Using an interactive web application to identify pre-exposure prophylaxis adherence among men who have sex with men.

Background: Men who have sex with men (MSM) are at a high risk for HIV infection. While pre-exposure prophylaxis (PrEP) is an effective oral preventive strategy, its success is largely dependent on consistent medication adherence. Objective: The aim of this study was to develop the machine learning web application and evaluate the performance in predicting PrEP adherence. Methods: The PrEP prospective cohort study of the MSM population conducted in Western China from 2019 to 2023, and we collected adherence data and personal characteristics data from 747 MSM. Predictor variables were screened and the performance of several machine learning methods in predicting nonadherent behaviors were compared. Results: A total of 11 candidate variables were screened that predicted nonadherent behaviors. We developed and evaluated five machine learning models that performed well in predicting adherence. Attitudes of male sexual partners, self-efficacy, HIV testing, number of male sexual partners, and risk perception were the most important predictors of adherence. The optimal prediction model was displayed in a shiny web application for online calculation of the probability of occurrence of nonadherent behaviors among MSM. Conclusions: Machine learning performed well in predicting nonadherent behaviors among MSM. An interactive and intuitive web application can help identify individuals who may have nonadherent behaviors, resulting in improved medication adherence and increased prevention efficacy.

One Country, Different Reactions- How did the Gay Community in Israel Respond to the New Mpox Threat?

Mpox affected mainly men who have sex with men (MSM). This study aimed to assess MSM's response to the threat, and compare MSM living in central Israel vs. its periphery. Data were collected by anonymous electronic surveys between September and October 2022 through a geospatial application ("Grindr"). Of the 665 MSM participants, 221 (33.2%) were vaccinated against mpox. In the multivariate analysis, living in central Israel, being in steady relationships, HIV infection, PrEP use, noticing suspicious skin lesions, and changing sexual behavior predicted vaccination. Of all participants, 317 (47.6%) changed their sexual behavior. In the multivariate analysis, living in central Israel, engaging in risky sexual behavior and being vaccinated against mpox predicted sexual behavior change. Of the 444 participants who were not vaccinated, 245 (55.1%) lived in peripheral regions of Israel. Those who lived in the periphery were less likely to get vaccinated or change their sexual behavior compared with MSM who lived in central Israel. Although the study was limited in size and the study population was relatively homogeneous, MSM perceived mpox as a potential threat on health, and almost 50% changed their sexual behavior and nearly one-third were vaccinated against mpox. The trend was mainly observed in MSM who were at high risk to acquire mpox and those who lived in central Israel.

Functional diversity along the anteroposterior axis of the ventromedial hypothalamus.

Innate behaviors ensure animal survival and reproductive success. Defending their territory, escaping from predators or mating with a sexual partner, are fundamental behaviors determining the ecological fitness of individuals. Remarkably, all these behaviors share a common neural substrate, as they are under the control of the ventromedial hypothalamus (VMH). Decades of research have contributed to understanding the exquisite diversity of functional ensembles underlying the wide array of functions that the VMH carries out. These functional ensembles are usually distributed throughout the dorsoventral and mediolateral axes of this nucleus. However, increasing evidence is bringing to attention the functional diversity of the VMH across its anteroposterior axis. In this review, we will overview our current understanding of how different ensembles within the VMH control a wide array of animal behaviors, emphasizing the newly discovered roles for its anterior subdivision in the context of conspecific self-defense.

Characteristics of preschool-age children who engage in problematic sexual behaviors with siblings.

