Sexual Health Behaviors Research Articles

Exploring Sexual Satisfaction in Lesbian and Bisexual Women from a Minority Stress Perspective

Sexual health among lesbian and bisexual (LB) women has largely been studied in the context of sexual health behaviors. Less is known about aspects of sexual health such as sexual satisfaction and minority stress processes as possible predictors of sexual satisfaction. This study explored sexual satisfaction and minority stress in LB women. Single and partnered cisgender LB women (N = 627) were compared on measures of sexual satisfaction and proximal minority stress (i.e., internalized homonegativity and outness/concealment). The proximal minority stress variables were tested as predictors of sexual satisfaction in a regression analysis. Multigroup analyses were also conducted to explore differences between lesbian and bisexual women in the regression analysis. Participants were recruited through LGBT+ websites and other social media platforms in Norway. Results showed that lesbian women were more open about their sexual orientation, reported greater identification with the LGBT+ community, and were more sexually satisfied than bisexual women. Those with a steady partner were also more sexually satisfied than those who were single. Being younger, partnered and experiencing less internalized homonegativity (IH) predicted greater satisfaction in LB women overall, and no differences in the predictors across sexual orientation were found in the multigroup analysis.

The HIV prevention decision-making cascade: Integrating behavioural insights into HIV prevention efforts

The syndemic of HIV, sexually transmitted infections (STIs), and early pregnancy remain a key challenge to global public health. Decision-making around sexual and reproductive health (SRH) behaviours is critical to ensuring the uptake of biomedical technologies. Drawing from behavioural science theories, we propose a novel conceptual framework—the Decision Cascade—to describe the decision-making process that a user will go through as they navigate these decisions. Analogous to the HIV prevention and treatment cascade, this model describes key steps individuals go through when deciding to use HIV prevention technologies. Each step (being cued/triggered to act, reacting to the behaviour, evaluating the behaviour, assessing the feasibility of acting and the timing and final execution of the action), is influenced by a myriad of individual and socio-cultural factors, shaping the ultimate decision and behaviour outcome in a continual cycle. This framework has applications beyond HIV prevention, extending to other SRH technologies and treatments. By prioritizing human-centered design and understanding user decision-making intricacies, interventions can enhance effectiveness and address the complexities of SRH service uptake across diverse populations. The Decision Cascade framework offers a comprehensive lens to inform intervention design, emphasizing the need for nuanced approaches that resonate with the realities of decision-makers. Adopting such approaches is essential to achieving meaningful impact in HIV prevention and broader SRH initiatives.

Prevalence and factors associated with hepatitis B susceptibility among men who sex with men on HIV pre-exposure prophylaxis in Northeastern Brazil: a cross-sectional study

BackgroundThis study aimed to determine the prevalence and factors associated with susceptibility to hepatitis B virus (HBV) among cisgender men who have sex with men (MSM) on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil.MethodsThis was a cross-sectional, analytical study conducted between September 2021 and June 2023. Participants underwent structured interviews to collect sociodemographic and clinical information, including hepatitis B vaccination history, HIV PrEP use and sexual health history. Blood samples were collected for hepatitis B serologic testing: HBV surface antigen (HBsAg), HBV surface antibody (anti-HBs), total and IgM HBV core antibody (anti-HBc). HBV susceptibility was defined as nonreactive results for all these serological markers.ResultsA total of 287 participants were enrolled into the study. The median age of the individuals was 31 years (interquartile range: 27; 36). HBV susceptibility was found in 58 out 286 individuals (20.3%; 95% CI: 15.9–25.2). Seventy-six percent of the participants reported completing the three-dose hepatitis B vaccine schedule. Susceptibility was significantly associated with a monthly income ≤ 5 minimum wages (PR: 2.02; 95% CI: 1.01–4.05), lack of complete hepatitis B vaccination schedule (PR: 4.52; 95% CI: 2.89–7.06), initiation of HIV PrEP (PR: 2.18; 95% CI: 1.21–3.94), duration of six months of HIV PrEP (PR: 2.16; 95% CI: 1.19–3.91), absence of tattoos (PR: 1.55; 95% CI: 1.00–2.40) and no history of sexually transmitted infections (PR: 1.65; 95% CI: 1.07–2.54).ConclusionOur findings highlight the significant burden of HBV susceptibility among MSM on HIV PrEP in Northeastern Brazil. Socioeconomic factors, vaccination status, PrEP use and sexual health behaviors play critical roles in determining susceptibility to HBV. Integrating hepatitis B screening and vaccination into PrEP services is critical for identifying and addressing HBV susceptibility among MSM. Interventions aimed at increasing vaccination coverage and promoting safer sexual practices are essential for mitigating the burden of HBV infection in this population.

