Casual Partners Research Articles

Combinations of Sexual Activities During a Sex Episode with Recent Casual Male Partner Among Men Who Have Sex with Men: A Cross-Sectional Study

ABSTRACT We examined combinations of nine sexual activities that occurred during a sex episode with a recent male partner among men who have sex with men (MSM) who attended an urban sexual health clinic from April-2017 to September-2017. We collected the following sexual activities: tongue-kissing, penises touching, using saliva during mutual masturbation, performed rimming, received rimming, performed fellatio, received fellatio, insertive anal sex, and receptive anal sex. During a single-sex episode, the most common combinations of sexual activities involved all nine activities (10.6%, 166/1542). We assessed the agreement between any two sexual activities that occurred together during a sex episode. Agreement was highest for receiving rimming and receptive anal sex (kappa = 0.40; 95% CI: 0.35, 0.45), and performing rimming and insertive anal sex (kappa = 0.38; 95% CI: 0.33, 0.42). Agreement was lowest for insertive anal sex and receiving fellatio (kappa = −0.01; 95% CI: −0.05, 0.03), and receptive anal sex and insertive anal sex (kappa = −0.08; 95% CI: −0.13, 0.03). The sexual activities that occur between men are correlated with one another and this will influence transmission between anatomical sites.

Finding Intimacy Online: A Machine Learning Analysis of Predictors of Success.

While an extensive scientific literature now exists on the use of online dating services, there are very few studies on user satisfaction with dating apps and with the resulting offline dates. This study aimed to assess the level of satisfaction with Tinder use (STU) and the level of satisfaction with Tinder offline dates (STOD) in a sample of adult users of the app. The study also aimed to examine, among 28 variables, those that are the most important in predicting STU and STOD. Overall, 1,387 Tinder users completed an online questionnaire. A machine learning model was used to rank order predictors from most to least important. On a 4-point scale, participants' mean STU score was 2.39, and, on a 5-point scale, mean STOD score was 3.05. The results indicate that satisfaction with dating apps and with resulting offline dates is strongly predicted by participants' age and by their motives for using Tinder (enhancement, emotional coping, socialization, finding "true love," or casual sexual partners), whereas the variables negatively associated with satisfaction were those related to psychopathology. Interestingly, 65.3 percent of app users were married or "in a relationship," and only 50.3 percent of app users were using it to meet someone offline. Generally, participants who engage with the app to cope with personal difficulties seem more likely to report higher levels of dissatisfaction, suggesting that dating apps are a poor coping mechanism and highlighting the need to address underlying problems or pathologies that may be driving their use.

A randomized controlled trial of a brief motivational interviewing-based group intervention for emerging adults experiencing homelessness: 12-Month effects on substance use and sexual risk behavior

IntroductionFew brief evidence-based risk reduction programs for emerging adults experiencing homelessness focus on the interrelated problems of substance use and sexual risk behavior. This study examines outcomes from a 12-month evaluation of AWARE, a brief Motivational Interviewing (MI)–based group risk reduction intervention for this population. MethodsIn a cluster randomized crossover trial, N = 276 18–25-year-olds received AWARE or usual care at drop-in centers serving homeless youth in Los Angeles County. We evaluated intervention effects on substance use and condomless sex (primary outcomes), as well as drinking consequences and protective strategies, number of casual partners, self-efficacy, and motivation for change (secondary outcomes). ResultsAWARE participants self-reported reductions in their alcohol use and negative consequences from drinking, and an increase in use of drinking protective strategies. AWARE participants also reported an initial decrease in drug use other than marijuana, followed by a slight uptake later on, as well as an initial increase in importance of cutting down on other drug use followed by a decrease. Control group participants did not show change in these outcomes. Among those who reported casual sex partners at both baseline and 12-month surveys, exploratory analyses indicated that AWARE participants had a 29 % decline in condomless sex with casual partners compared to a 6 % decline for control group participants. ConclusionsFindings build on our pilot work by demonstrating that AWARE has long-term benefits on drinking among emerging adults experiencing homelessness. Further work should seek to strengthen its long-term effectiveness in reducing drug use in this population.

