Unprotected Vaginal Intercourse Research Articles

Source of information, knowledge, and sexual behaviour related to HIV/AIDS amongst university students in an inland territory of central Italy

Italian university students were investigated for: sources of information about HIV, knowledge of HIV risk behaviours, as well as sexual behaviours and condom use. A self completed anonymous questionnaire was administered to 430 university students in Campobasso, Italy (mean age 23,1; males 35,8%). Although TV, radio and the printed press were the most common sources of HIV information (>60% of respondents), most respondents preferred to receive information from physicians or resource centres (50 and 51%). Most students (>97%) were aware that specific sexual behaviours (unprotected vaginal or anal intercourse) and sharing of needles with illegal injecting drug users could transmit HIV. Most students (>50%) did not regularly use condoms (despite understanding their protective effect), and continued to engage in behaviours considered risky. Males were significantly more likely than females to engage in vaginal sex (84 vs. 67%) or anal sex (37 vs. 13%) with both regular and casual partners. Although knowledge of HIV in itself is not enough to produce behaviour change, increases in students’ levels of knowledge may be useful.

Retail demand for emergency contraception in United States following New Year holiday: time series study.

To estimate the increase in sales of emergency contraception following the New Year's Eve/New Year's Day holiday. Time series analysis using autoregressive integrated moving average (ARIMA) model. Traditional (that is, "bricks and mortar") retail outlets-grocery stores, drug stores, mass merchandisers, club stores, dollar stores, and military outlets-in the United States from 2016 to 2022. Marketing data on weekly aggregated sales of items classified as emergency contraception gathered between 2016 and 2022 (n=362). On the basis of dates, weeks were classified as following the New Year holiday (n=6) or not (n=356). Weekly sales of levonorgestrel emergency contraception per 1000 women of reproductive age in the US population. Sales of levonorgestrel emergency contraception significantly increased after the New Year holiday (0.63 (95% confidence interval 0.58 to 0.69) unit increase per 1000 women aged 15-44). Holidays that share some aspects of the elevated risks of unprotected sexual intercourse with the New Year holiday (Valentine's Day, St Patrick's Day, US Independence Day) were associated with increased sales, albeit to a lesser degree, with respective sales increases per 1000 women aged 15-44 of 0.31 (0.25 to 0.38), 0.14 (0.06 to 0.23), and 0.20 (0.11 to 0.29). Holidays without these expectations (Easter, Mother's Day, Father's Day) were not significantly associated with sales of levonorgestrel emergency contraception. Increased sales of emergency contraception following the New Year's holiday suggest that this period is associated with increased risks of unprotected vaginal intercourse compared with other holidays. Targeting behavioral risks, prevention strategies to mitigate sexual violence, and improving access to contraception around holidays may limit the risks associated with unprotected vaginal intercourse.

The association between HIV disclosure, spousal testing and unprotected vaginal intercourse within marriage among HIV positive married MSM in China

ABSTRACT Disclosure of HIV status can encourage spouses of people diagnosed with HIV to prioritize HIV prevention. However, few studies have reported the HIV disclosure status of married men who have sex with men (MSM) and their female spouses. The purpose of this study was to describe the prevalence of HIV disclosure, and whether it was associated with spouses’ HIV testing uptake and unprotected vaginal intercourse within marriage for MSM living with HIV (HIV + MSM) in China. A cross-sectional study was conducted in three Chinese cities. Of 309 participants, only 31.1% of men had disclosed their HIV status to spouses. About 80% of participants reported that their spouses had been tested for HIV. A small proportion of men (9.1%) had unprotected sex with their spouse after HIV diagnosis. Multivariate analyses indicated HIV disclosure was positively associated with HIV testing uptake of spouses, but there was no significant association between HIV disclosure and unprotected marital sexual behaviors for HIV + MSM. The findings indicated that HIV disclosure to spouses is uncommon among married HIV + MSM in China, and HIV disclosure is associated with increased uptake of HIV testing among spouses of MSM, but it does not decrease the unprotected sexual behaviors in marriage.

