Sexually Transmitted Infections Transmission Research Articles

Impact of education and clinic site champion on extragenital testing for sexually transmitted infections.

Sexually transmitted infections (STIs) are on the rise in the United States. Infections at extragenital (EG) sites (throat or rectum) may serve as an overlooked reservoir for STIs. The aims of this project were to determine the proportion of patients receiving EG testing and to observe the impact of an educational intervention. Phase I included four urgent care clinics and baseline data for adults receiving STI testing (Chlamydia trachomatis and Neisseria gonorrhoeae). Clinics received access to an educational presentation regarding the importance of EG testing. Two of these clinics served as pilot sites for the implementation of self-collection kits. Phase II involved further expansion and utilization of clinic site champions. Phase I baseline data indicated that less than 1% of samples from patients receiving STI testing were from EG sites. There was an increase in EG testing after the educational intervention and implementation of self-collection kits. A larger increase in EG testing was seen after utilization of a site champion in Phase II. EG infections serve as a potential source for STI transmission which makes multi-site testing necessary. Our interventions to improve EG testing were most effective in Phase II after implementing a clinic site champion.

Sexually Transmitted Infections in Adolescents and Young Adults: A Cross Section of Public Health.

Sexually transmitted infections (STIs) can be caused by a number of microorganisms that vary greatly in size, life cycle, clinical manifestations, and sensitivity to available treatments. Transmission of STIs can occur during unprotected (or condomless) sexual contact and through the exchange of body fluids during any type of activity. The prevalence of sexually transmitted diseases remains high in the world, despite diagnostic and therapeutic improvements for these infectious diseases that rapidly eliminate the contagiousness of patients. Our study determines the prevalence of STI pathogens in adolescents and young adults in the population of the Province of Macerata (Italy). We will analyze data in correspondence to age and gender, and we will compare our results to international studies. We analyzed STI test results from the entire database of a Provincial Health Authority for the period 2021-2022. The samples came from the following age groups: 0-12, 13-18, 19-25, and 26-35 from 2021 to 2022. The results came from vaginal and cervical swabs (for females); urethral, rectal, and pharyngeal swabs (for males and females); and seminal fluid (for males) for the following infections: HPV, Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasmas, Gardnerella, Trichomonas vaginalis, Neisseria gonorrhoeae, and Treponema pallidum. The results also came from blood tests for HIV, hepatitis C, hepatitis B, and Treponema pallidum (TPHA, VDRL). In addition, we examined results from urine tests for chlamydia, Neisseria gonorrhoeae, trichomonas, and Treponema pallidum. The literature for other countries reports the need for comprehensive, culturally and developmentally sensitive care to address sexuality-related issues in adolescents and young adults, a need that also applies to Italy. These data will be of great importance in adopting evidence-based STI control programs in Marche Region. This study could, indeed, represent a landmark for public health officials and professionals, with the aim of promoting adolescents' access to sexual health services to receive useful information, strengthening preventive measures in younger age groups, and designing sexual education programs.

Understanding dynamics and overlapping epidemiologies of HIV, HSV-2, chlamydia, gonorrhea, and syphilis in sexual networks of men who have sex with men.