Risky sexual behaviours and associated risky determinants among students’ of federal polytechnic, Oko, Anambra State

Adolescence is a period of life with specific health and developmental needs and rights. It is also a time to develop knowledge and skills, learn to manage emotions, relationships and attributes as well as abilities that will be important for enjoying the adolescent years. It is also a period of assuming adult roles. Purpose: This study was aimed at exploring the risky sexual behaviours and factors associated with Risky sexual behaviours (RSB) among students’ of Federal Polytechnic Oko. Cross-sectional design was used for this study. Method: The Instrument used for collection of data was an adapted Questionnaire (University of Florida sexual behaviour questionnaire 2019). 444 students who volunteered were used for the study. Multi-stage sampling technique was used. In stage 1, simple random sampling technique was used to select four (4) schools out of the eight (8) schools in Federal Polytechnic Oko (FPO). In stage 2, out of the four (4) schools, Proportionate sampling technique was used to select one departments from the schools, whereby for each school with less than four (4) departments, one (1) department was selected and for any school with more than four (4) departments, two (2) departments were selected. Finally, simple random sampling technique was used to select the participants for the study from the selected departments. The face and content validity was established and the reliability coefficient of the instruments was 0.82. Data analysis was done using chi-square. Result: The results indicated that 426 (97.3%) of the participants practised risky sexual behaviour, while 12 (2.7%) did not practise RSB, however, only 140 (32.0%) had definite practice (mean score>2.5). Most of the students practised unprotected vaginal 390 (89.0%), oral 345 (78.7%) and anal sex 307 (70.1%). More than two-thirds 317 (71.0%) of the students had multiple sexual partners and engaged in smooching. More than half of the respondents were influenced by certain factors that predisposed to risky sexual behaviour, 344 (78.5%) exposed themselves to pornography, (343) 78.3% cohabitate with opposite sex, while, about half of the students accepted that risky sexual behaviour can be reduced through increase in STIs awareness. Increase in condom use (37.7%) and STI testing (35.2%) were strongly agreed as ways of reducing RSB. Nishtha and Siddharth, 2019, opined that specific sexual behaviour among students include but not limited to too early initiation of sexual activity, sexual intercourse without the use of contraception, unplanned pregnancy, multiple sexual partner and sexual intercourse with a partner infected with an STI and HIV/AIDS, unprotected vaginal sex, oral sex and outercourse/smooching (non – penetrative sexual activity) among others. Some of the factors associated with risky sexual behaviours include: Substance abuse, Prestige of Multiple Partners, Sexual Activity for Financial Gain, Sexual Activity for Good Grades, Casual Sex Partners, Peer Pressure, Gender Issues, Media, Sexual Activity to Relieve Stress, Easy access to sex, watching of pornographic.

Patterns of PrEP and condom use among PrEP users in Belgium: a web-based longitudinal study

BackgroundTailoring pre-exposure prophylaxis (PrEP) service delivery is key to scaling-up PrEP uptake. Optimal implementation of tailored services requires, among other things, insights into patterns of PrEP use, sexual behaviours and condom use over time.MethodsBetween September 2020 and January 2022, we conducted a web-based, longitudinal study among PrEP users in Belgium. In three questionnaire rounds every six-months, we assessed PrEP and condom use, and sex with steady, casual and anonymous partners in the preceding three months. Based on the patterns of PrEP use in the preceding three months, we identified distinct PrEP use categories. We investigated differences in baseline socio-demographics and sexual behaviours by PrEP use category using Fisher’s exact and one-way ANOVA tests. Patterns in PrEP and condom use over time were examined using descriptive analyses and visualised in alluvial diagrams.ResultsIn total, 326 participants completed the baseline questionnaire, and 173 completed all three questionnaires. We identified five distinct PrEP use categories: daily (≥ 90 pills), almost daily (75–89 pills), long period (> 7 consecutive days and < 75 pills) with or without additional short period use, short period (1–7 consecutive days and < 75 pills) and no PrEP use (0 pills). During the study, percentages of individuals in each PrEP use category varied, but did not change significantly over time. At baseline, daily and almost daily users were more likely to report five or more casual sex partners, ten or more anonymous sex partners and anal sex on a weekly basis with casual or anonymous partners compared to those using PrEP for long or short periods. Up to 12.6% (n = 16/127) of participants reporting anal sex with casual or anonymous partners, indicated always using condoms and PrEP with these partners. One in three (n = 23/69) participants who reported anal sex with steady partners had condomless anal sex and did not use PrEP with these partners; with casual or anonymous partners less than 3% reported this.ConclusionsOur findings show that there is little variation in PrEP use over time and that PrEP use was associated with sexual behaviours, which could be taken into account when designing tailored PrEP care.

