Higher Number Of Sexual Partners Research Articles

The Need for Cervical Cancer Control in HIV-Positive and HIV-Negative Women from Romania by Primary Prevention and by Early Detection Using Clinically Validated HPV/DNA Tests.

BackgroundIn Romania, a country with no organized national surveillance program regarding cervical cancer, the early diagnosis of HPV (Human Papilloma Virus) infections is a major requirement, especially in HIV-infected women. The objective of this study was to determine the HPV prevalence and type distribution in young HIV-positive women and to assess the difference in the risk factors for developing cervical cancer compared to those of HIV-negative women.MethodWe conducted one cross-sectional cohort study from June 2013–September 2014, including 1,032 women: 992 HIV- women who were 36.5 years old (limits: 17 ÷ 84) and 40 HIV + women who were 22.9 years old (limits: 17 ÷ 30) with iatrogenic HIV infected. We detected HPV types with the Linear Array HPV Genotyping test (Roche, Romania).ResultsDNA/HPV was detected in 18/40 (45%) of the HIV+ patients and in 350/992 (35.2%) of the HIV- patients (OR = 1.5, 95%CI 0.76÷2.96). After age adjustment, the overall HPV prevalence was 51.6% in HIV+ versus 63.2% in HIV- women aged under 25, and 22.2% in HPV+ versus 47.2% in HIV- women aged 25–34. We detect HIV being a risk factor for acquiring multiple HPV type infections (OR = 2.30, 95% CI 0.88÷5.97). The eight most common HPV types (high-risk, and low-risk) for women below age 30, HIV+ / - were: HPV 16, 18, 31, 51, 58, 68, and 6 and 82 respectively. To assess the risk factors of HIV-positive women for acquiring HPV infection, we analyzed the CD4/μL, ARN/HIV copies/μL, the age group, the number of sexual partners, smoking, and the type of HPV infection (single versus multiple infections). We found that the number of sexual partners and smoking are statistically significant risk factors.ConclusionEven though there are no significant differences regarding the prevalence of HPV infection in HIV + versus HIV – patients, multiple infections were more frequent in the first group. In our study group young HIV-infected patients under HAART therapy, high number of sexual partners (more than 3) and smoking were detected to be risk factors. Future organized screening for HPV infection using sensitive and specific methods are necessary at the national level in Romania.

Pornography Use and Sexual Behavior Among Polish and German University Students

The purpose of this study was to explore the relationship between pornography use and sexual behavior in young adults from two culturally different countries. Data were collected in an online survey among German (n = 1,303; G) and Polish (n = 1,135; P) university students aged 18 to 26 years. Pornography use was associated with engaging in a greater variety of sexual activities (e.g., sexual role playing, using sex toys; G > P) rather than with a high number of sex partners or condom use consistency. The differences between the samples were found primarily for females (in anal sex experience and age at the first sexual intercourse; G > P).

Sexual health behaviors of Deaf American Sign Language (ASL) users

BackgroundLittle is known about the sexual health behaviors of Deaf American Sign Language (ASL) users. ObjectiveWe sought to characterize the self-reported sexual behaviors of Deaf individuals. MethodsResponses from 282 Deaf participants aged 18–64 from the greater Rochester, NY area who participated in the 2008 Deaf Health were analyzed. These data were compared with weighted data from a general population comparison group (N = 1890). We looked at four sexual health-related outcomes: abstinence within the past year; number of sexual partners within the last year; condom use at last intercourse; and ever tested for HIV. We performed descriptive analyses, including stratification by gender, age, income, marital status, and educational level. ResultsDeaf respondents were more likely than the general population respondents to self-report two or more sexual partners in the past year (30.9% vs 10.1%) but self-reported higher condom use at last intercourse (28.0% vs 19.8%). HIV testing rates were similar between groups (47.5% vs 49.4%) but lower for certain Deaf groups: Deaf women (46.0% vs 58.1%), lower-income Deaf (44.4% vs 69.7%) and among less educated Deaf (31.3% vs 57.7%) than among respondents from corresponding general population groups. ConclusionDeaf respondents self-reported higher numbers of sexual partners over the past year compared to the general population. Condom use was higher among Deaf participants. HIV was similar between groups, though HIV testing was significantly lower among lower income, less well-educated, and female Deaf respondents. Deaf individuals have a sexual health risk profile that is distinct from that of the general population.

