Engagement In Sexual Risk Behaviors Research Articles

Life in the fast lane: the role of temporal processing in risk-taking behaviors

An existing theoretical framework proposes that aberrant temporal processing and a fast internal clock, denoted by overestimation and under-reproduction of time, increases the likelihood of engagement in risky behaviors (ERB). The primary aim of this project was to improve our understanding of the relationship between temporal processing and ERB in college students. The present study used the Wittmann and Paulus (2008) theoretical framework to examine the associations between temporal processing and ERB in college students. College student participants (N = 215) completed self-report measures of ERB, delay aversion, inhibitory control, ADHD symptoms and objective cognitive time estimation and time reproduction tasks. Time estimation accuracy was significantly associated with lower engagement in sexual risk behaviors (OR = .988; 95% CI: .979, .996; p = .006) and aggressive behaviors (OR = .989; 95% CI: .980, .998; p = .018). Time reproduction was not significantly associated with ERB. The present study established preliminary support for the associations between aberrant temporal processing, namely aberrant time estimation, and ERB among college students.

Parent-child communication about substance use, puberty, sex, and social media use among Hispanic parents and pre-adolescent children.

Previous research has noted that Hispanic pre-adolescents may be at an increased probability for engagement in risk-taking behaviors. The purpose of this study was to explore parent-child communication among Hispanic parents and 4th-6th grade children related to substance use, puberty, sex, and social media use. A qualitative descriptive design was used to examine Hispanic parents'/caregivers' communication with their children about substance use behaviors, pubertal developments, engagement in sexual risk behaviors, and social media use. The study included two components: four focus groups consisting of 23 children; five focus groups and one interview consisting of 24 adults. All were conducted until data saturation was reached. Parents and pre-adolescents were interviewed separately. Interviews with parents and pre-adolescents were audio-recorded, transcribed verbatim, and analyzed using content analysis techniques. The themes that emerged from the interviews were about children's feelings, parents' feelings, communication messages that children received from their parents, and information parents provided to their children during parent-child communication. The results indicate discrepancies between information that parents provided and information that the pre-adolescents reported. The results have implications for healthcare providers in that parents need to be better educated on communicating effectively with their pre-adolescents about risk-taking behaviors. Healthcare providers may help facilitate parent-child communication with Hispanic families. More research is needed to develop intervention programs for Hispanic parents to learn how to effectively communicate with their pre-adolescent children in a developmentally appropriate manner.

Exploring Bias-Based Bullying and Intersecting Social Positions as Correlates of Sexual Risk Behaviors Among Adolescents.

Purpose: The current study extends the limited body of intersectional research on adolescents' sexual health by examining experiences of bias-based bullying and multiple intersecting social positions associated with engagement in sexual risk behaviors. Methods: Participants were 14,968 sexually active 9th and 11th grade students surveyed as part of the 2019 Minnesota Student Survey (15% lesbian/gay/bisexual/queer/pansexual/questioning [LGBQ] and/or transgender/gender diverse [TGD] or gender questioning). Exhaustive Chi-square Automatic Interaction Detection analysis was used to identify experiences (i.e., bias-based bullying victimization) and intersecting social positions (i.e., sexual orientation identity; gender identity/modality; race/ethnicity; physical disabilities/chronic illness; mental health/behavioral/emotional problems) associated with the highest prevalence of three sexual risk behaviors. Results: Overall, 18% of adolescents reported 3+ sex partners in the last year, 14% reported drug/alcohol use before last sex, and 36% reported not discussing protection from sexually transmitted infections with new sexual partners. Adolescents with 2+ marginalized social positions, some of whom also experienced bias-based bullying, were part of 53% of the highest prevalence risk groups. For example, 42% of Multiracial or Latina/x/o gender questioning adolescents who identified as LGBQ reported 3+ sex partners in the last year-twice the sample average. Adolescents who were Black, American Indian/Alaska Native, Latina/x/o, Multiracial, TGD, or gender questioning were in the highest prevalence nodes across all outcomes. Conclusion: Adolescents with multiple marginalized social positions and who experience bias-based bullying engage in high-risk sexual behaviors at higher-than-average rates. Findings underscore the importance of addressing intersecting experiences of stigma to reduce high-risk sex behaviors and promote health equity among adolescents.

