Behavioral intention to have risky sex in young men and women: The role of sexual excitation and assertiveness

Due to the complex role of sexual excitation in risky sexual behaviors, this study aimed to disentangle this phenomenon by jointly analyzing the combined role of three forms of sexual excitation: genital and subjective, and individual´s propensity. Therefore, we examined the relationship between the components of the Dual Control Model, that is, propensity for sexual excitation/inhibition, in addition to genital and subjective arousal, and sexual assertiveness and intention to engage in casual sexual encounters in which sexual risk was implicitly or explicitly present. The sample consisted of 99 heterosexual young adults (55 men and 45 women) with ages ranging from 18 to 32 years. Participants performed an experiment in the laboratory, which involved them watching a sexual clip and then being presented with two erotic excerpts (stories) depicting casual sexual encounters in which there was an existence of implicit and explicit sexual risks. In men, the propensity for sexual inhibition was the most determining variable in preventing them from sexual risk-taking. In women, intention to engage in risky sexual behaviors was better determined by their propensity for sexual excitation and sexual assertiveness in negotiating the use of contraceptive methods. This research highlights the relevance of excitation and inhibition as a trait, in addition to subjective arousal and sexual assertiveness in intention to engage in risky sexual behaviors.

A church-based intervention for families to promote mental health and prevent HIV among adolescents in rural Kenya: Results of a randomized trial

OBJECTIVE

To evaluate a family- and church-based intervention for adolescents and caregivers in rural Kenya to improve family relationships, reduce HIV risk, and promote mental health.

METHOD

The intervention was developed using community-based participatory methods and focused on strengthening family communication. Modules addressed economic, relationship, and HIV-related topics using evidence-based behavioral strategies alongside culturally grounded content. A stepped wedge cluster randomized trial was conducted with 124 families (237 adolescents ages 10 to 16; 203 caregivers) from 4 churches. Participants completed interviewer-administered surveys over 5 rounds. Primary outcomes included family communication, HIV risk knowledge, self-efficacy, and beliefs. Secondary outcomes included parenting, social support, mental health, and adolescent sexual behavior. We estimated intent-to-treat effects via ordinary least squares regression with clustered standard errors.

RESULTS

Relative to controls, the intervention group reported better family communication across domains at 1- and 3-months postintervention and higher self-efficacy for risk reduction skills and HIV-related knowledge at 1-month postintervention. Sexually active youth in the intervention reported fewer high-risk behaviors at 1-month postintervention, including unprotected sex or multiple partners. Male caregivers in the intervention reported higher parental involvement at both time points, and youth reported more social support from male caregivers at 3-months postintervention. No effects on secondary outcomes of parenting, social support, and mental health were detected.

CONCLUSIONS

This intervention holds promise for strengthening positive family processes to protect against negative future outcomes for adolescents. Implementation with religious congregations may be a promising strategy for improving sustainability and scalability of interventions in low-resource settings. (PsycINFO Database Record

Exploring Unprotected Anal Intercourse among Newly Diagnosed HIV Positive Men Who Have Sex with Men in China: An Ethnographic Study

BACKGROUND

Unprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.

METHODS

We employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.

RESULTS

Some men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing lovers or stable partners, the fear of losing partners in a context of non-serostatus disclosure was testified to be a major concern. MSM with casual partners reported that anonymous sexual encounters and moral judgments played a significant role in their sexual risk behaviors. Simultaneously, self-reported negative emotional and psychological status, perception and idiosyncratic risk interpretation, as well as substance abuse informed the intrapersonal context for UAI.

CONCLUSION

UAI among these HIV positive MSM was embedded in an intrapersonal context, related to partner type, shaped by anonymous sexual encounters, psychological status, and moral judgments. It is important that prevention and intervention for secondary HIV transmission among newly diagnosed HIV positive MSM in China take into account these contextual factors.

Risk factors for transactional sex among young females in post-conflict Liberia

This study aimed to examine the risk factors for engaging in transactional sex among young females in Montserrado County, Liberia. Data from an HIV behavioral survey conducted among young people aged 14 - 25 years were used. The analytical sample included 493 sexually-experienced females. Bivariate and multivariate analyses were conducted. We found that 72% of our sample had ever engaged in transactional sex. Engagement in transactional sex was associated with education (OR: 0.5); reporting no earned income (OR: 1.9); longer duration of sexual activity (OR: 3.5); early sexual debut (OR: 2.5); history of sexual violence (OR: 2.1) and multiple sexual partnerships (OR: 4.0). Respondents' age, residence, and drug/alcohol use were not associated with engagement in transactional sex. HIV interventions should incorporate educational strategies to reduce the prevalence of transactional sex among young people. These strategies should include economic opportunities to offset financial need as well as efforts to eradicate sexual violence.