BACKGROUND: Problematic sexual behavior (PSB) between siblings can be a form of sibling sexual abuse (SSA). A notable gap in research are studies examining PSB among preschool-age children with siblings. OBJECTIVE: This study examined the impact of child maltreatment, exposure to family sexuality, and use of coercive sexual behavior on preschool-aged children PSB with siblings and with nonsiblings. PARTICIPANTS AND SETTING: All 284 children were ages 3-6 years with PSB who had siblings in the home (197 initiated PSB with siblings and 87 initiated PSB with non-siblings). METHODS: The two groups were compared on types of PSB, use of coercion, child maltreatment history, exposure to family sexuality, and caregiver attitudes. Caregiver report measures were the Child Sexual Behavior Inventory- Third Edition (CSBI-III), the Family Sexuality Index, and intake form on maltreatment experienced (i.e., physical abuse, sexual abuse, emotional abuse, neglect, exposure to domestic violence, caregiver drug use, and failure to protect). RESULTS: Maltreatment history was significant, t(258) = -3.36, p < .001; sibling initiators were associated with higher rates of sexual and physical abuse, and neglect than non-sibling. Exposure to family sexuality was significant with non-sibling initiators demonstrating greater exposure than the sibling group, t(282) = 2.66, p = .008. There was no significance between groups for types of PSB including use of coercion. CONCLUSIONS: Results illuminated unique dynamics of PSB with siblings of preschool-aged children. A developmental framework integrating child maltreatment, impulsivity, environmental factors, and capabilities are key considerations for conceptualization, prevention, and response that is distinct from SSA of adolescents.

Investigation of the psychometric properties of the Toronto Alexithymia Scale in men with and without compulsive sexual behavior.

Background: Previous studies have provided initial evidence supporting the association between compulsive sexual behavior (CSB) and alexithymia, but these studies did not investigate the psychometric property of a measure of alexithymia in individuals with CSB, which is necessary. Aim: This study investigated the factor analysis, reliability, and construct validity of the Toronto Alexithymia Scale (TAS) in men with CSB and control individuals. Methods: This cross-sectional study included 418 participants (304 individuals with CSB and 114 control individuals) who underwent a semi-structured psychiatric interview and completed the following instruments: the Sexual Compulsivity Scale, Hypersexual Disorder Screening Inventory, Beck Anxiety Inventory, Beck Depression Inventory, TAS, and Barratt Impulsiveness Scale. The eligible participants were men 18 years of age or older who were literate and residing in Brazil. Individuals who met the diagnostic criteria for Goodman's criteria for sex addiction were subsequently assessed for the excessive sexual drive (International Classification of Diseases-Tenth Revision F52.7) criteria. Those who met this second criteria were considered individuals with CSB. Participants who did not reach this point were considered control individuals. We conducted factor analysis, reliability analysis (internal consistency and temporal stability), and discriminant and construct validity analyses. Outcomes: The outcomes included the TAS total score and scores on TAS factors 1, 2, 3, and 4. Results: The extracted factors explained 44% of the variance in the TAS. Factor 1 explained 21%, but 3 items (items 2, 9, and 21) did not load onto this factor. The Cronbach's alpha was 0.83, and the reproducibility (intraclass correlation coefficient) was 0.70. The TAS can differentiate between individuals with CSB and control individuals. The different forms of validity were demonstrated through correlations between factors 1 to 4 and the total score, as well as with impulsivity, hypersexuality, sexual compulsivity, and depression. Surprisingly, anxiety was only weakly correlated with factors 1 and 2. Moreover, the TAS-4 score was not correlated with impulsivity. Clinical Implications: The TAS can be used in clinical practice to identify men with difficulties in recognizing subjective experiences, and proper interventions can subsequently be provided to these patients to increase their treatment efficacy. Strengths and Limitations: Various dimensions of alexithymia covary with other key psychopathological symptoms of CSB. This study examined a convenience sample. The results cannot be generalized to the broader population. Factors 3 and 4 presented low internal consistency (0.50). Conclusion: In general, TAS presented good psychometric properties in a sample mainly composed of individuals with CSB.

Factors associated with online dating among college students engaging in casual sexual behavior in China: cross-sectional study.

