Multiple Sexual Partners Research Articles

Adolescents' Knowledge and Attitudes about Contraception, Sexuality, Sexually Transmitted Diseases, and Pelvic Health

Background: Sexually Transmitted Infections (STIs) can cause serious health complications, including pelvic inflammatory disease, infertility, ectopic pregnancy, adverse pregnancy outcomes, and cervical cancer. Adolescents and young adults are particularly vulnerable to STIs due to risk-taking behaviors, multiple sexual partners, and inconsistent condom use. Our study aimed to examine the knowledge about contraceptive methods and sexually transmitted infections, and attitudes toward sexual health education among adolescents in Croatia. Methods: The participants were high school students aged 16 to 18 years. The study was conducted at Antun Gustav Matoš Gymnasium, Zabok. We obtained study data via an anonymous survey. Results: The study included 204 adolescents in their final years of high school. The total number of adolescents who had sexual intercourse was 47 (23%). The percentage of sexually active female and male adolescents was 21% and 27%, respectively. In the surveyed group of adolescents, 86% had never heard of subcutaneous progestin implants and 72% had never heard of contraceptive sponges. All adolescents had heard of oral contraceptives and condoms. In the surveyed group of adolescents, 58% had never heard of trichomoniasis and 10% had never heard of HSV. All adolescents had heard of HIV and syphilis. A total of 147 (72%) of the surveyed adolescents believed it as necessary to provide health education in schools. Conclusion: The initiation of sexual activity among adolescents in Croatia remains unchanged when compared to previous studies. Their current knowledge of sexually transmitted diseases and contraceptive methods should be improved through continuous, well-designed, and comprehensive sexual health education.

Can platform use patterns be an indicator of HIV-related risk and sub-group heterogeneity among men who have sex with men in Singapore: a latent class analysis.

Low-level HIV epidemic settings like Singapore face the challenge of reaching men at-risk who have less contact with programmes. We investigated patterns of meeting platform use by men seeking male sexual partners (MSM) as potential marker of risk to differentiate sub-groups for interventions. Latent Class Analysis (LCA) was applied to a survey sample of MSM recruited from bars/clubs, saunas and a smartphone application, using purposive sampling. The best-fit LCA model which identified homogeneous sub-groups with similar patterns of meeting platform was factored in multivariable regression to identify associations with risk behaviors on the pathway to HIV infection. Overall 1,141 MSM were recruited from bars/clubs (n = 426), saunas (n = 531), and online (n = 184). Five patterns emerged, reflecting salient platform use characteristics: Sauna-centric (SC; n = 413), App-centric (AC; n = 276), Multiple-platforms (MP; n = 123), Platform-inactive (PI; n = 257), and "Do not hook up" (DNH; n = 72) classes. Men in the SC and MP classes had high probabilities of using saunas to meet partners; SC were older and less likely to have disclosed their sexual orientation. The MP class had high probabilities of connecting across all platforms in addition to saunas and more likely to have disclosed their sexual orientation, than the PI class. Men in the SC and MP classes had twice the odds of reporting multiple sex partners (aORSC = 2.1; 95%CI: 1.33.2; aORMP = 2.2; 95%CI: 1.14.6). Single/non-partnered MSM and those using alcohol/drugs during sex had 1.7 (95%CI: 1.22.5) and 3.2 (95%CI: 2.05.1) the odds respectively, of reporting multiple sex partners. The SC and MP classes had higher odds of engaging in group sex while MSM using alcohol/drugs during sex had twice the odds of reporting group sex. Alcohol/drugs and group sex were independently associated with condomless sex (as was lower education). Group sex, alcohol/drugs during sex, disclosure of sexual orientation or being Singaporean/permanent resident were associated with recent testing for HIV. The five distinct risk profiles identified can help tailor differentiated HIV interventions-combined with field knowledge and other prevention-to expand HIV self-testing, Pre-Exposure Prophylaxis and other services (e.g., Mpox vaccination) to sub-groups at risk.

Sexual Intercourse and Genetic Integration: A Philosophical Exploration of the Mysteries of DNA

This paper investigates the intriguing implications of recent research conducted by the academics from Seattle’s Fred Hutchinson Cancer Research Center and the University of Washington in Seattle on the mysteries of DNA and its integration into the human body through sexual intercourse. The study reveals that engaging in sexual activity with a man leads to the absorption of his DNA by a woman, with the amount of genetic material retained increasing with multiple sexual partners. The presence of genetically distinct male cells in a woman’s body, including the brain, highlights the potential long-term effects on her physiology and psychology. Furthermore, this genetic integration can influence the genetic composition of a woman’s eggs and subsequently affect the developing fetus. The findings underscore the importance of sexual responsibility, faithfulness, and the impact of extramarital affairs on marital relationships. Additionally, the research offers insights into the Behavioural tendencies observed in children that are inconsistent with their biological parents, suggesting a link to genetic integration. Understanding these complexities can contribute to fostering healthier relationships, families, and societies.

