Heterosexual Partners Research Articles

Perceptions of Weight Change Among Romantic Partners: Considering Body Image, Relationship Experiences, Gender, and Sexual Orientation.

Romantic relationship experiences have been found to be relevant to body image and weight in adulthood. In this study, we investigated predictors of heterosexual, lesbian, and gay romantic partners' (N = 500, Mage = 29.3) perceptions of their own and their partners' weight at the beginning of their relationship and 4.8 years later, on average. Perceived changes in participants' own weight status was associated with greater body dissastisfaction and longer relationship length. Perceived changes in partners' weight status was associated with their partners' BMI, as well as relationship quality. We also found that gender was important in understanding some of these associations. Implications of weight perceptions for individuals' and their partners' health and well-being and the critical role of relationship quality are discussed in the context of the health regulation model.

Contact patterns and HPV-genotype interactions yield heterogeneous HPV-vaccine impacts depending on sexual behaviors: An individual-based model

Human papillomaviruses are common sexually transmitted infections, caused by a large diversity of genotypes. In the context of vaccination against a subgroup of genotypes, better understanding the role of genotype interactions and human sexual behavior on genotype dynamics is essential. Herein, we present an individual-based model that integrates realistic heterosexual partnership behaviors and simulates interactions between vaccine and non-vaccine genotypes. Genotype interactions were considered, assuming a previous vaccine-genotype infection shortened (competition) or extended (synergy) the duration of a secondary non-vaccine-genotype infection. Sexual behavior determined papillomavirus acquisition and transmission: only 19.5% of active individuals at most 1 partner r during the year, but > 80% of those with ≥ 2 partners, were infected before vaccine introduction. The pre-vaccination situation was consistent with all genotype interaction scenarios. These genotype interactions, despite being undetectable during the pre-vaccination era, markedly impacted genotype prevalence after vaccination started, with a significant increase/decrease of non-vaccine genotypes prevalence for respectively competitive/synergistic interactions. These prevalence changes were more pronounced in individuals with ≤ 3 partners per year (up to 30% of prevalence modification assuming 65% vaccine coverage) but barely visible for individuals with > 3 partners per year (at most 0.30%). Results suggest the presence of genotype interaction, which is consistent with the pre-vaccine situation, may impact the dynamics of non-vaccine genotypes, particularly in less active individuals.

Men’s experience of perpetrating intimate partner violence following disclosure of HIV status by their seropositive female intimate partners: a qualitative study

Background Gender-Based (GB) intimate partner violence is a social and public health issue globally. Several risks of violence related to male sexual partners’ perpetration of intimate partner violence (IPV) following the disclosure of their female intimate partners’ HIV + status have been reported. No research has been conducted on male sexual partner’s perspectives of perpetrating IPV following their female intimate partners’ disclosure of human immunodeficiency virus (HIV) seropositive status as a risk factor for the perpetration of IPV in Ghana. Objective The objective of this study is to explore and describe male sexual partners’ views or perspectives of perpetrating IPV following their female intimate partners’ disclosure of being HIV positive in Ghana. Methods Interpretive phenomenological approach was used to collect and analyse data from a purposive sample of 18 Male participants whose female intimate relations informed them of being HIV + in Ghana. The sample population was taken from Ghana because such research has been reported elsewhere but none has been done in Ghana. A semi-structured interview guide was used to collect the data. The interview guide covered topics such as background information, participants’ reaction to HIV positive disclosure, lived experiences of participants, and Participants’ understanding of different forms of IPV. Results The findings of this study reveal five main themes that emerged from the interviews which include views on the perpetration of emotional, psychological, and verbal abuse; views on the perpetration of sexual deprivation; views on the perpetration of social isolation; views on the perpetration of financial abuse and views on escalated perpetration of physical abuse. Conclusion From the data, HIV positive status disclosure served as a risk factor for different forms of GB IPV against HIV positive women in Ghana, thus making this group more vulnerable and exposed to more GB IPV. Strategies to prevent the perpetration of IPV against women newly diagnosed as HIV positive are needed. We recommend screening all newly diagnosed HIV-positive women for abuse as an additional prevention strategy for IPV associated with disclosure of positive HIV status. KEY MESSAGES HIV positive status disclosure serves as a risk for the perpetration of IPV. Men are predisposed to violence upon hearing that their female heterosexual intimate partners are HIV positive. HIV infection information is distressful to receive from an intimate partner.