Objective: This study aimed to investigate the factors associated with online dating among college students engaging in casual sexual behavior, by understanding these factors, targeted intervention measures can be formulated for relevant departments to help college students better manage their sexual health and offer useful reference for the development of sexual health education. Methods: A cross-sectional survey was conducted using a stratified cluster sampling method. Demographic and behavioral information was gathered through questionnaires for univariable and multivariable logistic regression analysis. Results: A total of 595 college students engaging in casual sexual behavior were included in the study, of whom 345 (57.98%) had found casual sexual partners through the internet. Multiple regression analysis indicated that male participants, those aged 20-21 years, those who had recently attended AIDS-themed lectures or health education classes at school, participants who were willing to engage in commercial sexual activities during online dating, participants who accepted sexual activities among men who have sex with men (MSM), those who reported having sexual intercourse with regular partners in the past year, participants who wanted to know if their online dating partners were HIV-diagnosed, those who had engaged in commercial sexual behavior in the past year and those who perceived themselves to be at risk of HIV infection were more likely to engage in online dating. Participants with general/disharmonious family relationships, those who consistently used condoms during casual sexual behavior and those who occasionally used condoms were less likely to engage in online dating. Conclusion: There were a certain extent proportion of casual partners among college students were sourced from the internet, indicating the profound influence of online dating on casual sexual behavior. Therefore, future research and intervention measures should focus on sexual health education and promotion on online dating platforms, strengthen regulations and guidance on college students' online dating behavior, and raise awareness of HIV prevention in this group.

From Parental Behavior to Sexual Function: Recent Advances in Oxytocin Research.

Purpose of Review: Oxytocin plays many diverse roles in physiological and behavioral processes, including social activity, parental nurturing, stress responses, and sexual function. In this narrative review, we provide an update on the most noteworthy recent findings in this fascinating field. Recent Findings: The development of techniques such as serial two-photon tomography and fiber photometry have provided a window into oxytocin neuroanatomy and real-time neuronal activity during social interactions. fMRI and complementary mapping techniques offer new insights into oxytocin's influence on brain activity and connectivity. Indeed, oxytocin has recently been found to influence the acquisition of maternal care behaviors and to mediate the influence of social touch on brain development and social interaction. Additionally, oxytocin plays a crucial role in male sexual function, affecting erectile activity and ejaculation, while its role in females remains controversial. Recent studies also highlight oxytocin's interaction with other neuropeptides, such as melanin-concentrating hormone, serotonin, and arginine vasopressin, influencing social and affective behaviors. Finally, an update is provided on the status of clinical trials involving oxytocin as a therapeutic intervention. Summary: The exploration of oxytocin's complexities and its interplay with other neuropeptides holds promise for targeted treatment in various health and disease contexts. Overall, these findings contribute to the discovery of new and specific pathways to allow therapeutic targeting of oxytocin to treat disorders.

Same-Sex Sexual Behavior, Age-Class, and Coalitions in Male Rhesus Macaques (Macaca mulatta).

In the present study, relations between same-sex sexual behavior (SSB), age-class, and coalitional behavior in male rhesus macaques were examined in a re-analysis of data first analyzed and reported by Clive et al. (2023). Age-class as a focal variable was indicated in an extensive literature review, which showed that male non-adult (juvenile, adolescent) participation in SSB is extensive in this and related primate species and associated with various benefits. Clive et al. (2023) excluded juveniles from their analysis. In the re-analysis (n = 995 mounting events), it was found that non-adult involvement was substantial (51%). Most dyads contained at least one non-adult (76%). Young and prime adult mounters most often selected non-adults to mount. Mounters were often sexually motivated: most for adolescents (72%); equally for juveniles (57%) and adults (56%). Finally, the highest rate of SSB with coalitional context appeared in adolescent-adult dyads involved in multiple repeated mounts. SSB, age-class, special friendships, bonding, and coalitions were linked, as reported in some other primate species and human societies cross-culturally. Employing age-class in male SSB analysis improved description and explanation.

Sexual Affectivity in Autism Spectrum Disorder: Bibliometric Profile of Scientific Production.

