely unacceptable. Various studies in India have reported heightened premarital sexual activities among youngsters. Objective: The objective of the study was to assess the involvement of youth in premarital sexual practices studying at Panjab University. Methods: The cross-sectional study was conducted at Panjab University situated in Chandigarh, India between February and August 2020. Purposive sampling was used to recruit students. Data was collected using a pre-tested, semi-structured, self-administered questionnaire. The nature of the data was quantitative and was analyzed through SPSS version 20. Results: A total of 211 (female/male: 51.7%/48.3%, mean age: 22.5 years) respondents were enrolled. Prevalence of premarital sex was 68.7% with an average age of sexual debut 18.5 years. 62.1% of respondents were practicing unprotected sex. 91% of respondents were involved in vaginal sex, 61.4% in oral sex, 29% in online sex, and 19.3% in anal sex. 66.8% of respondents were involved in the habit of masturbation. In students having a positive premarital sexual background, 78.2% of respondents had sexting, 38.8% had friends with benefits, 33.9% had one-night stands, 4.8% had a threesome and 2.3% had gay sex. Out of all the respondents involved in premarital sexual practices, 86.9% were satisfied with sexual life. Conclusion: There is a need to empower the younger population involved in risky sexual behavior by accelerating their sexual and reproductive rights education to propagate safe sexual behavior in premarital sexual practices.

Women's attitudes towards negotiating safe sexual practices in Nigeria: Do family structure and decision-making autonomy play a role?

BACKGROUND: The risk of contracting sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) is related to women's sexual attitudes, beliefs, and power dynamics within marriages in developing countries. Despite the interventions towards improving women's sexual health and well-being, women are disproportionately affected by the risk of STIs transmission compared with their male counterparts in most sub-Saharan African countries including Nigeria. This study examined the roles of family structure and decision-making autonomy on women's attitudes towards negotiating safe sexual practices in Nigeria. METHODS: The study involved analyses of data from a nationally representative and weighted sample size of 28,219 ever-married/cohabiting women aged 15-49 years from the 2018 Nigeria Demographic and Health Survey. Descriptive and statistical analyses were carried out, including frequency tables, Pearson's chi-square test, and multivariable binary logistic regression model. RESULTS: The overall prevalence of having positive attitudes towards negotiating safe sexual practices were 76.7% and 69.6% for a wife justified in asking the husband to use a condom if he has an STI and refusing to have sex with the husband if he had sex with other women, respectively. The results further showed that polygamous unions negatively influenced urban and rural women's attitudes towards negotiating safe sexual practices, but women's decision-making autonomy on how to spend their earnings was found to be a protective factor for having positive attitudes towards negotiating safe sexual practices with partners. Surprisingly, there were significant variations in attitudes towards negotiating safe sexual practices among urban and rural women who enjoyed decision-making autonomy on their healthcare (aOR 1.70; CI 1.32-2.18 and aOR 0.52; CI 0.44-0.62, respectively). Plausibly, such women might have constrained them to compromise their sexual relationships for fear of being neglected by partners. CONCLUSION: The outcomes of this study have some policy implications for both maternal and child health. There is the need to intensify programmes aimed at improving women's sexual health and rights towards achieving sustainable development goals of preventing deaths of newborns, ending STIs and creating gender in Nigeria.

Pathways and Patterns of Entrance into BDSM.

Prior limited research on entrance into BDSM divided paths of entry into external or internal factors (Yosta & Hunter, 2012), while research on age at entry into BDSM has not considered variation by BDSM role identity, gender, sexual orientation, and other demographic differences. In this mixed-methods exploratory study, we contribute to this literature by collecting and analyzing qualitative interviews with 96 self-described practitioners of BDSM to more fully describe distinct pathways into BDSM, adding nuance to prior descriptions of entry. We also collected and analyzed surveys with 2,017 self-described practitioners of BDSM to examine patterns of age at entry into BDSM practices and fantasies, and selection into older or younger age at practice and age at fantasy by BDSM role identity, gender, sexual orientation, and other demographic characteristics. Interview respondents told "constructionist sexual stories" describing introductions to BDSM via popular culture including pornography and other media, the Internet, or a sexual partner that awaked an inherent interest, along with "essentialist sexual stories" which described self-discovery solely attributed to an inherent personality characteristic. Survey data revealed that age at fantasy and onset of behavior varied by social-environmental factors. Pathways and patterns into BDSM behavior and fantasies therefore reflect a combination of idiosyncratic interests, exposure to ideas via the media or partners, and stratified social norms and opportunities related to sexual behavior.

