Transactional sex and risky sexual practices in Jamaica.

BACKGROUND: Transactional sex relationships (TSRs) create financial and emotional support for men and women, as well as an increased sexual risk. Studies have reported high HIV and STI transmission rates among young women in transactional sex relationships. However, little is known about TSR prevalence in Jamaica and risky sexual practices among participants. This study investigates the sexual behaviour of Jamaicans in TSR. METHODS: Secondary data analysis of a national survey revealed that 586 participants (38%) self-reported being in at least one TSR in the last 12 months. We also identified a third category called "Benefluids", who play both roles of benefactor and beneficiary in transactional sex relationships. RESULTS: 59 percent of male Benefluids had two to five transactional sex relationship partners in the last 12 months, compared to 40% of female Benefluids. Twenty-eight percent of female Benefluids reported sexually transmitted infection symptoms in the last 12 months compared to 13.5% of male Benefluids. While females reported more sexually transmitted infection symptoms, young men had the highest sexual risk precursors. CONCLUSIONS: People in transactional sex relationships often play the role of beneficiaries and benefactors to meet material and sexual needs but this increases the risk of STI symptoms.

Condom Failure Among HIV-Negative Men in Serodiscordant Relationships in Australia, Brazil, and Thailand.

Condoms continue to be used by many gay, bisexual, and other men who have sex with men (GBM) to reduce the risk of HIV transmission. However this is impacted by condom failure events, defined here as condom breakage and slippage. In a prospective, observational cohort study of 343 HIV serodiscordant male couples recruited through high HIV caseload clinics and hospitals between 2012 and 2016 in Australia, Brazil, and Thailand, condom failure rates and associated factors were analysed, including with the study partner versus other sexual partners. There were 717 reported instances of condom failure from an estimated total of 25,831 sex acts with condoms, from over 588.4 participant years of follow up. Of the HIV-negative partners (n = 343) in the study, more than a third (n = 117, 36.7%) reported at least one instance of condom failure with any partner type during study follow-up. Condom failure with their study partner was reported by 91/343 (26.5%) HIV-negative partners, compared with 43/343 (12.5%) who reported condom failure with other partners. In total, there were 86 events where the HIV-negative partner experienced ano-receptive condom failure with ejaculation, representing 12.0% of all failure events. In multivariable analysis, compared to Australia, HIV-negative men in Brazil reported a higher incidence risk rate of condom failure (IRR = 1.64, 95%CI 1.01-2.68, p = 0.046) and HIV-negative men who reported anal sex with other partners reported an increased risk of condom failure compared with men who only had sex with their study partner (IRR = 1.89, 95%CI 1.08-3.33, p = 0.025). Although at least one event of condom failure was reported by a significant proportion of participants, overall condom failure events represented a small proportion of the total condom protected sex acts.

The impact of adverse childhood experiences on mental health, sexual risk behaviors, and alcohol consumption in adulthood.

The purpose of the study was to determine how Adverse Childhood Experiences (ACE) relate to adulthood flourishing, symptoms of depression, anxiety, somatization, self-reported health, sexual risk behaviors, and alcohol consumption. A quantitative cross-sectional methodology was used. A total of 452 adults completed the survey. The most prevalent ACE include physical abuse (44.69%), separation/divorce of parents (41.81%), living with someone with alcohol problems (39.38%), and being sworn, insulted, or humiliated by adults at home (35.62%). Almost one out of every four respondents (24.34%) reported being touched by an adult, 17.92% reported that an adult tried to manipulate the respondent into touching them, and 8.19% were forced to have sexual intercourse. Results indicate that women reported a higher number of ACE than men. The number of ACE is inversely related to flourishing and self-reported health; while being positively associated with participant's scores in depression, anxiety, somatization, sexual risk behaviors, and alcohol use. The regression model, including the eleven ACE and respondents' sex and age, achieved medium effect sizes for somatization, depression, and anxiety symptoms and small effect sizes for flourishing, self-reported health, sexual risk behaviors, and alcohol consumption. Specific ACE have a particularly significant negative impact on mental health outcomes: forced intercourse, witnessing familial violence, verbal humiliation, and living with individuals struggling with mental health issues and drug consumption or who were incarcerated. In conclusion, the study highlights the alarming prevalence of ACE among the Honduran population and their significant negative impact on mental health outcomes during adulthood.

Substance use, economic vulnerability, and HIV/STI risk among female sex workers in Mexico.

BACKGROUND: Economic hardship (e.g., difficulty to pay for basic needs) has been associated with increased HIV/STI risk among female sex workers (FSW), and may be exacerbated by high levels of substance use. Few studies have assessed the intersection of economic hardship, substance use, and HIV/STI risk among FSW. METHODS: Quantitative data were collected via questionnaires among 469 FSW residing in Tijuana and Ciudad Juarez, Mexico. Using logistic regression, we assessed the role of economic hardship on the association between substance use (past 30-days alcohol use, drug use, or injection drugs use with clients, and past 6-months drug use) and testing positive for an STI (also an indicator of HIV risk). RESULTS: Drug use in the preceding six months was significantly associated with testing positive for an STI (AOR = 1.8, CI: 1.1 = 2.9, p = .02); no difference in this association was found by whether women reported economic hardship. Past 30-day drug use with clients was associated with STI infection, but only among those who did not report economic hardship (AOR = 1.5, 95% CI: 1.1-1.9, p < .01). CONCLUSIONS: Findings suggest that economic hardship influences the association between substance use and increased risk for HIV/STI among FSW; however, these associations may be more complex than previously hypothesized.