The aim of the present study was to describe the scientific production on sexuality and affectivity of autistic people. The inclusion criteria were articles published in all languages from the year 2000 to 2023, excluding reviews, proceedings, and other works not considered original. The search was performed in the Web of Science Core Collection and RStudio was utilized to analyze the records, with the "Bibliometrix 4.1.0" package and the VOSviewer software. A total of 314 articles were included, from the USA, Australia, and parts of Europe. The production peak was found in the year 2020, the most cited articles referred to the children's population, and the most important journals were specialized on the subject. As for the thematic content, 29 keywords emerged that were grouped into three clusters. In the first group, children associated with vulnerability and victimization were underlined, in which multifocal interventions were needed to prevent risk; in the second, we found adolescents and the need for sex education that is adapted and comprehensive; and lastly, adults who must be able to perform an adequate transition that eases the adaptation of neurodivergent individuals.

The PornLoS Treatment Program: Study protocol of a new psychotherapeutic approach for treating pornography use disorder.

Background: The introduction of Compulsive Sexual Behavior Disorder (CSBD) into the 11th International Classification of Diseases has raised expectations for better treatment options for CSBD. Furthermore, the treatment demand has increased, particularly for pornography use disorder (PUD), a subtype of CSBD. Presumably due to the easy access to Internet pornography an increasing prevalence of PUD is observed. Consequently, providing tailored and effective treatment is essential. Methods: This article provides an overview of the manualized short-term PornLoS Treatment Program (Pornografienutzungsstörung effektiv behandeln- Leben ohne Suchtdruck; translation: Treating pornography use disorder effectively - life without craving). The program combines 24 individual and 6 group psychotherapy sessions with an interdisciplinary approach by offering a novel treatment framework. This includes, e.g., a mobile app, establishment of self-help groups, and access to other social services such as couple counseling. The cognitive-behavioral treatment program contains interventions addressing psychoeducation, cue exposure, impulse control, cognitive restructuring, emotional regulation, and relapse management.We here also describe the study protocol of an ongoing four-arm randomized controlled trial. The aim is to test two variants of the PornLoS Treatment Program differing with respect to their treatment goal (abstinence or reduced pornography use) against cognitive-behavioral treatment as usual and against a waitlist control group. The primary outcome is the absence of a PUD diagnosis at the end of therapy. The total target sample size will comprise n = 316 patients with PUD across eight study sites. Results: The results will be presented at international conferences and published in a scientific peer-reviewed journal.

Use of a five-category partner-type classification within a chlamydia and gonorrhoea service evaluation highlights opportunities for targeted partner notification to improve STI control.

OBJECTIVES: Partner notification (PN) is a key component of sexually transmitted infection control. British Association for Sexual Health and HIV guidelines now recommend partner-centred PN outcomes using a five-category partner classification (established, new, occasional, one-off, sex worker). We evaluated the reporting of partner-centred PN outcomes in two contrasting UK sexual health services. METHODS: Using the electronic patient records of 40 patients with a positive gonorrhoea test and 180 patients with a positive chlamydia test, we extracted PN outcomes for the five most recent sexual contacts within the appropriate lookback period. RESULTS: 180 patients with chlamydia reported 262 partners: 220 were contactable (103 established, 9 new, 43 occasional, 52 one-off, 13 unknown/unrecorded). 40 patients with gonorrhoea reported 88 partners: 53 were contactable (7 established, 1 new, 14 occasional, 10 one-off and 21 unknown/not recorded). No sex worker partners were reported. Most established partners of people with chlamydia (96/103) or gonorrhoea (7/7) were notified but fewer (60/103 and 6/7, respectively) attended for testing. Of those, 39 had a positive chlamydia test and two had a positive gonorrhoea test. For both chlamydia and gonorrhoea, most occasional and new partners were reported to be notified but there was a sharper decline in those tested. For both infections, one-off partners had the lowest rates of accessing services and testing. For chlamydia, 81% were notified (42/52), 23% accessed services (12/52) and 21% tested (11/52). However, 91% of those tested were positive (10/11). The number of contactable one-off gonorrhoea contacts was small and few attended. CONCLUSIONS: Measuring partner-centred PN outcomes was feasible. There were differences in partner engagement with PN between the different infections and partner types. If these findings are replicated in larger samples, it suggests that interventions to target one-off partners who have low rates of PN engagement yet high levels of positivity could play a key role in reducing infection at population level.