Social capital mediates knowledge gaps in informing sexual and reproductive health behaviours across Africa

Advancing sexual and reproductive health is essential for promoting human rights and women’s empowerment, and combating the HIV/AIDS epidemic. A large body of literature across the social sciences emphasizes the importance of social capital, generated through the strength of social networks, for shaping health behaviours. However, large-scale measurement of social capital and social networks remains elusive, especially in the context of low-income countries. Here we delve into the role of social capital dynamics, and in particular social connectedness across communities as measured through Facebook friendship links, in shaping knowledge diffusion and behaviour related to sexual and reproductive health in 495 regions across 33 countries in Africa. Our findings demonstrate that regions with higher levels of social connectedness are more similar in their knowledge about contraception and HIV testing, as well as their adoption of these behaviours. We further observe that the influence of social connectedness becomes stronger when the knowledge gaps between regions are larger. In other words, regions are more similar in behaviours, despite knowledge gaps, when they are socially connected. These insights carry significant policy implications, especially for the design and targeting of public health campaigns. We highlight that social connectedness can serve both as a driver and an obstacle in behaviour formation, underscoring the importance of understanding its influence on health-related outcomes.

Understanding the high-risk human papillomavirus prevalence and associated factors in the European country with a high incidence of cervical cancer.

High-risk human papillomavirus (HR-HPV) is a known cause of cervical cancer (CC). Latvia has a high incidence of CC compared with the average incidence in the European Union. This study aims to fill the data gap on the HR-HPV burden in Latvia, providing information on its prevalence and associated factors. The cross-sectional study was conducted from February 2021 to April 2022. Participants 25-70 years old visiting a general practitioner (general population) or those referred to a colposcopy clinic with changes in their cervical cytology (colposcopy population) collected vaginal self-sample and completed a paper-based questionnaire. Samples were analyzed with Cobas 6800 System (Roche) for HPV16, HPV18 and other HR-HPV (HPV31/33/35/39/45/51/52/56/58/59/66/68). Descriptive statistics for categorical variables were performed. The Chi-square test was used to determine for the statistical significance of differences in the proportions of the dependent variable between subgroups of the independent variable. Univariate and multivariate binary logistic regression were used to identify factors associated with positive HR-HPV status. Results were considered statistically significant at P < 0.05. A total of 1274 participants provided a valid sample. The prevalence of any HR-HPV infection was 66.8% in the colposcopy group and 11.0% in the general population. Factors associated with positive HR-HPV status were marital status single/divorced/widowed (vs. married/cohabiting) [adjusted OR (aOR) 2.6; P = 0.003], higher number of lifetime sex partners [aOR 5.1 (P < 0.001) and 4.0 (P = 0.001)] for six or more and three to five partners in the general population; in the colposcopy group, the statistical significance remained only for Latvian ethnicity (vs. other) (aOR 1.8; P = 0.008) and current smoking (vs. never) (aOR 1.9; P = 0.01). We documented a comparison to European Union HR-HPV infection burden in Latvia. Any HR-HPV positivity was significantly associated with sexual and other health behavior.