Descuento sexual y conductas sexuales arriesgadas en una muestra de adultos jóvenes de Colombia / Sexual Discounting and Sexual Risk Behavior in a Sample of Young Adults from Colombia / Desconto sexual e comportamento sexual de risco em uma amostra de jovens adultos da Colômbia

El objetivo del presente trabajo fue describir la tasa de descuento sexual y evaluar la relación entre el autorreporte de conductas sexuales arriesgadas (csa) y el descuento sexual en una muestra de adultos jóvenes en Colombia. Para esto, se realizó una investigación no experimental de corte transversal y correlacional. Ciento treinta y seis participantes fueron sometidos a un cuestionario de autorreporte de conductas de riesgo sexual, a la tarea de descuento sexual (sddt) y al cuestionario de elección monetaria (mcq). Los análisis de la curva de descuento sexual demuestran que el valor de la opción de tener sexo seguro disminuye con el in-cremento en la demora en la obtención de un condón (i. e., descuento sexual). Adicionalmente, se observa que el grado de descuento sexual está asociado con csa, como el número de parejas sexuales y el número de relaciones sexuales en los últimos tres meses, y que hay una diferencia en el patrón de descuento sexual entre hombres y mujeres.

The goal of this study was to describe the rate of sexual discounting and its relation with the self-report of sexual risk behavior in a sample of young adults from Colombia. To achieve this goal, a correlational cross-sectional non-experimental study was done. One hundred thirty six young adult participants responded to a sexual risk behavior self-report questionnaire, a sexual delay discounting task (sddt), and a monetary choice questionnaire (mcq). The results suggest that the value of the safe sex option decreases with the delay to obtain a condom (i. e., sexual discounting). Additionally, it was observed that the sexual discounting rate was associated with the self-report of sexual risk behavior, like, the number of sexual partners and sexual encounters in the last three months. It was also observed a different pattern of sexual discounting between men and women

O objetivo deste estudo foi descrever a taxa de desconto sexual e avaliar a relação entre o autorrelato de com-portamentos sexuais de risco (csr) e o desconto sexual em uma amostra de jovens adultos na Colômbia. Para isso, foi realizada uma investigação não experimental, transversal e correlacional. 136 participantes foram submetidos a um questionário de comportamentos se-xuais de risco autorreferidos, à tarefa de desconto sexual (sddt) e ao questionário de escolha monetária (mcq). As análises da curva de desconto sexual mostram que o valor da opção de praticar sexo mais seguro diminui com o aumento do atraso na obtenção do preservativo (ou seja, desconto sexual). Adicionalmente, observa-se que o grau de desconto sexual está associado à csr, assim como o número de parceiros sexuais e o número de relações sexuais nos últimos 3 meses, e que existe uma diferença no padrão de desconto sexual entre homens e mulheres.

Balance decisional sobre el uso del condón asociado a la conducta sexual de riesgo en universitarios / Decisional balance of condom use associated with risky sexual behavior in university students

Resumen La adquisición de alguna Infección de Transmisión Sexual (ITS) y los embarazos no planificados son riesgos a los que se enfrentan los jóvenes ante la decisión de no usar condón al tener relaciones sexuales. La aproximación del balance decisional enfatiza qué costos y beneficios están asociados a la conducta sexual de riesgo. Las decisiones acerca del uso del condón son un precursor de la conducta y este proceso puede estar influido por los beneficios que se perciban sobre él. El objetivo de la presente investigación es identificar la relación de las ganancias y pérdidas del uso del condón con la conducta sexual de riesgo. Se evaluó la conducta sexual de riesgo y el uso del condón masculino en sus relaciones sexuales. Se midieron las ganancias y las pérdidas del condón con una escala de medición, en una muestra de 257 universitarios, con una edad entre 18 y 39 años (. = 22.34; DE = 3.6) de Querétaro, México. La evaluación del balance decisional indica que las ganancias son mayores que las pérdidas (costos) del uso consistente del condón en las relaciones sexuales. Se encontraron asociaciones entre las ganancias y las pérdidas con indicadores de la conducta sexual de riesgo. Se observa que los universitarios que no utilizan condón manifiestan mayores pérdidas por utilizarlo. En las ganancias, se aprecia un aumento en las puntuaciones cuando se usa condón. Lo encontrado provee apoyo para el desarrollo de intervenciones que promuevan las ganancias o beneficios para incrementar el uso consistente del condón.