Predictors of divorce and duration of marriage among first marriage women in Dejne administrative town

Divorce is a common occurrence in the marital lives of spouses. Consequently, numerous divorced spouses and their children face various social, economic, physiological, and health problems after breaking their marriage. This study aimed to identify the predictors of divorce and the duration of marriage. We conducted a community-based cross-sectional study among 423 randomly selected residents of Dejen Township in April 2020, of which only 369 respondents met the study inclusion criteria. We used structured questionnaires to collect data. The predictors of divorce and duration of marriage were analyzed using binary logistic regression and the Gompertz regression model, respectively. A p value less than 0.05 was used to express statistical significance. The prevalence of divorce was 21.14% [95% CI (19.01–23.27%)]. Half of these women broke up their marriage after 11 years. A high age difference (7 or more years) between spouses, an early marriage, infertility among women, the presence of third parties, women without formal education, women in the workforce, sexually dissatisfied women, women who did not live together with their husbands at the same address, partner violence, marital control behaviour of husbands, drug-abused husbands, spouses without children, and women who knew multiple sexual partners were the significant predictors of divorce. Partner violence, sexually dissatisfied women, women who made their own marriage decisions, marital control behaviour of husbands, women who did not live together with their husbands at the same address, drug-abused husbands and spouses without children were significant predictors of shorter marriage durations. In this study, the prevalence of divorce was high. Therefore, a community-based, integrated strategy is needed to minimize the divorce rate.

Investigating fertility health knowledge and lifestyle risk factors among Nigerian university students: A cross-sectional survey.

Adolescents who are unaware of infertility risk factors and the long-term health effects of their lifestyle choices may participate in unsafe sexual and lifestyle behaviors. Their reproductive goals and health may be affected by such behaviors. Adolescents' awareness of male and female infertility risk factors was assessed, along with lifestyle risk variables related to sexual behavior and psychoactive substance use. The causes of inconsistent condom use were also examined. In 2022, a cross-sectional survey was undertaken involving 598 sexually active university students from Nigeria (18.6 years±0.9), the majority of whom were female (57.2 %). Descriptive statistics, bivariate analysis, and binary logistic regression were utilized in the data analysis to determine the influence of lifestyle factors and levels of knowledge on fertility. Most participants had a moderate understanding of male and female infertility risk factors. The results showed that female students were more informed. Multiple sexual partners and psychoactive substance use were common lifestyle variables. Younger female students, those with several partners, and participants who frequently used alcohol and narcotics used condoms inconsistently. The study emphasizes the need for fertility health and lifestyle risk education for Nigerian youth. Despite moderate knowledge, lifestyle implications on fertility are unclear. Fertility health education in schools could help students make informed reproductive choices and lower the risk of infertility and chronic diseases. Research is needed to confirm findings and inform nationwide targeted interventions.

Facteurs associés aux dermatoses infectieuses au Centre Hospitalier Universitaire Départemental du Borgou/Alibori, Bénin

Background: Infectious dermatoses are widespread in sub-Saharan Africa and are influenced by many factors. The aim was to study the epidemiological and clinical characteristics of infectious dermatoses and their associated factors in the Dermatology-Venerology Department of CHUD-B/A. Material and Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection, over a 12-year period from January 1, 2009 to December 31, 2020. The sample consisted of all patients with infectious dermatoses whose records could be used. Data were analyzed using Epi info 7.2.3.1 software. Results: A total of 1,512 records were collected for patients with at least one infectious dermatosis during the period. The mean age was 27.68 ± 15.9 years. There were almost as many men as women, with a sex ratio of 1.04. The most frequent reason for consultation was pruritus (64.55%). Mycotic dermatoses (59.46%) predominated, followed by viral dermatoses (22.75%). Unprotected sexual intercourse was a factor associated with bacterial dermatoses, multiple sexual partnerships a factor associated with viruses, and female sex a protective factor for cutaneous parasitoses. Conclusion: Infectious dermatoses play an important role in dermatological consultations, with a predominance of mycotic dermatoses. The factors associated with their occurrence are varied.

Examining Women's HIV Protective Behaviors in Nepal.

