Comparison of Men's and Women's Attempts to Dissuade Sexual Partners From the Couple Using Condoms

Undergraduate students were asked about their use of condoms and their attempts to dissuade sexual partners from the couple using condoms during sexual intercourse. Nearly 14% of women and nearly 17% of men who had engaged in sexual intercourse admitted to having actively tried to dissuade a partner from the couple using condoms. Thirty percent of the men and 41% of the women said that a sexual partner had tried to dissuade them. Attempts to dissuade partners from the couple using condoms were most common among students who reported having 10 or more lifetime sexual partners. For both men and women, the most frequently employed categories of verbal strategies were (1) sex feels better without a condom, (2) will not get pregnant, and (3) will not get a sexually transmitted disease. These three categories accounted for about three-fourths of the lines used. Avoidance of condoms because of a perceived decrease in physical pleasure poses a particular problem for sex and health educators.     

天津市男同性恋人群高危性行为与性病网络调查

[目的]通过网络调查了解天津市男同性恋人群性传播疾病流行状况,探讨其与高危性行为的关系。[方法]对天津市某同性恋网站招募的480名同性恋者进行网上问卷调查,并为其提供免费HIV、梅毒检测。[结果]被调查者中99人曾患性病,性病组与非性病组相比更多见：多性伴、肛交、口交、卖淫、使用安全套等情况。经逐步Logistic回归分析显示：6个月内不同男性伴数、肛交、卖淫、与固定性伴性交时使用安全套为男同性恋者患性病的危险因素。62人参与免费检测,HIV阳性率4.8%,梅毒阳性率为16.1%。[结论]天津市男同性恋人群中普遍存在高危性行为,已具备性病流行环境。在干预中应针对高危性行为进行控制,倡导健康性行为,加强减少性伴和正确认识安全套防病作用的教育。     

中国大陆男男性接触者艾滋病性病高危险行为情况调查

目的 调查中国大陆男男性接触者（men who have sex with men,MSM)的艾滋病（acpuired immunodeficiency syndrome,AIDS）和性病（sexually transmitted diseases,STD）高危险行为及相关情况。方法 采用不同记名邮寄问卷形式调查。结果 发放调查问卷1800份,回收有效问卷729份,应答率40.5%。调查对象平均31.0岁。首次男男性交平均18.6岁。累计男性伴平均数39.2人,75.7%有过肛交行为。近一年内,63.6%有过陌生男性伴,39.8%曾群交,9.3%“买”过性,３.8％“卖”过性。约半数与女性性交过。　133人自述患过性病（18.2%）。62人检测过人类免疫缺陷病毒（human immune deficiency virus,HIV）抗体,11人阳性（17.7%）。约2/3使用过避孕套。结论 被调查的MSM在性方面相当活跃,HIV感染率在这一人群中巳达较高水平,而且流行全直接蔓延到异性恋人群。     

Schoolwide effects of a multicomponent HIV, STD, and pregnancy prevention program for high school students.

Few studies have tested schoolwide interventions to reduce sexual risk behavior, and none have demonstrated significant schoolwide effects. This study evaluates the schoolwide effects of Safer Choices, a multicomponent, behavioral theory-based HIV, STD, and pregnancy prevention program, on risk behavior, school climate, and psychosocial variables. Twenty urban high schools were randomized, and cross-sectional samples of classes were surveyed at baseline, the end of intervention (19 months after baseline), and 31 months afterbaseline. At 19 months, the program had a positive effect on the frequency of sex without a condom. At 31 months, students in Safer Choices schools reported having sexual intercourse without a condom with fewer partners. The program positively affected psychosocial variables and school climate for HIV/STD and pregnancy prevention. The program did not influence the prevalence of recent sexual intercourse. Schoolwide changes in condomuse demonstrated that aschool-based program can reduce the sexual risk behavior of adolescents.     