Abstract The acquisition of a Sexually Transmitted Infection (STI) and unplanned pregnancies are risks that young people deal when deciding not to use a condom when having sexual intercourse. During the decision-making process, individuals value the benefits (gains) and losses (costs) associated with a behavior. Cost-benefit analysis has been investigated to examine the differential impact of gains and losses on risky behaviours. The decisional balance approach emphasizes that costs and benefits are associated with risky sexual behavior. Decisions about condom use are a precursor to behavior, and this process may be influenced by perceived benefits. In the present study, it is proposed that the balance between the benefit and the loss of condom use contributes to consistent condom use. These factors as determinants of behaviour must be considered under the cultural context in which they are carried out. The objective of this research is to identify the relationship of gains and losses from condom use with risky sexual behaviour. It was hypothesized that: 1) Young people will evaluate the benefits (gains) with higher scores compared to the losses (costs) in deciding to use a condom in sexual intercourse. 2) The gains will be greater in those college students who use a condom more frequently and the losses will not be the same among those who use a condom. To evaluate risky sexual behavior and the use of the male condom in their sexual relations were considered. Condom gains and losses were measured with a measurement scale in a sample of 257 university students, aged between 18 and 39 years (. = 22.34; SD = 3.6) from Querétaro, México. With reference to sexual behavior, it was found that 89.1 % have started their sexual activity. The average age of initiation of sexual life is 15.41 years. The frequency of sexual activity is once or twice each month. The mean of sexual partners is 4.2, with a median of 3. The 68.5 % reported using some contraceptive method and regarding the use of condoms, 27.8 % always use it and 5.7 % never use it. To evaluate the decisional balance, subtracting the gain and loss factors created a net difference score. The gain factor was subtracted from its counterpart of the loss factor to indicate the preference for having sex with a condom. The decisional balance assessment indicates that the gains are greater than the losses (costs) of consistent condom use in sexual intercourse. Associations were found between gains and losses with indicators of risky sexual behavior. It is observed that university students who do not use a condom show greater losses from using it. In gains, there is an increase in scores when using a condom. Additionally, it is observed that university students, who sometimes use a condom, show greater losses for using it, unlike those who always use it, which show low scores in the losses of using it. In gains factor, there is an increase in the scores when using a condom, that is, those who never or almost never use a condom have the lowest scores and as the scores increase, the frequency of using a condom in their sexual relations also increases. In conclusion, gains and losses from male condom use are associated with risky sexual behavior (age of sexual activity, number of partners and condom use) in the university context. The findings provide support for the development of interventions that promote gains or benefits to increase consistent condom use. It is important to consider in specific interventions those young people who decide to continue having sex without using a condom despite the costs and possible consequences of not using it.

Actualización sobre la neurofisiología de la conducta sexual y el riesgo reproductivo en adolescentes / Update on the neurophysiology of sexual behavior and reproductive risk in adolescents

Introducción: Se realizó una revisión que permite comprender mejor por qué es necesaria una visión más integradora de la neuropsicología del adolescente para la aplicación de métodos de intervención desde las neurociencias que permitan enfrentar la conducta de riesgo sexual y reproductivo. Objetivo: Actualizar sobre los aspectos particulares de la neurofisiología de la adolescencia, que los puede hacer proclives a desarrollar una conducta de riesgo en cuanto a la función reproductiva. Material y Método: Revisión de la literatura sobre el tema, publicada en el período 2017-2022. Se utilizaron las bases de datos: PubMed/MEDLINE, Lilacs, Scielo, Cochrane, y The National Library of Medicine. Resultaron incluidas 26 fuentes bibliográficas para las citas, por reunir los requisitos de mayor especificidad, originalidad y aporte al tema. Desarrollo: El desarrollo del adolescente genera transformaciones radicales en su personalidad, que están relacionadas con cambios importantes en las estructuras cerebrales, que aún no están completamente desarrolladas. Las técnicas de resonancia magnética muestran que los principales cambios en el cerebro del adolescente afectan la corteza prefrontal, por lo que son más proclives a la falta de autorregulación y a una excesiva excitabilidad. La plasticidad de esta etapa explicaría cómo las conductas erróneas pueden imprimirse negativamente y dar lugar a las actitudes que llevan al fracaso, particularmente aquellas relacionadas con la sexualidad y la función reproductiva. Conclusiones: Se aportaron reflexiones críticas que permiten confirmar el hecho de que existen insuficiencias en los métodos para la modificación de la conducta de riesgo sexual y la función reproductiva en adolescentes. Se aportan nuevos enfoques de enfrentamiento.

