Measures Of Sexual Behavior Research Articles

What Chemsex does to the brain - neural correlates (ERP) regarding decision making, impulsivity and hypersexuality.

Chemsex describes the use of specific substances (methamphetamine, GHB/GBL, mephedrone, ketamine) which initiate or enhance sexual experiences and is mainly prevalent among men who have sex with men. Many Chemsex users experience somatic complications (for example sexually transmitted diseases) and sometimes adverse sociological, psychological, and neurological symptoms, such as depression, impulse control disorders or hypersexuality. Changes in impulsivity and deficits in executive functions have demonstrated to be associated with addiction and impulse control disorders as well as frontal brain dysfunction and behavioral control deficits. This study aims to explore the effects of neurophysiological correlates of inhibition and decision making in Chemsex users with an EEG paradigm using event-related potentials (N2, P3). 15 Chemsex users and 14 matched control subjects, all of them men who have sex with man, participated in an auditory Go/NoGo/Voluntary Selection EEG paradigm. In addition, clinical data (e.g. regarding depression), demographic information as well as measures of well-being and sexual behavior were collected. The results demonstrated that clinical symptoms, hypersexuality, and sexual risk behavior were more pronounced in Chemsex users compared to non-users. P3 amplitudes did not differ significantly between groups. However, the Chemsex users showed decreased electrophysiological N2 responses in fronto-central brain regions during decision-making, indicating compromised executive function and inhibitory control. The observed impairments may lead to increased risk behavior regarding drug abuse and hypersexuality. Understanding the neurobiological mechanisms can contribute to targeted interventions in order to mitigate the negative consequences of engaging in Chemsex and improve general well-being.

Strategies to develop an LGBTQIA+-inclusive adolescent sexual health program evaluation.

Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum. To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies. We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures. Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations.

Application of the sexual therapy combined with vacuum negative pressure hydropneumatic/pneumatic bubble massage in primary intravaginal anejaculation.

Primary intravaginal anejaculation (PIAJ) is a relatively uncommon male sexual dysfunction characterized by an inability to achieve intravaginal ejaculation during all sexualintercourse. Effective treatment optionsfor this condition are lacking.We aimed to explore the clinical effect of the sexual therapy combined with vacuum negative pressure hydropneumatic/pneumatic bubble massage (VNPHP/PBM) on primary intravaginal anejaculation, and its possible mechanism. A total of 95 PIAJ patients were randomly divided into three groups, including group A with 32 patients treated with the sexual therapy combined with VNPHP/PBM, group B with 32 patients treated with the sexual therapy and group C with 31 patients treated with VNPHP/PBM. The efficacy of therapeutic regimes, latency of the somatosensory evoked potentials of dorsal nerve (DNSEP), glans penis (GPSEP) and penile shaft sensory threshold (PSST), measures of sexual behavior of patients, as well as the self-rating anxiety scale (SAS) sores of patients and their partners, were compared before and after treatment amongthree groups. The total effective rate of group A (84.38%) was higher than those of groups B and C (53.13% and 41.94%), however, no differences were found between groups B and C. The ratios of patients and their partners with anxiety, frequency of observing erotic films of patients, ratios of patients with special self-masturbation and frequency of masturbation decreased significantly in the three groups after the treatment. The decreasein the ratios of patients and their partners with anxiety, frequency of observing erotic films of patients in groups A and B were higher than those of group C, however, no differences were identified between groups A and B. The decreasein the ratios of patients with special self-masturbation and frequency of masturbation in group A were higher than those of group B, however, no differences were found between groups A and C, B and C. There were no differences in the latency of DNSEP, GPSEP, and PSST among the three groups before and after treatment. The sexual therapy combined with VNPHP/PBM has good therapeutic effects on PIAJ, which might be achieved by reducing the anxietylevel of patients and their partners,improving sexual behavioral patterns, rather than increasing the sensitivity of penis including dorsal nerve and glans penis.

Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data

ABSTRACT Sexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices. Trial registration: ClinicalTrials.gov identifier: NCT04437667.

