Curriculum-based sexual and reproductive health education: revealing its relevance for risky sexual behaviors among secondary school students in Mwanza, Tanzania

BACKGROUND

Secondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS. In Tanzania, the burden of teenage pregnancy was reported to be 27% in 2016. The integration of sexual and reproductive health (SRH) education into the school curriculum is one of the proven crucial interventions. However, there is limited information on the extent to which curriculum-based SRH education is relevant for fostering good practices for coping with RSBs. This study sought to describe students' and teachers' perceptions of the relevance of curriculum-based SRH education.

METHODS

A qualitative study was conducted from May to June 2020 (involving 5 secondary schools in Ilemela district, Mwanza, Tanzania). In-depth interviews (30) were conducted among secondary school students and 10 interviews for teachers. The data were collected in Swahili and then transcribed and translated into English after which thematic content analysis was performed.

RESULTS

The majority (56%) of secondary school students were revealed to have a limited understanding of curriculum-based SRH education, which was limited to a few aspects of health that involved married people and pregnant women. Teachers of different subjects had different perceptions about the relevance of curriculum-based SRH education. Civics teachers had the perception that it was relevant and enough, while Biology teachers thought that it was not enough. Students reported utilizing the information taught in class to manage and navigate RSBs. Moreover, they expressed a need for additional delivery strategies to be used for a comprehensive understanding of sexual and reproductive health.

CONCLUSION

Despite the identified gaps in providing a comprehensive knowledge that builds on the appropriate attitudes and skills, the existing curriculum-based SRH education in secondary schools was utilized to help students in addressing and managing RSBs. However, there is a need for more comprehensive information and an improved delivery approach for SRH to equip students with the necessary skills when faced with RSBs.

Effect of a Randomized Controlled Trial of Housing Vouchers on Adolescent Risky Sexual Behavior Over a 15-Year Period

We examined whether a housing voucher intervention influenced adolescent risky sexual behavior (RSB) across 15 years in the Moving to Opportunity Study. Low-income families in public housing that resided in 5 cities were randomized to one of three treatment groups: a housing voucher to move to low-poverty neighborhoods (i.e., < 10% poverty rate), a Sect. 8 voucher but no housing relocation counseling, or a control group that could remain in public housing. Youth and their caregivers completed baseline surveys, as well as two uniform follow-ups: interim (2001-2002; 4-7 years after baseline) and final (2008-2010; 10-15 years after baseline). Approximately 4,600 adolescents (50.5% female) aged 13-20 years participated at the final timepoint. Adolescents reported on their RSB, including condom use, other contraceptive use, early sexual initiation (< 15 years old), and 2+ sexual partners in the past year. We modeled each indicator separately and as part of a composite index. We tested baseline health vulnerabilities as potential effect modifiers. The low-poverty voucher group and the Sect. 8 voucher group were combined due to homogeneity of their effects. Applying intent-to-treat (ITT) regression analyses, we found no significant main effects of voucher receipt (vs. control) on any RSB. However, we found protective effects of voucher receipt on RSB among youth with health problems that limited activity, and youth < 7 at baseline but adverse effects among females, youth > 7 at baseline, and youth who were suspended/expelled from school. Results highlight the importance of understanding how housing interventions differentially influence adolescent health and behaviors.

Adults and Family as Supportive of Adolescent Sexual Development in the Age of Smartphones? Exploring Cybersexual Violence Victimization, Pornography Use, and Risky Sexual Behaviors

Among adolescents, engagement in risky sexual behavior is an important public health concern. Research has begun to explore the impact of adolescents' online experiences with their social and behavioral health as approximately 95% of adolescents have access to a smartphone connected to the internet. However, little research has specifically examined how online experiences impact sexual risk behaviors among adolescence. To fill gaps in the existing research, the current study sought to investigate the association between two potential risk factors and three sexual risk behavior outcomes. We examined how experiencing cybersexual violence victimization (CVV) and using pornography during early adolescence was associated with condom use, birth control use, and use of alcohol and drugs before sex among U.S. high school students (n = 974). Additionally, we explored multiple forms of adult support as potential protective factors of sexual risk behaviors. Our findings suggest that CVV and porn use may be associated with risky sexual behaviors for some adolescents. In addition, parental monitoring and support from adults at school may be two ways to support healthy adolescent sexual development.

