Unprotected Sex Research Articles

Put at and kept from risk: The sexual risk dilemmas confronting marginalized youth.

The current study examines Bay-Cheng and Ginn's (2024) claim that marginalized youth confront two intertwined sexual risk dilemmas: being put at risk by unjust social forces and structures that threaten their sexual health and safety; and being kept from risk by those same forces and structures, thus compromising their development and dignity. We explored the presence and relevance of these dilemmas using interviews conducted in 2022 with 101 racialized and/or queer (i.e., a sexuality other than exclusively heterosexual) young women and trans or nonbinary youth aged 16-21 and living in Melbourne (Australia), New York City (United States), and Toronto (Canada). We conducted a directed content analysis of the data and examined intersectional group-based comparisons of code frequencies. We found that 80% of participants felt endangered (i.e., put at risk) and/or obstructed (i.e., kept from risk) by social and material conditions. Over half felt put at risk through exposure to hostility and harm, and over one-third of participants described precarious life circumstances as keeping them from taking wanted sexual risks. Group-based and intersectional comparisons indicated that feeling put at risk is associated with marginalized gender and sexuality identities and corresponding discrimination. We also found tentative signs that feeling kept from risk may be more closely linked to race and racism than marginalization by gender and/or sexuality. The findings highlight the diverse implications of interlocked social injustices for youths' sexual lives, particularly the infringement on their rights both to safety and to risk.

Generational Differences in Sexual Health Education Experiences Among LGBTQ+ Adolescents and Adults: Findings from a U.S. National Probability Sample

ABSTRACT Few U.S. states require school-based sex education to be representative or inclusive of LGBTQ+ people. Data suggests that adolescents’ receipt of necessary topics in sex education has declined in the past 25 years, yet the literature on LGBTQ+ people’s sex education experiences in the United States is largely limited to non-probability samples. Data were from a national probability sample of adolescents and adults in the United States. Individuals identifying as LGBTQ+ (N = 818) were asked an open-ended item about the type of sex education they would have liked to have received. Participants were classified into four generational cohorts: Boomer+, Generation X, Millennials, and Generation Z. Inductive content analyses and chi-square tests of independence were used. Having sex education that normalized LGBTQ+ identities was the most reported topic, with Boomer+ being more likely to report this and Generation X being least likely. About one-quarter of respondents indicated they would have liked any type of sex education. Millennials were more likely to report wanting more information on sexual orientation and gender identity and safe sexual practices compared to other cohorts. Nearly one-fourth of respondents indicated their sex education did not need improvement/was unnecessary. Older generations wished their sex education normalized their identities, while Generation Z and Millennials reported wanting more information on safe sex and/or sexual violence prevention. Findings from this study can inform the development of tailored sexual health education programs for LGBTQ+ individuals, particularly considering that current programming may not be different compared to the sex education received by earlier generations.

A cross-sectional study of knowledge and stated practices regarding HIV among truck drivers in Basirhat health district, West Bengal

Background: HIV is an important public health problem throughout the world as well as in India and truck drivers are a vulnerable population. A cross-sectional study was designed aiming to assess the knowledge and stated practices of truck drivers regarding HIV transmission, and prevention of its associated factors in Basirhat Health District, West Bengal. Methods: This study employed a rigorous cross-sectional design to assess the knowledge and practices of 111 truck drivers in Basirhat Health District, West Bengal, regarding HIV. Participants were selected using simple random sampling from parking zones and Dhaba. Data were collected through face-to-face interviews using a structured questionnaire. Results: The study uncovered intriguing insights into the knowledge and practices of truck drivers regarding HIV/AIDS. While the majority of participants had heard about HIV/AIDS, around half of the participants demonstrated good knowledge of HIV/AIDS. Surprisingly, misconceptions prevailed, including the belief that mosquitoes can transmit HIV. Participants displayed limited knowledge of AIDS symptoms and preventive measures, with uncertainty surrounding free HIV testing locations and free treatment availability. Alarmingly, a staggering 88.29% of truck drivers had never sought HIV testing, citing various reasons. Conclusions: The study underscores the necessity of targeted interventions to address knowledge gaps and promote safe sexual practices among truck drivers in the Basirhat Health District. Health workers and media campaigns can play a pivotal role in increasing awareness and prevention of HIV/AIDS among this population.