Knowledge and Attitudes of Medical and Nursing Students in a Greek University Regarding Sexually Transmitted Diseases.

the present study aimed to assess the knowledge and attitudes of medical and nursing students at the University of Patras, western Greece, regarding sexually transmitted infections (STIs), sexual behavior and STI prevention measures, as well as the level of future healthcare professionals' education. A descriptive, cross-sectional study was conducted. A total of 231 medical and nursing students (n = 106 medical, and n = 125 nursing) completed and returned the pre-tested study questionnaire. Most participants (77.5%) were females and46.1% were in the age group of 18-21 years. Syphilis, HIV/AIDS, and Hepatitis B were regarded as STIs by 65.8% of them. Medical students could predominantly list the widely known STIs compared to nursing students (p = 0.004). Regarding HIV/AIDS, 72.7% of the respondents reported that it is transmitted sexually and through blood transfusion. However, medical students were better informed than nursing students (p = 0.001). Medical students as well as students in the final year of their studies were found to be better informed about the vaccines available to prevent STIs. Regarding the question about what constitutes a risky sexual behavior, 71.4% answered sexual intercourse without the use of condom and 18.6% indicated having sex with an unknown partner. Most participants (69.7%) were satisfied with the education provided by their institution and no statistically significant difference was observed between medical and nursing students. Almost all students (97.8%) agreed that the course/subject of sex education must be included in school programs. A comprehensive analysis of knowledge and attitudes of Greek medical and nursing students regarding STIs, prevention measures and education level was conducted. The results of the present study could assist in the development of targeted training courses that can improve healthcare professionals' knowledge and ability to manage STIs.

Prepubescent Electronic Cigarette Exposure Affects Sexual Motivation and Puberty in Female But Not Male Long-Evans Rats.

A method for delivering vaporized nicotine to animals has been developed using e-cigarette devices. The present experiment was designed to measure the effects of e-cigarette nicotine on pubertal onset and development of reproductive behavior in female and male Long-Evans rats. Rats received daily 10-min sessions of electronic-cigarette vaporized nicotine (5% Virginia Tobacco JUUL Pods) or room air in a whole-body exposure chamber (postnatal day 28-31). Pubertal onset was monitored daily (ie, vaginal opening in females, preputial separation in males). Two weeks later, rats were tested for sexual motivation using the partner-preference paradigm, whereby subjects were given the opportunity to approach either a sexual partner or a same-sex social partner. Four weeks later, partner preference was assessed again, 10 min after rats were re-exposed to their same prepubertal treatment. We found that prepubescent electronic-cigarette vaporized nicotine disrupted puberty and sexual motivation in female but not male rats. In vaped females, vaginal opening was delayed and less time was spent with the male stimulus compared to room-air controls. In contrast, no effect of e-cigarette vapor was observed on pubertal onset or on any measures of sexual behavior in male rats. No effects were observed in either female or male rats on the second partner-preference test. Prepubescent vaporized nicotine affected the development of reproductive physiology and behavior in female rats but not in male rats, whereas an additional acute exposure to nicotine vapor had no effect in either female or male adult rats. Given the prevalence of increasingly younger users, more animal research is needed to explore the effects of e-cigarette smoking on multiple developmental systems including reproductive physiology and behavior. This model could be useful in exploring multiple behavioral and physiological endpoints in both sexes. Adjustments to the duration of exposure and control conditions will be necessary for future experiments to best model human use.

Do risk, time and prosocial preferences predict risky sexual behaviour of youths in a low-income, high-risk setting?

Young people in sub-Saharan Africa are particularly at high risk of sexually transmitted infections. Little is known about their preferences and even less about their association with risky sexual behaviour. We conducted incentivized economic experiments to measure risk, time and prosocial preferences in Zimbabwe. Preferences measured at baseline predict biomarker and self-reported measures of risky sexual behaviour gathered 12 months later. We find robust evidence that individuals more altruistic at baseline are more likely to be Herpes Simplex Virus Type-2 (HSV-2) positive 12 months later. Analysis by sex shows this association is driven by our sample of women. Having more sexual partners is associated with greater risk tolerance amongst men and greater impatience amongst women. Results highlight heterogeneity in the association between preferences and risky sexual behaviour.

