Safer Sex Behaviors Research Articles

Evaluation of Two Comprehensive Sexuality Education Programs: Safer Choices and Reducing the Risk

It has been over ten years since the Safer Choices and Reducing the Risk comprehensive sexuality programs have been evaluated with high school students. A pretest- posttest design was used to examine the effectiveness of these two programs with a 2009 sample. Three hundred and seventy-four middle school students participated in the Safer Choices program and 469 high school students participated in the Reducing the Risk program. Findings show that knowledge of pregnancy and sexually transmitted infections as well as behavioral intentions to engage in safer sex behavior significantly increased from pretest to posttest. Overall, the programs were found to be effective for males and females and the race/ethnic groups examined.

The Association between Noncommercial Partnerships and Risk of HIV among Female Sex Workers: Evidences from a Cross-Sectional Behavioral and Biological Survey in Southern India

This paper examines the association between female sex workers' (FSWs) noncommercial partnerships with risk of HIV in Andhra Pradesh, India. Data were drawn from a cross-sectional behavioral and biological survey conducted in 2009 among 3225 FSWs from Andhra Pradesh. Participants were asked about their sexual partnerships, condom use, and vulnerability factors and tested for HIV and sexually transmitted infections. The key independent variables considered were presence of a noncommercial sexual partner (no, yes) and the nature of such partnerships (regular, nonregular). FSWs who reported husband as noncommercial partner were considered to have a regular partner, while the rest were defined as having nonregular partners. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated to measure the associations between variables of interest. Almost three-fourths (74.8%) of FSWs reported having noncommercial partners (regular: 55.6%; nonregular: 19.3%). FSWs in nonregular partnerships were more likely to be HIV positive (13.1% versus 10.9%, adjusted OR: 1.4, 95% CI: 1.1–1.8), have syphilis (10.3% versus 4.2%, adjusted OR: 2.3, 95% CI: 1.6–3.3), use condoms inconsistently with occasional clients (21.0% versus 16.5%, adjusted OR: 1.5, 95% CI: 1.2–1.9), and report forced sex (25.1% versus 14.1%, adjusted OR: 1.9, 95% CI: 1.5–2.4) as compared to those in regular partnerships. HIV prevention programs need to emphasize safe sex behaviors, particularly among FSWs who have nonregular partners.

Differences in Psychosocial Risk Variables for HIV as a Function of Sexual Experience

The aim of this study was to analyze the differences in psychosocial risk variables for HIV as a function of sexual experience in an adolescent population. The study sample consisted of 846 adolescents of both sexes aged between 14 and 19 years. Participants responded to several questionnaires that assessed four psychosocial variables related to risk sexual behavior for HIV infection: 1) perception of peer group norms, 2) condom use self-efficacy, 3) attitudes towards condom use and 4) parental communication about sexuality, STIs, HIV and pregnancy. Participants in both groups with sexual experience (with and without penetration) reported better communication with their mothers on sexuality and scored higher in positive attitudes towards condom use than those in the group without sexual experience. The sexual experience with penetration group perceived more negative peer group norms related to safe sexual behavior than the group without sexual experience; the group without sexual experience had a higher perception of condom use self-efficacy than the sexual experience with penetration group.

Inherent dangers in orogenital sex during pregnancy

Coitus and cunnilingus during pregnancy are generally safe; whereas orogenital sex involving vaginal air insufflations can be very dangerous, causing even the death of the women. We carried out a search of case reports and reviews concerning air embolism during pregnancy due to orogenital sex. Physicians consultations must cover all the rules of safe sexual behavior, including avoidance of vaginal air insufflations in the third trimester.