We aimed to investigate the overlapping epidemiologies of human immunodeficiency virus (HIV), herpes simplex virus type 2 (HSV-2), chlamydia, gonorrhea, and syphilis in sexual networks of men who have sex with men (MSM), and to explore to what extent the epidemiology of one sexually transmitted infection (STI) relates to or differs from that of another STI. An individual-based Monte Carlo simulation model was employed to simulate the concurrent transmission of STIs within diverse sexual networks of MSM. The model simulated sexual partnering, birth, death, and STI transmission within each specific sexual network. The model parameters were chosen based on the current knowledge and understanding of the natural history, transmission, and epidemiology of each considered STI. Associations were measured using the Spearman's rank correlation coefficient (SRCC) and maximal information coefficient (MIC). A total of 500 sexual networks were simulated by varying the mean and variance of the number of partners for both short-term and all partnerships, degree correlation, and clustering coefficient. HSV-2 had the highest current infection prevalence across the simulations, followed by HIV, chlamydia, syphilis, and gonorrhea. Threshold and saturation effects emerged in the relationship between STIs across the simulated networks, and all STIs demonstrated moderate to strong associations. The strongest current infection prevalence association was between HIV and gonorrhea, with an SRCC of 0.84 (95% CI: 0.80-0.87) and an MIC of 0.81 (95% CI: 0.74-0.88). The weakest association was between HSV-2 and syphilis, with an SRCC of 0.54 (95% CI: 0.48-0.59) and an MIC of 0.57 (95% CI, 0.49-0.65). Gonorrhea exhibited the strongest associations with the other STIs while syphilis had the weakest associations. Across the simulated networks, proportions of the population with zero, one, two, three, four, and five concurrent STI infections were 48.6, 37.7, 11.1, 2.4, 0.3, and < 0.1%, respectively. For lifetime exposure to these infections, these proportions were 13.6, 21.0, 22.9, 24.3, 13.4, and 4.8%, respectively. STI epidemiologies demonstrate substantial overlap and associations, alongside nuanced differences that shape a unique pattern for each STI. Gonorrhea exhibits an "intermediate STI epidemiology," reflected by the highest average correlation coefficient with other STIs.

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

Sexually 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. This 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). A quantitative, cross-sectional design was applied. Participants were 400 adults aged 18-34years (M = 23years; SD = 4.27), recruited from the Republic of Ireland. Over 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. As 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.

Investigating causes of the high prevalence of sexually transmitted infections in Du Noon.

In South Africa, sexually transmitted infections (STIs) represent a significant public health issue. Sexually transmitted infections contribute significantly to the burden of disease in South Africa and are recognised as one of the main causes of the human immunodeficiency virus (HIV) epidemic. The aim of this study was to investigate the potential causes of the high prevalence of STIs in the Du Noon population. A mixed methodology study involving 40 participants between the ages of 18 years and 45 years was conducted at Du Noon community health centre from 01 May 2021 to 15 May 2021. Both structured questionnaires and one-on-one patient interviews with open-ended questions were utilised to collect data. Cultural beliefs, having multiple partners, a lack of partner notification, alcohol consumption, and a lack of condom usage were found to be the main contributing factors to the high incidence of STIs. Sex education appears to be lacking. Our findings reflected the other well-known cultural and socioeconomic issues confronting South African communities, for example, poverty, age-disparate relationships, and polygamous relationships. The cultural perspectives and understandings of sexual interactions of older men appear to have an impact on younger generations; as do peer pressure, social media and other socio-economic factors. There is an urgent need to shift cultural ideologies and norms among the youth. More research is needed to understand the views and misconceptions of the general public about STIs.Contribution:This study highlighted how health education challenges, interpersonal relationships, and socioeconomic barriers are still important factors in STI transmission.

A Study on Knowledge, Attitude, and Practice Related to Sexually Transmitted Infections Among Students of Nonmedical Background in Manipal, India.

Sexually transmitted infections (STIs) are one of the major public health problems in India with adolescents being a vulnerable section of the affected population. According to the World Health Organization (WHO), one in twenty adolescents contracts an STI every year, excluding the human immunodeficiency virus (HIV) and other viral infections. It is important to assess the knowledge, attitude, and practices related to STIs among adolescents and young adults of non-medical backgrounds to educate them properly about protective and preventive measures and to allay misconceptions, if any. This is a cross-sectional study involving 507 engineering students who were asked to fill out the predesigned anonymous questionnaire form. Results were statistically analyzed and tabulated. Of the 507 students, 375 were males and 132 were females. The mean age of the patients was 20.5 years. HIV was the most commonly identified STI (94.2%), followed by herpes genitalis (76.5%). Around 97.4% and 85.7% identified the sexual route and blood transfusion as the modes of transmission of STIs, respectively. A total of 90.9% said that the Internet was their primary source of information regarding STIs. Infertility and cancer were identified as complications by 59.5% and 25% of them, respectively. Only 23.4% were aware of the National STI Control Program. The results with respect to attitudes and practices related to STIs were variable. Our study reflects that with change in time, the attitude of young adults toward sexuality is becoming very casual, but knowledge remains low. A lot of educational activities should be undertaken to educate our youth about various aspects of STIs and thus reduce the burden of the disease in the community.

