Using phylogenetics to infer HIV-1 transmission direction between known transmission pairs.

Inferring the transmission direction between linked individuals living with HIV provides unparalleled power to understand the epidemiology that determines transmission. Phylogenetic ancestral-state reconstruction approaches infer the transmission direction by identifying the individual in whom the most recent common ancestor of the virus populations originated. While these methods vary in accuracy, it is unclear why. To evaluate the performance of phylogenetic ancestral-state reconstruction to determine the transmission direction of HIV-1 infection, we inferred the transmission direction for 112 transmission pairs where transmission direction and detailed additional information were available. We then fit a statistical model to evaluate the extent to which epidemiological, sampling, genetic, and phylogenetic factors influenced the outcome of the inference. Finally, we repeated the analysis under real-life conditions with only routinely available data. We found that whether ancestral-state reconstruction correctly infers the transmission direction depends principally on the phylogeny's topology. For example, under real-life conditions, the probability of identifying the correct transmission direction increases from 32%-when a monophyletic-monophyletic or paraphyletic-polyphyletic tree topology is observed and when the tip closest to the root does not agree with the state at the root-to 93% when a paraphyletic-monophyletic topology is observed and when the tip closest to the root agrees with the root state. Our results suggest that documenting larger differences in relative intrahost diversity increases our confidence in the transmission direction inference of linked pairs for population-level studies of HIV. These findings provide a practical starting point to determine our confidence in transmission direction inference from ancestral-state reconstruction.

Mapping and size estimation of men who have sex with men in virtual platforms in Delhi, India.

INTRODUCTION: In India, the HIV epidemic is concentrated among Key Populations (KPs), such as men who have sex with men (MSM), who bear a disproportionate burden of HIV disease. Conventional targeted interventions (TI) mitigate HIV transmission among MSM by focusing on physical hotspots. As increasingly, there is a shift within India's MSM community to connect with sex partners online, novel approaches are needed to map virtual platforms where sexual networks are formed. The objective of this study was to estimate the number of MSM in Delhi using virtual platforms to connect for sex and to describe patterns of their use. METHODS: The study was conducted in the state of Delhi among MSM over 18 years of age who used virtual platforms to look for sexual partners. Virtual platforms were identified through community consultations. Size estimation was carried out by enumerating the number of online users, accounting for duplication across sites and time and based on interviews with 565 MSM. RESULTS: 28,058 MSM (95% CI: range 26,455-29,817) use virtual sites to find sexual partners. We listed 14 MSM specific virtual sites, 14 general virtual sites, 19 social networking pages and 112 messenger groups, all used by MSM. Five virtual sites met feasibility criteria to be included in the virtual mapping. Of the MSM on these sites, 81% used them at night and 94% used them on Sundays, making these the peak time and day of use. Only 16% of users were aware of organizations providing HIV services and 7% were contacted by peer educators in the preceding three months. Two-fifths (42%) also visited a physical location to connect with sexual partners in the month prior to the study. DISCUSSION: TI programs that focus on physical hotspots do not reach the majority of MSM who use virtual sites. MSM active on virtual sites have a low awareness of HIV services. Virtual mapping and programmatic interventions to include them must be incorporated into current public health interventions to reach MSM at risk of HIV.

Going beyond 'regular and casual': development of a classification of sexual partner types to enhance partner notification for STIs.

OBJECTIVES: To develop a classification of sexual partner types for use in partner notification (PN) for STIs. METHODS: A four-step process: (1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; and review of PN guidelines; qualitative interviews with public, patients and health professionals to generate an initial comprehensive classification; (2) multidisciplinary clinical expert consultation to revise the classification; (3) piloting of the revised classification in sexual health clinics during a randomised controlled trial of PN; (4) application of the Theoretical Domains Framework (TDF) to identify index patients' willingness to engage in PN for each partner type. RESULTS: Five main partner types emerged from the evidence synthesis and consultation: 'established partner', 'new partner', 'occasional partner', 'one-off partner' and 'sex worker'. The types differed across several dimensions, including likely perceptions of sexual exclusivity, likelihood of sex reoccurring between index patient and sex partner. Sexual health professionals found the classification easy to operationalise. During the trial, they assigned all 3288 partners described by 2223 index patients to a category. The TDF analysis suggested that the partner types might be associated with different risks of STI reinfection, onward transmission and index patients' engagement with PN. CONCLUSIONS: We developed an evidence-informed, useable classification of five sexual partner types to underpin PN practice and other STI prevention interventions. Analysis of biomedical, psychological and social factors that distinguish different partner types shows how each could warrant a tailored PN approach. This classification could facilitate the use of partner-centred outcomes. Additional studies are needed to determine the utility of the classification to improve measurement of the impact of PN strategies and help focus resources.

