Risky sexual behavior and associated factors among out-of-school youths in Addis Ababa, Ethiopia; mixed methods study.

INTRODUCTION: Sexual risky behaviors, as defined by the World Health Organization, encompass a spectrum of sexual activities that heighten the likelihood of negative outcomes related to sexual and reproductive health. Despite the implementation of various healthcare programs and interventions, youths continue to encounter challenges in accessing reproductive health services. Consequently, they remain vulnerable to engaging in high-risk sexual behaviors; 50.36% of adolescents in Ethiopia. Therefore, this study was aimed to determine the prevalence of risky sexual behavior and associated factors among out-of-school Youths in Addis Ababa, Ethiopia; 2023. METHODS: A community based cross sectional mixed methods study was conducted among 701 youths in Addis Ababa from September 1st to 30th, 2023. The quantitative data were collected through face to face interview using a pre-tested structured questionnaire, while qualitative data were gathered through in depth interviews and focus group discussions. For the quantitative study, the study samples were chosen using systematic sampling. Conversely, purposive sampling was employed for the qualitative study. Variables with P-value ≤ 0.25 in the bivariate analysis were considered as candidates for the multivariable analysis. Statistical significance was declared at a P-value less than 0.05. RESULTS: The prevalence of risky sexual behavior among out of school students in Addis Ababa was 40.6% (95%CI: 36.8, 44.1). Age 15-19 years (AOR: 2.52; 95%CI: 1.61, 3.94), being female (AOR: 2.84; 95%CI: 1.93, 4.18), fathers who were unable to read and write (AOR: 4.13; 95%CI: 2.04, 8.37), alcohol consumption (AOR: 2.07; 95%CI: 1.33, 3.19), peer pressure (AOR: 2.59; 95%CI: 1.81, 3.72), live together with either of biological parent (AOR: 2.32; 95%CI: 1.52, 3.55), watching pornography (AOR: 2.10; 95%CI: 1.11, 3.97) and parental monitoring (AOR: 0.59; 95%CI: 0.39, 0.90) were factors associated with risky sexual behavior. CONCLUSION AND RECOMMENDATIONS: A lower prevalence of risky sexual behavior compared to prior research efforts. Age, gender, educational level of the husband, alcohol consumption, peer pressure, living arrangements, exposure to pornography, and family monitoring emerged as significant factors associated with risky sexual behavior. Therefore, government should prioritize strategies to reduce substance use, mitigate the impact of watching pornography, and enhance parent-youth connectedness.

Prevalence of risky sexual behavior and associated factors among Injibara University students, Northwest Ethiopia.

Introduction: Engaging in risky sexual behaviors can lead to HIV infection, sexually transmitted infections, and unintended pregnancy among youths. University students had greater sexual risks for many reasons. Therefore, this study aimed to assess the magnitude and associated factors of risky sexual behaviors among regular undergraduate students at Injibara University, Northwest Ethiopia. Methods: A cross-sectional study was conducted at Injibara University from 20 January to 30 2020. Multistage sampling was employed to select 770 students. Data were collected using a semistructured self-administered questionnaire. A binary logistic regression model was used to identify factors associated with risky sexual behavior. Adjusted odds ratios with 95% CIs were determined, and variables with P-values <0.05 were considered significant. Result: A total of 770 students participated in the study, providing a response rate of 100%. In this study, 294 (38%, 95% CI: 35%, 42%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with not tested for HIV (AOR = 1.62, 95% CI: 1.15-2.31), peer pressure (AOR = 1.90, CI: 1.37-2.64), basic HIV knowledge (AOR = 2.16, CI: 1.65-2.89), substance use (AOR = 3.56, CI: 2.11-6.06), watching pornography videos (AOR = 1.58, CI: 1.11-2.23), and HIV risk perception (AOR = 1.37, CI: 1.02-1.91). Conclusion and recommendation: A substantial proportion of university students in this study engaged in unsafe sexual behavior. Risky sexual behaviors are more likely to occur when students are under peer pressure, use substances, have no perceived HIV risk, watch pornography, and have inadequate basic HIV knowledge. Therefore, tailored strategic interventions such as life skill training should be designed to bring about positive behavioral changes among university students.