Indirect effects of acute alcohol intoxication on sexual risk-taking: The roles of subjective and physiological sexual arousal

Three experiments supported the idea that alcohol fosters sexual risk-taking in men and women, in part, through its effects on sexual arousal. In Experiment 1, increasing alcohol dosage (target blood alcohol levels of .00, .04, .08%) heightened men's and women's risk-taking intentions. Alcohol's effect was indirect via increased subjective sexual arousal; also, men exhibited greater risk-taking than women. In Experiment 2, an extended dosage range (target blood alcohol levels of .00, .06, .08, .10%) heightened men's risk-taking intentions. Alcohol's effect again was indirect via subjective arousal. Physiological sexual arousal, which was unaffected by alcohol, increased risk-taking via increased subjective arousal. In Experiment 3, alcohol increased women's risk-taking indirectly via subjective arousal, but alcohol-attenuated physiological arousal had no effect on risk-taking. Implications for alcohol myopia theory and prevention interventions are discussed.

Psychophysiological response patterns and risky sexual behavior in heterosexual and homosexual men

The past few years have seen an increased awareness of the relevance of studying the role of sexual response, emotion, and traits such as sensation seeking and the propensity for sexual inhibition in risky sexual behavior. The current study examined the association between self-reported sexual risk taking and psychophysiological response patterns in 76 heterosexual and homosexual men. Measures included genital, electrodermal, startle eyeblink, and cardiovascular responses, and stimuli included threatening (depicting coercive sexual interactions) and nonthreatening (depicting consensual sexual interactions) sexual film excerpts. Sexual risk taking was hypothesized to be associated with decreased inhibition of sexual arousal and hyporeactive affective and autonomic responses to threatening sexual stimuli. Controlling for age and number of sexual partners in the past year, sexual risk taking (number of partners during the past 3 years with whom no condoms were used) was found to be associated with stronger genital responses and smaller eyeblink responses to both threatening and nonthreatening sexual stimuli. Correlations between genital and subjective sexual arousal were relatively low. Sexual risk taking was related to sensation seeking but not to the propensity for sexual inhibition. The findings suggest that risky sexual behavior may involve a role for psychophysiological mechanisms that are specific to sex as well as for ones that are associated with more general approach/avoidance response tendencies.

Immunity to HIV-1 is influenced by continued natural exposure to exogenous virus

Unprotected sexual intercourse between individuals who are both infected with HIV-1 can lead to exposure to their partner's virus, and potentially to super-infection. However, the immunological consequences of continued exposure to HIV-1 by individuals already infected, has to our knowledge never been reported. We measured T cell responses in 49 HIV-1 infected individuals who were on antiretroviral therapy with suppressed viral loads. All the individuals were in a long-term sexual partnership with another HIV-1 infected individual, who was either also on HAART and suppressing their viral loads, or viremic (>9000 copies/ml). T cell responses to HIV-1 epitopes were measured directly ex-vivo by the IFN-γ enzyme linked immuno-spot assay and by cytokine flow cytometry. Sexual exposure data was generated from questionnaires given to both individuals within each partnership. Individuals who continued to have regular sexual contact with a HIV-1 infected viremic partner had significantly higher frequencies of HIV-1-specific T cell responses, compared to individuals with aviremic partners. Strikingly, the magnitude of the HIV-1-specific T cell response correlated strongly with the level and route of exposure. Responses consisted of both CD4⁺ and CD8⁺ T cell subsets. Longitudinally, decreases in exposure were mirrored by a lower T cell response. However, no evidence for systemic super-infection was found in any of the individuals. Continued sexual exposure to exogenous HIV-1 was associated with increased HIV-1-specific T cell responses, in the absence of systemic super-infection, and correlated with the level and type of exposure.

Serosorting, the practice of seeking to engage in unprotected sexual activities only with partners who are of the same HIV-1 status, is a growing trend. Unprotected sexual intercourse between two HIV-1 infected individuals can lead to consequences such as HIV-1 super-infection. However, continued exposure to HIV-1 may also have an important influence on the immune response. Here, we explored this influence in a cohort of HIV-1 infected individuals who were in long-term partnerships with other HIV-1 infected individuals. We found that individuals, who regularly engaged in unprotected receptive sexual intercourse with an HIV-1 infected viremic partner, displayed higher T cell responses to HIV proteins compared to those who were not regularly exposed to a viremic partner. None of the individuals within this study showed evidence of systemic super-infection. Exposure had limited impact on general activation or poly-functionality. These results are clearly of importance for HIV-1 infected individuals who chose to engage in unprotected sexual activity with other HIV-1 infected individuals. These data also reveal a more general mechanism that occurs in infectious diseases: immune responses to chronic viruses are influenced not only by the virus within the host, but also by exposure to the virus from without.