Community-Based Interventions and Behaviors of HIV+ Persons in Congo-Kinshasa

Introduction: Sub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their life. Starting in early 2000, Congolese HIV+ patients have undergone a variety of medico-social inputs designed to decrease risky behaviors among people in the program and their family members.
 Goals: This inquiry aimed to understand how PLWHs assess the influence of community-based incentives within their society, as primarily conceived to improve daily behaviors of each person living with HIV (PLWH), and a few selected family members with unknown HIV-serostatus.
 Methods: From December 2020 to March 2021, a cross-sectional study was engaged to gather qualitative-driven information from nine in-depth interviews, three focus groups, and two key-informant interviews. Changes were self-assessed through data gotten from 2004-2014 in sexual cleansing, levirate and sororate marriage, Kintwidi phenomenon, stigma and discrimination, sexual gender-based violence (SGBV) and female genital mutilation (FGM), unprotected receptive vaginal or anal intercourse, and behavioral rejection of condoms throughout a decade of Congolese Community-based Interventions (CBIs) implemented from 2004. Grounded on the socioecological model (SEM), this ethnographic study was based on the meaning of the influence of CBIs on cultural behaviors among PLWHs for HIV/AIDS prevention purposes.
 Results: Data from Kinshasa and Bandundu were coded and analyzed through NVivo R1 and Excel, showing significant negative sentiments for all eight key-cultural components in PLWHs.
 Conclusion: Out of the holistic approach employed to tackle HIV/AIDS in communities, the comprehensive strategy enabled for social change in Congo-Kinshasa brought specific impactful insights in terms of behavior according to interviewed PLWHs. Findings could be used to inform further preventive activities to alleviate any community HIV burden in sub-Saharan Africa.

Arthritis-Dermatitis Syndrome: a Case of Disseminated Gonococcal Infection with Petechial Skin Rash

A previously healthy 36-year-old woman was admitted to the hospital with vaginal discharge, bilateral ankle pain, and a lower extremity skin rash, all of which developed after unprotected vaginal intercourse with a new male partner. On examination, there was a petechial and purpuric rash involving the lower extremities and bilateral tenosynovitis of the ankle dorsiflexor tendons. Urine NAAT was positive for Neisseria gonorrhea, confirming disseminated gonococcal infection (DGI). The patient was initially treated with oral azithromycin and intravenous ceftriaxone, but as a result of psychosocial circumstances, she was prematurely discharged on an oral cephalosporin agent. She represented with treatment-failure DGI and was treated with a 7-day course of intramuscular ceftriaxone. Repeat urine NAAT was negative for gonorrhea and the patient remained asymptomatic. This case features an atypical cutaneous manifestation of DGI, characterized by a painless petechial and purpuric skin rash rather than the tender papulo-pustular lesions that are typically seen. Additionally, it highlights the importance of DGI treatment with a 7-day parenteral cephalosporin therapy when antibiotic susceptibility is not available.

Penile bacteria associated with HIV seroconversion, inflammation, and immune cells.

The foreskin is a site of heterosexual acquisition of HIV-1 among uncircumcised men. However, some men remain HIV-negative despite repeated, unprotected vaginal intercourse with HIV-positive partners, while others become infected after few exposures. The foreskin microbiome includes a diverse group of anaerobic bacteria that have been linked to HIV acquisition. However, these anaerobes tend to coassociate, making it difficult to determine which species might increase HIV risk and which may be innocent bystanders. Here, we show that 6 specific anaerobic bacterial species, Peptostreptococcus anaerobius, Prevotella bivia, Prevotella disiens, Dialister propionicifaciens, Dialister micraerophilus, and a genetic near neighbor of Dialister succinatiphilus, significantly increased cytokine production, recruited HIV-susceptible CD4+ T cells to the inner foreskin, and were associated with HIV acquisition. This strongly suggests that the penile microbiome increases host susceptibility to HIV and that these species are potential targets for microbiome-based prevention strategies.

Characterizing a sexual health and HIV risk stratification scale for sexually active adolescent girls and young women (AGYW) in Tanzania.

