HIV/AIDS risk perception and behavior of college students of the Metekel Zone,Benishangul Gumuz regional state,Ethiopia

Sexual and reproductive health problems are the main causes of death, disability and disease among young people in the world, particularly in Africa. The objective of this study was to assess human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) risk perception and behavior, and factors associated with risk perception, among college students of the Metekel Zone, Ethiopia. An institutional-based cross-sectional study design was used. The data were collected using a pretested and self-administered questionnaire, were entered into EPI INFO version 6 and exported into Statistical Package of Social Sciences (SPSS) version 16 for analysis. Variables with p < 0.02 in the bivariate logistic regression were entered to multivariate logistic regression and variables with p < 0.05 were considered as statistically significant. Three hundred and eighty-eight students were participated. Total 43% of respondents (50.70% males and 34.10% females) had had sex. About 48.81% of the sexually active respondents reported that they had had sexual intercourse with two or more partners. About 16.49% of study participants perceived themselves at risk of getting HIV/AIDS and the most frequently, cited reasons for perceiving oneself at risk were having sex without a condom, having multiple sexual partners and having sex with commercial sex workers (CSW). Chewing khat (adjusted OR = 3.54, 95% CI: 1.45?8.63); being willing to undergo voluntary counseling and testing (VCT) (adjusted OR = 4. 30, 95% CI: 1.09?16.88); having seen a person infected/dead of HIV (adjusted OR = 4.23, 95% CI: 1.36?13.13) and having multiple sexual partners (adjusted OR = 6.10, 95% CI: 2.40?15.44) were significantly associated with HIV risk perception. The risk perception of HIV/AIDS among the college students was low despite their involvement in different risky sexual behaviors. The government should use mass media techniques, such as television, radio, mobile services and posters to spread information on HIV transmission prevention among college students, especially information on the importance of condom use, minimizing the number of sexual partners and VCT. College administrations need to disseminate information through special lectures, and group discussions about khat chewing, HIV/AIDS and VCT.     

The Characteristics and Risk Factors of Web-Based Sexual Behaviors Among Men Who Have Sex With Men in Eastern China: Cross-sectional Study

BackgroundFinding casual sex partners on the internet has been considered a huge challenge for HIV transmission among men who have sex with men (MSM) in China.ObjectiveThis study aimed to identify the characteristics and risk factors of finding causal sex partners on the internet among MSM in Zhejiang Province, China.MethodsThis was a cross-sectional study. Participants were enrolled by 4 community-based organizations (CBOs) and 10 Voluntary Counselling and Testing (VCT) clinics through advertisements in bathrooms, bars, and gay hook-up apps from June to December 2018. A CBO- or physician-assisted survey was conducted to collected information on finding casual sex partners, perceived HIV infection, and HIV risk behaviors.ResultsAmong 767 participants, 310 (40.4%) reported finding causal sex partners on the internet. Factors associated with finding casual sex partners on the internet included watching pornographic videos on the internet more than once a week (adjusted odds ratio [aOR]=1.881, 95% CI 1.201-2.948), discussing “hooking-up online” with friends (aOR=4.018, 95% CI 2.910-5.548), and perceiving that the likelihood of HIV infection among casual sex partners sought on the internet was “medium” (aOR=2.034, 95% CI 1.441-2.873) or “low” (aOR=2.548, 95% CI 1.524-4.259). Among the participants who reported finding casual sex partners on the internet, 30.2% (91/310) reported having unprotected sex with casual sex partners encountered on the internet in the past 6 months. On multivariate logistic regression analyses, knowing the HIV infection status of casual sex partners sought on the internet was significantly associated with performing inserted intercourse (aOR=1.907, 95% CI 1.100-3.306) and a decreased risk of inconsistent condom use (aOR=0.327, 95% CI 0.167-0.642).ConclusionsWeb-based casual sexual behavior is becoming more prevalent, and the rate of unprotected sex among MSM in Zhejiang Province is high. Future HIV prevention approaches should emphasize the importance for MSM to proactively determine the HIV infection status of potential casual sex partners sought on the internet.     

