High-risk Sexual Behavior Research Articles

Simultaneous Alcohol and Cannabis Use and High-Risk Sexual Behaviors.

Alcohol and cannabis use rates are highest in college-aged young adults, and both alcohol and cannabis use are independently related to high-risk sexual behaviors (HRSBs). HRSBs (e.g., sex without protection against sexually transmitted infections) are a prevalent public health problem in college students, with little research examining simultaneous alcohol and cannabis use (i.e., using both alcohol and cannabis at the same time so the effects overlap) and HRSBs. We examined simultaneous alcohol and cannabis-related HRSB frequency, gender differences in simultaneous alcohol and cannabis-related HRSBs, and differences in HRSBs between simultaneous and non-simultaneous users. Alcohol and cannabis using college students (N = 534; Average Age = 19; 66.9% reported identifying as female) were recruited through a psychology department's human subjects research pool and completed a one-time, online, self-report survey. One-third of participants engaged in simultaneous alcohol and cannabis use prior to sexual intercourse in the past 3 months. Additionally, over one-third of participants reported heavy drinking (4/5 or more drinks for women/men) simultaneously with cannabis use prior to sexual intercourse in the past 3 months. Simultaneous alcohol and cannabis use was significantly and positively related to sexual intercourse after simultaneous use and after heavy drinking simultaneously with cannabis use. Past year simultaneous alcohol and cannabis users, relative to non-simultaneous users, reported increased incidents of sex without protection against sexually transmitted infections. No gender differences in simultaneous alcohol and cannabis-related HRSBs were found. Future research should continue examining simultaneous alcohol and cannabis use and HRSBs.

Mpox Outbreak 2022: A Comparative Analysis of the Characteristics of Individuals Receiving MVA-BN Vaccination and People Diagnosed with Mpox Infection in Milan, Italy.

Mpox caused a worldwide outbreak in 2022, disproportionately affecting MSM reporting high-risk sexual behaviors. The aim of this study was to compare the characteristics of people receiving MVA-BN vaccination with those of individuals diagnosed with mpox to guide future vaccination policies. This was a retrospective study on people with mpox infection or vaccination at San Raffaele Scientific Institute, Milan, Italy, from May to November 2022. Characteristics were compared using Mann-Whitney or chi-square/Fisher's exact tests; multivariable logistic regression and classification tree analysis were applied. Overall, 473 vaccinated individuals and 135 with mpox were included; 472/473 and 134/135 were MSM. People with mpox were more frequently living with HIV (48.9% vs. 22.4%, p < 0.001), had ≥1 previous STI (75.6% vs. 35.7%, p < 0.001), were chemsex users (37.8% vs. 6.34%, p < 0.001), were with a higher number of partners (23.0% vs. 1.69%, p < 0.001), and had engaged in group sex (55.6% vs. 24.1%, p < 0.001). At multivariable analysis, PLWH (aOR = 2.86, 95%CI = 1.59-5.19, p < 0.001), chemsex users (aOR = 2.96, 95%CI = 1.52-5.79, p = 0.001), those with previous syphilis (aOR = 4.11, 95%CI = 2.22-7.72, p < 0.001), and those with >10 partners (aOR = 11.56, 95%CI = 6.60-21.09, p < 0.001) had a higher risk of infection. This study underscores the importance of prioritizing MSM with prior STIs and multiple partners as well as chemsex users in vaccination policies to curb mpox spread. A destigmatized assessment of sexual history is vital for comprehensive sexual health strategies.

Sexualised drug use and chemsex in Italy: A questionnaire study based on a cohort of clients attending a STI outpatient service in Milan.

Chemsex is a heterogeneous phenomenon with differences in distribution, setting, motivations and type of substances consumed between countries. The lack of data at national level of the Italian situation creates a perception of reduced need for intervention. Anonymous paper questionnaires were distributed to patients who had registered themselves at the STI Department IRCCS Ca' Granda Policlinico in Milan. A significant association was demonstrated between use of sexualised drugs, chemsex and the following variables: (1). Number of partners: in the group of clients with more than five partners, sexualised drug users were more than twice compared with those in the group with less than five partners (35.2% vs 16.2%) p<0.0001. (2). Use of dating apps: more than one out of two persons who used drugs during sex affirmed looking for partners on internet, p = 0.0059. (3). Low condom uses with occasional partners: percentage of individuals who declared not to use condoms or devices during their sexual encounters with occasional partners is more than twice as high in the sexualised drug users group with respect to controls (44.6% vs 21.4%); p = 0.0006). (4). Use of post exposure prophylaxis (PEP): among the PEP users, more than half participants belonged to the sexualised drug users' group; p = 0.0021. Sexualised drug use and chemsex are frequently practiced in Milan. This survey identified a specific population with higher-risk sexual behaviours and increased incidence of acute bacterial STIs.