Correlates of Transactional Sex Among Black Men and Women Who Misuse Opioids.

The rise in opioid misuse coincides with increased sexually transmitted infection (STI) and HIV incidence. Transactional sex is an under-researched phenomenon among Black Americans who misuse opioids, and may increase their risk of STI or HIV transmission. Given the disproportionate impact of the opioid epidemic on Black Americans and the risks associated with opioid misuse, the current study aims to investigate sociostructural factors, history of violence, and sexual risk factors associated with transactional sex among Black men and women. A sample of n = 375 Black adult Kentuckians reporting opioid misuse completed a survey including transactional sex, sociostructural, violence history, and sexual risk measures. Results of chi-squares and independent samples t-tests revealed that compared to men who did not report engaging in transactional sex, men who engaged in transactional sex were less educated, reported being sexually assaulted or having an unwanted sexual experience in their lifetime, and were more likely to use opioids or cocaine before or during sex in the last year. Women who engaged in transactional sex had a history of violence, more structural barriers, higher psychological distress, and engaged in more sexual risk behaviors compared to women who did not engage in transactional sex. Implications for future research and interventions with this population are discussed.

Australian Sexual Health Service Users’ Perspectives on Reducing the Oral Transmission of Bacterial STIs: A Qualitative Study

ABSTRACT Growing rates of bacterial sexually transmitted infections (STIs) demand new approaches to STI prevention. Sexual practices involving saliva or direct contact with the mouth increase the risk of STI transmission, but community awareness remains largely unexplored in the literature. The Community Awareness and Surveillance of STI Transmission study sought to explore sexual health clinic attendees’ awareness of oral STIs; experiences when seeking testing and treatment; and acceptable educational and clinical interventions. Twenty-one semi-structured interviews were conducted with a diverse group of Melbourne Sexual Health Center attendees’. Reflective thematic analysis was undertaken, revealing key themes across people of different genders, sexual identities, ages, and nationalities. All participants emphasized the importance of understanding how their sexual practices might put them at risk of an oral STI. They also sought care from specialist sexual health services with the expectation that health-care providers (HCPs) in these settings had more understanding of diverse sexual practices. Participants’ decisions to protect themselves against oral STIs were primarily driven by the effect the decision had on pleasure and intimacy. Comfort during the health-care encounter and trust in HCPs facilitated better understanding of individual STI risk. Differences in awareness and risk reduction strategies were noted based on past experience with oral testing and STIs. These findings highlight the importance of HCPs and public health interventions providing solutions that recognize the central role of pleasure and intimacy in our sexual lives.

Perilaku Seksual Lesbian, Gay, Biseksual,Transgender, dan Risikonya terhadap Infeksi Menular Seksual

Lesbian, gay, bisexual, transgender (LGBT) face many gaps in sexual health aspects, including an increased risk of human immunodeficiency virus (HIV infection), sexually transmitted infections (STIs), and pregnancy. LGBT often experience social stigmatization, isolation, and rejection, even from their respective parents. Risk of STIs is related to sexual orientation, sexual anatomy, and sexual behaviour. LGBTs sexual activity may vary and with multiple partners, who are vulnerable to transmission of STIs and HIV infection. Health care providers are responsible for an open discussion regarding sexual health issues; including sexual orientation, sexual behavior, and gender identity.