Women's autonomy in decision making has important sexual and reproductive health implications. This study uses a nationwide analysis in Nepal to examine women's autonomy, attitude toward intimate partner violence (IPV) behaviors, and HIV-related knowledge in the execution of HIV protective behaviors such as having one sexual partner or getting an HIV test to prevent HIV transmission. Secondary data analysis was conducted using the nationally represented Nepal Demographic and Health Survey (2016-2021) dataset. The sample included 9,904 women ages 15 to 49 who self-identified as ever married. Factor analysis for women's autonomy, attitude toward IPV behaviors, and HIV-related knowledge were conducted based on social dominance theory. Structural equation modeling was conducted, and the results indicated that higher autonomy decreased the risk of HIV infection through having one sexual partner. Factors related to multiple sex partners included unemployment, religious affiliation, and age. Similarly, higher autonomy, HIV-related knowledge, having a formal job, and urban residence increased women's likelihood of taking an HIV test. Women's higher education, greater wealth, religious affiliation, and youth also correlate with HIV testing. Future HIV prevention interventions should include strategies that support women's social and economic empowerment and enhance women's ability to make informed choices about their health and risks.

Mpox across countries from Central and Eastern Europe - 2022 outbreak

BackgroundThe aim of the study was to assess socio-demographical characteristics, clinical presentation, and outcomes in patients diagnosed with mpox. MethodsA survey on patients diagnosed with mpox was performed in 14 countries from Central and Eastern Europe. Data was compared according to HIV status and country of origin (EU vs. non-EU). Mpox diagnosis was confirmed by RT-PCR from oropharyngeal swabs, skin lesions, and other body fluids. ResultsOut of 154 patients confirmed with mpox in 2022, 99.3% were males, with a median age (years) of 35 (IQR 30–39), 90.2% MSM and 48.7% PLWH. Compared to HIV-negative subjects, PLWH had more frequent high-risk behaviours:chemsex (p = 0.015), group sex (p = 0.027), and a history of sexually transmitted infections (STIs) (p = 0.004). Persons from EU were more often PLWH (p = 0.042), MSM (p < 0.0001), had multiple sexual partners (p = 0.025), practiced chemsex (p = 0.008) or group-sex (p = 0.005) and had more often history of STIs (p < 0.0001). The median CD4 cell count/mL at mpox diagnosis was 713 (IQR 486–996) and 73.5% had undetectable HIV VL. The commonest clinical features were fever (108 cases), lymphadenopathy (78), and vesiculo-pustular rash: penile (76), perianal (48), limbs (67). Fifty-one (31%) persons were hospitalized due to complications or epidemiological reasons. Three patients received tecovirimat or cidofovir. The outcome was favorable for all patients, including 4 with severe forms. ConclusionsMpox was diagnosed predominantly in young MSM, with high-risk behaviors and history of STIs. Effective contact tracing and vaccination are important strategic pillars to control mpox outbreaks.

Maltreatment and Parent-Child Attachment as Predictors of Dating Violence and Risky Sexual Behaviour Among High-Risk Teens.

A history of maltreatment can increase risk for dating violence (DV) and risky sexual behaviour (RSB) among adolescents. Secure parent-child attachment may reduce this risk, yet few studies have examined this as a protective factor. This study differentiated developmentally appropriate, exploratory sexual behaviours from RSB and examined whether maltreatment experiences and parent-child attachment in adolescence predicted DV and RSB reported five years later in a high-risk sample. Participants were 179 adolescents (46% girls; M age = 15.34, range = 12-18 years) at risk for aggressive and antisocial behaviour. Adolescents reported their maltreatment histories and attachment to their parents at Time 1; five years later, at Time 2, they reported their experiences with DV perpetration and victimization and engagement in RSB. Both bivariate correlations and structural analyses demonstrated that maltreatment was associated with DV perpetration and victimization but not RSB, and attachment avoidance was associated with fewer RSB but not DV. Attachment anxiety was associated with physical DV perpetration and greater condom use, but only at the correlational level; attachment anxiety was not associated with DV or RSB in the structural model. There were no significant interaction effects. Findings highlight the importance of considering key developmental factors such as maltreatment and parent-child attachment in understanding adolescent risk for DV and RSB, and may inform future research that accounts for contextual factors such as motivation for violence perpetration and contraceptive use with multiple and/or casual sex partners.

Ethnic discrimination, acculturative stress, and sexual risk among Latinx emerging adults: Examining moderation effects of familism support and ethnic identity.