Perceptions of Safer Sexual Behaviors within the HIV/AIDS Community in Bangladesh

Perceptions of Safer Sexual Behaviors within the HIV/AIDS Community in Bangladesh

The use of erection enhancing medication and party drugs among men living with HIV in Europe

Studies have shown more erectile dysfunction (ED) in men living with HIV (MLHIV), relative to age matched HIV-negative men. Erection enhancing medication (EEM) is more frequently used by HIV-positive men than in the general male population. Increased sexually transmitted infection has been described in HIV-positive men with ED using EEM. This study investigated the use of EEM and party drugs (methyleendioxymethamfetamine (XTC), gammahydroxybutyrate (GHB) “fluid XTC” and alkyl nitrites “poppers”) among MLHIV. Self-administered questionnaires were distributed consecutively to all patients attending 17 European HIV treatment centers. The sample included 1118 HIV-positive men, among whom 74.5% men having sex with men (MSM). The use of EEM was more frequent in MSM than in heterosexual men (odds ratio (OR) 3.33, p<0.001) and was associated with increased sexual risk behavior (OR 3.27, p<0.001). Nonmedically indicated use of EEM was linked to increased use of party drugs (OR 2.30, p=0.01). Physicians taking care of MLHIV need to be aware of the high prevalence of (nonmedical) use of EEM and party drugs. Medical provision of EEM should be combined with a discussion on safer sex behavior and the risk related to concomitant use of party drugs and illegal EEM.

The prevalence and antibiotics susceptibility pattern of Neisseria gonorrhoeae in patients attending OPD clinics at St. Mary's Hospital Lacor Uganda.

Gonorrhea is one of the most common sexually transmitted infections (STls) in developing countries, and the emergence of resistance to antimicrobial agents in Neisseria gonorrhoeae is a major obstacle in the control of gonorrhoea. Periodical determination of the prevalence and monitoring of antimicrobial susceptibility of N. gonorrhoeae is essential for the early detection of emergence of drug resistance. A total of 640 consecutive patients who attended the Outpatient Department (OPD) Clinics at St. Mary's Hospital Lacor between Jan 2007-Dec 2011, with gonococcal urethriris symptoms and whose urethral swabs and high vagina swabs (HVS) were cultured, were involved in the study. Two hundred and fifty six (256) patients had positive pus swab culture, of which 151 (23.6%) showed growth of Neisseria gonorrhoeae. All the isolates were tested for antimicrobial susceptibility using the Kirby Bauer-disc diffusion techniques. Gonococcal isolates showed rapid decrease in susceptibility to the antimicrobials especially to ampicillin, tetracycline and erythomycin, ciprofloxacin, and intermediate to chloramphenicol, however, gentamicin and cefotaxime have remained as a single dose sensitive treatment for Neisseria gonorrhoeae. Sensitization on drug use and adopting preventive measures and continuous education on safer sexual behavior through health care authorities would lead to reduction in the prevalence of Neisseria gonorrhoeae and resistance to antimicrobial. Gonorrhea is one of the most common sexually transmitted infections (STIs) in developing countries, and the emergence of resistance to antimicrobial agents in Neisseria gonorrhoeae is a major obstacle in the control of gonorrhea. Periodical monitoring of antimicrobial susceptibility of N. gonorrhea is essential for the early detection of emergence of drug resistance.

HIV serostatus disclosure is not associated with safer sexual behavior among HIV-positive men who have sex with men (MSM) and their partners at risk for infection in Bangkok, Thailand