Development and validation of holding time (HoT), a novel tool to measure the control over ejaculation in males

ABSTRACT Introduction As per ISSM definition, premature ejaculation is based on the assessment of three constructs, namely, ejaculatory latency, control over ejaculation and its associated bother. There is an objective tool to measure ejaculatory latency. There are tools to measure bother as well. However, there is no objective tool to measure ejaculatory control in males. Objective To develop and validate a novel objective tool, namely, Holding Time (HoT) to measure control over ejaculation in males. Methods After obtaining ethical committee approval and written informed consent from the participants and their heterosexual partners, study was initiated. A group of sexually active heterosexual healthy male volunteers as controls and another group of voluntary sexually active heterosexual participants who reported premature ejaculation (PE) in our outpatient department were administered Premature Ejaculation Diagnostic Tool (PEDT). Each participant underwent sexual stimulation sessions in adequate privacy, wherein the audio-visual stimuli as well as stimulation by their heterosexual partner were used for sexual arousal. Following this, they masturbated, which began after reaching the level seven of Mosher's scale of genital sensations, which is the highest point of sexual arousal prior to reaching orgasm. Their heart rate was monitored throughout the session, which was recorded using digital pulse oxymeter. This was taken as additional objective biological evidence to record highest point of arousal. The heterosexual partner's opinion with regard to increase in size of glans as well as increased pulsations in penis was also taken into account to record the highest point of arousal, which was an additional crosscheck mechanism. The time from the highest point of sexual arousal to the point at which the study participant expressed inability to hold ejaculation to any further point of time was recorded using stopwatch by the investigator as the HoT. The test was repeated after 6 weeks to assess test-retest reliability, which was measured using Pearson's coefficient (r). Correlations between PEDT diagnosed PE and self-reported PE, with stopwatch measured HoT was assessed to validate HoT. Results Ten healthy controls (Mean age 30.3±4.64 years) and ten volunteers with self-reported PE (Mean age 29.6±4.25 years) participated in the study conducted from May 2020 to April 2021. The mean stopwatch measured HoT in seconds, recorded by healthy volunteers and self-reported PE were 119.6±33.6 and 32.4±12.8 respectively. Test-retest reliability was good for both the healthy volunteers (r =0.983) and volunteers with PE (r =0.839). It had a sensitivity of 90% and specificity of 91% for diagnosis of PE. The positive predictive value was 79.4% and negative predictive value was 95.5%. Excellent correlations between PEDT and HoT with respect to the diagnosis of PE demonstrated construct validity of HoT. Conclusions The development of an objective tool to evaluate the control over ejaculation helps to develop more objective definition and better management of ejaculatory dysfunctions in males. As per preliminary validation data, Holding Time (HoT) is a reliable objective tool to measure control over ejaculation in males. Disclosure Work supported by industry: no.

Heterosexual Identification and Same-Sex Partnering: Prevalence and Attitudinal Characteristics in the USA.

This paper used the 2011-2017 National Survey of Family Growth to estimate population sizes and attitudinal characteristics of heterosexual-identified men who have sex with men (MSM) and women who have sex with women (WSW) aged 15-44 years. Analyses estimated population sizes in stages: after excluding respondents who reported only one lifetime same-sex partner, which happened before the age of 15; after excluding males who reported nonconsensual male-male sex; after excluding respondents who reported only one lifetime same-sex partner, regardless of the age at which that experience occurred; after excluding respondents who reported only two lifetime same-sex partners, the first of which occurred before age 15; and after excluding males who reported male-male sex work. The broadest criteria included many individuals with limited same-sex sexual histories or those who experienced nonconsensual sex or potentially coerced sex in youth. After excluding those respondents, analyses showed that heterosexual-identified MSM and WSW had a diversity of attitudes about gender and LGB rights; only a distinct minority were overtly homophobic and conservative. Researchers should carefully consider whether to include respondents who report unwanted sexual contact or sex at very young ages when they analyze sexual identity-behavior discordance or define sexual minority populations on the basis of behavior.

