Spanish Validation of the Brief Pornography Screen Within a Clinical Sample of Individuals with Gambling Disorder.

Problematic pornography use (PPU) shares characteristics with behavioral addictions, such as gambling disorder (GD), and PPU and GD may frequently co-occur. In order to fill existing gaps in screening instruments for PPU validated in GD, the study examined the psychometric properties of the Spanish version of the Brief Pornography Screen (BPS) within a clinical sample of individuals with GD. A total of 200 individuals seeking treatment for GD were consecutively recruited. The psychometric properties of the BPS were examined by performing confirmatory factor analysis (CFA) and testing for evidence of convergent and discriminant validity. The CFA supported a one-factor solution showing high internal consistency (α = 0.81). The BPS showed convergent validity and correlated with psychological distress, general psychopathology, impulsive tendencies, and low self-directedness. The BPS demonstrated adequate psychometric properties and is therefore recommended as a brief screening tool for identifying probable PPU in individuals seeking treatment for GD.

HIV incidence and its associated factors among young adults with multiple sexual partners in Maputo, Mozambique: a vaccine preparedness study.

INTRODUCTION: Sub-Saharan Africa has a high burden of HIV, particularly among female sex workers (FSW) and men who have sex with men (MSM). Future clinical trials to evaluate vaccines and other interventions to prevent HIV will need to enroll populations with high HIV incidence. We conducted an observational study of HIV incidence among men and women with multiple sexual partners-including MSM and FSW-in Maputo, Mozambique, in order to prepare the country to conduct future efficacy trials of candidate HIV vaccines and other HIV prevention products. METHODS: We conducted a prospective observational HIV incidence study in Maputo, Mozambique, that enrolled adults aged 18-35 years, without HIV, who had two or more sexual partners in the preceding three months. Recruitment strategies prioritized participation of MSM and FSW. Participants were followed for 24 months with HIV-1 testing every 3 months and staff-administered behavioral questionnaires every 6 months. Cox proportional hazard modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV acquisition. RESULTS: From January 2014 to October 2017, 505 adults without HIV were enrolled with median age of 21 years (interquartile range:19-24); 41% were female and 82% were single. There were 19 HIV seroconversions (10 female and 9 male) during 943 person-years (PY) of observation (overall HIV incidence 2.02/100PY; 95%CI 1.21-3.15). The highest HIV incidence was observed among sex workers (2.08/100PY; 95%CI 0.25-7.52) and MSM (19.18/100PY; 95%CI 3.96-56.06). Increased hazard of incident HIV was observed among participants who were MSM (HR = 27.95, 95%CI 4.39-117.94), p = 0.0004), reported three or more sexual partners at enrollment (HR = 7.39, 95%CI 1.64-33.25, p = 0.009), and indicated ever having a sexual partner living with HIV (HR = 9.64, 95%CI 2.23-41.71, p = 0.002). CONCLUSION: Our findings may inform inclusion criteria for upcoming clinical trials of HIV prevention interventions, including vaccine candidates, which may prioritize enrollment of MSM, people with more than three sexual partners, and people with sexual partners who are living with HIV. These same populations are in need of further intervention to reduce HIV incidence.

A Digital Sexual Health Intervention for Urban Adolescent and Young Adult Male Emergency Department Patients: User-Centered Design Approach.

