Condom Use Research Articles (Page 1)

ABSTRACT This study explored perceptions of sexual norms and practices related to HIV prevention and PrEP use among three generations of men who have sex with men (MSM) in the ANRS-PREVENIR cohort in France in 2022. Using a qualitative approach with three focus groups, we identified key themes: societal transformations, evolving sexual norms, and changing attitudes toward PrEP. Participants (29–63 years) belonged to three distinct generational groups: those who began their sexual life before 1981 (pre-HIV era), between 1981 and 1995 (HIV era, pre-ARV), and after 1995 (post-ARV era). Results reveal changes regarding sexual norms and practices, including reduced condom use, PrEP's role as a turning point in HIV prevention, offering freedom from the constraints previously imposed by the epidemic, and a perceived reduction in PrEP-related stigma. These changes were more pronounced in the two older generations who experienced the most the societal transformations. PrEP seems to gradually replacing condom use as the main HIV prevention tool, becoming central to MSM’s individual harm reduction strategies. Its widespread use also appears to facilitate access to a larger number of new sexual partners. While PrEP-related stigmatization has decreased, it persists, negatively affecting prevention strategies. This underscore the need for inclusive, adapted Research on Healthcare Performance RESHAPE, INSERM U1290PrEP promotion.

Background Dating applications, or “dating apps,” are widely used by sexual minority men (SMM) to form social and sexual connections. These platforms support intimacy, identity expression, and community engagement but have also been linked to sexual health risks and psychological distress. Although research on dating app use is growing, studies remain limited. This study examines dating app use, tribe identity, and sexual health behaviors in a sample of U.S. SMM. Methods A total of 549 gay and bisexual men aged 18–50 years completed an online survey and were recruited via Qualtrics Survey Panels, assessing dating app use, tribe identity, sexual activity, condom use, and awareness and use of pre-exposure prophylaxis (PrEP). Descriptive statistics explored patterns of digital engagement, identity expression, and sexual health behaviors. Results Most participants (69.4%) reported using dating apps, primarily for casual sex (46.3%). Among sexually active participants, 39.9% did not use condoms during their last sexual encounter. Only 17.8% of those aware of PrEP were currently using it, and 33.5% had never heard of it. Tribe identity was diverse but not universal; 32.1% reported no affiliation, while others identified with groups such as “Clean-cut,” “Bear,” and “Jock,” revealing potential links to appearance-based norms and sexual decision-making. Conclusion Dating app use may influence both health behaviors and digital communication patterns among sexual minority men. Our findings underscore the need for inclusive, culturally responsive interventions that address gaps in sexual health knowledge while also considering how digital discourse and platform design shape communication, perception, and engagement.

Introduction: Sexuality is determined by multiple factors. The knowledge and perceptions of the individual's environment will determine their behavior in this regard. Identifying the perceptions in a population that attends higher education is important to carry out specific prevention activities, since the repercussions of their sexual behavior are decisive for the public health of populations. Objective: Determine what are the perceptions and the main sexual risk behaviors in American university students. Method: Systematic review. The search was carried out in the Cochrane, Medigraphic and PubMed databases with the search words sexual behavior, college students, finding 25,821 results, filtered by language (English or Spanish), access to full text, year of publication (2016- 2021), geographic area (American continent) and sample (university population), resulting in n=12 articles. Results: most of the authors agree that American university students, despite having knowledge regarding sexuality and Sexually Transmitted Infections (STIs), do not carry out preventive actions, with a beginning of sexual life approximately at the age of fifteen and multiple partners. simultaneous; condom use is predominant as a method of family planning and sexting as a risky sexual behavior has become more important in recent years. Conclusions: the high prevalence of risk behaviors and the low use of diagnostic tests supports the fact that America is one of the continents with the most annual diagnoses of STIs in the world, with consequences that can be of varying severity and even fatal.