Scripting Sex in Courtship: Predicting Genital Contact in Date Outcomes.

Despite increasing egalitarian values expressed among college students, dating is still characterized by traditional gender roles. Because traditional dating scripts are predominantly recited and enacted to the extent that men initiate and pay, there are assumptions that the sexual processes have not changed. This study investigates the sexual processes of male-initiated and female-initiated dates among college students in the US. Using data from the Online College Social Life Survey, we ask whether traditional components of the dating script explain traditional sexual outcomes (non-genital contact), as well as whether alternative dating scripts explain nontraditional sexual outcomes (genital contact). Using multivariate logistic regression models, we found that violations of the traditional script are associated with higher odds of genital contact for male- and female-initiated dates; however, the predictors of genital contact for female-initiated dates are not the same as those for male-initiated dates. This study highlights the variability of sexual scripts in dating practices, suggesting that the sexual scripts associated with dates are not as homogenous as we have previously believed.

Drug and Alcohol Use with Condomless Anal Sex among Men Who Have Sex with Men in Melbourne, Australia: A Retrospective Data Analysis from 2011 to 2017.

Rises in condomless anal sex among men who have sex with men (MSM) have been reported over the last decade but there is less certainty about the role that drugs, alcohol, play in this change. We examined the changes in drug and alcohol use among 22,255 MSM reporting condomless anal sex at Melbourne Sexual Health Centre in 2011-2017. There was a 7% annual increase in using drugs before and/or during condomless anal sex but a 3% annual reduction in condomless anal sex while drunk. MSM taking PrEP were more likely to report condomless anal sex with drug use (AOR: 1.21; 95%CI: 1.07-1.37) and alcohol use (AOR: 1.29; 95%CI: 1.14-1.46) compared with MSM not taking PrEP.

'Couro no couro': homens com práticas homossexuais e prevenção do HIV na Região Metropolitana do Recife / 'Leather on leather': men with homosexual practices and HIV prevention in the Recife Metropolitan Region

RESUMO O texto aborda as práticas sexuais e a prevenção do HIV nos circuitos de Homens que fazem Sexo com Homens (HSH) da Região Metropolitana do Recife, embasados em inquérito comportamental com 380 HSH de idade de 18 a 51 anos, e entrevistas com 20 dos respondentes. Os dados analisados foram coletados entre janeiro de 2016 e fevereiro de 2017, quando a Profilaxia Pré-Exposição (PrEP) ainda não estava disponível e a Profilaxia Pós-Exposição (PEP) era pouco conhecida (51,8%) e utilizada (1,3%). O Sexo Anal Desprotegido (SAD) (50,6% em parcerias fixas, 30,2% em casuais) ocorria, geralmente, com parceiros presumidamente negativos para HIV. As sorologias eram inferidas pelos vínculos (estranho, conhecido, amigo, namorado). As emoções (medo, tesão, amor, confiança, nojo, carência) eram importantes na configuração do SAD, normalmente articuladas às vinculações. Observaram-se regimes de prazer dissidentes da heteronormatividade: boca-ânus e boca-pênis; sexo a três e em grupo. Considerando a forte presença de SAD e a alta prevalência de HIV em Recife (21,5%), constatou-se a necessidade de ações educativas que apresentem técnicas da prevenção combinada (camisinha, PrEP, PEP, soroescolha, segurança negociada etc.) mediante narrativas que incorporem vínculos, emoções e regimes de prazer dissidentes, para que, ao se aproximarem dos contextos de usos, possibilitem escolhas mais seguras.

