Motives for coprophilia: Working with individuals who had been institutionalized with developmental handicaps

A condom skills educational program emphasizing how to use a condom was presented to groups of patients waiting to be seen in a public health sexually transmitted disease clinic. Compared to controls, patients exposed to the intervention were approximately half as likely to return within the subsequent 12 months with a new sexually transmitted disease. Other predictors of reinfection included previous infection and age less than 25.     

Prevalence and Correlates of Sex Exchange Among a Nationally Representative Sample of Adolescents and Young Adults

The present study examines prevalence and correlates of exchanging sex for drugs, money, food shelter, or other favors (sex exchange) among a nationally representative sample of youth and young adults. Adolescents and young adults (n = 11,620, 53% female, 47% male) from the National Longitudinal Study of Adolescent Health were used for the current sample. Participants completed in-home interviews at both waves. Results revealed that sex exchange was reported by 4.9% (n = 569) of the population in wave 2 or wave 3, and 4.6% (n = 26) of those who exchanged sex did so at both waves. More males reported exchanging sex than females (n = 332 versus n = 237). Respondents who reported child sexual abuse were more likely to exchange sex (95% CI 2.51–4.28, p < .05) than respondents who reported any other form of child abuse. Both males and females who engaged in sex exchange were at greater risk for sexually transmitted infections; however, the odds of ever exchanging sex were highest among males who ever had gonorrhea (OR = 6.2; 95% CI 3.75–10.3). Although sex exchange has been studied extensively among homeless and runaway youth, the current study reveals sex exchange also occurs in the general population.     

Predicting the Condom Assertiveness of Collegiate Females in the United States From the Expanded Health Belief Model

ABSTRACT. Collegiate females in the United States are susceptible to sexually transmitted infections (STIs) due to their propensity for sexual exploration, multiple sexual partnerships, and inconsistent safe-sex practices. Despite the potential for safe-sex communication to contribute to safer sex, little is known about the predictors of this form of sexual communication. Research on condom assertiveness—the unambiguous messaging that sex without a condom is unacceptable—is especially rare. This study employed the Expanded Health Belief Model (EHBM) in an attempt to understand why some collegiate females are more condom assertive than others. Compared with less condom-assertive females, more condom-assertive females have more faith in the effectiveness of condoms, believe more in their own condom communication skills, perceive that they are more susceptible to STIs, believe there are more relational benefits to being condom assertive, believe their peers are more condom assertive, and intend to be more condom assertive. Overall, EHBM variables accounted for nearly 70% of the variability in condom assertiveness. Several of these associations, however, were moderated by sexual compulsivity and general assertiveness. Implications of these findings for sexual health practitioners are discussed, and directions for future research are suggested.     

Position Statement on Tobacco on College and University Campuses

Objective: The authors examined the feasibility of conducting serologic testing for the herpes simplex virus 2 (HSV-2) among university students and assessed the psychosocial impact of an HSV-2 diagnosis. Methods: The authors recruited a convenience sample of 100 students (aged 18-39 years) without a history of genital herpes from 1 university between September 2004 and March 2006. Participants received HSV-2 antibody testing by Focus ELISA and Western Blot assays and completed a questionnaire that addressed psychological functioning. Twenty-eight participants completed the questionnaire again at a 3-month follow-up visit. Results: The study revealed (1) low test-reliability in the student population, (2) that positive test results may cause a decline in psychological well-being, and (3) that substantial resources are required to support students with positive HSV-2 results. Conclusions: Test performance, psychological impact, and availability of resources for counseling students with positive diagnoses should be considered before implementing HSV testing programs.     

Use of APTIMA Combo 2: The Experience of a Child Advocacy Center

The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for chlamydia and gonorrhea in sexually abused girls. No studies describe performance of APTIMA Combo 2 Assay with second target confirmation on the same testing platform. This nucleic acid amplification testing is evaluated within a large child advocacy center. Girls 3 to 18 years, 35% of whom reported consensual sexual activity, were prospectively tested by APTIMA Combo 2 on urine/vaginal swabs and by vaginal culture. A case of infection was defined as positive culture or positive urine or vaginal swab nucleic acid amplification testing with second target confirmation. Sensitivity of APTIMA Combo 2 on urine was found to be superior to vaginal culture and comparable to APTIMA Combo 2 on vaginal swabs for both infections. APTIMA Combo 2 on urine is less invasive, and its use may be preferred in this traumatized population.     