ABSTRACT Introduction Internal migrant girls, known as Kayayei , are among Ghana's most vulnerable urban populations, facing elevated sexual health risks due to economic insecurity and limited access to reproductive services. Guided by the Health Belief Model (HBM), this study examined barriers, enablers, and willingness to use condoms among sexually active Kayayei . Methods A mixed‐methods design was employed. Quantitative data were collected from 400 Kayayei using structured questionnaires, complemented by 40 in‐depth interviews (IDIs), two focus group discussions (FGDs) with 24 participants, and 20 key informant interviews (KIIs) involving market leaders, Kayayei association representatives, and child protection officers. Quantitative data were analysed descriptively, and qualitative data underwent thematic analysis. Results Only 25.5% of Kayayei reported condom use, while 74.5% did not, indicating low and inconsistent usage. Barriers included partner resistance, limited access, stigma, low self‐efficacy, and misconceptions about condom safety. Enablers comprised peer influence, prior sexual health education, and access to youth‐friendly services. Most expressed willingness to use condoms if freely available. Conclusions Condom use among Kayayei is shaped by psychological and structural determinants. Interventions combining behavioural change communication with economic and social support are vital to increase condom uptake and improve sexual health outcomes among Ghana's internal migrant girls.

African migrants in China are at increased risk of HIV and other STDs. Consistent condom use is the most effective and cost-efficient method of preventing STD/HIV. However, there is limited literature on condom use and its determinants among Africans in China. A national online cross-sectional survey was conducted among Africans in China from January to February 2021. Participants completed a survey including social-demographic characteristics, sexual behaviors, and personal networks. Multivariable logistic regression was conducted to identify factors associated with condomless sex. The study surveyed 1305 individuals, with 488 reporting sexual activity and being included in the analysis. Most were young, unmarried, Christian, migrants for study or business in China for over a year, insured, and about half proficient in Mandarin. Notably, 53% reported engaging in condomless sex. Among them, African migrants with low sexual health community engagement (80%), lacking condom distribution services (almost 70%), had an average of 5.61 friends. Multivariable logistic regression analysis revealed higher odds of condomless sex for seven variables: those migrating for study (adjusted odds ratio [aOR] 1.62, 95% confidence intervals [CI] 1.10-2.40), frequent contact with Chinese friends (aOR 1.71, 1.05-2.78), meeting more than one friend on social apps (aOR 1.57, 1.09-2.28), using social apps in China (aOR 2.19, 1.18-4.08), having over three regular partners (aOR 2.41, 1.02-5.69), using alcohol in the past 12months (aOR 2.13, 1.45-3.11), and alcohol before/during sex in the past 6months (aOR 2.16, 1.46-3.21). Our data suggest the need for comprehensive sexual health services that are tailored for African migrants in China. Expansion of condom distribution alongside community engagement and decentralized sexual health services based on personal networks is urgently needed among this population.

Indigenous Peoples in the United States experience disproportionate burdens of sexually transmitted infections (STIs), HIV, and viral hepatitis, but data about associated testing behaviors are limited. Given that substance use is a risk factor for STIs and viral hepatitis, there is a need for more research on testing behaviors among Indigenous people who use drugs. This research examines correlates of STI, HIV, and hepatitis C virus (HCV) testing among a sample of people who use drugs in a northern Midwest Indigenous community. This community based participatory research includes a survey among people who used drugs in a Northern Midwest reservation community (N = 227). We described when individuals were most recently tested for STIs, HIV, and HCV. We also examined correlates of past-year testing, including individual characteristics, drug use behaviors, sexual partners, and condom use. Most participants had been tested for STIs (63%), HIV (60%), and HCV (65%) in their lifetime, while a quarter had been tested STIs (33%), HIV (24%), and HCV (27%) in the past year. Recent testing for STI, HIV, and HCV was significantly associated with younger age, being a woman or gender minority, lifetime injection drug use, number of sex partners, and being willing to distribute HIV test kits. This study is among the few to examine STI, HIV, and HCV screening behaviors in an Indigenous community, and found that screening rates were suboptimal. Culturally relevant, Indigenous-led programs are essential to increase awareness and access to screening and ultimately address critical public health disparities.