Ethnic discrimination and acculturative stress play an important role in sexual risk behaviors for Latinx emerging adults, who are at disproportionate risk for sexually transmitted infections. Factors such as familism support and ethnic identity may be protective, yet research is limited. This study is guided by a culturally adapted stress and coping framework to examine associations of ethnic discrimination and acculturative stress with sexual risk behaviors (i.e., multiple sex partners, alcohol or drug use before sex, and condomless sex with a primary or casual partner), and examine the moderating roles of familism support and ethnic identity among Latinx emerging adults. Participants were recruited from Arizona and Florida and were primarily female (51.3%) with a mean age of 21.48 years (SD = 2.06). Using cross-sectional data from 158 sexually active Latinx emerging adults, this study employed multiple logistic regression and moderation analyses. Higher levels of ethnic discrimination and pressure to acculturate were associated with fewer sex partners, and higher levels of pressure against acculturation were associated with increased condomless sex with a casual partner. The moderation effect of higher levels of familism support on pressure to acculturate was associated with fewer sex partners, and the moderation effect of higher levels of ethnic identity on pressure against acculturation was associated with decreased condomless sex with casual partners. Examining the results within a culturally informed theoretical framework supports that protective factors may help mitigate sexual risk factors among Latinx emerging adults experiencing acculturative stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence of syphilis and associated risk factors among human immunodeficiency virus-infected patients at the Lagos University Teaching Hospital Nigeria: A cross-sectional study

Background: Worldwide, there was an estimated 7.1 million new cases of syphilis in 2020, and most of the infections were found in developing countries like Nigeria. The objective of the study was to determine the prevalence and risk factors for syphilis among human immunodeficiency virus (HIV)-infected patients in Lagos. Methods: A cross-sectional study was conducted in an HIV Clinic in Lagos, Nigeria, from April to June 2017 and 385 HIV-infected adult participants 18 years and above were recruited into the study. Structured questionnaires were used to collect data on sociodemographic and risk factors for syphilis. Blood samples were collected from all participants and tested for syphilis using rapid plasma reagin and Treponema pallidum hemagglutination assay test kits. Data were analyzed using SPSS (IBM) V. 20. Bivariate analysis was carried out using Chi-square, Fisher’s exact test, and Student’s t-test on sociodemographic and risk behavioral factors. Multivariable logistic regression analysis was performed with variables that were significantly associated with syphilis in bivariate analysis. A P &lt; 0.05 was considered to be statistically significant. Results: Out of 388 HIV-infected patients recruited into the study, 262 (67.5%) were female. The mean age was 43.6 ± 10.1 years, and 137 (35.3%) of them were in the age group of 41–50 years. The prevalence of syphilis in HIV-infected patients was 1.8%. The prevalence of syphilis was significantly higher in males (4.8%) than females (0.4%). The prevalence of syphilis was higher in those with no education or primary school education, and multiple sexual partners were statistically significant in the bivariate analysis but not in the multivariate analysis. Male gender was the only independent risk factor for syphilis, with an odds ratio of 11.79 (95% confidence interval [1.26–106.5], P = 0.03) in multivariate analysis. Conclusion: The prevalence of syphilis in this study was lower than previous work done in other HIV-positive cohorts in Nigeria. Males were more affected significantly in this study. Routine screening and testing for syphilis should be integrated into HIV care, especially in males.

Seroprevalence of Hepatitis B and C Viruses and Their Associated Factors Among Military Personnel at Military Camps in Central Gondar, Ethiopia: A Cross-Sectional Study.

Globally, viral hepatitis is a leading cause of death and is highly prevalent in Ethiopia. Military personnel are more vulnerable to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and there are no data on such populations in the study area. Therefore, this study aimed to determine the seroprevalence of HBV and HCV infections and their associated factors among military personnel in military camps in Central Gondar, Ethiopia. This institutional-based cross-sectional study was conducted with 277 military personnel from April to August 2022 at military camps in Central Gondar, Ethiopia. A systematic random sampling technique was used to select the study participants. Sociodemographic and other relevant data were collected using a structured questionnaire. Five milliliters of venous blood were collected using a vacutainer tube and tested for hepatitis B surface antigens and anti-hepatitis C virus antibodies using an enzyme-linked immunosorbent assay. Data were analyzed using STATA version 14 software and logistic regression models were used to determine the association between HBV/HCV infection and risk factors. Out of 277 participants, the overall seroprevalence of HBV and HCV infections was 19 (6.9%) and 9 (3.3%), respectively. The rate of HBV and HCV co-infection was 2 (0.7%). Having multiple sexual partners (p = 0.048), frequent alcohol use (p = 0.034), hospitalization (p = 0.014), and history of receiving injections from traditional practitioners (p = 0.040) were significant predictors of HBV infection. In contrast, a history of blood transfusion (p = 0.048) and sexually transmitted infections (p = 0.039) were significant risk factors for HCV infection. An intermediate prevalence of HBV and HCV infections was observed among the military personnel. Continuous screening, adherence to healthcare service guidelines, and strengthening of vaccination are crucial for preventing HBV and HCV infections.