p16INK4A Expression in Condyloma Acuminata Lesions Associated with High-Risk Human Papillomavirus Infection.

OBJECTIVE: The objective of this study was to discover the possible correlation between p16INK4A expression and the LR/HR-HPV infection in condyloma acuminate (CA) lesions. MATERIALS AND METHOD: This cross-sectional study was conducted during January-December 2017 on 33 CA patients. The expression of p16INK4A was detected by immunohistochemistry (IHC) staining. The positive interpretation was carried out by scoring which score 0 was negative, score 1 was sporadic, score 2 was focal, and score 3 was diffuses. The HPV genotypes were identified by reverse line blot, and 40 genotypes of HPV detected, including HR-HPV (HPVs 16, 18, 26, 31, 33,35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68a, 68b, 69, 73, and 82) and LR-HPV (HPVs 6, 11, 40, 42, 43, 44, 54, 55, 61, 62, 64, 70, 71, 72, 81, 83, 84, 87, 89, and 90). RESULTS: The expression of p16INK4A was significantly correlated with HR-HPV infection. Patients infected with HR-HPV had 0.644 times higher possibility to express p16INK4A gene compared to those infected with LR-HPV. LR-HPV genotypes detected in CA patients were HPVs 6, 11, 42, 61, 54, 81, 87, 89, and 90 and HR-HPV genotypes were HPVs 18, 26, 45, 51, 52, 67, 68B, 69, and 82. LR-HPV was found in 19/33 of patients and HR-HPV was in 14/33 of patients. The expression of p16INK4A in CA lesions was diffuse in15.2% of patients, was focal in 24.2% of patients , was sporadic in 39.4% of patients were, and was negative in 21.2% of patients . In LR-HPV group, there was no diffuse expression, focal expression was observed in 15.8%, sporadic in 47.4%, and negative in 36.8%, while in HR-HPV group, p16INK4A expression was detected in all lesions , in a way that its expression was diffuse in 35.7%, focal in 35.7%, and sporadic in 28.6%. CONCLUSION: IHC is a routine method in histopathological diagnosis, therefore the detection of p16INK4A expression by IHC can be used as a biomarker for HR-HPV infection diagnosis.

Uptake of oral fluid-based HIV self-testing among men who have sex with men and transgender women in Thailand.

BACKGROUND: Suboptimal uptake of HIV testing remains a primary bottleneck to HIV prevention and treatment for men who have sex with men (MSM) and transgender women (TGW) in Thailand. The World Health Organization has recommended HIV self-testing (HIVST) as an additional strategic HIV service. However, HIVST has not been fully endorsed and implemented in many countries in Southeast Asia. The aim of this study was to assess the uptake of oral fluid-based HIVST in MSM and TGW populations in Thailand. METHODS: During 2017 and 2018, we conducted a cross-sectional study using convenience sampling to enroll 2,524 participants from three major urban areas. Participants were recruited during outreach and online activities and were offered unassisted or assisted HIVST, or referral to HIV testing services. A descriptive analysis was performed for summarizing data. RESULTS: A total of 2,502 participants (1,422 MSM and 1,082 TGW) were included in the analysis with about one-third (36.1%) of them being first-time testers. Among all participants enrolled in the study, a total of 2,486 participants (99.3%) selected HIVST versus referral to HIV testing services. Of those who selected HIVST, 2,095 (84.3%) opted for assisted HIVST while the rest opted for unassisted HIVST: 1,148 of 1,411 MSM (81.4%) and 947 of 1,075 TGW (88.1%) selected assisted HIVST. While no serious adverse events were reported during the study, we found that among 179 participants who needed a confirmatory test and were referred to HIV testing services, 108 (60.3.4%) accessed these later services. CONCLUSIONS: This study demonstrated a high uptake of oral fluid-based HIVST among MSM and TGW populations in Thailand and that HIVST could be scaled up through the national epidemic control program. However, a better understanding of HIV testing-seeking behavior and innovative follow-up solutions are needed to improve and monitor linkages to services for people who undertake HIVST.