An Exploratory Study of HIV Risk Behaviors and Testing among Male Sex Workers in Beirut, Lebanon

Male sex workers (MSW) are a particularly high-risk subset of men who have sex with men in Lebanon and report higher numbers of sex partners and lower rates of condom use. The purpose was to explore the factors influencing sexual risk behaviors and HIV testing among MSW. Qualitative interviews were conducted with 16 MSW living in Beirut and working in bathhouses (hammam) or as escorts; content analysis identified emergent themes. Escorts reported more consistent condom use with clients and HIV testing than hammam MSW, with influential factors including HIV risk knowledge and perceived risk susceptibility, job security, and internalized stigma and related feelings of self-worth and fatalism regarding health and HIV risk. In contrast, both groups of MSW typically opted not to condoms with nonclient sex partners, in an effort to differentiate sex for work versus pleasure. The uptake of HIV testing was limited by concerns about the confidentiality of the test results and fear of repercussions of a positive test result for their health and employment. The respondents described an insular existence within the sex work culture, in part to limit exposure to stigma, which has implications for access to support as well as the influence of peer norms regarding sexual risk behavior and health seeking behaviors such as HIV testing. Further research is needed to tailor prevention and HIV testing efforts to reflect the distinct sexual health “cultures” that distinguish these two populations of MSW in Lebanon.

Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales

ObjectivesTo inform control strategies undertaken as part of an outbreak of Shigella flexneri 3a among men who have sex with men (MSM).MethodsAll men aged ≥18 years diagnosed with S flexneri...

P1288 : Budd chiari syndrome (BCS) in France from a large national cohort

increased in recent years. This increase may be due to factors such as high HCV viral load in blood and semen, sex with risk of mucosal damage, a higher number of sexual partners, presence of concomitant ulcerative sexually transmitted diseases and the use of recreational drugs. The aim of our study was to investigate the dynamics of HCV transmission in an outbreak of acute hepatitis C in HIV-infected MSM in Barcelona. Methods: Between 2008 and 2013, 113 cases of acute hepatitis C in HIV-infected MSM were diagnosed in the Infectious Diseases Unit, Hospital Clinic, Barcelona. Phylogenetic analysis of the HCV NS5B gene was performed in a total of 70 patients. Viral RNA was extracted from serum samples collected from each patient at the time of diagnosis. Massive sequencing was performed using the Roche 454 GS Junior platform. To define possible transmission networks, phylogenetic trees and multidimensional scaling maps were constructed from genetic distance matrices (Da). Results: At the time of diagnosis of acute hepatitis C, 53 of the 70 (76%) patients included in the study were receiving antiretroviral therapy. HIV viral load was undetectable in 48 patients (69%) and the mean CD4 cell count was 923 cells /ul. HCV viral load was 6.37 log IU/mL (range 3.73–6.99). Thirty-five of 53 (66%) patients treated with pegIFN and ribavirin achieved a sustained virological response. The prevalence of HCV genotypes was: 4d 51% (n =36), 1a 40% (n =28), 1b 7% (n =5) and 3a 1% (n =1). Phylogenetic analysis showed the existence of at least 13 monophyletic groups: 5 of genotype 1a, 2 of genotype 1b and 6 genotype 4d. Molecular analysis showed that the genetic distances between genotype 4d viruses (Da 5.42) were significantly lower than those of the subtypes 1a (Da 18.50, p < 2.2×10−16) and 1b (Da 15.25, p < 1.1×10−6). This result may suggest the existence of a single source of infection for genotype 4d and different sources for subtypes 1a and 1b. Conclusions: HCV infection spreads rapidly among HIV-infected MSM through a local network in Barcelona. The implementation of public health campaigns and preventive measures, as well as treatment interventions with the new direct-acting antivirals will allow the development of strategies to reduce the HCV transmission of HCV within these high-risk groups.

