Changes in the sexual behaviour of young people: introduction

Spatial analysis of HPV infection and contextual factors associated with higher HPV prevalence

OBJECTIVES

To identify areas with high rates of high-risk Papillomavirus (hrHPV) infection and associated contextual factors in the Centre Region of Portugal at the municipality level.

STUDY DESIGN

We conducted an ecological study in 78 municipalities located in the Central Region of Portugal from March 2019 to December 2022.

METHODS

We used data from the cervical cancer screening (CCS) program database after switching to primary HPV testing. Demographic, socio-economic, and healthcare availability variables were extracted from official sources (Statistics Portugal and Central Region Health Administration Information Systems). Spatial analysis and logistic generalised linear models were used to identify areas of high hrHPV infection and associated contextual factors.

RESULTS

The overall hrHPV infection prevalence was 9.9 %. We found three significant clusters, predominantly in municipalities near major urban centres. These clusters were characterised by higher population density, a greater proportion of younger women, higher median income per inhabitant, a larger proportion of residents with graduate degrees, and increased availability of healthcare units.

CONCLUSIONS

This study has uncovered the geographical distribution of hrHPV infection at the municipal level and highlights the contextual factors associated with higher prevalence. Identifying demographics and socio-economic predictors of high hrHPV infection could support public health programs by targeting interventions to specific populations and contexts. This might open up new scenarios for improving prevention and control strategies, offering more intensive screening in areas with the most urgent needs.

Human Papillomavirus Infection in Partners of Women Attending Cervical Cancer Screening: A Pilot Study on Prevalence, Distribution, and Potential Use of Vaccines

Background/Objectives: Human Papillomavirus (HPV) cross-infection among couple's partners is a widespread event and could lead to persistent infections. Unfortunately, the influence of male sexual partners of HPV-positive women on their cervical lesions and the potential role of HPV vaccines have been under-investigated. We evaluated the HPV prevalence in male partners of HPV-infected women, focusing on the possible correlation between partners' cervical lesions and the role of HPV vaccination. Methods: Two samples, genital and urethral swabs, were collected for each of the 90 patients recruited. HPV-DNA detection was carried out by the Allplex HPV28 detection assay. Results: HPV prevalence was 66.7% (60/90); high-risk HPV (hrHPV) genotypes were detected in 90% (54/60) cases and multiple infections in 55% (33/60). The most frequent hrHPVs were HPV31 (p = 0.0265) and HPV52 (p = 0.002), found in 18.3% (11/60) of cases, and HPV53 (p = 0.0116) in 16.7% (10/60). Statistical analysis showed a higher probability of a less severe cytological diagnosis with the increase in the number of genotypes detected (p = 0.0146). Among the HPV-positive partners of females with cervical lesions, 18.7% (6/32) and 62.5% (20/32) had vaccine genotypes of the quadrivalent and nonavalent vaccines, respectively. The nonavalent vaccine showed a significantly higher potential to prevent lesions (62.5% vs. 18.7%, p = 0.0001), with an absolute additional potential impact (AAI) of 31.1% in histological and 32.4% in cytological diagnoses. Conclusions: These preliminary results provide new insight into the correlation between the number of partner genotypes and the severity of cervical lesions and show promising results for the preventive potential of vaccinating male partners.

Sexual desire for non-normative sexual behaviors: differences between centennials and millennials considering sexual orientation

Introduction

Non-normative sexual behaviors were traditionally studied from a psychopathological perspective, although nowadays a distinction is made between paraphilia (nonpathological) and paraphilic disorder (mental disorder).

Methods

The present study aims to examine the differences between a group of millennials (n = 173) and centennials (n = 159) in their appetite for these sexual behaviors without the preconception of these behaviors as harmful or pathological.

Results

Differences in appetite related to exhibitionism and foot fetishism were found in the first instance, with millennials showing a greater appetite for these. When including sexual orientation in the analysis, in addition to exhibitionism and foot fetishism, differences were found in behaviors related to asphyxiation, bestiality and urophilia. Millennials and homobisexual centennials showed the highest appetite for exhibitionism behaviors, homo-bisexual centennials for choking behaviors and bestiality and homo-bisexual millennials for foot fetishism and urophilia-related behaviors.

