Condom Use Research Articles

Sociodemographic, Clinical, and Behavioral Factors Associated with Sexual Transmitted Infection among HIV-1 Positive Migrants in Portugal: Are There Differences between Sexes?

Sexually transmitted infections (STIs) continue to occur at high levels. According to the WHO, each year there are an estimated 374 million new infections with syphilis, gonorrhea, chlamydia, and trichomoniasis. STIs are associated with an increased risk of acquiring HIV infection. Migrants are reportedly highly affected by STIs. This study aims to characterize factors associated with STIs in a population of HIV-positive migrants living in Portugal. This is a cross-sectional observational study of 265 newly diagnosed HIV-1 positive migrants, who were defined as individuals born outside Portugal. This group of people were part of the BESTHOPE study that was developed in 17 Portuguese hospitals between September 2014 and December 2019, and included information collected through sociodemographic and behavioral questionnaires filled in by the migrant patients, clinical questionnaires filled in by the clinicians and HIV-1 genomic sequences generated through resistance testing (Sanger sequencing). A multivariable statistical analysis was used to analyze the association between sociodemographic characteristics, sexual behaviors, HIV testing and sexual infections. Most HIV-1 positive individuals included in the study were men (66.8%) and aged between 25 and 44 years old (59.9%). Men had a higher proportion of STIs when compared to women (40.4% vs. 14.0%) and the majority of men reported homosexual contacts (52.0%). Most men reported having had two or more occasional sexual partners in the previous year (88.8%) and 50.9% reported always using condoms with occasional partners, while 13.2% never used it. For regular partners, only 29.5% of the women reported using condoms, compared to 47.3% of men. Other risk behaviors for acquiring HIV, such as tattooing and performing invasive medical procedures, were more prevalent in men (38.0% and 46.2%, respectively), when compared to women (30.4% and 45.1% respectively) and 4.7% of men reported having already shared injectable materials, with no data for comparison in the case for women. Additionally, 23.9% of women reported having had a blood transfusion while only 10.3% of men reported having had this medical procedure. Meanwhile, 30.9% of the individuals reported having been diagnosed with some type of STI in the last 12 months. In addition, 43.3% of individuals that answered a question about hepatitis reported to be infected with hepatitis B, while 13.0% reported having hepatitis C infection. According to the multivariable analysis, the only transmission route was significantly associated with reports of previous STI infection: men who have sex with men (MSM) were 70% more likely to have been diagnosed with an STI in the past 12 months compared to the heterosexual route. HIV-1 infected men were more likely to report previous STIs than women. On the other hand, most migrant women had a regular sexual partner and never or only sometimes used condoms. This somewhat discrepant findings suggest that gender inequalities may make women unable to negotiate safe sexual practices, resulting in increased susceptibility to infection. However, since migrant women report less STIs, we cannot exclude that these STIs may remain undiagnosed. The implementation of safer sex awareness campaigns for condom use and screening for STIs in women is crucial. On the other hand, health education campaigns for STI knowledge need to be implemented for both MSM and women and their partners.

Can Support Groups Improve Treatment Adherence and Reduce Sexual Risk Behavior among Young People Living with HIV? Results from a Cohort Study in South Africa.

Adolescents and young adults living with HIV (AYLHIV) in sub-Saharan Africa experience poorer HIV outcomes than adults, including lower ART adherence and virologic suppression. They also have high rates of unprotected sex, increasing the risk of adverse sexual health outcomes and onward transmission. This one-arm, pre-post study investigates a structured 14-session support group aiming to boost treatment adherence and sexual protective behavior for AYLHIV in South Africa. Logistic and Poisson regression analyses were performed on self-reported pre- and post-intervention survey data collected approximately 7.5 months apart from a cohort of 548 AYLHIV. Participants were significantly more likely to report at least 95% adherence at follow-up and rate their health as "good;" they also demonstrated greater treatment knowledge and had fewer absences from school overall and due to illness. Among sexually active AYLHIV, contraception use at last sex increased significantly, while condom use did not. Effects were small, and greater programmatic emphasis on adherence and multifaceted service packages is likely necessary to promote viral suppression. Nonetheless, the intervention addresses an important gap in service provision for AYLHIV in South Africa. Findings denote the potential for incorporating care and treatment components into sexual and reproductive health interventions tailored for AYLHIV.