Sex, violence, & rock n' roll: Longitudinal effects of music on aggression, sex, and prosocial behavior during adolescence

The current study examined longitudinal associations between listening to aggression, sex, and prosocial behavior in music on a number of behavioral outcomes across a one-year period during adolescence. Adolescents (N = 548, M age = 15.32, 52% female) completed a number of questionnaires on musical preferences, general media use, aggression, sexual outcomes, and prosocial behavior at two different time points separated by about one year. Using structural equation modeling to analyze the data, results revealed that listening to aggression in music was associated with increased aggression and decreased prosocial behavior over time, even when controlling for initial levels of these behaviors. Listening to sexual content in music was associated with earlier initiation of sexual intercourse and a trend for a higher number of sexual partners (reported at Time 2). Prosocial behavior in music was not associated with any behavioral outcome longitudinally. Collectively, these results suggest that listening to certain types of content in music can have a longitudinal effect on behavior during adolescence.

Sexual initiation among adolescents (10 to 14 years old) and health behaviors.

To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents' schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence.

Community Violence Exposure and Sexual Behaviors in a Nationally Representative Sample of Young Adults: The Effects of Race/Ethnicity and Gender

ABSTRACTThis study examined whether exposure to community violence was related to sexual risk behaviors in a nationally representative sample of young adults and if there were gender or racial/ethnic differences in these relationships. The analytic sample for this study was drawn from the National Longitudinal Study of Adolescent Health and was composed of 7,726 unmarried, heterosexual African American, Caucasian, and Hispanic/Latino young adults aged 18 to 27 years old. Approximately 12% of participants reported some community violence exposures, with men and African Americans reporting the highest rates of such exposures. Regression analyses controlling for age, gender, parental education, and family structure indicated that exposures to community violence were associated with earlier sexual debut history, a higher number of sexual partners within the previous 12 months, and a higher number of total sexual partners. Additionally, violence exposures had stronger effects for males and weaker effects for African Americans. Primary and secondary sexual risk prevention initiatives would need to consider how patterns of sexual risk behaviors may be related to exposure to community violence and how such relationships may differ based on gender and race/ethnicity. Future research should also seek to illuminate pathways connecting these 2 major public health concerns.

Association Between Pornography Use and Sexual Risk Behaviors in Adult Consumers: A Systematic Review

The purpose of this review was to determine whether an association exists between sexual risk behaviors and pornography consumption. Consumption of pornography is common, yet research examining its link with sexual risk behaviors is in its infancy. Indicators of sexual risk behavior, including unsafe sex practices and a higher number of sexual partners, have been linked to poor health outcomes. A systematic literature search was performed using Medline, PsycINFO, Web of Knowledge, Pubmed, and CINAHL. Studies were included if they assessed the association between pornography use and indicators of sexual risk behaviors in an adult population. A total of 17 were included in the review, and all were assessed for research standards using the Quality Index Scale. For both Internet pornography and general pornography, links with greater unsafe sex practices and number of sexual partners were identified. Limitations of the literature, including low external validity and poor study design, restrict the generalizability of the findings. Accordingly, replication and more rigorous methods are recommended for future research.

Repeated STI and HIV testing among HIV-negative men who have sex with men attending a large STI clinic in Amsterdam: a longitudinal study.

In the Netherlands, men who have sex with men (MSM) are advised via informal guidelines to test for STI at least annually. We estimated the proportion of HIV-negative MSM testing repeatedly at 12-month or smaller intervals at a large STI clinic in the Netherlands. In addition, we explored whether repeated testing is related to risk behaviour. Longitudinal data of HIV-negative MSM visiting the Amsterdam STI clinic between 2009 and 2012 were analysed. To estimate the timing of repeated testing, Kaplan-Meier methods were used. Determinants for repeated testing (distinguishing testing at 12-month or smaller intervals and less than 12-monthly testing, with single testers as reference group) were identified using multivariate multinomial logistic regression analyses. In total, 19,479 consultations of 9174 HIV-negative MSM were identified. Of these MSM, 35% (95% CI 33% to 36%) were estimated to return to the STI clinic within 1 year following baseline consultation. Among 1767 men with at least two consultations and at least 2 years between baseline and last consultation, 43% tested repeatedly at 12-month or smaller intervals in those first 2 years. Repeated testers reported higher sexual risk behaviour (ie, only casual or both casual and steady sex partners, higher numbers of sex partners) at baseline compared with single testers. This effect tended to be slightly stronger for men testing repeatedly at 12-month or smaller intervals. The proportion of MSM testing for STI annually is low. MSM testing repeatedly had higher baseline levels of risk behaviour. Strategies to motivate MSM to test annually should be explored.