BackgroundThe relationship between HIV serostatus disclosure and sexual risk behavior is inconsistent across studies. As men who have sex with men (MSM) are emerging as the key affected population in Bangkok, Thailand with reported HIV prevalence of 30%, we assessed whether HIV disclosure is associated with protected sex in this population.MethodsA risk behavior questionnaire was administered using Audio Computer-Assisted Self-Interviewing (ACASI) to determine whether HIV serostatus disclosure was associated with protected sex in 200 HIV-positive MSM in Bangkok. HIV serostatus disclosure to the most recent sexual partner prior to or at the time of the sexual encounter was assessed. Protected sex was defined as insertive or receptive anal intercourse with a condom at the most recent sexual encounter.ResultsThe mean age was 30.2 years, CD4 was 353 cells/mm3, and one-third was on antiretroviral therapy. At the most recent sexual encounter, HIV serostatus disclosure rate was low (26%); 60.5% of subjects had not discussed their serostatus at all, while 5.5% had not revealed their true serostatus. Seventeen percent reported unprotected anal intercourse and about half had sex with their primary partners. The serostatus of the most recent sexual partner was HIV-positive in 19.2%, HIV-negative in 26.4%, and unknown in 54.4% of subjects. There was no association between disclosure and protected sex, with 41 of 48 (85.4%) disclosers and 104 of 126 (82.5%) of non-disclosers reported protected sex (p = .65). Subjects with HIV-positive partners were less likely to report protected sex overall (20 of 33, 60.6%) compared to those with HIV negative (82 of 96, 85.4%) or unknown (41 of 45, 91.1%) partners (p = .001). Age (27-32 years vs. ≤26 years, p = .008), primary partner status (p < .001), and HIV-positive serostatus of sexual partner (p < .001) were significantly associated with disclosure in the multivariate analyses.ConclusionRates of HIV disclosure to sexual partners by HIV-positive MSM in Bangkok are low. Despite low rates of HIV serostatus disclosure, most HIV-positive MSM reported protected sex with their partners at risk for infection. Future studies should focus on understanding barriers to disclosure and factors driving risk behavior amongst MSM in Thailand.

Disparities in safe sex counseling &amp; behavior among individuals with substance dependence: a cross-sectional study

BackgroundDespite the vast literature examining disparities in medical care, little is known about racial/ethnic and mental health disparities in sexual health care. The objective of this study was to assess disparities in safe sex counseling and resultant behavior among a patient population at risk of negative sexual health outcomes.MethodsWe conducted a cross-sectional analysis among a sample of substance dependent men and women in a metropolitan area in the United States. Multiple logistic regression models were used to explore the relationship between race/ethnicity (non-Hispanic black; Hispanic; non-Hispanic white) and three indicators of mental illness (moderately severe to severe depression; any manic episodes; ≥3 psychotic symptoms) with two self-reported outcomes: receipt of safe sex counseling from a primary care physician and having practiced safer sex because of counseling.ResultsAmong 275 substance-dependent adults, approximately 71% (195/275) reported ever being counseled by their regular doctor about safe sex. Among these 195 subjects, 76% (149/195) reported practicing safer sex because of this advice. Blacks (adjusted odds ratio (AOR): 2.71; 95% confidence interval (CI): 1.36,5.42) and those reporting manic episodes (AOR: 2.41; 95% CI: 1.26,4.60) had higher odds of safe sex counseling. Neither race/ethnicity nor any indicator of mental illness was significantly associated with practicing safer sex because of counseling.ConclusionsThose with past manic episodes reported more safe sex counseling, which is appropriate given that hypersexuality is a known symptom of mania. Black patients reported more safe sex counseling than white patients, despite controlling for sexual risk. One potential explanation is that counseling was conducted based on assumptions about sexual risk behaviors and patient race. There were no significant disparities in self-reported safer sex practices because of counseling, suggesting that increased counseling did not differentially affect safe sex behavior for black patients and those with manic episodes. Exploring the basis of how patient characteristics can influence counseling and resultant behavior merits further exploration to help reduce disparities in safe sex counseling and outcomes.Trial registrationNCT00278447

Comparision of HIV/AIDS knowledge and attitude of nursing and college of education students in Kumasi