Discussion

Exploring nonnormative behaviors from a non-psychopathological perspective will help us to understand the evolution of sexual appetite as part of human sexual diversity and to prevent risky behaviors.

Human Papilloma Virus (HPV) Detection in Oral Rinse vs. Oral Sponge: A Preliminary Accuracy Report in Oral Cancer Patients

BACKGROUND/OBJECTIVES

Human Papillomavirus (HPV) is a significant etiological factor in the development of oropharyngeal carcinogenesis. The detection of HPV in oral squamous cell carcinoma (OSCC) could be also crucial for diagnosis, prognosis, and treatment planning. This study compares the efficacy and accuracy of two non-invasive sampling methods, oral rinse, and oral sponge, in detecting HPV DNA in patients with OSCC.

METHODS

Twenty-six patients with histologically confirmed OSCCs were recruited (M/F = 15/11; mean age 68.6). From each patient, two self-collected oral specimens, in the form of an oral rinse and a salivary sponge (i.e., LolliSponge), were collected, and subsequently processed, utilizing INNO-LiPA HPV Genotyping Extra II for HPV DNA detection; Results: Oral sponge detection showed high specificity (100%), sensitivity (85.7%), and accuracy (96.2%) compared to the oral rinse sampling, also demonstrating an area AUC for its diagnostic performance significantly greater than 0.5 (0.93 vs. 0.5, p < 0.0001).

CONCLUSIONS

This study supports that oral sponge sampling offers valuable non-invasive alternatives for HPV detection in patients with OSCC, with the potentiality to facilitate saliva sampling in patients that may exhibit functional deficit due to OSCC. Further research is recommended to validate these findings in larger cohorts and to explore the integration of these methods into routine clinical practice for the management of HPV-related OSCC.

Prevalence and predictors of HIV testing among young men in Papua New Guinea: A cross-sectional analysis of a nationally representative sample

BACKGROUND

HIV testing is an important component of HIV prevention and serves as a gateway to other HIV-related services. However, the uptake remains suboptimal among young people, particularly in highly prevalent settings such as Papua New Guinea (PNG). This study aimed to assess the prevalence and determine the predictors of HIV testing uptake among young men aged 15-24 years in PNG.

METHODS

The 2016-2018 PNG Demographic and Health Survey (DHS) data was used. A total of 1,275 young men aged 15-24 years were included in the final analysis. Descriptive, bivariate, and multivariable logistic regression analyses were performed to determine independent predictors of HIV testing. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. All analyses were adjusted using survey weights to account for unequal sampling probabilities.

RESULTS

The overall prevalence of HIV testing among young men was 17.1% (95% CI: 15-19). Of those who were tested for HIV, about one-third (32.9%) had experienced a sexual debut at age <15 years, and 33.9% inconsistently used condoms during sex. In multivariable analysis, men aged 20-24 years (AOR 1.18, 95% CI: 1.00-2.31), who owned mobile phones (AOR 1.43, 95% CI: 1.00-2.55), who were aware that consistent condom use during sex can reduce HIV risk (AOR 2.18, 95% CI: 1.18-4.04), who had paid for sex (AOR 1.75, 95% CI: 1.01-5.83), and who had two or more sexual partners (AOR 1.37, 95% CI: 1.01-3.14) had increased odds of HIV testing. However, decreased odds of HIV testing were found among men who were never married (AOR 0.51, 95% CI: 0.29-0.88), lived in rural areas (AOR 0.54, 95% CI: 0.32-0.92), and consistently used condoms during sex (AOR 0.59, 95% CI: 0.34-1.01).

CONCLUSION

The findings show that HIV testing is low among young men in PNG. To increase HIV testing uptake among young men, it is crucial to implement comprehensive youth-friendly HIV/STI education and tailored sensitization programs and enable more accessible and affordable HIV testing services. Also, outreach and community-based testing programs for young men in rural and prioritized areas requiring urgent prevention interventions are feasible options in PNG.

Reproductive and sexual health literacy and associated factors among late-adolescent high school students in Arba Minch and Sawla towns, Southern Ethiopia, 2023: a cross-sectional study

BACKGROUND

Adequate literacy in reproductive and sexual health is essential for adolescents to obtain, comprehend, evaluate and apply information necessary for making well-informed decisions, as low literacy leads to harmful decision-making, risk-taking and poorer health and self-management. These factors increase the magnitude and severity of problems related to sexuality and reproduction, including unintended pregnancy, HIV/sexually transmitted infections, unsafe abortion and death. However, information regarding the status and affecting factors of literacy in the reproductive and sexual health of adolescents is scarce.