Sexual behavior and factors associated with young age at first intercourse and HPV vaccine uptake among young women in Germany: implications for HPV vaccination policies.

BackgroundIn Germany, immunization against human papillomaviruses (HPV) is free of charge for all females aged 12 to 17 years. Since HPV infection rates rise soon after first intercourse, immunization against HPV should be completed before sexual debut. Knowledge of country-specific data on age at first intercourse and related risk factors is important to optimize prevention of HPV and other sexually transmitted infections. Therefore, the primary aim of this study was to describe sexual behavior in young women in Germany. Secondary aims were to identify factors that are (i) associated with younger age at first intercourse and (ii) with HPV vaccine uptake.MethodsBetween 2010 and 2012, we conducted a cross-sectional study among randomly selected women aged 20 to 25 years in Germany. We used a structured, self-administered questionnaire to collect sociodemographic data, information on sexual habits such as age at first intercourse, and information on HPV vaccine uptake. We used univariate and multivariate logistic regression analyses to identify factors associated with younger age at first intercourse and with HPV vaccine uptake.ResultsA total of 823 women (response rate: 14.2%) participated, 785 (95.4%) of which reported having had intercourse already. 70% of these women experienced first intercourse before the age of 18 years. However, less than 5% were younger than 14 years at sexual debut. Younger age at first intercourse was independently associated with a higher number of sexual partners, smoking, and past pregnancies. HPV vaccine uptake was associated with higher education, whereas smoking and a migrant background reduced the chance of being vaccinated.ConclusionIn Germany, only a small proportion of women experienced first intercourse before the age of 14 years. Younger age at first intercourse was associated with behavior that might increase the risk of HPV infections or other sexually transmitted infections. Therefore, to optimize the HPV vaccination strategy, HPV vaccination series should be completed before the age of 14 years in Germany.

Methodological challenges in collecting social and behavioural data regarding the HIV epidemic among gay and other men who have sex with men in Australia.

BackgroundBehavioural surveillance and research among gay and other men who have sex with men (GMSM) commonly relies on non-random recruitment approaches. Methodological challenges limit their ability to accurately represent the population of adult GMSM. We compared the social and behavioural profiles of GMSM recruited via venue-based, online, and respondent-driven sampling (RDS) and discussed their utility for behavioural surveillance.MethodsData from four studies were selected to reflect each recruitment method. We compared demographic characteristics and the prevalence of key indicators including sexual and HIV testing practices obtained from samples recruited through different methods, and population estimates from respondent-driven sampling partition analysis.ResultsOverall, the socio-demographic profile of GMSM was similar across samples, with some differences observed in age and sexual identification. Men recruited through time-location sampling appeared more connected to the gay community, reported a greater number of sexual partners, but engaged in less unprotected anal intercourse with regular (UAIR) or casual partners (UAIC). The RDS sample overestimated the proportion of HIV-positive men and appeared to recruit men with an overall higher number of sexual partners. A single-website survey recruited a sample with characteristics which differed considerably from the population estimates with regards to age, ethnically diversity and behaviour. Data acquired through time-location sampling underestimated the rates of UAIR and UAIC, while RDS and online sampling both generated samples that underestimated UAIR. Simulated composite samples combining recruits from time-location and multi-website online sampling may produce characteristics more consistent with the population estimates, particularly with regards to sexual practices.ConclusionRespondent-driven sampling produced the sample that was most consistent to population estimates, but this methodology is complex and logistically demanding. Time-location and online recruitment are more cost-effective and easier to implement; using these approaches in combination may offer the potential to recruit a more representative sample of GMSM.

Sexual Practices of Female Sex Workers Who Inject Drugs in Osogbo, Nigeria.

Female sex workers (FSWs) who inject drugs have higher risks of HIV infection due to injection drug use and the array of sexual practices employed. This study, therefore, is designed to determine sexual practices of FSWs who inject drug in Osogbo, Nigeria. This study was a cross-sectional descriptive mixed-methods design. Twenty-seven FSWs who inject drug were selected from 11 brothels by snowball sampling and interviewed with a semistructured questionnaire and in-depth interview guide. The mean age of respondents was 26.2 ± 7.5. Many of the respondents were aware of the magnitude of HIV and some were sex workers first before turning to be drug users. Some of the respondents had ever tested for HIV and few had ever been treated for STI more than once. Some respondents were willing to have male clients who do not wear a condom in exchange for accepting more money in return. Many of the respondents reported use of condom, regular talking of herbs, and good personal hygiene as ways of protecting themselves from HIV. Respondents have relatively high numbers of sexual partners. Involving sex workers directly in HIV prevention campaigns will encourage them to look after their health and to access services that could help them.

