Study in sexuality of medical college students in India

Development of a Measure to Assess What Young Heterosexual Adults Say They Learn About Sex from Pornography

This study involved the development of two new measures to assess what some young heterosexual-identifying adults report learning about sex from pornography. Inventory items were generated from an extensive literature review and six qualitative focus group sessions with young adults (N = 54) aged 18-29 which explored how pornography could be used as a source of sexual information. A total of 135 items pertaining to sexual learning from pornography were produced, reviewed and categorized by a sample of young adults (n = 9), and finally reviewed for item and construct relevance by a panel of pornography, sex education and scale development experts (n = 6). Inventory items were administered to a sample of young adult university students (n = 1306). Two separate exploratory factor analyses were conducted for the female and male datasets. The final factors were reviewed by a panel of young adults  = 8) to identify the theme of each factor. Both the SIPI-F and SIPI-M yielded three factors: (1) How to be a good sexual partner, (2) Body aesthetic, and (3) Sexual exploration. Results show that pornography provides information about a range of sex-related topics. Findings also show that more frequent female pornography users reported learning more about how to be a good sexual partner and body aesthetic than less frequent pornography users. The SIPI-F and SIPI-M can be useful for examining a variety of questions regarding the use of pornography as an informal source of sexual information and its correlates.

Connaissances, attitudes et pratiques des étudiants en médecine en matière de sexualité

La sexualité est un aspect central de la personne humaine qui, devant des problèmes sexuels, va fréquemment se tourner vers une source qu'elle considère compétente et bien informée, son médecin. Les objectifs de notre étude étaient d’évaluer les connaissances, les attitudes et les pratiques des étudiants en médecine en termes de sexualité et d’identifier les principaux déterminants du manque de connaissances basiques à ce sujet. Notre étude était descriptive et analytique, menée auprès des étudiants à la faculté de médecine de Sfax (Tunisie). Le questionnaire, rempli individuellement et de manière anonyme par chaque étudiant, recueillait les données sociodémographiques, les connaissances en matière de sexualité ainsi que leurs sources, les attitudes adoptées par les étudiants vis-à-vis de la sexualité et les pratiques sexuelles. La note totale moyenne relative aux questions de sexologie était de 11,05/20. Les facteurs corrélés à un score moyen élevé aux questions de sexologie étaient le sexe masculin (p=0,003), le statut de marié (p=0,012), le niveau socio-économique élevé (p=0,02), les livres comme source d’informations (p=0,041) et la présence de pratiques sexuelles (p<0,001). Ces pratiques étaient toutes significativement plus fréquentes chez les étudiants de sexe masculin (p<0,001). Des lacunes dans les connaissances en matière de sexualité existent chez les étudiants en médecine, du moins dans certains de ses aspects. Un programme d'enseignement complet et uniforme sur la sexualité humaine, surtout dans ses aspects physiologiques, peut sensiblement améliorer la capacité des futurs médecins à fournir des soins optimaux à leurs patients.

Homophobia in Health Professionals in Ankara, Turkey: Developing a Scale

The aims of this study were to develop a sexual orientation attitude scale and use it to investigate the attitudes of psychiatrists, other physicians and first year medical students toward homosexuals and homosexuality in Ankara, Turkey. A cross-sectional study was performed with three groups including psychiatrists (n = 147), non-psychiatric physicians (n = 224) and first year medical students (n  =  280). A scale with 43 items consisting of four subscales (heterosexism, homophobia, homonegativity, neutrality) was developed which showed high internal consistency, validity and reliability in this sample of Turkish individuals. The internal consistency coefficients (Cronbach's alpha) for the subscales were 0.85-0.86, 0.95-0.95, 0.95-0.95, and 0.85-0.86, respectively. Being male, single, a graduate of a religious (Imam Hatip) or vocational high school, of rural origin, a student, more religious, heterosexual and studying at university hospitals were found to be related to higher scores (indicating more negative attitudes) on all subscales and the total scale and these differences were significant. Students had the highest scores and psychiatrists had the lowest scores in all subscales and the total scale. The results of this study indicate that physicians and medical students have negative attitudes toward homosexuals and that medical training on sexual health issues should be improved in Turkey.

Sexual Violence Against Women in India: Daily Life and Coping Strategies of Young Women in Delhi

This study assesses the current situation concerning sexual violence against women in India and women's individual coping strategies. We conducted 15 semistructured interviews with 17- to 22-year-old Indian college students. First, results about the current situation showed threatening circumstances for women and revealed how deeply sexual violence affects women's lives. Second, to cope with sexual violence women mentioned three types of strategies, namely (a) safety, (b) avoidance, and (c) empowerment strategies. In the discussion, we suggest that women's use of safety and avoidance strategies are safety behaviors that play a key role in maintaining women's fear and societal dynamics.

