The Impact of HIV Pre-exposure Prophylaxis (PrEP) Use on the Sexual Health of Men Who Have Sex with Men: A Qualitative Study in Seattle,WA

This study explores the impacts of HIV pre-exposure prophylaxis (PrEP) use on the sexual health of men who have sex with men (MSM). The authors conducted in-depth interviews with MSM who use PrEP (n = 14). Data was analyzed using interpretative phenomenological analysis. PrEP use reduced fear and shame associated with sex and facilitated greater sexual satisfaction and intimacy. Although participants generally viewed PrEP as empowering and beneficial, they also experienced PrEP-related stigma. The authors’ analysis emphasizes the importance of understanding the reasons MSM use PrEP and highlights opportunities for reducing harm and fostering sexual health among MSM who are using or considering PrEP.     

Self-Esteem and Risky Behaviors Among Residents of a Tanzanian Sugar Plantation: A Brief Report

ABSTRACT

Risky behaviors can increase acquisition risk of HIV and other sexually transmitted infections (STI). Self-esteem may be linked to risky behavior, but little research has assessed this relationship in low-resource regions. Using cross-sectional data from a study of Tanzanian plantation residents, the authors examined associations between self-esteem and two risky behaviors (problematic alcohol use and transactional sex). In unadjusted and adjusted analyses, higher self-esteem was significantly associated with less prevalent transactional sex (adjusted prevalence ratio [aPR]: 0.74, 95% confidence interval [CI]: 0.59–0.93) and less prevalent problematic alcohol use (aPR: 0.81, 95% CI:0.70–0.93). Self-esteem may be an appropriate target for STI prevention interventions.     

Family Characteristics and Structure as Determinants of Sexual Abuse Among Female Secondary School Students in Nigeria: A Brief Report

ABSTRACT

Child sexual abuse is associated with factors that enhance the vulnerability of the child, raising physical and mental health complications in adulthood. Three hundred and fifty students participated in this cross-sectional study. Important determinants of sexual abuse were parents not living together, not living with parents, family type, and current parents’ marital status (p < 0.05). Respondents living with both parents were two times less likely to experience sexual abuse (OR = 0.5, CI: 0.3, 0.9) than respondents living with their guardians. Respondents whose parents were living together were about two times less likely to experience sexual abuse (OR = 0.6, CI: 0.3–0.9) than respondents whose parents were not living together. Respondents whose parents were either divorced or separated were about six times more likely to experience sexual abuse (OR = 5.6, CI: 1.1–27.2) than respondents with widowed parents. The study showed that parental togetherness protected against child vulnerability and risk of being sexually abused.     

Regional Prevalence,Patterns and Correlates of Sexual Coercion Among Women in Sub-Saharan Africa: A Multi-Country Population-Based Study

Abstract

Objective: This study investigates the prevalence, perpetrators, and factors associated with forced sexual acts. Methods: Pooled secondary data from the most recent Demographic and Health Survey (DHS) in 22 sub-Saharan African countries was used in this study. The individual woman components of the questionnaire involving 148,720 women of reproductive age (15-49?years) were analyzed. Percentages and graphs were used to present distribution of study variables. Multivariable logistic regression was used to examine factors associated with sexual coercion. Results: Forced sexual acts were prominent in Rwanda (15.7%), Gabon (12.3%) and Democratic Republic of Congo (10.9%). The lowest mean age at first forced sexual acts was recorded in Gabon (14.1?years), Comoros and Mali (14.9?years each), whereas the maximum was recorded in Namibia (25.9?years). Results from adjusted logistic regression models identified that factors such as high women decision making power, large spousal age difference, rural residence, Islamic religious beliefs and listening to radio were significantly associated with reduction in the odds of forced sexual acts. Conversely, high-risk partner’s behavior, older age at start of first marriage, early age at sexual debut, most disadvantaged community, education, and the use of newspapers were significantly associated with higher odds of forced sexual acts. Conclusion: Based on the findings of this study, policies should be reinforced to handle perpetrators of sexual violence especially non-intimate partners. Population-based preventive measures of sexual coercion are essential to complement justice system responses. Our findings also showed the importance of building gender equity as part of sexual violence prevention approach.     