Sexual Dysfunctions and High-Risk Sexual Behaviors in Women with Severe Psychiatric Disorders

Background: Sexual Dysfunctions (SDs) and High-Risk Sexual Behaviors (HRSBs) are highly prevalent and substantial issues among patients with severe psychiatric disorders. However, studies exploring them are still infrequent. This study was conducted to evaluate SDs and HRSBs in women with severe psychiatric disorders.&#x0D; Methods: Female inpatients and outpatients of the Iran Psychiatry Hospital were selected if they were 18-60 years old, able to read, and diagnosed with schizophrenia, schizoaffective disorder, or type one Bipolar Disorder (B1D). After the initial interviews, the outcomes were assessed using the Female Sexual Function Index (FSFI), Youth Risk Behavior Surveillance System (YRBSS), and Sexual Risk Survey (SRS) questionnaires.&#x0D; Results: The mean (standard deviation) age of the 159 patients was 36.9 (10.1). B1D, schizophrenia, and schizoaffective disorder were diagnosed in 98, 53, and eight patients, respectively. FSFI evaluations demonstrated that several SDs, including pain and decreased sexual desire, are highly prevalent in them. Based on the results of YRBSS and SRS evaluations, the most predominant HRSBs were sexual behaviors without leading to complete intercourse, having sex without a barrier or effective contraception, using alcohol and drugs before sex, and impulsive sexual intercourse with inadequately known partners.&#x0D; Conclusion: All evaluated SDs had a high prevalence attributable to the pathophysiology of severe psychiatric disorders and related medications. HRSBs were also widespread due to impaired judgment, poor knowledge, or sexual characteristics of the disorders. These results support the need for further educating these patients concerning safe sexual behaviors and interactions of contraceptive medications with specific psychiatric medicines, including carbamazepine and sodium valproate.

IMPROVING REPRODUCTIVE HEALTH KNOWLEDGE THROUGH THE RESSIK PROGRAM (HEALTHY REPRODUCTION FOR STUDENTS WITHOUT ILLNESSES) AT PUBLIC SENIOR HIGH SCHOOL 2 MALANG

Reproductive health information for adolescent students is still considered taboo and has not yet been included in the school curriculum. A good understanding of adolescent reproductive health is crucial because adolescents are expected to have responsible attitudes and behaviors regarding the reproductive process. The high-risk sexual behaviors among adolescents are due to a lack of accurate knowledge about reproductive health and sexually transmitted diseases. This activity aims to enhance the knowledge of high school adolescents regarding reproductive health. The activity was held in November 2021 at Public Senior High School 2 Malang, involving male and female students. The activity was conducted through health education, discussions, and demonstrations about reproductive health. The chosen media for delivery were audiovisual materials (PowerPoint presentations and videos). Evaluation was carried out using pre-test and post-test questionnaires related to knowledge. The complete questionnaires underwent data analysis. The data analysis results from the participants, with a total of 218 respondents who thoroughly answered the provided questions, showed that the majority of participants were female (71%), aged 16 years (49.1%), from 10th grade (54.6%), enrolled in the science stream (66.6%), and had previously received information about reproductive health (77.1%). Furthermore, a significant difference in reproductive health knowledge scores was found among male students (p-value 0.000), while for female students, the difference was not significant (p-value 0.892). In conclusion, audiovisual educational media effectively enhances reproductive health knowledge.

Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs

BackgroundMany people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of these services. This study aimed to determine the levels of double counting of clients of harm reduction services, including needle and syringe programs, condom distribution, HIV testing and counseling, and methadone maintenance in five cities in Iran.MethodsBetween September and March 2020, our study included 1630 clients, 115 staff of harm reduction centers, and 30 experts in the field of harm reduction in five cities in Iran. Clients of harm reduction services were asked about using harm reduction services multiple times at the same center or at different centers in the last year using different identities. Estimates of double counting derived from client responses were validated by panels of center staff and experts in harm reduction.ResultsSynthesizing data from clients, staff, and experts, the final estimates of double counting of clients using harm reduction services were: HIV testing 10% (95% confidence interval [CI] 0–15), needle and syringe programs 17% (95% CI 8.5–20), condom distribution programs 13% (95% CI 3–19), HIV/STI counseling 10% (95% CI 0–16), and methadone maintenance 7% (95% CI 2–10).ConclusionDouble counting of clients in harm reduction services in Iran is substantial. Data on clients reach by harm reduction services need to be corrected for double counting to improve program planning, client population size estimation, and efficient resource allocation.