Prevalence and Predictors of Risky Sexual Behavior Among Young Men in India: Evidence From National Family Health Survey.

Objective: The study examines the prevalence and factors associated with high-risk sexual behavior among sexually active young Indian men. Methods: This study used samples of 14,584 men aged 15 to 29 from the National Family Health Survey (NFHS-5), 2019-21. Results: 14% of men engaged in early sexual debut (<18 years), 68% had unprotected sex, and 4% had multiple sexual partners in the past 12 months. Age, marital status, educational attainment, occupation, wealth quintile, alcohol consumption, internet use, media exposure, and region were significant predictors of risky sexual behavior. Conclusions: We suggest a tailored approach for effective policy design considering risk factors of risky sexual behavior.

Risky Sexual Behavior and Psychopathy: Testing the Relationship in a Non-Clinical Sample of Young Adults in Hong Kong.

This study aims to investigate the relationship between risky sexual behavior (RSB) and psychopathy in a non-clinical sample of 714 Hong Kong adults, shedding light on sex differences. Our findings reveal that males exhibit significantly higher mean levels of RSB (general, penetrative, and nonpenetrative), as well as egocentric (Factor 1) and callous (Factor 3) traits of psychopathy, along with increased sexual desire compared to females. Regression analyses indicate that elevated levels of antisociality (Factor 2) and callousness (Factor 3) traits of psychopathy, along with sexual desire, emerge as significant risk factors for engaging in general, penetrative, and nonpenetrative RSB. Intriguingly, higher age and being in a long-term relationship are associated with RSB. The implications of this study suggest potential avenues for reducing, if not entirely preventing, the inclination to engage in RSB in the presence of psychopathic traits.

Associations Between Negative Body Image and Sexual Health Practices in Emerging Adults from Malaysia.

Past findings on the association between negative body image and sexual health behaviors have been mixed and mostly derived from Western samples. The aim of the current study was to examine associations between indices of negative body image and sexual health practices that reduce the risk of disease transmission in emerging adults, and whether these associations are moderated by gender. Using an online survey, a convenience sample of 584 Malaysian adults aged 18-30 years (230 men, 354 women) completed measures of satisfaction with overall appearance, body size dissatisfaction, weight satisfaction, height satisfaction, and genital image evaluation. They also reported if they ever had partnered sex, condomless sex, and been screened for human immunodeficiency virus (HIV), as well as their lifetime number of penetrative sex partners. Hierarchical logistic and ordinal regression analyses indicated that more positive genital image evaluation, but not the other body image indices, was significantly associated with having had partnered sex and fewer lifetime penetrative sex partners. None of the body image indices were significantly associated with condomless sex. All associations were consistent across men and women. For HIV testing, a significant interaction between genital image evaluation and gender emerged. However, this was reduced to non-significance after controlling for the number of penetrative sex partners. Overall, our findings underline the importance of promoting improved genital image in interventions aimed at increasing positive sexual health behaviors.

Parental practices as predictors of adolescents' compulsive sexual behavior: a 6-month prospective study.

Compulsive sexual behavior (CSB) is a prevalent disorder among adolescents. To date, most studies focused on the self-report assessment of individuals without assessing possible parental practices that might alleviate or exacerbate adolescents' CSB. In the present research, I adopted the family systematic approach, which considers the effects of family context on children's and adolescents' development and examined whether and how parental (fathers' and mothers') support giving, communication, and restrictive mediation relate to children's current and future severity of CSB. The sample comprised 300 Israeli families [triad of mothers, fathers, and one adolescent (39% boys, 61% girls; age 14-18)]. Results indicate that maternal support and paternal quality of communication with children significantly predicted lower severity of current and future CSB, respectively. These findings highlight an important and understudied topic in the hope of motivating additional researchers and practitioners to adopt a familial, microsystem perspective on healthy sexual development-a perspective that holds great promise in promoting normal sexual development and in decreasing risky sexual behaviors.

Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal.