Unplanned Sexual Activity as a Consequence of Alcohol Use: A Prospective Study of Risk Perceptions and Alcohol Use Among College Freshmen

Objective: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption.

Participants: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. Methods: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. Results: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. Conclusions: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.     

A Preliminary Study of Body Image and HIV Sexual Risk Behavior in Black Gay and Bisexual Men: Implications for HIV Prevention

Nearly three decades since the onset of the AIDS epidemic, Black gay and bisexual men (BGBM) experience increasingly disproportionate rates of HIV and AIDS in the United States. The aim of this exploratory research investigation was to examine the relationship between body image and HIV sexual risk behavior in a community-based sample of 481 BGBM in the New York metropolitan area. Multivariable analyses demonstrated that men with a negative body image were less likely to use condoms during anal intercourse with a male sexual partner as compared to those respondents with a positive body image. These findings pose considerable implications for the influence of body image on HIV sexual risk behavior in BGBM.     

Reconciling Reality With Fantasy: Exploration of the Sociocultural Factors Influencing HIV Transmission Among Black Young Men Who Have Sex With Men (BYMSM) Within the House Ball Community: A Chicago Study

Studies involving the House Ball Community (HBC) have found high rates of HIV prevalence and undiagnosed HIV infection, as well as unique social and sexual network-related HIV risk and protective behaviors (Murrill et al., 2008; Sanchez, Finlayson, Murrill, Guilin, & Dean, 2010). Efforts to understand culturally appropriate and effective methods of HIV prevention services within the relatively understudied HBC are scarce (Phillips, Peterson, Binson, Hidalgo, & Magnus, 2011). This qualitative study, utilizing a diffusion of innovation theoretical framework, aimed to explore social norms regarding HIV and accessibility of HIV prevention services within the HBC. Thirty-seven participants (16 community leaders and 21 youths) engaged in focus group discussions. Participants discussed the perceptions of HIV and stigmatization within the HBC, general and HBC-specific risk factors for HIV transmission, as well as HIV prevention needs and strategies for culturally appropriate HIV interventions. Findings from this qualitative study highlight both the vulnerability of the HBC to HIV transmission and the corresponding support for HIV prevention interventions.     

Prevalence of Sexually Abusive Experiences in Childhood and Adolescence Among a Community Sample of Latinas: A Descriptive Study

This study examined the prevalence, severity, and circumstances of self-reported sexually coercive and abusive experiences in childhood and adolescence in a community sample of Latina women (N?=?204) ages 18 to 34 years. Results from structured phone interviews indicated that 35%?of the women reported experiencing some form of sexual abuse, 31%?of the reported perpetrators were family members, and 52%?were boyfriends, friends, or acquaintances. Of those who reported an abusive experience, 44%?had not disclosed the abuse to anyone; for those who did disclose, 74%?reported feeling supported. Findings highlight the importance of including peer and dating-partner abuse in the assessment of CSA and the necessity for outreach to Latina women who may have never disclosed their experiences of abuse.     

Transactional Sex: Supply and Demand Among European Men Who have Sex with Men (MSM) in the Context of Local Laws

Objectives: Transactional sex (TS) is generally defined as the trading of sex for material goods. Cast within the broader context of prostitution laws, we examined variations in the sociodemographic profile of men who have sex with men engaging in TS by payment direction (buying/selling). Methods: The data were collected as part of the 38-country European Men who have sex with men Internet Survey project, conducted in 2010. Results: About 12% of respondents reported engaging in TS in the past year. TS was associated with laws, age, education, employment, and residence. Conclusions: The striking sociodemographic differences in TS by payment direction suggest a power differential and a leading role of socioeconomic factors in TS.     

Space,People, Interventions and Time (SPIT): A Model for Understanding Children's Outdoor Play in Post‐Disaster Contexts Based On a Case Study from the Triple Disaster Area of Tohoku in North‐East Japan

Play in the outdoor environment is important for children as part of their childhood and is particularly important for children in a post‐disaster situation. This article explores issues around outdoor play opportunities in the Tohoku region of north‐east Japan, 13 months after the triple disaster of earthquake, tsunami and nuclear power plant failure. A model of space, people, interventions and time (SPIT) is used to understand the situation in this unique case study.