A Contextualization of Transgender Women and Condom Use Using the HIV Syndemic Framework: Scoping Review.

Objective: To contextualize condom use in the transgender women population utilizing the HIV syndemic framework. Methods: Studies reporting condom use frequency and syndemic factors associated with HIV risk in transgender women were systematically searched. We followed the Scoping Reviews (PRISMA-ScR) checklist. Results: Social factors have a proven relationship with using condoms and HIV among transgender women. Syndemic factors, defined as co-occurring adverse factors that interact to contribute to risk behaviors, deserve a specific analysis to develop strategies to face HIV among transgender women. Conclusions: A syndemic perspective allows to generate specific health intervention and prevention policies to protect transgender women.

Association between HIV Perceived Risk and Intimate Partner Violence among Women / Asociación entre Percepción de Riesgo de VIH y Violencia de Pareja en Mujeres

Abstract HIV risk perception and Intimate partner violence (IPV) are related to HIV infection in women. However, there is a lack of information regarding on the association between risk perception and IPV in the Mexican population. This study aimed to identify and characterize subgroups based on their risk perception through the analysis of latent classes and to evaluate the variables associated with HIV risk perception. An online survey was conducted to assess sexual and preventive behavior, HIV risk perception, and intimate partner violence. Three hundred thirty-two women participated; the sampling was for convenience. Two latent classes were identified: a group with risk perception (85%) and one without risk perception (14.6%). The variables associated with the risk perception were a sexual attraction to men, not having a stable partner, perceiving oneself as at risk of acquiring HIV due to sexual behavior, and the presence of IPV. HIV prevention programs for women must address the stigmas related to HIV, such as the idea that the risk only occurs when they have multiple sexual partners, promote accurate HIV risk perception and prevent IPV in all its expressions and contexts.

Resumen En mujeres, la violencia de pareja está relacionada a una mayor probabilidad de adquirir la infección por VIH. De igual forma, una inadecuada percepción de riesgo de adquirir el virus coloca a las mujeres en una situación vulnerable. Existe una falta de información ente la asociación de la VPI y la percepción de riesgo es mujeres mexicanas. Este estudio persiguió dos objetivos: el primero fue identificar y caracterizar subgrupos en función de su percepción de riesgo a través del análisis de clases latentes; el segundo objetivo consistió en evaluar las variables asociadas con la percepción de riesgo de VIH. Se realizó una encuesta en línea para evaluar el comportamiento sexual y preventivo, la percepción del riesgo de VIH y la VP. Participaron 332 mujeres; el muestreo fue por conveniencia. Se identificaron dos clases latentes: un grupo con percepción de riesgo (85%) y otro sin percepción de riesgo (14,6%). Las variables asociadas a la percepción de riesgo fueron atracción sexual por hombres, no tener pareja estable, percibirse en riesgo de adquirir el VIH por la conducta sexual y haber sufrido de violencia de pareja en los últimos seis meses. Se concluye que los programas de prevención del VIH para mujeres deben abordar los estigmas relacionados con el VIH, como la idea de que el riesgo solo ocurre cuando tienen múltiples parejas sexuales, promover una percepción precisa del riesgo del VIH y principalmente, prevenir la VP en todas sus expresiones y contextos; así como también dar atención personalizada a mujeres que ya sufren de violencia de pareja.

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.

[Discourses about condom use and non-use among gay, bisexual men, and other men who have sex with men in two colombian cities.] / Discursos identificados sobre el uso y no uso del condón en hombres gais, bisexuales y otros hombres que tienen sexo con hombres en dos ciudades de Colombia.

