“Female ejaculation” and urinary stress incontinence

A substantial increase in religious identification has been observed in most European post-communist countries. As religiosity has been associated with sexually transmitted infection (STI) and HIV vulnerability among young people, this article examined the impact of religious upbringing and personal religiosity (religiousness) on sexual risks among University of Zagreb first-year undergraduate students, using data collected in 1998, 2003, and 2008. Female participants who reported strict religious upbringing were less knowledgeable about human sexuality than other women. Religiousness was negatively correlated with basic knowledge of human sexuality, but again only among women. Contrary to expectations, no significant associations were found between religious upbringing or religiousness and condom use. Both measures of religiosity, however, were related to decreased odds of sexual debut among young women. In the case of male participants, the impact of religiosity was marginal. Religious upbringing was associated (negatively) with sexual literacy and sexual debut—but only at the beginning of the observed period. Overall, religiosity does not seem to substantially reduce STI- and HIV-related risk-taking, particularly among men. Since the observed increase in the proportion of sexually active students during the 1998 through 2008 period was not matched by an increase in condom use, reducing STI and HIV vulnerability among Croatian youth remains an essential task.     

Young Parents’ Relationship Characteristics,Shared Sexual Behaviors,Perception of Partner Risks,and Dyadic Influences

Rising rates of heterosexually transmitted HIV among youth and young adults, particularly from ethnic minorities, create an urgent need to understand risk factors and perceptions of risk within the context of couple relationships. This study examined reports of young mothers and fathers (predominantly Latino) about background characteristics, relationship quality and length, HIV-related risk factors, and perceptions of partners’ behaviors and personal history. Higher concordance was found for relationship characteristics and partners' personal history (e.g., incarceration) than on shared sexual behaviors. Most males and females stated that they were monogamous; however, those whose partners reported concurrency were unaware of this. Many were unaware of their partners’ HIV testing status. Relationship quality was higher when females accurately perceived their partners' self-reported HIV-related risk behaviors. Length of the relationship did not influence concordance. Findings support the need for HIV prevention programs to promote open discussion about condom use and HIV testing within sexual partnerships.     

Condom Use Trajectories in Adolescence and the Transition to Adulthood: The Role of Mother and Father Support

Few studies have investigated how mother and father support differ on predicting youths' sexual risk behavior. We therefore examined the influence of parental support on condom use trajectories and its correlates in a predominantly African American sample [(N=627; 53% female; M = 14.86 years (SD=. 64)] from adolescence to young adulthood. We used hierarchical growth curve modeling to examine the relationship between condom use, substance use, psychological distress and parental support prospectively. We found that consistent condom use decreased over time and was associated negatively with psychological distress and substance use. Furthermore, both maternal and paternal support were associated with more condom use over time. We discuss the implications of our findings for HIV prevention programs.     

“It's a Different Condom,Let's See How It Works”: Young Men's Reactions to and Experiences of Female Condom Use During an Intervention Trial in South Africa

Although male partner cooperation is often essential for successful use of the female condom, only a few studies have directly assessed men's experiences of using the device. We examined barriers to and facilitators of female condom use via qualitative in-depth interviews with 38 young men (18 to 28 years) in South Africa whose partners, all university students, were enrolled in a female condom intervention trial. In all, 21 men used the female condom; the remaining 17 did not attempt use. The main facilitators to female condom use were convenience of use for men, curiosity to see how female condoms compared to male condoms, enhanced sexual sensation, and perceptions of better safety and comfort of the device compared to male condoms. The main barriers were men's limited familiarity with the device, insertion difficulties, and men's concerns about loss of control over sexual encounters. We recommend that human immunodeficiency virus (HIV) prevention and condom promotion programs around the world target men directly for education on female condoms and that they also work with couples jointly around issues of safer-sex communication and negotiation.     

A longitudinal examination of risk and protective factors associated with drug use and unsafe sex among young African American females

This study prospectively examined associations among multiple theoretically informed risk (e.g., depression, sexual sensation seeking, and risky peers norms) and protective factors (e.g., social support, STI knowledge, and refusal to have sex self efficacy) on unsafe sex among 715 African American adolescent females aged 15–21 who participated in an STI/HIV prevention intervention. Generalized estimating equation models were used to assess associations between baseline characteristics and sexual risk over a 12-month follow-up period. Overall risk in this population was high: at baseline, nearly a third of women reported sex under the influence of alcohol or substances; ≥ 2 partners for vaginal sex, and casual sex partners in the 60 days prior to baseline, and nearly 75% of those reporting vaginal sex used condoms inconsistently. In multivariable analysis, when risk and protective factors were simultaneously considered, higher levels of sexual sensation seeking were associated with having multiple sex partners and inconsistent condom use. Greater perception of risky peer norms was associated with a higher risk of having sex under the influence of alcohol or drugs. In addition, higher sex refusal self-efficacy was protective against having multiple; casual; and concurrent sex partners. Incorporating these salient factors into prevention programs may be critical to the development of targeted interventions for this population.     