The Relationship Between HIV Testing and HIV Transmission Risk Behaviors among Men in Cameroon

HIV testing stands out as a pivotal HIV preventive measure in the face of increasing HIV transmission risk behaviors. This study examined the relationship between HIV transmission risk behaviors and HIV testing among men aged 15 to 64 years in Cameroon. The dataset from the 2018 Cameroon Demographic and Health Survey (N=6978) were utilized. Chi-square tests examined the prevalence and association between HIV testing and HIV transmission risk behaviors. Multivariate logistic regression was fitted to predict the odds of HIV testing. About 58.7% had tested for HIV. Specifically, 55.8% of men who never tested for HIV were aged 15 and 24 years and 73% who never tested for HIV did not use a condom during their most recent sex. Remarkably, 27.3% of men aged 15-64 years who have never been tested for HIV also had multiple sexual partners, while 26.7% that never tested for HIV also did not use condom when engaging in paid sex. Regression results indicated that men aged 15-59 years who had multiple sexual partners (AOR=1.83, 95% CI=1.57-2.14, p&lt;.001), a recent STI (AOR=1.40, 95% CI=1.18-1.66, p&lt;.001), condom use during sex (AOR=1.30, 95% CI=1.10-1.53, p=.022) and paid for sex (AOR=1.19, 95% CI=1.01-1.41, p=.037), were associated with higher odds of testing for HIV compared to those who did not. HIV prevention efforts should focus on addressing the public health implications of unsafe sexual practices among men, devising innovative strategies for scaling up HIV testing among the vulnerable younger age groups and regions with lower HIV testing rates in Cameroon.

Pornography usage during adolescence: Does it lead to risky sexual behavior?

Are youths who consume pornography more likely to engage in risky sexual behaviors? Using longitudinal data from the National Study of Youth and Religion and an individual fixed effects strategy, this paper investigates the relationship between pornography use among 13- to 23-year-olds and a range of subsequent risky sexual behaviors. It also estimates a lagged dependent variable model where risky sexual behavior of the previous wave is included as a control. The findings suggest that moderate and frequent pornography use increases the likelihood of engaging in acts such as unprotected sex and having multiple sexual partners. Finally, a heterogeneity analysis by gender reveals that males and females behave differently in response to exposure to pornography, but that is true for only a few indicators of risky sex. The paper's findings provide critical information on determinants of risky sexual behavior and meaningful evidence for the policy debate on government censoring and monitoring online behavior.

Exploring Psychosocial and Structural Syndemic Effects as Predictors of HIV Risk Behaviors Among Black Women (HPTN 064).

Background: Syndemic models have been used in previous studies exploring HIV-related outcomes; however, these models do not fully consider intersecting psychosocial (e.g., substance use, depressive symptoms) and structural factors (unstable housing, concentrated housing vacancy) that influence the lived experiences of women. Therefore, there is a need to explore the syndemic effects of psychosocial and structural factors on HIV risk behaviors to better explain the multilevel factors shaping HIV disparities among black women. Methods: This analysis uses baseline data (May 2009-August 2010) from non-Hispanic black women enrolled in the HIV Prevention Trials Network 064 Women's Seroincidence Study (HPTN 064) and the American Community Survey 5-year estimates from 2007 to 2011. Three parameterizations of syndemic factors were applied in this analysis a cumulative syndemic index, three syndemic groups reflecting the level of influence (psychosocial syndemic group, participant-level structural syndemic group, and a neighborhood-level structural syndemic group), and syndemic factor groups. Clustered mixed effects log-binomial analyses measured the relationship of each syndemic parameterization on HIV risk behaviors in 1,347 black women enrolled in HPTN 064. Results: A higher syndemic score was significantly associated with increased prevalence of unknown HIV status of the last male sex partner (adjusted prevalence ratio (aPR) = 1.07, 95% confidence interval or CI 1.04-1.10), involvement in exchange sex (aPR = 1.17, 95% CI: 1.14-1.20), and multiple sex partners (aPR = 1.07, 95% CI: 1.06-1.09) in the last 6 months. A dose-response relationship was observed between the number of syndemic groups and HIV risk behaviors, therefore, being in multiple syndemic groups was significantly associated with increased prevalence of reporting HIV risk behaviors compared with being in one syndemic group. In addition, being in all three syndemic groups was associated with increased prevalence of unknown HIV status of the last male sex partner (aPR = 1.67, 95% CI: 1.43-1.95) and multiple sex partners (aPR = 1.53, 95% CI: 1.36-1.72). Conclusions: Findings highlight syndemic factors influence the lived experiences of black women.

