Sexual Practices Research Articles

Differences in Pediatricians' Income by Sex Over Time.

Previous Pediatrician Life and Career Experience Study (PLACES) 2016 data revealed that female pediatricians reported earning ∼94% of what male pediatricians reported, after adjusting for factors that might impact income. Has this disparity persisted? Data from PLACES, a national longitudinal study, was used to examine pediatrician-reported income from 2017 to 2022. A regression analysis estimated the adjusted differences in female and male pediatricians' annual income for each survey year. Models included sex and other key personal and practice characteristics for which female and male pediatricians' careers might differ. A mixed effects regression for longitudinal analysis examined income across years for female and male pediatricians and if time-variant characteristics are associated with increased or decreased income. PLACES participation ranged from 83.6% in 2017% to 75.5% in 2022 (analytic n = 1251 in 2017 and 1077 in 2022). The unadjusted mean annual income in 2022 was $237 168, $220 374 for female pediatricians and $284 286 for male pediatricians. Adjusting for key characteristics, female pediatrician income was ∼93% of male pediatrician income, a gap of ∼$ 11 000 annually. Income increased across years (coefficient = 0.03, P < .001). The year-sex interaction was not significant, indicating that the female-male disparity did not change over time. Three time-variant characteristics associated with increased income over time included increased portion of continuous full-time work, work hours, and time in administrative work. A national longitudinal study revealed that female pediatricians reported earning ∼93% of what their male colleagues reported, with a consistent gap from 2017 to 2022.

Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study

Background: Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups. Objectives: This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM. Methods: A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression. Results: The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using “glory holes” (aOR: 19.82; 95% CI: 1.60–245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52–16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72–9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27–7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13–3.30) also showed a higher likelihood of vaccine hesitancy. Conclusion: Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Alcohol consumption and risky sexual behaviours: consistent patterns in France and South Korea

Abstract Background Despite the concurrent increase in harmful alcohol use and risky sexual behaviours associated with STIs and HIV/AIDS among young adults, their relationship remains inconsistent due to the inherent influence of sociodemographic and cultural factors on drinking and sexual practices. This study aims to examine the relationship between alcohol consumption and risky sexual behaviours and cross-validate this relationship in France and South Korea. Methods We conducted a cross-sectional survey among young adults aged 18 to 30 in France and in South Korea in 2023-2024 (n = 998; 489 in France, 509 in Korea). A spearman partial correlation and a z-test on Fisher-transformed correlation coefficients were used to determine the relationship between alcohol use and risky sexual behaviours, as well as the consistency of this relationship across both samples. Results After controlling for age, gender, occupation, education, and perceived socioeconomic status, a positive correlation was found between the age of alcohol initiation and the age at first sexual intercourse in both samples (r=.17 in France, r=.28 in Korea; p &amp;lt; 0.001). Alcohol Use Disorder Identification Test (AUDIT) score and the frequency of drunkenness showed positive correlations with the number of sexual partners (r=.19, r=.26 in France; r=.19, r=.23 in Korea; p &amp;lt; 0.001). These two alcohol use indicators were also correlated with the frequency of inconsistent condom use (r=.15, r=.12 in France; r=.06, r=.14 in Korea; p &amp;lt; 0.001). The Z test confirmed that there is no significant difference in all correlation coefficients between the French and Korean samples. (p &amp;gt; 0.05, 95% CI). Conclusions An integrated health intervention aimed at simultaneously addressing harmful alcohol use and risky sexual behaviours is warranted to prevent high prevalence of sexually transmitted infections among young adults. Key messages • Recent data support that alcohol use is associated with risky sexual behaviours among young adults. • This relationship is consistent regardless of different sociodemographic and cultural settings.