Correlates of condom use among male university students from eastern China who engage in casual sex.

Consistent condom use with casual partners is critical for preventing the transmission of human immunodeficiency virus (HIV) among male university students. This study aimed to determine the level of consistent condom use and explore the correlates of condom use consistency in male university students in eastern China. A descriptive cross-sectional survey was conducted in 13 universities in Zhejiang Province, which involved the recruitment of 31,674 students by stratified random sampling. Among them, 545 male students who engaged in casual sex in the year prior to this study were included. Adjusted and unadjusted logistic regression models were used to examine the correlates associated with consistent condom use. Among the 545 male university students, only 205 (37.6%) consistently used condoms in the previous year. The following correlates were associated with higher rates of consistent condom use: 1) Knowledge, specifically, the number of correct answers to "HIV infection can be determined by appearance" (AOR: 2.06, 95% CI: 1.21-3.49); 2) never finding casual partners on the internet during the past over the prior year (AOR: 0.63; 95% CI: 0.40-0.99); 3) never drinking alcohol before casual sex during the last over the prior year (AOR: 0.30; 95% CI: 0.20-0.46); 4) never engaging in commercial sex (AOR: 0.57; 95% CI: 0.34-0.96); and 5) high condom self-efficacy score (AOR: 2.55; 95% CI: 1.44-4.49). The study found a low level of consistent condom use among male university students. Promoting condom self-efficacy, reducing web-based casual sex, drinking before sex, and commercial sex are essential to improving the level of consistent condom use among male university students to reduce the transmission of HIV.

Focusing on Safety or Pleasure Determine Condom Use Intentions Differently Depending on Condom Availability and STI Risk

Objective Regulatory Focus Theory suggests that goal pursuit is driven by two separate and fundamental motives. Being more focused on prevention motivates people to enact safer behaviors and avoid negative outcomes (e.g., to prevent diseases), whereas being more focused on promotion motivates people to take risks and pursue pleasurable experiences (e.g., condomless sex). Methods A quasi-experimental study (N = 476) examined if differences in regulatory focus (i.e., prevention vs. promotion) determined condom use intentions with a prospective casual partner, depending on condom availability delay and STI risk cues. Results Participants focused on prevention (vs. promotion) were less likely to consider having condomless sex across condom availability delays conditions. However, STI risk cues changed condom use intentions. When STI risk was lower, condom use intentions decreased as condom availability delays increased (particularly for participants focused on promotion). When STI risk was higher, condom use intentions were stronger and consistent across condom availability delays (particularly for participants focused on prevention). Conclusions These findings highlight the importance of distinct sexual motives when examining sexual health practices.

Partnership types and coital frequency as predictors of gonorrhea and chlamydia among young MSM and young transgender women.

Sexually transmitted infections pose a major public health challenge in the United States and this burden is especially acute in subpopulations like young men who have sex with men (YMSM) and young transgender women (YTW). Yet, the direct behavioral antecedents of these infections are not well understood making it difficult to identify the cause of recent increases in incidence. This study examines how variations in partnership rates and the number of condomless sex acts are associated with STI infections among YMSM-YTW. This study leveraged 3years of data from a large longitudinal cohort of YMSM-YTW. A series of generalized linear mixed models examined the association between the number of condomless anal sex acts, number of one-time partners, number of casual partners, and number of main partners and chlamydia, gonorrhea, or any STI. Results indicated the number of casual partners was associated with gonorrhea [aOR = 1.17 (95% CI: 1.08, 1.26)], chlamydia [aOR = 1.12 (95% CI: 1.05, 1.20)], and any STI [aOR = 1.14 (95% CI: 1.08, 1.21)] while the number of one-time partners was only associated with gonorrhea [aOR = 1.13 (95% CI: 1.02, 1.26)]. The number of condomless anal sex acts was not associated with any outcome. These findings suggest the number of casual partners is a consistent predictor of STI infection among YMSM-YTW. This may reflect the quick saturation of risk within partnerships making the number of partners, rather than the number of acts, the more relevant factor for STI risk.