An examination of the sexual health behaviors and cognitions of young U.S. community college students with respect to the intersection of gender and sexual identity

Objective: To assess the sexual health of young community college students so that health promotion priorities can be identified and tailored programming can be implemented for this understudied population. Participants: A national sample of 1,678 community college students. Methods: Survey data was analyzed to understand trends in sexual health – including differences by gender and sexual identity. Results: While 54% of the sample have had vaginal sex and 16% have had anal sex, rates of condom use for these behaviors are low (respectively 51% and 42%). Only 52% of students have communicated with a medical professional about sexual health and 42% have been tested for STIs. Young men have the lowest odds of communicating with a medical professional about sexual health. Heterosexual men have particularly low odds of getting tested for STIs. Conclusions: Community college students need additional resources – eg, education, accessible health care – to promote their sexual health.

The effect of an educational peer-based intervention program on sexual and reproductive health behavior.

The fact that adolescent people experience risky sexual behavior and have insufficient knowledge of sexual and reproductive health (SRH)indicates the need for SRH education. This study investigates the impact of peer-educated SRH programs on the knowledge and behaviors of adolescents. This study was conducted as a randomized controlled trial on 275 university students. The subjects were randomly assigned to the peer educators (n = 25), intervention (n = 125) and control (n = 125) groups using systematic random sampling. Peer educators provided face-to-face SRH education to the intervention group. The researcher provided the same education to the control group via the online conference method. SRH knowledge and behavior evaluated with scales before, after, and 3 and 6 months after the SRH education. The obtained data were analyzed using SPSS version 25 through statistical tests and analysis of covariance. The female and male ratio of the participants was almost equal (49.4%, 50.6%). The mean age was found to be 20.42 ± 1.14 years. The mean scores of the students in the intervention group increased from 21.20 ± 0.14 to 35.20 ± 0.07 for sexual health knowledge questionnaire (SHKQ), and from 130.56 ± 0.55 to 147,90 ± 0,25 for reproductive health scale (RHS) after the education. Compared with the control group, these increases in the mean scores of SHKQ and RHS were found to be statistically significant. The findings show the important role of the SRH peer education method on the effect of transferring knowledge about sexual behaviors. Health and education policy-makers are advised to implicate SRH peer education.

Sexually Transmitted Diseases and Attention-Deficit/Hyperactivity Disorder: A Systematic Literature Review.

Patients with attention-deficit/hyperactivity disorder (ADHD) suffer from inattention, hyperactivity, and impulsivity. Clinicians often assume that the specific difficulties associated with ADHD are bound to affect sexual behaviors, and favor risky sexual behaviors, thereby increasing the frequency of sexually transmitted diseases (STDs). This review provides an up-to-date synthesis of the literature concerning STDs in patients with ADHD. A systematic review of the literature was performed using the PubMed, PsychInfo, and Embase databases, with STDs as the main outcome measure. Patients with ADHD report more STDs than the general population. Results are limited by the small number of existing studies, as well as the heterogeneity of the outcome measures. Findings from this first systematic review of data on STDs in individuals with ADHD suggest that ADHD affects sexual health and sexual behaviors. Clinicians treating patients with ADHD should explore risky sexual behaviors in their patients and raise awareness about the risk of contracting STDs. Further studies are warranted to better evaluate the risk of contracting an STD in patients with ADHD.

Prevalence of Human Papillomavirus Infection and its Association with the Risk of Cervical Cancer among Hiv-Positive Women in Plateau State, North-Central Nigeria

