Influence of Profession as Risk of STIs in Intimate Partner Relationship in South Asian Countries

Mixing of sexual partners as part of the profession of female sex workers (FSWs) can be a risk in intimate partner relationship, which is primarily based on love and affection. Sexual relation with one partner provides emotional and psychological support. However, when it is a web of partners, it often results in unprotected sex, consequently creating a pathway for disease and increasing the vulnerability of FSWs to sexually transmitted infections (STIs). This paper analyses the subtleties of sexual behavior of FSWs and their vulnerability toward STIs in intimate partner relationship in South Asian countries. The basic data used in this paper have been taken from 3 countries, 1271 FSWs from Bangladesh, 1404 FSWs from Nepal, and 7399 FSWs from India. The data were collected through modified time location cluster sampling as a part of mapping and size estimation of most-at-risk populations (MARPs) in Nepal and key affected populations (KAPs) in Bangladesh during the period of 2010–2016. The data for India are taken from the integrated behavioral and biological assessment (IBBA), which assesses the prevalence of high risk population in India. The findings reveal that the majority of the FSWs were married, which reveals dynamics of sexual activity placing them at higher risk of STIs. About half of the FSWs had more than 15 coituses in the last 30 days in Nepal, which is a high risk factor. Unprotected sex is reported high across all three countries irrespective of all background characteristics. Condom use during intercourse in Bangladesh is less likely in older FSWs and more likely among educated FSWs who had coital frequency of 7 or more in the last 30 days. Interestingly, unmarried FSWs in Nepal are less likely to use condom in their last sex as against India where FSWs are more likely to use condom in their last sex. The prevalence of STI among uneducated FSWs is found higher in Bangladesh as compared to Nepal and India. The socio-demographic background characteristics showed a significant association with unprotected sex, coital frequency and prevalence of STI across all three countries.     

Minority Stress and the Risk of Unwanted Sexual Experiences in LGBQ Undergraduates

Sexual assault is prevalent among lesbian, gay, bisexual, and queer (LGBQ) college students, but its relationship to anti-LGBQ stigma has not been established. The goal of the present study was to determine whether minority stress, specifically internalized homophobia, predicted unwanted sexual experiences among LGBQ undergraduates (N = 763), whether routine behaviors (number of consensual sexual partners and alcohol use) mediated this relationship, and whether sense of LGBTQ community was a protective factor. Significant proportions of sexual minority men (10 %), women (18 %), and non-binary or transitioning students (19 %) reported an unwanted sexual experience since entering college. Internalized homophobia was associated with greater risk of unwanted sexual experiences. It also had a negative indirect effect on unwanted sexual experience risk through a negative association with number of sexual partners. Alcohol use did not mediate the relationship between internalized homophobia and unwanted sexual experiences. Sense of LGBTQ community was associated with lower risk, mediated by lower levels of internalized homophobia. The relationships between internalized homophobia and unwanted sexual experience risk were similar for women and men. These findings demonstrate that minority stress increases LGBQ students’ risk of sexual victimization and that in-group social relationships can mitigate this risk. We argue that minority stress is an important risk factor for sexual violence. Violence prevention interventions should attempt to reduce internalized homophobia, and colleges and high schools should establish LGBQ-affirming social climates and provide resources for LGBQ students, including targeted violence prevention efforts and programs that foster a sense of supportive community.     

Adolescent Sexting and Risky Sexual Behaviours in Zimbabwe: A Cross-Sectional Study

This study measured the relationship between sexting and risky sexual practices among school-going adolescents (N = 502, 53.8% female). Correlates of sexting to consistent condom use, age at sexual debut, transactional sex, intergenerational sex and multiple sexual partners were calculated. Prevalence of sexting was 13%, with boys twice more likely to have sent a sext compared to girls. Significant associations existed between sexting and sexual intercourse (95% CI 2.57–7.82), multiple lifetime sexual partners (95% CI 2.48–10.746) and intergenerational sex (95% CI 1.06–4.9). Condom use was significantly higher among girls (p < 0.001). Interventions targeting adolescents are likely to have higher impact if they address harmful effects of sexting.     