OBJECTIVE: The HIV increase cases raises concern worldwide. This phenomenon is related, among other things, to sexual practices where condom use is limited. To achieve the eradication of AIDS, international organizations have been interested in analyzing and understanding the sexual practices of certain population groups, within these men who have sex with other men. In this sense, the objective of this study was to analyze the discourses on the use and non-use of condoms held by a group of gay, bisexual and other men who have sex with men (GBHSH) men from two cities in Colombia. METHODS: A qualitative study was carried out with data analysis through the iterative process, from the interpretation of the Information, Motivation and Behavioral Skills (IMB) model. The collection of information was carried out between 2020 and 2021 through in-depth interviews, virtually and in person, with a sample of 20 GBHSH from Colombia from the cities of Cali and Medellín. RESULTS: In the Information component, it was identified that traditional sexual education had a negative impact and was very focused on a cisheterosexual and reproductive perspective. Regarding Motivational, it was highlighted that the majority were oriented towards not using condoms and that perceiving a low risk of contracting an STI was the main motivation for not using condoms. Regarding Behavioral Skills, it was analyzed that distrust towards the sexual partner promoted its use, but the intensification of pleasure, added to the consumption of alcohol and drugs, caused its use to decrease. It was also evidenced that the use of drugs such as PreP or PEP discouraged condom use in relationships. CONCLUSIONS: The information on condom use revolves around cisheteronormative practices, leaving aside the care related to STIs. The motivation for not using condoms revolves around misinformation, pleasure and trust in the couple, while the motivation for condom use revolves around health care. The behavior regarding the non-use of condoms is related to the previous points, while misinformation and pleasure in non-use predominate.

OBJETIVO: El aumento de casos de VIH suscita preocupación a nivel mundial. Este fenómeno se relaciona, entre otras cosas, con prácticas sexuales en donde se limita el uso del condón. Para lograr la erradicación del sida, organismos internacionales se han interesado en analizar y comprender las prácticas sexuales de ciertos grupos poblacionales, dentro de estos, los hombres que tienen relaciones sexuales con otros hombres. En este sentido, el objetivo de este estudio fue analizar los discursos sobre el uso y no uso del condón que tenía un grupo de hombres gais, bisexuales y otros hombres que tienen sexo con hombres (GBHSH) de dos ciudades de Colombia. METODOS: Se realizó un estudio cualitativo con análisis de datos por medio del proceso iterativo, desde la interpretación del modelo Información, Motivación y Habilidades conductuales (IMB, por sus siglas en inglés). La recolección de la información se realizó entre los años 2020 y 2021 por medio de entrevistas en profundidad, de manera virtual y presencial, con una muestra de 20 GBHSH de Colombia de las ciudades de Cali y Medellín. RESULTADOS: En el componente Información se identificó que la educación sexual tradicional tenía un impacto negativo y muy enfocado a una mirada cisheterosexual y reproductiva. Respecto a lo Motivacional, se destacó que la mayoría se orientaban al no uso del condón y que percibir un bajo riesgo de contraer una ITS era la principal motivación del no uso del condón. Con relación a las Habilidades Conductuales se analizó que la desconfianza hacia la pareja sexual promovía su uso, pero la intensificación del placer, sumado al consumo de alcohol y drogas, hacía que su uso disminuyera. También se evidenció que el uso de fármacos como el PreP o el PEP desestimulaban el uso del condón en las relaciones. CONCLUSIONES: La información sobre el uso del condón gira alrededor de prácticas cisheteronormativas, dejando de lado los cuidados relacionados con las ITS. La motivación sobre el no uso del condón gira alrededor de la desinformación, el placer y la confianza en la pareja, mientras que la motivación para el uso del condón gira alrededor del cuidado a la salud. El comportamiento sobre el no uso del condón se relaciona con los puntos anteriores, en tanto que predominan la desinformación y placer en el no uso.

Prevalence and factors associated with condom use among sexually active young women in Haiti: evidence from the 2016/17 Haiti demographic and health survey.