Food insecurity and risky sexual behaviors among college students during the COVID-19 pandemic

BACKGROUND

Sexually transmitted infections (STIs) and food insecurity are public health concerns in the United States (US) due to their growing prevalence and incidence among young people, and particularly in college students. Studies have reported that college students are at higher risk of STIs due to the high rates of risky sexual behavior (RSB). Most studies report a food insecurity prevalence of more than 30% among college students, which was more than twice the overall national food insecurity rate of 10.5% in 2020. This study aims to assess the relationship between food insecurity and RSB among college students during the early-stages of the COVID-19 pandemic.

METHODS

This was a cross-sectional study from a convenience sample of 320 students enrolled at the University of Nevada, Las Vegas during the 2020 Fall semester. Data was collected using an online survey. Univariate and multivariate logistic regression analyses were conducted.

RESULTS

Food insecure students were 2.9 times more likely to report receiving or giving fellatio without using a condom at least once in the past 6 months (P < 0.01) compared to food secure students. There was no significant association between food insecurity and other RSBs evaluated in this study.

CONCLUSIONS

The current study provides valuable information on food insecurity and RSB among college students during the early stages of the COVID-19 pandemic. Larger and longitudinal studies are needed to assess the trajectory of the association between food insecurity and fellatio with no condom use and other RSB among college students.

Prevalence and factors associated with condom use among sexually active young women in Haiti: evidence from the 2016/17 Haiti demographic and health survey

BACKGROUND

Young women in Haiti remain vulnerable to sexually transmitted infections and unintended pregnancy. However, little is known about condom use among this population. This study examined the prevalence and the factors associated with condom use among sexually active young women in Haiti.

METHODS

Data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the factors associated with condom use among sexually active young women in Haiti were assessed using descriptive statistics and binary logistic regression model.

RESULTS

The prevalence of condom use was 15.4% (95% CI 14.0-16.8). Being teenage (AOR = 1.34; 95% CI: 1.04-1.74), living in urban areas (AOR = 1.41; 95% CI = 1.04-1.90), having higher education level (AOR = 2.39; 95% CI: 1.44-4.00), being in the middle or rich category of household wealth index (AOR = 2.32; 95% CI: 1.53-3.53 and AOR = 2.93; 95% CI: 1.90-4.52), having correct knowledge of ovulatory cycle (AOR = 1.65; 95% CI: 1.30-2.10), having 2-3 lifetime sexual partners and one lifetime sexual partner (AOR = 2.04; 95% CI: 1.36-3.06 and AOR = 2.07; 95% CI: 1.35-3.17) had significantly higher odds of using condom. In addition, sexually active young women whose last partner was their boyfriend (AOR = 4.38; 95% CI: 2.82-6.81), and those whose last partner was a friend/casual acquaintance/commercial sex worker (AOR = 5.29; 95% CI: 2.18-12.85) were associated with increased likelihood of using condom compared with their counterparts whose partner was their spouse.

CONCLUSION

The Haitian government as well as institutions involved in sexual health should consider these factors when designing sexual and reproductive health interventions targeting young women. More specifically, to increase condom use and reduce risky sexual behaviors, they should combine efforts to raise awareness and induce sexual behavioral changes at two levels. In the education system, they should reinforce sexual education in primary and secondary schools while paying special attention to rural areas. In the whole society, it is important to deepen efforts toward increased awareness on family planning and condom use, through mass media and local organizations including religious ones. Priority should be given to the poorer households, young people and women, and rural areas, in order to maximize reduction in early and unintended pregnancy, and sexually transmitted infections. Interventions should include a condom price subsidy and a campaign to destigmatize condom use which is actually a "male affair".