Patterns of Adolescent Aggression and Victimization: Sex Differences and Correlates

This study identified heterogeneous patterns of peer and dating aggression and victimization among boys and girls and examined their relation to risk and protective correlates. Girls (n = 1648) and boys (n = 1420) in grades 8–10 completed surveys assessing 14 indicators of violence involvement. Latent class analyses indicated a four-class solution, though a test of measurement invariance indicated the nature of the classes differed by sex. Among boys and girls, three classes emerged: Uninvolved (45% of girls, 61% of boys), Peer Aggressor-Victims (23% of girls, 21% of boys), and Cross-Context Aggressor-Victims (CCAV) (12% of girls, 5% of boys). Those in the Peer Aggressor-Victims class were likely to report involvement in peer aggression only; however, girls in this class were likely to be involved only in moderate violence, whereas boys were likely to be involved in moderate and severe violence. Those in the CCAV class were likely to report involvement in all forms of violence except sexual and controlling aggression, which was likely only among boys. Among girls, but not boys, a Verbal Dating Aggressor-Victims class (21% of girls) emerged that was characterized by involvement in occasional verbal dating aggression only. Among boys, but not girls, a Cross-Context Physical Victims class (13% of boys) emerged that was characterized by being only a victim of moderate physical peer and dating violence. Unique and shared risk and protective factors distinguished class membership for girls and boys. Findings suggest the pathways leading to violence may differ by sex and result in different patterns of violence involvement.     

Religiosity, Alcohol Use, and Sex Behaviors Among College Student-Athletes

College student-athletes tend to consume more alcohol, engage in sex, and report more sex partners than nonathlete students. The current study examined the relationship between religiosity (e.g., influence of religious beliefs and church attendance) and alcohol use and sex behavior among college student-athletes. Most of the student-athletes (n = 83) were religious. Influence of religious beliefs was a significant predictor of less alcohol use and less sexual activity (i.e., oral and vaginal sex, number of sex partners). However, increased church attendance was not found to be a protective factor. Findings suggest that religious beliefs may contribute to reduction of alcohol use and sexual risk among college student-athletes. Consideration should be given to incorporating religiosity aspects in sexual and alcohol risk-reduction interventions for student-athletes.     

A Qualitative Exploration of Rural African American Youth Perceptions about the Effect of Dating Violence on Sexual Health

Adolescent dating violence (ADV) remains a significant concern, particularly among rural African Americans. Few studies have explored adolescents’ perceptions about the link between ADV and sexual health and none have targeted this population. Employing qualitative methods based in Community-Based Participatory Research and theory, this study explored rural African American adolescents’ knowledge, perceptions and beliefs about the impact of ADV on sexual health. Secondary data analysis of 20 semi-structured individual interviews, conducted with older adolescents (aged 18–21), revealed participants understood the link between ADV and sexual health consequences, specifically as it related to STI and HIV prevention, condom use, and refusal of sex; and the negative impact refusing sex, communicating about HIV and other STI prevention, and negotiating condom use can have on ADV. This included: (a) negative relationship outcomes, including ADV and fear; and (b) factors that impact one’s ability to refuse sex, communicate about HIV and STI prevention, and negotiate condom use. Findings underscore the need for comprehensive ADV prevention programs for rural African Americans.     

How Gendered Attitudes Relate to Women’s and Men’s Sexual Behaviors and Beliefs

This study examines associations between endorsement of a sexual double standard, gender role attitudes, and sexual behaviors and beliefs. First year university students in the northeastern United States (N = 434; 52 % female; 33 % Black, 29 % Latino, 39 % White; ages 17–19) participated during their first year of college. Endorsement of a sexual double standard was associated with more conventionally gender-stereotyped sexual behaviors and beliefs, specifically, more sexual partners and fewer perceived barriers to condom use for young men, and more perceived barriers to condom use for young women. Women who were more conventional about men’s roles in society tended to use condoms less, whereas women who were more conventional about women’s roles tended to use condoms more. Men who were more conventional about men’s roles tended to have fewer sexual partners. Findings suggest the importance of examining gender’s role in sexual behaviors and beliefs by assessing multiple gendered attitudes, rather than simply considering biological sex.     