The purpose of the study was to compare HIV/AIDS knowledge and attitudes of nurses and teachers in training. A questionnaire was administered to a cross section of 200 nurses and teachers in training at Kumasi. Respondents were asked to provide information on HIV/AIDS knowledge and attitudes. The data obtained were presented and analysed using the Statistical Product and Service Solutions (SPSS) version 16.0. Study results indicated that the majority of the respondents had a high level of HIV/AIDS knowledge, acceptance and positive attitude towards HIV/AIDS issues and patients. Nurses in training had higher HIV/AIDS mean knowledge score ((x=14.55) than teachers in training (x= 14.23). However, independent samples t-test analysis showed insignificant difference between knowledge scores of nurses and teachers in training (t (198=.95, significance level=0.05, sig. (2-tailed)=.33). Also, the nurses in training had higher HIV/AIDS mean attitude score (x= 14.54) than teachers in training (x=14.34). However, independent sample t-test showed insignificant difference between attitude scores of nurses and teachers in training (t (198) =.60, significance level = 0.05, sig (2-tailed) =.54). There was no statistically significant bivariate correlation between knowledge and attitude scores of respondents (r(198)=0.01, significance level=0.05,sig.(2-tailed)=.89). The study recommends that future HIV/AIDS prevention strategies and campaigns in schools and colleges should focus not only on HIV/AIDS knowledge but also on developing and maintaining safe sexual behavior and positive attitudes towards HIV/AIDS issues and patients.

Patterns of cocaine and opioid co-use and polyroutes of administration among street-based cocaine users in Montréal, Canada

BackgroundEffective public health programs aimed at problematic cocaine users are challenged by the fact that they can have complex patterns of drug use with respect to polysubstance use and routes of drug administration. This study was carried out to explore the presence of subgroups of cocaine users on the basis of their concurrent use of opioids and their routes of cocaine and opioid administration, and to determine if subgroups could be differentiated in terms of sociodemographic factors and risk behaviours. MethodsRegular cocaine users (≥1 per week) were recruited in low-threshold services located in the Montréal downtown area. The following variables were examined: demographic characteristics, types of drug used, routes of drug administration, and condom use with occasional or commercial sexual partners. Latent class analysis and multinomial logistic regression modeling were carried out. Results886 cocaine users were recruited (83.5% male: mean age 35.38 years). A 5-class model was identified: (1) “cocaine smokers” (CSs) (n=161; membership probability (MP)=0.183); (2) “cocaine smokers/sniffers” (CSSs) (n=201; MP=0.218); (3) “cocaine injectors” (CIs) (n=207; MP=0.231); (4) “cocaine-opioid injectors” (COIs) (n=277; MP=0.291); (5) “cocaine-opioid polyroute users” (COPs) (n=40; MP=0.077). Compared with COIs, other subtypes were significantly different in terms of either age, duration of cocaine use, ethnic background, homelessness, polydrug use or condom use. ConclusionThe heterogeneity of consumption patterns supports the importance of offering an array of interventions aimed at problematic cocaine users. These should include the provision of clean injecting and smoking material, the promotion of safe sexual behaviours and the prevention of initiation to drug injection. In the absence of specific treatment, cocaine users should have access to primary health care services and addiction treatment based on innovative behavioural and pharmacological approaches.

Integrating Psychological Theory Into the Design of an Online Intervention for Sexual Health: The Sexunzipped Website

BackgroundThe Internet can provide a confidential and convenient medium for sexual health promotion for young people.ObjectiveThis paper describes the development of an interactive, theory-based website (Sexunzipped) aimed at increasing safe sexual behavior of young people, as well as an outline of the evaluation protocol.MethodsThe website focuses on safer sex, relationships, and sexual pleasure. An overview of the site is provided, including a description of the theoretical constructs which form the basis of the site development. An integrated behavioral model was chosen as the guiding theory for the Sexunzipped intervention. A randomized trial design will be used to evaluate the site quantitatively.ResultsThe content of the site is described in detail with examples of the main content types: information pages, quizzes, and decision-making activities. We describe the protocol for quantitative evaluation of the website using a randomized trial design and discuss the principal challenges involved in developing the site, including the challenge of balancing the requirements of theory with young people’s views on website content and design.ConclusionsConsiderations for future interventions are discussed. Developing an online behavior-change intervention is costly and time consuming. Given the large public health potential, the cost involved in developing online interventions, and the need for attractive design, future interventions may benefit from collaborating with established sites that already have a user base, a brand, and a strong Internet presence. It is vital to involve users in decisions about intervention content, design, and features, paying attention to aspects that will attract and retain users’ interest. A central challenge in developing effective Internet-based interventions for young people is to find effective ways to operationalize theory in ways that address the views and perspectives of young people.