Conductas sexuales protectoras en estudiantes universitarios de primer año de una universidad de Chillán, Chile / Protective Sexual Behaviors in First-Year University Students at a University in Chillán, Chile

Objetivo: Determinar las conductas sexuales protectoras en estudiantes de una universidad de Chillán, Chile. Métodos: Estudio cuantitativo, descriptivo con un muestreo probabilístico por conveniencia de 234 estudiantes universitarios, para los criterios de inclusión destaca haber iniciado actividad sexual. La recolección de datos fue a través de Google forms. El instrumento utilizado fue "Cuestionario de conducta sexual segura". Resultados: Del total de los alumnos encuestados el 64,1 % son mujeres. En cuanto al estado civil, el 93,5 % se identifica soltero. Solo el 47,4 % detiene la actividad sexual para utilizar condón. El 80,8 % evita relaciones sexuales en la primera cita, un 81,6 % nunca tienen relaciones anales sin condón, y el 99,6 % nunca ha tenido sexo con personas que utilizan drogas. Se encontró que la media para conducta sexual protectora es de 70,2 %. Conclusión: Los encuestados presentan conductas sexuales protectoras(AU)

Objective: To determine protective sexual behaviors in students at a university in Chillán, Chile. Methods: Quantitative, descriptive study with a probability sampling by convenience of 234 university students, for the inclusion criteria it stands out to have initiated sexual activity. Data collection was through Google form. The instrument used was the "Safe sexual behavior questionnaire". Results: Of the total students surveyed, 64.1% are women. Regarding marital status, 93.5% identify themselves as single. Only 47.4% stop sexual activity to use a condom. 80.8% avoid sexual relations on the first date, 81.6% never have anal relations without a condom, and 99.6% have never had sex with people who use drugs. It was found that the mean for protective sexual behavior is 70.2 %. Conclusion: The respondents present protective sexual behaviors(AU)

Religious Disaffiliates' Experiences and Challenges with Sex, Sexuality, and Body Image.

In recent years, an increasing number of ultra-Orthodox Jews have left their insular communities, choosing instead to lead a secular life. This article illuminates their perceptions and experiences related to sexuality, sexual behavior, and sexual health. Based on thematic analysis of 37 in-depth, semi-structured interviews with ultra-Orthodox disaffiliates, we found that sexual experiences have played a decisive role in the disaffiliates' lives. First, some participants shared that experiencing sexual abuse during childhood led them to disaffiliate. Second, prior to disaffiliating, participants had very little knowledge about sex, which was an unspoken issue. This resulted in misunderstandings and miscommunication related to courtship and dating after disaffiliating. Moreover, the knowledge gap of secular social norms led to disaffiliates being sexually exploited, as well as to male disaffiliates behaving inappropriately and consequently suffering from social rejection and loneliness. While some participants celebrated their new sexual freedom, others were fearful and reluctant to have sex. We suggest that in transgressing social, cultural, and identity boundaries, disaffiliates experience "cleft habitus" and are situated in a prolonged liminal position that affects their sexual behavior, intimate relations, sexual health, and body image. During the liminal period, disaffiliates typically learn threshold concepts, which are often troublesome and threatening. There is a striking need to offer disaffiliates assistance and support throughout this difficult process. This analysis can shed light on other groups of religious disaffiliates and cultural immigrants.

Effect of Sexual Counseling Training in Gynecological Cancers According to the PLISSIT Model on Midwifery Students' Awareness and Attitude: A Randomized Clinical Trial.