Tough Talks Virtual Simulation HIV Disclosure Intervention for Young Men Who Have Sex With Men: Development and Usability Testing.

BackgroundHIV status disclosure is an important decision with barriers specific to young men who have sex with men (YMSM), who have the highest rates of new HIV infections in the United States. Behavioral and social determinants of the difficulty to disclose can include fear of rejection, stigma, loss of financial stability, and lack of communication skills. Once able to disclose, a person may have increased access to social support and improved informed risk reduction conversations and medication adherence. Despite the known challenges and advantages of disclosure, there are few effective tools supporting this behavior.ObjectiveTo address this gap in disclosure interventions, the Tough Talks (TT) app, an mHealth intervention using artificial intelligence (AI)–facilitated role-playing scenarios, was developed for YMSM. This paper reports stages of development of the integrated app and results of the usability testing.MethodsBuilding on the successful development and testing of a stand-alone interactive dialogue feature in phases 1-3, we conducted additional formative research to further refine and enhance the disclosure scenarios and develop and situate them within the context of a comprehensive intervention app to support disclosure. We assessed the new iteration for acceptability and relevance in a usability study with 8 YMSM with HIV. Participants completed a presurvey, app modules, and a semistructured qualitative interview.ResultsTT content and activities were based on social cognitive theory and disclosure process model framework and expanded to a 4-module curriculum. The AI-facilitated scenarios used dialogue from an utterance database developed using language crowdsourced through a comic book contest. In usability testing, YMSM reported high satisfaction with TT, with 98% (31/33) of activities receiving positive ratings. Participants found the AI-facilitated scenarios and activities to be representative and relevant to their lived experiences, although they noted difficulty having nuanced disclosure conversations with the AI.ConclusionsTT was an engaging and practical intervention for self-disclosure among YMSM with HIV. Facilitating informed disclosure decisions has the potential to impact engagement in sexual risk behaviors and HIV care. More information is needed about the ideal environment, technical assistance, and clinical support for an mHealth disclosure intervention. TT is being tested as a scalable intervention in a multisite randomized controlled trial to address outstanding questions on accessibility and effect on viral suppression.Trial RegistrationClinicalTrials.gov NCT03414372; https://clinicaltrials.gov/ct2/show/NCT03414372

Bridging the age gap: intergenerational communication of HIV risk and prevention among younger and older men who have sex with men

ABSTRACT Trends in HIV incidence and prevalence vary between younger MSM (YMSM) and older MSM (OMSM). HIV prevention was revolutionized with the advent of pre-exposure prophylaxis (PrEP), but uptake of PrEP among OMSM is relatively unknown. Community connectedness among MSM is a strong driver of prevention. This qualitative study sought to explore similarities and differences between YMSM and OMSM’s knowledge, perceptions, and barriers of HIV prevention and understand how intergenerational communication may enhance engagement in prevention, especially PrEP. Twenty semi-structured, in-depth interviews (ten YMSM and ten OMSM) were conducted with HIV-negative, non-monogamous MSM aged 18–24 and 55+ years. Interviews were transcribed and coded using NVivo 12 to identify themes within each age group and compare between age groups. YMSM expressed greater knowledge and more positive perceptions of PrEP than OMSM. OMSM felt that PrEP use increased engagement in sexual risk behavior. Both groups emphasized a need for more conversations between different age groups of MSM to educate each other about forms of prevention and reduce stigma. Intergenerational communication among MSM about HIV risk and prevention strategies may be an effective way to address the generational gaps in knowledge and perceptions and enhance engagement in HIV prevention.

The Sexual Risk Behaviors Scale (SRBS): Development & Validation in a University Student Sample in the UK.

University students are at risk of poor sexual health outcomes. The aim of this study was to develop and test the psychometric properties of the Sexual Risk Behaviors Scale (SRBS), a novel short tool for measuring engagement in sexual risk behaviors in university students. We developed a pool of six items based on a review of recent literature and tested its properties in 547 undergraduate students in the United Kingdom. We used Exploratory Factor Analysis and Confirmatory Factor Analysis to explore and determine the factor structure and dimensionality of the SRBS. We used Item Response Theory and specifically the Graded Response Model to investigate items’ discrimination, information, and differential functioning, respectively, and logistic regression to test whether higher SRBS scores predicted a diagnosis of any sexually transmitted infections in the past 12 months. Results showed that a unidimensional, five-item model fitted the data well, showing satisfactory fit indices and reliability, with all items providing adequate discrimination and information, and no differential item functioning by gender nor by sexual orientation. SRBS total scores significantly predicted the odds of being diagnosed with sexually transmitted infections in the past 12 months. Implications for public health prevention and intervention are discussed.