OBJECTIVE

To assess reproductive and sexual health literacy status and associated factors among late-adolescent high school students.

DESIGN

A cross-sectional, institution-based study.

SETTING

The study included eight secondary schools in Arba Minch town (Gamo Zone) and three in Sawla town (Gofa Zone) in the South Ethiopia Region.

METHODS

The study was done between 20 May and 20 June 2023, among late adolescent high school students. Using multistage sampling, 577 students were recruited. Reproductive health literacy was assessed using the Health Literacy Measure for Adolescents tool. Data were loaded into EpiData-V.3.1 and analysed using SPSS-V.25. Binary logistic regression analyses were used to identify associated factors. Variables with a p value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. A Hosmer-Lemeshow goodness-of-fit statistic was checked and satisfied. Statistical significance was indicated at a p value<0.05.

RESULT

The proportion of students with limited reproductive and sexual health literacy was 69.6% (CI 65.3% to 72.8%). The limited literacy status was significantly associated with school type (public school AOR 0.28 (0.17 to 0.46)), mother's occupation (merchant AOR 0.42 (0.23 to 0.76)), family monthly income (income 10 000-20 000 birr AOR 0.45 (0.22 to 0.95)), having regular physical exercise >30 min (more than once per week, AOR 0.44 (0.23 to 0.84)), and knowledge about condoms (poor AOR 2.23 (1.38 to 3.64)).

CONCLUSION

A notable segment of adolescents exhibited limited reproductive and sexual health literacy. The result emphasises the necessity of all relevant parties to work diligently to guarantee that school adolescents can easily obtain, comprehend, evaluate and use reproductive and sexuality-related information.

Orogenital Human Papillomavirus Infection and Vaccines: A Survey of High- and Low-Risk Genotypes Not Included in Vaccines

Knowledge of human papillomavirus transmission from the genital tract to the oral mucosa remains unsatisfactory, with poor and often inconsistent literature results. The increase in HPV-associated oral malignancies prompts further analysis of the simultaneous detection of the virus in the two anatomical areas and on the identification of genotypes to be included in future vaccines. Therefore, in this retrospective study, we evaluated orogenital HPV concurrence, hrHPV, lrHPV and type-concordance in 337 samples, as well as the prevalence of the most common genotypes not included in HPV vaccines. Concurrence was found in 12.5% (31/248) of cases, hr-concordance in 61.3% (19/31) and lr-concordance in 12.9% (4/31). Finally, type-concordance was found in 32.3% (10/31) of concurrent infections. Regarding the identification of non-vaccine genotypes, the significantly prevalent genotypes in the anogenital area were HPV66 (12.6%, p < 0.0001), HPV53 (11.1%, p < 0.0001), HPV51 (8.7%, p < 0.0001), HPV42 (8.2%, p < 0.0001) and HPV68 (5.6%, p = 0.0034) in women and HPV66 (14.6%, p = 0.0058), HPV42 (12.2%, p = 0.0428), HPV51 (12.2%, p = 0.0428), HPV53 (12.2%, p = 0.0428), HPV70 (12.2%, p = 0.0428) and HPV73 (12.2%, p = 0.0428) in men. Considering the results of our study, we recommend including the high-risk genotypes HPV51, HPV68, HPV53 and HPV66 in future HPV vaccine formulations.

Infidelity in the Adolescence Stage: The Roles of Negative Affect, Hostility, and Psychological Well-Being

BACKGROUND

Infidelity is a relational process common in all types of romantic relationships and has been established as one of the main causes of relationship breakdown. However, little is known about this type of transgression in adolescent romantic relationships, although it manifests as a fairly frequent behavior involving different motivations. Even less is known about the emotional impact of infidelity on the offending person and its association with hostile behavior and psychological well-being.

METHODS

Through an experimental study (N = 301 Spanish adolescents (190 female and 111 male; M_age = 15.59, SD = 0.69; range from 15 to 17), we sought to analyze the effect of manipulating two types of motivations for infidelity (sexual vs. emotional dissatisfaction) on negative affect, hostility, and psychological well-being.