Difference in Condom Use Among Sexually Active Males at Historically Black Colleges and Universities

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.     

F.O.R.E.play: The Utility of Brief Sexual Health Interventions Among College Students

Abstract

Objectives: The authors aimed to determine the most effective brief sexual health intervention for college students, while also evaluating students’ preferences for learning about sexual health, in order to develop a university program. Methods: A total of 302 students enrolled in an introductory college course participated and were randomly assigned to 1 of 3 brief interventions during a regularly scheduled class and completed pre- and postsurveys assessing knowledge, motivation to use condoms, and condom self-efficacy. Results: Findings indicated that having an actual person in charge of the learning process resulted in higher knowledge gains and highlighted a student preference for discussion-based learning, viewing pictures of sexually transmitted infections, and hearing real-life experiences about the consequences of unsafe sex. Conclusions: These findings will be used to tailor a future intervention targeting college students for use with freshmen students at this university.     

Correlates of Correct Condom Use Among High-Risk African American Men Attending an Urban STD Clinic in the South

ABSTRACT

The purpose of this cross-sectional study was to assess prevalence and correlates of correct condom use among high-risk African American men attending a publicly funded sexually transmitted disease (STD) clinic. Men 18 through 29 years of age and newly diagnosed with an STD were further assessed for study eligibility. Of 296 meeting eligibility criteria, 271 agreed to participate, thereby yielding a participation rate of 91.5%. Correct use, assessed by an index, was reported by 38%. Correct use was associated with having sex with three or fewer female sex partners, being in an exclusive relationship, not indicating problems with the fit or feel of condoms, and not being drunk/high while using condoms. The correct use of condoms among young African American men newly diagnosed with an STD may be a function of situational factors. These factors could potentially be addressed in the context of clinic-based behavioral intervention programs.     

American College Health Association Annual Pap Test and Sexually Transmitted Infection Survey: 2006

Objective: The authors describe the cervical cytology and sexually transmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers—representing more than 2 million college students—completed an online survey during February and March 2007. Results: Almost 13% of cervical cytology results were abnormal; most of these were atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions. In women, 2.9% of chlamydia tests and 0.4% of gonorrhea tests were positive. Human immunodeficiency virus (HIV) and syphilis tests were positive in 0.1% and 0.3% of students tested, respectively. Herpes simplex virus type 1 (HSV-1) accounted for 59.9% of genital herpes infections. Conclusions: College health centers are important sources for Pap and STI test data. Pap tests frequently yield low-grade abnormalities, and screening tests for chlamydia and especially gonorrhea are infrequently positive. Rates of HIV and syphilis in this population are low, raising concerns about positive predictive value when screening low-risk students. A majority of genital herpes infections are caused by HSV-1.     

Food: Sustenance and Symbol

Abstract

College students often delay or avoid seeking testing for sexually transmitted infections (STIs), even if the services are readily available. We used in-depth, semistructured interviews to survey 41 college students aged 18 to 23 years about factors that influence decisions about STI testing. We grouped statements into 9 themes that represent influences on the decision. The most frequently mentioned factors were negative consequences of testing and perceived vulnerability to infection; other issues that influenced decision making included perceived benefits, perceived severity of diseases, public knowledge and opinion, social norms, provider characteristics, test-site characteristics, and personal considerations. Social stigmas and negative consequences appear to represent significant barriers to college students' being tested, which could increase the risk of spreading infections to others. Clinicians and health educators should raise students' awareness of the need for screening and should work to reduce the barriers to screening, including social stigmas and negative consequences.     

The State of the Union: Sexual Health Disparities in a National Sample of US College Students

Abstract

Objective: To examine sexual health disparities between blacks and whites in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18–24; M = 20.1) responding to the Spring 2007 American College Health Association–National College Health Assessment; 64% were female and 94.7% were white. Results: Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. Conclusions: This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.     