High-risk sexual behavior by HIV-positive men who have sex with men--16 sites, United States, 2000-2002

The majority of persons living with human immunodeficiency virus (HIV) in the United States are men who have sex with men (MSM). High-risk sexual behavior by HIV-positive MSM exposes sex partners to HIV. The risk for transmitting HIV from an infected partner to an uninfected partner through unprotected insertive anal intercourse (UIAI) is greater than the risk for transmission through receptive anal intercourse or oral sex. Differences in sexual risk behavior might be associated with the perceived HIV serostatus of the partner (i.e., HIV positive, HIV negative, or unknown serostatus), as well as with the sex partner type (i.e., steady or nonsteady). During May 2000-December 2002, HIV-positive MSM were interviewed in a behavioral surveillance survey at surveillance sites in 16 states. This report describes insertive anal intercourse practices reported by these MSM; findings indicated that a large percentage of HIV-positive MSM were sexually abstinent, practiced safer sexual behavior by having protected insertive anal intercourse, or had UIAI with an HIV-positive partner. However, a small percentage of HIV-positive MSM reported UIAI with partners who were HIV negative or whose serostatus was unknown; for this group, more intensive and comprehensive HIV-prevention efforts are needed to eliminate this risk behavior.     

High-risk sex behavior and HIV prevalence among gay and bisexual men in the community of Madrid

BACKGROUND: To analyze high-risk sexual behavior as regards HIV, the use of preventive measures and the patient-reported prevalence of HIV infections among males belonging to one of the leading homosexual associations in the Region of Madrid. METHODS: Cross-sectional study conducted in 1997-1998 by way of mailed anonymous questionnaires. An analysis is made of the sociodemographic characteristics, how often condoms are used for different types of sexual intercourse with regular or casual partners, patient-reported prevalence of HIV and other related aspects. RESULTS: 157 questionnaires were returned by gay/bisexual males. These subjects averaged 32 years of age, 85% having a high school or college education, over the past 3 months, 56% had had intercourse with more than one man; 70.6% practiced insertive anal intercourse with a regular partner and 57.4% with casual partners, solely 32.5% and 61.1% of whom always used a condom. 69.7% had receptive anal intercourse with a regular partner and 39.4% with casual partners, 35.5% and 78.4% of whom respectively always used a condom. 86.6% had oral-genital intercourse, less than 10% having always used a condom. 137 were aware of their serological condition, and 15.2% were HIV positive. 10% had had some STD at some point during the previous year. CONCLUSIONS: A major percentage of those surveyed were involved in high-risk practices (several partners and unprotected high-risk sexual intercourse) which, in conjunction with the major prevalence of infection, can be said to be the same as a major seroconversion rate.     

Partner condom use among adolescent girls with sexually transmitted diseases.

PURPOSE: To explore associations of self-reported condom use with sexual risk knowledge and behaviors, perceptions of peer condom use, and communication with sexual partners about condom use among adolescent girls with sexually transmitted diseases (STDs). METHODS: Adolescent girls with cervicitis or pelvic inflammatory disease (PID) completed a 62-item self-administered questionnaire on sexual risk knowledge and behaviors, condom use, perceptions of peer condom use, and condom use negotiation with partners. Associations with frequency of condom use and condom use at last sexual intercourse were analyzed. RESULTS: A total of 24 girls were enrolled: 13 with cervicitis and 11 with PID; 22 had complete data for analysis. Compared with girls who reported low frequency of condom use, girls who reported condom use all or most of the time were younger (16.7 vs. 19.5 years; p = .008), were less likely to have a prior history of STD (67% vs. 0%; p = .03), and were more likely to think that all or most of their friends use condoms (72% vs. 0%; p = .02). Compared with girls who had not used a condom with last sexual intercourse, girls who had used a condom were younger (16.2 vs. 17.9 years; p = .04), had fewer lifetime partners (2.7 vs. 8.4; p = .03) and had higher mean scores in condom use negotiation (29.1 vs. 24.4; p = .02), and were more likely to think that all or most of their friends used condoms (100% vs. 31%; p = .001). Knowledge about condoms and STD prevention was high (mean 14.3 +/- 2.3 of 16) but was not associated with condom use. CONCLUSIONS: STD interventions for partner condom use among high-risk adolescent girls must recognize the decrease in condom use with increasing age and focus on maintaining safer sex behaviors, building condom use negotiation skills, and promoting the perception of condom use by friends.     

