Exploring psychosocial factors influencing sexually transmitted infection intention testing among medical students: a cross-sectional study in two universities.

Background: Despite the significant global burden of sexually transmitted infections (STI), detection rates are poor. Acceptance of these tests is influenced by several factors that have not been explored among Colombian medical students. Objectives: The aim of this study was to describe the behaviors and psychosocial factors toward STI screening among medical students of two universities in Pereira, Colombia, between March and June 2020. Methods: An observational, cross-sectional study was conducted with 284 medical students in the first 3 years of undergraduate at two universities. An online, self-administered survey was conducted between March 2020 and June 2020, using an instrument from the "STI Testing Questionnaire," to assess behaviors and psychosocial factors toward STI testing. Frequencies and percentages were used for descriptive analysis. The association between characteristics and psychosocial factors with STI testing intention was obtained using a logistic regression model. A p-value <0.05 was accepted as statistically significant for all analyses. Results: A total of 284 medical students participated in this study. The majority were female (56.7%), and 53.2% were from private universities. Eighty-four point 5% (84.5%) had risky sexual behaviors, and only 32.4% reported intentions to be tested for STIs. Among the psychosocial factors, 64.1% reported high social pressure, and 43.0% reported social fear. An association with the intention to undergo STI testing was identified in those who had been previously tested (OR = 2.486; 95% CI: 1.492-4.142) and in those who engaged in risky sexual behaviors (OR = 3.537; 95% CI: 1.437-8.704). Conclusion: Medical students exhibit a high prevalence of risky sexual behaviors but show a disturbing lack of intention to undergo STI screening. Prior experiences significantly influence screening intentions, while social pressure and fear also play a role. These insights can serve as a basis for targeted interventions to improve STI screening rates and enhance sexual health education among Colombian medical students.

Discrimination based on gender identity and decision-making regarding HIV/STI-protected sex, a cross-sectional study among trans and non-binary people in Germany.

BACKGROUND: Trans and non-binary people are often discriminated against. Discrimination has a negative impact on health and may affect sexual health and behavior. We explored the relationship between discrimination based on gender identity and the perceived ability to make decisions about their sex life to feel as protected as desired from HIV and sexually transmitted infections (STI) among trans and non-binary people in Germany. Secondarily, we assessed whether feeling unable of making HIV/STI-protected sex decisions was associated with behaviors related to increased HIV/STI risk. METHODS: We conducted a cross-sectional study using data from the Sexual Health and HIV/STI in Trans and Non-Binary Communities (TASG) survey conducted online between March-July 2022 among trans and/or non-binary people aged 18 years and older living in Germany. We described the prevalence of frequent discrimination based on gender identity. We calculated prevalence ratios (PR) with 95% confidence intervals (95% CI) for the associations between frequent experienced discrimination based on gender identity and feeling unable of making HIV/STI-protected sex decisions, and between feeling unable of making HIV/STI-protected sex decisions and behaviors related to increased HIV/STI risk. RESULTS: Among 3077 participants, 22% reported frequent discrimination based on gender identity. Participants experiencing such discrimination reported 1.4 times more often to feel unable to make HIV/STI-protected sex decisions (PR 1.4, 95% CI 1.1-1.8). This perceived inability was associated with increased prevalence of sex under drug influence (PR 2.9, 95% CI 2.3-3.7) and condomless penetrative sex with multiple partners without PrEP (PR 2.0, 95% CI 1.4-2.9). CONCLUSION: Feeling unable to make decisions to feel protected from HIV/STI among trans and non-binary people was associated with both frequent discrimination and behaviors that increase the HIV/STI risk. Strategies for empowering trans and non-binary people to assert their sexual decision-making needs should be explored.

Sexual behavior stigma and HIV/STI biospecimen self-collection among cisgender gay, bisexual, and other sexually minoritized men in the United States.