Profiles of Emerging Adult Online Daters and Psychosocial Cognitions about Condom Use

Online dating provides emerging adults with a way of connecting with others more frequently and efficiently than traditional courtship. Online dating sites pose opportunities for relationships and sexual encounters, which may be accompanied by engagement in sexual risk behaviors, such as lack of condom use. The present study used the theory of planned behavior to explore psychosocial cognitions (i.e. constructs) about condom use among online daters. The sample size consisted of N = 156 emerging adults (Mage = 20.6) who participated in an online survey of health behaviors and sexual risk. Using attitudes, subjective norms, and self-efficacy about condom use, latent class analysis identified four latent classes: Consistent Condom Users (17%), Inconsistent Condom Users with Low Dating Site Usage (23%), Inconsistent Condom Users with High Dating Site Usage (40%), and Consistent Condom Non-Users (20%). Consistent Condom Non-Users had the highest probability of utilizing dating sites 2+ hours per day, the highest probability of low self-efficacy and low subjective norms about condom use, and a zero probability of using a condom. Inconsistent Condom Users with Low Dating Site Usage and Inconsistent Condom Users with High Dating Site Usage varied in their attitudes and self-efficacy toward condom use. Consistent Condom Users were low on dating site usage, high on all psychosocial constructs, and had a 100% probability of using a condom. Results highlight the need to further explore interventions throughout college campuses and online within dating sites, to strengthen attitudes, subjective norms, and self-efficacy toward condom use among online dating emerging adults.

Dyadic analysis of criminal justice involvement and hiv risks among couples who inject drugs and their intimate partners in almaty, kazakhstan

BackgroundIncarceration increases HIV risk behaviors and strains intimate partnerships of couples of people who inject drugs (PWID) in Kazakhstan. Studies are yet to examine dyadic relationships between criminal justice involvement and injection drug and sexual HIV risk behaviors of couples who inject drugs in Kazakhstan. This study examined associations between individual and partner level criminal justice involvement and injection drug and sexual HIV risk behaviors among 216 intimate dyads (n = 432) of PWID in Almaty, Kazakhstan. MethodsThe Actor Partner Interdependence Model (APIM) using structural equation modeling examined individual (actor), partner and dyadic patterns (actor-partner) of associations between arrest, incarceration and drug crime conviction of dyads of male and female intimate partners of PWID using baseline data from Project Renaissance, a couples-focused HIV prevention intervention for PWID and their intimate partners. ResultsResults from the APIM identified significant associations between lifetime (β=0.10, CI95%=0.01.20, p=.021) and recent (β=0.12, CI95%=0.01.26, p=.045) arrest and increased risk of injection drug use with any partner for female partners. Partner-only effects were identified in which male PWID's recent arrest was associated with an increase in their study partners’ injection drug risk behaviors (β=0.10 CI95%=0.02, 0.20, p=.044). For female partners, prior incarceration was associated with increased engagement in injection drug risk behaviors (β=0.10 CI95% =0.02, 0.20, p=.035) with any partner. For male partners’ prior incarceration was associated with injection drug risk behaviors with their study partners (β=0.10 CI95%= 0.02, 0.20. p<.05). Female partners prior drug crime conviction was associated with their own (β=0.14 CI95%=0.01, 0.28, p=.048) and their intimate partners’ (β=0.18, CI95%=0.03, 0.33, p=.024) engagement in injection drug risk behaviors with any injecting partner. Recent drug crime conviction (β=0.12, CI95%=0.01, 0.24, p=.038) and arrest (β=0.13, CI95%, p=.022) was associated with increased engagement in sexual risk behaviors among female partners. ConclusionFindings from this study identified differences in how criminal justice involvement impacts sexual and injection drug and sexual risk behaviors between male and female partners of PWID. Future research must investigate how structural interventions at the dyadic level could address the negative impact of criminal justice involvement on sexual and injection drug HIV risks within the contexts of couples who are PWID.