The global burden of sexually transmitted infections

Understanding the global burden of sexually transmitted infections (STIs) is fundamental to being able to address and control these infections and the health harms they cause. The World Health Organization has renewed its global health sector strategy for the prevention and control of STIs. Reducing STIs remains an integral part of HIV prevention and of sexual and reproductive health programs. Data to measure and describe the global burden continue to improve, with systematic reviews and modeling providing global and regional data for the major STIs. Although substantial gaps remain, as many countries have limited data, the measures available demonstrate the scale of the problem for the main curable STIs, gonorrhea, chlamydia, syphilis, and trichomoniasis; the most common viral STIs, human papillomavirus and genital herpes; the interrelation between STIs and HIV; and the substantially unequal burden of these infections globally and among key populations. Regional and global trends in these infections are affected by population changes; the impact and availability of interventions, such as vaccination; changing behaviors that alter the dynamics of STI transmission; and the role of international travel in promulgating STIs in an increasingly interconnected world.

2685. Impact of Education and Clinic Site Champion on Extragenital Testing for Sexually Transmitted Infection

Abstract Background Over the last several years sexually transmitted infections (STIs) have been on the rise in the United States. A potential area for improving the diagnosis of STIs is appropriate testing of extragenital (EG) sites (i.e., throat or rectum). These sites may serve as a reservoir for infection and lead to increased transmission if not identified and treated. Prior studies have shown that in men who have sex with men, genital testing alone misses &amp;gt;70% of STIs. In other patient groups, this may range from 10-40%. The aims of this project were twofold: to determine the proportion of patients receiving EG STI testing, and to observe the effect of a two-phase educational intervention on EG site testing. Methods Phase I (Jul-Dec 2021) included four urgent care clinics within a Midwest health system. Retrospective baseline data was ascertained for all adults receiving STI testing for Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) at these clinics. Next, all four clinics received access to an educational presentation regarding the importance of EG testing for STI detection. Two of these clinics served as pilot sites for the implementation of patient self-collection kits. Data was compiled for all adults undergoing STI testing at these clinics for a 6-month period. Phase II (Jul 2022-Mar 2023) involved further expansion and utilization of a site champion at several family medicine clinics including on-site promotion of multi-site testing and patient self-collection. Educational materials as in Phase I were provided to site champions Results Phase I baseline data indicated that less than 1% of samples from patients receiving STI testing were obtained from EG sites. There was a small increase in EG site testing after the educational intervention and implementation of self-collected swab kits (Table 1). Phase II data showed an increase in EG testing after the utilization of a clinic site champion and the sharing of testing data in family medicine clinics (Table 2). Conclusion Rates of STIs have reached an all-time high in the United States. EG infections serve as potential sources for STI transmission. Adequate multi-site testing is necessary. Implementation was most effective when a clinic site champion was identified, and clinic testing data was provided to them. Disclosures All Authors: No reported disclosures

Effectiveness of interventions to reduce sexually transmitted infections and blood-borne viruses in incarcerated adult populations: a systematic review protocol.

This review will identify, synthesize, and make recommendations regarding the effectiveness of interventions to reduce sexually transmitted infections (STIs) and blood-borne viruses (BBVs) in incarcerated adult settings. High-risk sexual behaviors, intravenous drug use, piercing, and tattooing are well documented within incarceration environments. Despite the World Health Organization's Global Health Sector Strategy on Sexually Transmitted Infections 2016-2021 and the Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis, and Sexually Transmitted Infections for the Period 2022-2030, STI rates within adult incarceration environments continue to rise. Identifying and implementing best-practice interventions to prevent and manage STIs and BBVs will aid infection reduction in correctional settings. The review results will inform the development of educational programs, health promotion, and policies and procedures to improve health outcomes for incarcerated populations. This review will consider studies in any language from any adult incarceration facility. Studies set in juvenile facilities or detention centers will be excluded. Any intervention for preventing or reducing STI and/or BBV transmission will be included. This review will follow the JBI methodology for systematic reviews of effectiveness. Databases to be searched will include PubMed, CINAHL (EBSCO), Ovid Library, PsycINFO (EBSCO), Cochrane CENTRAL, and Scopus. Two independent reviewers will screen titles and abstracts and assess full-text citations against inclusion criteria. Methodological quality will be appraised using JBI's standardized critical appraisal instruments. Where possible, studies will be pooled using meta-analysis. Where statistical pooling is not possible, findings will be presented in narrative format. Certainty of evidence will be ascertained using the GRADE approach. PROSPERO CRD42022325077.