Madagascar has a lower HIV prevalence than countries on the African continent. The 2003-4, 2008-9 and 2021 Demographic and Health surveys and the 2018 Multiple Indicator Cluster survey reports were analysed. Between 2003 and 2021, there was a significant increase in the percentage of people reporting sex with multiple partners: for women from 2.6% [95% CI 2.3% - 2.9%] to 3% [95% CI 2.8% - 3.2%], and for men from 16.7% [95% CI 15.1% - 18.3%] to 24.1% [95% CI 23.2% -25.0%]. Similarly, there was a significant increase in the percentage of people reporting sex with a non-marital, non-cohabitating sex partner for women from 13.1% [95% CI 12.4% - 13.9%] to 18.5% [95% CI 17.9% - 19.1%] and for men from 31.8% [95% CI 29.9% - 33.8%] to 38.1% [95% CI 37.0% - 39.2%]. Between 2008 and 2021, among those reporting sex with multiple partners, condom use had significantly decreased for women from 7.6% [95% CI 4.9% - 10.3%] to 3.3% [95% CI 1.8% - 4.8%] and for men from 7.4% [95% CI 5.9% - 8.9%] to 3.8% [95% CI 2.9% - 4.7%]. Between 2003 and 2021 condom use among men reporting non-marital, non-cohabitating partners decreased significantly from 13.1% [95% CI 10.6% - 15.6%] to 9.1% [95% CI 8.1% - 10.1%]. The trends in risky sexual behavior and condom use are possible drivers of Madagascar's evolving HIV epidemic. An HIV prevalence study among pregnant women could help elucidate the current status of the HIV epidemic among the general population in Madagascar.

Mixed-methods outcomes from a statewide contraceptive access initiative in Missouri: How The Right Time supports access, method availability and patient-centered care.

The Human Immunodeficiency Virus (HIV) remains a major public health problem in Brazil. The country has marked regional inequalities, with the state of Pará having one of the highest mortality rates. Sexual transmission remains the main route of infection, associated with a lack of information and low condom use. Recent studies indicate a higher incidence among young, heterosexual, and economically active men. These data reinforce the importance of preventive strategies, educational campaigns, and expanded early diagnosis to control the epidemic and reduce HIV/AIDS-related morbidity and mortality.

Chlamydia and gonorrhoea have remained the most common nationally notifiable sexually transmitted infections (STIs) in the USA, demonstrating a need for more clarity on rates of testing and diagnosis. Behavioural changes (eg, declining condom use) may contribute to high cases, although sexual activity rates have decreased. Increased STI screening, especially among women, could also influence diagnosis rates. Research shows differences in infection rates by anatomical site (urogenital, oral, rectal) and the need for more comprehensive screening. This study aimed to explore how screening and diagnosis differ across sites in populations with exclusively opposite-sex sex partners. This rapid review assessed the current landscape of screening and diagnosis of chlamydia and gonorrhoea in populations with opposite-sex sex partners, focusing on comparisons across anatomical sites. CENTRAL, PubMed and Embase were searched, and a risk of bias assessment was conducted to qualitatively examine potential bias across studies. A total of 25 studies from 2010 to 2023 were reviewed, focusing on chlamydia and gonorrhoea screening and diagnosis across urogenital, rectal and pharyngeal sites. Urogenital screening was most common, while pharyngeal screening was least common. Diagnosis rates varied. Median test positivity was 8.8% (women) and 2.1% (men) for rectal chlamydia, 2.9% (women) and 4.1% (men) for rectal gonorrhoea, 2.3% (women) and 1.1% (men) for pharyngeal chlamydia, and 2.6% (women) and 2.4% (men) for pharyngeal gonorrhoea. Women were more frequently screened for extragenital sites, rectal and pharyngeal diagnoses were more common in women, and urogenital diagnoses were slightly more common in men. Most studies found co-occurrence of infection at multiple sites or extragenital infection without urogenital infection. This review highlights the current understanding of screening and diagnosis of chlamydia and gonorrhoea among populations with exclusively opposite-sex sex partners and supports the need for increased screening, particularly of extragenital sites, to reduce transmission rates.

This study examined human immunodeficiency virus (HIV) -related health literacy and prevention among students at a Southeastern Historical Black College and University (HBCU) using the Integrative Health Literacy Model and the Consolidated Framework for Implementation Research (CFIR). Seven gender-specific focus groups (n = 20) were created between June and October 2023. The discussions explored health and HIV information-seeking behaviors, knowledge, prevention practices, and campus culture. Transcripts were analyzed using the domains of health literacy and CFIR. Participants primarily relied on social media and Google for health information, often passively encountering content rather than actively seeking it. While most have basic knowledge of HIV, misconceptions persist regarding HIV transmission, prevention, and curability. Condom use and testing were endorsed but inconsistently practiced, and knowledge of pre-exposure prophylaxis (PrEP) was minimal. Female groups emphasized relational decision making and negotiation, while male groups raised more factual questions. Campus culture-including gossip, "dirty/clean" narratives, and sexual activity around events like homecoming-shaped both stigma and prevention behaviors. Barriers included comfort concerns regarding condom use, privacy concerns, judgmental staff, and uneven sexual health education before college. The students highlighted the need for private, affordable, and culturally resonant preventive strategies. The CFIR analysis identified opportunities for anonymous and bundled testing, peer-led education based on relationships and pleasure, and co-designed interventions that embed sexual health into campus life. Strengthening media literacy, promoting partner testing, improving awareness of PrEP and Rapid testing improve HIV prevention among HBCU students.