Similarity indices of the Dark Triad traits based on self and partner-reports: Evidence from variable-centered and couple-centered approaches

As the Dark Triad (DT) has been rarely examined from different rater perspectives, there is a lack of insight about important questions on assessment and understanding of these traits. The present study explores real similarity (assortment), reciprocity, assumed similarity and self-other agreement for the DT traits on 188 heterosexual romantic partners using self-reports and partner-reports. By using variable-centered and couple-centered approach and various analytic tools, moderate to high positive assortment was found for all DT traits, the highest for Machiavellianism. The levels of assumed similarity and self-partner agreement were similar or somewhat higher than those usually obtained for other personality traits. We discussed the implications of the results obtained concerning measurement and interpersonal relevance of the DT traits.

The geography and inter-community configuration of new sexual partnership formation in a rural South African population over fourteen years (2003-2016).

Understanding spatial configuration of sexual network structure is critical for effective use of HIV preventative interventions in a community. However, this has never been described at the population level for any setting in sub-Saharan Africa. We constructed the comprehensive geospatial sexual network among new heterosexual partnerships in rural KwaZulu-Natal, South Africa. In the Africa Health Research Institute (AHRI)'s population-based surveillance, we identified stable sexual partnerships among individuals (≥15 years) from 2003 to 2016. Sexual partnerships and residency were recorded via household surveys (every 4-6 months). We geolocated residents and migration events and mapped the geospatial linkages of sexual partners at the start of sexual partnerships. In a grid composed by 108 cells (nodes; 3kmx3km per cell) covering the surveillance area (438km2), we calculated the degree of connectivity and centrality of the nodes and examined their association with HIV prevalence and incidence per cell. Of 2401 new sexual partnerships, 21% (n = 495) had both partners living within the surveillance area at the start of sexual partnerships, and 76% (376/495) were linked to the geographic HIV cluster with high HIV prevalence identified in a peri-urban community. Overall, 57 nodes had at least one connection to another node. The nodes in the peri-urban cluster had higher connectivity (mean = 19, range: 9-32), compared to outside the cluster (6, range: 1-16). The node's degree of connectivity was positively associated with HIV prevalence of the cell (Pearson correlation coefficient = 0.67; p <0.005). The peri-urban cluster contained nine of the 10 nodes that composed of a single large central module in the community. About 17% of sexual partnerships (n = 421) were formed between a resident and a non-resident partner who out-migrated. Most of these non-resident partners lived in KwaZulu-Natal (86.7%), followed by Gauteng (9.7%), and the median distance between a resident and a non-resident partner was 50.1km (IQR: 23.2-177.2). We found that the peri-urban HIV cluster served as the highly connected central node of the network for sexual partnership formation. The network was also connected beyond the surveillance area across South Africa. Understanding spatial sexual network can improve the provision of spatially targeted and effective interventions.

Health Disparities Among Women by Sexual Orientation Identity and Same-Sex or Different-Sex Cohabiting Partnership Status.

The objective of this study was to compare health outcomes by sexual orientation identity and cohabiting partnership status (defined as whether heterosexual, lesbian, and bisexual women were non-partnered, partnered in a cohabiting same-sex relationship, or partnered in a cohabiting different-sex relationship). We used data on heterosexual (n=95,289) and sexual minority (n=2,600) women aged 18years and older from the 2013-2018 National Health Interview Survey. We estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) from multivariable logistic regression models comparing health outcomes by sexual orientation identity and cohabiting partnership status while controlling for sociodemographic characteristics. Compared with heterosexual women in a different-sex relationship, nonpartnered women generally reported worse health outcomes regardless of sexual orientation. Lesbian women with a same-sex partner were more likely to report poor/fair health (AOR, 1.61; 95% CI, 1.09-2.37), current cigarette smoking (AOR, 1.48; 95% CI, 1.14-1.94), and binge drinking (AOR, 1.63; 95% CI, 1.19-2.23) compared with heterosexual women with a different-sex partner. Bisexual women with a different-sex partner were more likely to report poor/fair health (AOR, 1.91; 95% CI, 1.23-2.97), severe psychological distress (AOR, 2.86; 95% CI, 1.78-4.59), current cigarette smoking (AOR, 1.38; 95% CI, 1.01-1.88), and binge drinking (AOR, 1.66; 95% CI, 1.18-2.32) compared with heterosexual women with a different-sex partner. More research is needed to identify the processes in which heterosexual and sexual minority women partner and cohabitate with members of the same or different sex-and whether or how this influences their health. Meanwhile, health care providers should be mindful that families are diverse, and acknowledging this diversity could be a first step toward achieving health equity for all women regardless of sexual orientation.