BACKGROUND: Young women in Haiti remain vulnerable to sexually transmitted infections and unintended pregnancy. However, little is known about condom use among this population. This study examined the prevalence and the factors associated with condom use among sexually active young women in Haiti. METHODS: Data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the factors associated with condom use among sexually active young women in Haiti were assessed using descriptive statistics and binary logistic regression model. RESULTS: The prevalence of condom use was 15.4% (95% CI 14.0-16.8). Being teenage (AOR = 1.34; 95% CI: 1.04-1.74), living in urban areas (AOR = 1.41; 95% CI = 1.04-1.90), having higher education level (AOR = 2.39; 95% CI: 1.44-4.00), being in the middle or rich category of household wealth index (AOR = 2.32; 95% CI: 1.53-3.53 and AOR = 2.93; 95% CI: 1.90-4.52), having correct knowledge of ovulatory cycle (AOR = 1.65; 95% CI: 1.30-2.10), having 2-3 lifetime sexual partners and one lifetime sexual partner (AOR = 2.04; 95% CI: 1.36-3.06 and AOR = 2.07; 95% CI: 1.35-3.17) had significantly higher odds of using condom. In addition, sexually active young women whose last partner was their boyfriend (AOR = 4.38; 95% CI: 2.82-6.81), and those whose last partner was a friend/casual acquaintance/commercial sex worker (AOR = 5.29; 95% CI: 2.18-12.85) were associated with increased likelihood of using condom compared with their counterparts whose partner was their spouse. CONCLUSION: The Haitian government as well as institutions involved in sexual health should consider these factors when designing sexual and reproductive health interventions targeting young women. More specifically, to increase condom use and reduce risky sexual behaviors, they should combine efforts to raise awareness and induce sexual behavioral changes at two levels. In the education system, they should reinforce sexual education in primary and secondary schools while paying special attention to rural areas. In the whole society, it is important to deepen efforts toward increased awareness on family planning and condom use, through mass media and local organizations including religious ones. Priority should be given to the poorer households, young people and women, and rural areas, in order to maximize reduction in early and unintended pregnancy, and sexually transmitted infections. Interventions should include a condom price subsidy and a campaign to destigmatize condom use which is actually a "male affair".

Barriers to Condom Negotiation and Use Among Female Sex Workers in the United States and United States-Mexico Border Cities: A Systematic Review.

Despite the effectiveness of male condoms, many Female Sex Workers (FSWs) report using condoms infrequently with multiple clients during sexual activity. As such, inconsistent condom use by FSWs is a public health concern as it can increase STI and HIV transmission. This systematic review synthesized extant evidence regarding barriers to condom use experienced by FSWs in the U.S and U.S. - Mexico border towns. The search was conducted through PubMed, CINAL, Cochrane, Medline, and PsychInfo. Studies were included if: they were conducted in the U.S. or U.S. - Mexico borders, their target population was FSWs, they examined condom use barriers experienced by FSWs, and they were published in English between 2011 and February 2021. Condom use barriers among FSWs were reported in all the articles including alcohol consumption and drug use before sex, venue stability, socio-economic status vulnerability, violence and gendered power dynamics, trust of regular clients, and age. The review findings indicate the need to develop interventions promoting condom use for both FSWs and their clients, as well as alternative interventions for HIV prevention such as pre-exposure prophylaxis (PrEP).

Validation of Brief Condom Use Attitudes Scales for Spanish-Speaking People Who Use Crack Cocaine in El Salvador.

People who use crack cocaine (PWUCC) are a population severely impacted by a concentrated epidemic of HIV. Behavioral interventions to prevent and treat HIV among PWUCC have been implemented around the world including in low- and middle-income countries which have been disproportionately affected by HIV. However, few studies have validated and assessed psychometric properties of measures on PWUCC, especially in transnational populations. Our sample was comprised of 1324 PWUCC, Spanish mono-lingual speakers, residing in the metropolitan area of San Salvador, El Salvador. Exploratory factor analysis and subsequent confirmatory factor analysis using statistical softwares SPSS and Amos were conducted on three abbreviated and translated condom use attitude measures (i.e., Condom Use Attitudes Scale-Spanish Short Form, Condom Use Social Norm-Spanish Short Form [CUSN-SSF], Condom Use Self-Efficacy-Spanish Short Form). Convergent validity was examined by computing bivariate correlations between the scales and condom use and sexually transmitted disease diagnosis. Results indicated that a two-factor, 8-item correlated model for the CUAS-SSF scale had an excellent fit and adequate reliability (α = .76). The confirmatory factor analysis for the 5-item CUSN-SSF scale indicated a satisfactory fit with 3 of 6 fit indices indicating adequate fit. Analysis of the two-factor 5-item CUSE-SSF scale indicated satisfactory fit and adequate reliability (α = .84). There were significant correlations between all measures and with self-reported condom use. Results indicate that these brief measures are reliable and valid and can be utilized to assess the effectiveness of HIV risk reduction interventions among Spanish-speaking PWUCC.

Exploring Contextual Differences for Sexual Role Strain Among Transgender Women and Men Who Have Sex with Men in Lima, Peru.