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 < 0,01), and by 122.54% after one month, 10.08 ± 5.35 (p < 0,01), compared to pre-intervention, 4.53 ± 3.96 (p < 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.

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.

Health Facility Capacity and Health-care Worker Knowledge, Attitudes, and Practices of Hepatitis B Vaccine Birth-dose and Maternal Tetanus-Diphtheria Vaccine Administration in Nigeria: A Baseline Assessment.

Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria. This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics. The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns. The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps.

Attention Deficit Hyperactivity Disorder and Sexual Functioning - is there a connection?

Understanding how ADHD affects sexual functioning is key to providing comprehensive care. This review looks into the current research on sexual health in people with ADHD, focusing on how common sexual dysfunction is, how ADHD symptoms might impact sexual behavior, and what role medications play. By summarizing the existing studies, this review aims to highlight what we don’t know yet and suggest future research to improve treatment and patient outcomes. The review covers literature related to sexual functioning in ADHD, particularly looking at connections to hypersexuality, paraphilias, and various sexual behaviors. A thorough search of electronic databases, including PubMed, PsycINFO, and Google Scholar, was conducted using relevant keywords such as 'ADHD,' 'hypersexuality,' 'paraphilias,' 'sexuality,' 'sexual behavior,' and 'sexual violence.' The study duration was 6 months. Common features of ADHD, such as impulsivity, poor impulse control, and difficulties with self-regulation, may contribute to risky sexual behaviors, compulsive sexual behavior, or the development of paraphilic interests. It's important for doctors dealing with ADHD in children to discuss sexual health as the patient nears adolescence and offer guidance on safe sex. Treatment should combine medication with therapy. Since impulsivity seems to play a big role in risky sexual behavior, making contraceptives readily available could be important for sexual health. Longitudinal studies are necessary to better understand the temporal relationships and progression of sexual behaviors and ADHD symptoms over time. Given the potential impact of ADHD on sexual behavior and functioning, healthcare providers should consider screening for ADHD in patients presenting with issues related to hypersexuality, paraphilias, or other sexual concerns.

Effects of Condom Availability on Their Use: A Field Experiment in a Peruvian Hostal

Perú has a high rate of unintended pregnancies. STI rates grow. New policies are needed. Contextual factors in the condom use decision are understudied. Self-reported measures of use have proven unreliable. I used a hostal (love-motel) to conduct a field experiment. 102 couples were randomly allocated to three groups with different levels of condom availability. Instead of using self-reported measures, after a couple left, I searched their room for used condoms. Couples in rooms with a condom on the nightstand were 268% more likely to use one than the control group. For couples with a condom available at the reception desk, the increase was 176%. Facilitating condoms in hostales is a suitable strategy to decrease unprotected sex in the country.

“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.

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.

Jitegemee (rely on yourself): a multi-phase process of co-creating a personal savings intervention with female sex workers in western Kenya to reduce their HIV risk