Conclusion to the special issue: Relationships in the time of COVID-19: Examining the effects of the global pandemic on personal relationships

This article serves as the conclusion of the special issue entitled “Relationships in the time of COVID-19: Examining the effects of the global pandemic on personal relationships.” The special issue includes 29 research articles with authors and samples from 28 countries spanning all continents except Antarctica. Romantic relationships between two heterosexual partners were studied most often in the special issue articles, but studies also focused on family relationships, friendships, and relationships between strangers. This article provides a summary of the special issue and its three broad themes: (1) stress, turbulence, conflict, and coping; (2) loneliness, isolation, and mediated communication; and (3) reflecting and reframing in relationships. The article concludes with the special issue editors’ reflections on relationship science and the pandemic.

Doing Everything: Intersections of Gender and Sexual Orientation in Caregiving for a Spouse With Dementia

Gender inequalities are rooted in and drive the division of labor over the life course, which result in heterosexual men and women acquiring different resources, skills, and identities. Gendered differences in caregiving reflect these varying gender repertoires. Whether and how these repertoires vary by sexual orientation is lesser understood. Our qualitative study seeks to explore the ways that sexual orientation and gender, and the related division of both paid and unpaid labor, shapes caregiving for a spouse or partner with Alzheimer’s disease and related disorders (AD). Our data, obtained from in-depth interviews conducted among lesbian (n=9), gay (n=6), and heterosexual spousal and partner (23 women and 14 men) caregivers of those with AD, reveal that, although all the caregivers spoke about “having to do everything,” with a particular focus on decision-making, they interpret this experience differently based on the intersections of gender and sexuality. The heterosexual women reported they were used to managing daily household life, yet they described having to make decisions as quite stressful: “I don’t like to be the boss.” Heterosexual husbands also lamented that they “had to do everything,” but commenting that they hadn’t realized what it took to “manage a household.” The concerns reported by lesbian and gay spouses and partners were similarly situated but more varied, as each group tended to report their previous divisions of labor as “less well-defined.” Our findings reflect both the influence of gender inequalities on how respondents experience “doing everything,” and their potential modification in same-sex relationships.

Proportion of Incident Genital Human Papillomavirus Detections not Attributable to Transmission and Potentially Attributable to Latent Infections: Implications for Cervical Cancer Screening.

Infections with human papillomaviruses (HPVs) may enter a latent state, and eventually become reactivated following loss of immune control. It is unclear what proportion of incident HPV detections are reactivations of previous latent infections vs new transmissions. The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) cohort study prospectively followed young newly formed heterosexual partners recruited between 2005 and 2011 in Montréal, Canada. We calculated the fraction of incident HPV detections nonattributable to sexual transmission risk factors with a Bayesian Markov model. Results are the median (2.5th-97.5th percentiles) of the estimated posterior distribution. A total of 544 type-specific incident HPV detection events occurred in 849 participants; 33% of incident HPV detections occurred in participants whose HITCH partners were negative for that HPV type and who reported no other sex partners over follow-up. We estimate that 43% (38%-48%) of all incident HPV detections in this population were not attributable to recent sexual transmission and might be potentially reactivation of latent infections. A positive HPV test result in many cases may be a reactivated past infection, rather than a new infection from recent sexual behaviors or partner infidelity. The potential for reactivation of latent infections in previously HPV-negative women should be considered in the context of cervical cancer screening.