Safer Sex and Partner Violence in a Sample of Women

Sexually transmitted infections (STIs), including HIV, continue to be associated with significant morbidity and mortality among women. Intimate partner violence (IPV), affecting approximately 25% of women, has been shown to be a risk factor for HIV and STIs. This study describes the relationship between sexual risk, safer sex, and partner violence in a sample of women. Women who experienced IPV reported greater coercive sexual risk behaviors and a decreased ability to practice some safer sex behaviors. Nurse practitioners should be aware of the relationship between IPV and sexual risk and screen all women during routine visits.

Effect of an educational intervention on Hungarian adolescents’ awareness, beliefs and attitudes on the prevention of cervical cancer

The alarming national data on the mortality and morbidity rates of cervical cancer as well as the results of a Hungarian survey demonstrating adolescents’ low level of understanding of human papillomavirus (HPV) infection and HPV vaccination encouraged the authors to conduct an educational intervention. The aim of this survey was to explore the impact of a brief, HPV-focused program on adolescents’ knowledge, beliefs and attitudes.A self-administered anonymous questionnaire was completed by 394 male and female adolescents in September, 2010, in Hungary. Half of the students (48.5%) then had a one-off educational intervention on aspects cervical cancer lasting 45min lesson, while the rest of the participants, the control group, did not have the educational intervention. Three months following the education, both groups were retested using the same questionnaire. Data were analysed using Statistical Package for the Social Sciences (SPSS).Following the education, significant increase was detected in cervical cancer awareness: causal relationship between HPV and cervical cancer (7.9%→22.1%, p<0.05), or perception of HPV vaccination (61.3%→85.9%, p<0.05). Similarly, health-related beliefs have enhanced, such as ‘HPV may cause cervical cancer’ (64.9%→81.0%, p<0.05) or ‘cervical cancer may be prevented by vaccination’ (66.5%→85.3%, p<0.05). Our data also highlighted that Hungarian adolescents have been practising extremely risky sexual behaviour. Nearly half of the sexually active adolescents had engaged in ‘one-night relationship’ (41.1%) as well as having sexual intercourse without any contraceptive safety measures (44.3%).In addition to providing adolescents with clear and meaningful information about the implications of a HPV infection and addressing their fears of screening and vaccination, health education should focus on promoting safe sex behaviour by promoting the use of condoms and reducing the number of sexual partners to limit the spread of HPV, and also on encouraging the participation in regular cervical screenings, thus reducing the incidence of cervical cancer.

The Intersection of Youth, Technology, and New Media with Sexual Health: Moving the Research Agenda Forward

Youth bear a significant proportion of the sexually transmitted infection (STI)/HIV burden in the United States, CDC, 2010. Available at: http://www.cdc.gov/std/stats09/default.htm, with rates of some STIs increasing among youth of color and young men who have sex with men. Technology use among youth also continues to increase. The ubiquitous nature of technology use among youth offers a multitude of opportunities to promote youth sexual health and to prevent disease transmission and unplanned pregnancies. To date, there have been a handful of peer-reviewed articles published regarding the feasibility, acceptability, and effectiveness of using new media and technology for sexual health promotion. Despite recent publications, there is still a real need for high-quality research to understand the impact of different forms of new media use on youth sexual health, as well as to determine the best ways to harness technology to promote safer sex behaviors, both for the short- and long-term. In March 2011, Internet Sexuality Information Services (ISIS), National Institute of Mental Health (NIMH), and the Ford Foundation convened a meeting of scientists and technology experts to discuss how to effectively conduct sexual health promotion research using new forms of technology. The meeting was structured to cover the following topic areas: (i) research-community partnerships, (ii) institutional review board and ethical issues, (iii) theoretical frameworks, (iv) intervention approaches, (v) recruitment methods, and (vi) assessing impact. Presentations included case studies of successful technology-based HIV/STI prevention interventions for youth, which led to broader discussions on how to conduct research in this area. This article summarizes the meeting proceedings, highlights key points, offers recommendations, and outlines future directions.