Sexual risk behaviour among HIV-infected women in the first twelve months after delivery in South Africa

This study aimed to assess sexual risk behaviour and its social correlates in HIV-infected women living in rural South Africa at six and twelve months post-partum. Participants were 699 HIV-positive women recruited prenatally by systematic sampling from twelve community health centres in Mpumalanga province, South Africa (mean age = 28.4 years, SD = 5.7; married =41.1%; serodiscordant or unknown partner status = 74.9%). They self-reported on their sexual activity six to twelve months after delivery; including use of condoms and partner involvement. Generalised linear mixed models were utilised to estimate unsafe sex outcomes from a prevention of mother to child transmission (PMTCT) intervention, socio-demographic factors, disclosure, and male involvement. About 20% of sexually active women in the past week had used condoms inconsistently at six and twelve months after delivery. Moreover, 16% and 18% of the women had not used a condom at last sex and 11% and 13% had unprotected sex with HIV-uninfected or unknown-status partners following delivery at six and twelve months, respectively. Higher inconsistent condom use was likely with lower male involvement. Promotion of condom use post-partum, as well as male involvement in sexual decisions, are important for safer sex post-partum by seropositive women.     

Dating Violence Victimization and Unprotected Sex Acts Among Adolescents in Mental Health Treatment

The objective of this study was to explore the relationship between dating violence victimization and unprotected sex acts among youth in mental health treatment. Sexually-active adolescents (n?=?261; ages 13–18) enrolled in mental health treatment completed an audio-assisted computerized self-interview (ACASI) to assess recent dating violence victimization, unprotected sex acts, depression symptoms, and recent alcohol use. Path analysis revealed that dating violence victimization was related to unprotected sex acts both directly and indirectly via its association with depression and condom use self-efficacy. These findings suggest that in order to reduce HIV-related risk behaviors among dating violence victims, treatment providers should consider depressive symptomatology and associated affect around sexual situations.     

Body Image Satisfaction and Involvement in Risky Sexual Behaviors Among University Students

This study examined the impact of body image satisfaction on university students’ (N = 465) involvement in risky sexual behaviors. A valid and reliable survey instrument was designed and administered to students in their classrooms at a Midwestern university. Of 465 participants, 53.8 % reported having low levels of body image satisfaction and 78.9 % indicated they had engaged in sexual intercourse during their lifetime. Of the sexually active students, 80 % have had sexual intercourse without the use of a condom, 76 % have had sexual intercourse while intoxicated, and 21 % have had sexual intercourse following illegal drug use. Students who had high body image satisfaction were significantly more likely to have ever engaged in sexual intercourse. These results should be considered when developing and implementing sexual education efforts for university students. Future studies should seek to identify specific strategies to increase body image satisfaction and decrease risky sexual behaviors among this high-risk population.     

The Use of Protection for Sexually Transmitted Infections (STIs) and Unwanted Pregnancy among Norwegian Heterosexual Young Adults 2009

This paper explores the use and none-use of condoms among young heterosexual adults in Norway. To what extent do young heterosexuals use condoms and other types of contraception, and in which context does the use take place? What are the motives underlying both use and non use of condoms? The results are based on a 2009 national web panel survey among 16–24 year-olds in Norway (n = 871). Most respondents reported having met their most recent sex partner via friends or family, and 62% referred to the sex partner as a sweetheart. One out of two claimed they had not used condoms during the first sexual intercourse with this partner. A factor analysis revealed 2-D of motivation for not using condoms, referred to here as ‘Fear of Suspicion’ and ‘Mutual Trust’. Multiple linear regression analysis revealed that, when controlled for gender, age, and number of sex partners in one’s life, ‘Mutual Trust’ had a statistically significant relationship to coital frequency and the number of years coitally active. None of the predictor variables had a statistically significant relationship with “Fear of Suspicion”. The most commonly reported motives for the most recent sexual intercourse were having been ‘sexually aroused’ and ‘in love’. A total of 56% reported using hormonal contraception, while 20% used condoms. The most important reasons for not using condoms were: ‘used other contraception’, ‘did not worry about STIs’, ‘more pleasurable without’, ‘had none available’, and ‘unprepared for intercourse’. The most important reasons for condom use were to ‘avoid pregnancy’, ‘avoid STIs’, and ‘avoid HIV’.     