Who's at Risk? Men's STD Experience and Condom Use in Southwest Nigeria

Many STD/HIV-prevention programs worldwide assume that individuals' risk of acquiring sexually transmitted diseases, including HIV infection, is highest in the context of commercial sex. To address this assumption, research conducted in urban Southwest Nigeria combined qualitative and quantitative methods to examine men's sexual behavior, condom use, and STD experience in different types of sexual relationships (marital, casual, and commercial). Logistic regression analysis of survey data indicates that number of sexual partners and sex with sex workers are positively and significantly related to STD experience. Follow-up in-depth interviews with clients of sex workers indicate, however, that these men are actually more likely to report having contracted an STD from a casual sex partner than from a sex worker. Men are most uncertain about their vulnerability to STDs with casual partners. Men's condom use is highest in commercial sex, inconsistent in casual relationships, and lowest in marriage. STD/HIV-prevention programs need to address the range of sexual relationships and the meanings and behaviors associated with them.     

The sexual behavior of US adults: results from a national survey.

OBJECTIVES. One consequence of the acquired immunodeficiency syndrome (AIDS) epidemic has been to highlight the need for population-based estimates of the number of individuals engaging in sexual behaviors that place them at risk for human immunodeficiency virus (HIV) infection. This paper describes the prevalence of various sexual behaviors in a nationally representative sample of adults in the United States. METHODS. Data were collected as part of a household probability survey of adults (n = 2058) in the United States. Data collected on sexual behavior included sexual orientation, frequency of intercourse, condom use, and number of sexual partners. RESULTS. Nearly all respondents were sexually experienced. Of those who were currently sexually active, 13% (1% of married respondents) had had sex with more than one partner in the previous year. Of those reporting having intercourse with more than one partner in the previous year, 7% used condoms consistently and 23% used condoms consistently with their casual partners. CONCLUSIONS. A significant proportion of individuals were found to have intercourse with multiple partners without using condoms. A minority of these respondents acknowledged that their behavior may place them at risk for HIV transmission.     

大学生性病艾滋病关联性行为研究

目的了解大学生的性行为状况，为学校和有关部门制订性教育、性病艾滋病健康教育和行为干预措施提供参考依据。方法选择浙江省2所综合性大学在校全日制1～4年级学生参加自答式问卷调查。结果2所大学学生有78．0％参加本调查，13．1％的大学生有过性行为，发生性行为的平均年龄19．51岁；首次性行为使用安全套占29．2％；发生性行为的地点主要为旅馆饭店，其次为家里；平均性伴侣1．54个，10．4％学生自己或者性伴侣有过流产的经历；有一定比例的学生分别有买卖性关系，同性或双性性行为；1．4％曾被诊断患过性病，曾经使用过安全套学生回答使用的主要原因是防止怀孕，最后一次性行为有47．8％使用安全套。68．6％～71．1％有性行为的学生认为自己或性伴侣怀孕、自己通过性行为感染性病艾滋病“不可能、可能性非常低或可能性较低”。结论大学生预防性传播感染和HIV／AIDS意识低下，自我保护意识差，安全套使用率低，使用安全套主要是为了防止怀孕而不是预防疾病；多性伴现象严重。同性性行为和卖淫嫖娼客观存在，大学生存在流产、性传播疾病和HIV感染的危险性．针对大学生进行性病艾滋病健康教育和行为干预迫在眉睫。     

Risk factors for HIV and other sexually transmitted diseases among adolescents in St. Petersburg, Russia.

CONTEXT: Over the past several years, there have been sharp increases in the prevalence of HIV and other sexually transmitted diseases (STDs) among young people in Russia. Very little is known about Russian adolescents' behaviors and attitudes that might influence their risk of acquiring these infections. METHODS: A 1995 survey of 533 students aged 15-17 attending eight St Petersburg high schools assessed their sexual risk practices, AIDS-specific attitudes and beliefs, sexual relationship patterns and preferences, and social characteristics. RESULTS: Overall, 39% of students were sexually experienced, and these young people had had, on average, 3.4 sexual partners. Only 29% of sexually experienced students said they consistently used condoms, and 29% said they never did. Unprotected vaginal intercourse was the predominant and preferred sexual practice; it also was the practice that most often occurred with students' last sexual partner. In all, 28% of students defined "safer sex" as condom use. Many young people believed that AIDS is a threat only to members of particular "risk groups"; relatively few believed that they could get AIDS (17%) or said that AIDS information had influenced their sexual behavior (29% of those who were sexually experienced). Females were more likely than males to prefer having an exclusive partner, and males were more likely to prefer having casual partners. CONCLUSIONS: Educational and behavioral interventions are urgently needed to help young people in Russia avoid HIV and other STDs. Risk and social characteristics identified in this study can help to guide the development and tailoring of risk reduction interventions.     

