The Relationship between the Use of Social Networking Sites and Sexually Explicit Material, the Internalization of Appearance Ideals and Body Self-Surveillance: Results from a Longitudinal Study of Male Adolescents.

Although there is now a substantial body of research suggesting a positive association between the exposure to sexualized content in the media and self-objectification/body surveillance, most of the studies have been cross-sectional, conducted in exclusively female samples, focused on the use of traditional media (e.g., printed magazines and TV), and have not assessed the role of the internalization of appearance ideals, which is potentially an important intervening variable in the relationship between media exposure and outcomes related to body concerns. Addressing the need for further assessments of self-objectification in more diverse samples, this study used five-wave longitudinal data to investigate the parallel changes in the use of social networking sites and sexually explicit material and the internalization of appearance ideals and body surveillance in Croatian adolescent men (Mage at baseline = 15.9, SD = 0.54; n= 743). Over a period of 22 months during the transition from middle to late adolescence, both the internalization of appearance ideals and body surveillance decreased. Furthermore, although the internalization of appearance ideals and body surveillance were associated both at baseline and over time, this study's results did not indicate a longitudinal relationship between respectively the use of online social networking sites and sexually explicit material and either the internalization of appearance ideals or body surveillance among adolescent males. Overall, this study's findings highlight the potential for a more specific assessment of the role of the use of social networking sites and sexually explicit material in self-objectification and body surveillance among young men. Future research may benefit from exploring the relationship between young men's modes of engagement with and motives for the use of social networking sites and body surveillance, as well as the possible association between the use of sexually explicit material and competency-based self-objectification, in particular sexual body functionality.

Correlates of anti-hepatitis C positivity and use of harm reduction services among people who inject drugs in two cities in Croatia.

BACKGROUND: We assessed correlates of anti-hepatitis C (anti-HCV) positivity and utilization of needle and syringe exchange programs (NSEP) and opioid agonist treatment (OAT) among people who inject drugs (PWID) in two Croatian cities. METHODS: We conducted a cross-sectional study using respondent-driven (RDS) sampling among PWID in Rijeka (N=255) and Split (N=399). We used RDS-weighted population estimates and multivariable logistic regression to explore correlates of anti-HCV positivity and NSEP and OAT utilization. RESULTS: Seventy-eight percent (78.0%) of PWID in Rijeka and 61.5% in Split had been tested previously for HCV, while 21.5% and 7.0%, respectively, were tested for HCV in the past 12 months. Among PWID who report being infected with HCV, 24.9% in Rijeka and 11.3% in Split received anti-HCV treatment. In Rijeka, PWID who utilized NSEP and, in Split, those who were ever imprisoned, had higher odds of anti-HCV positivity. In Rijeka, PWID on OAT were more likely to use non-sterile injecting equipment and to inject for longer than 10 years. PWID enrolled in NSEP were more likely to inject opioid agonist medication (OAM) and less likely to use non-sterile injecting equipment. More than half of PWID reported misuse of OAM in the past month, while out of PWID enrolled in OAT, 65.4% in Rijeka and 88.7% in Split injected OAM in the month prior to the survey. CONCLUSIONS: Key findings of the paper point to the need to scale up HCV testing and treatment, improve access to NSEP and the quality of OAT provisions in order to prevent its misuse among PWID.

Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study.

Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18-88 years (Mage = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96-3.03, p < .01). Religiosity (AOR = 1.12, p < .05) and the use of alternative medicine (AOR = 2.85, p < .001) increased the odds of vaccine refusal. However, individual characteristics seem to be relatively poor predictors of CVRH intentions in Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.

HIV and hepatitis C prevalence, and related risk behaviours among people who inject drugs in three cities in Croatia: Findings from respondent-driven sampling surveys.

BACKGROUND: There are limited data on HIV and hepatitis C virus (HCV) epidemiology among people who inject drugs (PWID) in Croatia. This study aims to provide data on HIV and HCV prevalence and sexual and injecting risk behaviours among PWID in Zagreb, Split, and Rijeka. METHODS: Using respondent-driven sampling (RDS) we recruited from November 2014 to February 2015 a total of 176 PWID in Zagreb, 255 in Rijeka and 399 in Split. Participants provided biological specimens for HIV and HCV testing and completed a behavioural questionnaire. RESULTS: The proportion of female PWID ranged from 19.5% in Zagreb to 26.0% in Split. In the month before the survey, 2.5% of PWID in Split, 5.6% in Rijeka and 8.0% in Zagreb reported sharing non-sterile needles and syringes. Many PWID injected opioid substitution therapy (OST) in the month before the survey (57.0% in Zagreb and 57.5% in Split and Rijeka, respectively). Among PWID who had a casual sexual partner in the past 12 months (ranging from 39.2% in Split to 44.4% in Rijeka) condom use was low. Although HIV prevalence was low (0.2% in Rijeka and Zagreb, 0.3% in Split), HCV antibody prevalence was considerable (29.1% in Zagreb, 31.5% in Rijeka, 38.3% in Split). HIV and HCV testing coverage in the past 12 months was insufficient (6.8% and 7.0% in Split; 13.2% and 13.5% in Zagreb; 20.2% and 21.5% in Rijeka, respectively). CONCLUSION: We found a low-level HIV epidemic and a sizable HCV epidemic among PWID in Zagreb, Split and Rijeka. Presence of high-risk injecting and sexual behaviours together with inadequate HIV and HCV testing coverage call for development of a comprehensive approach to harm reduction and introduction of needle and syringe exchange programmes in prisons, as well as strengthening sexual health interventions.