ABSTRACT In this text we address sexual practices and HIV prevention in the circuits of men who have sex with men (MSM) in the Metropolitan Region of Recife (RMR), based on a behavioral survey with 380 MSM, aged between 18 and 51 years, and interviews with 20 of the respondents. The analyzed data were collected between January 2016 and February 2017, when Pre-Exposure Prophylaxis (PrEP) was not yet available and Post-Exposure Prophylaxis (PEP) was little known (51%) and used (1.3%). Unprotected Anal Sex (UAS) (50.6% in steady partners, 30.2% in casual partners) generally occurred between partners who were presumed to be HIV-negative. Serologies were inferred by ties (stranger, acquaintance, friend, boyfriend). Emotions (fear, lust, love, trust, disgust, neediness) were important in UAS configuration, almost always linked to attachments. We observed dissident pleasure regimes of heteronormativity: mouth-anus and mouth-penis; threesome and group sex. Considering the strong presence of UAS and the high prevalence of HIV in Recife (21.5%), we found the need for educational actions that introduce combined prevention techniques (condoms, PrEP, PEP, serochoice, negotiated safety etc.) through narratives that incorporate dissident bonds, emotions, and pleasure regimes, so that, when approaching the contexts of use, they enable safer choices.

Sexual practices, risk perception and HIV self-testing acceptability among long-distance truck drivers in Ekiti State, Nigeria.

BACKGROUND: HIV/AIDS is a global health challenge with a high burden in sub-Saharan Africa. Long-distance drivers are a high-risk group whose assessment of HIV status, awareness and willingness to undergo HIV self-testing (HIVST) could help prevent the spread of HIV infections. OBJECTIVE: This study examined the sexual practices, risk perception and HIVST acceptability among long-distance truck drivers in Ekiti State, Nigeria. METHODS: A cross-sectional study was conducted among long-distance truck drivers between September 2019 and December 2019. A semi-structured questionnaire was designed to investigate the perceived sexual risk factors and willingness to undergo HIVST. RESULTS: Of the 306 drivers that participated in the study, almost half (49.8%) had their first sexual experience before they turned 18 years. About one-third (38.6%) had multiple sex partners and (34.0%) patronised commercial sex workers in the past 6 months. Consistent use of condoms was reported in a negligible percentage (3.0%), while 7.4% used intravenous drugs. Two-thirds of the respondents were interested in HIVST, while 32.2% knew their HIV status. Significant factors associated with multiple sex partners were the duration of working as a long-distance truck driver and patronage of sex workers. CONCLUSION: A significant proportion of the long-distance drivers were engaged in unsafe sexual practices and are at risk for HIV transmission. Considering the mobile nature of the long-distance drivers, the risky practices of these workers require intense advocacy, testing and treatment to reduce HIV transmission. Scaling-up testing using HIVST has the potential to bridge the gap in the diagnosis of HIV among long-distance drivers who are willing to be tested.

Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD).

BACKGROUND: Orgasm occurrence plays an important role in general sexual satisfaction for women. Until now, only few studies have focused on examining a broad spectrum of sexuality- and relationship-specific factors associated with orgasm in heterosexual women currently in a long-term relationship or on differences between the overall experience of orgasm and multiple orgasms. AIM: The present study aims to understand how various sexuality- and relationship-associated factors are related to experiencing partnered orgasm among heterosexual women having stable relationships in Germany. Moreover, the study aims to differentiate between the overall experience of orgasm and the experience of multiple orgasms and shed light on their impact on general sexual satisfaction. METHODS: Within the nationwide representative survey GeSiD (German Health and Sexuality Survey), n = 1,641 sexually active women aged between 18 and 75 years in heterosexual relationships reported their experience of orgasm during the latest sexual encounter. Data on the type of sexual practices, frequency of sexual activity and of masturbation, relationship satisfaction, feelings of love, closeness, and general sexual satisfaction were analyzed. OUTCOMES: The overall experience of orgasm, the experience of multiple orgasms, and associations between experiencing orgasm and sexual satisfaction. RESULTS: Frequency of sexual activity, relationship satisfaction, feelings of love and closeness were moderately to strongly positively correlated with each other and each showed positive associations with the likelihood of orgasm. Greater number of sexual practices and frequency of sexual activity were associated with an increased likelihood of experiencing multiple orgasms, which in turn was correlated with higher sexual satisfaction. CLINICAL IMPLICATIONS: In clinical and therapeutic work with women who have difficulty achieving orgasm, central issues should be the perceived relationship quality as well as regular sexual activity with the partner. STRENGTHS & LIMITATIONS: The present population-representative study is the first in Germany to identify significant factors associated with the experience of orgasm among heterosexual women in relationships. Further studies ought to include the frequency of orgasms in partnered sex over a longer period of time as well as the experience of orgasm during masturbation. CONCLUSION: The experience of orgasm for women is related to a variety of complex interpersonal mechanisms and to be associated with sexual satisfaction. Cerwenka S, Dekker A, Pietras L, et al. Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD). J Sex Med 2021;18:2028-2038.