A Dyadic Analysis of Criminal Justice Involvement and Sexual HIV Risk Behaviors Among Drug-Involved Men in Community Corrections and Their Intimate Partners in New York City: Implications for Prevention, Treatment and Policies.

People in community corrections have rates of HIV and sexual risk behaviors that are much higher than the general population. Prior literature suggests that criminal justice involvement is associated with increased sexual risk behaviors, yet these studies focus on incarceration and use one-sided study designs that only collect data from one partner. To address gaps in the literature, this study used the Actor Partner-Interdependence Model with Structural Equation Modeling (SEM), to perform a dyadic analysis estimating individual (actor-only) partner-only, and dyadic patterns (actor-partner) of criminal justice involvement and greater sexual risks in a sample of 227 men on probation and their intimate partners in New York City, United States. Standard errors were bootstrapped with 10,000 replications to reduce bias in the significance tests. Goodness of fit indices suggested adequate or better model fit for all the models. Significant actor-only relationships included associations between exposures to arrest, misdemeanor convictions, time spent in jail or prison, felony convictions, lifetime number of incarceration events, prior conviction for disorderly conduct and increased sexual risk behaviors. Partner only effects included significant associations between male partners conviction for a violent crime and their female partners' sexual risk behaviors. Men's encounters with police and number of prior misdemeanors were associated with their own and intimate partners' sexual risk behaviors. Women's prior arrest was associated with their own and intimate partners' sexual risk behaviors. The results from the present study suggest that men on probation and their intimate partners' criminal justice involvement are associated with increased engagement in sexual risk behaviors. It is necessary to conduct greater research into developing dyadic sexual risk reduction and HIV/STI prevention interventions for people who are involved in the criminal justice system.

Demographic and Psychosocial Factors Associated With Child Sexual Exploitation

Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.

Understanding the risk factors for HIV acquisition among refugee women in South Africa

ABSTRACT The prevalence of HIV in South Africa is among the highest in the world. This study provides an in-depth understanding of the risks for HIV transmission among refugee women residing in Durban, KwaZulu-Natal, South Africa. Qualitative interviews were conducted among refugee women originally from Sub-Saharan African countries. They reported sexual abuse by their intimate partners who were also having extramarital affairs with the local women. Condom use was low, with the women unable to negotiate use, due to fear of violence and religious beliefs, making them vulnerable to contracting HIV. Women were unable to leave their relationship due to financial constraints and dependence on their spouses. These dire circumstances also led to transactional sex. Uptake of HIV testing was high among the women. They were, however, uncertain of their partners’ HIV status. We conclude that the higher risk for HIV transmission among refugee women is associated with increased engagement in sexual risk behavior. Behavioral change is required within this population and we recommend counselling in line with the religious and cultural beliefs of the population. The acceptability of condom use requires promotion. Increasing employment opportunities will empower women and decrease the social and structural determinants of sexual risk behavior.

Predicting HIV testing in low threshold community contexts among young African American women living in the Southern United States

ABSTRACTSouthern U.S. African American women have disproportionately high HIV infection rates, and increasing HIV testing is a prevention priority. Research suggests that optimal testing conditions involve reaching out to community members and offering free tests in private, supportive contexts with minimal delays for results. These conditions were implemented with young African American women (N = 223, M age = 20.4 years) living in disadvantaged areas of a Southern U.S. city to identify participant characteristics associated with test choice. Participants were recruited using Respondent Driven Sampling. Structured field interviews assessed personal and social network characteristics, sexual practices, substance use, and behavioral impulsivity (assessed by a delay discounting task). A free HIV test was then offered, and test choice was the outcome variable. Testing was accepted by 69%, which exceeded the national lifetime test rate for this population by 7.4% (p < .05). All were sero-negative. Test refusal (31%) was associated with poorer educational performance, greater impulsivity (discounting), less social network encouragement to use birth control (ps < .05), and lower engagement in sexual risk behaviors (p < .10). Test choice did not differ by substance involvement. Thus, low threshold community testing promoted acceptance among this priority population, although a minority with specific characteristics likely need additional incentives for test acceptance.