INTRODUCTION: Disparities in HIV and other sexually transmitted infections (STIs) persist among cisgender sexually minoritized men in the United States, driven in part by sexual behavior stigma, which is a barrier to clinic-based HIV/STI testing. HIV/STI biospecimen self-collection (HSBS) is a novel testing approach that mitigates stigma by allowing for some testing-related procedures to be conducted by oneself in one's home or any private location rather than a facility that requires interpersonal interactions and exposure to other members of the public. HSBS has demonstrated acceptability, feasibility, and effectiveness in testing uptake, but the extent to which stigma persists in HSBS and the quantification of stigma's role in HSBS is limited. METHODS: From 2019-2020, a nationwide sample of sexually minoritized men completed an online biobehavioral survey. Those who agreed to be recontacted (N = 4147) were invited to participate in HSBS; consented participants received self-collection kits that were laboratory-tested if completed. Sexual behavior stigma and HSBS associations were assessed with logistic regression. RESULTS: Mean age of participants was 35 years, 58% (2421/4147) were non-Hispanic white, 82% (3391/4147) were gay-identifying, 47% (1967/4147) had at least a college degree, and 56% (2342/4147) earned ≥ $40,000 annually; 27% (1112/4147) expressed HSBS interest, and 67% (689/1034) completed HSBS. HSBS interest and completion were less common among non-Hispanic Black sexually minoritized men and sexually minoritized men of lower socioeconomic status. Stigma from family and friends was significantly, negatively associated with HSBS interest (aOR = 0.72, 95% CI = 0.56, 0.93). Among those who had not tested for HIV/STIs in the past year, anticipated healthcare stigma was marginally, negatively associated with HSBS completion (aOR = 0.40, 95% CI = 0.15, 1.07). Among those who had never previously tested for HIV/STIs, anticipated healthcare stigma was significantly, negatively associated with HSBS interest (aOR = 0.32, 95% CI = 0.14, 0.72). CONCLUSIONS: Sexual behavior stigma persists as an HIV/STI testing barrier, even in the case of HSBS, limiting its utilization. Increasing HSBS among sexually minoritized men in the US necessitates stigma mitigation efforts that directly address equity in implementation.

Sexual Health of Young Adults Living with Perinatally Acquired HIV in Paris, France: A Qualitative Study.

We aimed to explore the sexual health of young adults with perinatally acquired human immunodeficiency virus (PHIV). Eighteen to 25 years old PHIV participants were recruited in two tertiary care units in Paris. Sexually transmitted HIV was an exclusion criterion. Individual interviews were conducted. Transcripts were analyzed using a semio-pragmatic phenomenological method. Twenty-five participants were interviewed from March 2022 to September 2022. Some of them renounced being in any romantic relationship. Those who disclosed their HIV status to their romantic partner reported that dating was more complex and those who did not disclose reported that keeping HIV a secret was a significant mental burden. Young men tended to disclose their HIV status to their romantic partner whereas young women did not consider doing so before marriage. Many participants had to educate themselves about sexuality, through school or websites. Identified interlocutors for sexuality varied across participants. All participants were aware of U = U (Undetectable = Untransmittable) slogan. Despite that, participants remained worried about transmitting HIV to their sexual partners. That hindered their sexual satisfaction. In addition, they neglected the risk of unwanted pregnancies or sexually transmitted diseases (STDs). In our study, knowing the U = U slogan did not provide reassurance to PHIV participants regarding the risk of onward HIV transmission. Further, they showed very little concern for protecting themselves from their partner's STD.

Knowledge and attitudes regarding sexually transmitted infections among healthcare workers.

BACKGROUND: Healthcare workers have a fundamental role in providing care and education on sexually transmitted infections (STIs). However, their knowledge is often worryingly limited. This study aimed to assess the real knowledge and attitude regarding STIs among healthcare workers of the IRCCS Ospedale Policlinico San Martino, Genoa, Italy. METHODS: The recruited subjects were asked to complete a 31-item questionnaire, divided into 3 sections: socio-demographic context, knowledge about STIs, and personal sexual behavior. RESULTS: We enrolled 140 subjects, employed as nurses (52.9%), physicians (12.9%), laboratory technicians (7.1%), or other workers (27.1%). Despite the generalized erroneous belief of having a good level of knowledge on the matter, only one-third of the subjects could correctly identify STIs among a list of diseases, and less than one-third correctly recognize all possible ways of transmission. Human immunodeficiency virus (HIV) was the most frequently recognized STI (97%), but only 39.2% of healthcare workers were correctly informed about the body fluids that can transmit the virus. Most participants (93.5%) correctly identified condoms as effective in preventing STIs but did not indicate complete abstinence as the only way to guarantee protection against STIs. Most participants were informed on the oncogenic potential of human papillomavirus (HPV) infections (82%), the usefulness of the Pap test (85.7%), and the existence of vaccines against some STIs (63.5%). CONCLUSIONS: Overall, healthcare workers have limited knowledge about STIs. Creating specific educational programs aimed at healthcare providers should become a priority.