Cybersex and Attachment Styles: Proposal of the Emotional and Relational Aspects in Cybersex Activities (ERACA) Questionnaire.

The current study presents the development and the initial validation of a new questionnaire to assess individual differences in emotional and relational aspects related to cybersex activities (i.e., the ERACA). A total of 246 adults (105 females, mean age = 31.89 years, SD = 10.03) coming from the general adult population participated in the study. The items of the ERACA were developed considering the extant literature, and an exploratory factor analysis approach indicated a three-factor structure (i.e., the gratification of the Self through the objectification of other people, the gratification of the Self through relational aspects, betrayal, and infidelity). The associations between the dimensions of the ERACA and dimensional measures of both attachment styles and online sexual behaviors indicated that different aspects related to the quality of the relationships play a different role in individual differences concerning emotional and relational aspects of cybersex activities. The discussion emphasizes the potential usefulness of the ERACA questionnaire for both research purposes and from a health-promoting point of view.

Does anxiety sensitivity interfere with sexual well-being? Evidence from a community sample

Anxiety sensitivity has been identified as a transdiagnostic risk factor with implications for problems in sexual well-being; those with higher anxiety sensitivity tend to experience poorer sexual well-being. The current study extended work examining links between anxiety sensitivity and sexual well-being to a community sample while taking into account broader psychological well-being. Participants were 484 men, women, and gender diverse adults (M age = 31.70 years; SD = 11.26) who had engaged in partnered sexual activity at least once in their lifetime. We assessed sexual well-being broadly by including measures of sexual function, cognitive-affective responses (i.e. sexual satisfaction, sexual self-esteem, sexual distress), and sexual behavior (i.e. frequency of sexual activity, avoidance of sex). Multiple regression analyses showed that anxiety sensitivity is linked to poorer sexual well-being among men and women. Associations between anxiety sensitivity and sexual pain, sexual satisfaction (for women), and sexual distress persisted over and above the contributions of psychological well-being. Few gender effects were noted, suggesting that these experiences are common to all. Findings have clinical implications relevant to those working with individuals with anxiety or sexual problems.

Sexual orientation in transgender adults in the United States

BackgroundSexual orientation refers to a person’s enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures inclusive of transgender people and characterize sexual orientation identity, behavior, and attraction in a representative sample of the U.S. transgender population.MethodsBetween April 2016-December 2018, a U.S. national probability sample of transgender (n = 274) and cisgender (n = 1,162) adults were invited to complete a self-administered web or mailed paper survey. We assessed sexual identity with updated response options inclusive of recent identity terms (e.g., queer), and revised sexual behavior and attraction measures that included transgender people. Multiple response options were allowed for sexual behavior and attraction. Weighted descriptive statistics and sexual orientation differences by gender identity groups were estimated using age-adjusted comparisons.ResultsCompared to the cisgender population, the transgender population was more likely to identify as a sexual minority and have heterogeneity in sexual orientation, behavior, and attraction. In the transgender population, the most frequently endorsed sexual orientation identities were “bisexual” (18.9%), “queer” (18.1%), and “straight” (17.6%). Sexually active transgender respondents reported diverse partners in the prior 5 years: 52.6% cisgender women (CW), 42.7% cisgender men (CM), 16.9% transgender women (TW), and 19.5% transgender men (TM); 27.7% did not have sex in the past 5 years. Overall, 73.6% were “somewhat”/ “very” attracted to CW, 58.3% CM, 56.8% TW, 52.4% TM, 59.9% genderqueer/nonbinary-females-at-birth, 51.9% genderqueer/nonbinary-males-at-birth. Sexual orientation identity, behavior, and attraction significantly differed by gender identity for TW, TM, and nonbinary participants (all p < 0.05).ConclusionsInclusive measures of sexual orientation captured diverse sexual identities, partner genders, and desires. Future research is needed to cognitively test and validate these measures, especially with cisgender respondents, and to assess the relation of sexual orientation and health for transgender people.