Study’s Novelty/Excerpt This study investigates the prevalence and risk factors of HPV among HIV-infected women in Plateau State, Nigeria, highlighting a significant correlation between low CD4+ counts, high viral loads, and increased HPV infection rates. By utilizing comprehensive diagnostic methods including ELISA for HPV detection and cytology for cervical abnormalities, the research offers robust data linking immunosuppression and HPV-related cervical pathology in a high-risk population. The findings emphasize the urgent need for targeted interventions to improve sexual health behaviors and further research on how low immunity accelerates cervical cancer progression in both HIV-positive women and the broader population. Full Abstract Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) associated with cervical, uterine, and anogenital cancers. Persistent infection with HPV is associated with abnormal cervical cells, which can develop into cervical cancer if left untreated. Human papillomaviruses are the first viruses to have been acknowledged to prompt carcinogenesis, and they are linked with cancers of the uterine cervix, anogenital tumours, and head and neck malignancies. A hospital-based study of HIV-infected women across the three senatorial zones of Plateau State, Nigeria, was conducted between November 2018 to November 2020. Ethical approval for the study was first obtained from the ethical committee of Plateau State Specialist Hospital Jos, and informed consent to participate in the research was also obtained from each participant. HIV status confirmation was first done through standard rapid test procedures, followed by cytology testing via the Pap smear procedure to detect any precancerous or malignant changes in the cervix. Subsequent detection of HPV utilized the ELISA procedure, while CD4+ cell count and viral load estimations were done using flow cytometry and nucleic acid amplification techniques, respectively. Questionnaires were administered to obtain information on cervical cancer risk factors and clinical presentations. The overall prevalence of HPV was 28% among HIV-infected women. More HPV infection (31.9%) occurred in women with low CD4+ count (0-200 cells/mm3), and also highest (50.0%) among women with the highest HIV viral load (&gt;100 copies/mL). The possible risk factors identified in this study include multiple sexual partnering, low condom usage, and coinfection with other STIs, among others. In conclusion, this study identified a high HPV prevalence, low CD4+ counts, and coinfection with other STIs among high-risk populations (HIV-infected women). We, therefore, recommend improved sexual behaviours and further research on the impact of low immunity on the rate of progression of cervical abnormality to cervical cancer, not just in HIV-positive women but in the general population.

Direct and indirect estimation of adolescent sexual intercourse and contraceptive use in Rajasthan India: an application of the best friend methodology

BackgroundExisting estimates of adolescent sexual and reproductive health (ASRH) behaviors may be a gross undercount given the sensitivity of this behavior in Indian culture. The objective of this study was to estimate ASRH behaviors in Rajasthan, India using direct questions and the best friend approach that seeks to reduce social desirability bias.MethodsWe used population-based data of adolescents aged 15–19 in Rajasthan collected between September and December 2022. Data include whether the respondent and her closest female friend ever had a partner, ever had sex, ever used contraception, and were currently using contraception. We estimated respondent and best friend ASRH outcomes separately, overall and among unmarried adolescents for whom we anticipate social desirability bias is greatest.ResultsThe best friend approach performed well, with method assumptions largely met even before adjustments. Respondent and best friend estimates were similar among all adolescents except for current contraceptive use, which was higher for friends (though not significantly so). However, we observed large differences in ASRH behaviors between unmarried respondents and friends, with a significantly higher percentage of friends who ever had a partner (4.3% respondents, 11.6% friends), and a slightly higher percentage who ever had sex (2.4%, 3.8%) and who were currently using contraception (17.0%, 19.7% among those in need of contraception).ConclusionsWe observed potential benefits of using the best friend methodology in estimating premarital sexual activity, but further work is needed to refine social network-based measures of sensitive adolescent behaviors in larger study samples to better understand ASRH needs.

Determinants of substance use and the impact on mental health status, risky sexual and physical health behaviors among unmarried students

ABSTRACT Objective To assess the prevalence of substance use and its association with other risky behaviors among unmarried male students. Methods This was a cross-sectional study at the University of Nigeria on the use of cigarette, alcohol and psychoactive drugs among students who resided off-campus. Questionnaires were analyzed using SPPS (Version-25). Descriptive statistics were utilized in summarizing the responses. The correlates and predictors of substances use were also determined. Results A total of 491 students participated in the study (response rate = 98.1%). The prevalence of recent use of tobacco, psychoactive drugs, and alcohol was 28.1%, 20.6%, and 46.8% respectively. Also, 13% considered committing suicide, 22.4% were victims of sexual assault, while 56.1% experienced serious injury. Alcohol use (aOR = 0.078, [0.029–0.210], p < 0.001) and driving being drunk (aOR = 0.123, [0.030–0.503], p < 0.001) influenced the current use of tobacco. Previous suicide attempt (aOR = 5.765, [1.148–28.944], p < 0.05) was a predictor of alcohol use. Recent use of psychoactive drugs was influenced by their age and been driven by a drunk driver (p < 0.05). Conclusion Unmarried male students exhibited high prevalence of substance use and other risky health behaviors. These risky substances use practices were also influenced by their age, risky sexual and physical practices induced by alcohol and mental health status.