Adolescent sexual behavior and associated variables

Proportionally more adolescents are having sexual intercourse and at younger ages. It has been reported that 11.6 million teens in the US between ages 13-19 years have had sexual intercourse. Many, however, do not use contraception, even though the prevalence of condom use has increased over the last ten years. The authors analyzed survey data to identify sexual activity among adolescents by grade, gender, number of partners, and contraceptive use, and to determine the association of intercourse with condom use, alcohol consumption, smoking, and AIDS/HIV education. 56.8% of 568 9th-12th grade respondents reported having had sexual intercourse: 33.5% in 9th grade, 58.9% in 10th grade, 68.5% in 11th grade, and 71.6% in 12th grade. Although more males than females reported having had sexual intercourse, no significant difference was found between males and females in each grade level on the number of lifetime sex partners or sex partners for the previous three months. 25% reported using alcohol during last sexual intercourse, 5% indicated using both alcohol and other drugs, and 22% reported that no contraception was used or that they were not sure if anything was used. Sexually active respondents were significantly more likely to consume alcohol and to smoke. The authors also found no significant difference for use of condoms between those who had AIDS/HIV education and those who had not, except that those who had AIDS/HIV education were less likely to have multiple partners. 42.5% of all sexually active respondents reported using a condom. Only 38.5% of those exposed to AIDS/HIV education in schools reported using a condom during last intercourse compared to 30% of those not exposed to such education.     

广州市少教所学员性病艾滋病高危因素调查分析

目的调查羁押场所青少年学员中性行为状况及感染性病艾滋病的高危因素,为性病综合干预提供指导。方法采用调查问卷方式对学员进行性行为调查;同时对学员进行皮肤性病调查;并根据他们当中性病的感染情况,分析有关高危因素。结果青少年学员中总体首次性生活年龄提前,13岁以下者占5.1%,16岁以前84.6%的人都有性生活史;58.3%的学员有超过2个性伴,17.9%的人有超过5个性伴;性病防护意识薄弱,安全套使用意识差,只有17.3%的人在性生活中每次都使用安全套,而48.1%的人从不使用安全套。结论进一步加强对青少年性病艾滋病知识教育、在这一人群中进行安全套推广十分必要。     

Daily participation in sports and students' sexual activity

CONTEXT: Previous studies suggest that student athletes may be less likely than nonathletes to engage in sexual behavior. However, few have explored sexual risk behavior among athletes in early adolescence. METHODS: In 2005, a sample of 10,487 students in 26 Los Angeles public middle and high schools completed a self‐administered survey that asked about their demographic characteristics, sports participation, sexual behaviors and expectations, and parental relationships. Chi‐square analyses compared reported levels of daily participation in sports, experience with intercourse, experience with oral sex and condom use at last intercourse by selected characteristics. Predictors of sexual experience and condom use were assessed in multivariate logistic regression analyses. RESULTS: One‐third of students reported daily participation in sports. This group had higher odds of ever having had intercourse and ever having had oral sex than their peers who did not play a sport daily (odds ratios, 1.2 and 1.1, respectively). The increases in risk were greater for middle school sports participants than for their high school counterparts (1.5 and 1.6, respectively). Among sexually experienced students, daily sports participants also had elevated odds of reporting condom use at last intercourse (1.4). CONCLUSIONS: Students as young as middle school age who participate in sports daily may have an elevated risk for STDs and pregnancy. Health professionals should counsel middle school athletes about sexual risk reduction, given that young students may find it particularly difficult to obtain contraceptives, STD testing and prevention counseling.     

Sexual behavior, knowledge, and attitudes about AIDS among college freshmen.