Anti-Retroviral drug and condom use among discordant couples in Western Kenya

Anti-Retroviral drug and condom use among discordant couples in Western Kenya

Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China

ObjectiveLGBTQ-affirmative cognitive-behavioral therapy (CBT) addresses minority stress to improve sexual minority individuals’ mental and behavioral health. This treatment has never been tested in high-stigma contexts like China using online delivery. MethodChinese young sexual minority men (n = 120; ages 16–30; HIV-negative; reporting depression and/or anxiety symptoms and past-90-day HIV-transmission-risk behavior), were randomized to receive 10 sessions of culturally adapted asynchronous LGBTQ-affirmative internet-based CBT (ICBT) or weekly assessments only. The primary outcome included HIV-transmission-risk behavior (i.e., past-30-day condomless anal sex). Secondary outcomes included HIV social-cognitive mechanisms (e.g., condom use self-efficacy), mental health (e.g., depression), and behavioral health (e.g., alcohol use), as well as minority stress (e.g., acceptance concerns), and universal (e.g., emotion regulation) mechanisms at baseline and 4- and 8-month follow-up. Moderation analyses examined treatment efficacy as a function of baseline stigma experiences and session completion. ResultsCompared to assessment only, LGBTQ-affirmative ICBT did not yield greater reductions in HIV-transmission-risk behavior or social-cognitive mechanisms. However, LGBTQ-affirmative ICBT yielded greater improvements in depression (d = −0.50, d = −0.63) and anxiety (d = −0.51, d = −0.49) at 4- and 8-month follow-up, respectively; alcohol use (d = −0.40) at 8-month follow-up; and certain minority stress (e.g., internalized stigma) and universal (i.e., emotion dysregulation) mechanisms compared to assessment only. LGBTQ-affirmative ICBT was more efficacious for reducing HIV-transmission-risk behavior for participants with lower internalized stigma (d = 0.42). Greater session completion predicted greater reductions in suicidality and rumination. ConclusionsLGBTQ-affirmative ICBT demonstrates preliminary efficacy for Chinese young sexual minority men. Findings can inform future interventions for young sexual minority men in contexts with limited affirmative supports.

Caregiver-Youth Communication Patterns and Sexual and Reproductive Health Among American Indian Youth.

Improving communication between American Indian caregivers and their youth has been suggested as an Indigenous-forward strategy to help alleviate the sexual and reproductive health (SRH) disparities faced by American Indian youth as a result of the legacy of colonial violence against American Indian communities. Studies with non-American Indian and American Indian populations suggest that effective communication about SRH between parents and youth plays a role in reducing sexual risk behaviors among youth. There is limited research that examines youth sexual risk behaviors in relation to communication patterns separately assessed in caregivers and youth. The current study aimed to examine the association between caregiver-youth communication patterns and engagement in sex, age at sexual debut, and condom use among American Indian youth in the United States. The study draws on baseline caregiver and youth data collected fromNen ŨnkUmbi/EdaHiYedo, astepped wedge design trial with American Indian youth living on the Fort Peck Reservation in Montana. 113 caregiver responses were matched to 145 youth for the current study. Caregiver-youth communication patterns were examined in relation to youth engagement in sex, age at sexual debut, and number of protected acts of vaginal and/oranal sex. Multivariable models were used to adjust for confounders and to examine relationships between caregiver-youth communication and youth sexual risk outcomes. An increase in overall level of self-reported youthcommunication with caregivers about sexual and reproductive health topics was significantly associated with a greater likelihood of youth ever having engaged in sex. A significant interaction effect between youth communication and convergence with caregiver response was observed for the number of protected acts of vaginal and/or anal sex, where caregiver communication (regardless of self-reportedyouth communication with caregivers) was associated with a greater number of protected sex acts. This study fills a gap in the extant literature by reporting on relationships between communication about SRH, assessed separately in caregivers and youth, and youth sexual risk behaviors. Findings emphasize the importance of involving American Indian caregivers in SRH interventions to improve SRH outcomes among American Indian youth, and inform future experimental research that will evaluate how changes in caregiver communication potentially impact youth SRH.

Leveraging A Digital Pill System to Understand Prevention-Effective Adherence to Oral Hiv Pre-Exposure Prophylaxis Among Men Who Have Sex with Men with Substance Use.