Sexual and gender politics inform relational expectations surrounding sexual experiences of Peruvian transgender women (TW) and men who have sex with men (MSM). We used the framework of sexual role strain, or incongruence between preferred sexual role and actual sexual practices, to explore potential conflicts between personally articulated identities and externally defined norms of gender and sexuality and its potential to increase HIV/STI risk. Cross-sectional individual- and dyad-level data from 766 TW and MSM in Lima, Peru were used to assess the partnership contexts within which insertive anal intercourse was practiced despite receptive role preference (receptive role strain), and receptive anal intercourse practiced despite insertive role preference (insertive role strain). Sexual role strain for TW was more common with non-primary partners, while for MSM it occurred more frequently in the context of a primary partnership. Receptive role strain was more prevalent for TW with unknown HIV status (reference: without HIV) or pre-sex drug use (reference: no pre-sex drug use). For homosexual MSM, receptive role strain was more prevalent during condomless anal intercourse (reference: condom-protected) and with receptive or versatile partners (reference: insertive). Among heterosexual or bisexual MSM, insertive role strain was more prevalent with insertive or versatile partners (reference: receptive), and less prevalent with casual partners (reference: primary). Our findings suggest TW and MSM experience different vulnerabilities during sexual role negotiation with different partner-types. Future studies should explore the impact of sexual role strain on condom use agency, HIV/STI risk, and discordances between public and private presentations of gender and sexual orientation.

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.

Trabajo sexual y pandemia de la COVID-19: salud sexual y mental de una muestra de trabajadoras sexuales de Colombia

Introducción: En diversos países las mujeres trabajadoras sexuales han sido estigmatizadas y discriminadas, lo que causa en ellas problemas de salud mental y sexual. No obstante, se desconoce cómo la pandemia por COVID-19 y el distanciamiento social han impactado en su salud. El objetivo de la presente investigación, de tipo descriptivo, fue evaluar factores psicosociales, la salud mental, las estrategias para prácticas sexuales con protección, las actitudes hacia el VIH y la sexualidad durante el periodo de confinamiento. . Método: Participaron 98 mujeres trabajadoras sexuales de tres sectores de la Bogotá, quienes respondieron a escalas psicométricas en salud mental y sexual. Resultados: Más del 60 % de las participantes indican sentir abandono estatal, baja clientela y poco o ningún ingreso económico; afectación emocional, una tendencia a presentar actitudes negativas frente a la sexualidad, actitudes favorables hacia el uso del condón, las pruebas de detección del VIH y una alta tendencia a emplear estrategias de persuasión cuando el cliente se niega a usar protección. Conclusiones: Las problemáticas en salud mental y sexual se mantienen e intensifican en pandemia para las trabajadoras sexuales en Colombia, lo cual sigue siendo un reto a escala nacional que requiere una intervención eficaz y efectiva desde lo económico y psicosocial.

Introduction: In different countries, women sex workers have been stigmatized and discriminated against causing mental and sexual health problems in them. However, it is unknown how the pandemic and social distancing have impacted on their health. The objective of this descriptive research was to evaluate psychosocial factors, mental health, strategies for safe sexual practices, attitudes towards HIV and sexuality during the confinement period. Method: 98 female sex workers from three sectors of Bogotá participated, who responded to psychometric scales on mental and sexual health. Results: More than 60% of the participants indicate feeling abandonment of the state, low clientele and little or no economic income; emotional involvement, a tendency to present negative attitudes towards sexuality, positive attitudes towards condom use, HIV testing and a high tendency to use persuasion strategies when the client refuses to use protection. Conclusions: Mental and sexual health problems continue and intensify in pandemic for sex workers in Colombia, which continues to be a national challenge that requires efficient and effective intervention from the economic and psychosocial aspects.

Individual and context correlates of the oral pill and condom use among Brazilian female adolescents.