Effectiveness of Social Media-Based Intervention in Intention Change of Adolescents for Promoting Sexual Health Behavior in Western Terai of Nepal.

Sexually transmitted infections (STIs) in adolescents are among the major public health challenges that have to be prevented in time. Traditional education falls short of reach; social media offers accessible ways. However, there is no research on such an issue in Nepal. Accordingly, this study was conducted to assess the effectiveness of a social media-based health education intervention in changing the intention of promoting sexual health among adolescents in Nepal. Study Design: A quasi-experimental study. A total of 160 adolescent students aged 14-19 years old from four purposively selected schools were evenly divided into intervention and non-intervention groups. Sampling and data collection were performed between May and June 2023. Data were collected through self-administered questionnaires for pretest and posttest evaluation. The intervention was delivered and followed up through a Facebook Messenger group. The obtained data were managed and analyzed using SPSS 21, with a significance level of 5%. Social media-based health education interventions played a significant role in promoting the sexual health behavior of adolescents. The adolescents' knowledge and attitude scores on STIs increased from 2.33 to 4.62 and from 21.87 to 26.30. In addition, their scores on subjective norms, perceived behavioral control, and intentions in promoting sexual behavior increased from 13.93 to 17.59, from 19.96 to 25.40, and from 13.07 to 18.06, respectively, which were statistically significant. The utilization of social media platforms such as Facebook Messenger groups is an effective medium for delivering health educational messages. Hence, increasing social media-based health education is a cost-effective intervention for promoting the health and sexual behaviors of adolescents.

Telenovela (Spanish Soap Opera) Interventions on Latino Health: A Scoping Review.

Introduction: The use of telenovelas shows promise as a mode of education that could enhance Latino people's ability to prevent or manage different health conditions. This scoping review examined the available evidence about telenovela interventions on Latino health. Methods: A scoping review was conducted by searching five peer-reviewed databases for articles published on any date in English or Spanish. The methods of this review were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews recommendations. Results: A total of 431 articles were identified, and 22 articles published between 1999 and 2022 were included in the final scoping review. Nineteen telenovela interventions were described in the literature. Most studies included telenovela interventions without other elements (n = 15; 68%), and 91% were conducted in the U.S. (n = 20). Studies were qualitative (n = 8; 36%), quantitative (n = 8; 36%), and mixed methods (n = 6; 27%), and most telenovela interventions were developed and/or tested in Spanish (n = 10; 53%). The most common topics for the telenovela interventions were substance use/risky sexual health behaviors, cardiovascular disease, and mental health. Conclusions: This scoping review may serve to continue empirical and theoretical work on telenovela-style entertainment interventions on Latino health and future implementation in real-life settings.

Psychosocial Factors Associated with Recent Casual Sex among Urban College Students

Casual sex is one sexual health behavior reported by college students. The present study examined the extent of past 30-day casual sex behavior and risk and protective factors for casual sex among college students. Students were requested to complete a survey in classrooms. Logistic regression analyses were employed to examine the research questions. Results indicated that 39.2% of students engaged in casual sex in the past 30 days. Univariate analyses revealed grade level, risky behaviors, emotional connectedness, and individual stressors were significantly associated with past 30-day casual sex. Final logistic regression modeling found having sex while drunk and reporting depression as an individual stressor were significantly associated with casual sex among college students. Supporting students engaging in casual sex with alcohol education and mental health resources may be needed on college campuses.

"What Did You Say, ChatGPT?" The Use of AI in Black Women's HIV Self-Education: An Inductive Qualitative Data Analysis.