Condom Use Among South African University Students in the Province of KwaZulu-Natal

South Africa has one of the highest HIV infection rates in the world, with young people particularly affected. Condoms are an effective preventative method against HIV among sexually active adults. This study assessed the level of condom usage among university students in South Africa and their attitudes towards condom usage, negotiation efficacy and confidence in condom usage. It was a cross-sectional study conducted amongst South African university students living at the university residences. Students were randomly selected and required to complete a self-administered questionnaire. The mean age of participants (n?=?441) was 22.7?±?4.3 years. The mean age of sexual debut was 17.7?±?3.0 years with 1.4?±?1.47 (range 0–13) current partners. Less than half of the students used a condom at sexual debut and only 28.5% used condoms during recent sexual activity. Those students who used a condom at first sexual intercourse had marginally more positive attitudes about condom usage than those who did not do so (p?=?0.056). Students with a single current partner had more positive attitudes about condom usage than those with multiple current partners (p?=?0.021). Only 32.5% (n?=?127) of the students were very confident in using condoms. Similarly, only 33.0% (n?=?130) of the participants felt that they could definitely negotiate condom use with their partners. We conclude that condom use among South African students is low and that they lack the confidence to use condoms. We recommend that programmes to step up condom use must also incorporate educational interventions on usage.     

Using Sex-Related Alcohol Expectancies to Predict Condom Use Among a General Sample of Men and Women in the United States

Sex-related alcohol expectancies (SRAE) are known to moderate the relationship between alcohol use and risky sexual behavior in high risk populations; however, SRAEs have not been thoroughly explored in populations traditionally viewed at lower risk for HIV and/or STI. Participants (n = 649) were recruited through internet-based direct marketing in the United States. Predictors of SRAE vary by gender. Controlling for alcohol use and other predictors, age predicted condom use among women, and SRAE was correlated with condom use for men. Sexual health programming geared towards non-traditionally identified high-risk populations is necessary and provides unique opportunities to increase condom usage.     

Condoms,Sex, and Sexually Transmitted Diseases: Exploring Sexual Health Issues Among Asian-Indian College Students

Sexually transmitted infections (STIs) continue to pose a serious risk to college students in the US. According to the Centers for Disease Control, the highest rates of STIs are among college students and adolescents. Specifically regarding Asian-Indian students, more research is needed to thoroughly understand the knowledge, attitudes and sexual behaviors of this population. A comprehensive review of the literature found a paucity of studies involving Asian-Indian involvement in sexual activity. Therefore, the present study was undertaken to fill gaps in the research. The present study examined Asian-Indian college students’ involvement in sexual behaviors, overall STI knowledge, condom use rate, perceived benefits and barriers to condom use, and history of STIs and STI testing. A five page survey was completed by 122 Asian-Indian college students. Results indicated that overall STI knowledge was low. Females, students who perceived fewer barriers to condom use and students who had lived in the US for at least 3 years held significantly higher STI knowledge levels than their counterparts. Such findings could be used by community and university-based health educators to more effectively serve the needs of Asian-Indian students.     

Condom Influence Strategies in a Community Sample of Ethnically Diverse Men and Women1

Few studies have examined comprehensively the ways in which men and women at risk for HIV infection influence their partners to use condoms. This study examines the condom influence strategies (CISs) of an ethnically diverse community sample of 113 (55% male) heterosexually active men and women. Results indicate that individuals at risk for HIV endorse a variety of CISs (withholding sex, direct request, seduction, relationship conceptualizing, risk information, deception, and pregnancy prevention) when attempting to procure condom use with a sexual partner. These CISs were related significantly and meaningfully to a set of safer sexual variables including 3 measures of condom use. Significant gender differences in CISs were not found. Results suggest that safer sexual behavior theories should continue to focus on interpersonal aspects of condom use and underscore the importance of an interpersonal approach to safer sexual intervention.     