Development of a scale for attitude toward sexually transmitted infections based on the Health Belief Model.

OBJECTIVES: Determination of the attitudes of individuals toward sexually transmitted infections (STIs) can also help identify barriers to health service-seeking behavior. Hence, this study aimed to develop a scale for determining the attitudes of individuals toward sexually transmitted diseases. STUDY DESIGN: This was a methodological study. The Health Belief Model (HBM) framework was used to elucidate the perceptions and interpretations of illnesses among individuals. After reviewing the relevant literature, an item pool was created to include 4 dimensions (perceived susceptibility (A), perceived severity (B), perceived benefit (C), and perceived barriers and self-efficacy (D)) about sexually transmitted diseases from the perspective of HBM. Exploratory factor analysis was conducted to evaluate the construct validity of the scale. Moreover, confirmatory factor analysis was used to examine the suitability of the items in terms of factor structures. RESULTS: The final version of the scale comprised 19 items and 4 subdimensions. The first subdimension of the scale accounted for 20.11% of the total variance, whereas the second, third, and fourth subdimensions accounted for 17.83%, 12.50%, and 8.75% of the total variance, respectively. Collectively, these four subdimensions accounted for 59.19% of the total variance. The Cronbach's alpha reliability coefficient of the scale was found to be 0.74. CONCLUSIONS: Briefly, the present study led to the development of a novel assessment tool, Attitude Toward Sexually Transmitted Infections Scale. Higher scores on the scale indicated higher likelihood of taking action for a possible STI treatment according to the HBM approach.

'Every strategy needs to be contributing to erasing the stigma': Maori and Pacific young people talk about overcoming barriers to testing for sexually transmitted infections.

BACKGROUND: Maori and Pacific young people are disproportionately impacted by sexually transmitted infections (STIs). Access to STI screening is important to reduce transmission and reproductive health complications. METHODS: Between November 2022 and May 2023, we held four wananga (workshops) with Maori and Pacific participants (15-24years old) to find out what barriers they encounter to STI testing, and hear their ideas about how to overcome these. Participants were recruited via youth-focused community organisations in the Wellington region of Aotearoa New Zealand. Inductive thematic analysis was used to understand data generated from discussions, drawing on Maori and Pacific models of wellbeing to frame themes. RESULTS: Thirty-eight participants were involved in the wananga. Barriers to STI testing related to five themes: (1) differences in cultural values and expression; (2) family/friends; (3) educational gaps; (4) psychological factors; and (5) structural obstacles. Suggested strategies to improve access to sexual health care included the need for free, flexible services, education and health promotion activities to reach young people in their spaces (e.g. church, marae, social media). Participants stressed the need for approaches to be community-based, delivered by trusted individuals using culturally appropriate messages, and saw participation in STI testing as beneficial for whanau/family and communities. CONCLUSIONS: To improve access to STI testing, participants described the need for free services, together with education and health promotion to improve inter-generational sexual health knowledge. Reframing messages around STIs to align with Maori and Pacific models of wellbeing was identified as a way to normalise conversations, in turn reducing the stigma surrounding STI testing.

Sexual health behaviours and partner notification practices related to sexually transmitted infections in young adults in Ireland.

BACKGROUND: Sexually transmitted infections (STIs) impose burdens on individuals and communities, while their prevalence in young people has risen continually in recent years. Partner notification is an effective public health strategy which can limit STI transmission. AIMS: This study aimed to explore young adults' sexual health behaviours, attitudes toward STI testing, and feelings toward visiting a sexual health clinic. It also aimed to investigate preferences for partner notification and the role of self-efficacy in people's intentions to notify a partner for STIs including the human immunodeficiency virus (HIV). METHODS: A quantitative, cross-sectional design was applied. Participants were 400 adults aged 18-34 years (M = 23 years; SD = 4.27), recruited from the Republic of Ireland. RESULTS: Over half of the participants reported never being tested for STIs. These young people placed less importance on undergoing regular STI testing and testing after unprotected sex than their counterparts who had been tested for STIs. Self-efficacy was significantly associated with intentions to notify partner(s) for STIs including HIV. CONCLUSIONS: As STIs are becoming increasingly prevalent in young adults, it is important to gain a deeper understanding of the interventions used to break the transmission chain and how different beliefs and attitudes may affect them. Self-efficacy was a key component in PN intentions, suggesting that the belief in someone's ability or skillset to perform a sexual health behaviour is positively related to their intention to perform the behaviour.