STI prevalence among men living with HIV engaged in safer conception care in rural, southwestern Uganda.

HIV care provides an opportunity to integrate comprehensive sexual and reproductive healthcare, including sexually transmitted infection (STI) management. We describe STI prevalence and correlates among men living with HIV (MLWH) accessing safer conception care to conceive a child with an HIV-uninfected partner while minimizing HIV transmission risks. This study reflects an ongoing safer conception program embedded within a regional referral hospital HIV clinic in southwestern Uganda. We enrolled MLWH, planning for pregnancy with an HIV-uninfected partner and accessing safer conception care. Participants completed interviewer-administered questionnaires detailing socio-demographics, gender dynamics, and sexual history. Participants also completed STI laboratory screening for syphilis (immunochromatographic testing confirmed by rapid plasma reagin), and chlamydia, gonorrhea, trichomoniasis, and HIV-RNA via GeneXpert nucleic acid amplification testing. Bivariable associations of STI covariates were assessed using Fisher's exact test. Among the 50 men who completed STI screening, median age was 33 (IQR 31-37) years, 13/50 (26%) had ≥2 sexual partners in the prior three months, and 46/50 (92%) had HIV-RNA <400 copies/mL. Overall, 11/50 (22%) had STIs: 16% active syphilis, 6% chlamydia. All participants initiated STI treatment. STI prevalence was associated with the use of threats/intimidation to coerce partners into sex (27% vs 3%; p = 0.03), although absolute numbers were small. We describe a 22% curable STI prevalence among a priority population at higher risk for transmission to partners and neonates. STI screening and treatment as a part of comprehensive sexual and reproductive healthcare should be integrated into HIV care to maximize the health of men, women, and children.

Pre-exposure prophylaxis use among HIV serodiscordant couples: a qualitative study in Mozambique

Background: Pre-exposure prophylaxis (PrEP) has the potential to reduce HIV transmission and stem the HIV epidemic. Unfortunately, PrEP uptake in rural sub-Saharan Africa has been slow and medication adherence has been suboptimal. Objective: To explore the perspectives, attitudes, and experiences of HIV serodiscordant partners taking PrEP and develop a messaging campaign to improve PrEP uptake in rural Mozambique to reduce HIV transmission among serodiscordant partners. Methods: In this qualitative study, we interviewed 20 people in serodiscordant relationships using PrEP at a rural health center in Zambézia province, Mozambique and employed inductive and deductive coding to elicit their perspectives, attitudes, and experiences related to learning their partner's HIV status, barriers to PrEP uptake, obstacles to PrEP adherence, and decisions to disclose their PrEP use with family and friends using thematic analysis. Results: Our analysis generated nine themes across various levels of the socioecological model. Participants reported a strong desire to stay in the discordant relationship and highlighted the importance of working together to ensure PrEP and antiretroviral therapy adherence, with the majority skeptical that adherence could be achieved without both partners' support (individual and interpersonal). Although most participants were reticent about sharing their serodiscordant status with family and friends (individual and interpersonal), those who did found their family and friends supportive (interpersonal). Participants suggested increasing community health agent availability to help people navigate HIV prevention and treatment (organizational). We then created three oral stories, using themes from the interviews, with examples from various levels of the socioecological model that will be used to generate support for PrEP use among community members. Conclusions: Our findings informed oral template stories that will be used to emphasize how couples can work together to improve PrEP uptake and reduce incident HIV infections in serodiscordant couples elsewhere in rural Mozambique.

Substance use and risk of HIV infection among Men who have Sex with Men in India: Analysis of National IBBS data, India.

HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances.Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015.For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection.One in 3 MSM (33.88%) in India were substance users, thus exhibiting "multi-risk" (MR) behaviors. Significantly higher HIV prevalence (3.8%, P < .05) was reported among MR-MSM, despite 97.2% of them being aware of HIV. Higher HIV prevalence among MSM exhibiting homosexual behavior for ≤1 year is of specific concern, as this accounts to recent infections and indicates the increased vulnerability of the infection among the new entrants.Substance-use resulting in high-risk sexual behavior was significantly associated with higher HIV prevalence among MR-MSM. Integrated targeted interventions focusing on safe sex and safe-IDU practices among MR-MSM are required to end the disease transmission.

Physical Distancing Due to COVID-19 Disrupts Sexual Behaviors Among Gay and Bisexual Men in Australia: Implications for Trends in HIV and Other Sexually Transmissible Infections.

INTRODUCTION: In March 2020, Australian state and federal governments introduced physical distancing measures alongside widespread testing to combat COVID-19. These measures may decrease people's sexual contacts and thus reduce the transmission of HIV and other sexually transmissible infections (STIs). We investigated the impact of physical distancing measures due to COVID-19 on the sexual behavior of gay and bisexual men in Australia. METHODS: Between April 4, 2020, and April 29, 2020, 940 participants in an ongoing cohort study responded to questions to measure changes in sexual behaviors during the COVID-19 pandemic. Men reported the date they become concerned about COVID-19 and whether they engaged in sexual behavior with regular or casual partners or "fuckbuddies" in the 6 months before becoming concerned about COVID-19 (hereafter referred to as "before COVID-19"), and following the date, they become concerned about COVID-19 (hereafter referred to as "since COVID-19"). Before and since COVID-19 was based on individual participants' own perceived date of becoming concerned about COVID-19. RESULTS: The mean age of was 39.9 years (SD: 13.4). Most participants (88.3%) reported sex with other men during the 6 months before COVID-19. Of the 587 men (62.4%) who reported sex with casual partners before COVID-19, 93 (15.8%) continued to do so in the period since COVID-19, representing a relative reduction of 84.2%. CONCLUSION: Gay and bisexual men in Australia have dramatically reduced their sexual contacts with other men since COVID-19. These behavioral changes will likely result in short-term reductions in new HIV and STI diagnoses. If sexual health screenings are undertaken before resuming sexual activity, this could present a novel opportunity to interrupt chains of HIV and STI transmission.

Post-exposure prophylaxis completion and condom use in the context of potential sexual exposure to HIV.

OBJECTIVES: Post-exposure prophylaxis (PEP) care remains a challenge for individuals with potential sexual exposure to HIV in terms of PEP completion and ongoing risk behaviours. METHODS: A retrospective analysis was carried out on data from the French Dat'AIDS prevention cohort (NCT03795376) for individuals evaluated for PEP between 2004 and 2017. A multivariable analysis was performed of predictors of both PEP completion and condom use [odds ratios (ORs)] and their associated probabilities (P, with P > 95% being clinically relevant). RESULTS: Overall, 29 060 sexual exposures to HIV were evaluated for PEP [36% in men who have sex with men (MSM) and 64% in heterosexuals]. Overall, 12 different PEP regimens were offered in 19 240 cases (46%). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) was the preferred backbone (n = 14 304; 74%). We observed a shift from boosted protease inhibitor-based regimens to nonnucleoside reverse transcriptase inhibitor- or integrase inhibitor-based regimens in recent years. Overall, 20% of PEP prescriptions were prematurely discontinued. Older age, MSM, intercourse with a sex worker, rape and intercourse with a known HIV-infected source patient were factors associated with increased rates of PEP completion (OR > 1; P > 98%). None of the 12 PEP regimens was associated with premature discontinuation. We also found 12 774 cases of unprotected sexual intercourse (48%). Condom use decreased (OR < 1; P > 99%) with the year of exposure, and was lower in MSM and rape victims. Condom use increased (OR > 1, P > 99%) with age, and was higher in those who had intercourse with a sex worker or with a female partner and in those with knowledge of the partner's HIV status. CONCLUSIONS: We provide new insights into how rates of condom use and PEP completion might be improved in those receiving PEP by targeting certain groups of individuals for interventions. In particular, youth and MSM at risk should be linked in a prevention-to-care continuum.