Perceptions of MSM on targeted sexual healthcare about HPV vaccination: a French qualitative study

Abstract Background To improve the effectiveness of public health policies, HPV vaccination campaigns target “high-risk groups”, such as men who have sex with men (MSM). In France, HPV vaccination is recommended for MSM up to the age of 26, rather than 19 for the general population. It’s crucial to assess the impact of such targeting policies on MSM who are eligible for HPV vaccination. Methods A qualitative study was conducted between April and July 2022 among MSM participating in the “Vaccigay” electronic survey in France (Brosset et al. 2023). Participants were selected based on age and declared HPV vaccination status. Semi-structured interviews were conducted by telephone using a thematic grid on the barriers and facilitators influencing the uptake of the vaccine against HPV. The interviews lasted on average 40 minutes. The audio-recorded verbatims were transcribed and thematically analysed using NVivo software. Results A total of 22 viewpoints were analysed. Two opinions emerged without differences in terms of individuals’ profile. The reasons MSM advocated for targeted sexual healthcare stemmed from the recognition of epidemiological factors, as well as the need for greater listening and understanding from healthcare workers. MSM who didn’t support targeted sexual healthcare did so because they felt stigmatised and because sexual orientation might not always be clear. Among them, some advocated for sexual healthcare based on sexual practices rather than sexual orientation. Others emphasized the necessity of extending prevention tools for sexual risks existing for MSM to the general population. Conclusions The findings of this study prompt reflection on universal versus targeted public health policies, as well as sexual and gender discrimination within the healthcare system. We recommend improving healthcare workers’ education on sexual healthcare, and that HPV vaccination guidelines could be extended to all adults up to 26, regardless of their sexual orientation. Key messages • Improving knowledge among healthcare workers and MSM about HPV and sexual health is important. • It is important to extend the age for the HPV vaccination, regardless of sexual orientation.

Family-based sexual health intervention for adolescents; A systematic review and meta-analysis

Abstract Background Family-based interventions are important in promoting adolescent sexual health outcomes. However, the effectiveness of these interventions in promoting adolescent sexual and reproductive health (ASRH) in Lower and middle-income countries (LMIC) has not been empirically evaluated. This review aimed to summarise the effectiveness of family-based sexual and reproductive health interventions in promoting ASRH in LMIC. Methods We conducted a systematic search for studies published in English from 2000 to October 2023 using MEDLINE, PsyINFO, CINAHL, Web of Science, and EMBASE databases. Studies were included if they involved adolescents aged 10-19 years, included family members in a key intervention component, evaluated the effectiveness of the interventions using an experimental or quasi-experimental design, assessed ASRH outcomes reported by adolescents and were conducted in LMIC setting. Standardized mean difference (SMD) and 95% confidence intervals were computed and meta-analyses were conducted using random effect models. Results Ten articles involving 2,246 participants were included in the review. The studies were nostly conducted in Africa. Across studies, there was no significant impact of family-based interventions in improving adolescent sexual health knowledge (SMD=0.5, 95%CI: -1.98 to 2.98), attitudes (SMD= -0.05, 95%CI: -1.92 to 1.82), practices (SMD=0.53, 95%CI: -0.69 to 1.75), or sexual communication with their family (SMD= 0.14, 95%CI: -0.42 to 0.7). Although individual studies reported a mixed effect of family-based interventions in improving sexual health outcomes, the pooled results from the meta-analysis showed no significant impact of family-based interventions. Conclusions Our review did not find any significant impact of family-based interventions in improving ASRH in LMIC. We recommend interventions using innovative approaches and novel strategies to align with the socio-cultural and economic background of the study setting. Key messages • This study found no significant impact of family-based interventions in improving ASRH in LMIC. • Additional studies, particularly from Asia, using culturally relevant interventions is required in this area.