Relationship Factors’ Impact on Condom Use Among College Students

Research indicates that a number of college students are at risk for HIV, sexually transmitted diseases, and unplanned pregnancy as a result of their sexual behaviors. Specific behaviors placing college students at risk include having sex with multiple partners, poor communication about safer sex practices with their sexual partners and not using condoms consistently and correctly when engaging in sexual activity. The purpose of this paper is to identify potential differences in safer sex practices and factors that influence condom use among college students. A four-page, 18-item survey was developed to determine participants’ condom use and the impact of relationship status and other demographic factors on condom use. Analyses revealed that the number of lifetime vaginal sexual partners and participants’ sex influenced condom use. There were no significant differences in relationship status, duration, trust, honesty and condom use. These findings should be considered with designing interventions to increase condom use among college students.     

AIDS Knowledge,Self-Esteem,Perceived AIDS Risk,and Condom Use Among Female Commercial Sex Workers1

This paper explores the effects of type of sexual partner (customer vs. primary partner) and several social psychological enabling resources (self-esteem, perceived personal risk of HIV infection, and knowledge about AIDS/HIV) on condom use among 141 female commercial sex workers. The data examine condom use during the respondents' most recent sexual activity with a male partner. Logistic regression analysis supports earlier findings that commercial sex workers are significantly more likely to use condom during commercial sex with a customer, rather than relational sex with a spouse or significant other. Subsequent multiple logistic regression analysis indicates that, controlling for type of sexual partner (client vs. primary partner), the odds of condom use are significantly increased by the respondents' knowledge about AIDS, level of self-esteem, and personal sense of risk of AIDS infection.     

Low Prospects and High Risk: Structural Determinants of Health Associated with Sexual Risk Among Young African American Women Residing in Resource-Poor Communities in the South

African American women at increased risk of HIV/sexually transmitted infection (STI) may engage in risky sex as a coping mechanism for depressed economic conditions. This study examines the association between high-risk sexual behavior and structural determinants of sexual health among a sample of young African American women. 237 young African American women (16–19 years old) from economically disadvantaged neighborhoods in North Carolina were enrolled into a randomized trial testing the efficacy of an adapted HIV/STI prevention intervention. Logistic regression analyses predicted the likelihood that young women reporting lack of food at home, homelessness and low future prospects would also report sexual risk behaviors. Young women reporting a lack of food at home (22 %), homelessness (27 %), and low perceived education/employment prospects (19 %) had between 2.2 and 4.7 times the odds as those not reporting these risk factors of reporting multiple sex partners, risky sex partners including older men and partners involved in gangs, substance use prior to sex, and exchange sex. Self-reported structural determinants of sexual health were associated with myriad sexual risk behaviors. Diminished economic conditions among these young women may lead to sexual risk due to hopelessness, the need for survival or other factors.     

Association of intimate partner violence with sociodemographic factors in married women: a population-based study in Iran

Intimate partner violence (IPV) is a neglected public health issue in Iran. This study was conducted among married women residing in urban Rasht (northern Iran), to estimate the prevalence and frequency of different forms of IPV from husband and their associations with socio-demographic factors. We carried out a population-based cross-sectional survey with cluster sampling design from February to October 2015. The samples consisted of married women aged ≥ 18 years with total household in Rasht city (north Iran) as the sample frame. We administered the Revised Conflict Tactics Scale (CTS-2) to estimate prevalence of past-year IPV. Of 2091 women, 57.1% had suffered psychological aggression, 27.6% physical abuse, 26.6% sexual abuse, and 6.9% injury. A significant association with IPV was found for women with, age ≤ 40 years, unemployed, low education, husband’s addiction and rented-householders. Women who experienced physical abuse, had less age at marriage than women without violence. Also women with sexual coercion had less length of marriage than other non-abused women. On logistic regression, the strongest predictor of psychological, physical and sexual abuse was unemployment of spouse, whereas for injury it was low educational level (<12 years) of women. Our findings suggest that risk of IPV is high in our population. There is an obvious need of preventive and treatment activities. Our findings point at that various forms of abuse are different from each other in terms of differing characteristics of the perpetrators and it might be that also different strategies are needed to reduce and prevent these violence. Confirmation by further research is needed.