BackgroundHIV prevalence among female sex workers (FSW) is significantly higher than among women in the general population. Studies have shown that FSW engage in unprotected sex which provides higher compensation when they face emergency situations. We co-created a savings intervention – Jitegemee (rely on yourself) – with FSW to encourage them to save part of their earnings to withdraw in emergency situations in order to reduce risk.MethodsWe undertook a five-phase intervention development process between February 2021 and July 2023: 1) qualitative interviews with FSW to identify essential intervention features; 2) pilot trial to assess intervention feasibility; 3) literature review of studies on economic empowerment of FSW; 4) scoring of key components of Phases 1–3 on a scale of 1–5 (1 = definitely exclude, 5 = definitely include), for inclusion in the intervention package; 5) workshops with FSW and other key stakeholders to co-design the intervention.ResultsIn phase 1, nearly all participants (99%) found the intervention acceptable to them and 95% believed it would be acceptable to other FSW. Participants suggested inclusion of financial literacy (75%), savings groups (38%) and goal-setting (24%). In the feasibility assessment, 41% saved, of whom 46% withdrew some savings. Condom use was higher among FSW who withdrew their savings compared to those who did not (χ2 7.52; p = 0.006). In Phase 3, we identified 14 intervention components. In phase 4, all suggested intervention components scored 4.5 on average. In phase 5, we held 3 workshops with FSW to co-design the intervention, which included instructions for how to save and make withdrawals, financial literacy training, and formation of savings groups.ConclusionsA savings intervention for and by FSW was highly acceptable and feasible. Involving end-users in the design process is likely to result in greater economic security among FSW and lower engagement in higher risk transactional sex.

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.

Manifestações dermatológicas da Monkeypox

Objective: This study aimed to identify the primary mucocutaneous manifestations secondary toMonkeypox infection and determine the prevalence of coinfection with other sexually transmittedinfections (STIs). Methods: Searches were conducted in the PubMed, LILACS, SciELO, Cochrane Library, andVirtual Health Library databases using the descriptors “monkeypox,” “dermatological,” “dermatology,”“cutaneous,” “skin,” and “mucocutaneous,” combined with the Boolean operators “and” and “or.” All articles published between January 2017 and October 2022 that addressed mucocutaneous manifestations secondary to Monkeypox infection, regardless of language, wereincluded. Technical notes from the Brazilian Ministry of Health and World Health Organization recommendations were also incorporated. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the studies. Data were independently evaluated by three reviewers. Exclusion criteria included the absence of photographic records of the lesions, lack of laboratory confirmation of infection, “letter to the editor” publications, duplicates, and articles primarily focused on systemic manifestations without association with the integumentary system. Results: A total of 22 publications were included in this study. The most frequently affected anatomical sites were the genital and perianal regions, though lesions were also reported on the torso, face, oropharynx, limbs, palms, and soles. There is a possibility that the infection may present nonspecifically as a maculopapular rash. Lesions are typically multiple, with either localized orwidespread distribution. In the latter case, the progression is centrifugal, beginning on the face.The most prevalent characteristic of the elementary lesion is central umbilication, which eventuallydevelops a crusted appearance. Umbilicated papules are often associated with pain, which gradually transitions to varying degrees of pruritus. Coinfection with HIV and other STIs was particularly notable among men who have sex with other men and/or have multiple partners and who use condoms inconsistently.Conclusions: Monkeypox can present with various cutaneous manifestations, none of which arepathognomonic of the disease. The chronological evolution of the elementary lesions (papule, vesicle,pustule, crust) is not always precise, with multiple stages potentially coexisting in the same area of the body. The primary behavioral factor associated with infection is unprotected sexual activity, especially among men who have sex with other men. Coinfections with HIV, syphilis, gonorrhea, chlamydia, and/or herpes were observed in the majority of cases.

Prevalence and factors influencing substance abuse among secondary school students in Mbeya City, Tanzania

