Social Exchange and Sexual Behavior in Young Women's Premarital Relationships in Kenya

Transactional sex, or the exchange of money and gifts for sexual activities within nonmarital relationships, has been widely considered a contributing factor to the disproportionate prevalence of HIV/AIDS among young women in sub-Saharan Africa. This study applied social exchange theory to premarital relationships in order to investigate the linkages between a variety of young women's resources-including employment and material transfers from male partners-and sexual behaviors. Data on the first month of premarital relationships (N=551 relationships) were collected from a random sample of young adult women ages 18-24 in Kisumu, Kenya, using a retrospective life history calendar. Consistent with the hypotheses, results showed that young women's income increases the likelihood of safer sexual activities, including delaying sex and using condoms consistently. Material transfers from the male partner displayed the opposite effect, supporting the view that resources obtained from within the relationship decrease young women's negotiating power.     

Minority Stress Theory: An Examination of Factors Surrounding Sexual Risk Behavior Among Gay and Bisexual Men Who Use Club Drugs

Background: Few studies have examined the impact of minority stress theory (MST) upon sexual risk behavior among gay and bisexual men using club drugs. Similar studies have focused on ethnic minorities and women; however, gay and bisexual men demonstrate greater likelihood for risk behaviors leading to HIV/AIDS. Objective: This study examines sexual risk behavior from the perspective of minority stress theory upon substance-using gay and bisexual men and their partners. Methods: Multivariable logistic regression analysis examined minority stress associations with participant sexual risk behaviors, drug use, and partner type, controlling for demographics. Results: 396 gay and 54 bisexual respondents, ages 18–67, reported at least one-time drug use while engaging in sexual risk behavior. In the adjusted model, expectations of rejection associated with lower odds of sexual risk behavior, while older age approached significance. Conclusions: Theoretical origins for examining risk behavior among gay and bisexual men may underscore risk and protective factors, while ultimately holding implications for prevention and treatment interventions.     

Sex,drugs and matrices: Mathematical prediction of HIV infection

The purpose of this paper is to consider a very simple model of the AIDS epidemic. This model illustrates how the spread of AIDS can be affected by parameters whose values, at the present time, are very imprecise or unknown. Of particular interest are the data related to sexual encounters and practices, data which are often unreliable or ambiguous. In this regard, the present model also suggests that the epidemiology of AIDS is particularly sensitive to the limitations in the assessment of sexuality/drug‐related behavior. Using a system of elementary differential equations, the present paper illustrates (using 3 examples) that depending upon the value of critical parameters, one could predict either very rapid increases of seropositivity or a decreasing rate of seropositivi‐ty. Thus, in order to diminish the ambiguity, it becomes crucial to make careful estimates of the sexual “interaction” coefficients, along with all other parameters, to insure that reasonable predictions can be made.     

Sexual Risk-Taking among High-Risk Urban Women with and without Histories of Childhood Sexual Abuse: Mediating Effects of Contextual Factors

This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by being intoxicated during sex and engaging in sex work, whereas the association between relational control and unprotected sex was not mediated by contextual factors for the childhood sexual abuse group. The mechanisms of risk are different for those with divergent childhood sexual abuse histories and thus interventions should be developed to educate women with a history of childhood sexual abuse about ways to avoid revictimization, particularly within a context of poverty, prostitution, and drug use.     

Achieving the Optimal Vaginal State: Using Vaginal Products and Study Gels in Uganda,Zimbabwe, and South Africa

Preferences and practices related to the vaginal condition have implications for the use of vaginal HIV prevention products. The authors used qualitative methods to explore narratives relating to the vaginal state amongst women in South Africa, Uganda, and Zimbabwe who had previously participated in a biomedical HIV prevention trial. They investigated women's behaviors related to optimizing the vaginal state, experiences and perceptions of the gel's effect on the vaginal state and on penile-vaginal intercourse, women's narratives on male partner perceptions, and how preferences relating to the vaginal state may have interfered with gel use.     