Seasonal variations in kissing and sexual activities among men who have sex with men in Melbourne, Australia: implications for seasonal sexually transmissible infection preventions and interventions.

Background Previous studies have shown that there is a peak in sexually transmissible infection (STI) cases and sexual activities around summer, but there has been no study examining whether kissing also follows a similar seasonal pattern. The aim of this study was to examine the seasonal patterns of kissing and sex partners among gay, bisexual and other men who have sex with men (MSM). METHODS: A short cross-sectional study was conducted among MSM attending the Melbourne Sexual Health Centre between March 2016 and February 2017. Participants were asked to report the number of kissing-only, sex-only and kissing-with-sex male partners in the last 3 months. The mean number of male partners was calculated and stratified by Australia's seasons. The seasonal trend in the number of partners was assessed by negative binomial regression models. RESULTS: In total, 4391 MSM were included in the analysis. The number of kissing-only and sex-only partners increased significantly from autumn to summer among MSM in Melbourne (Ptrend <0.001). MSM reported the highest number of male partners for kissing-only (mean: 4.91; 95% confidence intervals (CI): 4.78-5.04) and sex-only (mean: 1.91; 95% CI: 1.83-1.99) around summer compared with other seasons. However, the number of kissing-with-sex partners remained stable across seasons. CONCLUSIONS: The study data suggest that there is a peak in kissing-only and sex-only partners among MSM around summer and holiday seasons.

The relationship between chronic diseases and number of sexual partners: an exploratory analysis.

BACKGROUND: We investigated sex-specific associations between lifetime number of sexual partners and several health outcomes in a large sample of older adults in England. METHODS: We used cross-sectional data from 2537 men and 3185 women aged ≥50 years participating in the English Longitudinal Study of Ageing. Participants reported the number of sexual partners they had had in their lifetime. Outcomes were self-rated health and self-reported limiting long-standing illness, cancer, coronary heart disease, and stroke. We used logistic regression to analyse associations between lifetime number of sexual partners and health outcomes, adjusted for relevant sociodemographic and health-related covariates. RESULTS: Having had 10 or more lifetime sexual partners was associated with higher odds of reporting a diagnosis of cancer than having had 0-1 sexual partners in men (OR 1.69, 95% CI 1.01 to 2.83) and women (OR 1.91, 95% CI 1.04 to 3.51), respectively. Women who had 10 or more lifetime sexual partners also had higher odds of reporting a limiting long-standing illness (OR 1.64, 95% CI 1.15 to 2.35). No other statistically significant associations were observed. CONCLUSIONS: A higher lifetime number of sexual partners is associated with increased odds of reported cancer. Longitudinal research is required to establish causality. Understanding the predictive value of lifetime number of sexual partners as a behavioural risk factor may improve clinical assessment of cancer risk in older adults.

Positive correlation between high mate value and slow life history strategy is moderated by trait heritability.

Life history theory - which considers the influence of environmental factors that occur over the course of an organism's life in determining patterns of development and behavior - has been used to provide insight into the cause and interpretation of a wide variety of individual differences traits. Recent research has added individual differences in mate value to this list, such that high mate value has been correlated with a slow life history strategy. The current research replicated and further explored this relationship across two studies. Consistent with previous research, Study 1 demonstrated a moderate correlation between life-history strategy and a general assessment of self-perceived mate value. Study 2 expanded this investigation to include a multifactor assessment of self-perceived mate value and provided evidence that the relationship between mate value and life history strategy may be moderated by mate value trait heritability. Specifically, the relationship between mate value and life history strategy was found to be significantly stronger for those mate value traits with the lowest heritability estimates. Results are interpreted and discussed in terms of facultative calibration of evolved psychological mechanisms and conditional behavioral strategies.