Daily oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, though efficacy depends on adherence. Digital pill systems (DPS) can enable direct, real-time adherence measurement. HIV-negative men who have sex with men (MSM) with substance use (excluding alcohol) utilized a DPS over 90 days and completed weekly surveys reporting sexual activity, condom use, and substance use. Responses indicating (1) any sexual activity and substance use or (2) condomless anal intercourse (CAI) in the prior week were categorized as high risk for HIV acquisition. PrEP adherence data for the 7-day period preceding each response was dichotomized as ≤ 3 and ≥ 4 doses/week, indicating prevention-effective adherence, and compared by HIV risk level. Thirteen MSM were analyzed (median age: 32). Of 113 surveys, 48.7% indicated high HIV risk, with 12.4% reporting CAI alone, 16.8% any sexual activity and substance use, and 19.5% both CAI and substance use. Weekly mean PrEP adherence was 90.3% (6.3 of 7 doses/week), with ≥ 4 doses/week recorded during 92.0% of weeks. The proportion of participants with ≥ 4 recorded doses/week was 88.9% during weeks with CAI alone, 89.5% during weeks with any sexual activity and substance use, 92.0% during weeks with both CAI and substance use, and 92.8% during lower risk weeks. Participants ingested ≥ 4 doses/week during 89.1% of all high-risk weeks and 94.8% of low-risk weeks. Overall, participants maintained high levels of PrEP adherence while engaging in HIV risk behaviors. DPS can be deployed concurrently with data collection tools to assess ingestion patterns during periods of elevated risk.

Inconsistent condom use among crack users: differences in vulnerabilities between the sex

The study aimed to estimate the prevalence of unprotected sexual relations and associated factors, by sex, among crack users in Pernambuco. A cross-sectional study was developed in a consecutive sample of 1,062 crack users from Pernambuco, Brazil between August/2014 and August/2015. The effect of factors associated with inconsistent condom use was estimated using multiple regression. The prevalence of HIV infection among women (8.1%) was double that among men (4.3%). Inconsistent condom use occurred in 77.8% of women and 74.7% of men. There were differences between the sexes for factors associated with unprotected sexual intercourse. Among men, inconsistent use was related to programmatic vulnerability, such as having access to condoms. Among women, social vulnerability was decisive, including factors related to religion. These differences suggest specific strategies for preventing Sexually Transmitted Infections.

Dynamic analysis and optimal control of HIV/AIDS model with ideological transfer

This paper presents an HIV/AIDS model with ideological transfer in male susceptible individuals, and considers condoms and education as control measures. First, it gives the threshold R0 of the model. Then it proves that the disease-free equilibrium is globally asymptotically stable when R0<1. Under different threshold conditions, the local stability of the boundary equilibria is given. The existence of the endemic equilibrium is also given. We also perform numerical simulations for different parameter values. Furthermore, when considering control measures, the simulation results show that effective and long-term use of condoms significantly reduce the number of infected individuals and education should be vigorously promoted when the epidemic is controllable. This result provides theoretical guidance for effective control the spread of HIV.

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

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

Delay in healthcare seeking and associated factors among patients presenting with sexually transmitted infection symptoms in the Horo Guduru Wollega Zone, Oromia, Western Ethiopia, 2022.