The emergence of widely accessible artificial intelligence (AI) chatbots such as ChatGPT presents unique opportunities and challenges in public health self-education. This study examined simulations with ChatGPT for its use in public education of sexual health of Black women, specifically in HIV prevention and/or HIV PrEP use. The research questions guiding the study are as follows: (a) does the information ChatGPT offers about HIV prevention and HIV PrEP differ based on stated race? and (b) how could this relatively new platform inform public health education of Black women educating themselves about sexual health behaviors, diagnoses, and treatments? In addressing these questions, this study also uncovered notable differences in ChatGPT's tone when responding to users based on race. This study described valuable insights that can inform health care professionals, educators, and policymakers, ultimately advancing the cause of sexual health equity for Black women and underscoring the paradigm-shifting potential of AI in the field of public health education.

Knowledge, Attitudes, and Utilization of HIV PrEP among Black College Students in the United States: A Systematic Review

Considering the diverse socio-cultural norms, sexual attitudes, and mental and emotional immaturity that generally exist among young adults, Black college students are behaviorally vulnerable to acquiring new HIV infections before requisite exposure to HIV prevention education. Black college students (aged 18 to 34) fall within the description of one of the highest priority populations at risk for new HIV infection given the overall under-utilization and racial disparities in the HIV pre-exposure prophylaxis (PrEP) coverage among Black people in the United States (U.S). Yet, research addressing sexuality and HIV PrEP amongst Black college students are limited. This systematic review undertakes a comprehensive exploratory search of eight databases and includes four studies that have been conducted regarding Black college students HIV PrEP knowledge, attitudes and PrEP utilization in the U.S. Our findings suggest a high rate of sexual activity and hesitancy to initiate PrEP due to fear, exacerbated by low comprehensive knowledge of PrEP, low self-perceived HIV risk, and low HIV testing before any PrEP educational intervention. Positive PrEP utilization was closely associated with high self-perceived HIV risk following PrEP education, particularly when individual and structural factors were satisfactorily addressed. Current evidence suggests that PrEP is grossly under-utilized by Black college students who may benefit from it, and attitudes are driven by multiple determinants informed by psycho-social and structural barriers to PrEP access or acceptability in the U.S. Therefore, PrEP education is a potent tool for improving sexual health behaviour and attitude among Black college students.

Sexual health behaviours and partner notification practices related to sexually transmitted infections in young adults in Ireland

BackgroundSexually transmitted infections (STIs) impose burdens on individuals and communities, while their prevalence in young people has risen continually in recent years. Partner notification is an effective public health strategy which can limit STI transmission.AimsThis study aimed to explore young adults’ sexual health behaviours, attitudes toward STI testing, and feelings toward visiting a sexual health clinic. It also aimed to investigate preferences for partner notification and the role of self-efficacy in people’s intentions to notify a partner for STIs including the human immunodeficiency virus (HIV).MethodsA quantitative, cross-sectional design was applied. Participants were 400 adults aged 18–34 years (M = 23 years; SD = 4.27), recruited from the Republic of Ireland.ResultsOver half of the participants reported never being tested for STIs. These young people placed less importance on undergoing regular STI testing and testing after unprotected sex than their counterparts who had been tested for STIs. Self-efficacy was significantly associated with intentions to notify partner(s) for STIs including HIV.ConclusionsAs STIs are becoming increasingly prevalent in young adults, it is important to gain a deeper understanding of the interventions used to break the transmission chain and how different beliefs and attitudes may affect them. Self-efficacy was a key component in PN intentions, suggesting that the belief in someone’s ability or skillset to perform a sexual health behaviour is positively related to their intention to perform the behaviour.

(085) Investigating the Relationship Between Experiences of Sexual Health Education and Sexual Health Outcomes