Network Analysis of Sexual Sensation Seeking, Internalized Homophobia, and Social Norms Among Men Who Have Sex with Men with Different Sexual Partner Types.

Men who have sex with men (MSM) are at disproportionate risk for developing sexually transmitted infections (STIs) such as HIV. Understanding the relationships among factors related to risky sexual behaviors, such as internalized homophobia, sexual sensation seeking, and individual and community norms, among MSM with different sexual partner types may contribute to designing targeted interventions for reducing risky sexual behaviors and STI transmission. We conducted a cross-sectional study recruiting 781 MSM in Sichuan Province, China. All participants were divided into groups with and without sexual partners, groups with regular and casual sexual partners, and groups with only male and both male and female partners in the past 6 months. Network analysis was used to analyze the relationships among dimensions of self-reported sexual sensation seeking, internalized homophobia, and social norms in different groups. Of 781 MSM, 606 (77.6%) had sexual partners in the past 6 months, and among these participants, 429 (70.8%) had casual sexual partners, and 103 (17.0%) had both male and female sexual partners. The complex and intensive relationships between dimensions were mainly observed in networks of MSM with any type of sexual partners, with individual norms (dimension of social norms) presenting strongly negative relationships with fresh feeling (dimension of sexual sensation seeking) and homosexuality morality (dimension of internalized homophobia). One dimension of sexual sensation seeking (i.e., fresh feeling) and two dimensions of internalized homophobia (i.e., homosexuality morality and self-identification) were relatively central variables in most groups, especially for those with casual sexual partners. Our study highlights the role of individual norms in restraining sensation seeking, internalized homophobia, especially among MSM with sexual partners. Intervention targeting these central variables may contribute to reduced risky sexual behaviors and further slow the spread of STIs in MSM.

Staged HIV transmission and treatment in a dynamic model with long-term partnerships

The transmission dynamics of HIV are closely tied to the duration and overlap of sexual partnerships. We develop an autonomous population model that can account for the possibilities of an infection from either a casual sexual partner or a long-term partner who was either infected at the start of the partnership or has been newly infected since the onset of the partnership. The impact of the long-term partnerships on the rate of infection is captured by calculating the expected values of the rate of infection from these extended contacts. The model includes three stages of infectiousness: acute, chronic, and virally suppressed. We calculate HIV incidence and the fraction of new infections attributed to casual contacts and long-term partnerships allowing for variability in condom usage, the effect of achieving and maintaining viral suppression, and early intervention by beginning HAART during the acute phase of infection. We present our results using data on MSM HIV transmission from the CDC in the U.S. While the acute stage is the most infectious, the majority of the new infections will be transmitted by long-term partners in the chronic stage when condom use is infrequent as is common in long-term relationships. Time series analysis of the solution, as well as parameter sensitivity analysis, are used to determine effective intervention strategies.

Increased clonality among Neisseria gonorrhoeae isolates during the COVID-19 pandemic in Amsterdam, the Netherlands.

Distancing measures during the COVID-19 lockdown led to a temporary decrease of casual sex partners among clients of the Centre for Sexual Health (CSH) in Amsterdam, the Netherlands. We investigated the effect of this change on the genotypic and phenotypic distribution of Neisseria gonorrhoeae (Ng) isolates from CSH patients. From each Ng-positive patient we sequenced one isolate, resulting in 322 isolates which constituted two groups: 181 isolates cultured from 15 January to 29 February 2020 (before the first lockdown) and 141 cultured from 15 May to 30 June 2020 (during the first lockdown). Patient characteristics showed significantly more symptomatic patients and significantly fewer reported sex partners during the lockdown. Phenotypic data showed an increase in low-level azithromycin resistance and ceftriaxone susceptibility during the lockdown, and this remained after the study period. The diversity in sequence types (STs) decreased slightly during the lockdown. A shift occurred from ST 8156 being predominant before lockdown to ST 9362 during lockdown and a remarkably low median SNP distance of 17 SNPs was found between ST 9362 isolates obtained during lockdown. These findings reflect restricted travel and the change in sexual behaviour of CSH clients during the lockdown, with a potentially increased local transmission of the ST 9362 strain during this period, which led to genotypic and phenotypic changes in the Ng population. This shows that public health measures have far-reaching consequences and should be considered in the surveillance of other infectious diseases.