We use a cohort of female sex workers (FSWs) in Senegal to show how large anticipated economic shocks lead to increased risky sexual behavior. Exploiting the exogenous timing of interviews, we study the effect of Tabaski, the most important Islamic festival celebrated in Senegal, in which most households purchase an expensive animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3 percentage points (pp) (65.5%) and 43.1 pp (22.7%) in the 9 days before Tabaski, or a maximum of 49.5 pp (76%) in the 7 day period preceding Tabaski. The evidence suggests the economic pressures from Tabaski are key to driving the behavior change observed through the price premium for condomless sex. Those most exposed to the economic pressure from Tabaski were unlikely to be using condoms at all in the week before the festival. Our findings show that Tabaski leads to increased risky behaviors for FSWs, a key population at high risk of HIV infection, for at least 1 week every year and has implications for FSWs in all countries celebrating Tabaski or similar festivals. Because of the scale, frequency, and size of the behavioral response to shocks of this type, policy should be carefully designed to protect vulnerable women against anticipated shocks.

Childhood Adversity Determines the Syndemic Effects of Violence, Substance Misuse, and Sexual Behavior on Psychotic Spectrum Disorder Among Men.

BACKGROUND AND HYPOTHESIS: Childhood adversity (CA) increases the risk for several adult psychiatric conditions. It is unclear why some exposed individuals experience psychotic symptoms and others do not. We investigated whether a syndemic explained a psychotic outcome determined by CA. STUDY DESIGN: We used self-reported cross-sectional data from 7461 British men surveyed in different population subgroups. Latent class analysis (LCA) identified categorical psychopathological outcomes. LCs were tested by interaction analysis between syndemic factors derived from confirmatory factor analysis according to CA experiences. Pathway analysis using partial least squares path modeling. RESULTS: A 4-class model with excellent fit identified an LC characterized by both psychotic and anxiety symptoms (class 4). A syndemic model of joint effects, adducing a 3-component latent variable of substance misuse (SM), high-risk sexual behavior (SH), violence and criminality (VC) showed synergy between components and explained the psychotic outcome (class 4). We found significant interactions between factor scores on the multiplicative scale, specific only to class 4 (psychosis), including SM × SH, SH × VC, and SM × VC (OR > 1, P < .05); and on the additive scale SM × SH (relative excess risk due to interaction >0, P < .05), but only for men who experienced CA. CONCLUSION: Multiplicative synergistic interactions between SM, SH, and VC constituted a mechanism determining a psychotic outcome, but not for anxiety disorder, mixed anxiety disorder/depression, or depressive disorder. This was specific to men who had experienced CA along direct and syndemic pathways. Population interventions should target SM and VC in adulthood but prioritize primary prevention strategies for CA.

Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women.

Despite the continued prevalence of HIV and condoms' proven effectiveness in HIV prevention, many young men continue to engage in condom use resistance (CUR). Research shows that sexual compulsivity and childhood sexual abuse (CSA) victimization are risk factors for CUR. Given that sexual activity between men is the most common method through which HIV is transmitted, and that men who have sex with men and women (MSMW) are up to five times as likely to contract or transmit HIV as men who have sex with women only (MSWO), understanding the CUR behaviors of MSMW is uniquely important. Young, single men who had had sex with a woman in the past year (N = 623) completed questionnaires assessing their previous sexual experiences with men and women, history of CSA, sexual compulsivity, and CUR to determine how MSMW classification may moderate the associations between these variables. Results revealed full, moderated mediation, such that CSA was significantly associated with sexual compulsivity among MSMW, but not MSWO. Furthermore, sexual compulsivity was subsequently associated with CUR, in a model accounting for 5.35% of CUR variance. Such findings suggest that exposure to CSA may render MSMW especially susceptible to maladaptive, sexually compulsive desires and behaviors. As a result, MSMW may be more likely to disregard the inherent risks associated with condomless sexual activity and engage in CUR. Thus, intervention programs seeking to reduce the transmission of HIV and other STIs should prioritize targeting MSMW who experienced CSA to reduce sexual compulsivity and increase condom use.

Association between educational attainment and risky sexual behaviour among Ghanaian female youth.