Sexually transmitted infections (STIs) are the most prevalent communicable diseases that impact people's health and wellbeing. One of the main obstacles to successful prevention and control of STIs is the delay in seeking healthcare, which can result in significant personal and economic losses. However, there are limited studies on the delay in healthcare seeking among STI patients in resource-limited countries such as Ethiopia. This study aims to assess delays in seeking healthcare and associated factors among patients presenting with STIs at public health facilities in the Horo Guduru Wollega Zone, Oromia, Western Ethiopia, 2022. A cross-sectional study was conducted at public health facilities in the Horo Guduru Wollega Zone from 15 March to 15 May 2022. The study included 507 participants and used a consecutive sampling method. The outcome variable of the study was the delay in seeking healthcare among STI patients. A binary logistic regression model was used to identify candidate variables with a p-value of less than 0.25 after analyzing each variable separately. Finally, a multivariable analysis was performed to determine statistically significant variables at a p-value of less than 0.05, and an adjusted odds ratio (AOR) was reported. The proportion of individuals with STIs who delayed seeking healthcare in the Horo Guduru Wollega Zone was 61.3% [95% confidence interval (CI): 57%-65.5%]. Factors such as age >35 years (AOR = 2.23, 95% CI: 1.26-3.95), higher educational level (AOR = 2.72, 95% CI: 1.55-4.74), lack of condom use (AOR = 1.63, 95% CI: 1.05-2.55), and travel time to health facilities of >1 h (AOR = 4.30, 95% CI: 1.70-10.89) were found to be significantly associated with delayed healthcare seeking. This study found that the magnitude of delay in seeking healthcare was higher than the national average and identified several contributing factors. Interventions such as developing educational programs and improving access to healthcare services are crucial for supporting patients with STIs. Enhancing healthcare accessibility in rural areas and promoting the use of condoms through targeted community outreach can reduce travel time and prevent delays in seeking healthcare for STIs.

Incidence and risk factors associated with acquired syphilis in HIV pre-exposure prophylaxis users.

Acquired syphilis continues to affect millions of people around the world. It is crucial to study it in the context of HIV Pre-Exposure Prophylaxis (PrEP) to achieve the goals set out in the 2030 Agenda since the literature suggests increased risk behaviors for sexually transmitted infections. This study aimed to investigate the incidence and factors associated with acquired syphilis among PrEP users. This retrospective cohort included data on PrEP users from all over Brazil from 2018 to 2020, retrieved from the national antiretroviral logistics system. We calculated the proportion of syphilis before PrEP, the incidence during the user's follow-up, reinfections, and their possible associated factors. We conducted descriptive, bivariate, and multivariate analysis, estimating the crude Relative Risk, adjusted Odds Ratio (aOR), and their respective confidence intervals (95%CI). Most of the 34,000 individuals who started PrEP were male (89.0%), white (53.7%), self-identified as male (85.2%), homosexual, gay, or lesbian (72.2%), and had 12 schooling years or more (67.8%). Of these, 8.3% had syphilis in the six months before starting PrEP, and 4% had it in the first 30 days of using the prophylaxis. We identified a loss-to-follow-up rate of 41.7%, although the loss and the cohort shared similar characteristics. The proportion of missed syphilis tests was high: 33.4% in the 30 days and 38.8% in the follow-up period. In the 19,820 individuals effectively monitored, the incidence of acquired syphilis was 19.1 cases per 100 person-years, and 1.9% of users had reinfection. The rate of missed syphilis tests at the 30-day follow-up was 33.4%, and the total follow-up test period was 38.8%. The multivariate analysis identified female gender (aOR 0.3; 95%CI 0.2-0.5), being white or Black (aOR 0.9; 95%CI 0.7-0.9 and aOR 0.7; 95%CI 0.7-0.99, respectively) as protective factors for syphilis. Being homosexual, gay, lesbian (aOR 2.7; 95%CI 2.0-3.7), or having a history of syphilis in the six months before PrEP (aOR 2.2; 95%CI 1.9-2.5) were risk factors for syphilis during PrEP use. Behaviors related to the risk of syphilis included accepting something in exchange for sex (aOR 1.6; 95%CI 1.3-1.9), irregular condom use (use in less than half of sexual intercourse sessions; aOR 1.7; 95%CI 1.53-2.1) and recreational drug use (poppers; aOR 1.5; 95%CI 1.53-2.1). Syphilis in the context of PrEP has high rates and is associated with sociodemographic and behavioral factors. We recommend additional studies targeting prevention in this population to curb these figures.

The impact of past HIV interventions and diagnosis gaps on new HIV acquisitions, transmissions, and HIV-related deaths in Côte d'Ivoire, Mali, and Senegal.