Sex Knowledge and Attitude Among Medical Interns in a Tertiary Care Hospital Attached to Medical College in Ahmedabad, Gujarat

Introduction: Sexuality is one of the most basic human experiences. But in India, there are many myths and misconceptions about sexuality. Poor sex knowledge causes many of these problems. Liberal attitude without adequate knowledge is harmful. As a future frontier of health care, medical interns play an important role to improve knowledge and attitude. But, in India, very few students can communicate about sexuality, and friends and pornographic materials remain as common sources of sex knowledge, which are unreliable.

Aims: To asses sex knowledge and attitude among medical interns and find its correlation with sociodemographic details.

Materials and Methodology: A cross-sectional study was conducted among 60 interns using a Sex Knowledge and Attitude Questionnaire II (SKAQ II). Data was analyzed by MS Excel for Windows. P < .05 was considered statistically significant.

Results: Mean age of interns was 22 ± 0.89 yrs. Mean score of sex knowledge of males was 25.47 ± 4.44, whereas that of females was 24.88 ± 4.77. Females had more knowledge of menstrual cycle and conception. Males had better knowledge regarding sexual acts in adolescence and its effects on marriage life. Sex knowledge and attitude were moderately correlated. Males had a liberal attitude, especially about abortion and masturbation.

Conclusion: The result revealed a need to improve sex knowledge and attitude among medical interns through sex education and adding sex education sessions in the teaching curriculum. Better knowledge and positive attitudes toward sex will be beneficial to the interns and the whole society.

The knowledge and perceptions of the first year medical students of an International University on family planning and emergency contraception in Nicosia (TRNC)

BACKGROUND

Informing the individuals on family planning including emergency contraception is a significant step for preventing unintended pregnancies. Although there is a number of studies on family planning and emergency contraception globally and in Turkey, no such data are available in the Turkish Republic of Northern Cyprus. The objective of this study was to evaluate the knowledge and perceptions on family planning and emergency contraception of the first year students of an international medical school in Nicosia, Northern Cyprus and to increase awareness for developing new policies on the issue.

METHODS

The data of this cross-sectional study were collected in February 2016 by a questionnaire of 36 questions. Of the 229 students, 189 (82.5%) completed the questionnaire. The data were evaluated by SPSS 18.0 statistical program. The differences of variables were evaluated by Chi square test, p < 0.05 being accepted as significant.

RESULTS

The distribution of participants from 23 countries according to nationality revealed three leading countries: Nigeria, Turkey and Syria. Of the students, 53.6% knew the definition of family planning. The sources of information were mainly school, the internet and media, with a total of 60.9% of the participants who stated having prior information on the subject. Awareness of contraceptive methods was indicated by more than 90% and emergency contraception by 66.1% of the participants. However, the students were unable to differentiate between modern and traditional family planning methods; 85.6% did not have knowledge of the most effective period for emergency contraception and 63.1%, of the definition of emergency contraceptive pills.

CONCLUSIONS

In conclusion, the knowledge and awareness level of the first year medical students on family planning and emergency contraception was insufficient. Family planning and emergency contraception education should be provided for the students at the first year of all faculties as well as medical schools and relevant programs should be included in the curricula of medical education.

Prevalence of Anal HPV Infection Among HIV-Positive Men Who Have Sex With Men in India

BACKGROUND

India has a large population of HIV-positive individuals, including men who have sex with men (MSM), and the incidence of human papillomavirus (HPV)-related cancers is high. In developed countries, HIV-positive MSM exhibit the highest prevalence of anal HPV infection and incidence of anal cancer. Little is known about anal HPV infection in HIV-positive Indian MSM.

METHODS

We evaluated 300 HIV-positive MSM from 2 cities in India. Men were tested for anal HPV infection using L1-HPV DNA polymerase chain reaction with probes specific for 29 types and a mixture of 10 additional types. CD4 level and plasma HIV viral load were measured. Participants completed an interviewer-administered questionnaire including a sexual history.