An Experiment Using a Sexual Strategies Explanation to Alleviate Internalized Homophobia Among Men Who Have Sex With Men in China.

Some men who have sex with men (MSM) having more casual sex and sexual partners is interpreted to be a sign of mental disorder and used to justify negative attitudes toward them by some. MSM may internalize this attitude causing internalized homophobia (IH). According to the sexual strategies theory, MSM having more casual sex is the result of differences between men's and women's sexual strategies and is unrelated to sexual orientation. We investigated whether this explanation would reduce IH and improve mental health in MSM. We recruited 255 Chinese MSM online using Wenjuanxing, Douban, Weibo, Tieba, and Blued and divided them using simple randomization into an experimental group (n = 77; sexual strategies explanation provided), an active control group (n = 99; minority stress explanation provided), and a control group (n = 79; no intervention) with pretest (N = 255); a 1 week post-test (n = 195); and a 1 month follow-up test (n = 170) of outcome measures. IH, mental distress (MD), sort-term mating orientation, and risky sexual behaviors were measured online. The data were analyzed by SPSS 28. IH was associated with MD while being married was associated with IH and sexual contact with women with both more IH and MD as were not being masculine and self-identifying as straight. The sexual strategies explanation reduced IH related to pathologizing sexual behaviors and high-risk sexual behaviors while the minority stress explanation reduced MD. Providing a sexual strategies explanation may be used to de-stigmatize casual sex among MSM.

Mpox outbreak in the Netherlands, 2022: public health response, characteristics of the first 1,000 cases and protection of the first-generation smallpox vaccine.

In early May 2022, a global outbreak of mpox started among persons without travel history to regions known to be enzootic for monkeypox virus (MPXV). On 8 August 2022, the Netherlands reported its 1,000th mpox case, representing a cumulative incidence of 55 per million population, one of the highest cumulative incidences worldwide. We describe characteristics of the first 1,000 mpox cases in the Netherlands, reported between 20 May and 8 August 2022, within the context of the public health response. These cases were predominantly men who have sex with men aged 31-45 years. The vast majority of infections were acquired through sexual contact with casual partners in private or recreational settings including LGBTQIA+ venues in the Netherlands. This indicates that, although some larger upsurges occurred from point-source and/or travel-related events, the outbreak was mainly characterised by sustained transmission within the Netherlands. In addition, we estimated the protective effect of first-generation smallpox vaccine against moderate/severe mpox and found a vaccine effectiveness of 58% (95% CI: 17-78%), suggesting moderate protection against moderate/severe mpox symptoms on top of any possible protection by this vaccine against MPXV infection and disease. Communication with and supporting the at-risk population in following mitigation measures remains essential.

Correlates of Mpox Vaccination among Sexual Minority Men in the United States: Sexual Behavior, Substance Use, and Main Partner Relationships

ABSTRACT Sexual minority men (SMM) have accounted for the majority of infections during the 2022 outbreak of the orthopox virus known as mpox (previously “monkeypox”) in the US. This study examined correlates of mpox vaccination. Between July 28 and September 22, 2022, adult cisgender SMM (n = 2,620) not previously diagnosed with mpox responded to recruitment advertisements on social networking applications and completed an online survey. Of these, 730 (27.9%) received at least one vaccine dose. Logistic regression indicated sex with a casual partner was positively associated with vaccination. Stimulant drug use was negatively associated with vaccination; meanwhile, the use of ecstasy, ketamine, gamma-hydroxybutyrate (GHB) or psychedelics was positively associated with vaccination. Among partnered SMM, non-monogamous sexual agreements, relationship length of ≥2 years, and relationship functioning were positively associated with vaccination. Even at low levels of relationship functioning, SMM in non-monogamous relationships of ≥2 years were more likely to be vaccinated than single SMM. At very high levels of relationship functioning, partnered SMM were more likely to be vaccinated than single SMM regardless of sexual agreement or relationship length. Findings are discussed in relation to prior research on HIV, other STI prevention, and theories of dyadic functioning and health in this population.