Background: It is very important to show health professionals and students that sexuality is important in women with gynecological cancer, to increase their awareness in this area and to ensure the formation of positive attitudes towards sexuality. This study aimed to determine the effect of sexual counseling training in gynecological cancers according to the PLISSIT Model on Midwifery students' Awareness and Attitude. Methods: This randomized controlled study was conducted between May and November 2022 by midwifery students studying at Sakarya University in Turkey. 36 students were allocated to the control group and 38 to the intervention group using block randomization. The intervention group was given 3 sessions training based on the PLISSIT model, whilethe control group underwent no training. Data were collected before the training and one month after completing the intervention using the Gynecological Cancer Awareness Scale (GCAS) and Sexual Attitudes and Beliefs Scale (SABS). Data analysis was done using SPSS software version 22 with Chi square test, independent and paired t-test. A significance level of P<0.05 was used. Results: In the intervention group, a significant difference was found within the group in terms of the GCAS (P<0.001), and SABS (P<0.001) scores after the study. In the control group, there was no significant difference within the group in terms of the GCAS (P=0.16) and SABS (P=0.26) scores. There was a significant difference between the intervention and control groups in terms of GCAS (P=0.004) and SABS (P<0.001) scores one month after training. Conclusion: It was found that sexual counseling training in gynecological cancers according to the PLISSIT Model was effective in creating awareness and positive attitudes in mMidwifery students.Trial Registration Number: NCT05967104.

Sexual Expression and Subsequent Marital Quality Among Partnered Older Adults.

A great deal of research has linked aspects of couples' sex lives to the quality of their relationships. Yet most of this work is with younger couples. Although sexual frequency is associated with positive marital quality, less is known regarding how sexual expression-sexual attitudes, desires, and behaviors-influences later positive and negative marital quality, particularly in older couples. Using latent class analysis and dyadic data on 620 heterosexual couples in long-term marriages from Rounds 2 and 3 of the National Social Life, Health, and Aging Project, we examined how couple-level configurations of sexual expression influence later marital quality. Generally, the latent classes with more agreement on sexual expression and higher overall sexual frequency were associated with later higher positive marital quality for both wives and husbands. Sexual expression configurations were associated with wives' negative marital quality, not husbands' negative marital quality. Across classes, wives' better mental health and husbands' functional limitations were associated with later marital quality. It is essential for practitioners to recognize the relevance of sexual expression to marital quality in older couples.

Childhood gratification syndrome: Demystifying the clinical conundrum with a narrative literature review of the past 5 decades.

Background: Childhood gratification syndrome (CGS) refers to self-stimulatory or masturbatory behaviors in children, which may have an onset as early as in infancy (IGS). Aim: The aim of this review is to understand the various clinical manifestations of CGS/IGS and their clinical differentiation from commonly misdiagnosed neurological and physical illnesses and to formulate a preliminary approach to their diagnosis and management. Methods: This narrative review is based on a search of literature over the past 50 years (1972-2022) in three online databases (PubMed/Medline, Embase, and Google Scholar). Results: The behaviors are episodic, occurring for brief periods, involving posturing, stereotypical limb movements, pubic pressure with autonomic hyperactivity, and postepisodic lethargy. They mimic seizures, movement disorders, abdominal pain, and tics. The paper also highlights the gap in the current knowledge to guide future research in the area. CGS usually represents nonpathological "pleasure-seeking" habits of childhood, but at times, it may become problematic for the child and his family. A careful history and videotape analysis of the events confirms the diagnosis and behavioral therapy with parental reassurance as the mainstay of treatment. Conclusion: A better understanding and clinical awareness of the CGS are necessary to prevent misdiagnosis and delay in appropriate intervention.

Combination of low doses of mirtazapine plus venlafaxine produces antidepressant-like effects in rats, without affecting male or female sexual behavior.

RATIONALE: Pharmacological treatments for depression are not always effective and produce unwanted side effects. Male and female sexual dysfunction is one of these side effects, which can lead to treatment withdrawal. Combination of two antidepressants with different mechanisms of action, like mirtazapine (MTZ) and venlafaxine (VLF) have been shown to be effective for treatment-resistant depression in humans. Combination of low doses of these drugs may still exert antidepressant-like effects without altering sexual behavior. OBJECTIVES: To investigate the potential antidepressant-like effect of the chronic administration of low doses of MTZ plus VLF combined, as well as its impact on male and female sexual behavior in rats. METHODS: The antidepressant-like effect of a 14-day treatment with combinations of MTZ plus VLF (0/0, 2.5/3.75 or 5/7.5 mg/kg) was assessed in young adult male and female rats in the forced swim test (FST). The 5/7.5 mg/kg MTZ/VLF combination was also tested in the chronic mild stress (CMS) test, in both males and females treated for 21 days. The sexual effects of this last treatment were assessed in sexually experienced males and in gonadally-intact females during proestrus. RESULTS: The 5/7.5 mg/kg MTZ/VLF combination produced an antidepressant-like effect in the FST and reversed the CMS-induced anhedonia in both male and female rats. This combination did not alter male sexual behavior, female proceptive and receptive behaviors or the regularity of the estrous cycle. CONCLUSION: The combination of low doses of MTZ and VLF might be a promising therapeutic alternative to treat depression without affecting the sexual response.