RESULTS

The prevalence of anal HPV was 95% (95% confidence interval: 91% to 97%). The 3 most common types were HPV 35 (20%), HPV 16 (13%), and HPV 6/11 (13%). History of taking antiretroviral medications decreased risk of anal HPV 16 infection [relative risk (RR): 0.6 (0.4-1.0)]. Having an increased number of vaginal sex partners lowered risk of any anal HPV infection. Ever having receptive sex increased risk of any anal HPV [RR: 1.2 (1.1-1.4)] and anal HPV 16 [RR: 6.5 (1.8-107)].

CONCLUSIONS

Almost all Indian HIV-positive MSM had anal HPV infection. The prevalence of HPV 16 was lower and the prevalence of other oncogenic HPV types was higher than in similar populations in North America and Europe. Vaccine-based prevention strategies for HPV infection in India should consider potential differences in HPV type distribution among HIV-infected MSM when designing interventions.

Assessing the knowledge, attitude and practice of family planning among women living in the Mbouda health district, Cameroon

BACKGROUND AND OBJECTIVE

Promotion of family planning has been shown to reduce poverty, hunger, maternal and infant mortality, and contribute to women's empowerment. But many resource-limited countries still have very low rates of contraceptive use. The present study aimed to assess the knowledge, attitude and practice of family planning among women living in a resource-poor rural setting.

METHODS

We conducted a cross-sectional study in January 2010 in the Mbouda Health District, Cameroon. After a multistage random selection, 120 households were selected. Participants were women aged at least 15 years old, sexually active, and who volunteered to participate in the study. Data were collected during an anonymous interview using a structured pre-tested questionnaire.

RESULTS

A total of 101 women were enrolled, their ages ranging from 18-58 years with a mean of 31.7 ± 8.8 years. Ninety-six percent of these women had already heard about family planning. Almost all respondents (98 %) were aware of at least one contraceptive method, the most cited being the male condom (96 %), the safe period (86.1 %), injectables (76.2 %) and oral pills (75.2 %), Sixty-six women (65.3 %) were currently practicing at least one contraceptive method, and the three prevailing methods used were: the safe period (50 %), the male condom (34.8 %), and injectables (12.1 %). The main reasons precluding women from practicing contraception were lack of knowledge (31.4 %), uselessness (31.4 %) and unbearable side effects (8.6 %). Fourteen of these women (42.4 %) expressed the willingness to start practicing contraception if they received more information about the subject. Decision on the number of children to have was made by both the man and the woman in 59.5 % of cases. The practice of contraception had been decided by the couple in 39.6 % of cases, and 9.4 % of men were not aware that their wives were currently practicing contraception.

CONCLUSION

Although the level of awareness about family planning and contraceptive methods is quite satisfactory, the level of contraceptive use is not optimal in our setting. Consequently, more adapted educational and counseling interventions should be undertaken among women, and family planning messages directed to men need to be included too.

Garnering an in-depth understanding of men who have sex with men in Chennai, India: a qualitative analysis of sexual minority status and psychological distress

Men who have sex with men (MSM) in India are a hidden and largely understudied population, and have an HIV prevalence 17 times higher than that of the general Indian population. Experiences of social marginalization and negative psychosocial conditions occur concurrent to HIV risk among Indian MSM. To better understand the contextual variables driving HIV risk and inform intervention development, five focus groups (n = 46) and nine key informant interviews were conducted with 55 MSM in Chennai in 2010. NVivo software was used to code the transcripts, and data were analyzed using qualitative descriptive analysis methodology. Participants described sources of psychological distress and low self-worth related to gender non-conformity and sexual minority status. These included stigma from society, pressure to marry, lack of familial acceptance, childhood sexual abuse, and the imperative to keep sexual minority status a secret. Participants' personal evaluations revealed that self-acceptance may be an important resilience factor that can shield these psychosocial and HIV risk factors. In promoting health-seeking behavioral changes for Indian MSM at an individual level, our findings point to the potential strength of strategies that focus on self-acceptance of one's sexual minority identity to foster better psychosocial and overall health.

Pre-marital sex and its predicting factors among Malaysian youths

INTRODUCTION

This study aimed to examine the prevalence of pre-marital sex and its predicting factors among youth trainees undergoing a national skill training programme in the state of Malaysia.

METHODS

Participants filled up health screening surveys at the beginning of their training period. A total of 1328 out of 1377 trainees were included in the study. Logistic regression was done to determine the potential predicting factors of pre-marital sex among the trainees.

RESULTS

Most trainees were 18 years old (97.1%) and 56% were female and 44% were male. The prevalence of pre-marital sex among trainees of these youths was 4.6%. A total of 6.2% of the female trainees as compared to 2.6% of their male counterpart had had pre-marital sex. Analysis using multiple logistic regression revealed only six significant predictor variables which were religion, race, lover, reading or watching porn, masturbation and bullying.