Projecting HIV Transmission in Japan

BackgroundLittle is known about the epidemiology of HIV in Japan, though newly-identified cases amongst men who have sex with men (MSM) show an increasing trend. Predictions of future trends in the HIV epidemic are essential to identify suitable interventions.MethodsA deterministic, compartmental model was developed that incorporated risk groups, disease stages, and treatment and testing parameters. This model was calibrated against current figures on new infections and run over 30 years to identify trends in prevalence amongst MSM, low-risk men and low-risk women. Multivariate sensitivity analysis was used to estimate sensitivity ranges for all outcomes.ResultsWithout new interventions amongst MSM in Japan, HIV prevalence will climb from its current rate of 2.1% to 10.4% (sensitivity range 7.4% to 18.7%), while HIV prevalence among low-risk men and women will likely decline. With small changes in safer sex behavior and testing rates, HIV prevalence can remain stable or even decline amongst MSM.ConclusionsJapan is at risk of an epidemic of HIV amongst MSM unless significant changes are made to its current public health intervention framework. More research is necessary to understand the key drivers of the epidemic in Japan.

HIV risk perception among men who have sex with men in two municipalities of China-implications for education and intervention

Men who have sex with men (MSM) are recognized as being at high risk for HIV infection. While studies have found that the prevalence of risky behaviors routinely remained high among MSM, few have focused on reasons why MSM may perceive they were or were not at risk for HIV infection. The objective of this study was to examine HIV risk perception among MSM in Beijing and Chongqing, China. A qualitative study consisting of eight focus group discussions and 65 in-depth interviews were conducted with MSM in the two cities. Participants felt that most MSM were aware of the high prevalence of HIV infection among MSM. Yet despite this awareness, most participants thought it was unlikely they would become infected with HIV. The reasons raised by participants included: AIDS was a foreign disease, cleaning after sex prevented transmission, being the insertive partner during sex was not risky, their partner(s) could be trusted, and feeling lucky made HIV/AIDS acquisition unlikely. The findings of this study suggest that a multi-pronged and tailored approach is needed to increase risk perception and safe sex behaviors among MSM in China. This may be achieved through HIV/AIDS interventions that use MSM-friendly media targeting misconceptions of HIV risk, stigma, and discrimination rather than simply distributing condoms.

Neurological Function, Information–Motivation–Behavioral Skills Factors, and Risk Behaviors Among HIV-Positive Alcohol Users

The purpose of this study was to examine neurological impairment in combination with information-motivation-behavioral skills (IMB) variables. The study tests the role of IMB variables as mediators of antecedent variables of demographics, life stress, social support, and neurological impairment with outcome measures of HIV preventive and risk behaviors in a sample of HIV-positive, alcohol-using adults (n = 250) with a history of alcohol abuse/dependence. Neurological impairment was measured with the Color Trails Test (CTT). Average performance on the CTT by the sample was substantially worse than established norms. In a directional latent variable model, neurological impairment directly predicted lower transmission knowledge scores and poorer performance on an observational condom skills assessment. Greater neurological impairment was significantly associated with greater age. Future interventions geared toward HIV+ adults who use alcohol should take into consideration HIV-related and age-related neurological functioning which may impede the facilitation of safe sex behaviors.