We surveyed 158 college freshmen on an urban campus to determine their sexual practices and their knowledge and attitudes about acquired immunodeficiency syndrome (AIDS). Many students (47%) were heterosexually active; 1% were homosexual, 1% were bisexual, and 51% had not been sexually active. Among the 77 sexually active students, many engaged in activities that can facilitate transmission of human immunodeficiency virus (HIV): 58% did not always use condoms with a new partner; 31% had had two or more sex partners in the last year; 8% engaged in anonymous sex; and 14% of sexually active women had anal intercourse. Although most sexually active students said they would use condoms more or reduce the number of their sexual partners if they believed these changes would reduce "my risk for getting AIDS," few students had adopted these safer sexual practices. Safer sexual practices were associated with heightened personal concerns about AIDS but not with knowledge, which was at a high level. These findings underscore the need for preventive programs that overcome the gap between knowledge and safer sexual behaviors in this and similar groups of adolescents and suggest that programs that heighten personal concerns may be most effective. Community-based physicians who care for adolescents should develop such preventive programs and integrate them into their practices.     

American women's sexual behavior and exposure to risk of sexually transmitted diseases.

According to nationally representative data from the 1988 National Survey of Family Growth and the 1988 and 1989 General Social Surveys, 67% of all women aged 15-44 who have ever had intercourse have had more than one partner, 41% have had four or more, 23% six or more and 8% more than 10; 71% have had one or more nonmarital partners. Fewer than 1% of currently married women report having had more than one partner in the previous three months, compared with 13% of formerly married women and 9% of single women who are sexually active. For the most part, women with multiple partners do not have characteristics that set them apart from other women; women in all age-groups and racial or ethnic groups appear equally likely to have multiple partners while unmarried. Fifty-seven percent of women who report multiple partners have never been married, and another one-quarter are currently divorced. Twenty-one percent are teenagers, 46% are aged 20-29 and 24% are in their 30s. Between 27% and 39% of all sexually active women aged 18-44 are estimated to have had direct or indirect contact with more than one sexual partner during the preceding 12 months (including women with only one partner whose partner had multiple partners). About 20% of currently sexually active women reported using the condom, but one in five condom users had not used one at last intercourse. Once social and demographic factors are controlled, condom users with multiple partners are less likely than other condom users to have used a condom at last intercourse.     

HIV/AIDS protective factors among urban American Indian youths

This research examined how family and individual factors influence 3 HIV/AIDS risk behaviors: having more than 1 sexual partner in the last 3 months, substance use at last sexual intercourse, and condom non-use at last sexual intercourse. The sample includes 89 sexually active American Indian adolescents living in a large Southwestern U.S. city. Logistic regression results revealed that family communication acts as a protective factor against HIV risk through a lower reported substance use during last sexual intercourse, but it did not appear to affect the number of multiple recent sex partners. Family and personal involvement in American Indian cultural activities, both low on average in this urban sample, had no effect on outcomes. This study advances knowledge on sexual health risk and protective factors among American Indian adolescents, an understudied group, and provides implications for prevention intervention with American Indian youths and their families.     

Revisiting Obesity and Condom Use in Men Who Have Sex with Men

The incidence of both eating disorders and sexually transmitted diseases (STD) is relatively high among men who have sex with men (MSM). Yet, only one study has explored the influence of body mass index (BMI) on sexual risk-taking behaviors in this population. The objective of this study was to reexamine the practice of anal intercourse among overweight and obese MSM and to assess the consistency with which condoms were used. MSM who had placed same-sex sexual advertisements were asked to complete a brief online survey. A total of 576 MSM completed the survey, which assessed: age, HIV-status, height, weight, rejection of sexual partners, number of anal intercourse partners, and condom use during anal intercourse. Increased BMI was associated with a lowered likelihood of rejecting sexual partners and decreased number of actual anal intercourse partners. Increased BMI was also associated with decreased condom use. In addition to cardiovascular disease, obese MSM may be at a higher risk for STDs relative to normal weight MSM. There was some evidence to suggest that inconsistent condom use in such men may be an expression of the overexcitement concomitant with the comparatively rare event of acquiring an anal intercourse partner.