Early Adversity and Sexual Risk in Adolescence: Externalizing Behaviors as a Mediator.

Sexual risk behavior in adolescence can result in serious health consequences that persist across the lifespan, particularly for female youth. While adverse childhood experiences (ACEs) are linked to engagement in sexual risk behavior later in life, little research has examined pathways that may help explain this association. To address this gap, the present study examined whether internalizing and externalizing behaviors mediated the link between (ACEs) and sexual risk behavior in female youth. We examined data from 122 adolescent girls, ages 13-18, who were involved in the juvenile justice system or receiving social supports from local agencies and schools. Girls were asked to report their exposure to ACEs and engagement in sexual risk behavior and caregivers were asked to report on girls' internalizing and externalizing behaviors. Regression analyses indicated that girls who experienced more ACEs and exhibited more externalizing behaviors demonstrated higher rates of sexual risk. Further, externalizing behaviors partially mediated the association between ACEs and sexual risk behavior. Findings suggest that increased exposure to ACEs and higher incidence of externalizing behaviors may place girls at heightened risk for sexual risk behavior. Interventions aimed at decreasing externalizing behaviors may be particularly important in reducing sexual risk behavior among at-risk female youth.

Parenting perspective on the psychosocial correlates of adolescent sexual and reproductive health behavior among high school adolescents in Ethiopia

BackgroundWhile parents are a crucial part of the social environment in which adolescents live, learn and earn, they could play important roles in efforts to prevent adolescent sexual and reproductive health (SRH) risk behaviors and promote healthy development. Involving parents in prevention programs to risky SRH practices in adolescents requires understanding of the effect of different parenting practices and styles on these behaviors. The purpose of this study was to investigate the relationships between various aspects of perceived parenting and self-reported engagement in sexual risk behavior among adolescents.MethodsA cross-sectional study was employed among 406 randomly selected 14–19 years old high school adolescents in Legehida district, Northeast Ethiopia from 15 February to 15 March/ 2016. Structured and pre-tested self-administered questionnaire adapted from the Youth Risk Behavior Surveillance questionnaire was used for the data collection. Bivariate and multivariate logistic regression analysis with odds ratio along with the confidence interval of 95% were used. P-value < 0.05 were considered for statistical significance.ResultsAbout two-third (64.5%) of the participants reported that they had ever had sex. Nearly half (48.6%) of the participants who were currently sexually active reported that they engaged in at least one type of risky sexual behavior. Specifically, 42.7% reported starting sexual life earlier, 32.2% having more sexual partners in the past 12 months and 23.8% never used condom during the most recent sexual intercourse. High quality parent─adolescent relationships (AOR = 0.53; 95% CI (0.45–0.63) and authoritative form of parenting (AOR = 0.74; 95% CI (0.61–0.92) were associated with lower odds of engaging in risky sexual behaviors in adolescents. The odds of risky sexual behaviors were about three-fold higher in adolescents who perceived parental knowledge as poor (AOR = 2.97; 95% CI (1.51–4.25) and to some extent (AOR = 3.00; 95% CI (1.43–5.55) toward SRH than those whose parents were very knowledgeable. Adolescents with poor behavioral beliefs on SRH issues had a 37% increased odds of engaging in risky sexual behaviors.ConclusionsTherefore, to engage the parents within preventive interventions design to support healthy SRH behaviors among adolescents, the role of authoritative parenting style, and improved quality of parent-adolescent relationship, as well as improving adolescents’ behavioral beliefs and parental knowledge towards SRH are essential.