HIV Focused Sexual Risk-Reduction Interventions Targeting Adolescent Boys and Young Men in Sub-Saharan Africa: A Scoping Review

Adolescent girls and young women’s exceptionalism with HIV interventions has left adolescent boys and young men (ABYM) trailing behind, thus becoming a marginalized and underserved population. The scoping review aimed to provide an overview of interventions that have targeted sexual risk behaviors in ABYM in Sub-Saharan Africa (SSA) over the previous 21 years with critical insights on ‘what works’ in preventing the sexual transmission of HIV. A scoping review guided by Arksey and O’Malley’s (in Int J Soc Res Methodol 8(1):19–32, 16) framework and the 2015 Johanna Briggs Institute’s guidelines was conducted. A search of literature published between 2000 and 2020 was reviewed and twenty nine interventions from nine Sub Saharan African countries that met the eligibility criteria were reviewed. The review provides evidence on the successes and the limitations of sexual risk behavior interventions for ABYM in SSA. There is clear and consistent evidence that interventions reduce sexual risk behaviors in adolescent boys and young men. Their efficiency seems to grow with the length and intensity of the intervention. Positive effects were generally observed in condom use and on measures of HIV knowledge, attitudes and sexual behaviors as well as uptake of HIV tests and voluntary male circumcision. This review shows that sexual-risk interventions engaging men and boys in SSA are promising and warrant further rigorous development in terms of conceptualization, design and evaluation.

(103) Olfactory Investigation of the Male is Stimulated by Administration of Dihydrotestosterone and Blunted by Co-administration of Flutamide in Ovariectomized Rats Primed with Estradiol

Abstract Introduction Although Hypoactive Sexual Desire Disorder (HSDD) is a common condition with a relevant impact on women’s quality of life, approved androgenic formulations for its treatment are lacking. In previous studies, we demonstrated that the administration of Dihydrotestosterone (DHT), a non-aromatizable androgen, in ovariectomized (OVX) Long-Evans rats primed with Estradiol Benzoate (EB), enhanced measures of sexual behavior. Objective To further clarify the mechanisms underlying the facilitating action of testosterone on female sexual function by investigating the effect of AR (androgen receptor) activation in a validated animal model. Methods After sexual training and hormonal wash-out, OVX Long-Evans rats were treated with different hormonal regimens: oil (O) + O (negative control group), 10 mcg EB+500 mcg Progesterone (P) (positive control group), 10 mcg EB+500 mcg DHT, and 10 mcg EB+500 mcg DHT+10 mg flutamide (FLU), a nonsteroidal AR antagonist (n=4 per group). EB was administered s.c. 48 h, P and DHT s.c. 4 h, and flutamide i.m. 48 and 24h prior to video-recorded sexual behavioral testing sessions. These took place in bisected unilevel pacing chambers, with sexually experienced males. Five testing sessions were conducted every 8 days. The main outcome measures were appetitive behaviors: the number of hops/darts (partial solicitation), full solicitations and olfactory investigations. Results A significant difference emerged among the 4 groups for all the outcome measures. Regarding solicitations, animals treated with EB+DHT displayed a higher number of hops/darts and full solicitations than the negative control group (O+O), although significantly lower than the positive control group (EB+P) for hops/darts (p=0.025). As a novel finding, we observed that the stimulating effect of EB+DHT was blunted in rats treated with EB+DHT+FLU, which showed a lower number of behaviors than EB+DHT rats (p=0.014 for hops/darts, and p=0.083, approaching statistical significance, for full solicitations). Interestingly, a significant difference was detected in the frequency of olfactory investigations, with the EB+DHT group displaying a higher frequency not only when compared with O+O rats (p=0.047), but also with EB+DHT rats (p=0.047 for both comparisons). Once again, the co-administration of FLU significantly reduced the stimulating effect (p=0.005 for olfactory investigations for EB+DHT+FLU vs. EB+DHT). Conclusions These data, to be confirmed in larger samples, indicate that the positive modulation exerted by androgens on appetitive behaviors, homologous to sexual interest in women, are independent of aromatization. In addition, a specific stimulating effect was detected for olfactory investigations. Disclosure No