CONCLUSION

The prevalence of pre-marital sex amongst Malaysian youths is low as compared to those in developed countries. However, as pre-marital sex and pregnancy outside wedlock are largely socially unacceptable in Malaysia and may be kept hidden from others, the complications and social problems that may follow from this behaviour should be taken into consideration. Measures such as sex education and awareness programmes are needed among youth to curb this phenomenon from becoming a social as well as a public health concern.

AIDS knowledge and HIV stigma among children affected by HIV/AIDS in rural China

The current study was designed to assess the level of AIDS knowledge and its relationship with personal stigma toward people living with HIV/AIDS (PLWHA) among children living in communities of high HIV prevalence in rural China. The data were collected in 2009 from 118 orphanage orphans (children who had lost both of their parents to HIV and living in AIDS orphanages), 299 family-cared orphans (children who had lost one or both of their parents to HIV and living with surviving parents or extended families), 326 vulnerable children (children who were living with HIV-infected alive parents), and 276 comparison children (children from the same community who did not experience HIV-related illness and death in their family). Children were asked to answer 20 questions of AIDS knowledge. A 10-item stigma scale was employed to assess children's own attitude toward PLWHA. Both bivariate and multivariate tests were performed to answer our research questions. The data in the current study demonstrate a relatively low percent of correct AIDS knowledge (60%) among samples. The comparison children reported the best score of AIDS knowledge and orphanage orphans scored the lowest. The children with better AIDS knowledge have less personal stigma toward PLWHA. The findings in the current study suggest the need of appropriate education strategies to provide AIDS knowledge to children, particularly for HIV-affected children living in communities of high HIV prevalence in rural China.

Local hierarchies and distributor (non) compliance: a case study of community-based distribution in rural north India

Community-based distribution of family planning services is particularly appropriate for South Asia, which has hard-to-reach rural populations. In Uttar Pradesh (UP), India, local status hierarchies of gender, caste, and generation shape the nature of relationships that community-based distributors (CBDs) create with their clients. In this case study of an "ideal" distributor, we uncover the conflicting expectations that many CBDs experience: to comply with project objectives without violating local social norms that limit interactions across status boundaries. Our CBD responded to these dual pressures with varying strategies, often perpetuating social distance and restricting information and services for men, adolescents, and other marginalized populations.

Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia

Background

Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.

Methods

Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.

Results

Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 ± 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).

Conclusions

It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.

Exploring context and dynamics of homosexual experiences among rural youth in India

There is a lack of community-based studies that have examined level and context of homosexual activity in India among male youth. As part of a larger study on sexual behavior and gender attitudes of rural youth in Northern India, this study identified a subgroup of young men who reported homosexual experiences, even though they did not identify themselves as homosexual. This article attempts to examine the levels and range of sexual practices and attitudes of the homosexually active male youth by comparing them with their peers who reported heterosexual experiences. Study findings indicate that about one-fifth of sexually active male youth reported homosexual experiences. These young men begin their sexual careers early; engage with a higher number of sexual partners, both male and female; and are more likely to report inconsistent condom use, as compared to their heterosexually active peers. With high levels of partner mixing and inconsistent condom, use it appears that, for this subgroup of young men with high risk behaviors, homosexual experiences are only one part of their sexual lives and not the main factor that would contribute to their HIV vulnerability. Interventions need to be mindful of these issues, rather than rushing into labelling youth as homosexual or heterosexual for programmatic purposes. At the same time, as high-risk behaviors are largely unexplored among a general population of rural male youth, there is need for more in-depth ethnographic and culturally specific sexuality research to explore if there is a subculture that may promote sexual practices including same-sex activities that influences HIV vulnerability.

Sexual attitudes and behaviors among medical students in Dokuz Eylul university, Turkey