Delay discounting of protected sex and compulsive sexual behavior in women with borderline personality disorder.

Background and aims: Borderline personality disorder (BPD) is a complex mental health condition characterized by emotional dysregulation, impulsivity, and unstable interpersonal relationships. Some individuals with BPD regularly engage in sexual risk behavior such as unprotected sex and are at higher risk of contracting sexually transmitted infections. This study investigates discounting of condom- or dental dam-protected sex in women with BPD compared with a control group. Methods: Data were collected from 40 women diagnosed with BPD and 40 healthy controls with an average age of 27.28 years (SD = 6.14) using the Sexual Delay Discounting Task (SDT), the Borderline Symptom List-23 (BSL-23), and the Compulsive Sexual Behavior Disorder Scale-19 (CSBD-19). Results: Women with BPD were less likely to use an immediately available condom or dental dam and more likely to discount safer sex than controls. Partner desirability and the perceived STI risk influenced the participants' likelihood of having protected sex. Women with BPD showed more symptoms of compulsive sexual behavior (CSB) than controls. However, sexual delay discounting was not significantly correlated with borderline symptoms or CSB in the BPD group. Discussion and conclusions: These findings contribute to our understanding of sexual impulsivity in women with BPD and highlight the omission and delayed availability of safety measures as important contributors to sexual risk behavior and STI risk in women. Impulsive sexual behavior, as well as the accompanying sexual health concerns, should receive special attention in the treatment of women with BPD.

Uso de condón en jóvenes chilenos: El rol de los determinantes sociales, roles de género y salud mental / Condom use among young Chileans: The role of social determinants, gender roles and mental health

ANTECEDENTES: Pese a las diversas estrategias implementadas en materia de educación sexual y prevención de ITS, las cifras de la Décima Encuesta Nacional de Juventud revelan que poco más de la mitad de los jóvenes utilizaron condón en su última relación sexual. Se han descrito diversos predictores sociodemográficos, culturales y psicológicos, pero no se observan estudios recientes en Chile que los aborden. Objetivo: Examinar la relación de determinantes sociales, roles de género y sintomatología de salud mental con el uso de condón en jóvenes chilenos. MATERIAL Y MÉTODOS: Se utilizaron datos secundarios emanados de la Décima Encuesta Nacional de Juventud. La muestra analítica estuvo compuesta por 5.507 jóvenes que habían iniciado su vida sexual. Se realizaron modelos de regresión logística binomial múltiple a través de estimaciones de datos basadas en encuestas. RESULTADOS: Los jóvenes de mayor edad, las mujeres, las personas que se identifican con alguna etnia, quienes están en una relación de pareja y aquellos diagnosticados con alguna ITS tienen menos probabilidad de usar condón en su última relación sexual. CONCLUSIÓN: Las características individuales contribuyen a explicar la adherencia a conductas preventivas, pudiendo reflejar dinámicas subyacentes con factores psicológicos y culturales que deben ser analizados. Identificar los factores socio estructurales, culturales y psicológicos asociados a las conductas sexuales preventivas y de protección debería transformarse en una prioridad sanitaria, ya que permite diseñar e impulsar campañas de comunicación social más efectivas.

BACKGROUND: Despite various strategies implemented to promote sexual education and prevent sexually transmitted infections (STIs), the 10th National Youth Survey revealed that slightly more than half of young people in Chile used a condom during their last sexual encounter. While several sociodemographic, cultural, and psychological predictors have been described, recent studies specific to Chile are scarce. AIM: To examine the relationship between social determinants, gender roles, and mental health symptoms with condom use in young Chileans. MATERIAL AND METHODS: Secondary data from the 10th National Youth Survey were analyzed. The analytical sample comprised 5,507 young people who had started their sexual life. Multiple binomial logistic regression models were run using survey-based data estimates. RESULTS: Older youth, women, people who identify with any ethnicity, those in a dating relationship, and those diagnosed with an STI are less likely to use a condom at last intercourse. CONCLUSION: Individual characteristics can explain adherence to preventive behaviors and may reflect underlying psychological and cultural factors. Identifying socio-structural, cultural, and psychological factors associated with preventive and protective sexual behaviors should be a health priority, as it enables the design and promotion of more effective social communication campaigns.