To estimate the epidemiological impact of past HIV interventions and the magnitude and contribution of undiagnosed HIV among different risk groups on new HIV acquisitions in Côte d'Ivoire, Mali and Senegal. HIV transmission dynamic models among the overall population and key populations [female sex workers (FSW), their clients, and MSM]. Models were independently parameterized and calibrated for each set of country-specific demographic, behavioural, and epidemiological data. We estimated the fraction of new HIV infections over 2012-2021 averted by condom use and antiretroviral therapy (ART) uptake among key population and nonkey population, the direct and indirect contribution of specific groups to new infections [transmission population-attributable fraction (tPAF)] over 2012-2021 due to prevention gaps, and the distribution of undiagnosed PWH by risk group in January 2022 and their tPAF over 2022-2031. Condom use and ART may have averted 81-88% of new HIV infections over 2012-2021 across countries, mostly because of condom use by key population. The tPAF of all key populations combined over 2012-2021 varied between 27% (Côte d'Ivoire) and 79% (Senegal). Male key population (clients of FSW and MSM) contributed most to new infections (>60% in Mali and Senegal) owing to their higher HIV prevalence and larger prevention gaps. In 2022, men represented 56% of all PWH with an undiagnosed infection in Côte d'Ivoire (male key population = 15%), 46% in Mali (male key population = 23%), and 69% in Senegal (male key population = 55%). If HIV testing and ART initiation rates remain at current levels, 20% of new HIV infections could be due to undiagnosed key population PWH in Côte d'Ivoire over 2022-2031, 53% in Mali, and 65% in Senegal. Substantial HIV diagnosis gaps remain in Western Africa, especially among male key population. Addressing these gaps is key to impacting the HIV epidemics in the region and achieving the goal of ending AIDS by 2030.

Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey.

Background Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16-29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results Aboriginal and Torres Strait Islander (n =231) and non-Indigenous (n =2062) respondents reported similar condom use (40% vs 43%, P =0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P =0.002), STIs (60% vs 49%, P P =0.006) testing, STI diagnosis (29% vs 21%, P =0.042), and intoxication during last sex (30% vs 18%, P Conclusions Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates.

Ethnic affiliation and protective sexual behaviours among youth in Nigeria.

Investing in the sexual and reproductive health of young adults can directly and indirectly contribute to accelerated economic growth. Looking beyond individual determinants of sexual behaviours and focusing on cultural factors such as ethnic affiliation are crucial for interventions and programme planning, particularly in a context like Nigeria. Using a concurrent triangulation mixed-methods design, this article explores the associations between ethnic affiliations and protective sexual behaviours of young adults in Nigeria. The quantitative data was derived from a representative sample of 1,393 male and female youth aged 16-24 years in three states purposively selected from three regions in Nigeria, while qualitative data was based on 18 focus groups and 36 in-depth interviews. The quantitative data was analysed using frequency distributions and regressions, while content analysis was employed to analyse qualitative data. Descriptive results showed that abstinence was higher for Hausa (80%) young adults compared with Yoruba (72%) and Igbo (68%) young adults. Condom use was lowest for Hausa (56%) young adults compared with Igbo (80%) and Yoruba (81%) young adults. The effect of education on abstinence differed by ethnicity and living with two parents was associated with a higher likelihood of abstinence among youth in all ethnic groups. Fear of early fatherhood and unplanned pregnancy was a prominent reason for protective sexual behaviour among Yoruba, Igbo, and Hausa young adults. The findings from this study show that young adults who engage in protective sexual behaviours may identify different rationales for this behaviour based on their ethnic background. Programme planners interested in promoting and encouraging protective sexual behaviours should recognize these multiple reasons across different ethnic affiliations to scale up and sustain existing interventions.

Unveiling the influence of reproductive health on poverty: a cross-sectional study in Magwi County, South Sudan

Objective: To understand the relationship between household poverty and reproductive health characteristics in Magwi County, South Sudan. Background: Household poverty is a significant issue in many countries, including South Sudan. Poverty has been identified as a major obstacle to international development, affecting various aspects of development goals such as food security and health. Despite interventions by organizations like the World Bank, poverty rates in beneficiary countries like South Sudan have not seen significant reductions, suggesting the presence of predictors of poverty from behavioral, structural, and political origins. Methods: The study was conducted using an analytical cross-sectional survey design. The study targeted female and male spouses in households and employed a multistage sampling approach to select participants. Result: The results of the study revealed that the level of household poverty in Magwi County was 42%. The prevalence of household poverty was found to be influenced by reproductive health characteristics. The use of short-acting contraception by women was associated with a higher prevalence of poverty, whereas women who had ever aborted a pregnancy had a lower prevalence of poverty. Unintended pregnancy and inconsistent condom use by men were also associated with higher poverty rates, whereas men with only one sexual partner had lower poverty rates. Conclusion: This study provides valuable insights into the relationship between household reproductive health characteristics and poverty in Magwi County, South Sudan. It emphasizes the need for comprehensive approaches that address both behavioral and structural factors to effectively reduce poverty and improve development outcomes.