Sexual Victimization in Adulthood and Associated Factors Among Men and Women: Cross-Sectional Evidence from Mainland China

Limited empirical research addresses sexual victimization and related factors among the general adult population in China. To address this gap, we explored the association between sexual victimization in adulthood and associated factors (unwanted sexual experiences [USE] before age 18, binge drinking prior to sex, hooking up, violent pornography use, awareness and perceived behavioral control of consent, and sexual refusal assertiveness) among a convenience Chinese sample. A cross-sectional study was performed in September 2020 among 898 screened men and women from 29 provinces in mainland China. Overall, 52.5% of men and 57.9% of women experienced sexual victimization at least once in adulthood. Men and women differed in the severity of sexual victimization in adulthood, with the mean severity scores of women being significantly higher than those of men. Hierarchical ordinal logistic regression revealed that, after considering control variables, correlates of severity of sexual victimization in adulthood included gender (OR 3.17, 95% CI 2.30-4.40), severity of USE before age 18 (OR 2.28, 95% CI 1.92-2.73), binge drinking prior to sex (OR 2.52, 95% CI 1.83-3.49), hook-up history (OR 2.24, 95% CI 1.49-3.39), violent pornography use (OR 1.07, 95% CI 1.04-1.09), lack of perceived behavioral control of communicating consent (OR 1.04, 95% CI 1.01-1.07), and sexual refusal assertiveness (OR 0.92, 95% CI 0.89-0.95). These findings indicate that early adverse sexual experiences, potential risky sexual behaviors, violent pornography use, and beliefs about consent and refusal may play an important role in predicting sexual victimization among Chinese adults.

The Risk of HIV/STDs Infection and Transmission Among Never-Married Male Migrants in China: Is Risk Attributable to Bachelorhood or Migration?

In the context of sex-ratio imbalance and rural-to-urban migration in China, never-married male migrants may become a vulnerable group as well as a bridge population that facilitates HIV/STDs transmission. It is still not clear, however, whether increased HIV/STDs transmission risk can be attributed to bachelorhood, migration, or both. This study identified the contributions of bachelorhood and migration to an increased risk of HIV/STDs infection, as well as the risk of HIV/STDs transmission across populations and regions. Data were from a cross-sectional questionnaire survey, in which 180 never-married non-migrant males in rural areas, 558 never-married male migrants, and 302 married male migrants in urban areas of China were interviewed in 2017. Results showed that never-married male migrants are more likely to engage in commercial sex and unsafe sex than never-married non-migrant males, and their likelihood of engaging in unsafe sex was also higher than married male migrants. Although never-married male migrants were less likely to have multiple sex partners than married male migrants, they were more likely to have multiple sex partners and sex partners from different regions than never-married non-migrant males. These findings indicate that both migration and bachelorhood increase the risk of HIV/STDs infection for never-married male migrants, and migration also increases the risk of HIV/STDs transmission across populations and regions.

Association between childhood sexual abuse and patterns of HIV risky sexual behaviors among men who have sex with men in China: A latent class analysis

BACKGROUND

Increasing prevalence of risky sexual behaviors among men who have sex with men (MSM) exacerbate the transmission of HIV. Previous studies had demonstrated that childhood sexual abuse (CSA) was associated with one or more sexual behaviors, but few studies have been conducted among MSM in China.

OBJECTIVE

This present study aimed to estimate latent classes of risky sexual behaviors and test for CSA differences in latent class memberships among Chinese MSM.

PARTICIPANTS AND SETTING

The eligible participants were MSM aged 16 years or older who reported ever having oral or anal sex with men in the past 6 months.

METHODS

Data were obtained from an anonymous questionnaire between September 2017 to January 2018 in three cities in China, and contained questions about sexual-related behaviors and CSA experience. Latent class analysis (LCA) was used to classify the patterns of sexual behaviors and binomial regression was used to examine the relationships among these variables.

RESULTS

Among 628 MSM, 22.6% reported experiencing CSA. A two-classes pattern of sexual behaviors was identified, with 46.7% in the low-risk class and 53.3% in the high-risk class. MSM who experienced CSA were more likely to be high-risk group compared to those without CSA experiences [odds ratio (OR) = 1.981; 95% confidence interval (CI) =1.329-2.954)].

CONCLUSIONS

CSA was prevalent among Chinese MSM. And MSM with CSA experiences are more prone to be assigned to the high-risk group. Future HIV interventions need to focus on MSM who experienced CSA.

Moderating effect of self-efficacy on the association of intimate partner violence with risky sexual behaviors among men who have sex with men in China

Background

In China, men who have sex with men (MSM) face a high risk of HIV infection. Intimate partner violence (IPV) is common in this population and leads to various adverse consequences, including risky sexual behaviors, substance abuse, and poor mental health, which pose huge challenges to HIV prevention and control.