Identification of verocytotoxin-producing Escherichia coli O117:H7 in men who have sex with men, England, November 2013 to August 2014.

Between November 2013 and August 2014, nine cases of verocytotoxin-producing Escherichia coli O117:H7 VT1 were confirmed in adult men. Further investigation using semi-structured interviews revealed that eight cases were United Kingdom (UK)-born men who have sex with men (MSM) who had sexually acquired infection in the UK. Most were HIV-positive with high numbers of sexual partners. This behavioural profile resembles that associated with the recent rapid increase in other sexually acquired infections in MSM.

Prescription Drug Misuse and Sexual Risk Behaviors Among Young Men Who have Sex with Men (YMSM) in Philadelphia.

This study examined the relationship between prescription drug misuse and sexual risk behaviors (i.e. unprotected sex, increased number of sex partners) in a sample of young men who have sex with men (YMSM) in Philadelphia. Data come from a cross-sectional study of 18-29 year old YMSM (N = 191) who misused prescription drugs in the past 6 months. Associations were investigated in two regression models: logistic models for unprotected anal intercourse (UAI) and zero-truncated Poisson regression model for number of sex partners. Of 177 participants engaging in anal intercourse in the past 6 months, 57.6 % engaged in UAI. After adjusting for socio-demographic variables and illicit drug use, misuse of prescription pain pills and muscle relaxants remained significantly associated with engaging in receptive UAI. No prescription drug class was associated with a high number of sex partners. This study provides additional evidence that some prescription drugs are associated with sexual risk behaviors among YMSM.

The influence of pornography on sexual scripts and hooking up among emerging adults in college.

The explosive growth in access to the Internet has led to a commensurate increase in the availability, anonymity, and affordability of pornography. An emerging body of research has shown associations between pornography and certain behaviors and attitudes; yet, how pornography actually influences these outcomes has not been documented. In two studies (Study 1N=969; Study 2N=992) we examined the hypothesis that pornography influences potentially risky sexual behavior (hooking up) among emerging adults via sexual scripts. Our results demonstrate that more frequent viewing of pornography is associated with a higher incidence of hooking up and a higher number of unique hook up partners. We replicated these effects both cross-sectionally and longitudinally while accounting for the stability of hook ups over the course of an academic semester. We also demonstrated that more frequent viewing of pornography is associated with having had more previous sexual partners of all types, more one occasion sexual partners ("one night stands"), and plans to have a higher number of sexual partners in the future. Finally, we provided evidence that more permissive sexual scripts mediated the association between more frequent pornography viewing and hooking up. We discuss these findings with an eye toward mitigating potential personal and public health risks among emerging adults.

SIFILIS SECUNDÁRIA – CORRELAÇÃO CLÍNICO PATOLÓGICA

Introdução: Nos últimos anos tem-se verificado um ressurgimento da sífilis. A infecção pelo Treponema pallidum encontra-se sobretudo associada ao uso inconsistente do preservativo e ao elevado número de parceiros sexuais nos meses que precedem o diagnóstico. Na sequência do aumento do número de casos diagnosticados, torna-se premente uma maior sensibilização das características clínico-patológicas da doença. Este artigo descreve e correlaciona as características clínicas e histopatológicas de sífilis secundária em 7 doentes observados no Serviço de Dermatologia do Hospital Santa Maria, em Lisboa, Portugal.Material e Métodos: Foram estudadas nove biópsias de lesões mucocutâneas de sete doentes com sífilis secundária, observados entre 2009 e 2013, tendo sido correlacionados os achados histopatológicos com os achados clínicos.Resultados: O presente estudo revelou um largo espectro de alterações histopatológicas que variam desde um infiltrado inflamatório com localização à derme superficial até uma extensão perivascular na derme profunda. Apesar de se verificar alguma correlação entre os diversos padrões de inflamação e o tipo de lesões cutâneas, as lesões maculares associaram-se com um infiltrado inflamatório superficial enquanto as lesões papulares, maculopapulares e nodulares se associaram a um processo inflamatório profundo. O tipo de célula predominante no infiltrado foi o plasmócito. Os neutrófilos foram observados apenas num caso de condylomata lata.Conclusões: As características histopatológicas de sífilis secundária parecem ser tão variadas como as características clínicas. É da responsabilidade dos profissionais que lidam com estes doentes estarem particularmente atentos à grande variedade semiológica desta patologia, lembrarem-se de o colocar como hipótese diagnóstica clínica e estarem conscientes da necessidade de estabelecer uma estreita interacção com os dermatopatologistas. A colaboração entre patologistas e clínicos permite uma correlação da clínica, serologias e achados histopatológicos de forma a estabelecer mais plausivelmente o diagnóstico de sífilis.