Correlates of HIV Infection among Men who have Sex with Men in Mvita Sub-County, Mombasa County, Kenya

Purpose: The broad objective of the study was to determine the correlates of HIV infection among men who have sex with men in Mvita sub-county, Mombasa County, by December 2020.&#x0D; Methodology: Descriptive cross-sectional study design using quantitative methods was used to collect data from a study population which included 121 HIV positive and 119 HIV negative MSM. The respondent-driven sampling (RDS) was used to obtain the sample of respondents while chi-square and multivariable logistic regression were used to identify the variables which were associated with HIV infection. Data generated from the questionnaires was collected, cleaned, coded and analyzed using STATA software Version 17. Level of significance was fixed at p=0.05, with a 95% confidence interval.&#x0D; Findings: Majority of the MSM (51%) were between 19-29 years, were single (71%), were christian (60%) had attained primary education (45%), were working (63%), 55% had an income of less than Ksh. 5000 but only 38% were married to a female. Majority (91%) of HIV negative MSM accessed PEP/PrEP and only 70% used PEP/PrEP for HIV prevention. However, majority (60%) of HIV positive MSM had anal sex with multiple casual male partners, 49% sometimes had condomless insertive anal sex while 49% had condomless receptive anal sex. HIV positive MSM also had anal sex more than once while high on alcohol (41%), always used drugs before engaging in anal sex (33%) and were non-adherent to ARVs, PrEP/PEP due to lack of transport (66%), alcohol use (24%), and drug use (15%), among other factors.&#x0D; Unique Contribution to Theory, Practice and Policy: From the study findings, the Government/NGO must address the MSM issues for instance, by increasing the number of HIV programmes targeting MSM, adequately funding them and actively engaging the MSM in running the them. Also, by sensitizing the communities, human right groups, religious leaders, politicians and other stake holders on matters pertaining MSM and lobbying for the review of the laws that criminalizes same sex relationship.

Condom Use Beliefs Differ According to Regulatory Focus: A Mixed-Methods Study in Portugal and Spain

ABSTRACT Reports worldwide have been showing increasing rates of sexually transmitted infections (STIs) and condomless sex in recent years. Research has identified several individual and situational variables that can determine the decision to use condoms or forgo their use. We argue that such a decision can also be shaped by motives related to pleasure and safety (i.e., regulatory focus in sexuality). Using open ended questions, we asked 742 Portuguese and Spanish adults to indicate situations and reasons that could inform the decision making process with casual partners and the functions/attributes related to condoms. Using thematic analyses, we coded the drivers of condomless sex and condom use into themes and subthemes, and computed their frequencies. Using quantitative measures, we also asked participants to indicate their condom use expectancies and perceived barriers. Comparing participants according to regulatory focus revealed some differences. Pleasure promotion participants were more likely to consider that condom use decision making is driven by unexpectedness, pleasure, and intimacy pursuit, attached more pleasure reduction functions to condoms, expected more negative outcomes in condom use, and endorsed more sensation and partner barriers in condom use. In contrast, disease prevention participants were more likely to consider that condom use decision making is driven by adequate sexual education, responsibility, and behavioral control, and attached more health protective functions to condoms. These differences can inform the development of tailored intervention and awareness campaigns aimed at helping people to use condoms more consistently with casual partners and to avoid behaviors that put them at risk of STI transmission.

Who is Exposed to HIV Prevention Interventions? An Assessment of Associated Factors Among Adolescent Girls and Young Women in South Africa

This study examined the prevalence of HIV risk factors and their association with intervention exposure among adolescent girls and young women (AGYW) living in six South African districts in which a combination HIV-prevention intervention was being implemented. A cross-sectional household survey was conducted from 2017 to 2018 among a representative sample of AGYW aged 15–24 years living in the six districts. We used an electronic questionnaire for self-reported demographic and behavioural questions and blood samples were taken to confirm HIV status in the laboratory. Chi-Squared tests and multivariate binary logistic regression were used to examine associations between demographic characteristics, HIV acquisition and transmission risk factors and the likelihood of participating in any of the key components of the combination HIV-prevention intervention. Among the 4399 participants, 45.3% reported inconsistent condom use with casual partner and 46.6% with a main partner. Almost half of participants (47.8%) had participated in one or more components of the HIV-prevention intervention, and in a multivariate logistic regression, those reporting a higher number of HIV risk behaviours were no more (or less) likely to participate. Participants who were not in high school were significantly less likely to have participated in the intervention compared to those still in high school, when adjusting for age and HIV risk factors. The barriers to access and uptake of combination HIV prevention interventions among AGYW who are out of the education system need to be explored and combination HIV prevention interventions and implementation strategies need to be tailored to reach this population.