The Cedar Project: Understanding Barriers to Consistent Condom use over Time in a Cohort of Young Indigenous People who use Drugs

ABSTRACT Little information exists on the use of condoms as protective barriers to sexually transmitted infections (STIs) among indigenous people in Canada. This study explores risk factors of inconsistent condom use (during consensual sex) over time among participants in the Cedar Project, a prospective cohort study of indigenous young people living in Vancouver and Prince George, British Columbia, who use drugs. Due to the serial measurements for each study subject, generalized estimating equations modeling with logit link was used to accommodate the temporal correlation within subjects. For young women, inconsistent condom use over time was predicted by having a recent STI (adjusted odds ratio [AOR] = 1.76, 95% confidence interval [CI] [1.12, 2.79]), smoking crack daily (AOR = 1.63, 95%CI [1.02, 2.61]), and having experienced recent sexual abuse (AOR = 2.07, 95%CI [1.20, 3.56]). Among young men, living in Prince George (AOR = 1.63, 95%CI [1.14, 2.39]) and daily crack smoking (AOR = 1.56, 95%CI [1.02, 2.40]) were associated with inconsistent condom use over time. Among participants who used injection drugs, inconsistent condom use was associated with smoking crack daily (AOR = 1.59, 95%CI [1.04, 2.43]) and sharing needles (AOR = 1.78, 95%CI [1.26, 2.51]). The availability and effectiveness of sexual health services must be prioritized for indigenous people, and the design of culturally safe sexual health programs requires the meaningful involvement of young indigenous people.     

The role of family interactions in HIV risk for gay and bisexual male youth: A pilot study

Despite ongoing prevention efforts, young gay and bisexual males continue to engage in sexual behaviors that place them at disproportionately high risk for HIV infection. Parental monitoring and parent–child communication have been found to be associated with low-risk sexual behavior among heterosexual youth, but the role of family interactions for gay and bisexual male youth remains largely unexplored. To help address this gap, an exploratory study of recorded and coded interactions among 35 gay and bisexual youth and their parents was done to begin to identify which types of family interactions were associated with youth high-risk sexual behavior. Parent–son communication that was mutual and low in conflict was found to be most prevalent among youth with the fewest reported high-risk sexual behaviors. These preliminary findings, along with a case example, demonstrate how social workers can coach families to engage in productive and potentially influential interactions that reduce HIV-related sexual behaviors among young gay and bisexual males.     

Determinants of self-perceived risk for AIDS

This paper examines self-perceptions of risk for AIDS and factors that contribute to estimations of risk. On the basis of a telephone survey of 1,540 adults age 18 to 60, we address the question: What heuristic factors predict perception of risk for AIDS? Results show that five heuristic categories determine self-perceptions of risk: sexual practices, moral evaluations of people with AIDS, emotional response to AIDS, protective actions in response to AIDS, and demographic characteristics. Number of sexual partners over the past five years and knowledge of sexual partners' past sexual behavior are associated significantly with increased perceptions of risk. Fear of AIDS and worry about one's health also contribute significantly to self-perception of risk, as does shame associated with having AIDS. Asian-Americans and persons with no particular religious affiliation report greater perceptions of risk. These findings call attention to heuristic factors in considering theories of risk and in designing interventions to change preventive actions associated with high risk for AIDS.     

Religiosity,sexual behaviors,and sexual attitudes during emerging adulthood

The current study examined associations between religiosity and sexual behaviors and attitudes during emerging adulthood. Two hundred and five emerging adults completed surveys about five aspects of their religiosity (group affiliation, attendance at religious services, attitudes, perceptions of negative sanctions, and adherence to sanctions) and their sexual behaviors (abstinence, age of onset, lifetime partners, condom use) and attitudes (conservative attitudes, perceived vulnerability to HIV, and condom‐related beliefs). Associations were found between the measures of religiosity and sexuality, although the patterns differed by measures used. Religious behavior was the strongest predictor of sexual behavior. Many aspects of religiosity were associated with general sexual attitudes, which was not the case for perceived vulnerability to HIV and condom‐related beliefs. The findings support reference group theory and highlight the importance of considering the specific constructs of religiosity and sexuality assessed in studies of these topics.     