Enhancing literacy among the elderly on sexually transmitted infections: an educational intervention

Abstract Issue Sexually transmitted infections (STIs) pose significant public health concerns across different settings and countries, especially in elderly populations, in which recent increases have been noted. This project aimed to target STIs literacy among the elderly, addressing a crucial gap in public health education. Description of the problem This project focused on improving STIs literacy among elderly residents in a municipality in Northern Portugal. Using innovative methods such as tailored materials and interactive sessions, the intervention aimed to evaluate their effectiveness through pre-, post-, and one-month follow-up STD-KQ questionnaire assessments (composite score of total correct calculated as average, ranged from 0 to 27). Statistical analysis used SPSS IBM for Mac OS® v29. Descriptive statistics: mean ± standard deviation for continuous, proportions (%) for categorical variables. Analysis included only individuals with complete data. ANOVA with Bonferroni post hoc tested intervention impact on STD-KQ scores. Results Fifty-one individuals participated in this study, with an average age of 70,89 ± 5,10 years old, and 64,7% female. The average STD-KQ score increased by 151.54% immediately after, 11.39 ± 5.66 (p &amp;lt; 0,01), and by 122.54% after one month, 10.08 ± 5.35 (p &amp;lt; 0,01), compared to pre-intervention, 4.53 ± 3.96 (p &amp;lt; 0.01). The score at one month follow-up remained similar to post-intervention (p = 0.39), presenting a significant improvement in STIs knowledge. Lessons This pioneering project, to the best of our knowledge the first of its kind, demonstrates the effectiveness of tailored educational interventions in improving STIs literacy among the elderly, with sustained effects after one month. This innovative approach can be adapted and scaled up for broader use in different settings and countries. Key messages • Tailored educational interventions can be a powerful public health strategy to effectively enhance long-term STI literacy among elderly populations. • Assessing knowledge about STIs can be a crucial initial step for physicians to provide or refer for comprehensive education on safe sexual practices in this age group.

Factors associated with risky sexual behaviors among undergraduate students in Thailand

BackgroundRisky sexual behaviors refer to actions or practices that increase the likelihood engaging in sexual intercourse. Such behavior can lead to HIV infection/AIDS, sexually transmitted diseases, and unintended pregnancy. The impact of risky sexual behaviors is a growing public health concern. These issues pose significant challenges to public health, particularly among university students and younger age groups who may be more vulnerable to various factors. Thus, this research aimed to examine the factors and sexual health literacy associated with risky sexual behaviors among undergraduate students in the four major regions of Thailand.MethodA cross-sectional study was conducted among 916 undergraduate students in their final semester of the 2023 academic year, from March to May 2024, at public, autonomous, and private universities across four regions: northern, central, southern, and northeastern of Thailand. The study employed multistage random sampling method. A self-administered structured questionnaire was used to assess risky sexual behaviors and the data were analyzed using multiple logistic regression.ResultsA total of 916 students participated in the study. The prevalence of risky sexual behavior was 46.84% (95% CI:43.56% to 50.12%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with grade point averages (GPA) between 2.00–3.00 could protective risky sexual behaviors was 42% as compared to GPA > 3.00 (AOR = 0.58, 95%CI:0.42 to 0.79), ex-substance use (AOR = 3.48, 95%CI:1.46 to 8.26), Current smoker (AOR = 2.90, 95%CI:1.90 to 4.43), negative attitudes toward risky sexual behaviors (AOR = 2.32, 95%CI:1.32 to 4.06), access to places of ill repute and access to sexual arousal stimuli (sometime) (AOR = 2.23, 95%CI:1.41 to 3.52), social influences (high level) (AOR = 0.29, 95%CI:0.15 to 0.55), and sufficient to excellent level of the application of information about sexual health (AOR = 0.48, 95%CI:0.26 to 0.87) of statistical significance at P < 0.05, which was significantly associated with risky sexual behavior.ConclusionThe findings of this study offer important insights for preventing risky sexual behaviors among undergraduate students across four regions. By promoting healthy sexual practices and encouraging behavior modification, negative consequences can be reduced. Public health care providers, policymakers, and stakeholders should implement tailored strategies, such as comprehensive sexual education and accessible health services, to address the specific needs of these students. These targeted interventions can significantly reduce the prevalence of risky sexual behaviors.