Introduction: A review was carried out to allow a better understanding of why a more inclusive vision of adolescent neuropsychology is necessary for the application of intervention methods in the field of neuroscience that allow confronting sexual and reproductive risk behavior. Objective: to update on the particular aspects of the neurophysiology of adolescence, which can make them prone to develop risk behavior in terms of reproductive function. Material and Methods: Review of the literature on the subject, published in the period 2017-2022. Databases such as PubMed/MEDLINE, Lilacs, SciELO, Cochrane, and The National Library of Medicine were used. Twenty-five bibliographic sources were included for citations, as they met the requirements for greater specificity, originality, and contribution to the topic. Development: The development of the adolescent generates radical transformations in his personality, which are related to important changes in brain structures that are not yet fully developed. Magnetic resonance techniques show that the main changes in the adolescent brain affect the prefrontal cortex, which is why they are more prone to a lack of self-regulation and excessive excitability. The plasticity of this stage would explain how erroneous behaviors can be negatively imprinted, giving rise to attitudes that lead to failure, particularly those related to sexuality and reproductive function. Conclusions: Critical reflections are provided, which confirm the fact that there are weaknesses in the methods for the modification of sexual behavior and reproductive risk in adolescents. New confrontation methods are provided.

Consumo de álcool em universitário e sua associação com o comportamento sexual de risco: uma revisão sistemática / Alcohol consumption in college students and its association with risky sexual behavior: a systematic review / Consumo de alcohol en universitarios y su asociación con comportamientos sexuales de riesgo: una revisión sistemática

O consumo de substâncias psicoativas, principalmente o álcool, encontra-se presente em diversos meios de comunicação, geralmente tendo seu uso associado a fatores desejáveis como poder, prazer, sucesso financeiro e sexual. Os jovens universitários quando ingressam em cursos de graduação, demonstram mudanças comportamentais, ocasionadas por novas responsabilidades, além de terem maior contato e oportunidade de uso de álcool, drogas e prática de sexo inseguro. Assim, tornam-se mais vulneráveis aos comportamentos sexuais de risco (CSR), como relação sexual desprotegida, multiplicidade de parceiros e uso de drogas (lícitas ou ilícitas). Os CSR podem ter como consequência as infecções sexualmente transmissíveis (ISTs) e a gravidez não planejada. OBJETIVO: Analisar como o consumo de álcool por universitários, associa-se ao comportamento sexual de risco desses indivíduos. METODOLOGIA: Trata-se de uma revisão sistemática em que a busca de artigos para pesquisa ocorreu no mês de agosto de 2022 nas bases de dados LILACS, SciELO e PubMed, resultando em 313 artigos, que após os critérios de inclusão e exclusão resultaram em 22 artigos para o desenvolvimento do estudo. RESULTADOS: Constatou-se um alto nível de consumo de álcool entre os universitários, com elevada propensão à comportamentos sexuais de risco, principalmente não utilizar preservativos e múltiplos parceiros sexuais. CONCLUSÃO: Existe associação entre o consumo de álcool e o comportamento sexual de risco entre os acadêmicos e que existe à necessidade de uma intervenção para conscientizar e educar esses jovens à respeito da disseminação de IST's.

The consumption of psychoactive substances, especially alcohol, is pre- sent in various media, usually associated with desirable factors such as power, pleasure, financial and sexual success. Young college students, when entering undergraduate cour- ses, show behavioral changes caused by new responsibilities, besides having greater con- tact and opportunity to use alcohol, drugs and unsafe sex. Thus, they become more vulnerable to risky sexual behavior (SCOR), such as unprotected sexual intercourse, mul- tiple partners, and drug use (licit or illicit). RSCs can result in sexually transmitted infec- tions (STIs) and unintended pregnancy. OBJECTIVE: To analyze how alcohol consump- tion by college students is associated with risky sexual behavior. METHODOLOGY: This is a systematic review in which the search for articles for research occurred in August 2022 in the LILACS, SciELO and PubMed databases, resulting in 313 articles, which after inclusion and exclusion criteria resulted in 22 articles for the development of the study. RESULTS: We found a high level of alcohol consumption among college students, with a high propensity for risky sexual behavior, especially not using condoms and mul- tiple sexual partners. CONCLUSION: There is an association between alcohol consump- tion and risky sexual behavior among students, and there is a need for an intervention to educate these young people about the spread of STIs.

El consumo de sustancias psicoactivas, especialmente alcohol, está presente en diversos medios de comunicación, generalmente asociado a factores deseables como poder, placer, éxito financiero y sexual. Los jóvenes universitarios, al ingresar en los cursos de graduación, demuestran cambios de comportamiento, causados por nuevas responsabilidades, además de tener mayor contacto y oportunidad de consumir alcohol, drogas y sexo inseguro. Así, se vuelven más vulnerables a los comportamientos sexuales de riesgo (CSR), como las relaciones sexuales sin protección, las parejas múltiples y el consumo de drogas (lícitas o ilícitas). Los CSR pueden provocar infecciones de transmisión sexual (ITS) y embarazos no deseados. OBJETIVO: Analizar cómo se asocia el consumo de alcohol por parte de los estudiantes universitarios con las conductas sexuales de riesgo. METODOLOGÍA: Se trata de una revisión sistemática en la cual la búsqueda de artículos para investigación ocurrió en agosto de 2022 en las bases de datos LILACS, SciELO y PubMed, resultando en 313 artículos, que después de los criterios de inclusión y exclusión resultaron en 22 artículos para el desarrollo del estudio. RESULTADOS: Se observó un alto consumo de alcohol entre los universitarios, con alta propensión a comportamientos sexuales de riesgo, especialmente el no uso de preservativo y la multiplicidad de parejas sexuales. CONCLUSIÓN: Existe una asociación entre el consumo de alcohol y las conductas sexuales de riesgo entre los estudiantes universitarios y que es necesaria una inter- vención para educar a estos jóvenes sobre el contagio de las ITS.