Prevention of STI Transmission among Men Who Have Sex with Men in Indonesia through Circumcision Behavior

Introduction: The proportion of Sexually Transmitted Infections (STIs) among MSM has increased by around 0,2% from the first quarter and second quarter of 2023, for this reason, prevention efforts are needed in the form of implementing circumcision behavior among men. Objective: to understand the relationship between circumcision and transmission of STIs through MSM in Indonesia. Method: This research has a cross-sectional design with the population being men who have sex with men (MSM) across 24 provinces in Indonesia totaling 6,000 people, while the research sample is mostly MSM totaling 4,290 people with inclusion criteria being: men who are at least 15 years old, have ever had sex with men at least once in the past year, and have lived in the survey city for around one month. Samples were taken using the Respondent Driven Sampling (RDS) technique. The data used is secondary data in the form of 2018-2019 Biological Behavior Survey (STBP) data. Data in the study were analyzed using logistic regression analysis of risk factor models using STATA 14 software. Results: MSM who were circumcised had a 3.0 times greater chance of not having STI symptoms compared to MSM who were not circumcised (95% CI: 2.5- 3.7) after controlling for sex-buying and selling behavior. Conclusion: circumcision behavior is one of the efforts to prevent the spread of STI among MSM, recommending the need to create regulations regarding the importance of circumcision behavior in Indonesia.

Changes in Oral and Anal Sex With Opposite-Sex Partners Among Sexually Active Females and Males Aged 15 to 44 Years in the United States: National Survey of Family Growth, 2011-2019.

Oral and anal sex with opposite-sex partners is common and associated with sexually transmitted infection (STI) transmission. Trends in these behaviors over the last decade, during which bacterial STI diagnoses have reached historic highs while HIV diagnoses have decreased, are not well understood. We examined recent trends in oral and anal sex and associated condom use with opposite-sex partners among females and males. We analyzed data from 16,926 female and 13,533 male respondents aged 15 to 44 years who reported sex with an opposite-sex partner in the past 12 months from the National Survey of Family Growth, 2011-2019. We used survey-weighted linear or logistic regression to evaluate linear temporal trends in oral and anal sex behaviors. From 2011-2013 to 2017-2019, reports of oral sex and number of oral sex partners in the past 12 months increased among females (85.4% in 2011-2013 to 89.4% in 2017-2019; odds ratio [OR], 1.05 [95% confidence interval {CI}, 1.02-1.09], and β = 0.014 [95% CI, 0.005-0.023]; respectively) but not males (ranges, 87.9%-89.1%; 1.27-1.31). Condom use at last oral sex decreased among both females and males (6.3%-4.3%: OR, 0.93 [95% CI, 0.88-0.99]; 5.9%-4.4%: OR, 0.95 [95% CI, 0.91-1.00]). Anal sex (ranges, 21.0%-23.3% [females] and 23.3%-24.6% [males]), number of anal sex partners (females, 0.22-0.25; males, 0.26-0.30), and condom use at last anal sex (females, 15.3%-18.2%; males, 27.0%-28.7%) remained stable. The frequency of oral and anal sex with opposite-sex partners among U.S. 15- to 44-year-olds, paired with limited and-for oral sex-decreasing condom use, demonstrates the need to understand the role of these behaviors in increasing STI diagnosis rates and the potential role of extragenital screening and condoms in reducing STI transmission.