Who’s Hitched? Lesbian, Gay, Bisexual, and Heterosexual Partnering in Canada

Who’s Hitched? Lesbian, Gay, Bisexual, and Heterosexual Partnering in Canada

ATTITUDES TOWARDS SAME-SEX PARTNERSHIP: A SOCIOLOGICAL RESEARCH OF YOUNG PEOPLE IN SPLIT (CROATIA)

One of the current dilemmas of modern society is how to look at homosexuals, same-sex partners, forming same-sex partnerships, and raising children in such communities. Homosexuals are classified as sexual minorities and are often excluded from society, which is not new because members of sexual minorities have long been accompanied by numerous persecutions and repressions. This paper aims to examine the attitudes of young people towards homosexuality and same-sex partnership. The paper presents the results of the research conducted in 2019 using a survey method on a sample of 303 respondents aged 15 to 35 years. The results show that most young people do not consider homosexuality to be a disease and approach LGBT people in the same way as the rest of society, not paying attention to someone's sexual orientation. Respondents are predominantly open to the possibility of marriage between same-sex partners while they to a lesser extent agree with the adoption and upbringing of children by same-sex partners. They believe that there is a difference in the upbringing of children raised by same-sex partners from children raised by heterosexual partners, which can be justified by the discrimination and violence to which children of same-sex partners are exposed to. Also, young people think that homosexual parents can be good parents and provide their children with everything they need and that it is better for children to grow up in same-sex families than in homes for abandoned children. Although they state that such communities are almost equal to heterosexual communities, they are aware of their exposure to social exclusion.

Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD)

Orgasm occurrence plays an important role in general sexual satisfaction for women. Until now, only few studies have focused on examining a broad spectrum of sexuality- and relationship-specific factors associated with orgasm in heterosexual women currently in a long-term relationship or on differences between the overall experience of orgasm and multiple orgasms. The present study aims to understand how various sexuality- and relationship-associated factors are related to experiencing partnered orgasm among heterosexual women having stable relationships in Germany. Moreover, the study aims to differentiate between the overall experience of orgasm and the experience of multiple orgasms and shed light on their impact on general sexual satisfaction. Within the nationwide representative survey GeSiD (German Health and Sexuality Survey), n=1,641 sexually active women aged between 18 and 75 years in heterosexual relationships reported their experience of orgasm during the latest sexual encounter. Data on the type of sexual practices, frequency of sexual activity and of masturbation, relationship satisfaction, feelings of love, closeness, and general sexual satisfaction were analyzed. The overall experience of orgasm, the experience of multiple orgasms, and associations between experiencing orgasm and sexual satisfaction. Frequency of sexual activity, relationship satisfaction, feelings of love and closeness were moderately to strongly positively correlated with each other and each showed positive associations with the likelihood of orgasm. Greater number of sexual practices and frequency of sexual activity were associated with an increased likelihood of experiencing multiple orgasms, which in turn was correlated with higher sexual satisfaction. In clinical and therapeutic work with women who have difficulty achieving orgasm, central issues should be the perceived relationship quality as well as regular sexual activity with the partner. The present population-representative study is the first in Germany to identify significant factors associated with the experience of orgasm among heterosexual women in relationships. Further studies ought to include the frequency of orgasms in partnered sex over a longer period of time as well as the experience of orgasm during masturbation. The experience of orgasm for women is related to a variety of complex interpersonal mechanisms and to be associated with sexual satisfaction. Cerwenka S, Dekker A, Pietras L, et al. Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD). J Sex Med 2021;18:2028-2038.

The impact of genital warts on sexual function and sexuality-related distress in late adolescence.

Adolescence is a transition period during which sexual experiences gain importance. Genital warts are sexually transmitted lesions that have been shown to negatively affect sexual perception. This study aimed to evaluate the impact of genital warts on female sexual function and sexuality-related distress in adolescence. A total of 90 female adolescents between the ages of 17 and 21 who had regular sexual intercourse with heterosexual partners were included in this prospective case-control study. Female Sexual Function Index, Arizona Sexual Experiences Scale, and Female Sexual Distress Scale-Revised scores of adolescents with genital warts (n = 45) were compared to healthy subjects (n = 45). Total Female Sexual Function Index and Arizona Sexual Experiences Scale scores revealed significant dysfunction in adolescents with genital warts (20.7 ± 4.13 (20.9) vs. 28.2 ± 3.51 (28.7), p < 0.0001; 17.1 ± 3.61 (17) vs. 13.02 ± 3.01 (13), p < 0.0001, respectively). Total Female Sexual Distress Scale-Revised score was significantly decreased in the presence of genital warts (23.82 ± 9.73 (23) vs. 8.8 ± 7.38 (6), p < 0.0001). Significant correlations were found between the total Female Sexual Distress Scale-Revised score and the total Female Sexual Function Index score, and the Arizona Sexual Experiences Scale score (r = -0.78, p < 0.0001; r = 0.68, p < 0.0001, respectively). This study revealed that genital warts have significantly unfavorable effects on sexuality in adolescence leading to sexual dysfunction as well as sexuality-related distress. Regarding to the present findings, promoting sexual health in addition to physical well-being may increase success in clinical management of genital warts.