Adolescent girls and young women (AGYW) aged 15 to 24 years face disproportionately high risks of acquiring HIV and other sexually transmitted infections (STIs). A sexual health risk stratification tool can support the development and implementation of tailored HIV and STI prevention services for sub-groups of at-risk AGYW. Data were collected among sexually active AGYW aged 15 to 24 years in Tanzania between April 2015 and March 2017. Exploratory and confirmatory factor analyses were conducted to construct and assess the latent structure of a ten-item scale for rapid assessment of sexual health risks. Items with high factor loadings and minimal cross loadings were retained in the final scale. Scale performance was appraised against condomless sex (defined as unprotected vaginal or anal intercourse) reported by AGYW for construct validity. A three-factor structure of vulnerability to HIV among AGYW was supported with subscales for socioeconomic vulnerability; lack of adult support; and sexual behavioral risks. The chi-square goodness-of-fit test, root mean square error of approximation, comparative fit index, and Tucker-Lewis index indicated a strong goodness-of-fit of the three-factor scale. Cronbach alphas (0.55 for socioeconomic vulnerability, 0.55 for lack of support, and 0.48 for sexual risk) indicated sub-optimal internal consistency for all sub-scales. The factor-item and factor-factor correlations identified in these analyses were consistent with the conceptual framework of vulnerability of HIV infection in AGYW, suggesting good construct validity. The scale also demonstrated a statistically significant association with condomless sex and could be potentially used for sexual health risk stratification (OR = 1.17, 95% CI: 1.12, 1.23). The sexual health and HIV risk stratification scale demonstrated potential in identifying sexually active AGYW at high risk for HIV and other STIs. Ultimately, all AGYW in Tanzania are not at equal risk for HIV and this scale may support directing resources towards those at highest risk of HIV.

An Overview of Seminal Plasma Hypersensitivity and Approach to Treatment

Seminal plasma hypersensitivity (SPH) presents with localized vaginal and/or systemic allergic symptoms on exposure to protein components of seminal plasma. Although the true incidence is unclear, it is a likely underdiagnosed but an important cause of vulvovaginitis and dyspareunia that affects women across the entire globe. Systemic SPH is likely elicited by an IgE-mediated reaction to seminal plasma proteins other than spermatozoa. Localized reactions are likely mediated by a non-IgE immunologic mechanism. The diagnosis of both conditions is made clinically. Clinical presentation typically involves local vaginal discomfort and/or systemic symptoms including urticaria, angioedema, wheezing, dyspnea, gastrointestinal symptoms, or frank anaphylaxis. In roughly half of cases of localized SPH, reactions occur after first-time intercourse. Use of a condom prevents reactions, which aids confirming a diagnosis. In addition to a detailed history, skin prick and/or serologic testing may assist in making the diagnosis. Both local and systemic SPH are managed by the use of barrier contraception or intravaginal graded desensitization. Although SPH has not been shown to directly cause infertility, it may make conception challenging due to the discomfort or systemic symptoms caused by unprotected vaginal intercourse. Data indicate that women with localized reactions have variable fertility outcomes, although the majority are able to have resolution of symptoms after desensitization and have normal term pregnancies. This review provides a step-by-step approach for evaluating and treating women with localized or systemic SPH.

Infertility: Understanding investigation and treatment options

The World Health Organisation has defined infertility as the inability to become pregnant after 12 months of regular unprotected vaginal sexual intercourse. Primary infertility refers to couples that have never conceived, whereas secondary infertility refers to couples that have failed to conceive despite previous pregnancy. In the general population, 80% of couples are expected to be able to conceive within a year and 90% by the end of 2 years. With the rising trend for increasing maternal age at time of first pregnancy and the obesity epidemic, the incidence of infertility is likely to increase. Couples unable to conceive will seek help and advice from their GP. Infertility is highly emotive, and patients and their partners subject to investigation and management for infertility are likely to experience anxiety. Although primarily managed in secondary care, a robust understanding of investigation and treatment options for infertility can enable GPs to educate and support patients, as well as manage expectations.

"Does 'No, Not without a Condom' Mean 'Yes, Even Without a Condom'?: The Fallout from R v Hutchinson"

In R v Kirkpatrick, the Court of Appeal for British Columbia held that consent to sexual activity cannot be established where a man proceeds with unprotected vaginal intercourse when his sexual partner has insisted on a condom. While this finding should be uncontroversial, it is in fact contrary to the Supreme Court of Canada ruling in R v Hutchinson. In this comment we argue that the approach taken in Kirkpatrick is correct and consistent with the landmark decision in R v Ewanchuk. We urge the Supreme Court of Canada to reconsider its majority judgment in Hutchinson in order to fully recognize the central role that a condom plays in whether a woman agrees to participate in sexual activity.