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients who undergo vaginoplasty are at risk of developing HPV-related lesions throughout their life, from low risk condylomata acuminata (CA) to cancerous lesions. However, the HPV status of neovaginal lesion in this patient group were often undocumented. We reported a case of CA, with HPV type 6 and 18 positive, affecting both the neovagina and vulva in a MRKH patient who underwent vaginoplasty (12 months ago). Additionally, we explore the relationship between HPV infection and neovaginal lesions through a review of current literatures. A 21-year-old MRKH patient after vaginoplasty was diagnosed with condylomata acuminata in the neovagina and vulva and was HPV 6 and 18 positive. The colposcopy biopsy of the condylomata acuminata (CA) lesions in the neovagina confirmed a CA lesion, with positive immunohistochemistry (IHC) staining for low-risk HPV (lrHPV). The vulvar lesions were removed by cryoablation with liquid nitrogen, and the neovaginal lesions were treated with carbon dioxide laser ablation. Post-treatment follow up showed complete resolution of neovaginal and vulvar CA, with complete epithelization of the neovaginal lesions. MRKH patients who undergo vaginoplasty are at risk of developing HPV-related lesions throughout their life. This is the first published case of coinfection with both hrHPV and lrHPV, with lrHPV-related CA in an MRKH patient after Sheares' vaginoplasty. Routine HPV screening, HPV vaccination, and condom use should be indicated in this population.

HIV pre-exposure prophylaxis (PrEP) is transforming global HIV prevention, but its implementation coincides with observations of rising bacterial sexually transmitted infection (STI) rates among men who have sex with men, raising questions about whether PrEP is preventing one epidemic while facilitating others. To reconcile this apparent contradiction, we developed a minimal dynamical model of the simultaneous transmission of HIV and chlamydia (as an example of a curable STI). The model integrates three key mechanisms: 1) risk-mediated self-protective behavior, 2) reduction in condom use among PrEP users, and 3) PrEP-related asymptomatic STI screening. We show that these mechanisms can generate a "testing paradox:" True STI prevalence may decline while observed trends rise. This paradox emerges because increased PrEP uptake amplifies screening intensity, which can lower transmission but simultaneously inflate detection. By systematically mapping the parameter space of PrEP uptake, screening frequency, and risk perception, we identify broad and plausible conditions under which the paradox arises. Our findings reconcile conflicting epidemiological evidence and remark that the net effect of PrEP on STI dynamics depends critically on asymptomatic screening strategies. These results highlight the potential dual role of PrEP programs in reducing both HIV and bacterial STI incidence, while emphasizing the need to align screening and treatment policies to maximize benefits and minimize risks, e.g., antimicrobial resistance.

Background In Nepal, sexual relationships outside of the traditional arranged marital system are increasingly common. Despite the availability of modern sexual health care, research on how to effectively deliver sexual health services to unmarried young adults in Nepal is limited. Objective This study examined key theoretical correlates between Andersen's Behavioral Model of Health Service Use and actual sexual health service use among unmarried young adults (aged 18 to 25) in Kathmandu, Nepal. Methods Unmarried young adults between 18 and 25 were recruited from colleges and universities in the Kathmandu area. A total of 110 women and 93 men completed the survey ( n = 203). Using a cross-sectional correlational design, the analysis involved descriptive statistics, bivariate analysis, and logistic regression. Findings and conclusions Approximately 37% of participants reported engaging in sexual intercourse, with 55.7% reporting condom use during most recent intercourse. Less than half (39.1%) were aware of available sexual health services, and less than one-third (26.6%) were aware of Human Papillomavirus (HPV). Over a third of participants (40.9%) reported experiencing unwanted sexual contact, and 5.9% had a history of forced sexual intercourse. The actual reported sexual health service use within the past 12 months was 13.9%. Logistic regression analyses showed higher perceived youth friendliness of the health system (OR: 1.19; CI: 1.01–1.39; p < .05), sexual attraction to the same or both sexes (OR: 2.91; 95%; CI: 1.54–5.50; p < .01), higher perceived sexual risk (OR: 1.33; 95%; CI: 1.11–1.59; p < .01), as well as prior health awareness and behaviors (e.g., cigarette consumption, dating app use), were statistically significant correlates of sexual health service use. These findings indicate a need for further research to understand the experiences of Nepalese young adults with sexual healthcare and essential elements of youth-friendly health systems.