Gaining a healthy sexual attitude and behavior and being able to show appropriate approaches to patients in terms of sexual issues are important acquisitions for medical students. The aim of the present study was to determine, compare, and evaluate the sexual attitudes and behaviors of Dokuz Eylul University Faculty of Medicine students. An anonymous questionnaire was filled in by first- and sixth-year students in order to determine their sexual attitudes and behaviors. While information sources in the adolescence period for both genders were friends in the first place, these sources were mostly mothers, books, newspapers--magazines for females, and newspapers--magazines and television for males. The opinion of males about having sexual intercourse before marriage for males was positive, and females were more tolerant about males having this experience before marriage as compared to females having sexual experience before marriage. Rates of expression of having sexual intercourse and masturbation were found to be higher for male students. The first sexual experience with a sex worker or sentimentally insignificant partner was high among males. In general, the rate of condom use was lower, and the rate of coitus interruptus was found to be higher than in foreign studies. All the students declared 'my own will and values' as the most frequent factor affecting their sexual attitudes and behaviors, and high rates for 'social factors', 'religious requirements', 'the expectations of families', and 'protection from sexually transmitted diseases' were observed. The findings lead to the conclusions that gender differences exist in the sexual attitudes and behaviors of medical students; the enhancing effect of the traditional structure on gender discrimination is still continuing; students are not provided with sufficient scientific approach or training prior to the university education; and beyond biomedical training, they should receive more support in those fields during their medical education.

Adolescent attitudes and relevance to family life education programs

The study was conducted in seven private coeducational English-medium schools in Cochin to understand adolescent attitudes in this part of the country. Queries submitted by students (n=10,660) and responses to separate pretested questionnaires for boys (n=886 received) and girls (n=589 received) were analysed. The study showed a lacuna of knowledge among adolescents with the most frequently asked queries being on masturbation, and sex and sexuality. More than 50% of adolescents received information on sex and sexuality from peers; boys had started masturbating by 12 yr age and 93% were doing so by 15 yr age. Although 73% of girls were told about menstruation by their parents, 32% were not aware, at menarche, that such an event would occur and only 8% were aware of all aspects of maintaining menstrual hygiene. 19% of boys succumbed to peer pressure into reading/viewing pornography; more than 50% of adolescents admitted to having had an infatuation around 13 yrs of age or after. 13% of boys admitted to having been initiated into smoking by friends; mostly between 14-16 yrs age; 6.5% boys had consumed alcohol with peers or at family functions, starting between ages of 15 to 17 yrs. Though >70% of adolescents were aware about AIDS, adequate knowledge about its spread and prevention was lacking.

Religious and cultural influences on contraception

OBJECTIVE

To elucidate the religious and cultural influences that may affect the acceptance and use of various methods of contraception, including emergency contraception.

METHODS

Literature searches were conducted to identify religious teachings related to family, sexual relations, and family planning for Christianity, Judaism, Islam, Hinduism, Buddhism, and Chinese religious traditions. Religious scholars from each of the major religions were consulted for additional information regarding how various subgroups within that religion may interpret and apply religious teachings in specific circumstances.

RESULTS

Religious and cultural factors have the potential to influence the acceptance and use of contraception by couples from different religious backgrounds in very distinct ways. Within religions, different sects may interpret religious teachings on this subject in varying ways, and individual women and their partners may choose to ignore religious teachings. Cultural factors are equally important in couples' decisions about family size and contraception.

CONCLUSION

When new immigrants are faced with the challenges of acclimating to a new society and a new way of life, they may anchor strongly to traditional religious and cultural expectations regarding family, sexuality, and fertility. While health care providers must be cautious not to attribute stereotypical religious, social, and cultural characteristics to women seeking advice about contraception, they do need to recognize that different value systems may influence contraception decision-making in couples of different faiths. This increased cultural awareness needs to be tempered by the understanding that each patient encounter is unique. The values that an individual woman holds may not be in keeping with the official teachings of her religion or the cultural norms reported by other members of the same culture.

Sexual intercourse and current contraceptive use among university students in Finland

OBJECTIVE

To ascertain the current frequency of sexual intercourse, the current use of contraceptives, the ever use of emergency contraception, and the ever experience of condom failure among Finnish university students.

STUDY DESIGN

The study population consisted of Finnish undergraduate university students (19-34 years of age) in 2004. The randomly selected sample comprised 5030 subjects. The data were collected by postal questionnaire, the response rate being 62.7%. Data were presented with frequency distributions and cross-tabulations. Chi-square test was used. Frequencies for women and men were presented and tested separately.

RESULTS

A total of 80% of students were currently practicing sexual intercourse. Approximately half of the female students currently used hormonal contraception and one-third used a condom. Almost half of the men currently used a condom. The simultaneous use of condom and hormonal contraception was rare. Condom failure was common. The ever use of emergency contraception appeared to be associated with condom failure.

CONCLUSION

Of Finnish university students 80% were sexually active and hormonal contraceptives were the most popular method of contraception among female students. The use of the condom should be practiced more often for prevention of sexually transmitted diseases.