BACKGROUND: Adolescents and young adults frequently present to the emergency department (ED) for medical care and continue to have many unmet sexual health needs. Digital interventions show promise to improve adolescent and young adult sexual health; yet, few interventions focus on male ED patients, despite their infrequent use of contraceptives and rising rates of sexually transmitted infections. OBJECTIVE: This paper describes the design and development of Dr. Eric (Emergency Room Interventions to Improve Care), a digital app focused on promoting condom use among sexually active adolescent and young adult male ED patients. METHODS: This study followed 4 phases of app development, which were based on user-centered design and the software development lifecycle. In phase 1, define, we explored our target population and target health problem (infrequent condom use among male ED patients) by collecting key stakeholder input and conducting in-depth interviews with male patients and urban ED medical providers. In phase 2, discover, we partnered with a digital product agency to explore user experience and digital strategy. In phase 3, design, we refined Dr. Eric's content, a 5-part sexual health educational module and a 10-week SMS text messaging program that focuses on condom use and partner communication about effective contraceptives. We conducted semistructured interviews with male adolescent and young adults to gather feedback on the app and perform usability testing, editing the app after each interview. We also interviewed informatics experts to assess the usability of a high-fidelity prototype. Interviews were recorded and analyzed via descriptive thematic analysis; informatic expert feedback was categorized by Nielsen's heuristic principles. In phase 4, develop, we created the technical architecture and built a responsive web app. These findings were gathered leading to the final version of the digital Dr. Eric program. RESULTS: Using data and key stakeholder input from phases 1 and 2, we iteratively created the Dr. Eric prototype for implementation in the ED setting. Interviews with 8 adolescent and young adult male ED patients suggested that users preferred (1) straightforward information, (2) a clear vision of the purpose of Dr. Eric, (3) open-ended opportunities to explore family planning goals, (4) detailed birth control method information, and (5) games presenting novel information with rewards. Five usability experts provided heuristic feedback aiming to improve the ease of use of the app. These findings led to the final version of Dr. Eric. CONCLUSIONS: Following these mobile health development phases, we created a digital sexual health mobile health intervention incorporating the principles of user experience and interface design. Dr. Eric needs further evaluation to assess its efficacy in increasing condom use among adolescent and young adult male ED patients. Researchers can use this framework to form future digital health ED-based digital interventions.

Sibling sexual abuse: What do we know? What do we need to know? Stage 1 analysis of a 2-stage scoping review.

BACKGROUND: Sibling sexual abuse is a common form of intra-familial sexual abuse, yet it remains under-studied and under-recognised, leaving many children unprotected and unsupported. Practitioners need rigorously conducted evidence syntheses to inform decision making in this complex practice area. OBJECTIVE: A scoping review was conducted with the broad research question: What is known about sibling sexual abuse? in order to map the research and to establish areas of knowledge and gaps requiring attention. METHOD: The review followed the guidelines of Arksey and O'Malley (2005), and through searches of 11 academic databases, 3 grey literature databases, journal handsearch and Google, identified 91 empirical papers for review. RESULTS: While poorly and inconsistently defined, sibling sexual abuse is a common form of child sexual abuse with significant consequences for the whole family. It may involve children of any age and sex, entail the full range of sexual behaviours, and can take place in families from across the socioeconomic spectrum. Disclosure is uncommon during childhood, with multiple barriers including the nature of the caregiving environment in which sibling sexual abuse often takes place. Official records are likely to under-report the frequency and duration of the abuse. CONCLUSIONS: There is considerable scope for further research across all aspects of sibling sexual abuse. This paper represents the most comprehensive (albeit not complete) overview of the current body of knowledge in this field to date, and presents key findings as well as a summary of practice and research recommendations.

Self-reported sexually transmitted infections and associated risk factors among female university students.

Background: The spread of sexually transmitted infections (STIs) is an ongoing public health challenge, and awareness of risk factors is essential for designing effective preventive interventions. This study aimed to assess self-reported STI occurrences and identify risk factors and sexual behaviors associated with STIs among female university students. Methods: This is a cross-sectional, online questionnaire study, including 384 female university students seeking contraceptive counseling at a gynecology clinic in Uppsala, Sweden, and reporting having had sex. Associated risk factors and behaviors were assessed by comparing those who reported STIs and those who did not. Results: The mean age of participants was 22.8 years. Seventy-eight (20%) had contracted at least one STI, with seven (9%) experiencing multiple infections. Seventy-three (94%) reported first-date sexual activity without a condom among STI experienced. Chlamydia trachomatis was the most common STI pathogen (68% of all infections), followed by Herpes simplex virus (18%) and Mycoplasma genitalium (13%). Behavioral factors associated with self-reported STIs were first-date sexual activity without a condom, not using condom at first intercourse, younger age at first intercourse, a higher number of sexual partners overall and in the last 12 months, experience of anal sex, dating app usage, and regretting sexual activity after substance use (P < 0.003 for all). Conclusions: Condom use was low among the respondents, and STIs were common regardless of the high level of education in this group. Contraceptive counseling needs to highlight the importance of condom use in addition to contraceptive efficacy. It is also essential to consider the specific risk factors and behaviors prevalent among young adults to reduce the spread of STIs.