[Condom use among young Chileans: The role of social determinants, gender roles and mental health]. / Uso de condón en jóvenes chilenos: El rol de los determinantes sociales, roles de género y salud mental.

BACKGROUND: Despite various strategies implemented to promote sexual education and prevent sexually transmitted infections (STIs), the 10th National Youth Survey revealed that slightly more than half of young people in Chile used a condom during their last sexual encounter. While several sociodemographic, cultural, and psychological predictors have been described, recent studies specific to Chile are scarce. AIM: To examine the relationship between social determinants, gender roles, and mental health symptoms with condom use in young Chileans. MATERIAL AND METHODS: Secondary data from the 10th National Youth Survey were analyzed. The analytical sample comprised 5,507 young people who had started their sexual life. Multiple binomial logistic regression models were run using survey-based data estimates. RESULTS: Older youth, women, people who identify with any ethnicity, those in a dating relationship, and those diagnosed with an STI are less likely to use a condom at last intercourse. CONCLUSION: Individual characteristics can explain adherence to preventive behaviors and may reflect underlying psychological and cultural factors. Identifying socio-structural, cultural, and psychological factors associated with preventive and protective sexual behaviors should be a health priority, as it enables the design and promotion of more effective social communication campaigns.

Sexual Behavior and Health From Adolescence to Adulthood: Illustrative Examples of 25 Years of Research From Add Health.

Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health.

Factors associated with condom use behaviour among young university students / Fatores associados ao uso de camisinha entre jovens universitários / Factores asociados con el uso del condom entre jóvenes universitarios

As the rates of sexually transmitted infections among Brazilian youth rise, college students present with low rates of condom use. Understanding which factors affect preventive behaviours may assist in promoting them. This study aimed to test the Theory of Planned Behaviour (TPB) as a model of condom use behaviour among young university students. Data on sexual behaviour, TPB, and personality variables were collected online with 343 sexually active students aged between 18 and 29. Seventy participants also provided follow-up data after 30 days. Structural equation models and ordinal regressions were used to analyse the effects of TPB variables on condom use behaviour. Attitude was the main predictor of behavioural intention in the cross-sectional and longitudinal models. Being in a relationship and lower age at sexual debut were also associated with less frequent condom use behaviour in the cross-sectional analysis. Behavioural intention and perceived control were associated with condom use behaviour. (AU)

Enquanto a incidência de infecções sexualmente transmissíveis cresce entre jovens brasileiros, universitários apresentam pouco uso de preservativos. Compreender quais fatores afetam a adoção de comportamentos preventivos pode auxiliar na sua promoção. Esse estudo testou a Teoria do Comportamento Planejado (TCP) como modelo de uso de camisinha entre jovens universitários. Foram coletados dados sobre comportamento sexual, TCP, e personalidade em questionário online com 343 estudantes sexualmente ativos entre 18 e 29 anos de idade. Setenta participantes também responderam ao follow-up após 30 dias. Modelos de equações estruturais e regressões ordinais foram usados para analisar os efeitos das variáveis da TCP no uso de preservativo. Atitude foi o principal preditor da intenção comportamental nos modelos transversal e longitudinal. Estar em um relacionamento e menor idade na primeira relação sexual também foram associados a uso menos frequente de preservativo na análise transversal. Intenção comportamental e controle percebido foram associados com uso de preservativo. (AU)

Mientras la incidencia de infecciones de transmisión sexual aumenta entre los jóvenes brasileños, los estudiantes universitarios reportan poco uso de preservativos. Comprender qué factores inciden en la adopción de conductas preventivas puede ayudar en su promoción. Este estudio probó la Teoría del Comportamiento Planeado (TCP) como modelo de uso de preservativos entre jóvenes universitarios. Los datos sobre comportamiento sexual, TCP y personalidad fueron recopilados en un cuestionario en línea con 343 estudiantes sexualmente activos entre 18 y 29 años. Setenta participantes también respondieron al seguimiento después de 30 días. Se utilizaron modelos de ecuaciones estructurales y regresiones ordinales para analizar los efectos de las variables de TCP sobre la utilización del condón. La actitud fue el principal predictor de la intención en los modelos transversal y longitudinal. Estar en una relación y una edad más temprana en la primera relación sexual se asociaron con el uso menos frecuente de preservativo en el análisis transversal. La intención conductual y el control percibido se asociaron con el uso de condones. (AU)

Women empowerment and sexually transmitted infections: Evidence from Bangladesh demographic and health survey 2014.