The presence of chlamydia, gonorrhea, or syphilis infection is a significant risk factor for HIV acquisition and transmission and disproportionately impacts men who have sex with men (MSM) and transgender women. While HIV preexposure prophylaxis (PrEP) reduces HIV risk, its use may influence sexual behaviors, potentially increasing sexually transmitted infection (STI) exposure. Conversely, PrEP users are often more engaged in care, regularly screened and treated for STIs, and may access other prevention tools such as doxycycline postexposure prophylaxis. Studies on the relationship between PrEP use and STIs have shown mixed results. This cross-sectional analysis included 392 participants (381 cisgender MSM; 11 transgender women) enrolled in the US-based Multicenter AIDS Cohort Study/WIHS Combined Cohort Study between 2021 and 2024 who were sexually active in the year prior to STI testing and HIV negative at their most recent study visit. We assessed whether bacterial STI positivity (i.e., laboratory-confirmed chlamydia and gonorrhea at the urethral, pharyngeal, and/or rectal sites and/or current/past syphilis infection) differed by current PrEP use (yes/no). Multi-variable logistic regression models included sociodemographic and behavioral covariates that were associated with bacterial STI positivity at p < 0.05, with the most parsimonious models selected based on the lowest Akaike Information Criterion. Overall, 32.7% reported current PrEP use. Syphilis was the most prevalent STI (6.8%), followed by chlamydia (3.2%) and gonorrhea (2.1%); 11.7% of PrEP users tested positive for at least one STI, compared with 6.1% of non-PrEP users. Among PrEP users, 37.9% reported stopping or decreasing condom use, and 31.6% reported an increased number of sex partners after initiating PrEP. In both bivariate and multi-variable models, PrEP use was associated with higher odds of gonorrhea positivity (adjusted odds ratio = 4.70, 95% confidence interval [CI]: 1.10-20.04, p = 0.037) and greater odds of being positive for at least one STI (crude odds ratio = 1.94, 95% CI: 1.06-3.90, p = 0.041). No significant differences were observed for chlamydia and syphilis by PrEP use status. Overall, these findings suggest that current PrEP users (vs. non-PrEP users) have an increased odds of bacterial STI positivity, particularly gonorrhea, in a diverse, multi-city cohort of HIV negative, sexually active MSM and transgender women in the United States PrEP remains highly effective in preventing HIV, and our results underscore the importance of integrated sexual health services that support ongoing STI screening and prevention alongside PrEP use among sexual and gender minorities.

Introduction: A notable proportion of Sri Lankan HIV patients report external migration with male preponderance. To address STI/HIV related vulnerabilities of the male employment seekers, the Sri Lanka Bureau of Foreign Employment (SLBFE) is conducting a pre-departure training.Objectives: This study aimed to explore HIV-related Vulnerabilities among prospective male overseas employment seekers at pre-departure training centres in Colombo.Methods: A descriptive cross-sectional study was conducted among 432 male overseas employment seekers attending SLBFE pre-departure training in Colombo. Data were collected using interviewer-administered questionnaire. assessing HIV knowledge (10-items awarding 1 mark to correct answer). Attitudes (seven 5-point Likert scale questions awarding -2 to +2 to each response) and high-risk behaviors for HIV. Composite knowledge and attitude scores were calculated for each individual. Data analysis done for measures of central tendency and dispersion. associations were calculated using chi-squared testing with level of significance considered at p&lt;0.05.Results: The mean age of participants was 27.86 years (SD=7.38) and 70.0% heading for Middle East. One-in-five (21.0%) demonstrating low level of HIV knowledge. Better knowledge was seen with higher educational levels (p &lt;0.001). More than one-third (36.2%) showed a negative attitude towards HIV. Among 331 who reported sexual exposures ever, 32.9% had engaged in high-risk practices.Conclusion: A significant portion of the sample demonstrated inadequate HIV awareness, negative attitudes and high-risk behaviours which poses a high risk of acquiring HIV. Further research is needed to understand low condom use and assess risks among returnees from overseas employment.