Sexual behavior among men who have sex with women, men, and Hijras in Mumbai, India--multiple sexual risks

We describe the same-sex partnerships and sexual risk behavior of men attending sexually transmitted infection (STI) clinics in Mumbai, India. The HIV prevalence among 2,381 men sampled was 14%; 62% had a documented STI. Almost all men reported sex with women; additionally, 13% also reported having sex with other men, 13% reported sex with Hijras (male-to-female transgenders), and 11% had sex with all 3 genders. Men who had sex with men and/or Hijras as well as women, reported having greater numbers of partners, including female sex workers (FSW), and were more likely to engage in insertive anal and oral sex with women. The prevalence of HIV was higher among men having sex with Hijras (14%) or with all 3 genders (13%) than among men having sex with men and women (8%). A high proportion of men who attend STI clinics in Mumbai are behaviorally bi- or tri-sexual and have multiple partners with whom they engage in risky sex. STI/HIV prevention programs should not assume that men only have sex with women.

AIDS related knowledge, attitudes, and professional preparation among social work students in India

Three-hundred and eighty-five social work students enrolled in 11 colleges in India were surveyed. Overall, the students demonstrated a moderate degree of knowledge about HIV/AIDS. However, they were generally unconcerned about the contagion. Three-fourths admitted to their lack of competence to deal with HIV+ patients. Regression analyses identified the positive effect of AIDS knowledge in combination with variables 'actual contact with AIDS patients' and 'sense of competence' on attitude toward PHWA. The paper discusses a curriculum strategy aimed at gender sensitive content and recommends behavior change as the best approach to reverse the tide of the contagion.

High HIV prevalence and risk behaviors in men who have sex with men in Chennai, India

OBJECTIVE

To estimate HIV and sexually transmitted disease (STD) prevalence and behavioral risk characteristics of men who have sex with men (MSM) in Chennai, India.

METHODS

A cross-sectional population-based random sample survey was conducted in 2001. Randomly selected residents of 30 slums in Chennai were interviewed for behavioral risk factors through face-to-face interviews. Sera and urine were examined for syphilis, HIV-1, gonorrhea, and chlamydia. Logistic regression analyses were used to assess associations between MSM status and HIV infection and to identify risk characteristics of MSM.

RESULTS

Of 774 men, 46 reported (5.9%) sex with other men. MSM were more likely to be seropositive for HIV (odds ratio [OR] = 8.57; 95% confidence interval [CI]: 1.83, 40.23) and were more likely to have a history of STD (OR = 2.66; 95% CI: 1.18, 6.02) than non-MSM. Men who used illicit drugs in past 3 months (adjusted odds ratio [AOR] = 4.01; 95% CI: 1.92, 8.41), ever exchanged money for sex (AOR = 3.93; 95% CI: 1.97, 7.84), or were ever tested for HIV (AOR = 3.72; 95% CI: 1.34, 10.34) were significantly more likely to report sex with men.

CONCLUSIONS

MSM in Chennai slums are at high risk for HIV. HIV prevention strategies aimed at changing unsafe drug and sexual practices should target the general population of men, with specific attention to areas with high rates of MSM.

Sexual knowledge, attitudes, and risk behaviors of students in Turkey

This survey produced baseline information about student knowledge of sexually transmitted diseases (STDs), their sexual attitudes, and their behavior to help establish control and education programs. The study was conducted at Ege University, Izmir, Turkey, during the 1999-2000 academic year. A total of 2,217 first- and fourth-year students determined by stratified sampling constituted the study group. All students who volunteered to participate completed a questionnaire assessing sociodemographic and knowledge factors, sexual attitudes, behavior, and history of STDs. The rate of students having had sexual experience was 36.6%. Males were more sexually active than females. Most students (71.4%) began sexual activity at ages 15-19 without any difference by gender. Males reported significantly more sexual partners than females. Similarly, the rate of male students never using condoms was significantly higher than females. Condom was the most frequent contraception method, followed by oral contraceptives and withdrawal. Mean score on the knowledge questions was 16.29 (highest score 30). The most widely known STD was HIV infection and AIDS. Students' knowledge of transmission routes, signs and symptoms, and risk groups of STDs was insufficient. Main sources of knowledge were visual and print media, and friends. Most students (84.7%) viewed prevention from STDs as a person's own responsibility. Young people in Turkey are sexually active and tend to engage in high-risk behavior. However, their knowledge on sexual health and sexually transmitted diseases is insufficient. Study results suggest a need for implementation of STD control programs and provision of school sexuality education for adolescents and young adults.