Characteristics of Sexually Transmitted Infection (STI) Patients at the Tanggul Health Center in Jember Regency in the January-June 2023 Period

The incidence of sexually transmitted infections (STIs) can expand as the risk factors increase that increase the transmission of STIs, including having unprotected sexual contact with multiple partners, having a history of STIs, having a history of sexual violence, alcohol use, prostitution, having sexual partners who have sexual contact. additional and concomitant or have a history of previous STIs, drug use, and use of intravenous drugs. This study aimed to present the characteristics of sexually transmitted infections in Tanggul Health Center, Jember Regency, Indonesia. This study is a descriptive observational study. A total of 52 research subjects participated in this study. Analysis of variable characteristics was carried out univariately with SPSS version 25. The highest prevalence of STIs was gonorrhea, namely 20 people (38.46%), the age group with the most STIs, namely 25-49 years, as many as 36 people (69.23%), sex of STI sufferers the most were men, 37 people (71.15%) and the risk factors for experiencing STIs that were most common were customers of sex workers, 31 people (59.61%).

“It’s not safe for me and what would it achieve?” Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe

Partner notification (PN) is considered integral to the management of sexually transmitted infections (STI). Patient-referral is a common PN strategy and relies on index cases notifying and encouraging their partners to access treatment; however, it has shown limited efficacy. We conducted a mixed methods study to understand young people’s experiences of PN, particularly the risks and challenges encountered during patient-referral. All young people (16–24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. PN slip uptake and partner treatment were recorded. Among 1807 young people (85.0% female) offered PN slips, 745 (41.2%) took up ≥1 PN slip and 103 partners (5.7%) returned for treatment. Most participants described feeling ill-equipped to counsel and persuade their partners to seek treatment. Between June and August 2021, youth researchers conducted in-depth interviews with 41 purposively selected young people diagnosed with an STI to explore their experiences of PN. PN posed considerable social risks, threatening their emotional and physical safety. Except for a minority in long-term, publicly acknowledged relationships, participants did not expect PN would achieve successful outcomes. Public health discourse, which constructs PN as “the right thing to do”, influenced participants to adopt narratives that concealed the difficulties of PN and their unmet needs. Urgent interrogation is needed of whether PN is a suitable or constructive strategy to continue pursuing with young people. To improve the outcomes of preventing reinfection and onward transmission of STIs, we must consider developing alternative strategies that better align with young people’s lived experiences. Plain language summary Partner notification is a public health strategy used to trace the sexual partners of people who have received a sexually transmitted infection (STI) diagnosis. It aims to interrupt the chains of STI transmission and prevent reinfection by treating both the person diagnosed and their sexual partners. The least effective but most common partner notification strategy used in many resource-limited settings is called “patient referral”. This involves a sexual healthcare provider encouraging the person diagnosed to give a “partner notification slip” to their potentially exposed sexual partner/s and persuading them to access treatment. This research sought to better understand young people’s experiences of partner notification, particularly the risks and challenges they faced during patient-referral. All young people (16–24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. Young people trained as researchers interviewed 41 young people who had received a STI diagnosis to explore their experiences of partner notification. Only a small number (5.7%) of the partners of those who took a slip attended the service for treatment. Most participants felt they did not have the preparation, skills, or resources to persuade their partners to seek treatment. Many described negative experiences during and after partner notification, including relationship breakdown, reputation damage, and physical violence. These findings suggest that we should reconsider if partner notification is suitable or effective for use with young people. We should explore alternative approaches that do not present risks to young people’s social, emotional, and physical safety and well-being.

Network Analysis of Sexual Sensation Seeking, Internalized Homophobia, and Social Norms Among Men Who Have Sex with Men with Different Sexual Partner Types.