BACKGROUND: Sexually transmitted infections (STIs) among women have led to substantial public health and economic burdens in several low-middle-income countries. However, there is a paucity of scientific knowledge about the relationship between empowerment and symptoms of STIs among married Bangladeshi women. This article aimed to examine the association between women empowerment and symptoms of STIs among currently married Bangladeshi women of reproductive age. MATERIALS AND METHODS: We extracted data from the Bangladesh Demographic and Health Survey (BDHS), conducted from June 28, 2014, to November 9, 2014. We utilised cross-tabulation, the conceptual framework and multivariable multilevel mixed-effect logistics regression to explore the association between women's empowerment indicators and women's self-reported symptoms of genital sore and abnormal genital discharge. All of the analysis was adjusted using cluster weight. RESULTS: We found that among 16,858 currently married women, 5.59% and 10.84% experienced genital sores and abnormal genital discharge during the past 12 months, respectively. Women who depended on husbands to make decisions regarding their health care (AOR = 0.75, 95% CI = 0.67-0.84), significant household purchases (AOR = 0.79, 95% CI = 0.71-0.88), and visiting family or relatives (AOR = 0.72, 95% CI = 0.64-0.80) were less likely to report signs of abnormal genital discharge. Women who could make joint healthcare decisions with their husbands were also less likely to report genital sores (AOR = 0.78, 95% CI = 0.67-0.90). CONCLUSION: Genital sores and abnormal genital discharge were prevalent across all parameters of women empowerment among currently married women in Bangladesh. Our estimates show that the husband plays a significant role in decision-making about sexual and reproductive health. Efforts need to be invested in establishing culturally relevant gender policies which facilitate the involvement of women in joint decision-making.

"Sex is supposed to be naturally more pleasurable": Healers as providers of holistic sexual and reproductive healthcare in Uganda.

Global health researchers often approach Traditional, Complementary, and Alternative Medicine (TCAM) from a health efficacy perspective, asking whether the presence of plural medical systems helps or hinders the uptake of biomedicine. Medical anthropologists, by contrast, typically emphasize how plural medical systems encourage us to rethink health ontologies-that is, who and what comes to constitute the experience of health and illness, and through which practices. Building on both approaches, we explore the role of "healers," a term we use to encompass several different kinds of TCAM providers, in the sexual and reproductive healthcare (SRH) of young people from southcentral Uganda, a region well known as an HIV/AIDS epicenter. Drawing from ethnographic data, we describe three reasons that young people seek SRH from healers. First, they associate stigma, scarcity, and high costs with biomedical SRH. Second, healers work across biomedical and non-biomedical therapeutic divides, prescribing herbs for sexually transmitted infections while simultaneously referring clients to biomedical HIV clinics. Third, healers provide counseling focused on pleasurable and economically-motivated sex. Because these therapies diverge from international and national HIV prevention messaging that frames non-marital and transactional sex in terms of danger and disease, healers' holistic approach to SRH may help to reconstitute the meaning, practice, and experience of "sexual health" in contemporary Uganda. This has important implications for improving global SRH programs and for understanding the continued appeal of TCAM more generally.

Intervención lúdica para la prevención de enfermedades de transmisión sexual / Playful intervention for the prevention of sexually transmitted diseases