Status quo and characteristic analysis among MSM-users of the "Internet Plus-based AIDS Comprehensive Prevention Service System" in Guangzhou

Objective: To analyze the characteristics of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM who frequently using the Internet in Guangzhou. Methods: An online survey was conducted among MSM who were recruited through gay-website portals between August and September, 2018 in Guangzhou, to collect information regarding the use of and attitudes on the "Interner Plus-based AIDS Comprehensive Prevention Service System" . Logistic regression was used to explore the association between the use of Internet intervention tools and related behavioral characteristics. Information on the awareness of AIDS, HIV testing, and condomless anal sex behavior were compared between the core or non-core services users. Results: A total of 777 Internet-based MSM were recruited as participants including 638 men (82.1%) as core service users. MSM were satisfied in using the the "Interner Plus-based AIDS Comprehensive Prevention Service System" while more than 80.0% of the users felt that the tools were helpful in: increasing the HIV awareness, promoting test uptake, and reducing those related risk behavior. Comparing with those who did not use the tools, the users showed higher rates in practising condomless anal intercourse (1.50-1.86 times), commercial sex with men (11.60-21.21 times), and unprotected vaginal intercourse (13.62-20.67 times), in the last 6 months. Proportions of core service users appeared as: [96.6% vs. 74.8%, aOR (95%CI): 8.80 (4.85-15.97)] on HIV testing, [56.4% vs. 22.3%, aOR (95%CI): 4.54 (2.94-7.02)] on regular HIV testing and [86.2% vs. 80.6%, aOR (95%CI): 1.75 (1.06-2.89)] on awareness of HIV knowledge respectively, which were all significantly higher than the non-core service users. Conclusions: The frequent Internet using MSM in Guangzhou claimed to have had high acceptance and satisfaction on the local Internet HIV intervention service tools. The "Internet Plus-based AIDS Comprehensive Prevention Service System" had effectively reached the high-risk subgroups of MSM, increasing the awareness on related risk and promoting testing on HIV.

Sexual Risk Behaviors Among Black and Puerto Rican Women in Their Late Thirties: A Brief Report.

In New York City, over 90% of women newly diagnosed with human immunodeficiency virus (HIV) are Black and Latina; a quarter of these infections occur among 30-39 year-olds. A survey was administered to 343 Black and Puerto Rican women (2014-2016) to examine two HIV infection risk factors: relationship exclusivity and havingexperienced childhood sexual abuse (CSA). A majority of male partners (69.7%) had at least one risk for HIV transmission. Women in non-exclusive sexual relationships (nESRs) had higher-risk partners, but engaged in safer sex practices than those in ESRs. Two-thirds of women in ESRs (64.8%) reported unprotected vaginal intercourse, although 33.5% had partners with a history of concurrent relationships. Among women in nESRs, havingexperienced CSA was a strong risk factor for HIV infection. Black and Latina women's vulnerability to HIV infection is significant, even when in exclusive relationships. Safer sex counseling should be integrated in primary care.

Unpacking the practice of ukujola in contemporary South Africa: understanding informal/casual sexual relations of young African adults in the context of HIV and AIDS

HIV and AIDS continue to pose a global health and development challenge, particularly in sub-Saharan Africa. South Africa has the largest number of people living with HIV (PLHIV) in the world. In spite of the accelerated efforts to combat the HIV and AIDS epidemic, there still remains an unabated challenge, i.e. continuing new infections, particularly among young African adults. HIV is largely transmitted through unprotected vaginal and anal sexual intercourse. This study sought to unpack the meaning of ukujola (casual or informal sexual relationships) as socially constructed by Zulu people, and to identify underlying socio-economic factors for ukujola. This study uses a generic qualitative study approach in which 32 qualitative interviews (4 focus groups, 20 in-depth interviews and 8 key-informant interviews) were conducted with isiZulu-speaking participants (aged 21–34) from Umgungundlovu district, KwaZulu-Natal province. The study found that ukujola relationships are a relatively new phenomenon in Zulu society. Ukujola relationships encompass all “illegitimate” relationships, i.e. in which there has never been involvement of the families. The involvement of families in negotiating ilobolo (bride wealth) is a pre-requisite for legitimate relationships, particularly marriage. Multiple concurrent sexual partnerships typically exist in ukujola relationships, and unprotected sex is common. There is a need for a national dialogue on ilobolo in the context of HIV and AIDS.

Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil.

Objective:There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls.Methods:We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors.Results:Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%).Conclusion:The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.

Trends in unprotected intercourse among heterosexual men before and after brothel ban in Siem Reap, Cambodia: a serial cross-sectional study (2003\u20132012)

BackgroundFollowing Cambodia’s implementation of the 100% condom use program with enforcement of condom use and STI treatment services for sex workers in 2001, sexually transmitted infection and HIV declined markedly. In 2008, Cambodia implemented a law to ban brothel-based sex work. We reported trends in unprotected vaginal intercourse with sex workers among heterosexual men buying sex before (2003–2008) and after (2009–2012) the brothel ban in Cambodia. We also determined the association of brothel ban with these men’s reports of unprotected intercourse with sex workers.MethodsIn this serial cross-sectional study, we collected yearly behavioural data on random cross-sectional samples of heterosexual men buying sex who attended the only government health centre in Siem Reap for voluntary confidential counselling and testing (VCCT) between 2003 and 2012. We used multivariable Poisson regression analysis on the 10-year data of 976 men to obtain the adjusted prevalence ratio (aPR) of unprotected intercourse in the last 6 months by brothel closure.ResultsMen buying sex from non-brothel-based sex workers increased almost 3-fold from 17% in 2007–2008 before brothel closure to 55% in 2011–2012 after brothel closure (p < 0.001). Unprotected intercourse with sex workers in the last week increased significantly from 37% (2003–2004) before brothel closure to 65% (2011–2012) after brothel closure. This increase corresponded closely with the increase in self-reported unprotected intercourse from 35% to 61% by the sex workers (n = 1805) attending the same clinic for VCCT. Brothel closure was associated with an increased risk (aPR: 1.65; 95% CI: 1.40–1.94) of unprotected intercourse with sex workers. HIV prevalence in the heterosexual men declined significantly from 26% in 2003–2004 to 4.8% in 2007–2008 and 0 case in 2009–2010 before increasing to 5.6% in 2011–2012.ConclusionOur findings suggest that the brothel ban had led to an increase in unprotected intercourse with all sex workers for men buying sex. This effect could be attributed to reduced condom access, a consequence of the lack of feasibility to implement the 100% condom use program following the brothel ban. The ban on brothels in Cambodia should be reviewed.

Effectiveness of an evidence-based HIV prevention intervention when implemented by frontline providers.

Carefully conducted randomized trials have established that sexual behavior change interventions can significantly reduce intervention participants' risk of acquiring HIV. Establishing the effectiveness of these evidence-based interventions when implemented by frontline HIV prevention service providers is increasingly important in order to achieve maximum public health impact. This study sought to assess the effectiveness of an evidence-based intervention when implemented by frontline HIV prevention service providers. We evaluated Sisters Informing Sisters on Topics about AIDS (SISTA), an HIV prevention intervention for heterosexual African American women, as implemented by four AIDS service organizations. Women enrolled in HIV counseling, testing, and referral (CTR) at each agency served as contemporaneous controls. Measures included self-reported number of occasions of unprotected vaginal intercourse and number of vaginal sex partners in the previous 90 days. 1,262 participants completed baseline and follow-up assessments across both conditions (SISTA = 537 [57%]; CTR = 725 [62%]). In the full sample of HIV-negative women, CTR participants' odds of having had unprotected sex decreased over time by 38% while SISTA participants' odds of having had unprotected sex did not change. Similar results were found among only those participants who had sex at baseline. Hypothesized interaction effects indicating positive changes in sexual risks over time for SISTA participants were not observed.

Sexual Behavior in Germany.