High seroprevalence of syphilis and genital herpes in migrants in transit in Chiapas, MexicoAlta soroprevalência de sífilis e herpes genital em migrantes em trânsito por Chiapas, México

To determine the prevalence of antibodies against Treponema pallidum and herpes simplex virus type 2 (HSV-2), and to identify the factors associated with these infections among migrants in transit in Chiapas, Mexico. Cross-sectional study conducted during 2021-2022, in three migrant shelters in Chiapas, Mexico. Participants answered a questionnaire and provided a blood sample to detect antibodies against Treponema pallidum and HSV-2. The study calculated seroprevalence and assessed associated factors using Chi-square (χ2) tests and odds ratios. A total of 462 migrants participated, with an average age of 31.2 years; 56.9% were women, and 41.1% came from Honduras. The seroprevalence of HSV-2 was 29.9%; for syphilis it was 4.5%, and it was higher in men (8.0%) than in women (1.9%). Among pregnant women, 15.4% had antibodies against syphilis. Notable variables associated with syphilis include being male, having a history of genital lesions, having same-sex partners, and seropositivity to HSV-2. Regarding HSV-2, factors associated with infection included being female, age, schooling, sleeping in the street, a history of HIV testing, early sexual debut, number of sexual partners, and syphilis. A high prevalence of syphilis and HSV-2 was found among the migrant population evaluated. Syphilis is confirmed as a re-emerging infection, even in women. Migrants have vulnerabilities associated with sexual behavior, so prevention, diagnosis, and treatment measures should be focused on this population group.

Assessing compulsive sexual behavior disorder: The development and international validation of the compulsive sexual behavior disorder-diagnostic inventory (CSBD-DI).

The World Health Organization's International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD), a new diagnosis that is both controversial and groundbreaking, as it is the first diagnosis to codify a disorder related to excessive, compulsive, and out-of-control sexual behavior. The inclusion of this novel diagnosis demonstrates a clear need for valid assessments of this disorder that may be quickly administered in both clinical and research settings. The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries. In the first study, data were collected in community samples drawn from Malaysia (N = 375), the U.S. (N = 877), Hungary (N = 7,279), and Germany (N = 449). In the second study, data were collected from nationally representative samples in the U.S. (N = 1,601), Poland (N = 1,036), and Hungary (N = 473). Across both studies and all samples, results revealed strong psychometric qualities for the 7-item CSBD-DI, demonstrating evidence of validity via correlations with key behavioral indicators and longer measures of compulsive sexual behavior. Analyses from nationally representative samples revealed residual metric invariance across languages, scalar invariance across gender, strong evidence of validity, and utility in classifying individuals who self-identified as having problematic andexcessive sexual behavior, as evidenced by ROC analyses revealing suitable cutoffs for a screening instrument. Collectively, these findings demonstrate the cross-cultural utility ofthe CSBD-DI as a novel measure for CSBD and provide a brief,easily administrable instrument for screening for this novel disorder.

Scripts for consensual sex as risk factors for sexual aggression: A three-wave longitudinal study with university students in Germany.