Methods

An anonymous cross-sectional study was conducted to investigate the lifetime prevalence of IPV and prevalence of risky sexual behaviors during the previous 6 months in a convenience sample of 578 MSM from 15 cities covering seven geographical divisions in mainland China. The associations between IPV and risky sexual behaviors and the moderating effect of self-efficacy on these associations were explored through univariate and multivariate regression analyses.

Results

The prevalence rates of IPV perpetration and victimization were 32.5% and 32.7%, respectively. The proportions of participants who reported inconsistent condom use with regular or casual partners and multiple regular or casual sexual partners were 25.8%, 8.3%, 22.2%, and 37.4%, respectively. Multiple IPV experiences were positively associated with risky sexual behaviors; for example, any IPV victimization was positively associated with multiple regular partners, adjusted odds ratio (ORa) = 1.54, 95% CI [1.02,2.32], and multiple casual partners, ORa = 1.93, 95% CI [1.33, 2.80]. Any IPV perpetration was positively associated with inconsistent condom use with regular partners, ORa = 1.58, 95% CI [1.04, 2.40], and multiple casual partners, ORa = 2.11, 95% CI [1.45, 3.06]. Self-efficacy was identified as a significant moderator of the association between multiple casual sexual partnership and emotional IPV.

Conclusions

In conclusion, given the high prevalence of both IPV and risky sexual behaviors among Chinese MSM in this study, the inclusion of self-efficacy in interventions targeting IPV and risky sexual behaviors should be considered.

Mental health and risky sexual behaviors among Chinese college students: a large cross-sectional study

BACKGROUND

College students are at-risk populations of mental health problems and risky sexual behaviors. However, little literature focuses on the association between mental health problems and risky sexual behaviors. Our study examined the association between mental health problems (depressive symptoms, suicide, and mental disorders) and risky sexual behaviors among a large sample of Chinese college students.

METHODS

A total of 49,728 Chinese college students (47.5% male) eventually participated in the analysis. A self-administered questionnaire was used to measure mental health, risky sexual behaviors (casual sex, no condom use at last sexual intercourse, group-sex, and a high number of sexual partners), and other sociodemographic characteristics. Logistic regression analysis was used to explore the relationship between mental health and risky sexual behaviors. To ensure the data is representative of the nation's statistics, all analyses were weighed.

RESULTS

The prevalence of depressive symptoms, suicide ideation and suicide attempts, and mental disorders was 42.83%, 41.29%, and 7.74%, respectively. 26.13% of participants were sexually active in the previous twelve months. Nearly 35% of sexually active participants were engaged in risky sexual behaviors. Logistic regression results demonstrated that mental health problems were associated with risky sexual behaviors after adjusting confounders.

LIMITATIONS

cross-sectional analysis; The self-reported variables may be subject to recall bias and fraud.

CONCLUSIONS

There is a relatively high prevalence of mental health problems and risky sexual behaviors amongst Chinese college students. A significant association between mental health problems and risky sexual behaviors was suggested by our study. Our findings support the importance of advocating for mental and reproductive healthcare for college students.

The Relationship Between Violence Syndemics and Sexual Risk Behaviors Among African American Adolescents: Implications for Future Research

PURPOSE

We present a conceptual framework based on a review of the literature to highlight the interconnecting and reinforcing elements of a violence syndemic and how this syndemic influences sexual risk behaviors among African American heterosexual adolescents.

METHODS

We review existing peer-reviewed published research from 2000 to 2020 that links a violence syndemic (i.e., racism and race-related stress, neighborhood and police violence, peer violence, and family violence and disruptions) to adolescent sexual risk behaviors. Empirical findings and theoretical underpinnings are used to document this relationship and illuminate the factors that mediate this relationship.

RESULTS

Empirical studies support the links between specific types of violence and sexual risk behaviors among African American adolescents. Further, existing studies point to the important relationships among the specific types of violence, supporting a violence syndemic approach.

CONCLUSIONS

While more researchers are examining socio-ecological contextual factors as important predictors for sexual risk behaviors, there remains inadequate understanding about how violence types reinforce one another to heighten sexual risk behaviors among African American heterosexual adolescents. This article presents new directions for adolescent research, especially how a violence syndemic approach can be used to explain sexual risk, but also to refocus intervention design on the complex burdens experienced by this population.