Background: Substance abuse among students has far-reaching social, religious, economic, health and demographic consequences, such as unplanned pregnancies, school dropouts, abortions, maternal and newborn mortality, infection risks and other psychological problems. Our study investigated the prevalence of substance abuse among secondary school students in Mbeya City, Tanzania. Methods: This school-based cross-sectional study was conducted from January to May 2021 among secondary students from Mbeya City, Tanzania. Students completed a self-administered substance use questionnaire. Data were analysed using descriptive statistics. Results: A total of 343 students were requested to participate in the study. However, 300 agreed to indicate 87% response rate. 9.7% (n=59) reported substance use, primarily cannabis, 75% (n=225) and alcohol, 68% (n=204). Friends influenced substance use among 82.7% of users. Reported immediate effects included misbehaviour, 73.7% (n=221) and unprotected sex, 72.3% (n=217). Long-term harms were predominantly brain damage (86.7%). Community education (78%) and media campaigns (76.7%) were suggested to curb use. Conclusion: Substance abuse among a sizable minority of Mbeya City secondary school students is driven by peer influence and has detrimental impacts reported by students themselves. Comprehensive education and preventive strategies engaging families, schools and communities are recommended to address this critical youth issue. Keywords: Substance abuse; cannabis; alcohol; secondary school students; Tanzania.

The compromises and contradictions of ‘feminist’ sex and relationships education in the home: empowerment vs. protection in digital risk societies

ABSTRACT This paper discusses findings from interviews conducted in England with 15 self-identified feminist mothers about sex and relationships education in the home. Participants’ understandings and enactments of being sexuality educators for their children involved what they described as open and honest ‘sex positive’ communication with their children, based on their subjective views about gender and sexual rights, safety and wellbeing. Participants were concerned about protecting their children from oftentimes gendered risks of judgement shame and abuse. Feminist sex and relationships education in the home for these mothers was shaped, and sometimes constrained, by the gendered sociocultural conditions of their children’s lives. Implications are discussed regarding the need for self-reflexivity amongst feminist mothers, supported by collaborative local and community educational initiatives to identify and collectively tackle the social contexts in which risks and harms arise for children.

Mpox outbreak among men who have sex with men in Kraków, Poland; June 2022-November 2022.

Mpox is a zoonotic disease caused by the mpox virus (MPXV). Sporadic cases reported before 2022 were almost universally linked to direct contact with animals or travel to endemic regions in Africa. However, in 2022, a significant shift occurred with human-to-human transmission, leading to a global outbreak in 117 countries. In Poland, 217 cases of mpox were reported. The aim of this study was to evaluate the epidemiology, clinical presentations, laboratory findings, and co-infections with sexually transmitted pathogens among patients with mpox. A retrospective analysis of all mpox cases diagnosed at the University Hospital in Kraków between June 2022 and November 2022 was performed. Forty-five patients aged 19-48 years (median age 34) were diagnosed with mpox. Most of them were male 44 (98%) and 42 (93%) identified themselves as men who have sex with men (MSM). Twenty-two (49%) of the patients had previously been diagnosed with HIV. During mpox diagnosis, new cases of sexually transmitted infections (STIs) were identified. Specifically, 4 patients (9%) were newly diagnosed with HIV, 5 with syphilis, 4 with Chlamydia trachomatis, 3 with Neisseria gonorrhoeae infection, and 2 with Ureaplasma urealyticum infection; among this group, 4 patients (33%) had more than one sexually transmitted co-infection. The mpox outbreak in Kraków in 2022 primarily affected MSM and was transmitted through sexual contact. Healthcare professionals should be aware of emerging STIs. Educational initiatives should emphasize the importance of vaccinations, safe sexual practices and regular testing.

HIV/AIDS Information Sources and Safe-Sex Practices among Artisans in Ilorin, Kwara State, Nigeria

HIV/AIDS Information Sources and Safe-Sex Practices among Artisans in Ilorin, Kwara State, Nigeria

Microelimination of Hepatitis C in Patients with Substance Use and Dual Disorders - a Portuguese Study.