Associated Factors of Sexual Initiation among Male Vocational High School Students in Zhejiang Province, China: A Cross-sectional Study.

This study aims to investigate the factors associated with sexual initiation among male vocational high school students (MVHSS) in Zhejiang Province, and provide a scientific basis for preventing unsafe sexual behavior and sexual health issues among adolescents. The prevalence of sexual behavior among young students has risen significantly in recent years. Contracting HIV poses a serious physical and psychological burden on young individuals and their families. Thus, it is imperative to promptly and effectively address the spread of HIV among young people. The objectives of this study are to investigate the demographic characteristics of male vocational high school students (MVHSS) who have engaged in sexual activity and to identify associated factors, such as sexual attitudes and lifestyle, that may influence sexual initiation among this population, and to offer recommendations for interventions and policy development aimed at promoting healthy sexual behaviors among MVHSS. A survey was conducted among vocational high school students in grades one and two in Zhejiang Province. Variables that were statistically significantly associated with sexual initiation in bivariate analyses were included in a multivariate logistic regression model, which adopted a backward elimination procedure with a p-value > 0.10 as the exclusion criterion. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to describe the relationship between dependent and outcome variables. Of the 1032 male participants, 17.4% had initiated sexual behavior. The multivariate analysis results indicated thatThose who were frequent smokers (adjusted OR[AOR] =4.89, 95% CI: 2.36-10.13), those who reported having been in love (AOR=2.86, 95% CI: 1.84-4.44), those currently in love (AOR=4.47, 95% CI: 2.68-7.45), those willing to have sex with a high school student (AOR =2.63, 95% CI: 3.31-6.50), those willing to pay for sex (AOR =1.90, 95% CI: 1.10-3.27), and those who had received sex education and STDs/AIDS prevention education in school (AOR =2.21, 95% CI: 1.53-3.18) were more likely to initiate sexual behavior. Sexual attitudes among MVHSS are liberal, and the prevalence of sexual initiation is high. Interventions targeted at improving sexual safety education, reducing the rate of early initiation of sexual behavior, and promoting condom use among students must be implemented to reduce the risk of HIV infections and STDs among sexually active MVHSS.

Providing HIV-assisted partner services to partners of partners in western Kenya: an implementation science study.

Assisted partner services (APS), or exposure notification and HIV testing for sexual partners of persons diagnosed HIV positive (index clients), is recommended by the World Health Organization. Most APS literature focuses on outcomes among index clients and their partners. There is little data on the benefits of providing APS to partners of partners diagnosed with HIV. We utilized data from a large-scale APS implementation project across 31 facilities in western Kenya from 2018 to 2022. Females testing HIV positive at facilities were offered APS; those who consented provided contact information for all male sexual partners in the last 3 years. Male partners were notified of their potential HIV exposure and offered HIV testing services (HTS). Males newly testing positive were also offered APS and asked to provide contact information for their female partners in the last 3 years. Female partners of male partners (FPPs) were provided exposure notification and HTS. All participants with HIV were followed up at 12 months post-enrolment to assess linkage-to antiretroviral treatment (ART) and viral suppression. We compared HIV positivity, demographics and linkage outcomes among female index clients and FPPs. Overall, 5708 FPPs were elicited from male partners, of whom 4951 received HTS through APS (87% coverage); 291 FPPs newly tested HIV positive (6% yield), an additional 1743 (35.2%) reported a prior HIV diagnosis, of whom 99% were on ART at baseline. At 12 months follow-up, most FPPs were taking ART (92%) with very few adverse events: <1% reported intimate partner violence or reported relationship dissolution. FPPs were more likely than female index clients to report HIV risk behaviours including no condom use at last sex (45% vs. 30%) and multiple partners (38% vs. 19%). Providing HIV testing via APS to FPP is a safe and effective strategy to identify newly diagnosed females and achieve high linkage and retention to ART and can be an efficient means of identifying HIV cases in the era of declining HIV incidence. The high proportion of FPPs reporting HIV risk behaviours suggests APS may help interrupt community HIV transmission via increased knowledge of HIV status and linkage to treatment.