[A survey on sexual needs and factors of HIV risky sexual behaviors among elderly men at different ages in two communities of Qiandongnan Miao and Dong autonomous prefecture]

Objective: To understand sexual needs and factors of risky sexual behaviors among elderly men at different ages in two communities of Qiandongnan Miao and Dong autonomous prefecture and provide basis for targeted HIV prevention and intervention. Methods: Two communities in the prefecture were selected as study sites. Questionnaire surveys were carried out among elderly men aged 50 and over who visited or consulted in the communities from June to December 2018, and they were tested for HIV and syphilis antibodies. Results: Among 400 elderly men, 209 (52.2%) were 50-64 years old, and 191(47.8%) were above 65 years old. They were mainly Miao people, accounting for 66.3% (265/400), and 235 (58.8%) had an education no more than 6 years. HIV awareness of the two age groups were only 25.8% (54/199) and 26.2% (50/191), respectively. Among those aged 50-64, 142 (68.0%) felt normal sexual desire, and 153 (73.6%) reported penile erections or erections in most cases whenever sex, and 52.9% (110) ejaculated most of the time. HIV prevalence was 1.0% (4/400). Compared with the over 65-year-old group, the proportion of having sex with spouse/stable partners (89.5%, 179/200), proportion of no condom use with their spouse/stable sexual partners during the most recent sex (93.8%, 168/179), proportion of having casual sex (11.0%, 23/209) and commercial sex (3.8%, 8/209) were all higher among 50-64 age group. In comparison to those aged over 65 years old, average monthly income>3 000, and use of sex helper, aged 50-64 (OR=2.70, 95%CI: 1.22-5.95), average monthly income ≤1 000 yuan (OR=2.79, 95%CI: 1.25-6.21), and no use of sex helper (OR=3.78) (95%CI: 1.65-8.67) were related factors of HIV risky sexual behavior last time. Conclusion: Elderly men in the minority prefecture had low HIV awareness. Compared with those≥65 years old, the 50-64 age group had more active sexual behaviors and higher sexual needs. Those from 50-64 age group, with lower economic level and good sexual ability were more likely to have HIV risky sexual behaviors.

Sexual orientation and sex-related substance use: The unexplored role of bisexuality

Using alcohol and drugs in sexual contexts is associated with negative health consequences, including increased risk for HIV/STIs, sexual victimization, unplanned pregnancies, and overdose. Evidence suggests millions of adults regularly use alcohol in sexual contexts, thus increasing their risk for these consequences. However, no nationally representative estimates exist for rates of regular alcohol and/or drug use in sexual contexts. Additionally, previous studies suggest sexual minority individuals are more likely to use substances in sexual contexts than heterosexuals; however, none of these studies examined for multiple dimensions or subgroups of sexual orientation. Thus, using two distinct datasets-one large, nationally representative sample (N = 17,491) and an Internet-collected convenience sample (N = 1001)-we explored the associations between sexual orientation (dimensions and subgroups) and rates of regular sex-related alcohol and/or drug use in American adults. Results showed that sexual minority individuals were significantly more likely to report regularly using substances in sexual contexts compared to heterosexuals; however, results varied based on dimension of sexual orientation and by sex. Across both samples, bisexual individuals exhibited the highest rates of regular sex-related substance use. Findings suggest that sexual minorities, and bisexual individuals in particular, may be at increased risk for regular sex-related substance use and its associated negative health consequences. Future research should include nuanced and multidimensional assessments of sexual orientation to investigate sex-related alcohol and/or drug use and its associated risks, as well as examine the potential direct and indirect pathways by which these disparities may be conferred.

Predicting risky sexual behaviors among college student drinkers as a function of event-level drinking motives and alcohol use

BACKGROUND

Risky sexual behaviors (e.g., sex without protection against pregnancy or sexually transmitted infections, sexual coercion, sex with unknown partners) are common among college students. To effectively decrease these behaviors, it is necessary to further understand factors associated with their occurrence. Drinking motives are a known predictor of both alcohol use and alcohol-related consequences, which may theoretically include risky sex. This study aimed to understand how drinking motivation interacts with alcohol use to predict risky sexual behaviors among college student drinkers.