Sexual Behaviors and Sexually Transmitted Diseases of Lesbians

ABSTRACT

The Boston Lesbian Health Project surveyed 1633 lesbians about their health status, health related behaviors and health problems. This paper reports on those parts of the questionnaire that dealt with sexual behaviors and sexually transmitted diseases. The sample was predominantly monogamous, but few had been in their present relationship for more than five years. Sexual practices were similar to those reported in previous studies of lesbians and to those reported in a study of heterosexual women. Sexually transmitted diseases were rare in women who had never had sex with a male partner. The majority of the sample did report a history of male sexual partners and therefore are at risk for abnormal pap smears and other sexually transmitted diseases.     

Spirituality,Sacrifice, and Relationship Quality for Expectant Cohabitors

Given negative effects of cohabitation, we examine negative (ambivalence, conflict) and positive (commitment, satisfaction) relationship quality, as explained by perceptions of ease of relational sacrifices and spirituality, for unmarried cohabitors expecting their first child (46 individuals). Controlling for race/ethnicity and education, perceived ease of relational sacrifice was associated with greater satisfaction and lower ambivalence and conflict, whereas spirituality was not associated with any of the relationship quality variables. Examined together, greater ease of relational sacrifice and higher spirituality were associated with greater commitment and satisfaction and lower ambivalence and conflict. Given that many studies of cohabitation focus on demographic factors and that many studies of spirituality focus on married couples, the current study expands knowledge regarding relationship quality for nontraditional couples.     

Sexual Practices Among a Sample of Young Lesbian and Bisexual Women from Mexico: An Exploratory Study

Objective: To describe sexual practices in Mexican lesbian and bisexual women. Materials and method: An online survey was conducted with a nonprobabilistic sample of self-identified lesbian (n?=?768) and bisexual (n?=?371) women from the 32 states of Mexico. Results: Lesbians less frequently reported having had sex with a man than bisexual women. Preferred sexual practices with other women were external genital stimulation with fingers, internal genital stimulation with fingers, and oral genital stimulation. Most (～80%) participants did not use protection to prevent sexually transmitted infections. Conclusions: Our results can inform the design of promotion and prevention programs in sexual health aimed at sexual minority women.     

Prevalence of Sexually Transmitted Diseases and Risk Behaviors from the NIMH Collaborative HIV/STD Prevention Trial

ABSTRACT

This cross-sectional study describes the baseline prevalence and correlates of common bacterial and viral sexually transmitted diseases (STDs) and risk behaviors among individuals at high risk for HIV recruited in five low- and middle-income countries. Correlations of risk behaviors and demographic factors with prevalent STDs and the association of STDs with HIV prevalence are examined. Between 2,212 and 5,543 participants were recruited in each of five countries (China, India, Peru, Russia, and Zimbabwe). Standard protocols were used to collect behavioral risk information and biological samples for STD testing. Risk factors for HIV/STD prevalence were evaluated using logistic regression models. STD prevalence was significantly higher for women than men in all countries, and the most prevalent STD was Herpes simplex virus-type 2 (HSV-2). HIV prevalence was generally low (below 5%) except in Zimbabwe (30% among women, 11.7% among men). Prevalence of bacterial STDs was generally low (below 5% for gonorrhea and under 7% for syphilis in all sites), with the exception of syphilis among female sex workers in India. Behavioral and demographic risks for STDs varied widely across the five study sites. Common risks for STDs included female gender, increasing number of recent sex partners, and in some sites, older age, particularly for chronic STDs (i.e., HSV-2 and HIV). Prevalence of HIV was not associated with STDs except in Zimbabwe, which showed a modest correlation between HIV and HSV-2 prevalence (Pearson coefficient = .55). These findings underscore the heterogeneity of global STD and HIV epidemics and suggest that local, focused interventions are needed to achieve significant declines in these infections.     

Exploring Dimensions of Racism,Homophobia, and Social Network As Concomitant Predictors of Condom Use in a Sample of Black MSM

With a convenience sample of 148 Black men who have sex with men (MSM) who primarily resided in the Washington, District of Columbia, metropolitan Area, the purpose of this research was to concomitantly use dimensions of racism, homophobia, and social network constructs in a regression model to predict condom use. In the model, analysis indicated that condom nonusers versus consistent users experienced more conversations with friends regarding salient topics (i.e., HIV status) (odds ratio [OR] = .86, p < .01) and fewer discussions with sexual partners about salient topics (OR = .77, p = .02). Furthermore, inconsistent condom users versus consistent users experienced higher levels of internalized homophobia (OR = 1.12, p = .04) and less racism associated with physical characteristics (OR = .89, p = .04). Notably, all of the racism dimensions identified in this research were nonsignificant as positive predictors of condom use. Overall, based on the findings, internalized homophobia may need to be isolated or targeted as an HIV-risk factor when implementing individual- and group-level HIV-prevention strategies for Black MSM. Moreover, improved communication skills among Black MSM pertaining to discussing salient topics (i.e., HIV status) with their sexual partners could also be used as a possible HIV-prevention strategy.     