Women's Unprotected Sex Intentions: Roles of Sexual Victimization,Intoxication, and Partner Perception

Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.     

Condom Use Completeness,Perceptions, and Sexual Quality at Most Recent Sexual Event: Results from a U.S. Nationally Representative Probability Sample

Abstract

Objectives: To explore perceptions of condoms associated with complete use and evaluate relationships between condom perceptions, condom use, and sexual quality.

Methods: Using data from a U. S. nationally representative probability sample, we assessed individuals’ condom use perceptions and related characteristics of their most recent sexual event through bivariate and regression analyses (n?=?234).

Results: Most participants reported complete condom use and neutral or positive perceptions of condoms. Though incomplete use was associated with orgasm among women, arousal and pleasure did not differ by gender or duration of condom use.

Conclusions: We found no evidence that delayed application or early condom removal increased sexual arousal or pleasure, which may help sexual health promotion interventions address negative cultural ideas about condoms.     

Determinants Influencing Male Condom use Among University Students in Portugal

ABSTRACT. A self-administered questionnaire was carried out among university students in Portugal, with the aim to examine determinants influencing male condom use, according to the information–motivation–behavioral skills model (J. Fisher & Fisher, 1992). Students’ levels of information, motivation, and behavioral skills regarding preventive sexual behavior (male condom use) were ascertained and were used to determine their association with condom use among 880 male and 1,807 female students aged 18 to 35 years old. Although 86.9% of respondents indicated that they used a condom during their first sexual intercourse, only 32.8% used a condom always during sexual intercourse in the last 12 months. Most young people, especially women, had a good level of information regarding HIV/AIDS transmission/prevention. They also showed reasonable positive attitudes and had positive subjective norms and intentions toward HIV/AIDS preventive behaviors. Men presented a higher perceived difficulty and a lower perceived effectiveness of HIV/AIDS preventive behavior, therefore reporting higher risk acceptance. A path analysis revealed that preventive sexual behavior did not depend directly on information level but on motivation and behavioral skills (especially among men). Information about HIV prevention/transmission was not significantly associated with condom use. The finding that motivation and behavioral skills were the strongest determinants of condom use suggested that these may be important factors in effective sexually transmitted infection-prevention programs.     

Getting your partner to use condoms: Interviews with men and women at risk of HIV/STDs

Data from individual semistructured interviews with 90 young heterosexual couples were analyzed to identify strategies that men and women at risk of HIV/STDs would use to influence their partners to use condoms for the purpose of disease prevention. In addition, we explored whether participants thought influencing strategies would differ for pregnancy prevention. Content analysis of the interview data indicated that participants would use the following verbal strategies: persuading/suggesting, commanding/asserting, and threatening to withhold sex. Several participants, particularly those who had recently used condoms with their partners, reported that they would also use non‐verbal strategies involving condoms themselves (e.g., putting a condom on, buying or getting condoms, or presenting a condom to their partner). Many participants believed that they would use a different strategy for pregnancy prevention because it would be easier to convince a partner to use condoms for that purpose.     

Investigating the role of individual characteristics,interpersonal sexual communication,media exposure,and gender differences on condom use among chinese college students in hunan

Objectives: The objective of this study was to investigate factors of condom use among a sample of 490 sexually active Chinese college students. Methods: A cross-sectional survey by systematic sampling was conducted on students' interpersonal sexual communication, media exposure, and condom use. Multiple regression was employed for analysis. Results: Self-efficacy, peer and partner sexual communication, parent norms about condom usage, HIV/AIDS information from brochures, and exposure to sexual content in books were associated with variables related to condom use. Conclusions: The current study underscores the importance of self-efficacy and peer and partner sexual communication in HIV preventive intervention programs that promote condom use among young Chinese.     

Context of First Same‐Sex Condom Use and Nonuse in Young Black Gay and Bisexual Males

Despite high human immunodeficiency virus (HIV) rates among young Black men who have sex with men (YBMSM), there are limited data about condom use during first same‐sex (FSS). This study sought to understand socio‐contextual factors of 50 YBMSM aged 15–19 years that influenced condom use during FSS. Condom use was influenced by individual, partner, and community factors. Individual factors—recent illness or sexually transmitted infections (STI)—prompted condom use, while frequent HIV testing prompted nonuse. Partner factors—proactive encouragement from partners—prompted condom use, while trust and condom discomfort prompted nonuse. Larger community factors—such as presence of females—were key for use, while limited sexual health information combined with peers who discouraged condoms prompted nonuse. A multilevel approach may be useful in developing sexual health programming for these young men.     