BACKGROUND: Studies have examined the impact of contextual factors on the use of contraceptives among adolescents and found that many measures of income and social inequality are associated with contraceptive use. However, few have focused on maternal and primary health indicators and its influence on adolescent contraceptive use. This paper assesses whether maternal mortality rates, antenatal care visits, and primary healthcare coverage are associated with pill and condom use among female adolescents in Brazil. METHODS: We used data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national, school-based cross-sectional study conducted in Brazil. A subsample of all female adolescents who had ever had sexual intercourse and were living in one of the 26 State capitals and the Federal District was selected (n = 7415). Multilevel mixed effects logistic regression models were estimated to examine the effect of contextual variables on pill and condom use. RESULTS: Sixty-five percent of female adolescents reported using pill while 21.9% reported using condom during the last sexual intercourse. Adolescents living in municipalities with low maternal mortality and high antenatal care coverage were significantly more likely to use pill during the last sexual intercourse compared to those from municipalities with high maternal mortality and low antenatal care coverage. Primary healthcare coverage (proportion of the population covered by primary healthcare teams) was not significantly associated with either condom or pill use during the last sexual intercourse. CONCLUSION: Our findings suggest that promoting the use of pill among female adolescents may require approaches to strengthen healthcare systems rather than those focused solely on individual attributes.

Condom-Protected Sex and Minority Stress: Associations with Condom Negotiation Self-Efficacy, "Passing" Concerns, and Experiences with Misgendering among Transgender Men and Women in Brazil.

This cross-sectional exploratory study aims to verify associations between condom-protected sex, condom negotiation self-efficacy, self-esteem, and four minority stressors (experiences with misgendering, "passing" concerns, anticipated prejudice, and perceived prejudice) among transgender men (TM) and transgender women (TW). 260 individuals (192 TW and 68 TM) residing in two Brazilian states participated in the study. Data was collected online and in two hospital programs for transgender people and included sociodemographic data, condom-protected sex, the Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) Scale, the Rosenberg Self-Esteem Scale, and four minority stressors. Measures that were significantly associated with condom-protected sex were tested as independent variables in a linear regression model. The main results suggest that lower condom negotiation self-efficacy, higher "passing" concerns, and higher experiences with misgendering were predictors of lower frequency of condom-protected sex. These negative outcomes were found among both TM and TW, which justifies their inclusion in public health policies. Structural strategies and clinical interventions are suggested to address condom negotiation self-efficacy and "passing" concerns in transgender populations.

Internet Study about Risk Factors Associated with HIV among Heterosexuals in Puerto Rico.

OBJECTIVE: Heterosexual intercourse is the main mode of HIV transmission among heterosexual women in Puerto Rico and the third for men. We conducted an Internetbased study of heterosexual young adults in Puerto Rico to explore their sexual practices, beliefs and decision-making skills for HIV prevention. Data presented in this study will help to understand the factors that contribute to the sexual transmission of HIV among heterosexuals within the Puerto Rican context. METHODS: We administered an online-based survey to a sample of 618 young adult heterosexual men and women. Data were collected using Perseus Survey Solutions software. RESULTS: Overall, most participants expressed they had the same sexual partner in the previous six months, never or almost never used male condoms with their main partner and did not perceive themselves at-risk of contracting HIV (have a low HIV risk perception). Men reported using male condoms more frequently than women (e.g. male condom on their male partner) during vaginal sex, in particular single and younger men. Women expressed more positive attitudes toward male condoms than men. CONCLUSION: Results confirm the need to implement interventions that increases the sense of vulnerability among heterosexuals, as well as skills and use of male condoms. This study contributes additional data on sexual practices and attitudes to encourage the identification of new or current changes in HIV protective or risk factors, specifically for an understudied population of Heterosexuals in Puerto Rico.

Spanish Translation, Adaptation, and Validation of the Multidimensional Condom Attitudes Scale with Young Colombian Men and Women.

Infection by HIV/AIDS or other STIs and unplanned pregnancies are sexual health problems of considerable impact around the world. Condoms are the only method that prevents all those risks, and attitudes toward the use of condoms are among the best predictors of their consistent use. The purpose of the present study was to translate, adapt, and validate a Spanish-language version of the Multidimensional Condom Attitudes Scale (MCAS) using a sample of young people from Colombia. A total of 1441 young people between the ages of 18 and 26 years responded to a web-based survey conducted between January 2018 and February 2018. The dimensionality of the scale was explored and confirmed to replicate the original five-factor structure (alphas ranged from .65 to .86). Criterion validity was adequate. Women had more positive attitudes toward identity stigma associated with condom use, while men had more positive attitudes toward reliability and effectiveness of condoms and were less embarrassed with condom negotiation and use. The Spanish-language MCAS is suitable for measuring condom-related attitudes among Colombian youth. Future research is needed to validate the Spanish version of the MCAS with other Spanish-speaking populations.