Background: Ghanaian female youth aged 15-24 years are especially vulnerable to sexually transmitted infections (STIs) compared to their male counterparts. Objectives: This study examined the association between educational attainment and risky sexual behavior among Ghanaian female youth. Method: A cross-sectional study was conducted using a nationally representative sample of youth from the 2014 Ghana Demographic and Health Survey (n=1702). The outcome of interest was risky sexual behavior, defined as having last intercourse with a non-marital partner without condoms. Descriptive and inferential statistical tests were utilized. Results: Overall, the prevalence of risky sexual behavior was 66.9%. In the bivariate analysis, risky sexual behavior differed by level of education. Compared to women with a college-level education, a significantly higher proportion of women with secondary education reported risky sexual behavior (72.9%), followed by those with primary education (65.7%) (p<0.001). In the multivariable-adjusted model, there was a significant interaction between education and household wealth index (P =0.030) and between education and the type of place of residence (P =0.045) on risky sexual behavior. Conclusion: Culturally appropriate and targeted interventions are warranted to increase condom use among these subgroups and curb the rising rates of STIs among Ghanaian female youth.

Alcohol consumption and risky sexual behaviors among fishers in Elmina in Ghana.

BACKGROUND: Alcohol consumption is part of human social behavior and constitutes a routine part of social life in many countries. Prior studies have found over-indulgence of fishers in alcohol in fishing communities. The study uses the Alcohol Myopia Theory (AMT) to analyze and explain the phenomena of fishers engaging in sex after alcohol consumption, and condom use with sexual partner(s) after alcohol consumption. The study investigated alcohol consumption, predictors of alcohol consumption, and the reasons for drinking alcohol among fishers. It also examined fishers' engagement in sex after alcohol consumption, the use of condoms with sexual partners after drinking alcohol, and predictors of the use of condoms with sexual partners after drinking alcohol. METHODS: A cross-sectional convergent parallel mixed-method design was used to study 385 fishers in Elmina. Also, two focus group discussions were conducted among male and female fishers. Descriptive statistics were used to analyze the quantitative data, while the qualitative data was analyzed thematically. RESULTS: Generally, 59.2% of participants indulged in alcohol consumption. Most male participants (70.6%) indulged in alcohol consumption than female participants (48.5%). Also, 48.5% of participants indulged in binge alcohol consumption, while 38.1% indulged in moderate alcohol consumption. The predictors of alcohol consumption were sex, religion, and type of fishing occupation. Participants identified consuming alcohol to kill loneliness and boredom, to forget family and work-related issues, and to have fun as reasons why fishers consume alcohol. Sixty-four percent of participants have ever engaged in sexual intercourse after consuming alcohol in the past 12 months. However, 70% of participants did not use a condom the last time they had sex after drinking alcohol. Only ethnicity of participants predicted their use of a condom the last time they had sex after drinking alcohol. The primary reasons for the non-use of condoms were do not like using condoms (37.9%), forgetting to use a condom (33.0%), and had sex with a trusted regular partner (15.5%). CONCLUSIONS: This study demonstrated that alcohol consumption was prevalent among fishers, especially among male fishers, which contributes to risky sexual behaviors among them as espoused by the AMT. It is recommended that fishers are targeted for alcohol use and risky sexual behavior programs and interventions since alcohol use is prevalent among them and most of them also engage in unprotected sexual intercourse after consuming alcohol.

Alcohol use disorder among healthcare professional students: a structural equation model describing its effect on depression, anxiety, and risky sexual behavior.

BACKGROUND: Mental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population. METHODS: This was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio. RESULTS: We enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ2 = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (ß = 0.381, P < 0.001), depression (ß = 0.152, P = 0.004), and anxiety (ß = 0.137, P = 0.001). CONCLUSION: AUD, depression and anxiety are a significant burden in this health professional student population and there's need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.

Youth sexual offending in Hong Kong: examining the role of self-control, risky sexual behaviors, and paraphilic interests.