Mounting exhibited between cows is not associated with sexual motivation.

Females of various species exhibit mounting behavior toward other mature females, i.e., female-female (f-f) mounting. Cows exhibit f-f mounting, which is commonly considered a sexual behavior based on a few similarities with male sexual mounting. Here, we hypothesized that the degree of f-f mounting exhibited by cows in estrus would increase when they are sexually motivated by sexually relevant stimuli. To test this hypothesis, two groups of four cows each were prepared. First, estrus was induced in one of the cows in each group by injecting estradiol in the presence of a non-sexually active male steer as a stimulus animal (steer-stimulus condition), and all f-f mounts were recorded. Estrus induction was repeated until induced in all cows. We then changed the stimulus animal from the steer to a sexually active bull (bull-stimulus condition), and the estrus induction procedures were repeated as before. We confirmed that estrus was induced successfully in cows injected with estradiol and that they were sexually motivated by switching the stimulus animal from steer to bull, as they spent relatively more time with the stimulus animal in the bull-stimulus than in the steer-stimulus condition and when not in estrus. However, f-f mounting frequency in the bull-stimulus condition showed no significant difference to that in the steer-stimulus condition. We observed that six of the eight subjects exhibited f-f mounting when not in estrus, which accounted for 44.6 % of f-f mounting we observed (n = 668). These findings suggest that f-f mounting in cows is not associated with sexual motivation.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Typological classification of attitudes toward premarital sexual behavior among Chinese undergraduates.

BACKGROUND: Premarital sexual behavior (PSB) is a controversial topic in China. However, in recent times, changes in attitudes have led to PSB being more common among college students. This study investigated the attitudes of Chinese undergraduates toward PSB to identify whether a typological classification exists among them. METHODS: A total of 278 undergraduate students from two public universities in Mainland China completed a 17-item survey that included five dimensions( emotions, responsiveness, sexual health, sexual freedom, and condemnation) on attitudes toward PSB. Data were collected online from April 2023 to July 2023. RESULTS: The PSB questionnaire demonstrated good reliability and construct validity in this study, with a Cronbach's α of 0.759 and a KMO value of 0.769. Meanwhile, a series of models were estimated specifying one through five latent classes and three typologies on the attitude were identified: "Affective,""Avoidant," and "Open." After the best fitting model was determined, multiple analysis of variance testing of different factors such as gender, year of study and where one came from were found to have significant effects on attitude complexity (p < .01). CONCLUSION: This research will contribute to the dissemination of information on PSB in China, which will be helpful in understanding relevant issues associated with PSB.

Sexual choking/strangulation and its association with condom and contraceptive use: Findings from a survey of students at a university in the Midwestern United States.

INTRODUCTION: Consensual sexual choking has become prevalent among young United States (US) adults. In sex between women and men, women are overwhelmingly the ones choked, perhaps reproducing traditional heteronormative power dynamics. No research has examined the relationship between being choked during consensual sex and the use of external condoms and other contraceptives. METHODS: We administered a cross-sectional campus-representative survey to 4989 undergraduate students at a large public Midwestern US university. RESULTS: Half of respondents (n = 1803) had ever been choked during sex. Having been choked was associated with a significantly lower likelihood of event-level condom use (OR = 0.32 [0.19, 0.54] for >5 times lifetime choking among men and OR = 0.35 [0.27, 0.45] for >5 times lifetime choking among women compared to those with no choking experiences) and in the past 6 months (OR = 0.42 [0.24, 0.72] for >5 times lifetime choking among men and OR = 0.59 [0.43, 0.81] for >5 times lifetime choking among women compared to those with no choking experiences). Also, having ever been choked was associated with a significantly greater likelihood of having used an implant/intra-uterine device in the past 6 months (OR = 1.85 [1.28, 2.68] for >5 times lifetime choking compared to those with no choking experiences). CONCLUSION: Recognition that sexual choking is prevalent among young people has only recently emerged and educational programs are lacking. Study findings could be used to engage people in discussions about choking in relation to gender, power, and reproductive health agency.