Internalized homophobia and sexual risk behavior in men who have sex with men: The mediational role of sexual self-concept.

Men who have sex with men (MSM) are one of the populations most likely to be infected with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) worldwide. Sexual risk behaviors (SRB) are the main route of HIV transmission. Among the factors associated with SRB, internalized homophobia (rejection of one's sexuality) is a risk factor unique for MSM. However, how this factor influences SRB is not clear. Therefore, the present study attempts to clarify the mechanism of action of the relationship between internalized homophobia on SRB based on the mediating effects of sexual self-concept. A study was conducted with 124 MSM living in Chile over 18 years of age (M = 24.4 and SD = 4.19). Through path analysis, it was observed that internalized homophobia has slight inverse effects on SRBs (multiple sexual partners and sexual activity under the influence of alcohol or drugs) when the sexual self-efficacy dimension acts as a mediating variable. These findings suggest that developing sexually transmitted infections (STIs) and HIV/AIDS prevention campaigns focused on MSM must highlight the development of a healthy sexual self-concept and address self-stigma.

Psychological Factors and Sexual Risk Behaviors: A Multidimensional Model Based on the Chilean Population.

Human immunodeficiency virus (HIV) is a global health problem, with sexual risk behaviors (SRB) being the main routes of spreading the virus. Evidence indicates that different psychological factors influence SRB (e.g., attitude towards condoms, sexual self-concept, sexual sensation seeking, knowledge of sexual risk behaviors, risk perception). This study proposes an explanatory model of sexual risk behaviors in young people and adults. The sample consisted of 992 young people and adults aged between 18 and 35 years. The model presented good levels of fit (X2 = 3311.433, df = 1471, CFI = 0.964, TLI = 0.959, RMSEA = 0.036), explaining 56% of the variance of sexual activity with multiple partners, 77% of the inadequate use of protective barriers, and 58.8% of sexual activity under the influence of alcohol or drugs from a set of psychological factors in self-report measures. The details of the results offer novel contextual evidence for the prioritization of prevention-oriented psychosocial interventions.

Problemas emocionales, personalidad oscura, sexting y grooming en adolescentes: el rol del género y la edad / Emotional Problems, Dark Personality, Sexting and Grooming in Adolescents: the role of Gender and Age

Resumen El presente estudio tuvo como objetivo estudiar si los problemas emocionales (depresión y ansiedad) y la Personalidad Oscura eran predictores del sexting y el grooming, y si este comportamiento varía según el género y la edad. Se constituyó una muestra de 728 adolescentes entre 11 y 18 años (38% hombres) de tres escuelas secundarias privadas ubicadas en Buenos Aires y Paraná, Argentina. Completaron un Cuestionario de sexting, el Cuestionario de Solicitación e Interacción Sexual a menores online por parte de adultos para evaluar el comportamiento de grooming, la Escala de síntomas psicosomáticos de Rosenberg, el Inventario de depresión de Kovacs para niños y el Dirty Dozen para los rasgos de Personalidad Oscura. Los resultados mostraron que 12% de los adolescentes admitió haber padecido una conducta de grooming. Las formas más frecuentes fueron el envío de mensajes escritos de carácter sexual (11%) y fotos (10%) y luego, en orden de frecuencia, el envío de videos (4%), pero no se detectaron diferencias por género. Los predictores significativos de sexting y el tamaño de su varianza explicada variaban según el género (R² = 47% para mujeres y R² = 12% para hombres, respectivamente). En el caso de las mujeres, mayor edad y puntajes de psicopatía fueron predictores significativos, y en el de los hombres, menor ansiedad fue el predictor significativo. Un modelo estructural explicó una varianza del 6% para el sexting y 21% para el grooming, indicando que no hubo invarianza, según el género. Las regresiones lineales para predecir el grooming a partir del sexting también sugirieron que el género moderaba esta relación.

Abstract The present study aimed to study if emotional problems (depression and anxiety) and Dark Personality were predictors of sexting and grooming, and if this behavior differs by gender and age. A sample of 728 adolescents between 11 and 18 years of age (38% male) from three private high schools located in Buenos Aires and Paraná, Argentina, was drawn. They completed a Sexting questionnaire, the Questionnaire for Online Sexual Solicitation and Interaction of Minors with Adults for grooming behavior, Rosenberg Scale of Psychosomatic Symptoms, the Kovacs Depression Inventory for Children and the Dirty Dozen for dark personality traits. Results showed that 12% of adolescents admitted having carried out a sexting behavior. Sending written messages of a sexual nature (11%) and photos (10%) were the most prevalent ways, followed by videos (4%), but no differences were detected according to gender. Significant predictors of sexting and the size of its explained variance ranged by gender (R² = 47% for females and R² = 12% for men, respectively). In the case of females, older age and psychopathy were the significant predictors. In the case of males, less anxiety was the significant predictors. A structural model explained a variance of 6% for sexting and 21% for grooming, indicating that there was no inavariance, according to gender. Linear regressions to predict grooming from sexting also suggested this relationship was moderated by gender.