Chronic hepatitis C (CHC) is a serious condition of public health importance. In Portugal, the prevalence of detectable hepatitis C virus (HCV) antibodies is approximately 0.54%, with a higher prevalence in high-risk groups. Compared with the general population, the prevalence of HCV infection is higher in individuals with psychiatric disorders. As no studies have reported the prevalence of HCV antibodies in Portuguese patients with psychiatric conditions and substance use disorders, we conducted an observational, prospective study of patients followed in the Dual Pathology Outpatient and Inpatient Unit of Coimbra Hospital and University Center (CHUC), Patients were tested for HCV antibodies. Of the 149 patients, 17.4% were positive for HCV antibodies and 7.4% had detectable HCV RNA indicating CHC. Most patients with confirmed CHC were male inpatients, aged 50 to 59 years, and reported unprotected sex with more than one concurrent partner in the past 6 months. Their most common psychiatric diagnosis was "Disorders due to use of multiple specified psychoactive substances, including medications." The prevalence of HCV antibodies and confirmed CHC were higher in patients followed in the Dual Pathology Outpatient and Inpatient Unit than in the general Portuguese population.

Measuring non-events: infertility estimation using cross-sectional, population-based data from four countries in sub-Saharan Africa.

Does the prevalence of 12-month infertility in Burkina Faso, Côte d'Ivoire, Kenya, and Uganda differ between women trying to conceive and the broader population of women exposed to unprotected sex, and how are prevalence estimates affected by model assumptions and adjustments? Estimates of 12-month infertility among tryers ranged from 8% in Burkina Faso to 30% in Côte d'Ivoire, increasing substantially among a larger population of women exposed to unprotected intercourse. While having a child is a fundamental human experience, the extent to which women and couples experience infertility is a neglected area of research, particularly in sub-Saharan Africa. Existing estimates of infertility in this region vary widely from 2% to 32%, however, potential impacts of variability in study populations and model assumptions have not been well-examined. We used cross-sectional nationally representative survey data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda. We employed a multi-stage cluster random sampling design with probability proportional to the size selection of clusters within each country to produce representative samples of women aged 15-49. Samples ranged from 3864 in Côte d'Ivoire to 9489 in Kenya. We created two analytic samples in each country-tryers and a broader sample of women exposed to unprotected sex-exploring differences in population characteristics and estimating the period prevalence of 12-month infertility using the current duration (CD) approach. We also examined the impact of several model assumptions within each of the two analytic samples, including adjustments for recent injectable contraceptive use, unrecognized pregnancy, infertility treatment, underreported contraceptive use, and sexual activity. Employing the CD approach among tryers produced an overall 12-month infertility prevalence of 7.9% (95% CI 6.6-12.7) in Burkina Faso, 29.6% (95% CI 15.3-100.0) in Côte d'Ivoire, 24.5% (95% CI 16.5-34.6) in Kenya, and 14.7% (95% CI 8.1-22.4) in Uganda. Results among women exposed to unprotected intercourse indicated much higher levels of infertility, ranging from 22.4% (95% CI 18.6-30.8) in Uganda to 63.7% (95% CI 48.8-87.9) in Côte d'Ivoire. Sensitivity analyses suggest infertility estimates are particularly sensitive to adjustments around pregnancy recognition timing and sexual activity, with little impact of adjustments for recent injectable contraceptive use, infertility treatment, and underreporting of traditional and coital dependent contraceptive use. There was substantial digit preference in responses at 12 months, particularly among the tryers, which could introduce bias. Data quality concerns in the reproductive calendar may impact the accuracy of the CD approach among the broader sample of women exposed to unprotected sex, particularly with regard to underreported contraceptive use, induced and spontaneous abortions, and unrecognized pregnancies. Lastly, we lacked information on postpartum amenorrhea or abstinence. Understanding the inconsistencies in definition and analytic approach and their implications for infertility estimation is important for reliably monitoring population-level infertility trends, identifying factors influencing infertility, improving prevention programs, and ensuring access to quality treatment and services. This study was supported by grants from the Bill & Melinda Gates Foundation (INV009639) and the National Institute of Child Health and Human Development (K01HD107172). The funders were not involved in the study design, analyses, manuscript writing, or the decision to publish. The authors have no conflicts of interest to declare. N/A.