O ENGAJAMENTO DOS ESTUDANTES DE MEDICINA COM AS PRÁTICAS PROFILÁTICAS DO HIV

The human immunodeficiency virus (HIV) remains one of the main global public health challenges, with approximately 1.5 million new infections in 2021, despite the therapeutic advances that have transformed the prognosis of AIDS. In Brazil, HIV has an incidence rate of 17.69 cases per 100,000 inhabitants in 2020, with a significant increase among young people aged 13 to 29, especially in the North and Northeast regions. This cross-sectional study analyzed 50 medical students from a university in Brazil, investigating the association between age group and safe sex practices, such as the use of condoms, as well as the perception of vulnerability to HIV. The results indicate that 61.2% of the students used condoms during sexual relations in the last 12 months, with no significant correlation with age group (p=0.507). However, 50% of the students justified not using condoms because they trusted their partner, and 82% believed that they would be unlikely to be infected with HIV because of their social environment. Statistical analysis also showed that the perception of invulnerability to HIV does not vary significantly with age group (p=0.350). This study investigated risk perception and condom use among medical students, concluding that there is no significant correlation between age group and safe practices. Trust in the partner was a relevant factor in the non-use of condoms, highlighting the need for educational campaigns to promote preventive behaviors and awareness among future health professionals.

Discussion of HIV and Other Sexually Transmitted Infections with Sex Partners of Nigerian Men who have Sex with Men and Transgender Women: Implications for Interventions to Promote Safer Sex Practices.

Discussion of HIV and other sexually transmitted infections (STIs) among sex partners facilitates risk reduction. We evaluated HIV/STI-related communications, including broad assessment of any self-reported discussion of the topic and specific discussion of each partners' HIV status, among a historically marginalized and presently criminalized community of sexual and gender minorities (SGM) in Nigeria. From 2013-2018, we enrolled SGM aged 18+ in Lagos or 16+ in Abuja who reported anal sex with men. At enrollment and 3-, 9-, and 15-month follow-up visits, participants were asked about their sexual behaviors and communications with main sexual partners (MSP) and casual sexual partners (CSP). Questions included "have you talked with your [MSP/CSP] about sexually transmitted infections and HIV?" Multivariable robust Poisson regression with generalized estimating equations was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV/STI-related communications with some or all of each type of sexual partner. Among 2795 SGM enrolled with median age 23 years (interquartile range 20-27), questions about HIV/STI-related communications with MSP were answered by 2436 (87.2%) and with CSP by 2398 (85.9%). Communication with MSP was reported by 68.1% (1659/2436), of whom 897 (54.1%) discussed their own HIV status and 925 (55.8%) discussed their partner's status. Communication with CSP was reported by 43.9% (1052/2398), of whom 389 (37.0%) discussed their own HIV status and 385 (36.6%) discussed their partner's status. Among participants with both MSP and CSP, HIV/STI-related communication with MSP was more common among participants with higher than secondary education (aRR 1.40 [95%CI 1.24-1.58)], who were divorced/separated/widowed (aRR 1.19 [95% CI 1.06-1.33]), who discussed their HIV status with CSP (aRR 1.18 [95%CI 1.10-1.25]), discussed CSP's HIV status (aRR 1.20 [95%CI 1.13-1.27]), and used a condom at last sex with CSP (aRR 1.16 [95%CI 1.08-1.25]). HIV/STI-related communication with CSP was more common among participants with higher than secondary education (aRR 1.36 [95%CI 1.12-1.66]); who were divorced/separated/widowed (aRR 1.38 [95%CI 1.13-1.69]), who discussed their HIV status with MSP (aRR 1.47 [95%CI 1.27-1.69]), who discussed CSP's HIV status (aRR 1.22 [95%CI 1.06-1.40]) and used a condom at last sex with CSP (aRR 1.22 (95%CI 1.08-1.38]). HIV/STI-related communications with main and casual sex partners were both associated with safer sex with CSP. HIV prevention and treatment programs for SGM should promote open communications in sexual relationships and consider deployment of modern strategies to facilitate disclosure, especially in settings with criminalizing legislation.