Abstract Introduction Young people (16–24-year-olds) experience the highest diagnosis rates of STIs. Lack of engagement, public awareness, lack of training, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of interventions such as sexual health education and other services. Whilst relationship and sexual health education (RSE) has been part of many school curriculums for generations, young people’s experiences of RSE can vary widely. Objective This research aims to provide insight into the experiences of sexual health education, sexual health behaviours and recommendations to improve engagement and sexual health outcomes amongst adolescents. Methods An online quantitative survey was conducted between June and July 2021 (n=5,457). 855 respondents were recruited from a market research panel (answering a 20-minute survey) and a further 4,602 respondents were recruited via public links (answering a cut-down survey). All respondents were living in the UK and aged 18+. Data were analysed using descriptive statistics and adjusted to reflect the sample size of LGBTQ+ and heterosexual respondents. Results 90% of respondents received formal sex education, however, only 12% agreed sex education had a positive long-lasting effect on their sexual life. Reproductive biology, pregnancy, safe sex, and avoiding STIs were the core pillars of sex education, whilst different sexualities, pleasurable intimate relations, gender identity and trans-specific topics were covered less than 13% of the time. Although 90% of respondents declared they have a good understanding of sexual health risks, sexual health outcomes in this group were sub-optimal; safe sex was only consistently practiced by 43% of respondents and regular testing only carried out by 25% of respondents. Conclusions Whilst most participants reported receiving sexual health education, their experiences varied. Despite a high self-reported understanding of sexual health risks, sexual health outcomes were sub-optimal. This research highlights the potential beneficial effects of an exhaustive sexual health education on attitude, knowledge, and behaviours among adolescents to improve the long-term sexual health outcomes. Recommendations include designing programmes based on young people’s experiences of sexual education, reviewing current guidance and practices adding on key topics outside the main pillars of sexual education, increasing guidance and training for educational institutions and supporting RSE provisions in alliance with external educators and services. Disclosure Yes, this is sponsored by industry/sponsor: Reckitt. Clarification: Industry initiated, executed and funded study. Any of the authors act as a consultant, employee or shareholder of an industry for: Reckitt.

Associations Between Negative Body Image and Sexual Health Practices in Emerging Adults from Malaysia

Past findings on the association between negative body image and sexual health behaviors have been mixed and mostly derived from Western samples. The aim of the current study was to examine associations between indices of negative body image and sexual health practices that reduce the risk of disease transmission in emerging adults, and whether these associations are moderated by gender. Using an online survey, a convenience sample of 584 Malaysian adults aged 18–30 years (230 men, 354 women) completed measures of satisfaction with overall appearance, body size dissatisfaction, weight satisfaction, height satisfaction, and genital image evaluation. They also reported if they ever had partnered sex, condomless sex, and been screened for human immunodeficiency virus (HIV), as well as their lifetime number of penetrative sex partners. Hierarchical logistic and ordinal regression analyses indicated that more positive genital image evaluation, but not the other body image indices, was significantly associated with having had partnered sex and fewer lifetime penetrative sex partners. None of the body image indices were significantly associated with condomless sex. All associations were consistent across men and women. For HIV testing, a significant interaction between genital image evaluation and gender emerged. However, this was reduced to non-significance after controlling for the number of penetrative sex partners. Overall, our findings underline the importance of promoting improved genital image in interventions aimed at increasing positive sexual health behaviors.

Sexual and reproductive health knowledge, attitudes, and behaviors: A survey of 12-17 year old Sudanese refugees in Chad.

Adolescents living in humanitarian settings are often at a higher risk of negative sexual and reproductive health outcomes, and yet, limited information is available on adolescents' experiences and needs in these settings while available services do not always correspond to their needs. This study explored knowledge, attitudes, and behaviors relating to sexual and reproductive health among 12-17 year old refugees from Darfur currently living in two refugee camps in eastern Chad. The research team conducted a cross-sectional survey of 689 adolescent girls and boys, informed by participatory research activities, to explore key sexual and reproductive health topics. This study found that sexual and reproductive health knowledge among adolescents is low, with only 69.1% able to identify at least one modern contraceptive method. Early marriage was uncommon (5% of girls, 0.8% of boys), but 17.6% of adolescents had already had a romantic relationship. Few adolescents (11.4%) had ever had sex, but among these adolescents,18.4% reported using a condom the last time they had sex. No boys reported current modern contraceptive use, but 28.3% of girls, both married and unmarried, reported current use. These findings demonstrate the importance of making sexual and reproductive health services in humanitarian settings more adolescent-responsive and minimizing barriers to access, including addressing community stigma surrounding adolescents' use of sexual and reproductive health services and increasing trust in the confidentiality of sexual and reproductive health services in the camps.