Men who have sex with men (MSM) are at disproportionate risk for developing sexually transmitted infections (STIs) such as HIV. Understanding the relationships among factors related to risky sexual behaviors, such as internalized homophobia, sexual sensation seeking, and individual and community norms, among MSM with different sexual partner types may contribute to designing targeted interventions for reducing risky sexual behaviors and STI transmission. We conducted a cross-sectional study recruiting 781 MSM in Sichuan Province, China. All participants were divided into groups with and without sexual partners, groups with regular and casual sexual partners, and groups with only male and both male and female partners in the past 6 months. Network analysis was used to analyze the relationships among dimensions of self-reported sexual sensation seeking, internalized homophobia, and social norms in different groups. Of 781 MSM, 606 (77.6%) had sexual partners in the past 6 months, and among these participants, 429 (70.8%) had casual sexual partners, and 103 (17.0%) had both male and female sexual partners. The complex and intensive relationships between dimensions were mainly observed in networks of MSM with any type of sexual partners, with individual norms (dimension of social norms) presenting strongly negative relationships with fresh feeling (dimension of sexual sensation seeking) and homosexuality morality (dimension of internalized homophobia). One dimension of sexual sensation seeking (i.e., fresh feeling) and two dimensions of internalized homophobia (i.e., homosexuality morality and self-identification) were relatively central variables in most groups, especially for those with casual sexual partners. Our study highlights the role of individual norms in restraining sensation seeking, internalized homophobia, especially among MSM with sexual partners. Intervention targeting these central variables may contribute to reduced risky sexual behaviors and further slow the spread of STIs in MSM.

Geosexual Archetype, Preventive Behaviors, and Sexually Transmitted Infections Among High-Risk Men Who Have Sex With Men.

Social geography plays an important role in transmission of sexually transmitted infections (STIs) among men who have sex with men. Previous qualitative work had identified 7 "geosexual archetypes," each with distinct travel patterns for sex and potentially important differences in STI rates. The objective of this article was to explore what could be learned about STI transmission by looking at STI prevention strategies (condom use and preexposure prophylaxis use) and prevalence of STIs among these geosexual archetypes. We analyzed data from the Sex Now 2019 online survey in Canada. Men who have sex with men who reported 3 or more partners in the past 6 months were included in the analysis (n = 3649). The most common archetype was "geoflexible" (sex at home, partner's home, and other places; 35.6%), followed by "privates" (sex only at own/partner's home; 23.0%); the least common archetypes was "rover" (sex not at home or partner's place; 4.0%). There were significant variations in both STI prevention strategies and prevalence of bacterial STIs in the past year by geosexual archetype. In particular, among those who were HIV negative, those who reported a geoflexible archetype and used preexposure prophylaxis but did not use condoms consistently had a 52.6% prevalence of bacterial STIs, which was much higher compared with all other groups. Within other archetypes, those living with HIV had the highest prevalence of bacterial STIs. Geosexual archetype together with participant's STI prevention strategies was a strong predictor of bacterial STI risk. Understanding how place is connected to bacterial STIs is key in prevention as individuals do not live in isolation.

Awareness, Approach and Practice of Youth towards preclusion of Sexually Transmitted Infections at KIU-TH, Ishaka Bushenyi District