Social networks and condomless intercourse with female partners among male sex workers in the Dominican Republic.

Male sex workers (MSW) in the Dominican Republic (DR) have multiple sexual partners, including personal and client-relationships, and are disproportionately affected by human immunodeficiency virus (HIV). We examined the prevalence of condomless anal and/or vaginal intercourse (CI) among MSW in the DR as a function of social network factors. Self-report surveys and social network interviews were administered to MSW recruited through venue-based sampling (N = 220). A generalized linear model was used to complete a Poisson Regression model and identify variables significantly associated with the outcome of interest. CI was more common with female (28.3%) than with male partners (4.9%). Factors associated with CI with the last female partner included older age of MSW, CI with the last male partner, having a stable female partner (a consistent or main partner), and having ≥1 family member in the participants' social network. Partner and social network characteristics associated with CI among MSW suggest the utility of dyadic and network interventions to reduce HIV risk.

Assessing Human Immunodeficiency Virus (HIV) Prevention Through Knowledge and Condom Use Among Female Sex Workers at the Border of Haiti and Dominican Republic.

Geographic border studies are relatively scare, but have the potential to inform bilateral health policies that affect the well-being of female sex workers (FSWs) who work at these borders as well as those individuals who solicit their services, both groups being at high risk for human immunodeficiency virus (HIV). We applied bivariate and multivariate techniques to examine FSWs' HIV knowledge and condom use across three partner types, at the Haiti Dominican Republic border, using data from the Study on Sex Workers (n = 241, 2014). Condom use was significantly lower among FSWs on the Haitian side of the border compared to the Dominican side, yet levels of HIV knowledge were similar; specifically, 81% of respondents on the Dominican side reported using condoms every time they had sex with a client, compared to 38% of peers in Haiti (p < 0.001). After introducing controls, FSWs in Haiti continued to have lower odds of using condoms with clients (p < 0.001), noncommercial partners (p < 0.001), and regular partners (p < 0.05) compared to peers in the Dominican Republic. This unique border study highlights disparities in FSWs' condom use regardless of HIV knowledge. The lack of consistent condom use by FSWs in Haiti has the potential to exacerbate the HIV epidemic at the border and impact both nations' HIV incidence rates.

HIV/AIDS-related Knowledge and Behavior among School-attending Afro-Descendant Youths in Ecuador.

BACKGROUND OR OBJECTIVES: HIV/AIDS transmission in Ecuador is considered a concentrated epidemic; therefore, there are some studies on high risk groups but there is limited published data regarding the HIV/AIDS risk factors among adolescents of African descent. In this study, we sought to explore the determinants of HIV/AIDS-related knowledge and behavior among afro-descendant youths attending schools in the city of Esmeraldas, Ecuador. METHODS: A cross-sectional survey among school-attending youths was conducted in Esmeraldas, Ecuador in 2010. Our target population was afro-descendant youths attending the last two years of high school. Thirty public high schools enrolling students in junior and senior years were identified. Outcome data were analyzed in the form of three composite variables. A multivariate linear regression model was built for each outcome. RESULTS: A total of 213 school-attending afro-descendant youths aged 14 to 21 years old were enrolled in this study. Gender distribution was almost equal with a 1:1.17 male to female ratio. Overall, students in this population scored well in comprehensive knowledge of HIV with 88% having medium or higher knowledge. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Knowledge of HIV and its determinants was medium to high, but knowledge of sexually transmitted diseases was low among afro-descendant Ecuadorian adolescents in our study. Results of this study might be instrumental in facilitating decision-making processes related to the planning, implementation, and evaluation of HIV/AIDS prevention and control strategies in this specific population.

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.

Psychometric Properties of the Condom Use Self-Efficacy Scale among Young Colombians.