Economic vulnerability, violence, and sexual risk factors for HIV among female sex workers in Tijuana, Mexico.

Economic vulnerability is often reported to underlie involvement in sex work among female sex workers (FSW), but may also create urgency in women's work, limiting women's negotiating power with clients and in turn, increasing their vulnerability for violence and HIV. This study assessed economic vulnerability in relation to violence and sexual risk behaviors for HIV among a sample of FSW in Tijuana, Mexico. FSW at least 18 years of age were recruited through venue-based sampling for a survey (n = 228) and in-depth interviews (n = 50) to investigate HIV risk factors in this region. Using crude and adjusted logistic regression models, we assessed lack of financial support from others as well as reports of financial hardship separately in relation to experiencing sexual violence (e.g. by clients, police, relationship partners, in the past 6 months), physical violence (past 6 months), STI diagnosis, and inconsistent condom use (past 30 days). Qualitative interviews (n = 50), conducted with a subsample of the survey participants, were also examined for related themes. FSW who reported no financial support were more likely to report sexual violence (OR = 2.1; 95% CI:1.1-4.2). FSW who reported financial hardship were more likely to experience sexual violence (OR = 1.9; 95% CI:1.1-3.6) and physical violence (OR = 1.9; 95% CI:1.1-3.6), as well as to report past 30-day inconsistent condom use (OR = 2.4; 95%CI: 1.3-4.6) and to test positive for an STI (OR = 1.9; 95% CI:1.1-3.4). Qualitative data substantiated these findings. Findings suggest that interventions to improve economic well-being may be useful to prevent the intersecting concerns of violence and HIV among FSW.

Factores asociados a la práctica de conductas sexuales de riesgo en línea en adolescentes escolarizados / Factors associated with the practice of online sexual risk behaviors in school adolescents

Introducción: El avance de la tecnología y las nuevas formas de comunicación a nivel mundial en la actualidad ofrece a los adolescentes nuevas formas de socialización e interacción, generando que las redes sociales se conviertan en un área importante de sus vidas. Esta nueva tendencia de comunicación, así como el natural deseo de explorar la sexualidad y teniendo en cuenta que este estudio se realizó con adolescentes de etapa media, ha llevado a los jóvenes a interesarse por una nueva modalidad del ejercicio de la misma, a través de la internet y las redes sociales. Objetivo: Determinar los factores asociados a la práctica de conductas sexuales de riesgo en línea en adolescentes escolarizados. Material y Métodos: Estudio cuantitativo descriptivo observacional de corte transversal incluyó 244 estudiantes de bachillerato con rango de edad entre 15 a 17 años en Bogotá. Se indago por las variables de este estudio, se validó y aplico el instrumento conductas sexuales de riesgo en redes sociales virtuales, de forma auto diligenciada. Conclusión: Se describió la frecuencia de las prácticas sexuales en línea y se determinó que variables hacen que se aumente el riesgo para realizar conductas sexualizadas en internet, en este estudio el sexo biológico, el grado escolar, el practicar juegos sexualizados, entre otras, aumentan el considerablemente el riesgo, mientras que hubo variables que no presentaron asociación como estrato socioeconómico, entre otras, para finalizar se determinó las que se convierten en factores protectores.

Introduction: Advancements in technology and new forms of communication worldwide offer adolescents new ways of socializing and interacting, transforming social networks into an important area of their lives. This new communication trend and the natural desire to explore their sexuality, considering that this study was conducted with middle-school adolescents, have led teenagers to become interested in a new way of practicing their sexuality through the Internet and social media. Objective: To determine factors associated with the practice of online sexual risk behaviors in school-aged adolescents. Material and methods: Quantitative, descriptive, observational, cross-sectional study that included 244 high school students between 15 and 17 years of age in Bogotá. The variables of this study were examined, and the instrument for sexual risk behaviors in virtual social media was validated and applied using a self-administered form. Conclusion: The frequency of online sexual practices was described, and the variables that increase the risk of engaging in sexualized behaviors on the Internet were determined. In this study, biological sex, school grade, play sexualized virtual games among other variables, considerably increased the risk of engaging in sexualized behaviors, while some variables did not show an association, such as socioeconomic status, among others. Finally, the variables that become protective factors were determined.

Development and Evidence of the Validity of the Condom Use Attitudes Scale for Youth and Adults in a Chilean Context.