When do condom use intentions lead to actions? Examining the role of sexual communication on safer sexual behavior among people living with HIV

This study investigated the moderating role of sexual communication in the association between intentions to use condoms and unprotected sex in a sample of 358 individuals living with HIV (233 men, 125 women, M age = 43). Longitudinal analyses revealed a significant interaction between condom intentions and sexual communication: individuals who were high in both condom intentions and safer sex communication engaged in less unprotected sex with all partners and with partners of HIV negative or unknown serostatus over six months of follow-up. Among individuals low in communication, intentions were not associated with unprotected sex. Implications for interventions are discussed.

“Pinch, Leave an Inch and Roll”: Applying the Communication-for-Behavioural-Impact (COMBI) Approach to the Promotion of Proper Male Condom Use in Jamaica

IntroductionTHE PROMOTION OF CONSISTENT CONDOM has been a longstanding strategy in the response to the HIV and AIDS epidemic. The generic use a condom every time message has been featured in many health communication campaigns promulgating consistent condom use. This article recounts the experience of the Pinch, Leave an Inch and Roll campaign which focused on the specific steps of putting on a male condom properly, and targeted males aged fifteen to twenty-four years. The campaign was planned during 2008 and implemented during 2009-2010 by the National HIV/STI Programme of Jamaica as one strategic communication activity within their overall behaviour change communication which includes a mix of mediated and interpersonal communication-based interventions. Communication for Behavioural Impact (COMBI), a multifaceted approach to communication planning, is used as the framework for understanding the process of creating the Pinch, Leave an Inch and Roll campaign. It must be noted that while the COMBI approach was not purposefully used in the entire planning process of the campaign, it is applied here post-implementation as a way to conduct a structured review of what occurred during the evaluation, design, and execution stages. Of the National HIV/ STI Programme's many campaigns, Pinch, Leave an Inch and Roll was chosen as a good example of communication in action because summative evaluation indicated that it had a relatively high message recall one year after its implementation.1 The campaign also employed many of the tenets of development communication campaign planning.2Background to the National HIV/STI Programme and its condom promotion activitiesThe National HIV/STI Programme of Jamaica was established in 1986 by the Ministry of Health as an extension of the former Sexually Transmitted Disease Control Programme, which was in existence from 1930. The National HIV/STI Programme is responsible for coordinating and leading the implementation of Jamaica's response to HIV and AIDS. In order to fulfil this mandate, the National HIV/STI Programme focuses on four main components: prevention; treatment, care and support; enabling environment and human rights; and monitoring and evaluation.3Within the HIV-prevention component of the National HIV/STI Programme, behaviour-change communication interventions promoting safer sexual behaviour are created to control the transmission of HIV and AIDS among the wider population and, in particular, among the most at-risk populations which include sex workers, men who have sex with men, people living with HIV, out-of-school youth, homeless drug users, and inmates. The prevention efforts aimed at changing risky sexual activities and sustaining safer sexual practices a multisectoral approach. The HIV prevention team within the Ministry of Health collaborates closely with other agencies offering services that are useful to the various targeted populations. In order to ensure that individuals possess the self-efficacy to adopt and maintain relevant behaviours, the HIV prevention team utilises a number of strategies, including community outreach activities and special events which usually include free HIV testing, and distribution of free condoms coupled with condom demonstrations undertaken by the client and guided by the intervention officer. These are supported by national media campaigns which not only provide information but also encourage the practice of appropriate safer-sex behaviours such as consistent condom use.Other strategies of the National HIV/STI Programme's HIV prevention component include the of cultural vehicles such as television shows and party interventions. Through sponsoring of various television and party events, the programme is able to position its efforts in locations which are likely to increase the visibility of key messages and allow for the conduct of condom demonstrations. In 2009, for example, the National HIV/STI Programme sponsored Magnum Kings and Queens of the Dancehall, the popular Jamaican dancehall competition aired weekly on the television station TVJ. …