There have not been any population-based surveys in Germany to date on the frequency of various types of sexual behavior. The topic is of interdisciplinary interest, particularly with respect to the prevention and treatment of sexually transmitted infections. Within the context of a survey that dealt with multiple topics, information was obtained from 2524 persons about their sexual orientation, sexual practices, sexual contacts outside relationships, and contraception. Most of the participating women (82%) and men (86%) described themselves as heterosexual. Most respondents (88%) said they had engaged in vaginal intercourse at least once, and approximately half said they had engaged in oral intercourse at least once (either actively or passively). 4% of the men and 17% of the women said they had been the receptive partner in anal intercourse at least once. 5% of the respondents said they had had unprotected sexual intercourse outside their primary partnership on a single occasion, and 8% said they had done so more than once; only 2% of these persons said they always used a condom during sexual intercourse with their primary partner. Among persons reporting unprotected intercourse outside their primary partnership, 25% said they had undergone a medical examination afterward because of concern about a possible sexually transmitted infection. Among some groups of persons, routine sexual-medicine examinations may help contain the spread of sexually transmitted infections. One component of such examinations should be sensitive questioning about the types of sexual behavior that are associated with a high risk of infection. Information should be provided about the potential modes of transmission, including unprotected vaginal, oral, and anal intercourse outside the primary partnership.

Risk profile and HIV testing outcomes of women undergoing community-based testing in San Diego 2008\u20132014

Women comprised 19% of new HIV diagnoses in the United States in 2014, with significant racial and ethnic disparities in infection rates. This cross-sectional analysis of women enrolled in a cohort study compares demographics, risk behaviour, and sexually transmitted infections (STI) in those undergoing HIV testing in San Diego County. Data from the most recent screening visit of women undergoing voluntary HIV screening April 2008 –July 2014 was used. HIV diagnosis, risk behaviour and self-reported STIs were compared among women aged ≤24, 25–49, and ≥50, as well as between HIV-infected and uninfected women and between Hispanic and non-Hispanic women. Among the 2535 women included, Hispanic women were less likely than other women to report unprotected vaginal intercourse (p = 0.026) or stimulant drug use (p = 0.026), and more likely to report one or fewer partners (p < 0.0001), but also more likely to report sex with an HIV-infected individual (p = 0.027). New HIV infection was significantly more prevalent among Hispanic women (1.6% vs. 0.2%; p < 0.001). Hispanic women were more likely than other women to be diagnosed with HIV despite significantly lower rates of risk behaviour. Culturally specific risk reduction interventions for Hispanic women should focus on awareness of partner risk and appropriate testing.

Sex Differences in Virtual Network Characteristics and Sexual Risk Behavior among Emerging Adults.

Emerging adults (EAs)ages 18 to 24 account for a large proportion of all sexually transmitted infections (STIs), HIV infections, and unintended pregnancies in the United States. Given the increased influence of online media on decision-making, we examined how EA online networks were associated with sexual risk behaviors. We used egocentric network data collected from EAs aged 18 to 24 years old across the United States (N=1,687) to examine how online norms (e.g., acceptance of HIV infections, other STIs, and pregnancy) and network characteristics (i.e., network size and density; ties' closeness, race, age, and sex similarities) were associated with participants' unprotected vaginal intercourse (UVI) in the last 30 days. Findings suggested that in male EAs, there was a strong association between sexual norms, structural characteristics, and sexual risk behavior compared to females. Researchers and practitioners may wish to address online peer norms and EAs' online network composition when developing online sexual risk prevention tools.

Patterns of risky sexual behaviors among emerging adults in intimate sexual relationships in two tertiary institutions in southwestern Nigeria

ABSTRACTThis study explored patterns of risky sexual practices and perceived vulnerability to sexually transmitted infections among 450 sexually active emerging adults (18–25 years) through a self-administered questionnaire and 43 interviews. Findings showed that 97.4% of men and 98.1% of women were in intimate sexual relationships, among which 74% of men and 46.5% of women had unprotected vaginal intercourse and anal sex (α = 1.74 for men and 1.09 for women) within the past month. Consequences of unprotected sexual practices notwithstanding, engagement in risky sexual practices prevail. Redesigning of current behavioral modification approaches targeted toward promoting healthy sexual practices in young adulthood is required.