Condom use is the most effective preventive behavior against HIV transmission, and its inadequate use is a public health problem that occurs mostly among youth and young adults. Although there are scales that measure condom use, those that exist correspond to English-speaking developments or do not have psychometric evidence to support them, so it is possible that the available adaptations of instruments do not adequately reflect the phenomenon in the Chilean population. Thus, the study aims to develop a scale to assess attitudes toward condom use in Chilean youth and young adults. Initially, a sample of students between 18 and 39 years (n = 520) was used for debugging the instrument. Then, a second sample was taken from the general population aged 18 to 40 (n = 992) to confirm the factor structure of the proposed model. The final scale has 10 items and 3 attitudinal dimensions (affective, cognitive, and behavioral). The results show that the identified structure provides adequate levels (ω > 0.7) or at least sufficient of reliability (ω > 0.6) and presents evidence of validity, based on the internal structure of the test, through ESEM (CFI = 0.993; TLI = 0.984; RMSEA = 0.056). In addition, evidence of validity was obtained based on the relationship with other variables and strong invariance between the scores of men and women. It is concluded that the scale developed has adequate psychometric properties to assess, in brief form, condom use attitudes in equal samples for research and screening purposes.

Effects of a School-Based Drug Prevention Program on Sexual Risk Behavior Among Adolescents in Brazilian Schools.

Sexual risk behaviors are closely related to the use of alcohol, tobacco, and other illicit drugs as well as teen dating violence. School-based drug prevention programs that teach social and personal skills could potentially also reduce sexual risk behaviors. We examined the effects of the #Tamojunto program on youth sexual risk behaviors. A randomized controlled trial was conducted with 6391 7th and 8th grade students in 72 public schools in six Brazilian cities. Baseline data were collected prior to program implementation. Two waves of follow-up assessments occurred after 9 and 21 months. Analyses were performed taking into account the multilevel structure of the data. We used intention-to-treat to evaluate changes in the prevalence of sexual risk behaviors over time and between groups. Adolescent age ranged from 11 to 15 years, with a mean of 12.6 ± 0.8 years, and 51.0% were female. Among all participants, receipt of #Tamojunto was associated with higher risk of lifetime sex at 21 months follow-up (OR 1.27, 95% CI [1.03, 1.56]). Among girls, at 9 months follow-up, the program was associated with higher likelihood of having engaged in sex in the last month (OR 1.76, 95% CI [1.13, 2.74]). At 21 months follow-up, girls receiving the program were more likely to report engaging in condomless sex in the last month (OR 1.64, 95% CI [1.07, 2.50]). #Tamojunto may be ineffective and possibly harmful for preventing sexual risk behaviors, especially among girls. We suggest further investigation of the possible mediating role of life skills intervention components on girl's sexual behaviors.

Mexican descent college student risky sexual behaviors and alcohol use: The role of general and cultural based coping with discrimination.

OBJECTIVE: This study investigates cultural and general coping strategies as potential protective or risk factors to risky sexual behaviors (RSBs) and alcohol use in the face of discrimination for Mexican descent college students. Participants: Data collection was conducted from September 2016 to May 2017 and included 796 Mexican descent emerging adults. Methods: Linear regressions were conducted to test main and interaction effects of discrimination, and general and cultural coping strategies on RSBs and alcohol use issues. Results: Higher discrimination experiences were not associated with RSBs or alcohol use issues. Only ethnicity-based coping was found to be a significant moderator to the relationships between discrimination and the outcome variables of RSBs and alcohol use issues. Conclusions: This study has implications for the way mental health clinicians explore the intersection of ethnic identity and coping as a means of understanding the relationship among discrimination, RSBs, and alcohol use issues.

Health risk behavior and cultural stress among Venezuelan youth: a person centered approach.

BACKGROUND: In recent years, more than 5 million Venezuelans have left their once prosperous country, with several hundred thousand settling in the United States (US). At present, our understanding of the health risk behavior profiles of Venezuelan émigré youth, and their links with cultural stress, remains limited. OBJECTIVES: Drawing from a sample of recently-immigrated Venezuelan youth in the US, we aim to identify subtypes of youth according to their involvement in health risk behaviors (i.e., substance use, sexual risk behavior, violence) and assess the associations between class membership and key constructs related to cultural stress theory (i.e., negative context of reception, family communication/support). METHOD: Latent profile analysis and multinomial regression were performed using data from a community-based convenience sample of 402 recently-arrived Venezuelan immigrant youth (ages 10-17; 56% male). RESULTS: We identified five subtype classes: (1) "Abstainer" (36%), (2) "Alcohol Only" (24%), (3) "Alcohol/Tobacco" (24%), (4) "Aggression" (8%), and (5) "Multidimensional Risk" (8%). Compared to Class #1, youth in Classes #3 and #5 reported significantly higher levels of negative context of reception and lower levels of family functioning while controlling for demographic factors. Youth in Class #5 reported the lowest levels of family economic hardship and the longest duration in the US. CONCLUSION: It is vital that we support both Venezuelan youth who abstain from risk behavior and, at the same time, develop and implement programs that target the needs of those who are at elevated risk for serious consequences related to substance use, sexual risk behavior, and violence.