Application of machine learning for risky sexual behavior interventions among factory workers in China.

Assessing the likelihood of engaging in high-risk sexual behavior can assist in delivering tailored educational interventions. The objective of this study was to identify the most effective algorithm and assess high-risk sexual behaviors within the last six months through the utilization of machine-learning models. The survey conducted in the Longhua District CDC, Shenzhen, involved 2023 participants who were employees of 16 different factories. The data was collected through questionnaires administered between October 2019 and November 2019. We evaluated the model's overall predictive classification performance using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. All analyses were performed using the open-source Python version 3.9.12. About a quarter of the factory workers had engaged in risky sexual behavior in the past 6 months. Most of them were Han Chinese (84.53%), hukou in foreign provinces (85.12%), or rural areas (83.19%), with junior high school education (55.37%), personal monthly income between RMB3,000 (US$417.54) and RMB4,999 (US$695.76; 64.71%), and were workers (80.67%). The random forest model (RF) outperformed all other models in assessing risky sexual behavior in the past 6 months and provided acceptable performance (accuracy 78%; sensitivity 11%; specificity 98%; PPV 63%; ROC 84%). Machine learning has aided in evaluating risky sexual behavior within the last six months. Our assessment models can be integrated into government or public health departments to guide sexual health promotion and follow-up services.

Sexual behavior and self-declaration of sexual orientation among people 18–64 years in Brazil: results from the Knowledge, Attitudes, and Practices survey, 2013 and the National Health Survey, 2019

BackgroundPopulation surveys involving the monitoring of high-risk sexual behavior have been recognized as important public health tools to control the HIV epidemic and other sexually transmitted infections (STIs).MethodsUsing data from the Knowledge, Attitudes, and Practices survey (PCAP-2013) and from the National Health Survey (PNS-2019), indicators of sexual behavior were compared according to sociodemographic characteristics among individuals aged 18–64 years, including size (%) estimates of men who have sex with men (MSM) and women who have sex with women (WSW). Specifically, the PNS-2019 prevalence estimates of homosexual, bisexual, heterosexual males and females were compared with those from the PCAP-2013. To compare PCAP and PNS proportional distributions, the Pearson's chi-square test, adjusted by the Rao-Scott’s correction, was applied.ResultsSize (%) estimates of MSM and WSW obtained by direct questions from the PCAP-2013, showed higher homosexuality prevalence estimates than those resulting from the PNS-2019 self-declared sexual orientation. Significant differences were found between the MSM proportions according to the PCAP-2013 (3.7%; 95% CI 3.1–4.4%) and to the PNS-2019 (2.2%; 95% CI 1.9–2.5), and between the WSW proportions (4.6%; 95% CI 4.0–5.4%) and (2.1%; 95% CI 1.8–2.4), respectively. Results from both surveys showed MSM and WSW prevalence estimates increase with educational level, decrease with age, and is larger among people who do not live with partner, live in urban areas and in state capitals. Regarding condom use at last sexual intercourse, no differences between the PCAP-2013 and the PNS-2019 estimates were found at the national level, but significant improvements were found for MSM, people aged 18–24 and 25–34 years, and individuals not living with a partner.ConclusionsThe underestimation of MSM and WSW prevalence by self-declared sexual orientation suggests that sexual minorities face many difficulties related to disclosing their sexuality and reinforces the importance of developing public health interventions for changing population attitudes and promoting sexual orientation disclosure. Moreover, the low use of condoms in both surveys (PCAP-2013 and PNS-2019) carried out 6 years apart highlights the need of public policies to expand prevention strategies for HIV infection and other STIs.