Prevalence and associated characteristics of youth who trade sex in a representative sample of high school students.

INTRODUCTION: Our understanding of youths' sex trading predominantly stems from non-representative studies with high-risk populations (e.g. homeless/runaway youth). The purpose of this study is to identify the prevalence and associated characteristics of youth who report sex trading (compared to those who do not) in a representative sample of high school students. METHODS: Data comes from the 2018 Youth Assessment, a cross-sectional survey administered to 9th through 12th graders across 24 high schools in Dane County, a predominantly urban area in Wisconsin, U.S.A. All youth who answered the question, "have you ever had sexual contact in order to stay safe or to get something like a place to stay, money, gifts, alcohol or drugs?" were included for secondary data analysis (n = 13,714). Participants were 70% White, 50% female/47% male, and 90% minors. Chi-square tests and logistic regression analyses were conducted. RESULTS: 2.47% of youth reported sex trading, of whom 91% were minors. Bivariate analysis revealed significant differences across demographics, economic instability, behavioral health and substance use, delinquency, and romantic/sexual behaviors. Multivariate results suggested that students who reported substance use, cutting class, 3 or more out-of-school suspensions, knowing a friend involved in a gang, dating violence, foster care involvement, or identifying as LGBTQ+ were more likely to report sex trading. CONCLUSIONS: Although the causal order of characteristics analyzed in relation to the sex trading is not known, these findings have important implications for sex trading prevention, assessments, and intervention, particularly among youth with marginalized identities and adverse experiences.

Internet Study about Risk Factors Associated with HIV among Heterosexuals in Puerto Rico.

OBJECTIVE: Heterosexual intercourse is the main mode of HIV transmission among heterosexual women in Puerto Rico and the third for men. We conducted an Internetbased study of heterosexual young adults in Puerto Rico to explore their sexual practices, beliefs and decision-making skills for HIV prevention. Data presented in this study will help to understand the factors that contribute to the sexual transmission of HIV among heterosexuals within the Puerto Rican context. METHODS: We administered an online-based survey to a sample of 618 young adult heterosexual men and women. Data were collected using Perseus Survey Solutions software. RESULTS: Overall, most participants expressed they had the same sexual partner in the previous six months, never or almost never used male condoms with their main partner and did not perceive themselves at-risk of contracting HIV (have a low HIV risk perception). Men reported using male condoms more frequently than women (e.g. male condom on their male partner) during vaginal sex, in particular single and younger men. Women expressed more positive attitudes toward male condoms than men. CONCLUSION: Results confirm the need to implement interventions that increases the sense of vulnerability among heterosexuals, as well as skills and use of male condoms. This study contributes additional data on sexual practices and attitudes to encourage the identification of new or current changes in HIV protective or risk factors, specifically for an understudied population of Heterosexuals in Puerto Rico.

Sex is associated with the persistence of non-optimal vaginal microbiota following treatment for bacterial vaginosis: a prospective cohort study.