Parejas sexuales de personas que viven con VIH / sida: orientación sexual, aspectos sociodemográficos, clínicos y comportamentales / Parcerias sexuais de pessoas vivendo com HIV/Aids: orientação sexual, aspectos sociodemograficos, clinicos e comportamentais / Sexual partnerships of people living with HIV / Aids: sexual orientation, sociodemographic, clinical and behavioral aspects

Objetivo: Analizar la influencia de la orientación sexual de las variables socio-demográficas, clínicas y de comportamiento entre las parejas sexuales de las personas que viven con el Virus de la inmunodeficiencia humana/Síndrome de inmunodeficiencia adquirida. Métodos: Estudio transversal realizado en un servicio de asistencia médica especializada en el tratamiento de personas con el Virus de la Inmunodeficiencia Humana, con 173 participantes. En el análisis de los resultados se utilizó el test Chi-cuadrado de Pearson o exacto de Fisher. Resultados: Se identificó asociación entre la orientación sexual y las variables: sexo, edad, estado civil, grupo de edad, escolaridad, renta, forma de exposición, tipo de asociación, uso consistente del preservativo, presencia de infección, práctica sexual, presencia del compañero en las consultas de rutina, divulgación del VIH al compañero y considerar importante la divulgación de su condición serológica para el compañero. Conclusión: Establecer un emparejamiento sexual en el contexto del VIH y tener una orientación no heterosexual presentó diferencias estadísticas entre las variables sociodemográficas y comportamentales

Objetivo: Analisar a influência da orientação sexual sobre as variáveis sociodemograficas, clínicas e comportamentais entre parcerias sexuais de pessoas que vivem com vírus da imunodeficiência humana/Síndrome da imunodeficiência adquirida. Métodos: Estudo transversal realizado em um serviço de assistência médica especializada no tratamento de pessoas com o Vírus da Imunodeficiência Humana, com 173 participantes. Na análise dos resultados utilizou-se o teste Qui-quadrado de Pearson ou exato de Fisher. Resultados: Identificou-se associação entre a orientação sexual e as variáveis: sexo, idade, estado civil, faixa etária, escolaridade, renda, forma de exposição, tipo de parceria, uso consistente do preservativo, presença de infecção, prática sexual, acompanhamento do parceiro nas consultas de rotina, divulgação do HIV para o parceiro e considerar importante a divulgação da sua condição sorológica para o parceiro. Conclusão: Estabelecer uma parceria sexual no contexto do HIV e ter uma orientação não-heterossexual apresentou diferenças estatísticas entre as variáveis sociodemográficas e comportamentais

Objective: To analyze the influence of sexual orientation on sociodemographic, clinical and behavioral variables among sexual partners of people living with Human immunodeficiency virus/Acquired immunodeficiency syndrome. Methods: A cross-sectional study carried out in a medical assistance service specialized in the treatment of people with Human Immunodeficiency Virus, with 173 participants. Pearson's Chi-square or Fisher's exact test was used to analyze the results. Results: We identified an association between sexual orientation and variables such as gender, age, marital status, age, education, income, type of exposure, type of birth, consistent condom use, presence of infection, sexual practice, partner in routine consultations, disclosure of HIV to the partner and considers disclosure of their condition to the partner. Conclusion: Establishing a sexual partnership in the context of HIV and having a non-heterosexual orientation presented statistical differences between sociodemographic and behavioral variables

Expanding and Validating a Typology of Intimate Partner Violence: Intersections of Violence and Control Within Relationships.

This research explored an expanded typology of intimate partner violence (IPV), intersecting violent and controlling behaviors of partners. Secondary data were analyzed ( n = 714). Cluster analyses indicated that elements of IPV (control perpetration, control victimization, violence victimization, and violence perpetration) all clustered in high/low patterns, which intersected to form 10 unique categories of IPV. Support for all of Johnson's categories of IPV was found, but there was also evidence for the three control-related categories: Unidirectional Control, Bidirectional Control, and Control Resistance. This expanded typology can move research, practice, and policies beyond the gender symmetry debate.