Relationship of psychological stress with oral health status in commercial sex workers in Makassar City

&#x0D; Background : Depression can have a negative influence on dental health and increase the chance of engaging in high-risk sexual behavior. This study aims to determine the relationship between psychological stress with oral health status in commercial sex workers in Makassar&#x0D; &#x0D; &#x0D; Methods : This study is an analytic observational study using a cross-sectional design, was conducted in January 2022. The population in this study was 36 commercial sex workers in Makassar City, using total sampling technique. Exclusion criteria consisted of commercial sex workers who experienced cognitive impairment and commercial sex workers who did not complete the questionnaire. Psychological distress status was assessed using the General Health Questions (GHQ), and Depression syndrome using DSM-IV criteria. Oral health status was assessed using OHI-S and DMF-T. &#x0D; &#x0D; &#x0D; Results : Based on the OHI-S score, the sample had an average value of 5.45 ± 6.70, the DMF-T index, the sample had an average value of 7.76 ± 5.18, the mental health score for psychological pressure had an average of 20.72 ± 8.46 and depressive symptoms had an average of 10.52 ± 6.86.&#x0D; &#x0D; &#x0D; Discussion : This study found a significant relationship between psychological stress with oral health status in commercial sex workers in Makassar. Sex workers often feel they do not need oral health services and most of the pressure is always on sexually transmitted infections (STIs)&#x0D; &#x0D; &#x0D; Conclussion : There is a significant relationship between psychological distress and depressive symptoms, with oral health status in commercial sex workers in Makassar City.&#x0D;

Recently acquired hepatitis C: Epidemiological characteristics and treatment response in a large cohort of MSM living with HIV in Madrid

IntroductionWe analyzed epidemiological, clinical characteristics, and the response to treatment in people living with HIV (PLHIV) who recently acquired hepatitis C (RAHC) in a multicentre study in Madrid (Spain). MethodsMulticenter, ambispective, observational study of RAHC in men who have sex with men (MSM) infected with HIV. Clinical, epidemiological, and RAHC evolution were recorded prospectively in 2019 and 2020 and retrospectively in 2017 and 2018. In patients who received HCV treatment, sustained virological response (SVR) was provided 12 weeks after the end of treatment in an intention to treat analysis (ITT): all treated patients were included; and in analysis per-protocol (PP): missing patients were excluded. ResultsOverall, 133 patients were included. Median (IQR) age was 40 (34.3–46.1) years, 90.9% had at least one previous sexual transmission disease (STD), and 33.6% had previously hepatitis C. More than half of the prospective sample included patients using chemsex related drugs (57.3%), 45.7% of them intravenously. The most prevalent genotype was G1a (66.2%), followed by G4 (11.3%). Ten of 90 patients evaluated for spontaneous cure (11%) cured the infection spontaneously, and 119 had treatment after a median time of 1.8 (0.7–4.6) months: sustained virological response (SVR) was achieved in 90.7% in the ITT and 94.7% in the PP analysis, with no differences regarding the direct-acting antiviral agents (DAA) combination used. ConclusionsMSM infected by HIV with a RAHC were exposed to high-risk sexual behavior. Spontaneous cure rate was low, while SVR after treatment was achieved by more than 90%.

Influence of Educational Videos on Knowledge and Attitude on Reproduktive Health in Adolescent

Aims: Reproductive health education is essential to improve knowledge and attitude to grow up and live healthily. Audiovisual media as teaching method is considered as effective way to deliver message and material for health topic in teenager. It was reported that 10-14 years-old adolescent in Jakarta has reached 874,865 people in 2020. High populated of adolescent increased higher-risk sexual behavior. Sexual and reproductive education aims to increase knowledge about the anatomy and physiology of the organs and also improve attitude to avoid high-risk sex behavior. Objective: We aim to observe the effect of educational videos on the knowledge and attitudes of adolescents about reproductive health. Method: Quasi-experimental research with pre and post-test without control group. Research sample was 100 students of 231 Junior School Jakarta using systematic random sampling. Intervention was educational videos about healthy sex behavior. Result: We found significantly increased average knowledge (15,91 vs 23,24, p= 0,0001) and attitude (34,12 vs 43,26, p= 0,0001) score after the intervention. Conclusion: There was an significant diffrence of adolescents' knowledge and attitudes about reproductive health after educational video interventions. School and teacher play an active role in reproductive health counseling activities for adolescents with the right media.