Male sexual functions and behaviors in the age of COVID-19: Evaluation of mid-term effects with online cross-sectional survey study.

To evaluate the long-term effects of the coronavirus disease 2019 (COVID-19) pandemic on sexual functions and behavior in men with heterosexual partners. A total of 602 participants completed an online questionnaire, shared via social networks, between November 20 and December 20, 2020. Pre-pandemic sexual intercourse frequency, International Erectile Dysfunction Index (IIEF-15) score, intravaginal ejaculatory latency time (IELT), premature ejaculation diagnostic tool (PEDT) score, and activities during sexual intercourse were compared to the ones during the pandemic. In addition, the effects of various variables on participants' sexual functions were evaluated and analyzed according to age groups. The mean number of weekly sexual intercourse during the pandemic was 1.7+1.7, which was significantly lower than in the pre-pandemic period (p < 0.001). The ED score was significantly lower during the pandemic (p < 0.001) compared to the pre-pandemic period, however orgasmic function (p = 0.016), sexual intercourse satisfaction (p < 0.001), general satisfaction (p < 0.001), and PEDT scores (p = 0.004) were significantly higher. There was no significant difference in IELT before and during the pandemic (p = 0.391). Full-time employment and low education level were risk factors for developing ED and PE. The negative affect of the pandemic on sexual life was most prominent in the > 65 age group. Although kissing, oral and anal sex, and face-to-face sex positions decreased during the pandemic in all age groups, kissing and face-to-face sex positions remained the most preferred sexual behavior pattern (p = 0.002). There was no reduction in risky sexual behavior in the majority of the participants. At the end of one year with COVID-19, a decrease in erectile function and an increase in PE incidence were observed in men. Despite this, there was an increase in sexual desire and satisfaction. Although there were some changes in sexual behavior, the majority of pre-pandemic habits continued.

The Paradox of Time: Work, Family, Conflict, and the Social Construction of Time

ABSTRACT Today’s employees work longer hours and face constraints from nonstandard, rotating, or unpredictable schedules. Even when they are home, employees are often tethered to their jobs by technology and expected to be available. Higher demands on an employee’s time can lead to burnout and greater job-related stress, impacting work-family conflict. Drawing on in-depth interviews, we analyze how women in dual-income heterosexual partnerships make sense of and manage their family relationships in light of the competition between work-imposed demands and family time. Our study shows how women attempt to control their time by setting boundaries, scheduling, and allowing work and family time to blur as a way to address hectic work and family lives; however, this is often not successful, leading to paradoxical outcomes, particularly for those with children. Nevertheless, our participants make their limited time meaningful as a source of connection within their relational lives by ritualizing meals, accomplishing tasks, and sharing space. This study extends our theorizing on how work and family demands shape perceptions and meanings of the structure of time.

Epidemiological characteristic of newly reported HIV/AIDS cases with non-martial and non-commercial heterosexual behaviors in Zhejiang province, 2017-2019