Introduction: Little is known about the nature and prevalence of sexual offending among youth in Hong Kong. Methods: Testing self-control theory and sexual health risk factors (i.e., risky sexual behaviors [general and two subtypes] and paraphilic interests [general and 14 subtypes]), the prevalence of self-reported sexual offending behaviors (i.e., threat of sexual assault, penetrative sexual assault, and nonpenetrative sexual offense) was examined in a community-based sample of 863 young people (aged 17 to 20) in Hong Kong. Results: In this study, men reported significantly higher levels of threat of sexual assault and of general and 12 subtypes of paraphilic interests than women; and women reported a significantly higher level of a specific paraphilic interest subtype (i.e., transvestic fetishism) than men. Logistic regressions found that, in general, a low level of self-control and high levels of risky sexual behaviors and paraphilic interests were important factors in the participants' likelihood of issuing threats of sexual assault and engaging in penetrative and nonpenetrative sexual assault. Discussion: Important practical implications for reducing the tendency of young people to engage in sexual offending behavior can be derived from this study.

Socioeconomic determinants of risky sexual behaviors and HIV seropositivity among university students in South Africa: A case control analysis.

Socioeconomic determinants of risky sexual behaviors in sub-Saharan Africa are well known. The socioeconomic determinants of the sexual behaviors of university students, however, remain unclear. This case control study aimed to investigate the socioeconomic determinants of risky sexual behavior and HIV seropositivity among university students in KwaZulu-Natal (KZN), South Africa. Participants (N = 500; 375 HIV uninfected and 125 HIV infected) from four public higher educational institutions in KZN were recruited, using a non-randomized strategy. Socioeconomic status was assessed by food insecurity, access to the government loan scheme, and sharing of the bursary/loan with family. The findings of this study suggest that students reporting food insecurity were 1.87 times more likely to have multiple sexual partners; 3.18 times more likely to engage in transactional sex for money; and presented a fivefold higher risk of engaging in transactional sex for basic needs other than money. Accessing the government financing for education and sharing of the bursary/loan with family was also significantly associated with an increased risk of having an HIV seropositive status. A significant association between socioeconomic measures, risky sexual behavior, and HIV seropositivity is demonstrated in this study. Moreover, the socioeconomic risks and drivers when determining and/or developing HIV prevention interventions, including preexposure prophylaxis use, should be considered by healthcare providers based at campus health clinics.

Correlation between Selected Clinical Symptoms and Severity of Aggression, Impulsiveness and Their Selected Behavioral Manifestations in Patients with Polycystic Ovary Syndrome Phenotype A.

Previous studies on aggressiveness and impulsiveness in women with polycystic ovary syndrome (PCOS) are ambiguous. Furthermore, no biochemical or clinical factors related to these variables have been definitively confirmed. The aim of the study was to clarify whether, in women with phenotype A of PCOS, variables such as body mass index and clinical and biochemical hyperandrogenism have an impact on either the intensity of impulsivity or aggression or on other selected behavioral manifestations of these variables. The study included 95 patients diagnosed with PCOS phenotype A. The criterion for recruitment into the study group and the control group was body mass index. The study was conducted with the use of a closed-format questionnaire and calibrated clinical scales. Higher body mass index (BMI) values in women with PCOS phenotype A are associated with poor eating habits. The severity of impulsivity and aggression syndrome, as well as the tendency to engage in risky sexual behavior and patterns of alcohol consumption among patients diagnosed with PCOS phenotype A, are not dependent on BMI. The severity of impulsiveness and the syndrome of aggression in women with phenotype A PCOS are not associated with clinical symptoms of hyperandrogenism or with androgen levels.

Relationship Between Alcohol Consumption and Risky Sexual Behaviors Among Adolescents and Young Adults: A Meta-Analysis.

Objectives: Adolescents exposed to alcohol have increased risky sexual behaviors (RSBs); however, the association between alcohol consumption and RSBs has to be systematically and quantitatively reviewed. We conducted a meta-analysis of the literature to systematically and quantitatively review the association between alcohol consumption and RSBs in adolescents and young adults. Methods: We searched for qualified articles published from 2000 to 2020 and calculated pooled odds ratios (ORs) using the random-effect model. We also conducted meta-regression and sensitivity analyses to identify potential heterogeneity moderators. Results: The meta-analysis of 50 studies involving 465,595 adolescents and young adults indicated that alcohol consumption was significantly associated with early sexual initiation (OR = 1.958, 95% confidence interval (CI) = 1.635-2.346), inconsistent condom use (OR = 1.228, 95% CI = 1.114-1.354), and having multiple sexual partners (OR = 1.722, 95% CI = 1.525-1.945). Conclusion: Alcohol consumption is strongly associated with RSBs, including early sexual initiation, inconsistent condom use, and multiple sexual partners among adolescents and young adults. To prevent the adverse consequences of alcohol consumption, drinking prevention programs should be initiated at an early age and supported by homes, schools, and communities.