Las estrategias preventivas para las enfermedades de transmisión sexual en poblaciones jóvenes, se han convertido en una prioridad de salud pública. Los adolescentes y adultos jóvenes, se han identificado como los que tienden a participar más frecuentemente, en actividades sexuales riesgosas; dentro este grupo de población, se encuentran en su mayoría los estudiantes universitarios, de ahí que no solo los sistemas de salud deben dar respuesta a esta situación, también las distintas organizaciones educativas. Por tanto, se realizó un estudio descriptivo de corte transversal en dos universidades peruanas, con el objetivo de evaluar la percepción de la participación en un programa de intervención lúdica sobre el conocimiento y actitudes preventivas hacia las enfermedades de infección sexual. La muestra estuvo conformada por 149 participantes, de ellos 51,68% masculinos y 43,28% femeninas. Se realizó la valoración de la intervención mediante la escala de Likert y la intencionalidad conductual a través de la prueba T de comparación de medias. Los resultados mostraron, luego de la aplicación de las 16 actividades lúdicas, significacia estadística sobre mejora del conocimiento y la intencionalidad de cambios conductuales positivos en torno a la práctica de sexualidad responsable, además de la importancia de abordar la temática con información clara y precisa. Se concluye que las estrategias lúdicas son efectivas para la concientización sobre la prevención de ETS y embarazos no deseados; además se puede utilizarse para reforzar conocimientos, prácticas e inducir mejoras en las actitudes contra la estimagtización de las personas que viven con ETS(AU)

Application of Integrated Behavioral Model (IBM) to measure intention to get early screening and treatment of Sexually Transmitted Infections (STIs) among HIV at- risk sub-populations in Ethiopia.

BACKGROUND: Sexually Transmitted Infections (STIs) increase the risk of contracting Human Immunodeficiency Virus (HIV). Hence, early screening and treatment of STIs as a behavioral practice will reduce the odds of HIV infection among at risk and vulnerable sub-populations. To that end, HIV prevention strategies need to design evidence-based interventions using behavioral models or theories to help at-risk individuals adopt early screening and treatment of STI as preventive health behavior. In this study, commercial sex workers were considered as HIV at-risk sub-populations. OBJECTIVE: Measuring to what extent that Integrated Behavioral Model constructs explain individuals' intention to practice early screening and treatment of sexually transmitted infections as healthy behavior of interest in HIV prevention. DESIGN: Integrated Behavioral Model (IBM) measurement survey was conducted using Respondent Driven Sampling (RDS) in six towns located in the main transport corridors of Ethiopia. Respondents' answers to model construct-based questions and intention to practice the health behavior of interest were measured using Likert Scale. Analysis was done to assess the correlation and level of association of model construct-based questions with intention to practice the preventive health behavior. RESULTS: Respondents' attitude explained 32%, perceived control 2%, normative influence 21%, and self-efficacy 53 % of their intention to get early screening and treatment of sexually transmitted infections. CONCLUSION: Self-efficacy explained the variability of respondents' intention to get early screening and treatment of STIs most, while perceived control was the least. Hence, HIV prevention behavioral interventions targeting early screening and treatment of STIs should give high emphasis to self-efficacy.

Sexually transmitted infection (STI) research priority-setting: a two-stage study including the perspectives of patients, the public, clinicians and stakeholders.

OBJECTIVES: Patient and public involvement (PPI) in research priority-setting remains limited, especially for non-HIV STI. We identify and compare the top 10 patient and public STI research priorities with those of clinicians and STI stakeholders. METHODS: This two-stage study was conducted in May-August 2019. First, STI research priorities were canvassed through qualitative questionnaires issued to all patients attending a large sexual health clinic, all clinicians in region-wide mailing lists, all stakeholders identified through existing networks and the Charity Commission database, and to the Liverpool public. Raw responses were organised by theme into a shortlist of 25. In stage 2, these were ranked through priority-setting activities by telephone with patients and the public (n=8) and some clinicians (n=3), and in two workshops with clinicians (n=26) and stakeholders (n=5), respectively. The top 10 priorities were compared. RESULTS: Of 373 surveys submitted, 106 were analysed (83 patient and public; 23 clinician and stakeholder). Exclusions included lack of completion and responses out of scope. Among patient and public respondents, 55% (n=46) were aged 18-24 years, 51% (n=42) identified as heterosexual women and 23% (n=19) as men who have sex with men. Clinicians included all cadres; stakeholders were academics, commissioners and third sector representatives. In stage 2, 4 of 10 themes (STI education, targeted services for high-risk groups, antibiotic resistance and counselling for those with STI) were prioritised by all. Remote STI services and rapid diagnostics also ranked highly but the rationale differed between groups. CONCLUSION: This is the first non-HIV STI research priority-setting exercise to be reported in the UK. It identifies overlaps and differences between public and provider concerns, highlights gaps in the public understanding of STI research, and shows how PPI can promote research responsive to the concerns of both those who use and deliver services.