Review of the current knowledge on the epidemiology, pathogenesis, and prevention of human papillomavirus infection

Human papillomavirus (HPV) infection is a central and necessary, although not sufficient, cause of cervical cancer. Besides HPV, the additional multiple risk factors related with the onset of cervical cancer are early-age sexual activities; high number of sexual partners, which is the most salient risk factor; suppression and alteration of the immune status; long-term use of oral contraceptives; and other hormonal influences. The tumor-suppressor proteins p53 and pRb are degraded and destabilized through ubiquitination by viral oncoproteins E6 and E7. Over 95% of cervical cancer cases worldwide test positive for oncogenic HPV DNA. Although cervical screening procedures have been successful in reducing the disease burden associated with HPV infection because of lack of resources or inadequate infrastructure many countries have failed to reduce cervical cancer mortality. Therefore, prevention may be a valuable strategy for reducing the economic and disease burden of HPV infection. At present, two successful prophylactic HPV vaccines are available, quadrivalent (HPV16/18/6/11) 'Gardasil' and bivalent (HPV16/18) 'Cervarix' for vaccinating young adolescent girls at or before the onset of puberty. Recent data indicate that vaccination prevents the development of cervical lesions in women who have not already acquired the vaccine-specific HPV types. Moreover, several therapeutic vaccines that are protein/peptide-based, DNA-based, or cell-based are in clinical trials but are yet to establish their efficacy; these vaccines are likely to provide important future health benefits. The therapeutic vaccination mode of prevention is a promising area of research, as revealed in preclinical trials; however, clinical trials based on large populations are warranted before reaching a valid conclusion. This review summarizes the studies on the epidemiology of HPV infection, the pathogenesis of viral oncoproteins in the oncogenesis of cervical cancer, the economic and health burden of HPV-related diseases, and, finally, focuses on the results of recent clinical vaccination trials.

Current medical researchSummer-Fall 2013.

Based on ongoing evidence that there is a high rate of sexual activity and unplanned pregnancies among young adults and adolescents, researchers set out to assess the knowledge of family planning methods among this population (Sokkay et al. 2013). Participants were 10–24 years of age and were recruited as they presented to four pediatric clinics located in Houston, Louisville, St. Louis, and Toronto (for those under the age of 18 years, a signed parental consent form was required). The participants were provided a 23-item true/ false survey to assess their knowledge of the efficacy, side effects, and misconceptions regarding the most common family planning methods including abstinence and natural family planning (NFP) (i.e., referred to as “Rhythm” in the article). The four clinic sites yielded 354 completed surveys that represented a mean age of 16.2 (SD = 2.9) years for the participants, of which 39.6 percent reported being sexually active, 65.8 percent indicated using some form of contraception in the past, and only 2 percent having ever been pregnant. The major finding was that 55.8 percent (SD = 17.7%) was the mean correct score of the participants with progressively higher scores with increased age, sexual activity, and higher number of sexual partners. Participants were least likely to have knowledge of contraceptive implants (18%), NFP/Rhythm (28%) and the intrauterine device (IUD) (32%). Most (97%) were familiar with the hormonal pill and with condoms (92%). Significantly higher scores were noted among those who sought information on contraception through the internet and who were familiar with abstinence. A conclusion was that adolescents and young adults need more education on methods of contraception and in particular what are now called longacting reversible contraceptives (LARC), i.e., the IUD and hormonal implants.