Urinary tract infection among pregnant Jordanian women: role of hygiene and sexual practices

PurposeThe purpose of this study was to examine the association between hygiene and sexual practices and the incidence of urinary tract infection (UTI) among Jordanian pregnant women.MethodsThe cross-sectional data were collected using self- administered survey from October 2018 to January 2019 in central Jordan. A total of 200 pregnant women completed the survey. All of them were married and aged between 18 and 45 years (M = 27.45; SD = 6.06). The measures used were demographics, social, hygiene and sexual practices.ResultsA significant association was found between the incidence of UTI and the educational level of husbands (p = 0.05), history of UTI in previous pregnancies (p = 0.02) and being in the second trimester of pregnancy (p = 0.02). Their sexual and hygiene practices also were significantly associated with the incidence of UTI.ConclusionHistory of UTI in previous pregnancies, hygiene and sexual practices are associated with increased incidence of UTI among Jordanian pregnant women. Appropriate strategies and techniques to promote health and preventive behaviors for pregnant women with UTI should be provided to improve the quality of life among pregnant women and reduces economic burdens on health care system.

A UK survey of young people's views on condom removal during sex.

Non-consensual condom removal (NCCR) refers to the act of removing a condom during sex without the other person's permission. It poses physical and psychological risks to women's health. Views and attitudes regarding this sexual practice are not well understood in the UK. This study aimed to explore young people's views on the morality and criminality of NCCR and how their views are affected by negative health outcomes, relationship status, and socio-demographic characteristics. A quantitative online survey of people aged 18-25 living in the UK was conducted. The survey consisted of two NCCR scenarios, varied by health outcome and relationship status, followed by questions about the morality and criminality of NCCR and respondents' socio-demographic characteristics. Statistical analysis included Chi-square testing and logistic regression modelling. Most of the 1729 respondents considered NCCR to be a violation of consent to sex (97.4%-98.1%), to be wrong (99.3%-99.5%), and to be sexual assault (86.3%-89.2%). Respondents were more likely to support prison time for NCCR if the victim got pregnant (52.1%) (rather than depressed (41.6%)) or was part of a casual hook-up (53.9%) (as opposed to a long-term dating relationship (47.2%). Respondents who were female or non-heterosexual were more likely to view NCCR as sexual assault and support prison as a penalty for NCCR. The majority of young UK adults in this survey considered condom removal during sex without the other person's permission to be a violation of consent, morally wrong, and a form of sexual assault. Support for prison as a penalty was lower. These findings can inform future campaigns on consent in sexual relationships and legislation to provide support for women affected by NCCR.

'When extramarital sex threatens patriarchy': the iwushi-miri rite among Mgbowo women of southeastern Nigeria.

This study argues that not every instance of extramarital sexual intercourse among the Igbo women of southeastern Nigeria is adulterous. Using the sex-related rite of iwushi-miri (pouring of water) among the Mgbowo women of southeastern Nigeria (Igboland) as an example, the study explores to different means that women have had of negotiating extramarital sexual relationships, and sexual behaviours in the traditional, colonial and Christian patriarchal environments. The study brings together both ethnographic and feminist cultural resistance research to appraise the distinctions between punishable and culturally permitted extramarital sexual practices, and to highlight the role that extramarital sexual culture played in resisting the patriarchal domination of female sexuality in the age of empire. It also explores the challenges and the responses of Mgbowo women in negotiating extramarital relationships in a modern-day patriarchal setting. It sets out to explore how women's sex power, agency and influence have been silenced in the colonial archives and mainstream scholarship. Through semi-structured interviews, the analysis of material culture, and participant observation, this study provides insight into traditional sexual culture(s), marital intercourse, and sex-related rituals among Mgbowo women.