BackgroundHIV incidence is increasing among Latino gay, bisexual, and other men who have sex with men (MSM) in the Atlanta metropolitan area. Mobile phone apps represent an innovative tool to promote pre-exposure prophylaxis (PrEP) use, HIV testing, and condom use.ObjectiveThis study aimed to assess the acceptability and usability of Saludfindr, an Android-based HIV prevention app tailored to the needs of Latino MSM in the Atlanta area.MethodsWe recruited adult Latino MSM to interact with the app for 4 months. Saludfindr included initial and periodic health assessments; provision of suggestions regarding PrEP, HIV testing, and condom use; in-app product ordering; customized motivational messages; a customized sexual health clinic list; and a “Contact Us” button. To assess acceptability, we measured use of each app feature, PrEP and HIV testing uptake, and participant ratings of the app’s usefulness. We assessed usability using the System Usability Scale.ResultsWe enrolled 31 participants; the median age was 27 (IQR 24.5-32) years, 97% (30/31) were cisgender men, 81% (25/31) identified as MSM, and 61% (19/31) used the app in Spanish. All participants completed the initial health screening, with 84% (26/31) and 77% (24/31) completing the 2- and 4-month health screenings, respectively. Of all participants, 52% (16/31) and 23% (7/31) ordered condoms and home HIV tests through the app at least once, respectively. During the study period, 71% (22/31) of the participants got tested for HIV, of whom 68% (15/22) accessed it through clinic-based HIV testing. Of the participants not on PrEP at baseline, 41% (7/17) initiated PrEP during the study, and all of them did so at one of the clinics listed on the app. Saludfindr reached a System Usability Scale score of 74.5/100 (excellent).ConclusionsSaludfindr was highly acceptable and usable among Latino MSM participants in the Atlanta area. In-app assistance to access PrEP and clinic-based HIV testing referrals was well received. Further efforts are needed to increase users’ self-efficacy with home HIV self-testing.

Adolescent girls and young women (AGYW; aged 15-24 years) in Sub-Saharan Africa have shouldered a disproportionate share of the global HIV burden for decades and currently account for 78% of incident AGYW HIV cases worldwide. Condoms remain the predominate tool for HIV protection, but antiretroviral pre-exposure prophylaxis (PrEP) is increasingly available in Southern Africa. The DYnamics of Contraception in Eswatini (DYCE) study conducts bi-weekly phone surveys about sexual and reproductive health with a nationally representative panel of AGYW. We employ sequence analysis to classify longitudinal experiences from a pattern-based perspective and to create HIV protection behavior groups, based on patterns of reported daily oral PrEP use, condom use and sexual activity. From April to September 2024 (13 fortnights i.e. two-week periods) among the 237 DYCE participants in the analysis, 70.3% of sexually active participants used a condom at least once, of whom 20.9% used a condom with every sexual act. PrEP was used for at least one fortnight by 19% of women. Over 13 fortnights, 96% discontinued PrEP use, and 24% cycled on and off PrEP at least once. 49% of ever-PrEP users used PrEP for less than one-fifth of reported fortnights. Using sequence analysis, we identified four groups with variable HIV protection patterns and characteristics. 16% of participants were in the Protection: No Sex group (not sexually active); 64% in the Medium Protection: Less Sex group (spent > 50% of the time not sexually active); 13% in the Least Time Protected group (> 50% of the time sexually active without condom use); and 7% in the Medium Protection: PrEP group (PrEP used about 50% of the time). The Medium Protection: PrEP group was characterized by not being in school, two-thirds using modern contraception, 83% parous and a quarter married. In comparison, among those in the Protection: No Sex group half were in school, there was low modern contraceptive usage, a third had children and none were married. PrEP and condom use is inconsistent and does not reflect prevention-effective adherence among young women in Eswatini. Four groups based on duration of HIV protective behaviors exhibit distinct characteristics that can be used to target HIV protection messaging.