Psychosocial Determinants of Bad Quality of Life Among People Living with HIV/AIDS on Antiretroviral Drugs in Kinshasa /DR Congo

Context and Objective: The search for psychosocial determinants of bad quality of life (Qol) in people living with the human immunodeficiency virus (PLWHA) under Highly active antiretroviral therapy (HAART) constitutes a real public health problem in Kinshasa. Determine the psychosocial factors of bad Qol among PLWHA on antiretrovirals in Kinshasa. Methods: This was a case control study carried out in Kinshasa from January 15 to April 15, 2021, which included 1082 subjects divided into two groups including 541 PLWHA patients and 541 no-PLWHA. Sampling was non-probability based on matching patients from case to control. Recruitment was carried out first among PLWHA, then matching was done by age and sex considering the sample of PLWHA. The variables of interest were sociodemographic, condom use, psychoactive substance abuse, perceived stress, anxiety-depression, and bad Qol. Results: The average age of PLWHA was 50.4±10.7 years with a sex ratio of 2.81. A third of PLWHA (32.9%) were married (p&lt;0,001), 9.2% used condoms (p&lt;0,001), 68% had a secondary education (p=0,006), 54.3% had an occupation (p=0,005), 54.2% attended independent churches (p=0,033), 52.1% had an average socioeconomic level (p&lt;0,001), 12.2% consumed alcohol (p&lt;0,001), 15.3% had a bad Qol. The main determinants of bad quality of life were stage 4 (ORa : 3,06 IC95% : 1,47-7,79), side effects due to HAART (ORa : 1,90 IC95% : 1,04-3,60), perceived stress (ORa : 4,14 IC95% : 1,32-12,94) and anxiety-depression (ORa : 6,88 IC95% : 1,60-9,43). Conclusion: Bad quality of life is present among PLWHA in Kinshasa. It was linked to stage 4, side effects due to Highly active antiretroviral therapy, perceived stress, anxiety-depression in HIV-positive people.

Let’s Talk About Condoms: Social Engagement in a Sexual Health Intervention Targeting Young Adults in Denmark

Objectives We tested whether social activities and interactions as part of a condom campaign strengthened young adults’ condom-use intentions and normative perceptions of condoms compared to simple exposure to campaign information. Method Data from 3,041 young adults collected after four annual condom campaigns were analyzed and combined into a meta-analysis. Results Interaction about the campaign and engagement in campaign-related activities was associated with higher condom use intention and more positive pro-condom norms. Conclusions The authors call for a greater emphasis on social influence in youth-aimed sexual health campaigns. Implications for the research are discussed.

Prevalence and predictors of condom use among people who inject drugs in Georgia.

People who inject drugs (PWID) are more likely to engage in risky sexual behavior placing them at high risk of acquiring HIV and other STIs. This study aims to assess the prevalence and predictors of inconsistent condom use with casual and/or paid sexual partners among PWID in Georgia. Integrated Bio-Behavioral Surveillance Survey was conducted among PWID in seven major cities of Georgia. Study design was cross-sectional with respondent-driven sampling (RDS) methodology. Data collection was carried out through individual face-to-face interviews. In this paper we analysed subsample of 619 PWID who reported having casual and/or paid sexual partners during last 12 months and described prevalence and predictors of consistent condom use. Consistent condom use during casual and/or paid sex in past 12 months was reported by 49.4% of respondents. The likelihood of consistent use with casual and/or paid sexual partners was statistically significantly associated with residence, family income, drug use frequency, drug dependance and HIV risk self-perceptions. In multivariate analysis independent predictors of always using condom at casual/paid sex during the last 12 months were place of residence (aOR = 6.4; 95% CI: 3.2-12.7), family income (aOR = 2.1; 95% CI:1.3-3.5) and drug use frequency (aOR = 0.6; 95% CI: 0.4-0.9). The study revealed low prevalence of consistent condom use with casual and/or paid sexual partners among PWID in Georgia. Integration of safe sex educational interventions in harm reduction services will improve the rates of condom use among PWID and should focus PWID with lower socio-economic status and residing outside capital city.