“I Feel More Masculine Having Sex with a Woman Than Being Fucked by a Man”: Masculinity and Bisexual Men's Experiences of Sex with Women and Men

ABSTRACT Prior research with heterosexual and gay men suggests that heteronormative, hegemonic masculine norms influence sexual behaviors, including in relation to sexual health, and in sex between men, positioning in anal intercourse. This qualitative study offers an in-depth account of how bisexual men’s beliefs about masculinity and about the gendered nature of certain sexual behaviors may influence their experiences of sex with women and men, and the sexual practices they engage in. Twenty-two bisexual men participated in one-to-one, semi-structured interviews, where they were asked about their experiences of sex with women and men in relation to their beliefs about masculinity. A reflexive thematic analysis identified the influence of prevailing discourses of heteronormativity and hegemonic masculinity on sexual experiences and behaviors. Participants’ beliefs about masculinity and the gendered nature of certain aspects of sex influenced experiences relating to sexual performance, sexual assertiveness, positions adopted, practices engaged in, and how gender was enacted in sexual encounters. Sex with women was experienced as more masculine than sex with men: Participants described feeling more sexually assertive than their sexual partners, in control of the encounter, and responsible for facilitating their partners’ sexual pleasure. Sex with men was experienced as more egalitarian and provided favorable opportunities to relinquish sexual control and responsibilities around facilitating pleasure, and to feel less masculine, including by engaging in receptive anal intercourse. Findings therefore indicate that, for some bisexual men, masculinity is highly salient, influencing a range of sexual behaviors and experiences in sex with women and with men.

Canvassing Taboo: African Sexuality as Post-Cultural Discourse in the Kenyan Disconnect 2 and Nafsi Films

Sexuality narratives in the Kenyan film industry play a crucial role in directly and indirectly shaping narrative interests, addressing stakeholder concerns, and delivering effective messaging. Locally, these narratives are closely monitored, regulated, and classified due to their sensitive nature, compounded by their evolving nature as newer sexuality concepts integrate with traditional paradigms. This study aims to explore the social conceptualization of African Sexuality as a Post-Cultural Discourse in the Kenyan films Disconnect 2 and Nafsi. Utilizing film analysis and key informant interviews with industry professionals, the research reveals that post-cultural sexuality narratives are presented as non-threatening sexual ideals and practices that can coexist harmoniously with traditional sexual paradigms. Recommendations include establishing a structured hierarchy for sexual narratives in film production to depict both traditional and post-cultural themes effectively. By incorporating consequences within the post-cultural discourse, audiences can better engage with and understand the complex sexual ideologies presented in these films.

Dual HIV risk and vulnerabilities among people who inject drugs in Iran: Findings from a nationwide study in 2020