Sexual Behavior,Mental Health,Substance Use,and HIV Risk Among Agency-Based Male Escorts in a Small U.S. City

Abstract

Relatively little research has examined the personal sex lives of indoor male sex workers (MSWs) or possible connections in this group between sexual behavior and factors related to HIV risk. As part of a larger project, this study collected data from 30 agency-based indoor MSWs (mean = 22.4 years) about their sexual behavior, mental health, and substance use. Few HIV risk behaviors with clients occurred. Drug use and mental health problems were relatively frequent, but not related to increased risk behavior. Instead, MSWs appeared to employ rational decision-making and harm-reduction strategies. Conceptualization of MSW sexual behavior may be required where HIV risk is not attributed to sex work per se, but to other influences such as economic and relational factors.     

Sexual activity and risk taking in young heterosexual men: The relevance of sexual arousability,mood, and sensation seeking

In this research we explored three aspects of personality relevant to sexual activity and sexual risk taking in heterosexual men. Men with low inhibition of sexual arousal in the face of risk (low SIS2) reported more partners with whom they use no condoms and more lifetime “one night stands.” Men who experience increased sexual interest in states of depression (MSQ) reported more partners in the past year and more one night stands. The disinhibition subscale of the Sensation Seeking Scale was predictive of whether sexual intercourse had occurred in the past 6 months, and also of the number of sexual partners in the past year. A measure of an intention to practice safer sex was strongly related to measures of sexual arousability and inhibition (SIS/SES). We discuss some clear similarities and also some interesting differences with a parallel study of gay men. Individual differences in sexual excitation and inhibition proneness and the relation between mood and sexuality are clearly relevant to high‐risk sexual behavior and should be taken into consideration when designing behavioral interventions.     

Fallout from Communism: The Role of Feminism in Fighting HIV/AIDS among Women in Russia

ABSTRACT

I have no political platforms. I don't like the system of rules the word ‘feminist’ implies.

—Roza Khatskelevich, New York Times, 2003     

Contraceptive Use Patterns Within Females' First Sexual Relationships: The Role of Relationships,Partners, and Methods

This study used the 1995 National Survey of Family Growth (NSFG) to assess whether characteristics of females' sexual partners, relationships, and choice of contraceptive methods were associated with contraceptive use patterns within their first sexual relationship. White, Black, and Hispanic females under age 25 (N = 915) provided retrospective information on sexual activity and contraceptive use for first sexual relationships that occurred between 1991 and 1995. Females with older sexual partners and with same race/ethnicity partners (among Hispanics) had reduced odds of ever using contraception and/or uninterrupted use. Longer sexual relationships were associated with higher odds of ever using contraception but lower odds of uninterrupted use. Females who were older at first sex, who used hormonal methods (among Whites), or who switched to more effective methods during their first sexual relationships had higher odds of ever using contraception and/or uninterrupted use. In contrast, switching to less effective methods during a first sexual relationship was associated with reduced odds of uninterrupted use.     

Individual Differences in Women's Salivary Testosterone and Estradiol Following Sexual Activity in a Nonlaboratory Setting

Objectives: The current study evaluated women's salivary testosterone and estradiol levels before and after exposure to sexual stimuli in a U.S. sex club. Methods: Behavioral data and salivary samples were collected from 19 women during semistructured interviews. Results: Findings demonstrate substantial individual differences in the magnitude and direction of women's hormonal changes following sexual activity. Conclusions: In an age of individualized medicine, these findings highlight the need to better understand factors shaping variation in physiological responses to sexual activity. Findings contribute to a relatively small and contradictory literature on women's hormonal responses to sexual stimuli.     