Attitudes toward sexual behaviors: relationship with gender and sexual orientation

Most studies that have compared sexual attitudes between men and women have focused on heterosexual individuals or have not controlled for sexual orientation. In addition, many have used measures of general sexual attitudes, which have more difficulty in predicting sexual behaviors and sexual health than measures of attitudes toward specific sexual behaviors. Therefore, the present study aimed to analyze whether gender and sexual orientation are related to attitudes toward specific sexual behaviors in Spain. The study sample consisted of 1725 participants (55.8% women) aged between 18 and 35 years and of different sexual orientations. All participants completed an instrument to measure attitudes toward specific contextualized sexual behaviors. After controlling for age and current relationship status, the results reveal that while women have more positive attitudes toward solitary sexual behaviors and erotic material than men, men have more positive attitudes toward unconventional and online sexual behaviors than women. Bisexual people have more positive attitudes toward frequent dyadic sexual behaviors with casual partners than homosexual people. Finally, bisexual and homosexual people have more positive attitudes towards solitary sexual behaviors and erotic material, unconventional sexual behaviors, and online sexual behaviors than heterosexuals. It is concluded that gender and sexual orientation are related to attitudes toward different types of sexual behaviors.

The Global Distribution and Epidemiology of Psychoactive Substance Use and Injection Drug Use Among Street-Involved Children and Youth: A Meta-Analysis

Background: Globally, street-involved children and youth (SICY) who work and live on/of the streets are at higher risk of increased psychoactive substances and injecting drug use. Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic factors, and risk-taking behaviors associated with psychoactive substances and injecting drug use among SICY. Methods: Studies in English published from December 1 1985 to July 1 2022, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on psychoactive substances and injecting drug use among SICY. The pooled-prevalence estimates were obtained using a robust fixed-effects model. Results: The most commonly reported life-time and current psychoactive substance was tobacco followed by cannabis, LSD/ecstasy, cocaine, methamphetamine, heroin and injection drug use. The results showed that life-time and current prevalence of methamphetamine and cannabis use, as well as life-time prevalence of cocaine, LSD/ecstasy, heroin, tobacco, and injecting drug use increased as age rose while current prevalence of cocaine and tobacco use decreased as age rose. SICY who were male, homeless, had parents who had died, had history of substance use among family members or best friends, had experienced violence, had casual sex partners, had a history of working in the sex trade, and had unprotected sex were all related to psychoactive substance use and injecting drug use. Conclusions: Research examining this population suffers from lack of studies, therefore, improving the knowledge for interventions aimed at reducing risk behaviors, particularly those related to the transmission of sexually transmitted infections such as HIV is of great importance.

Identifying Patterns of Discontinuing and Recommencing Pre-exposure Prophylaxis in the Context of Sexual Behavior Among Gay and Bisexual Men in Australia

We mapped gay and bisexual men’s (GBM) patterns of using pre-exposure prophylaxis (PrEP) over time and explored sexual behavior as PrEP use changed. We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBM living in Australia who had changed their PrEP use since initiating. There was considerable diversity in patterns of discontinuation, suspension, and recommencement of PrEP. Reasons for changing PrEP use mostly centered on accurate perceived changes to HIV risk. Twelve participants reported condomless anal intercourse with casual or fuckbuddy partners after discontinuing PrEP. These sex events were unanticipated, condoms were not a preferred option, and other risk reduction strategies were applied inconsistently. Service delivery and health promotion can support safer sex among GBM when PrEP use fluctuates by promoting event-driven PrEP and/or non-condom-based risk reduction methods during periods off daily PrEP, and guiding GBM to better recognize changing circumstances of risk and when to recommence PrEP.