Exploring Relationships Between Internalizing Problems and Risky Sexual Behavior: A Twin Study.

Previous research links risky sexual behavior (RSB) to externalizing problems and to substance use, but little research has been conducted on relationships between internalizing problems (INT) and RSB. The current study addresses that literature gap, using both a twin sample from Colorado (N = 2567) and a second twin sample from Minnesota (N = 1131) in attempt to replicate initial results. We explored the hypothesis that the latent variable INT would be more strongly associated with the latent variable RSB for females than for males, examining relationships between INT and RSB via phenotypic confirmatory factor analysis and multivariate twin analyses. We found a small but significant phenotypic association between the latent variables. However, despite using two large twin samples, limited power restricted our ability to identify the genetic and environmental mechanisms underlying this association. Our sex differences hypothesis was not fully supported in either sample and requires further investigation. Our findings illustrate the complexity of the relationship between internalizing problems and risky sexual behavior.

Mental health, substance use, and risky sexual behaviors among women living with HIV.

INTRODUCTION: Risky sexual behavior has been explored in women living with HIV (WLHIV) internationally but is not well studied in WLHIV in the United States (U.S.). This merits further investigation due to the negative reproductive and HIV health outcomes associated with risky sexual behavior, such as the increased risk for HIV transmission and infertility from sexually transmitted infections (STIs). The aims of this study are to (1) describe sexual behaviors in a cohort of WLHIV in Florida, (2) determine whether demographic characteristics, substance use, and mental health symptoms are associated with risky sexual behavior in a cohort of WLHIV in Florida, and (3) explore whether the relationship between substance use and mental health symptoms and risky sexual behavior differs in reproductive-age (age 18-49), compared to non-reproductive-age WLHIV (age 50+). DESIGN: This was a cross-sectional analysis of data from a multisite cohort study done in Florida. METHODS: Data were collected from a sample of 304 participants who were recruited into the Florida Cohort Study from 9 clinical and community sites in Florida between 2014 to 2017. The predictor variables of interest were mental health symptoms, substance use, and demographic variables. The outcome variable of interest was risky sexual behavior which was defined as reporting ≥1 of the following: (1) at least one STI diagnosis in the past 12 months, (2) two or more sexual partners in the past 12 months, or (3) any inconsistent condom use in the past 12 months. Descriptive statistics, bivariate analysis, and logistic regression (p < 0.1) were conducted on the variables of interest. RESULTS: The mean age of the sample was 47.8 years, and approximately half (51.6%) of the sample was of reproductive-age. Reporting ≥1 risky sexual behavior was reported in over half (51.6%) of the reproductive-age WLHIV in the sample and 32% of the non-reproductive-age WLHIV in the sample. Binge drinking, alcohol-related problems, marijuana use, and age were all significantly associated with self-reporting ≥1 risky sexual behaviors in all WLHIV. Self-reporting binge drinking, marijuana use, and a high alcohol-related problems score respectively were associated with increased odds of self-reporting ≥1 risky sexual behavior in all WLHIV. Neither mental health symptoms nor race/ethnicity or education were significantly associated with self-reporting ≥1 risky sexual behavior in all WLHIV. Self-reporting severe anxiety symptoms and high alcohol-related problems scores respectively were associated with increased odds of self-reporting ≥1 risky sexual behavior only in reproductive-age WLHIV from the sample. CONCLUSION: Marijuana use, binge drinking, and alcohol-related problems appear to have a relationship with risky sexual behavior in WLHIV regardless of age. Reproductive-age also appears to influence risky sexual behavior in WLHIV, and specific reporting severe anxiety symptoms and high alcohol-related problems in reproductive-age WLHIV increases the odds of engaging in risky sexual behavior. CLINICAL SIGNIFICANCE: This study holds clinical significance for nurses and other clinicians working in reproductive health settings and clinics with WLHIV. Results indicate that it could be beneficial to do more screening for mental health symptoms (particularly anxiety) and alcohol use in younger reproductive-age WLHIV.