METHODS

One-hundred and eight primarily female (83.3%) college students (age: M=19.09, SD=1.16) who endorsed past-month alcohol use and lifetime history of sexual activity completed up to four weekly Internet surveys assessing daily quantity of alcohol use, drinking motives (i.e., social, enhancement, coping, conformity), and engagement in risky sexual behavior. From 403 reported drinking episodes, four Generalized Estimating Equations were used to predict risky sex from person-centered drinking quantity and drinking motives.

RESULTS

Strong social motives significantly increased the odds of engaging in risky sexual behaviors (p=0.004). Additionally, there was a significant interaction, such that the relationship between risky sex and drinking depends on enhancement motives (p=0.021).

CONCLUSIONS

Interventions targeting social and enhancement motives for drinking may be particularly effective in reducing the occurrence of risky sexual behaviors among college students, which may result in a reduction of the negative physical and psychological health outcomes accompanying these behaviors.

Alcohol Use and Sexual Risk Behaviors in a Migrant Worker Community

There are not many studies exploring the association between alcohol use and risky sexual behaviors among migrant workers. This study analyzed how changes in alcohol use was associated with changes in risky sexual behavior and psychosocial variables. Data for this study was drawn from an HIV risk reduction project. Repeated measures ANOVA and Linear mixed model statistical method was conducted to find changes and association between alcohol use, sexual risk and psychosocial variables over time. The sample (n = 203) was composed of African Americans (33.0 %) and Hispanics (77.0 %) men. Both groups, over time, showed reduction in sexual risk in accordance with reduction in alcohol use. Changes in alcohol use and psychosocial variables showed significant association with sexual risk changes over time. Psychological strategies like building social support should be considered for HIV risk reduction intervention directed towards high alcohol consuming migrant workers.

Sex-related substance use and the externalizing spectrum

BACKGROUND

Substance use before and during sexual activity is associated with many negative health outcomes. Estimates suggest that at least 4.3 million American adults annually engage in regular sex-related alcohol consumption, indicating that the intersection of substance use and sexual behavior is of public health concern. However, it is likely that when considering broader sex-related substance use, estimates would be notably higher. While substance use disorders and antisocial personality disorder have been associated with sex-related alcohol consumption, no study has investigated how regular sex-related substance use is associated with the broader transdiagnostic externalizing spectrum. Further, no studies have assessed whether or not sexual risk-taking behaviors can be integrated into the externalizing spectrum.

METHODS

In a large internet sample (N=936), we used confirmatory factor analysis, item response theory, and logistic regression to link sex-related alcohol and drug use to an externalizing latent variable; identified psychometric characteristics of these behaviors; and determined the extent to which one's externalizing level was associated with changes in odds of regular sex-related substance use. We then replicated these findings in a nationally representative sample (N=34,653).

RESULTS

Results highlighted the close association between sex-related substance use and externalizing, with externalizing increases being associated with significantly increased odds of regular sex-related substance use.

CONCLUSIONS

These findings bear notable implications for conceptualization and treatment of sex-related substance use. Transdiagnostic intervention can be an efficient means of addressing this problematic behavior as well as other comorbid presentations. Results expand the current conceptualization of the externalizing spectrum.

Dispelling the myth: Exploring associations between the HPV vaccine and inconsistent condom use among college students

Human papillomavirus (HPV) vaccination is safe and effective in preventing anogenital cancers and warts. However, myths have surrounded the HPV vaccine since its approval, including the possibility that HPV vaccinated young people are more likely to engage in risky sexual behaviors. The purpose of this study was to assess the association between HPV vaccination and engaging in inconsistent condom use in a sample of U.S. college students. A secondary data analysis of the National College Health Assessment-II (Fall 2013) was conducted in 2015. Risky sexual activity was operationalized as inconsistent condom use for oral, vaginal or anal sexual activity. Logistic regression models were stratified by sexual activity and gender, and controlled for socio-demographics and history of STIs. Inconsistent condom use was reported among females for vaginal (47%), oral (94%), and anal sex (75%); while males reported levels of inconsistency for vaginal (38%), oral (94%), and anal sex (58%). Sixty-nine percent of females reported receiving the HPV vaccine compared to 43% of males. Among females, there was no significant association between HPV vaccination and inconsistent condom use in any of the sexual activities. Among males, there was no significant association between HPV vaccination and inconsistent condom use in oral or vaginal sex. HPV-vaccinated males were less likely to report inconsistent condom use during anal sexual activity. This study contributes to the increasing evidence that HPV vaccination is not associated with risky sexual behavior. Dispelling this myth is important to facilitate uptake and completion of the HPV vaccine in the U.S.