IntroductionPeople who inject drugs (PWID) are a key population at risk of HIV in Iran. We measured the prevalence and covariates of HIV-related risk behaviours among PWID in Iran.MethodsWe conducted a respondent-driven bio-behavioural surveillance survey among PWID from July 2019 to March 2020 in 11 major cities. We assessed PWID’s recent (i.e., last three months) HIV-related risk behaviours using a four-level categorical variable: Only unsafe injection (i.e., sharing needles/syringes or injecting equipment), only unsafe sex (i.e., unprotected sex), dual HIV risk (i.e., both unsafe injection and unprotected sex), and safe injection and sex. Data were summarized using RDS-weighted analysis. Multinomial logistic regression models were built to characterize HIV-related risk behaviours and relative risk ratio (RRR) with 95% confidence interval (CI) were reported.ResultsOverall, 2562 men who inject drugs (MWID) were included in the regression analysis. The RDS-weighted prevalence of dual HIV risk was 1.3% (95% CI: 0.8, 1.9), only unsafe injection was 4.5%, and only unsafe sex was 11.8%. Compared to the safe injection and sex group, dual HIV risk was significantly and positively associated with multiple partnership (RRR = 15.06; 3.30, 68.73). Only unsafe injection was significantly associated with homelessness in the last 12 months (RRR: 3.02; 95% CI: 1.34, 6.80). Only unsafe sex was significantly associated with multiple partnership (RRR = 6.66; 4.27, 10.38), receiving free condoms (RRR = 1.71; 1.01, 2.89), receiving free needles (RRR = 2.18; 1.22, 3.90), and self-received risk for HIV (RRR = 2.51; 1.36, 4.66). Moreover, history of HIV-testing in the last three months was significantly associated with only unsafe injection (RRR = 2.71; 1.84, 3.80). Among the 90 women who injected drugs, none reported dual HIV risk behaviours.Discussion and conclusionsWhile the low prevalence of dual HIV risk among PWID is encouraging, unprotected sexual practices among PWID is concerning. Expanding sexual health education and care services as well as tailored interventions aimed at reducing high-risk sexual activities among PWID are warranted. Additionally, tackling potential misperceptions about risk of HIV transmission among PWID in Iran is warranted.

Trajectories and management of vascular risk following the diagnosis of multiple sclerosis: A population-based matched cohort study between 1987 and 2018 in England.

People with multiple sclerosis (PwMS) have an increased cardiovascular and cerebrovascular disease burden, but this could be mitigated by vascular risk factor management. We compared the trajectories of vascular risk factors, vascular comorbidities and clinical management in PwMS against the general population post-MS diagnosis while controlling for frailty. Retrospective longitudinal analysis using English data from the Clinical Practice Research Datalink between 1987 and 2018 comprising PwMS matched with up to six controls without MS by age, sex and general practice. We compared 12,251 PwMS with 72,572 matched controls; 3.8% of PwMS had mild-moderate frailty, 1.2% more than matched controls. Compared to controls, PwMS had an elevated incidence of Type 2 diabetes (HR 1.18, 95% CI (1.04, 1.34)), and starting antihypertensive medications (HR 1.40, 95% CI (1.33, 1.47)). Among those with hypertension at baseline, blood pressure trajectories did not differ between PwMS and controls. PwMS had increased rates of meeting targets for hypertension management (HR 1.25, 95% CI (1.12, 1.41)). The observation that PwMS with hypertension are more likely to meet treatment targets than matched controls is encouraging, but the elevated rates of vascular comorbidities suggest that tighter vascular management may be needed in this population.

“Gays in Your Living Room”: LGBTQ+ Television, Homophobia, and the Birth of Channel 4 in 1980s Britain

ABSTRACT This article examines the conflicting attitudes toward homosexuality and public-service broadcasting among British program-makers, pressure groups, newspapers, politicians, and viewers in the 1980s through the prism of Channel 4’s One in Five (1983), billed as “the first programme ever to begin to show what it means to be positively gay.” It pairs a close reading of the broadcast with wide-ranging research in the archives of broadcasters, LGBTQ+ organizations, Parliament, and the press to show why minority programming formed a major arena of contestation over the representation and rights of lesbian and gay people in late twentieth-century Britain. Straight opposition to One in Five captured the strength and characteristics of homophobia in the 1980s, while the program’s divisive effect on queer audiences illuminated divisions within the LGBTQ+ community at the cusp of the HIV/AIDS crisis. The program was dogged by difficulties in creating a cohesive queer identity capable of accommodating differences in gender and ethnicity, region and nation, lifestyle, class, sexual practices, and political orientation. The inception, production, and reception of One in Five simultaneously highlight the particularities of sexual politics in Thatcherite Britain and ongoing dilemmas about the processes and merits of achieving inclusion, diversity, and equality for marginalized groups.