La biomedicalización del riesgo sexual en América Latina en el siglo XXI / The Biomedicalization of Sexual Risk in Latin America in the 21st century / A biomedicalização do risco sexual na América Latina no século XXI

Resumen Introducción: aunque en la última década el concepto de biomedicalización ha sido relevante en América Latina para entender algunos procesos mediante los cuales la biomedicina participa en la constitución de sujetos y sus padecimientos, poco se ha explorado su relación con la conformación de la sexualidad. Desarrollo: el objetivo de este texto es analizar, desde una perspectiva sociológico-feminista, la biomedicalización del riesgo sexual al virus de inmunodeficiencia humana, mediante la profilaxis preexposición, y al virus del papiloma humano, mediante la aplicación de la vacuna de prevención en México, Colombia y Brasil. Primero, se presenta la noción de biomedicalización, sus usos teóricos en la sociología y los estudios de la ciencia, la tecnología y la biomedicina. Posteriormente, se abordan algunos textos que analizan algunas vicisitudes de la biomedicalización del riesgo sexual, mediante estas biotecnologías en los países mencionados. Finalmente, se problematizan algunas de las ventajas y retos teóricos del uso del concepto de biomedicalización en diversos contextos de América Latina y se señala cuál es su relevancia para comprender las relaciones y diferencias de género en la región. Conclusiones: en estos días, con el auge de la biomedicina y de las farmacéuticas transnacionales, se hace necesario analizar las implicaciones históricas, sociales y políticas de la biomedicalización de la sexualidad en contextos poscoloniales como el latinoamericano.

Abstract Introduction: In the last decade, the concept of "biomedicalization" has played a relevant role in Latin American Science, Technology, and Biomedicine (STS) studies amidst sociological and academic debates on the implications of biomedical interventions in the production of subjects and diseases. However, its relationship with sexuality has scarcely been evaluated. Development: This article aimed to analyze how sexual risk to avoid acquiring both human immunodeficiency virus through PrEP implementation and human papilloma virus through the preventive vaccine implementation in Mexico, Colombia, and Brazil has been thoroughly biomedicalized, from a sociological feminist perspective. First, the concept of biomedicalization and its theoretical uses in medical sociology and STS are briefly introduced. Then, few relevant texts are discussed that approach some aspects concerning the increase in biomedicalization of sexual risk within these biotechnologies in the three countries. Finally, we analyzed the advantages and challenges of introducing the concept of biomedicalization in the Latin American context and its relevance in terms of understanding sex-related relationships and differences. Conclusions: With the recent development of the biomedicine and transnational pharmaceutical industry, it is necessary to analyze the historical, social, and political implications of the biomedicalization of sexuality in the postcolonial contexts, such as those found in Latin America.

Resumo Introdução: ainda que na última década o conceito de biomedicalização tem sido relevante na América Latina para entender alguns processos mediante os quais a biomedicina participa na constituição de sujeitos e seus padecimentos, sua relação com a conformação da sexualidade tem sido pouco explorada. Desenvolvimento: o objetivo deste texto é analisar, desde uma perspectiva sociológico-feminista, a bio-medicalização do risco sexual ao vírus da imunodeficiência humana (VIH) mediante a Profilaxia pre-ex-posição (PrEP, por suas siglas em inglês), e ao vírus do papiloma humano (VPH) mediante a aplicação da vacuna de prevenção no México, na Colômbia, e no Brasil. Primeiro, se apresenta a noção de biomedi-calização, seus usos teóricos na sociologia e os STS (estudos da ciência, a tecnologia e a biomedicina, por suas siglas em inglês). Posteriormente se abordam alguns textos que analisam algumas variabilidades da biomedicalização do risco sexual, mediante estas biotecnologias nos países mencionados. Finalmente, se problematizam algumas das vantagens e desafios teóricos do uso do conceito de biomedicalização em diversos contextos da América Latina e se assinala qual é sua relevância para compreender as relações e diferenças de gênero na região. Conclusões: em nossos dias, com o auge da biomedicina e das farmacêuticas transacionais, se faz necessário analisar as implicações históricas, sociais e políticas da biomedicalização da sexualidade em contextos pós-coloniais, como o Latino-Americano.

Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE).

BACKGROUND: Condom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use. AIM: Our aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey. METHODS: The study participants were 100,962 adolescents 13-18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed. RESULTS: Of the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use. CONCLUSION: High condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.

Novel Service Delivery Approach to Address Reproductive Health Disparities within Immigrant Latino Communities in Geographic Hot Spots: An Implementation Study.

Latinx youths continue to have the highest rates of teenage births in the United States and are at increased risk of acquiring sexually transmitted infections, including HIV/AIDS. A community-based research partnership piloted Families Talking Together, a brief, parent-based sexual risk reduction program using a novel and culturally relevant approach. This mixed-methods study examined the feasibility and acceptability of Spanish-speaking promotoras de salud (that is, community health workers) as implementers of an evidence-based intervention (EBI) to reach underserved immigrant communities. Findings suggest that promotoras are capable of implementing the EBI with positive organizational, client, and implementation outcomes. Furthermore, promotoras hold particular promise for addressing reproductive health disparities as they are indigenous and trusted members of the community who can reach members of marginalized Latino populations.