OBJECTIVE: Determine the associations between factors and sexual practices and the composition of the vaginal microbiome (VM) of women treated for bacterial vaginosis (BV). DESIGN: Prospective cohort study. SETTING: The Melbourne Sexual Health Centre, Melbourne, Australia. POPULATION: Seventy-five reproductive-age women diagnosed with clinical BV, treated with first-line antibiotics and followed for up to 6 months. METHODS: Women self-collected vaginal swabs and completed questionnaires at enrolment, the day following antibiotics and monthly for up to 6months until BV recurrence or no BV recurrence (n = 430 specimens). Bacterial composition was determined using 16S rRNA gene amplicon sequencing. The effects of ongoing factors on VM composition (utilising 291 monthly specimens) were assessed using generalised estimating equations population-averaged models, which accounted for repeated measures within individuals. MAIN OUTCOME MEASURES: The relative abundance of vaginal bacterial taxa. RESULTS: Women who reported ongoing sex with a regular sexual partner (RSP) had a VM comprised of increased relative abundance of non-optimal BV-associated bacteria (Adjusted co-efficient [Adjusted co-eff] = 11.91, 95% CI 3.39to20.43, P = 0.006) and a decreased relative abundance of optimal, Lactobacillus species (Adjusted co-eff = -12.76, 95% CI -23.03 to -2.49, P = 0.015). A history of BV was also associated with a decreased relative abundance of Lactobacillus spp. (Adjusted co-eff = -12.35, 95% CI -22.68, P = 0.019). The relative abundance of Gardnerella, Atopobium and Sneathia spp. increased following sex with an RSP. CONCLUSIONS: Sex with an untreated RSP after BV treatment was associated with a VM comprised of non-optimal BV-associated bacteria. BV treatment approaches may need to include partner treatment if they are to achieve a sustained optimal VM associated with improved health outcomes. TWEETABLE ABSTRACT: Sex drives a return to a 'non-optimal' vaginal microbiota after antibiotics for bacterial vaginosis.

Prazeres, práticas sexuais e abjeção: travestis, transexuais e os limites em ser "gente" / Pleasures, sexual practices and abjection: travestis, transsexuals and limits of "being a person"

A proposta deste texto é estabelecer diálogos com os estudos sobre as travestilidades e transexualidades que possam contribuir para as problematizações acerca dos modos de subjetivação e práticas sexuais dissidentes e abjetas. As expressões de gêneros desviantes dos modelos de produção normativos são sublinhadas, neste diálogo, a partir da exploração dos prazeres e práticas sexuais que transbordam visões naturalizadas e reprodutivas, iniciando com a problematização da prostituição como modo de vida, trabalho, socialização e de descoberta de saberes em relação às práticas sexuais. Tais problematizações partem de duas pesquisas realizadas em pós-graduação em Psicologia, ambas sob orientação do método da cartografia e desenvolvidas com participantes do movimento social organizado. Com base em perspectivas teórico-políticas queer, procuramos por posições alternativas que não tomem a dissidência pelo viés da negatividade, mas interessados nas pedagogias alternativas que operam nos territórios de subjetivação trans e que ampliam as noções sobre "ser gente". Assim, entendemos que estas problematizações podem estabelecer conexões com outras experiências e provocar a ampliação de esquemas de saber que considerem as dissidências como formas de resistências micropolíticas e desejantes.(AU)

This paper proposes dialogues with studies about travestis and transsexuals that offered contributions to problematize modes of subjectivation and sexual practices dissidents and abjects. The gender expressions that deviate from normative production models featured, in this paper, from the exploration of pleasures and sexual practices that extrapolate naturalized and reproductive visions, starting with a problematization of prostitution as a way of life, work, socialization and discovery of knowledge regarding sexual practices. Such problematizations come from research developed in Psychology postgraduate courses, under the methodological guidance of cartography and developed with participants from the organized social movement. Based on queer theoretical-political perspectives, we objective alternative positions that do not consider dissent as negativity, but more interested in alternative pedagogical forms in territories of trans subjectivation and that can broaden the notions about being "a person". These problematizations can establish connections with other experiences and cause the expansion of knowledge schemes that consider dissent as modes of micropolitical and desiring resistance.(AU)