Globalization,Women, and Health in the 21st Century

Sexual partner mixing among men who have sex with men (MSM), based on both gender and partnership status, is an understudied theme in India. Using data from Round 2 of the Integrated Bio-behavioral Survey, this paper reports on gender and partnership status-based sexual mixing and levels of consistent condom use (CCU) among MSM in Maharashtra. A total of 689 MSM were sampled using probability-based sampling. Bivariate and regression analyses were carried out on condom use and partnership mixing. Over half (52%) of all MSM reported having only male partners while about one-third (34.5%) reported having partners of both gender. Over 70% of MSM engaged in sex with a mix of casual, regular, commercial and non-commercial partners. MSM with only male partners reported lower CCU as compared to MSM with partners of both genders (47.3% and 62%, respectively, p = 0.11). CCU levels differed significantly by status of sex partner. Overall, MSM having ‘men only’ as partners and those with partners of mixed status have greater risk behaviour in terms of low CCU. HIV prevention interventions need to focus attention on men in ‘exclusively male’ sex partnerships as well as MSM with a mix of casual, regular and commercial partners.     

Racial Sexual Mixing and Factors Associated with Condom Use Among Middle Eastern-Canadians

Background: Interracial relationships in Canada have increased over the years. However, little research has focused on comparing STI/HIV risk and condom use between those in intra- and interracial relationships, specifically among Middle Eastern-Canadians. Methods: A web-based survey was administered to Middle Eastern-Canadians. Logistic regression analysis was used to assess factors associated with consistent condom use. Analyses were stratified by partner’s race (Middle Eastern or non-Middle Eastern). Results: The analysis sub-sample consisted of 92 participants. Factors associated with consistent condom use varied between the stratified groups. Among those with Middle Eastern partners, attitude towards marriage and the family and control in the relationship were associated with condom use. Among participants with non-Middle Eastern partners, acculturation and HIV knowledge were found to be associated with condom use. Discussion: Factors associated with condom use varied between Middle Eastern-Canadians in intra- and interracial relationships. These differences illustrate the need for tailored interventions aimed at increasing condom use among this racial group.     

Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status

This analysis examined the importance of differential exposure to infected partners in epidemiologic studies of latex condom effectiveness for prevention of sexually transmitted infections. Cross-sectional, enrollment visit data were analyzed from Project RESPECT, a trial of counseling interventions conducted at five publicly funded US sexually transmitted disease clinics between 1993 and 1997. The association between consistent condom use in the previous 3 months and prevalent gonorrhea and chlamydia (Gc/Ct) was compared between participants known to have infected partners and participants whose partner infection status was unknown. Among 429 participants with known Gc/Ct exposure, consistent condom use was associated with a significant reduction in prevalent gonorrhea and chlamydia (30% vs. 43%; adjusted prevalence odds ratio = 0.42, 95% confidence interval: 0.18, 0.99). Among 4,314 participants with unknown Gc/Ct exposure, consistent condom use was associated with a lower reduction in prevalent gonorrhea and chlamydia (24% vs. 25%; adjusted prevalence odds ratio = 0.82, 95% confidence interval: 0.66, 1.01). The number of unprotected sex acts was significantly associated with infection when exposure was known (p for trend < 0.01) but not when exposure was unknown (p for trend = 0.73). Restricting analyses to participants with known exposure to infected partners provides a feasible and efficient mechanism for reducing confounding from differential exposure to infected partners in condom effectiveness studies.     

High prevalence of HIV infection among homeless and street-involved Aboriginal youth in a Canadian setting

Aboriginal people experience a disproportionate burden of HIV infection among the adult population in Canada; however, less is known regarding the prevalence and characteristics of HIV positivity among drug-using and street-involved Aboriginal youth. We examined HIV seroprevalence and risk factors among a cohort of 529 street-involved youth in Vancouver, Canada. At baseline, 15 (2.8%) were HIV positive, of whom 7 (46.7%) were Aboriginal. Aboriginal ethnicity was a significant correlate of HIV infection (odds ratio = 2.87, 95%CI: 1.02 – 8.09). Of the HIV positive participants, 2 (28.6%) Aboriginals and 6 (75.0%) non-Aboriginals reported injection drug use; furthermore, hepatitis C co-infection was significantly less common among Aboriginal participants (p = 0.041). These findings suggest that factors other than injection drug use may promote HIV transmission among street-involved Aboriginal youth, and provide further evidence that culturally appropriate and evidence-based interventions for HIV prevention among Aboriginal young people are urgently required.     