The Use of Internet Chat Rooms to Meet Sexual Partners: A Comparison of Non-Heterosexually Identified Men with Heterosexually Identified Men and Women

ABSTRACT. Objectives: Prior work suggests that many individuals use the Internet to meet romantic or sexual partners. Our intent was to explore perceptions and experiences with meeting people online. Methods: In 2008, the authors conducted U.S.-based online interviews with 65 predominantly White, self-identified heterosexual men and women and gay/bisexual men (Mean age = 30.8 years). Results: Reasons for meeting people online, desired partner characteristics, and the process of connecting for sex paralleled those observed in face-to-face contexts. People used Internet chat rooms to identify more partners and specific partner characteristics. “Background checks” of online partners, though often believed to be inaccurate, increased familiarity and trust leading to reduced condom use. Participants said online condom use negotiation was easier but usually occurred in face-to-face contexts. Conclusions: The fundamental processes of meeting partners online are similar in many ways to meeting partners face-to-face; however, the Internet facilitates rapid access to relatively large numbers of potential partners.     

The Association of Campus Resources for Gay,Lesbian, and Bisexual Students With College Students' Condom Use

Abstract

The author and colleagues examined campus resources for gay, lesbian, and bisexual (GLB) students at 119 US colleges to determine how the presence of such resources affected sexually active students' condom use. A random sample of unmarried, sexually active college students surveyed in 1999 completed questionnaires. Condom use was compared across schools with different levels of GLB resources. Condom use rates, analyzed by sex and sex-partner groups, ranged from 32% to 52%. With additional college variables controlled for, GLB resources were positively associated with the proportion of sexually active students who used condoms (p < .001). This association existed primarily for students with only opposite-sex partners. The author's findings suggest that campus resources for GLB students may be associated with college students' condom use.     

HPV Knowledge and Behaviors of Black College Students at a Historically Black University

College students are at high risk for human papillomavirus (HPV) infection, yet their knowledge and self-protective behaviors appear inadequate. Researchers who have measured HPV-related knowledge and behaviors in evaluating college intervention efforts pay secondary attention to black college students because this group generally represents only a small subset of samples of the broader college population. Objective and Participants The authors' purpose in this study was to examine HPV-related knowledge and behaviors in 351 black undergraduates attending a historically black southeastern university in the spring of 2003. Methods Voluntary and anonymous student participation was solicited in randomly selected undergraduate classes. Results Results indicated that most students lacked HPV awareness (64%), became aware of HPV largely after infection, and gained their HPV knowledge from a health-care provider or college class. The authors performed an analysis by gender and found that women were more knowledgeable about HPV than were men. Observed HPV-related knowledge and behaviors were similar to samples of the broader US college population. Conclusions Findings suggest a greater need for HPV intervention efforts for all college students, including those at black colleges.     

A pilot test of a self-guided,home-based intervention to improve condom-related sexual experiences,attitudes, and behaviors among young women

Objective: To conduct a pilot test of a brief, self-guided, home-based program designed to improve male condom use attitudes and behaviors among young women. Participants: Women aged 18–24 years from a large Midwestern University reporting having had penile–vaginal sex with two or more partners in the past 3 months. Sixty-seven enrolled; 91.0% completed the study. Methods: A repeated measures design was used, with assessments occurring at baseline, immediately post intervention (T2), and 30 days subsequent (T3). Results: Condom use errors and problems decreased, condom-related attitudes and self-efficacy improved, and experiences of condom-protected sex were rated more positively when comparing baseline with T2 and T3 scores. Further, the proportion of condom-protected episodes more than doubled between T1 and T3 for those in the lowest quartile for condom use at baseline. Conclusion: This low-resource, home-based program improved condom-related attitudes and promoted the correct and consistent use of condoms.