Mpox Case Presenting With Genital Lesions and Proctitis.

Monkeypox (Mpox) is a zoonotic Orthopoxvirus of the Poxviridae family, endemic to Africa. In August 2022, the US government declared it an emergency because of the worldwide spread. Traditionally, Mpox infection spreads through contact with infected animals. However, the 2022 outbreak Centers for Disease Control and Prevention (CDC) data note that 94% of cases had recent male-to-male sexual or close intimate contact, suggesting a novel sexual transmission. In this article, we report a 39-year-old HIV-positive man presenting with a diffuse cutaneous rash, perianal pain, and bloody stool of 2-week duration. A medical history includes intravenous drug use and multiple sexual partners. Physical examination revealed umbilicated, tan-colored, crusted cutaneous papules scattered across the face, trunk, and genital regions. Perianal lesion biopsy showed an acanthotic epidermis with spongiosis, ballooning degeneration of keratinocytes, and the formation of multinucleated syncytial keratinocytes. A dermal superficial/lichenoid mixed inflammatory cell infiltrate with multinucleated giant cells was noted. Perianal lesion polymerase chain reaction (PCR) was positive for Mpox. Colonoscopy revealed a 3-cm circumferential rectal ulcer with gray exudate and necrosis. A rectal ulcer biopsy showed an ulcerated mucosa with acute proctitis and necrosis. There were scattered macrophages with intranuclear inclusion and glassy vacuolization, and Mpox infection was confirmed by immunostaining with a Mpox-specific anti-Vaccinia virus antibody.

Effects of depot medroxyprogesterone acetate, the copper IUD and the levonorgestrel implant on testosterone, sex hormone binding globulin and free testosterone levels: ancillary study of the ECHO randomized clinical trial

BackgroundRobust information on relative effects of hormonal contraceptives on endogenous androgens is important for understanding beneficial and adverse effects, method choice and development of new methods.MethodsIn this ancillary study at the East London, South Africa site of the ECHO multicentre randomized trial, we compared effects of three contraceptive methods on serum androgen levels among contraceptive users aged 18 to 35 years. Participants were allocated by centrally-managed randomization to open label depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (IUD) or levonorgestrel implant.The primary outcome was free testosterone at 6 months.ResultsWe analysed stored baseline and 6-month serum samples in 398/615 participants (DMPA-IM 131/205, IUD 135/205 and implant 132/205). Median testosterone levels at baseline were DMPA-IM 0.82, IUD 0.9 and implant 0.87 nmol/L; at 6 months, DMPA 0.68 (lower than IUD, mean percentage difference 28.35, (p < 0.001), IUD 0.86 (unchanged) and implant 0.66, lower than IUD, mean percentage difference − 22.98, p < 0.001).Median SHBG levels at baseline were DMPA 52.4, IUD 50.5 and implant 55.75 nmol/L; at 6 months, DMPA 40.65, lower than IUD (mean percentage difference 21.19, p = 0.005), IUD 49.1 (unchanged), and implant 23.35 nmol/L, lower than IUD (mean percentage difference − 50.04, p < 0.001 and than DMPA (mean percentage difference − 39.45, p < 0.001).Free testosterone levels at baseline were DMPA 10, IUD 12 and implant 11 pmol/L; at 6 months, DMPA 11, less than IUD (mean percentage difference 13.53, p = 0.047), IUD 12 and implant 14, higher than IUD (mean percentage difference 14.15, p = 0.038) and than DMPA, (mean percentage difference 29.60, p < 0.001).ConclusionsThis is the first randomized trial to show lower SHBG and higher free testosterone with the levonorgestrel implant than with DMPA, and contrasts with reports of increased SHBG with combined oral ethinyl estradiol/levonorgestrel use, and reduced androgens (and impaired sexual function) reported with the etonorgestrel implant. The higher free testosterone with the LNG implant might improve sexual function, mood and bone health as well as increasing side-effects such as acne and hirsutism, and is consistent with the greater sexual activity (with respect to multiple sex partners, new sex partner and unprotected sex) with the implant compared with DMPA documented in the ECHO study.ECHO trial registrationClinicalTrials.gov, number NCT02550067 15/09/2015.Plain English summaryContraception, or family planning, is central to the role of women in societies. It is most important to have accurate information on the relative side-effects of various contraceptive options in order to empower women to make informed choices regarding their preferred method.Hormonal contraceptives contain various forms of the female sex hormones, estrogens and/or progestogens. These hormones have direct effects on the users, as well as modifying the levels of the users’ own circulating sex hormones, both the ‘female’ and the ‘male’ sex hormones (androgens).In this study, consenting participants requesting contraception, were allocated randomly to receive either depot medroxyprogesterone acetate (DMPA-IM) a 3-monthly progestogen injection, the copper intrauterine device (IUD), a non-hormonal contraceptive inserted within the womb, or the levonorgestrel implant, a device placed under the skin which releases a progestogen for 5 years.We measured the participants’ androgen levels after 6 months, and found for the first time that the active form of testosterone (free testosterone) was 29% higher with the implant than with DMPA-IM. The level with the IUD was intermediate, and significantly different from the other two methods.This finding is relevant to the effects experienced by users of these methods, because free testosterone has effects on sexual function, bone health and mood, as well as on conditions such as acne and hair distribution patterns.