Uso del preservativo, número de parejas y debut sexual en jóvenes en coito vaginal, sexo oral y sexo anal / Condom use, number of partners and sexual debut in young people in penile-vaginal intercourse, oral sex and anal sex

Objetivo. El objetivo del estudio es analizar en jóvenes el uso del preservativo, el número de parejas sexuales y la edad de debut sexual en coito vaginal, sexo oral y sexo anal, y comparar entre hombres y mujeres (primera parte del estudio), así como analizar si existen diferencias según el comportamiento sexual realizado en las tres variables (segunda parte del estudio). Material y método. Estudio ex post-facto descriptivo mediante encuesta online. Un total de 886 jóvenes heterosexuales (485 mujeres y 401 hombres) participaron para la primera parte del estudio. Para la segunda parte del estudio se seleccionó a los jóvenes que habían realizado los tres comportamientos sexuales objeto de estudio. Se utilizaron las dependencias de dos universidades españolas para difundir la encuesta por internet. Resultados. Las mujeres manifestaron utilizar con más frecuencia el preservativo durante el sexo oral y los hombres declararon tener mayor número de parejas sexuales con las que realizan el coito vaginal (4,57 vs. 3,80) y el sexo oral (3,34 vs. 2,65). La edad media de inicio para el coito vaginal y el sexo oral estuvo en torno a los 17años y para el sexo anal en torno a los 19años. La frecuencia de uso del preservativo y el número de parejas sexuales fueron mayores en el coito vaginal y la edad de debut sexual fue mayor en el sexo anal (hombres=19,20; mujeres=19,38). Conclusiones. Los resultados apoyan la idea de que los jóvenes utilizan el preservativo más para evitar embarazos que para prevenir ITS. También, que los comportamientos sexuales siguen un patrón de progresión en jóvenes heterosexuales (del coito vaginal al sexo anal) (AU)

Objective. The aim of this study is to analyse condom use, number of sexual partners and age of sexual debut in young people in penile-vaginal intercourse, oral sex and anal sex, to establish a comparison between men and women (first part of the study), and to analyse the differences according to sexual behavior conducted in the three variables (second part of the study). Material and method. Ex post facto descriptive study by online survey. A total of 886 young heterosexual people (485 women and 401 men) participated for the first part of the study. For the second part of the study, youngsters who had carried out the three sexual behaviors under study were selected. The premises of two Spanish universities were used to distribute the survey by internet. Results. Women reported a more frequent use condom during oral sex, and men reported to have more sexual partners with whom they perform penile-vaginal intercourse (4.57 vs. 3.80) and oral sex (3.34 vs. 2.65). The average onset age for penile-vaginal intercourse and oral sex was close to 17 years and for anal sex close to 19 years. Frequency of condom use and number of sexual partners were higher in penile-vaginal intercourse and the age of sexual debut was higher in anal sex (men=19.20; women=19.38). Conclusions. The results support the idea that young people use the condom more to prevent pregnancies than to prevent STD. Moreover, the sexual behaviors follow a pattern of progression in heterosexual young people (from penile-vaginal intercourse to anal sex) (AU)

Getting the terminology right in sexual health research: the importance of accurately classifying fuck buddies among men who have sex with men.

OBJECTIVE: The aim of this report was to raise the issue of the definition and classification of partner terminology in men who have sex with men (MSM) research, particularly in regards to 'fuck buddies'. If definitions in research differ from general consensus in the MSM population, it is possible that public health strategies will be ineffective as the target population may be inaccurate. METHODS: Thirty semistructured interviews with MSM attending the Melbourne Sexual Health Centre were conducted, focusing on the willingness to change sexual practices to reduce the risk of pharyngeal gonorrhoea. As part of these interviews, men were also asked their views on the terminology they used to describe their relationships and sexual partners. RESULTS: The degree of emotional attachment often defined the type or classification of relationships. There was a consensus among men that partners they engaged with for 'sex only' were classified as casual partners and partners with whom there was an emotional attachment or formalisation of the relationship were classified as 'regular partners'. However, the classification of 'fuck buddy' as a regular or casual partner was less clear. CONCLUSIONS: Further research is needed to ascertain the ways in which men conceptualise sexual relationships and define or classify partner types, particularly 'fuck buddy' relationships. A third category for sexual relationships should be considered to encapsulate fuck buddy relationships.