243. Obesity, Timing of Sexual Initiation And Sexual Risk Behaviors Among Adolescent Girls

Among sexually active adolescent females, obesity is associated with engagement in sexual risk behaviors, particularly with early sexual initiation. However, little research has explored the effect of obesity on the evolution of sexual risk behaviors. We seek to fill this gap by exploring whether timing of sexual initiation predicts associations between sexual risk behaviors and body mass index in early adolescence. Data from the National Longitudinal Survey of Youth 1997 cohort (NLSY97) were used. Females were included if sexual initiation occurred between ages 12 to 25, valid responses were provided to height and weight recorded at round 1, and participants responded to at least 2 of 4 sexual risk behaviors. The primary outcome, sexual risk score, was created based on responses to four sexual behaviors assessed in 1998: number of sexual partners in the past year; lifetime number of sexual partners; proportion of condom-protected sexual acts in the past year; and birth control use. A score of 1 was given to each of these variables which signified “at risk” if they had more than one sexual partner in the past year or ever, had used condoms less than 75% of the time, and were not using a birth control method. Multinomial logistic regression modeling was used to assess the relationship between BMI (independent variable) and sexual risk score (range=0-3) controlling for obesity in early or middle adolescence (ages 12-15 years), age at sexual initiation, race/ethnicity, household parental composition, and socioeconomic status. The sample included 3,474 females. Respondents’ mean age at enrollment was 14.5 years (SD=1.5); 51.8% were non- Hispanic White, 27.2% Black, and 19.9% Hispanic. Early (12-14 years), normative (15-17 years) and delayed (18-25 years) sexual initiators represented 20.4%, 55.2%, and 24.5% of the sample, respectively. The proportion of individuals with a risk score of 0, 1, 2, and 3 was 27.7%, 29.9%, 33.5%, and 9.0% respectively. An interaction was noted between obesity in adolescence and early sexual initiators when the sexual risk score increases from 0 to 1 (p=0.022). Regardless of obesity status, among early sexual initiators the relative risk of having a higher risk score is twice that of normative initiators, and the magnitude of this relationship holds across all risk score transitions (p=0.001; p=0.002; p= 0.037, respectively). Individuals who are obese in adolescence are three times the relative risk to have a risk score of 1 than a score of 0 as compared to individuals who are not obese in adolescence. There are associations between early sexual initiation, obesity and sexual risk-taking behaviors when comparing individuals who have higher risk scores to those with a low risk score.

The Association between Incarceration and Transactional Sex among HIV-infected Young Men Who Have Sex with Men in the United States.

Criminal justice practices in the USA disproportionately affect sexual and racial/ethnic minority men, who are at higher risk of incarceration. Previous research demonstrates associations between incarceration and sexual risk behaviors for men who have sex with men (MSM). However, little of this work focuses on young MSM (YMSM), particularly HIV-infected YMSM, despite nearly one-third reporting engagement in sexual risk behaviors, such as transactional sex. We therefore explored the association between incarceration and transactional sex among HIV-infected YMSM. We recruited 97 HIV-infected YMSM across 14 clinical sites in urban centers from August 2015 to February 2016. We used multivariate logistic regression to examine the relationship between incarceration and transactional sex among YMSM. The majority was 24years old (78%) and racial/ethnic minority (95%); over half were not in school and reported an annual income of < $12,000. In the multivariate model, having ever been incarcerated (aOR = 3.20; 95% CI 1.07-9.63) was independently associated with a history of transactional sex. Being 24years vs. younger (aOR = 9.68; 95% CI 1.42-65.78) and having ever been homeless (aOR = 3.71, 95% CI 1.18-11.65) also remained independently associated with a history of transactional sex. This analysis fills a gap in the literature by examining the relationship between incarceration and transactional sex among HIV-infected YMSM. Facilitating youths' engagement with social services available in their HIV clinic may serve as a key strategy in promoting health. Public health efforts need to address social-structural factors driving disproportionate rates of arrest and incarceration and related harms among this population.

Associations between Sociodemographic Characteristics and Sexual Risk Behaviors among Methamphetamine-using Men who Have Sex with Men

ABSTRACTBackground: Methamphetamine-using men who have sex with men (MSM) exhibit elevated rates of HIV and STI prevalence, indicating increased engagement in sexual risk behaviors. Objectives: This analysis elucidates associations between participant sociodemographics (i.e., age, racial/ethnic identity, sexual identity, educational attainment, and HIV status) and sexual risk behaviors, particularly substance use before/during sex, and engagement in condomless anal intercourse (CAI) with casual, anonymous, and/or exchange male partners. Methods: From March 2014 through January 2016, 286 methamphetamine-using MSM enrolled in a technology-based study to reduce methamphetamine use and HIV sexual risk behaviors. A robustly estimated generalized structural equation model employing the negative binomial family and log link function (n = 282) tested the simultaneous associations between participant sociodemographics and engagement in HIV sexual risk behaviors. Results: Participants' racial/ethnic identity (χ2(6) = 43.5; p < 0.0001), HIV status (χ2(6) = 22.0; p = 0.0012), educational attainment level (χ2(6) = 13.8; p = 0.0322), and years of age (χ2(6) = 32.4; p < 0.0001) all influenced participants' engagement in substance use before/during sex and engagement in CAI. Methamphetamine (χ2(2) = 7.0; p = 0.0309) and marijuana (χ2(2) = 9.7; p = 0.0079) use before/during sex influenced participants' engagement in CAI with casual, anonymous, and exchange male partners. Conclusion: Results indicate the importance of intervention efforts focused on younger racial/ethnic minority MSM with fewer years of educational attainment, and provides evidence of the specific subpopulations of MSM at greatest risk of detrimental effects of illicit substance use.