Condoms and Contexts: Profiles of Sexual Risk and Safety Among Young Heterosexually Active Men

Heterosexual men's sexual safety behavior is important to controlling the U.S. epidemic of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). While sexual safety is often treated as a single behavior, such as condom use, it can also be conceptualized as resulting from multiple factors. Doing so can help us achieve more nuanced understandings of sexual risk and safety within partner-related contexts. We used latent class analysis with data collected online from 18- to 25-year-old heterosexually active U.S. men (n = 432) to empirically derive a typology of the patterns of sexual safety strategies they employed. Indicators were sexual risk-reduction strategies used in the past year with the most recent female sex partner: condom use, discussing sexual histories, STI testing, agreeing to be monogamous, and discussing birth control. We identified four subgroups: Risk Takers (12%), Condom Reliers (25%), Multistrategists (28%), and Relationship Reliers (35%). Partner-related context factors—number of past-year sex partners, relationship commitment, and sexual concurrency—predicted subgroup membership. Findings support tailoring STI prevention to men's sexual risk-safety subgroups. Interventions should certainly continue to encourage condom use but should also include information on how partner-related context factors and alternate sexual safety strategies can help men reduce risk for themselves and their partners.     

Sexual Self-Efficacy and Gender: A Review of Condom Use and Sexual Negotiation Among Young Men and Women in Sub-Saharan Africa

Sexual self-efficacy (SSE), one’s perceived control of or confidence in the ability to perform a given sexual outcome, predicts sexual behavior; however, important questions remain regarding whether gender modifies observed associations. In a comprehensive review of peer-reviewed HIV-prevention literature focusing on youth (ages 10 to 25) in sub-Saharan Africa, we measured and assessed the influence of SSE on condom use and sexual refusal, overall and by gender. Our results, after reviewing 63 publications, show that SSE is inconsistently measured. Most studies measured condom use self-efficacy (CUSE) (96.8%) and/or sexual refusal self-efficacy (SRSE) (63.5%). On average, young men had higher CUSE than young women, while young women had higher SRSE than young men. While cross-sectional studies reported an association between high SSE and sexual behaviors, this association was not observed in interventions, particularly among young women who face a disproportionate risk of HIV acquisition. In all, 25% of intervention studies demonstrated that fostering CUSE increased condom use among young men only, and one of two studies demonstrated that higher SRSE led to reduced frequency of sexual activity for both men and women. Future research and HIV-prevention interventions must be gender targeted, consider improving CUSE for young men, and move beyond limited individual-level sexual behavior change frameworks.     

Sex drugs, peer connections, and HIV: Use and risk among African American, Latino, and Multiracial young men who have sex with men (YMSM) in Los Angeles and New York

African American and Latino young men who have sex with men are at high risk for HIV infection. We administered brief intercept surveys (N=416) at 18 Black and Latino gay pride events in Los Angeles and New York in 2006 and 2007. Ordinal logistic regressions were used to model the effects of substance use during sex, peer connectedness, relationship status, and homelessness on condom use. Alcohol use, crystal use, homelessness, and having a primary relationship partner were negatively associated with condom use, while peer connectedness and marijuana use during sex were positively associated with condom use. Implications for service providers and future research are discussed.     

Prevalence and risk and protective factors associated with HIV-related behavior among transgender people in Hong Kong

Abstract

This paper presents findings from the first large-scale quantitative study into HIV-related behavior among transgender people in Hong Kong. A survey of 195 transgender people found that only one-third of those who had engaged in sexual behavior in the past 3?months reported consistent condom use. Stable relationships, beliefs in low HIV transmission risk, and condom inaccessibility were cited as reasons for inconsistent condom use. The HIV testing figures were also strikingly low. This study demonstrates an urgent need for addressing HIV issues among transgender people in Hong Kong as there are currently no such specific services.     

Social,Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut,Lebanon

Objectives: We examined the social, relational and network determinants of condom use and HIV testing among men who have sex with men (MSM) in Beirut. Methods: Two-hundred thirteen men were recruited via respondent driven sampling and administered a survey. Results: Sixty-four percent reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% of participants had tested for HIV. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Conclusions: Multi-level social factors influence sexual health in MSM.