Early Sexual Debut and Its Associated Factors Among Young Women Aged 15-24 in Mali: A Multilevel Analysis.

Early sexual debut is associated with increased risk of several sexual and reproductive health problems, including unwanted pregnancies and sexually transmitted infections. Hence, determining factors that promote early sexual initiation is significant to guide policy and inform interventions aimed to promote the health of young people through to adulthood. This study examined the prevalence of early sexual debut and its associated factors among young women in Mali. Using cross-sectional nationally representative data from the 2018 Mali Demographic and Health Survey, a total of 4063 young women aged 15-24 were included in the study. Multilevel binary logistic regression analysis was done to determine the factors associated with early sexual debut. The results were presented using adjusted odds ratios (aOR) and 95% confidence intervals (CIs). The prevalence of early sexual debut in Mali was 17.8% (95% CI; 16-19.7%). Young women who attended higher school had lower odds of early sexual debut (aOR = 0.10, 95% CI; 0.01-0.82) compared to young women who had no formal education. Young women from richest households had lower odds of early sexual debut compared to those from the poorest households (aOR = 0.48, 95% CI; 0.27-0.82). Young women from households with large family size also had lower odds of experiencing early sexual debut compared to those in small family size (aOR = 0.81, 95% CI; 0.66-0.99). Furthermore, the odds of early sexual debut were lower among young women in Koulikoro (aOR = 0.59, 95% CI; 0.39-0.90), Sikasso (aOR = 0.35, 95% CI; 0.21-0.56), Segou (aOR = 0.40, 95% CI; 0.25-0.64), and Mopti (aOR = 0.44, 95% CI; 0.23-0.82) regions compared to young women in Kayes region. Higher odds of early sexual debut were found among currently employed compared to not currently employed young women (aOR = 1.74, 95% CI; 1.42-2.12) and currently married compared to not currently married young women (aOR = 4.64, 95% CI; 3.64-5.92). Young women from the Peulh ethnic groups compared to those from the Bambara ethnic groups were at a higher odds of early sexual debut (aOR = 1.43, 95% CI; 1.03-1.99). The findings suggest the need for interventions aimed at addressing early sexual debut among young women. These can include emphasizing the promotion and importance of female education, addressing the cultural practices that promote negative sexual norms/practices such as child marriages, and ensuring social change through efforts such as creating employment or economic opportunities for families.

Risky Sexual Behavior, Paraphilic Interest, and Sexual Offending: The Study of a Community Sample of Young Adults in Hong Kong.

Limited information is available on the prevalence and nature of sexual offending in Hong Kong. This cross-sectional study seeks to explore the role of risky sexual behavior (RSB) and paraphilic interests in self-reported sexual offending behavior (i.e., nonpenetrative-only, penetrative-only, and nonpenetrative-plus-penetrative sexual assault) in a community sample of young adults in Hong Kong. Using a large sample (N = 1885) of university students, the lifetime prevalence of self-reported sexual offending was 18% (n = 342; 23% males (n = 166), 15% females (n = 176)). Based on the study subsample of 342 participants who self-reported sexual offending (aged 18-35), the findings indicated that males reported significantly higher levels of general, penetrative-only, nonpenetrative-plus-penetrative sexual assault; and paraphilic interest in voyeurism, frotteurism, biastophilia, scatophilia, and hebephilia than females; while females reported a significantly higher level of transvestic fetishism than males. No significant difference was found in RSB between males and females. Logistic regressions found that the participants who possessed a higher level of RSB, particularly penetrative behaviors, and paraphilic interest in voyeurism and zoophilia were less likely to engage in a nonpenetrative-only sexual offense. Conversely, the participants who possessed higher levels of RSB, especially penetrative behaviors, and paraphilic interest in exhibitionism and zoophilia, were more likely to engage in nonpenetrative-plus-penetrative sexual assault. The implications for practice in areas such as public education and offender rehabilitation are discussed.