Pap Smear Cancer Coverage in Brazilian Capitals including the Pandemic Period Caused by the SARS-CoV-2 Virus: Ecological Study.

Cervical cancer develops slowly and may not manifest signs and symptoms at an early stage. It is worth mentioning the factors that can influence the onset of cervical cancer: smoking, early sexual life, multiple sexual partners, use of oral contraceptives, multiparity, low socioeconomic status, among others. An important risk factor for the onset of this disease is HPV infection, a virus associated with most cases of precursor lesions of this type of cancer. It is essential to understand the comprehensiveness of the scope and adherence to the recommended guidelines throughout the national territory. Therefore, health indicators are important management tools that make it possible to evaluate the services offered, measuring the reach of the target population, the supply and access to preventive exams. To analyze the trend of progress in cervical cancer coverage actions in Brazilian capitals from 2016 to 2021. This is an ecological study with temporal analysis that used secondary data referring to process indicators for cervical cancer control actions in women aged between 25 and 64 years living in Brazilian capitals between 2016 and 2021. Aspects related to the quality of care in the cervical cancer prevention program were evaluated using databases of the Cancer Information System (SISCAN), available in DATASUS. The indicators used to monitor and evaluate cervical cancer control actions were (i) cervical coverage, (ii) reason for cervical surgery, and (iii) proportion of cervical cancer every 3 years. In 2016, 410,000 tests were performed and notified in the SISCAN system in all Brazilian capitals, with emphasis on Curitiba, with 65,715 tests performed, and Porto Velho, with 174. In 2020, there was a reduction in exams compared to the previous year in all capitals, with the exception of Palmas, which went from 7655 exams to 9604. It was observed that all the capitals studied showed an increase in the annual percentage variation of Pap smear coverage, with the exception of Brasília, Manaus, Porto Alegre and Porto Velho, which did not show a statistically significant increase (APC = 3.01, 2.746, 3.987, 3.69, respectively). When analyzing the performance of oncotic cytology exams in the capitals according to the years 2019 and 2020, it was observed that only Manaus registered an increase in the number of procedures performed, reaching a difference of 56.5% from one year to the next. The ecological analysis revealed a worrying drop in the number of tests performed in 2020, reflecting a sharp drop in coverage actions in Brazilian capitals during the pandemic caused by the SARS-CoV-2 virus. The pandemic has exacerbated existing inequalities and highlighted the need for adaptive strategies to maintain essential screening services in times of crisis.

(011) Exploring Pretending Orgasm and Sexual Satisfaction Among Egyptian Women: A Cross-Sectional Survey Study