Sexualidad es tener sexo: las adolescentes en situación de calle / Sexuality is having sex: teenagers living in the streets

La investigación fue realizada con adolescentes en situación de calle de la ciudad de Medellín, Colombia. Objetivo: comprender los significados que tienen las adolescentes en situación de calle de la ciudad de Medellín sobre la sexualidad. Metodología: estudio cualitativo-etnográfico. Se aplicaron las técnicas de trabajo de campo y entrevista. Para el análisis de la información se codificó y categorizó. Ética: se fundamentó en el respeto, la confidencialidad y no implicó riesgos para las participantes. Resultados: la sexualidad significa tener relaciones sexuales por dinero o deseo, para esto hay que verse como mujer y protegerse física y mentalmente, cuando la relación no es estable. Conclusiones: la sexualidad se reduce a la genitalidad y les permite a las adolescentes tener dinero, afecto, protección y compañía

The research was focused on homeless teenagers from the city of Medellín, Colombia. Objective: understand the meaning of sexuality in female homeless teenagers from the city of Medellín. Methodology: ethnographic approach to qualitative research. The technics used were: Interview and field diary. Information was encoded and categorized for analysis. Ethics: it is based on respect, confidentiality and implied no risk for its participants. Results: sexuality means to have sexual intercourse for money or desire, for this you have to recognize yourself as a woman and be protected physical and mentally, when the relationship is not stable. Conclusions: sexuality is reduced to genital motions and opens a windows for teenagers to gain access to money, affection, protection and company

Mining for pairs: shared clinic visit dates identify steady HIV-positive partnerships.

OBJECTIVES: Here we examined the hypothesis that some stable HIV-infected partnerships can be found in cohort studies, as the patients frequently attend the clinic visits together. METHODS: Using mathematical approximations and shuffling to derive the probabilities of sharing a given number of visits by chance, we identified and validated couples that may represent either transmission pairs or serosorting couples in a stable relationship. RESULTS: We analysed 434 432 visits for 16 139 Swiss HIV Cohort Study patients from 1990 to 2014. For 89 pairs, the number of shared visits exceeded the number expected. Of these, 33 transmission pairs were confirmed on the basis of three criteria: an extensive phylogenetic tree, a self-reported steady HIV-positive partnership, and risk group affiliation. Notably, 12 of the validated transmission pairs (36%; 12 of 33) were of a mixed ethnicity with a large median age gap [17.5 years; interquartile range (IQR) 11.8-22 years] and these patients harboured HIV-1 of predominantly non-B subtypes, suggesting imported infections. CONCLUSIONS: In the context of the surge in research interest in HIV transmission pairs, this simple method widens the horizons of research on within-pair quasi-species exchange, transmitted drug resistance and viral recombination at the biological level and targeted prevention at the public health level.

Prevalence of and factors associated with unprotected anal intercourse with regular and nonregular male sexual partners among newly diagnosed HIV-positive men who have sex with men in China.

OBJECTIVES: This study investigated the prevalence of, and multi-dimensional factors associated with, unprotected anal intercourse (UAI) with regular male sexual partners ('regular partners') and nonregular male sexual partners ('nonregular partners') among newly diagnosed HIV-positive men who have sex with men (MSM) in Chengdu, China. METHODS: A total of 225 newly diagnosed HIV-positive MSM were interviewed using a combined interviewer-computer-assisted method in Chengdu, China. RESULTS: The prevalence of UAI with regular and nonregular partners since diagnosis was 27.7% and 33.8% among participants reporting having sex with regular and nonregular partners (n = 159 and 133), respectively. Adjusted analysis showed that: (1) cognitive variables based on the Health Belief Model (perceived susceptibility to HIV transmission and perceived severity of the consequences of HIV transmission, perceived barriers and perceived self-efficacy related to consistent condom use), (2) emotion-related variables (worry about transmitting HIV to others), (3) psychological factors (post-traumatic growth) and (4) socio-structural factors (perceived partners' responsibility for condom use) were significantly associated with UAI with regular and/or nonregular partners. CONCLUSIONS: Interventions are warranted, and should be designed with consideration of multi-dimensional factors and be partner type-specific.