Sexually Transmitted Infections (STIs) remains a serious reproductive health problem globally. Despite this fact, youths recklessly involve in sexual activities which predisposes them to STIs which could rather be easily preventable. Therefore, the aim of this study was to evaluate the knowledge, attitude and practice of youths aged 19–24 towards prevention of STIs at KIU-TH in Ishaka Bushenyi district, Uganda. The study was a descriptive crosssectional and quantitative methods were employed in data collection. Fifty respondents both male and female were selected using a convenient sampling method. Most respondents 30 (60%) were between 19 – 20 years, 30(60%) were students and 30(60%) were single. Knowledge towards prevention of STIs was good as majority 50(100%) understood the term STIs, 25(50%) knew HIV infection as an STIs, 50(100%) knew about transmission of STIs, 30(60%) had been sensitized and health educated about STIs prevention and majority knew condom use 30(60%) as one of the ways of preventing STIs. Attitudes were fair as majority 40(80%) believed that STIs can be dangerous and majority 40(80%) felt they could prevent STIs. Practice was poor as majority had 1-2 partners, 30(60%) and majority had their first partner at 15-17 years old 30(60%), majority of the respondents took alcohol 35(70%), majority 37(74%) reported teenage involvement in sexual relationship and 35(70%) reported alcohol as one of the most leading factors into sexual relationships, majority 33(66%) did not take precautions during sexual intercourse only 18(36%) used condoms. The study found out adequate knowledge towards STIs prevention and attitudes were fair but practices were poor. Keywords: knowledge, attitude, practice, youth, sexually transmitted infections, Uganda

Digital-Assisted Self-interview of HIV or Sexually Transmitted Infection Risk Behaviors in Transmasculine Adults: Development and Field Testing of the Transmasculine Sexual Health Assessment.

The sexual health of transmasculine (TM) people-those who identify as male, men, or nonbinary and were assigned a female sex at birth-is understudied. One barrier to conducting HIV- and sexually transmitted infection (STI)-related research with this population is how to best capture sexual risk data in an acceptable, gender-affirming, and accurate manner. This study aimed to report on the community-based process of developing, piloting, and refining a digitally deployed measure to assess self-reported sexual behaviors associated with HIV and STI transmission for research with TM adults. A multicomponent process was used to develop a digital-assisted self-interview to assess HIV and STI risk in TM people: gathering input from a Community Task Force; working with an interdisciplinary team of content experts in transgender medicine, epidemiology, and infectious diseases; conducting web-based focus groups; and iteratively refining the measure. We field-tested the measure with 141 TM people in the greater Boston, Massachusetts area to assess HIV and STI risk. Descriptive statistics characterized the distribution of sexual behaviors and HIV and STI transmission risk by the gender identity of sexual partners. The Transmasculine Sexual Health Assessment (TM-SHA) measures the broad range of potential sexual behaviors TM people may engage in, including those which may confer risk for STIs and not just for HIV infection (ie, oral-genital contact); incorporates gender-affirming language (ie, genital or frontal vs vaginal); and asks sexual partnership characteristics (ie, partner gender). Among 141 individual participants (mean age 27, SD 5 years; range 21-29 years; n=21, 14.9% multiracial), 259 sexual partnerships and 15 sexual risk behaviors were reported. Participants engaged in a wide range of sexual behaviors, including fingering or fisting (receiving: n=170, 65.6%; performing: n=173, 66.8%), oral-genital sex (receiving: n=182, 70.3%; performing: n=216, 83.4%), anal-genital sex (receptive: n=31, 11.9%; insertive: n=9, 3.5%), frontal-genital sex (receptive: n=105, 40.5%; insertive: n=46, 17.8%), and sharing toys or prosthetics during insertive sex (n=62, 23.9%). Overall barrier use for each sexual behavior ranged from 10.9% (20/182) to 81% (25/31). Frontal receptive sex with genitals and no protective barrier was the highest (21/42, 50%) with cisgender male partners. In total, 14.9% (21/141) of participants reported a lifetime diagnosis of STI. The sexual history tool was highly acceptable to TM participants. The TM-SHA is one of the first digital sexual health risk measures developed specifically with and exclusively for TM people. TM-SHA successfully integrates gender-affirming language and branching logic to capture a wide array of sexual behaviors. The measure elicits sexual behavior information needed to assess HIV and STI transmission risk behaviors. A strength of the tool is that detailed partner-by-partner data can be used to model partnership-level characteristics, not just individual-level participant data, to inform HIV and STI interventions.