Background: Gonorrhoea is a common sexually transmitted infection with serious health consequences if not well-treated. Resistance to common therapeutic agents and limited diagnostics further heighten its burden on sexual and reproductive health. This study determined the positivity level, spatial distribution and factors influencing test positivity for Neisseria gonorrhoeae in Kampala, Uganda. Methods: Clinical data and urethral swabs were primarily collected from men with urethritis at 10 high-volume surveillance facilities. Laboratory analysis followed conventional microbiology techniques. Statistical analysis was conducted using R 4.4.3. Results: Among 1663 participants, 923 (56%, 95% CI: 53–58%) tested positive for N. gonorrhoeae, with comparable levels in Kampala divisions. Co-positivity of HIV and N. gonorrhoeae ranged from 5–27%. At bivariable analysis, there was a lower risk of testing positive for N. gonorrhoeae among participants aged above 24 years. Individuals who never use condoms or infrequently use them were marginally at a higher risk for positivity compared to routine users. Only age was the independent predictor for positivity with N. gonorrhoeae (aPR = 0.93, 95% CI: 0.87–0.99, p-value = 0.017), with men aged above 24 years being less likely to test positive for N. gonorrhoeae. Conclusions: Spatial distribution of N. gonorrhoeae positivity in Kampala was found not to be significantly influenced by location in any of the five divisions. Public health interventions should be tailored to focus on the high-risk groups such as men aged below 25 years, incorporating targeted education and prevention programs, particularly emphasizing consistent condom use among sexually active individuals to improve sexual and reproductive health in Kampala and greater Uganda.

BackgroundWith the growing popularity and convenience of the internet, an increasing number of men who have sex with men (MSM) are seeking casual sexual partners online. However, the effect of online casual sexual behavior on other HIV-related risk behaviors remains unclear.ObjectiveThis study aims to explore the characteristics of internet-based casual sexual behavior and its relationship with HIV-related risk behaviors among MSM.MethodsThis cross-sectional study was conducted between June and December 2018 in 4 cities in Zhejiang Province, China. Peer-driven sampling was used for recruitment. Announcements were disseminated by 4 community-based organizations and 10 voluntary counseling and testing clinics online and offline. After informed consent, participants completed an electronic questionnaire covering demographic characteristics, casual sexual behaviors, HIV-related risk behaviors, and HIV prevention. SPSS (version 19.0; IBM Corp) was used to conduct chi-square tests, univariate and multivariate logistic regression analyses using a backward stepwise method based on the likelihood ratio test, and Poisson regression with robust variance to identify associations between finding casual sexual partners online and other risk behaviors. P values of <.05 were considered statistically significant.ResultsIn the past 6 months, 40.2% (302/751) of participants reported finding casual sexual partners online; 18.9% (142/751) reported finding casual sexual partners offline; 7.6% (57/751) reported having sexual intercourse with MSM without condoms after drinking alcohol; and 6.9% (52/751) reported condomless sex after using stimulants. Among those who found partners online, 62.5% (188/301) did so more than once per month and 39.5% (113/286) had more than one online sexual partner. In total, 39.3% (114/290) had sex with online partners at home and 10.1% (30/297) sought partners in other cities. Compared with participants who engaged in receptive anal intercourse (or both roles), those who engaged only in insertive intercourse reported a higher proportion of finding partners online more than once per month (72.7% vs 57.4%, P=.01), having more than 2 online sexual partners (52.1% vs 33.3%, P=.002), and conducting inconsistent condom use with online sexual partners (40.0% vs 25.8%, P=.01). Regression analysis showed that, compared with MSM who did not find partners online, those who did were more likely to report finding casual sexual partners offline (adjusted odds ratio [aOR] 9.398; 95% CI 5.956‐14.829), having sex without condoms after drinking alcohol (adjusted prevalence ratio [aPR] 1.788; 95% CI 1.062‐3.011), and having sexual intercourse without condoms after using stimulants (aPR 2.064; 95% CI 1.178‐3.617).ConclusionsInternet-based casual sexual behavior is increasingly common among MSM. Finding partners online was associated with offline partner-seeking and condomless use after alcohol or stimulant use. Future HIV prevention efforts should emphasize behavioral interventions tailored to MSM who use dating apps.