(1) Background: This study evaluated the psychometric properties of the Condom Use Self-Efficacy Scale among Colombian youth. (2) Method: A total of 2873 men and women between 18 and 26 years old (M = 21.45, SD = 2.26) took part in this study. All participants answered a socio-demographic survey, the Condom Use Self-Efficacy Scale, the UCLA Multidimensional Condom Attitudes Scale, The Condom Use Errors and Problems Scale, and the Sexual Assertiveness Scale. Sampling was web-based, and the survey was distributed via Facebook. (3) Results: The Condom Use Self-Efficacy Scale demonstrated adequate reliability (ordinal α ranged = 0.76 to 0.92). Exploratory and confirmatory factor analysis suggested a four-factor structure with an explained variance of 69%. This dimensionality was also invariant across gender. Moreover, positive attitudes toward condom use were significantly associated with appropriation and assertiveness. Two dimensions (appropriation and partner disapproval) showed significant gender differences. (4) Conclusions: The Spanish-Colombian version of the Condom Use Self-Efficacy Scale is a psychometrically adequate instrument to measure perceived condom use self-efficacy. This scale can be used in both research and professional settings to measure self-efficacy at using condoms in young people.

[DIFFERENCES IN SEXUAL NEGOTIATION STYLES AND SEXUAL SELF-EFFICACY IN USE OF CONDOM IN UNIVERSITY MEN AND WOMAN OF QUERETARO, MEXICO, 2018].

OBJECTIVE: To compare sexual negotiation levels and self-efficacy in male condom use in men and women. METHODS: Comparative crosssectional study of undergraduate students carried out during the year 2018 in a private university in the city of Querétaro, Mexico. Non-probabilistic sampling was used. Measured variables included sociodemographic characteristics, risky sexual behaviors, negotiation skills and sexual self-efficacy for condom use. The Mann Whitney U test and non-parametric variance analysis (Kruskal - Wallis) were used. RESULTS: Overall, 270 students were enrolled; 89.6% of university students were sexually active; the mean age of sexual activity initiation was 15.41 years. The average reported number of sexual partners was 4.2. In each sexual relation, 27.8% had used a condom. Differences were found between men and women in terms of sexual negotiation styles in the avoidance (p=0.04) and accommodation (p<0.00) domains, with higher scores for men compared to women. Women scored higher for self-efficacy in condom use (p<0.001). CONCLUSIONS: The young university students interviewed engage in risky sexual activities. Women exhibit greater sexual self-efficacy as well as better skills at negotiating condom use. Strengthening public policies targeted to the student population for the prevention of risky sexual behavior is needed. Further studies on interventions aimed at building strong sexual negotiation and self-efficacy among adolescents are required.

TITULO: DIFERENCIAS EN LOS ESTILOS DE NEGOCIACIÓN SEXUAL Y AUTOEFICACIA EN EL USO DEL CONDÓN EN HOMBRES Y MUJERES UNIVERSITARIOS DE QUERÉTARO, MÉXICO, 2018. OBJETIVO: comparar los niveles de negociación sexual y autoeficacia en el uso del condón masculino en hombres y mujeres. METODOS: estudio transversal de tipo comparativo en el que se incluyeron estudiantes de licenciatura de una universidad privada de la ciudad de Querétaro, México, durante el año 2018. Muestreo no probabilístico. Se midieron: características sociodemográficas, conductas sexuales de riesgo, habilidades de negociación y autoeficacia sexual para uso de condón. Se compararon los grupos mediante la prueba U de Mann Whitney y el análisis de varianza no paramétrico (Kruskal-Wallis). RESULTADOS: ingresaron 270 estudiantes, el 89,6 % de los universitarios tiene vida sexual activa, la edad promedio de inicio de vida sexual es a los 15,41 años; el promedio de parejas sexuales reportado es de 4,2. El 27,8 % ha usado condón en cada relación sexual. Se encontraron diferencias entre hombres y mujeres en los estilos de negociación sexual en los dominios de evitación (p = 0,04) y acomodación (p < 0,00), con puntajes más altos para los hombres en comparación con las mujeres. Respecto a la autoeficacia en el uso del condón, las mujeres son quienes puntúan más alto (p < 0,001). CONCLUSIONES: los jóvenes universitarios entrevistados tienen conductas sexuales de riesgo. Se requiere fortalecer las políticas públicas que faciliten la prevención de la conducta sexual de riesgo dirigidas a la población estudiantil. Es necesario realizar más estudios sobre intervenciones que fortalezcan las habilidades de negociación y la autoeficacia sexual en adolescentes.