Abstract Introduction Research on sexual satisfaction, especially orgasm, has focused on North American and Western contexts. Studies show women frequently pretend during PVI to end activity or avoid consequences. Reasons vary from emotional communication to mate deception, not always related to sexual dysfunctions. Sociosexuality may influence behaviors, with casual sex individuals less likely to fake orgasms for positive feedback. Limited research on non-Western societies, especially Egypt, prompted this study to explore prevalence and reasons for pretending orgasm among Egyptian women, investigating correlations with sexual orientation, sexual violence history, dysfunction, and family size. Objective 1. Prevalence of faking orgasm in Egyptian adults. 2. Reasons for faking orgasm in Egyptian women. 3. Correlations with sexual orientation, violence history, dysfunction, and family size. 4. Insights into sexual scripts in Egyptian society. Methods This cross-sectional survey investigates reasons for faking orgasm in Egyptian women. A convenience sample of women aged 18 and above was recruited through social media, community centers, and universities. Data collection occurred between [December 2020] and [February 2021], with participants providing informed consent for the online survey. The survey includes 51 questions on pretending orgasm and a structured interview for demographic information. Participants rated reasons on a Likert scale, and quantitative data will be analyzed using descriptive and inferential statistics to identify prevailing motives. Results In the survey of 626 Egyptian women: •38.6% (242 women) reported pretending orgasm during sexual encounters. •Common reasons for pretending included: wanting to end sexual activity (55.9%–350 women), avoiding negative consequences (66.6%–417 women), and pleasing their partner (55.9%–350 women). •Sociosexuality played a role, with 38.3% (240 women) of those interested in casual sex less likely to fake orgasms for positive feedback. •96.2% (602 women) identified as heterosexual, 1% (6 women) as homosexual, and 2.9% (18 women) as bisexual. •85.2% (534 women) were married, 6.4% (40 women) divorced, 2.6% (16 women) separated, and 5.7% (36 women) in a relationship. •91.8% (575 women) belonged to small families, and 8.2% (51 women) to big families. •14.1% (88 women) had multiple sexual partners, and 16.5% (103 women) suffered from psychological dysfunction. •43.2% (271 women) engaged in sexual relationships more than once a week, 26.9% (168 women) once a week, and 17.6% (110 women) once a month. •32.6% (204 women) were sexually satisfied, 9.6% (60 women) were not satisfied, and 7% (44 women) were neutral. •45.5% (285 women) had a history of sexual harassment, and 27.6% (173 women) had a history of Female Genital Mutilation (FMG). Conclusions The study reveals a prevalent practice of pretending orgasm among Egyptian women (38.6%). Reasons for pretending vary, with a significant percentage aiming to end sexual activity (55.9%), avoid negative consequences (66.6%), and please partners (55.9%). Sociosexuality plays a role, with 38.3% of those interested in casual sex less likely to fake orgasms for positive feedback. Findings emphasize open communication for sexual satisfaction and relationship well-being. Limitations include self-report bias and limited generalizability. Future research should explore diverse contexts and long-term effects on relationship satisfaction. Addressing complexities is vital for healthy relationships among Egyptian women. Disclosure No.

(146) Sex Education and Pattern of Sexual Behavior among Adolescents in a Sub-Urban High School

Abstract Introduction Adolescence being the transition from childhood to adulthood may be associated with risky sexual behavior with consequences that may last a lifetime. Sex education for teenagers to encourage safe sexual practices is necessary to build a society of adults with healthy sexual lifestyle. The details of the source of information, level of knowledge and actual sexual practices among these adolescents will inform the approach to supplying adequate information. Objective The objective of the study is to demonstrate the level of knowledge of adolescents about safe sexual practices, contraceptives and their pattern of behavior. Methods Data regarding knowledge and sexual behavior was obtained from adolescents in a Sub-Urban high school with the aid of pre-tested self-administered questionnaire. The data was imputed and analyzed with the IBM SPSS software. Results A total of 107 adolescents aged 13 to 19years (mean - 16.078years) with average weight of 47.931Kg; 53(49.5%) were males and 54(50.5%) were females. About half (51.4%) practice Christianity and 48.6% practice Islamic religion and majority (96.3%) were in their penultimate class in high school. Majority of respondents (87.7%) reported having formal sex education, the commonest source of sex education was school in 76.9%, other sources of information were parents (11.0%), friends and peers (8.7%), mass media (4.4%) and siblings (2.2%). The quality of knowledge of these adolescents may be poor, as many as 25% of respondents think that casual sex does not predispose to infections and only 21.8% had any knowledge of modern contraceptives. Nearly one-quarter (23.36%) of respondents have commenced sexual activities with the mean age at coitarche being 12.38±2.38years; majority in this category (92%) being males. The commonest form of sexual practice is peno-vagina intercourse which is seen in 21.7% of respondents, 13.3% practice masturbation, 5.8% of respondents have had homosexual activities, 6.7% practice oral sex and 1.9% practice peno-anal sex. Among the sexually active respondents, 72% have had multiple sexual partners, 32% practice casual sex. Majority (92%) have used male condoms before but only 32% of sexually active respondents regularly use condoms. Majority (98%) of sexually naïve were contented with their status and 13% of sexually active respondents wished they had delayed sexual activities. Conclusions Although, intervention at adolescence with sex and reproductive health services offers the opportunity to form societies with healthy sexual lifestyle, the level of knowledge of sex education among adolescents in Sub-Urban communities remain poor yet a significant proportion of these Adolescents have commenced sexual activities with some practicing risky sexual behavior. Disclosure No.