Objective: To understand the epidemiological characteristics and transmission routes of newly reported HIV/AIDS cases with non-martial and non-commercial (NMNC) heterosexual behaviors in Zhejiang province. Methods: A retrospective survey was conducted among HIV/AIDS cases that had NMNC heterosexual behavior history and diagnosed with HIV infection in Zhejiang between January 1st, 2017 and September 30th, 2019. The multiple correspondence analysis (MCA) was used to explore the association of social demographic characteristics with NMNC heterosexual partner types in the cases. Results: A total of 406 participants with NMNC heterosexual behaviors before HIV diagnoses were recruited in this study. Most of them were males (67.2%, 273/406), aged 25-49 years at HIV diagnoses (59.1%, 240/406). Prior to HIV infection confirmation, 36.0% (146/406) participants only had casual sexual partners, 52.0% (211/406) only had regular sexual partners, and 12.0% (49/406) had both. Statistical differences in marital status, occupation and income level were found among participants with different types of NMNC heterosexual partners (all P<0.05). Result of MCA indicted that monthly income ≤3 000 yuan RMB, self-employed, being married were only associated with casual NMNC heterosexual partner; working in service industry, education level of junior high school were only associated with regular heterosexual partner; working in enterprise, high school education level or above, monthly income ≥5 000 yuan RMB were associated with both casual and regular sexual partner. Conclusion: The HIV/AIDS cases with NMNC heterosexual behaviors before HIV diagnoses accounted for a large proportion in Zhejiang province during 2017-2019. Active intervention efforts should be made to improve the health awareness of the public to reduce the risk behaviors for HIV transmission.

Exchange and Communal Strengths’ Associations With Relational Characteristics and Forgiveness

Clark and Mills (2012) proposed that communal norms characterize “healthy marriages,” whereas exchange norms indicate “troubled” ones. Using the actor–partner interdependence model, we consider this proposal. Heterosexual married partners’ exchange and communal strength are examined with several relational features including trust, commitment, relational satisfaction, and control mutuality, as well as partner-specific tendencies toward forgiveness. The findings indicate that one’s communal strength is associated with positive relational features for both oneself and one’s spouse, as well as a greater propensity to forgive and lesser tendencies toward negative forgiveness (retaliation). Exchange strength was generally associated with negative forgiveness. However, the relationship between exchange strength and relational features is more complicated. Lesser communal strength was generally associated with lower levels of the relational characteristics. Yet, exchange and communal strength interacted, indicating exchange may play a protective function by buffering against the ill effects of a lack of communal strength for some relational characteristics.

Assisted Partner Notification and Uptake of HIV Testing among Men Who Have Sex with Men: A Randomized Controlled Trial in China

BackgroundAssisted partner notification (PN) is an effective approach for increasing HIV testing among heterosexual partners. There is sparse evidence on its effect among sexual partners of men who have sex with men (MSM).MethodsA randomized controlled trial was conducted to compare the effect of assisted PN and passive PN interventions on uptake of HIV testing among male and female sexual partners of newly HIV-diagnosed MSM. In the passive PN group, participants were encouraged to disclose their HIV status and refer and persuade sexual partners to access HIV testing services (HTS). In the assisted PN group, participants were further provided with HIV self-testing kits for sexual partners to take a test at home or allow a community health worker from MSM-serving community-based organization (CBO) to anonymously refer and persuade their sexual partners to access HTS. The primary outcome was the proportion of index cases who had any sexual partner accessing HTS within four months after randomization. This trial is registered with chictr.org.cn, ChiCTR1800017813.FindingsBetween August 2017 and January 2019, 187 MSM newly diagnosed with HIV in a large city Shenyang in northern China were enrolled in the study and randomly assigned to either passive PN (n=90) or assisted PN (n=97) study groups. The proportion of index cases who disclosed their HIV status to any sexual partners within three months of randomization was similar between passive PN (57%, 95% confidence interval [CI]: 46-67%) and assisted PN groups (58%, 95% CI: 48-68%). During four months of follow-up, the number of sexual partners named, referred to HTS, tested and testing positive per index case was 3•2, 0•7, 0•2 and 0•03 in the passive PN group, and 4•0, 1•0, 0•5 and 0•10 in the assisted PN group. Thirty-five percent of index cases in the assisted PN group had any sexual partners accessing HIV testing compared to 17% in the passive PN group (P = 0•004); 49% sexual partners who were disclosed by index cases in the assisted PN group had access HTS compared to 28% in the passive PN group (P = 0•007).InterpretationThe assisted PN strategy incorporating HIV self-testing and CBO outreach can increase uptake of HIV testing among sexual partners of MSM who were recently diagnosed with HIV.FundingNational Science and Technology Major Project of China, National Natural Science Foundation of China, and Project for Overseas Visiting Research of Liaoning Province.