Internet-based educational intervention to prevent risky sexual behaviors in Mexican adolescents: study protocol

BACKGROUND

Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15-19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents.

METHODS

A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1) when the adolescents enter the study (baseline), 2) once the intervention is completed (at 1 month) and 3) after 3 months of follow-up (at the fourth month). There will be three outcome variables: 1) knowledge in regard to sexually transmitted infections, 2) attitudes regarding condom use, and 3) self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates.

DISCUSSION

The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large-scale, easily implemented preventive tool.

TRIAL REGISTRATION

The study was registered at the ClinicalTrials.gov ID: NCT02686736 .

A review of 5-HT transporter linked promoter region (5-HTTLPR) polymorphism and associations with alcohol use problems and sexual risk behaviors

Alcohol use and sexual risk behaviors are multidimensional phenomena involving many genetic and environmental factors. 5-HT transporter linked promoter region (5-HTTLPR) polymorphism constitutes an important factor affecting alcohol use problems and risky sexual behaviors. This paper narratively reviews studies on 5-HTTLPR polymorphism and its associations with alcohol use problems and sexual risk behaviors. We searched the electronic databases, PubMed, Ovid, and Google Scholar for articles using MeSH terms. Relevant articles were reviewed and eligible articles were selected for the study. Many studies have reported a significant but moderate association between 5-HTTLPR polymorphism and alcohol use problems. These studies have implicated the presence of at least one S allele to be associated with significant increases in alcohol use problems. Similarly, some studies associate the S allele with increased sexual risk behaviors. Effective alcohol cessation initiatives and STI/HIV prevention programs should be modified to account for 5-HTTLPR polymorphism before planning interventions; genetic effects could moderate the intervention effect.

Relationship between Health Locus of Control and Risky Sexual Behaviors among Nigerian Adolescents

HIV/AIDS knowledge has been rated as the most important factor for HIV prevention. However, studies have also shown that knowledge alone does not always translate into reduced risky sexual behavior (RSB). Health locus of control (HLC) categorized as perceived control over health status (internal locus of control) or attribution of health status to chance or fate (external health locus of control) is a psychological construct that has been shown to impact health outcomes including RSB. This study thus investigated the relationship between HLC and RSB among Nigerian adolescents. A cross-sectional survey design was employed among 361 adolescents from nine senior secondary schools selected through stratified random sampling from Jos, Plateau State Nigeria. Data were collected between August and October of 2008. Health Locus of Control Scale was used to categorize individuals into having either an internal or external HLC. RSB was assessed using the Brief HIV Screener (BHS). Descriptive statistics were computed and Mann-Whitney U test was used to determine differences in BHS scores by HLC categories. Odds ratios and adjusted odds ratios were calculated for individual BHS question responses based on HLC. Participants were 169 males (46.8%) and 192 females (53.2%) with a mean age of 16.9. When grouped into HLC categories, 141 were internal and 220 were external. The mean score on the BHS showed statistically significant difference based on HLC (p=0.01). Odds for using a condom during sexual intercourse were higher for adolescents with an internal HLC while adolescents with an external HLC had significantly higher RSB scores. Prevention programs targeted at adolescents should also aim to internalize their HLC.

Application of the Information-Motivation and Behavioral Skills (IMB) model in risky sexual behaviors amongst male students

As AIDS is not merely a hygienic problem but a disease that creates a great deal of economic, cultural, and social problems, it is necessary for most of the state and nongovernmental organizations and individuals to participate in both controlling AIDS and preventing it. As no effective vaccine or therapy for this disease exists currently, the only method for avoiding being afflicted by this disease is prevention. The present study aims to examine the Information-Motivation and Behavioral Skills (IMB) model in risky sexual behaviors. For this purpose, a group of 151 male students was sampled using a multistage random sampling method to complete the quality of HIV information questionnaire, national AIDS questionnaire, international AIDS questionnaire and global positive attitude to AIDS questionnaire. The results show that there is a significant relationship between the perception of HIV infection risk and sexual behavior. Thus, the perception of risk is considered the first step toward modifying sexual behaviors from risk-taking behaviors to safer behaviors.