The Extent to which student “Gold Rush” contributes to sexual risky Behaviour amongst students in the spread of HIV/AIDS in higher institutions of learning: A case of Kwame Nkrumah University in Kabwe, Zambia

Transactional sex is very common in institutions of higher learning and has continued to influence high sexual risky behaviours amongst students in Zambian. The terminology that is commonly associated with transactional sex is “gold rush,” a situation where returning students in an institutional of higher learning negotiate for relationships with new students often times with the female first year’s students. The transaction takes place as the senior students negotiate for sexual favours in return for help in terms of money, answering assignments, protection from bullying and other forms of assistance. During transactional sex, there is high sexual risk behaviour as most of the time there is unsafe sex being practiced thereby leading to a high possibility of spreading HIV/AIDS pandemic and other sexually transmitted infections. The study aimed at exploring the vulnerability of students during gold rush. In its approach, the study used a mixed research methodological design. The findings of the study showed that there was high risky sexual behaviours between returning students and the first year’s students on campus leading to high risk exposure to the spread of HIV/AIDS and other related complications. It was recommended that enough sensitizations and well-coordinated awareness programs be engaged in order to mitigate the levels of vulnerability especially amongst female new students who reported on campus.

Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B-coinfected adults in care in the United States.

Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross-sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log-binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody-positivity associated with determinants of interest (age, injection drug use [IDU], high-risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%-5.6%) were HDV IgG antibody-positive, and 10/596 (1.7%; 95% CI, 0.6%-2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09-5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody-positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.

Survey of the Relationship between Age of Smoking Onset and Risk-Taking Behaviors among University Students: A Web-Based Study

Background. Smoking at a younger age puts people at greater risk for health damage. This study aimed to investigate the relationship between the age of smoking onset and high-risk behaviors such as smoking, alcohol consumption, substance abuse, and high-risk sexual behavior among university students in Tabriz, Iran. Methods. This web-based, cross-sectional study was conducted in Tabriz, Iran, in 2019. A total of 3,649 students were included in the study according to the proportion of students in each university. The required information was collected through an online questionnaire. Logistic regression analysis was used to assess the relationship between the age of smoking onset and high-risk behaviors. Results. The mean (standard deviation) age of the participants in the study was 22.85 (3.66) years old, and 55.7% were boys. The findings of the study indicate that students who initiated smoking at the age of 16 or younger exhibited higher likelihoods of alcohol consumption over the previous 30 days (OR= 1.77, CI 95%: 1.20 - 2.62) and participation in unsafe sexual practices (OR= 1.54, CI 95%: 1.06 - 2.26) compared to their non-smoking counterparts. Conclusion. Early smoking onset is associated with high-risk behaviors. The age of onset of smoking should be considered as one of the factors associated with high-risk behaviors, and smoking prevention programs should be started from adolescence.

Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation.

Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].

Exposure to prevention information, sexual health, and experience of discrimination: HIV exploration among high-risk populations in Vietnam

Context: HIV/AIDS has been a major public health concern worldwide, yet research on high-risk populations in Vietnam has paid little attention to prevention information, sexual behaviors, and discrimination. Aims: To investigate the above-mentioned groups’ exposure to prevention information, sexual health, and experiences of discrimination. Methods: The cross-sectional paper-based survey focusing on HIV-related risk behaviors, testing, and access to health services was administered to participants recruited through two-stage sampling in southern Vietnam. The questionnaire consisted of four sections, including sociodemographic characteristics, sexual behaviors, access to preventive information, and discrimination experience. Results: Among the 173 participants, approximately 60% identified as lesbian/gay/bisexual/transgender, with 51.4% reporting they had a potential risk of HIV acquisition and 85% engaging in high-risk sexual behaviors. Television was the most popular source of information on HIV prevention. The most common unsafe behavior among respondents was non-condom use during sex (72% in males and 25% in females), followed by drug use (41% in males and 7.4% in females). Significant disparities were identified in STI diagnosis, treatment, and HIV testing rates among sociodemographic groups (such as orientation, education, occupation, monthly income, and financial vulnerability). Discrimination experiences were also associated with different sociodemographic characteristics (such as men who have sex with men orientation, occupation, and engagement in high-risk sexual behaviors). Conclusions: Policymakers can allocate financial resources and support evidence-based interventions to address the HIV epidemic among high-risk populations in Vietnam, including educational campaigns on television, healthcare provider training programs, and stigma reduction efforts.

Improving chlamydia risk screening by using the CDC's 5 Ps approach to sexual health history at a large military base in North Carolina.