Emotional Intimacy Among Coupled Heterosexual and Gay/Bisexual Croatian Men: Assessing the Role of Minority Stress.

Emotional intimacy cuts across contexts as diverse as sexual motivation and satisfaction, psychological and physical health, and relational well-being. Although the experience of intimacy and its effects on sex life may be gender and sexual orientation-specific, the role of intimacy in personal and sexual relationships has been studied mostly among heterosexual individuals and couples. Using the minority stress framework (Meyer, 2003) to address this gap in knowledge, the present study comparatively explored levels and predictors/correlates of emotional intimacy, and its association with sexual satisfaction among coupled heterosexual and gay/bisexual men sampled online in a predominantly homonegative country (Croatia). Heterosexual participants (n = 860; M age = 36.4, SD = 9.09) were recruited in 2011 and gay/bisexual participants (n = 250; M age = 29.4, SD = 7.13) in 2013. Controlling for age and relationship duration, gay/bisexual men reported higher levels of emotional intimacy than heterosexual men. Suggesting that the role of emotional intimacy in sexual satisfaction is not sexual orientation-specific, the strength of the association between these two constructs was similar in both samples. However, internalized homonegativity, which was negatively associated with emotional intimacy in this study, remains a challenge to creating and maintaining intimacy in male same-sex relationships.

Distressing Sexual Difficulties in Heterosexual and Non-Heterosexual Croatian Men: Assessing the Role of Minority Stress.

Although research has shown a connection between minority stressors and internalizing mental health problems, the role of minority stress has mainly been neglected in the assessment of sexual problems among non-heterosexual men. Using online samples of heterosexual (n = 933) and non-heterosexual participants (n = 561) aged 18 to 50 years, this study aimed to comparatively assess sexual difficulties and problems and explore the role of minority stress in non-heterosexual men's sexual problems. Although the age-adjusted odds of reporting rapid ejaculation, delayed ejaculation, and sex-related anxiousness significantly differed between the two groups, the overall prevalence of sexual difficulties and the associated levels of distress did not significantly differ between the samples. In multivariate assessment, anxiety and depression significantly increased the odds of reporting distressing sexual difficulties among both heterosexual and non-heterosexual participants. In the non-heterosexual sample, positive body image significantly decreased the odds of experiencing sexual problems. Pointing to a role of minority stress, highest levels of victimization related to sexual orientation increased the risk of sexual problems. This association was partially mediated by negative emotions. Our findings offer some support for a recent call to include sexual orientation among the social determinants of health recognized by the World Health Organization.

Comparing the Prevalence and Correlates of Sexual Health Disturbances Among Heterosexual and Nonheterosexual Men: An Overview of Studies.

INTRODUCTION: Although sexuality is a central feature that distinguishes nonheterosexual men from heterosexual men, little is known about how sexual orientation influences male sexual function and sexual problems. This presents a challenge for adequate healthcare for gay and bisexual men. AIM: The aim of this article is to provide an overview of the literature on the prevalence and correlates of sexual health disturbances among heterosexual and nonheterosexual men. METHODS: PubMed and PsycINFO databases were searched for relevant studies published in English. Reference sections of selected papers were checked for additional studies of interest. MAIN OUTCOME MEASURES: Main outcomes were comparative findings of the prevalence and correlates of sexual health disturbances in heterosexual and nonheterosexual men. RESULTS: In total, we found nine studies of interest, five of which used a comparative design. Evidence regarding sexual orientation as a risk factor for male sexual difficulties is mixed, with more recent studies reporting nonsignificant associations. Heterogeneity of sampling strategies and indicators used to assess sexual orientation and sexual function in the studies, as well as the use of relatively small subsamples of nonheterosexual participants, preclude any conclusions about a comparative prevalence of male sexual disturbances. Several studies suggested that rapid ejaculation might be more prevalent among heterosexual than nonheterosexual men. However, a single study that controlled for frequency and patterns of male sexual activity failed to corroborate this finding. Two studies reported similar correlates of sexual dysfunction and sexual problems between heterosexual and nonheterosexual men (e.g., age and depression/anxiety symptoms), but also some sexual orientation-specific correlates (e.g., body image). Finally, significant but weak associations between minority stressors and sexual health disturbances among nonheterosexual men were reported in two studies. CONCLUSIONS: There is a lack of comparative assessment of the relationship between sexual orientation and male sexual difficulties. Based on an analysis of the existing studies' limitations, we conclude with recommendations for future studies. Stulhofer A, Sevic S, and Doyle DM. Comparing the prevalence and correlates of sexual health disturbances among heterosexual and nonheterosexual men: An overview of studies. Sex Med Rev 2014;2:102-111.