RESULTS

The main results revealed that committing infidelity motivated by hypothetical sexual (vs. emotional) dissatisfaction was indirectly related to lower psychological well-being through its effects on increased negative affect and hostility.

CONCLUSIONS

Last but not least, we discuss these findings, highlighting the possible implications of infidelity for the psychosocial and psychosexual development of adolescents.

Structural Equation Model Analysis of HIV/AIDS Knowledge, Attitude, and Sex Education Among Freshmen in Jiangsu, China

Background

The study of acquired immunodeficiency syndrome (AIDS) related knowledge, attitude, and sex education status of Jiangsu freshmen was conducted, which can provide data support directionally for the prevention work of HIV/AIDS among this population.

Methods

Male students (4,006) and female students (4,279) were selected from 20 universities or colleges in the Jiangsu province. The knowledge, attitudes, and sex education of freshmen were conducted with an online questionnaire. The log-binomial regression model was used to analyze the influencing factors of HIV/AIDS knowledge. In addition, a structural equation model was used to analyze students' health needs that affect knowledge awareness and knowledge mastery.

Results

The overall awareness rate of AIDS knowledge was 87.4%. The students in undergraduate colleges (OR = 2.523, 95% CI=2.223~2.864) and independent colleges (OR = 1.389, 95%CI = 1.172~1.646) were more likely to have a higher awareness compared with the students in junior colleges. In this study, 2,011 freshmen approved of premarital behavior, 4,921 freshmen insisted on using condoms when having sex, and 8,138 freshmen were willing to take HIV antibody test when they suspected they were infected. In total, 4,703 freshmen believed that sexual health education was necessary for colleges and universities, and most of them (57.2%) hoped that sex education in schools should be improved. The direct effect of sex education on knowledge awareness and attitude is 0.15 and 0.58. The mediation effect test found that the pass ability knowledge path of sex education indirectly affected sexual attitudes (0.05).

Conclusion

The awareness rate of HIV/AIDS among Jiangsu freshmen has not reached the national standard. Health education has a significant positive effect on knowledge awareness and attitude; however, students' needs in terms of time, place, and degree of sex education have not been met in time. It is necessary to strengthen the HIV/AIDS health education of college students in multiple ways.

Sexual orientation and health behaviors among college students in Italy

Studies regarding sexual orientation and health behaviors have largely neglected the Italian context. This research utilizes the second wave of the ‘Sexual and Emotional Life of Youths’ (SELFY) data set to compare the health behaviors of sexual minority (SM) and heterosexual college students in Italy. Results showed that bisexual women were more likely than heterosexual women to smoke both 1–7 and 8+ cigarettes per day, get drunk sometimes and often/very often, and use marijuana and/or ecstasy sometimes and often/very often. Homosexual women were more likely than heterosexual women to smoke 1–7 cigarettes per day, get drunk often/very often, and use marijuana and/or ecstasy often/very often. Homosexual men were more likely than heterosexual men to smoke 8+ cigarettes per day, but less likely to get drunk often/very often. Bisexual men were less likely than heterosexual men to participate in physical activity sometimes, often, and very often. Finally, bisexual men were less likely to exercise often than homosexual men. This work highlights that SM college students in Italy, particularly women, are more likely to engage in specific risky health behaviors compared to their heterosexual counterparts. More attention needs to be given to SMs in Italy to inform the Italian national health care system and to ensure that the appropriate care can be provided when required.

Limited detraditionalization of intimacy: Growing socioeconomic differences in contraceptive use at first intercourse in Italy

This paper investigates links between social inequality and reproductive behavior. It complements the extensive research on the stratification of young adults' life chances in education and the labor market by considering changes over time in the stratification of contraceptive use at first intercourse by parental background. We seek to understand detraditionalization trends in young people's sexually intimate behavior by investigating whether these trends were driven by particular social groups and how they were supported by policy initiatives. We study Italy from 1950 to 2006, which shows strong regional and socioeconomic disparities, and comparatively slow changes in religiosity and gender norms. Data from the "Survey on Italians' Sexual Behavior" (2006) and macro indicators on family planning centers are used. The findings show a steep increase in contraceptive use at first sexual intercourse over time, stratified by parental background, but only for condom use. We did not find that family planning centers intervened in these relationships.