Influence of Partner Type on Acceptability and Likelihood of Use of a Rectal Microbicide Among Young Men Who Have Sex With Men in the United States and Puerto Rico

This study examined how acceptability of placebo gel with receptive anal intercourse (RAI) and likelihood of future rectal microbicide use varied across partner types. Because no rectal microbicide is available yet, use of placebo permitted the study of gel use behavior in real-life circumstances. A total of 87 men who have sex with men (MSM) aged 18 to 30 years inserted placebo gel rectally before RAI during 12 weeks. Using mixed-methods design, participants completed a behavioral questionnaire and in-depth interview. In all, 62 men (71.3%) reported gel use with a lover (i.e., spouse equivalent, boyfriend), 32 (36.8%) with a one-night stand (i.e., man with whom you had sex once), and 29 (33.3%) with an “other” male partner. While gel acceptability was high across partner types, use with lovers was facilitated by trust and familiarity; yet trust made participants believe protection was less necessary. Conversely, participants expressed high likelihood of using gel with one-night stands, whom they perceived as riskier; yet they felt less comfortable discussing gel with them, often resorting to covert use or forgoing gel. A successful microbicide will be positioned as a sexual pleasure enhancer so that men can present it to their lovers and other partners as a gel that improves sex and secondarily prevents human immunodeficiency virus (HIV).     

Trust and Sexual Interaction: The Significance of the Internet on the Sex life and Sexual Risk Behaviors Of Gay and Bisexual Men in Spain

ABSTRACT

This study provides an understanding of the significance of the use of the Internet to find sexual partners, its impact on sexual life, and how it is linked to unprotected sex among gay and bisexual men. A grounded approach was used to analyze interviews with 31 men (aged 19 to 46 years) from Madrid, Barcelona, and Bilbao/San Sebastián, Spain. The results reveal that the Internet is impacting the form and style of life of many men, and particularly their experience of sexuality. Many men regard their sexual experiences with casual partners met through the Internet as unsatisfactory or frustrating. The men provided several reasons behind the search for sexual partners via the Internet: Some interviewees sought to channel needs other than the sexual (company, affection, stable partner). Trust and assumptions built into the virtual interaction become a key to understanding why some men have unprotected sex with partners met on the Internet.     

Club Drug Use,Sexual Behavior,and HIV Risk Among Community and Internet Samples of Hispanic MSM: Implications for Clinicians

ABSTRACT

Hispanic men who have sex with men (MSM) are at high risk of HIV infection. This study reports on the club drug use and sexual behaviors of two distinct samples (community and Internet) of Hispanic MSM living in the AIDS epicenter of Miami-Dade County. Both samples reported high rates of unprotected anal sex and high numbers of sex partners; rates of club drug use (cocaine, ecstasy, methamphetamines, GHB, amyl nitrites, and Viagra) were also high. Recent use of club drugs was associated with both unprotected receptive and insertive anal sex in the Internet sample, but not in the community sample. Implications for social work practice are discussed.     

Assessing Acceptability and Perceptions of a Novel Condom Use Intervention for Young Women

Objectives: To assess the acceptability of a novel condom use intervention for women, the Home-Based Exercises of Responsible Sex, that focuses on condom use experience, application skills, and self-efficacy. Method: Two hundred eighty women (M age 22.63, SD = 3.65) completed an online survey containing questions on condom use errors, experiences, ability, and self-efficacy, and on intervention acceptability. Results: Eighty-one percent reported that the intervention was acceptable. Significant positive predictors of acceptability were condom use ability (β = .18) and self-efficacy (β = .20). Discussion: Findings suggest that the intervention is acceptable and that different options for completing the intervention should be offered.     

The Association Between Sexual Behavior and Affect: Moderating Factors in Young Women

Sexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women. Female first-year college students (N = 477) completed monthly assessments of their sexual behaviors and positive and negative affect. Participants reported more negative affect in months in which they engaged in sexual behavior compared to months in which they did not. This association was moderated by partner type, such that only sexual behavior with casual partners was associated with increased negative affect. Participants reported more positive affect during months with kissing/touching only compared to months without sexual behavior; however, this association did not differ significantly from the association between oral/vaginal sex and positive affect. Condom use did not moderate the association between vaginal sex and positive or negative affect. In this sample of young women transitioning to college, engaging in sexual behavior was generally associated with negative affect; however, changes in affect depended on partner type and sexual behaviors. Findings have implications for sexual health education.     