The impact of COVID-19 vaccination on patients with congenital heart disease in England: a case-control study

BackgroundStudies predating widespread COVID-19 vaccination identified patients with congenital heart disease (CHD) as a group at increased risk of severe outcomes from COVID-19. Here we evaluate the impact of vaccination...

Risk of Clade II Mpox Associated with Intimate and Nonintimate Close Contact Among Men Who Have Sex with Men and Transgender Adults - United States, August 2022-July 2023.

A global outbreak of clade II mpox associated with sexual contact, disproportionately affecting gay, bisexual, and other men who have sex with men (MSM), has been ongoing since May 2022. Information on types of contact most associated with transmission is limited. This report used data from a multijurisdictional vaccine effectiveness case-control study of sexually active persons aged 18-49 years who identified as MSM or transgender, collected during August 2022-July 2023. Odds of mpox associated with selected types of intimate and nonintimate close contact with a person with mpox were estimated. Among 457 case-patients and 1,030 control patients who met minimum data requirements, 150 (32.8%) case-patients and 57 (5.5%) control patients reported close contact with a person with mpox and were included in this analysis. Adjusted odds of mpox were 5.4 times as high among those who reported having condomless receptive anal sex with a person with mpox, compared with participants who reported close contact with a person with mpox and no condomless receptive anal sex with that person (OR = 5.4; p = 0.031). Although the mpox vaccine is highly effective, vaccination coverage remains low; a multifaceted approach to prevention remains important and should include vaccination promotion, safer sex practices, and increasing awareness that mpox continues to circulate.

Residents’ place attachment and tourist sexual behaviour in a European coastal tourist destination

PurposeDespite extensive research into residents’ attitudes towards tourist behaviour, little has been explored about the extent to which visitors’ practices contribute to the formation of residents’ bonds with their place of residence, which is also a tourist destination. Therefore, this research aims to determine how residents’ perception of tourist sexual behaviour affects their engagement with the urban environment and the image of the city and tourist destination in which they live. To structure and interpret the various attitudes of the residents surveyed, the authors used a conceptual framework based on identity process theory (IPT) in relation to residents’ attitudes and the impact of a particular dimension of tourist behaviour – their sexual practices – on their perceived connection to their place of residence.Design/methodology/approachA questionnaire was administered to a sample of 457 residents in Salou to collect data regarding their assessments of the sexual behaviour of tourists in their community. A cluster analysis was used to classify residents according to their attitudes and stances towards the different sexual practices of visitors and their evaluation of the importance of those practices for current and future tourism at the destination. Finally, an analysis of variance was performed to compare significant differences in attitudes towards tourist behaviour and the attachment to Salou among the different segments of residents identified.FindingsThe study identified four groups of residents classified by their attitudes towards tourist sexual behaviour: permissive bystanders, supportive expectants, ambivalent pragmatics and opposed rejectors. Two attitudinal components explain the differences between the groups: tolerance and personal interest, which are associated with how residents construct their bond with Salou in terms of place attachment (PA). These results align well with IPT, as they highlight processes of assimilation, evaluation and the contribution of symbolic significance to the place of residence, mediated by the perception of tourist sexual behaviour.Practical implicationsSome practical recommendations are offered to tourist destination administrations regarding the differences among residents’ attitudes towards tourist behaviour and PA. The findings can serve as a valuable tool for designing tourism policies aimed at selecting markets, as well as for marketing and promoting tourist destinations.Originality/valueThe originality of this study lies in that it considers the role of tourist sexual behaviour as a compositional element of the identity of the place – a tourist destination – where residents live, providing new empirical data on an under-researched academic issue. This article attempts to contribute to a critical perspective by conceptualising and introducing new elements for understanding the identity, attraction and sexuality of tourist sites. The study also connects with the urban analysis of tourist destinations, incorporating the role of sex into the social construction of the tourist city, the creation of identity and image and the attribution of symbolic meaning to destination settings.