Chlamydia trachomatis is infecting service members (SMs) at a rate of two to three times that of the U.S. population. Currently, the military only screens female SMs under the age of 25 years, leaving many at-risk males to go undetected leading to further transmission. Service members are not routinely assessed for high-risk sexual activities, leading to increased chlamydia rate in Fort Bragg. At the primary care project site, screening was only done per HEDIS measure leading to only 5% STI positivity rate. The purpose of this project was to identify and screen SMs who are at high risk for chlamydia using the CDC's 5 Ps approach. This project took place at a large primary care clinic that only cared for active-duty soldiers over a 3-month period. The CDC's 5 Ps questionnaire was administered to SMs 30 years and younger during routine appointments. The SMs deemed high risk from the questionnaire were screened using urine G/C NAAT testing. Four hundred forty-nine SMs were assessed using the CDC's 5 Ps approach. The questionnaire identified 91 SMs (20%) at higher risk for STIs. Of the 45 urine samples submitted, six were positive for STIs. Of the six positive cases, five were male. Targeted screening resulted in 13.3% positive rate compared with the 5% in the current practice. The result suggests that targeted screening of young males and females can identify high-risk sexual behaviors leading to increased findings of asymptomatic chlamydia carriers, ultimately leading to decreased chlamydia incidence.

Adverse childhood experiences and clustering of high-risk behaviors among high school students: a cross-sectional study

ObjectivesThis study assessed the association between adverse childhood experiences (ACEs) and clustering of high-risk behaviors in a sample of high school students. Study designThis was a cross-sectional study. MethodsA sample of students who attended randomly selected classes in 99 high schools completed the 2019 Nevada Youth Risk Behavior Survey (N = 4959). The survey included six ACE measures: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) household physical abuse, (5) household mental illness, and (6) household substance abuse. Students were assigned a cumulative ACE score (range = 0–6). A count of high-risk behavior domains was created using multiple questions across the following domains: (1) violence behaviors, (2) suicidal indicators, (3) non-suicidal self-injury, (4) substance use, (5) high-risk sexual behaviors, (6) poor diet, (7) physical inactivity, and (8) high screen time (range = 0–8). The relationship between ACEs and the count of high-risk behavior domains was assessed using weighted negative binomial regression; incidence rate ratios (IRRs) were calculated adjusting for sociodemographic characteristics. ResultsMore than 40% of the sampled students reported high-risk behaviors across two or more domains. There was a strong, graded relationship between cumulative ACE score and the count of high-risk behavior domains. Compared with students who experienced zero ACEs, there was an increase in the count of high-risk behavior domains among students who experienced one ACE (adjusted IRR [aIRR] = 1.22, 95% confidence interval [CI] = 1.12–1.33), two ACEs (aIRR = 1.57, 95% CI = 1.42–1.73), three ACEs (aIRR = 1.73, 95% CI = 1.54–1.94), four ACEs (aIRR = 2.07, 95% CI = 1.84–2.33), five ACEs (aIRR = 2.69, 95% CI = 2.34–3.10), and six ACEs (aIRR = 2.91, 95% CI = 2.34–3.62). ConclusionTrauma-informed prevention efforts may be an efficient way to address multiple adolescent risk behaviors that cluster.

Mpox Incidence and Vaccine Uptake in Men Who Have Sex with Men and Are Living with HIV in Denmark.

(1) Background: Here, we investigate the incidence of mpox and factors associated with vaccine uptake in mainly well-treated men who have sex with men and are living with HIV (MSMWH). (2) Methods: This study included 727 MSMWH from the Copenhagen co-morbidity in HIV infection (COCOMO) study from 1 May to 31 October 2022. Mpox infection and vaccination status were obtained from the Danish Microbiology Database and The Danish Vaccination Register. Vaccination willingness was assessed through an online survey. (3) Results: At a median follow-up of 180 days, 13 (1.8%) participants had laboratory-confirmed mpox infections. Furthermore, 238 (32.7%) had received the mpox vaccine. A sexually transmitted disease (STD) in the preceding two years was associated with a higher risk of mpox infection (hazard ratio 7.1; 95% confidence interval (CI) [1.9-26.9]) and with higher odds of vaccination (adjusted odds ratio 3.1; 95% CI [2.2-4.6]). 401 (55.2%) participants responded to the survey. 228 (57.0%) reported very high vaccination willingness. The self-perceived risk of infection was associated with vaccine uptake. (4) Conclusions: The incidence of mpox was low. A prior STD was associated with both a higher risk of mpox infection and higher odds of vaccination. Despite high-risk sexual behavior and high vaccination willingness, a sizable fraction of participants had not been vaccinated.

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.