Situating Condoms in Sexual Lives: Experiences of Same-sex-Attracted men in Tanzania

ABSTRACT. This article examines ways in which same-sex-attracted men in Dar es Salaam perceive, seek, and enact sexual pleasure, and the roles that use and nonuse of condoms play in the lived sexual lives in which such pleasure is sought and created. It also identifies several HIV risk-minimizing strategies that same-sex practicing men are employing in their sexual relations, including but not limited to condom use. The article draws on conversations and interviews conducted during 15 months of ethnographic fieldwork with and among a diverse group of same-sex-attracted men in 2008 and 2009.     

At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

Child sexual abuse in Papua New Guinea is a human rights issue as well as an indicator of HIV risk in women. This study aimed to develop knowledge about the link between violence experienced by women and their HIV status. The study used a mixed method approach to collect quantitative and qualitative data through structured interviews with a sample of 415 women across four provinces of Papua New Guinea: National Capital District, Western Highlands, Western, and Morobe. Participants were asked about violence they had experienced as children and in their adult relationships and the impact of the violence. The quantitative data was analyzed using SPSS, and qualitative data was coded using a thematic approach. Child sexual abuse was reported by 27.5% of the sample (n?=?114). Women reporting child sexual abuse were more likely to live in violent relationships, be HIV positive, and have a higher number of sexual partners.     

Sexual Beliefs and Sexual Functioning: The Mediating Role of Cognitive Distraction

Dysfunctional sexual beliefs are vulnerability factors for sexual dysfunction. This cross-sectional study aimed to test the mediating role of cognitive distraction on the relationship between dysfunctional sexual beliefs about sexual functioning shared by men and women and sexual function. The authors used a sample of 421 cisgender heterosexual participants involved in a monogamous relationship. The hypothesized mediation model was tested using a bootstrapped cross product of coefficients approach. Results showed a significant negative, indirect effect between dysfunctional sexual beliefs and women's sexual function through cognitive distraction. The discussion of this study highlights the importance of cognitive factors in sexual functioning.     

The Trouble With Condoms: Norms and Meanings of Sexuality and Condom Use Among School-Going Youth in Kenya

ABSTRACT

Despite knowledge of the effectiveness of condoms in preventing HIV transmission, condoms continue to be reported in only a minority of sexual encounters even with nonpermanent partners. This study used focus-group discussions with youth and interviews with community leaders from 22 communities in the Nyanza and Rift Valley provinces, Kenya, to examine the sociocultural influences on condom use among school-going youth. Three overarching themes emerged from a thematic analysis of the data. Condoms did not fit with the purposes, meanings, and understandings of sexuality; in fact, condom use violated most of these. Condoms were also thought to be dangerous for girls and women, to contribute to the spread of HIV, and to be unnecessary for protection against HIV. Finally, given the hardships of life and multiple diseases and circumstances that threatened life, HIV was seen as just another trouble of living. Sex without a condom, within this context, was described as one of the pleasures of a short life. The complexities of sexuality evidenced in the discussions of these youth and adults challenge the viability of the ABC (abstain, be faithful, use a condom) message as a preventive measure against HIV transmission.     

Alcohol and Substance Use in Adolescence and Young Adulthood: The Role of Siblings

Interpersonal relationships within and outside the family have been a central part of alcohol and substance use research. Many studies have focused on the role of parents and peers; fewer studies have focused on siblings. This article examines siblings’ roles in alcohol, tobacco, and other drug (ATOD) use patterns and trajectories in the context of familial and nonfamilial factors across time. First, intraclass correlations were used to examine the degree to which older siblings’ ATOD use was associated with younger siblings’ ATOD use. Second, hierarchical regression analyses were conducted to examine the degree to which individual, parent, sibling, and peer factors over time were associated with adolescents’ and young adults’ ATOD use. It should be noted that developmentally proximal predictors were utilized in these models and within-family replication was also examined. Results demonstrate strong associations between older and younger siblings’ ATOD use. Moreover, the developmentally proximal sibling variables were predictive of younger sibling ATOD use in the context of other variables across all substances. Study findings are discussed in terms of identifying promising and potentially malleable points of intervention for future investigators.