Sexual aggression is a major problem among young adults. Sexual scripts are cognitive schemata representing typical elements of sexual interactions and serve as guidelines for sexual behavior. They may be linked to the risk of sexual aggression if they contain elements known to be associated with the perpetration of sexual aggression, such as alcohol use, sex with casual partners, and ambiguous communication of sexual intentions. The study was designed to examine pathways from risky sexual scripts for consensual sex to risky sexual behavior and sexual aggression perpetration in men and women. The study employed a three-wave longitudinal design with 12-month intervals. Participants were 2425 university students in Germany (58% female). At each wave (Time 1-Time 3), participants completed measures of risky sexual scripts and risky sexual behavior, defined by three aspects: Casual sex, alcohol consumption, and ambiguous communication of sexual intentions. Reports of sexual aggression perpetration were collected since the age of consent (14 years; Time 1) or in the past 12 months (Time 2 and Time 3) using the Sexual Aggression and Victimization Scale. Perpetration rates for men were 9.8% at Time 1, 12.2% at Time 2, and 9.5% at Time 3. For female participants, the corresponding rates were 6.0% at Time 1, 6.3% at Time 2, and 5.1% at Time 3. The gender difference was significant at Time 1 and Time 2, but not at Time 3. As hypothesized, more risky sexual scripts prospectively predicted more risky sexual behavior, which predicted a higher risk of sexual aggression perpetration. The findings held for men and women and for participants with exclusively opposite-sex and with both opposite- and same-sex contacts. Scripts for consensual sex may be risk factors for sexual aggression among men and women if they contain elements identified as risk factors for sexual aggression. The findings suggest that changing risky sexual scripts for consensual sex may be a promising strategy for preventing sexual aggression perpetration.

Sexual Behaviors and Human Papillomavirus Vaccination in a Heterosexually Active Adult Population at Increased Risk for HIV Infection.

Human papillomavirus (HPV) is the most common sexually acquired infection in the US. Vaccination is effective against infection with high-risk HPV strains, yet HPV vaccine coverage is lower in the US than the national target. This study aimed to determine the relationship between sexual behaviors and HPV vaccination in a heterosexually active population at increased risk for HIV infection. Data from 380 participants aged 18-45years obtained from the National HIV Behavioral Surveillance system increased risk heterosexuals cycle 5 (2019) in Houston, Texas, was analyzed. RDS-Analyst was used to generate population-based descriptive statistics. Modified Poisson regression models clustered on recruitment chain were conducted in SAS 9.4 to assess the relationship between sexual behaviors and HPV vaccination. Only 11.5% of participants had received at least one dose of the HPV vaccine. Regarding behaviors within the past 12months, 44.8% reported having condomless casual sex, 51.3% reported having concurrent sexual partnerships while in their most recent relationship, 14.5% reported exchanging sex, and participants had an average of 4-5 sex partners. Further, those who exchanged sex had a significantly lower prevalence of HPV vaccine uptake when compared to those who did not exchange sex (adjusted prevalence ratio 0.23; confidence interval 0.10-0.52), while all other measures of sexual behavior were not significantly associated with HPV vaccination. More research is needed to understand the relationship between exchange sex and low prevalence of vaccination, specifically in women who bear the highest burden of poor HPV-related morbidity and mortality.

Alignment of PrEP use and sexual behavior over four months among men who have sex with men in the southern United States.

Unlike antiretrovirals for HIV treatment, pre-exposure prophylaxis (PrEP) does not require continual adherence to be fully effective; rather, PrEP adherence is important only in the context of episodes of sexual risk. Therefore, studies of PrEP adherence and persistence must incorporate contemporaneous measurement of sexual behavior. Short, frequent surveys of PrEP use and sexual behavior allow for the measurement of the alignment between PrEP use and sexual behavior. We assessed the feasibility of using biweekly PrEP use and sexual behavior questionnaires to measure adherence and persistence on PrEP over a period of four months. We also measured the alignment of PrEP use and condomless anal sex. PrEP-using MSM in the southern US were recruited using online advertisements. Participants completed a baseline survey followed by brief surveys every two weeks for 16 weeks to report their PrEP use and sexual behavior over the preceding two-week period. Study retention was high: 91% of participants completed the baseline and final survey and, overall, 86% of study surveys were completed. Self-reported PrEP adherence and persistence were high, but instances of PrEP non-adherence were observed to frequently overlap with episodes of condomless anal sex. The most prominent reasons cited for missing PrEP doses were being too busy, not having PrEP on hand, and not being sexually active. Completing short, biweekly surveys of PrEP use and sexual behavior is feasible and acceptable to MSM in the southern US. Future studies should investigate incorporating biomarker measurements to validate self-reported adherence.

Where is Rural? Examining the Effect of Rural Classification Method on Disparities in HIV and STI Testing Uptake Among Men Who Have Sex with Men in the United States.