Trends in HIV Prevalence, Sexual Behavior, and Pre-Exposure Prophylaxis Willingness Among Transgender Women: An Analysis of Three Cross-Sectional Studies Conducted Mainly in Shenyang, China, 2014-2019.

Purpose: Although transgender women (TGW) bear the highest HIV burden worldwide, routine surveillance of this group is rare. We aimed to evaluate the trends in health characteristics of Chinese TGW. Methods: Three cross-sectional studies using snowball sampling were conducted in 2014, 2017, and 2019, primarily in Shenyang, China. A questionnaire and voluntary HIV testing were used to obtain information on background characteristics, sexual behaviors, pre-exposure prophylaxis (PrEP) willingness, and HIV status. Results: There were 220 respondents in 2014, 198 in 2017, and 247 in 2019 (average age 31.1±7.6 to 33.5±9.6 years). HIV prevalence significantly decreased from 29.5% (95% confidence interval [CI]: 25.3-38.4%) in 2014 to 19.4% (95% CI: 14.7-24.9%) in 2019 (p<0.05). The proportion of participants reporting condomless anal intercourse (CAI) with any partner fluctuated from 30.8% (95% CI: 25.1-36.1%) to 53.0% (95% CI: 45.8-60.1%). The proportion of participants willing to use PrEP decreased from 86.4% (95% CI: 81.1-90.6%) in 2014 to 62.8% (95% CI: 56.4-68.8%) in 2019. Factors significantly associated with HIV infection were CAI with any partner (multivariate odds ratio [ORm]: 3.58, 95% CI: 1.55-8.29 in 2017; ORm: 3.18, 95% CI: 1.56-6.46 in 2019) and PrEP willingness (ORm: 0.26, 95% CI: 0.12-0.58 in 2017). Conclusion: HIV prevalence and associated risk factors remain substantial among Chinese TGW. There is an urgent need to strengthen HIV surveillance in this population, and develop trans-friendly and effective interventions to minimize HIV prevalence and transmission.

Connecting through touch: Attitudes toward touch in pregnancy are associated with couples' sexual and affectionate behaviors across the transition to parenthood.

Touch is a universal nonverbal action often used by romantic partners to demonstrate affection and care for each other. Attitudes toward touch might be particularly relevant across periods of relational strain-such as the transition to parenthood-when couples face many novel stressors and shifting priorities which can interfere with their sexual and affectionate experiences. New parent couples (N = 203) completed self-report measures online across six time-points (two prenatal). We tested whether couples' attitudes toward touch (touch aversion, touch for affection, touch for emotion regulation) at baseline (20 weeks mid-pregnancy) predicted their frequency of sexual and affectionate behaviors from mid-pregnancy through 12-month postpartum. Both partners' more positive attitudes toward touch (i.e., for affection and emotion regulation) and lower aversive attitudes toward touch, as measured in mid-pregnancy, predicted couples' higher frequency and variety of sexual and affectionate behaviors at 3-month postpartum. Touch attitudes generally did not predict the degree of change in the frequency or variety of sexual or affectionate behaviors, with one exception: non-birthing parents' more positive attitudes toward touch for emotion regulation in mid-pregnancy predicted a slower decline in couples' affectionate behaviors across pregnancy. Findings underscore a link between new parents' attitudes toward touch and their subsequent sexual and affectionate behaviors, particularly in the early postpartum period. New parents need to navigate novel sexual changes and a nonverbal strategy such as touch might be useful to promote intimacy and care.