54.2 Social Media as a Unique Context for Adolescent Sexual Behavior

Social media provides a novel context for adolescents’ social interactions and risk behavior engagement. Recent statistics suggest that 92 percent of adolescents go online daily, 89 percent belong to at least one social networking site, and at least 88 percent engage in text messaging. Indeed, many adolescents report that most of their social interactions take place via social media, rather than in person. Given the proliferation of social media and text messaging among adolescents, it is critical to examine the ways in which this environment differs from traditional social contexts. This presentation will provide an overview of the features that define social media as a discrete context and will discuss the implications of these features for adolescents’ engagement in sexual risk behaviors, both online and offline.

Is it Too Soon to Meet? Examining Differences in Geosocial Networking App Use and Sexual Risk Behavior of Emerging Adults

Location-based geosocial networking smartphone applications (GSN apps) have become a popular way to meet romantic and casual sex partners. Although first used primarily by men who have sex with men (MSM), GSN apps are now commonly used in the population at large, particularly among emerging adults. Although, these apps may potentially contribute to increases in STI/HIV incidence, previous research linking GSN app use to sexual risk behavior has been mixed, with some suggesting app users report greater sexual risk behavior and others suggesting less. The present paper details findings of two studies with independent samples of emerging adults. The first, a pilot study, examined GSN app use among young MSM (n = 64) to identify possible within-group factors relating dating app use to sexual risk behavior. Results indicated that the time app users spent talking to each other through the app before meeting in person (time before meeting) was related to engagement in sexual risk behavior. Those who talked less before meeting in person engaged in more sexual risk behaviors than those who spent more time talking before meeting in person. The second study sought to expand upon this finding in a more representative sample of GSN app users (n = 129) and compared sexual risk behavior and impulsivity to non-users (n = 88). There were no differences in sexual risk behavior between GSN app users and non-users. However, when examining app users by time before meeting, those with a shorter time before meeting were more impulsive and more likely to report sexual risk behavior. These findings highlight the importance of understanding GSN app use in the spread of STIs/HIV among emerging adults.

Adverse Childhood Environment: Relationship With Sexual Risk Behaviors and Marital Status in a Large American Sample.

A substantial theoretical and empirical literature suggests that stressful events in childhood influence the timing and patterning of subsequent sexual and reproductive behaviors. Stressful childhood environments have been predicted to produce a life history strategy in which adults are oriented more toward short-term mating behaviors and less toward behaviors consistent with longevity. This article tests the hypothesis that adverse childhood environment will predict adult outcomes in two areas: risky sexual behavior (engagement in sexual risk behavior or having taken an HIV test) and marital status (currently married vs. never married, divorced, or a member of an unmarried couple). Data come from the Behavioral Risk Factor Surveillance System. The sample contains 17,530 men and 23,978 women aged 18-54 years living in 13 U.S. states plus the District of Columbia. Adverse childhood environment is assessed through 11 retrospective measures of childhood environment, including having grown up with someone who was depressed or mentally ill, who was an alcoholic, who used or abused drugs, or who served time in prison; whether one's parents divorced in childhood; and two scales measuring childhood exposure to violence and to sexual trauma. The results indicate that adverse childhood environment is associated with increased likelihood of engaging in sexual risk behaviors or taking an HIV test, and increased likelihood of being in an unmarried couple or divorced/separated, for both men and women. The predictions are supported by the data, lending further support to the hypothesis that childhood environments influence adult reproductive strategy.