Men who have sex with men (MSM) account for the majority of new HIV diagnoses in the United States, including in rural areas, and MSM in rural areas face additional barriers to accessing culturally competent and appropriate HIV/STI preventive care. Multiple methods have been used to classify areas in the United States as rural, but none of these methods is specifically designed to classify areas with respect to access to culturally competent care for MSM. Using data from a large, cross-sectional study of MSM we assessed the effect of using three different methods for classifying rurality on measurements of sexual behavior and HIV/STI testing uptake. We found that the prevalence of condomless anal sex and PrEP eligibility was similar across levels of rurality regardless of the method of classification used. Across all measures of rurality, rural MSM were less likely to have tested for HIV and STIs than non-rural MSM. The disparity in HIV/STI testing persisted even in the most inclusive measure of rurality used, indicating that HIV/STI prevention studies should consider using an inclusive approach to identifying and defining rurality.

Development and psychometric validation of the Sexual Fantasies and Behaviors Inventory.

To date, no measures of sexual fantasies and behaviors have been tested using modern structural equation modeling techniques. A total of 4,280 adults from the U.S., U.K., Canada, and Ireland completed a measure of diverse (paraphilic and normophilic) sexual fantasies and behaviors. Data were randomly split in half for a two-part analysis. First, an exploratory factor analysis (EFA) was performed to reduce the item pool and determine general factor structure. Second, we tested several models using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). These were followed by tests of measurement invariance (based on sex and sexual orientation) and criterion validity. For both the fantasies and behaviors, bifactor ESEMs were the most appropriate models. Similar specific factors emerged: (a) normophilia, (b) rough sex, (c) interest of intrusion, (d) assuming power, and (e) relinquishing power. Findings suggest that sexual interests show a hierarchical measurement structure. Males and nonheterosexuals had higher general fantasy scores; nonheterosexuals had higher general behavior scores. Heterosexuals generally scored lower than nonheterosexuals. Fantasy and behavior scores were positively related to Dark Triad traits and sociosexuality, and there were weak or no relationships with depression and anxiety. Results support the psychometric validation of the Sexual Fantasies and Behaviors Inventory. Strengths of this study include a large nonclinical sample with relevant psychological correlates and the use of modern psychometric methods. However, the use of an internet sample with self-report measures may be unrepresentative, although the internet has the advantage of being able to recruit from stigmatized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Predicting the Risk of Human Immunodeficiency Virus Type 1 (HIV-1) Acquisition in Rural South Africa Using Geospatial Data.

BackgroundAccurate human immunodeficiency virus (HIV) risk assessment can guide optimal HIV prevention. We evaluated the performance of risk prediction models incorporating geospatial measures.MethodsWe developed and validated HIV risk prediction models in a population-based cohort in South Africa. Individual-level covariates included demographic and sexual behavior measures, and geospatial covariates included community HIV prevalence and viral load estimates. We trained models on 2012–2015 data using LASSO Cox models and validated predictions in 2016–2019 data. We compared full models to simpler models restricted to only individual-level covariates or only age and geospatial covariates. We compared the spatial distribution of predicted risk to that of high incidence areas (≥ 3/100 person-years).ResultsOur analysis included 19 556 individuals contributing 44 871 person-years and 1308 seroconversions. Incidence among the highest predicted risk quintile using the full model was 6.6/100 person-years (women) and 2.8/100 person-years (men). Models using only age group and geospatial covariates had similar performance (women: AUROC = 0.65, men: AUROC = 0.71) to the full models (women: AUROC = 0.68, men: AUROC = 0.72). Geospatial models more accurately identified high incidence regions than individual-level models; 20% of the study area with the highest predicted risk accounted for 60% of the high incidence areas when using geospatial models but only 13% using models with only individual-level covariates.ConclusionsGeospatial models with no individual measures other than age group predicted HIV risk nearly as well as models that included detailed behavioral data. Geospatial models may help guide HIV prevention efforts to individuals and geographic areas at highest risk.