深圳市男男性行为人群相关高危行为干预及其影响因素研究

目的 了解深圳市男男性行为者(MSM)安全套使用及其相关影响因素.方法 2009年8-11月招募深圳市同性恋聚集地的同性接触人群作为访谈对象,采用统一调查表进行问卷调查.对调查的273名MSM进行人口学和行为特征分析;以近6个月发生性行为时不能坚持每次使用安全套的行为为应变量,而各类影响因素为自变量进行logistic回归分析.结果 调查对象来自全国各地,绝大部分为青壮年,平均年龄27.9岁,以未婚居多,文化程度较高,但对艾滋病知识缺乏;安全套使用率低,过去1年每次性行为均使用安全套的比例为20.5%;与同性发生性行为不使用安全套的原因主要是对方为"稳定的性伴和爱人"、"年轻,看起来没病"、"没有滥交".结论 深圳市MSM危险性行为普遍存在,安全套使用情况和影响因素各不相同,艾滋病极有可能在该人群中流行.

Abstract：

Objective To learn the condom-use and it's associated factors among men who have sex with men(MSM)in Shenzhen,so as to provide scientific basis for the development of prevention and control program.Methods Cross-sectional survey was conducted with standardized questionnaire used on individual case.Associated factors with behavior of not persistent condom use were analyzed,using logistic regression method as dependent variable and associated factors with behaviors as independent variables.Results Most of the MSM were young,with average age as 27.9.coming from 26 provinces of China.Only 20.5 percent of the participants were persistently using condoms every time with their sex partners in the past year. The main reasons of not constantly using condom with their male sex partners were having fixed partners,being young,healthy and being faithful.Conclusion High risk sexual behaviors and the low rate of condom-use among MSM might serve as potential risks for HIV epidemics.Data on the rate of condom use and the influencing factors among MSM varied for different sexual partners,suggested that targeted prevention measures should be conducted.     

Methamphetamine use and malnutrition among street-involved youth

We sought to explore the effect of crystal methamphetamine use on the risk of experiencing malnutrition among street-involved youth in Vancouver, Canada. Risk of malnutrition was defined as being hungry but not having enough money to buy food. Socio-demographic and drug use factors associated with risk of malnutrition were investigated using univariate and multivariate analysis among a prospective cohort of street-involved youth known as the At-Risk Youth Study (ARYS). Between September 2005 and December 2006, 509 street-involved youth were enrolled in ARYS, among whom 21% reported being at risk of malnutrition as defined above in the previous six months. In multivariate analysis, only non-injection crystal methamphetamine was significantly associated with being at risk of malnutrition among this cohort (Adjusted Odds Ratio [AOR] = 1.60, 95% Confidence Interval [CI]: 1.03 - 2.48, p = 0.036). Interventions seeking to address food insecurity among street youth may benefit from considering drug use patterns since methamphetamine use predicted higher risk in this setting.     

2006～2008年山东省部分女性性工作者安全套使用及其影响因素分析

[目的]了解女性性工作者安全套使用及其影响因素,为制定防治对策和干预措施提供依据。[方法]2006～2008年每年的7～9月,分层整群抽取青岛、烟台及德州3个市娱乐场所的女性性工作者,进行问卷调查。[结果]合计调查3 460人,75.17%的人<25岁,未婚者占75.87%,初中文化者占71.27%;最近1个月发生商业性行为时坚持使用安全套率为45.10%,与固定性伴这一比例为24.25%;11.20%的调查对象承认有吸毒史;31.42%最近1年做过HIV检测;不同场所、年龄、婚姻状况、文化程度、民族、艾滋病知识得分以及是否接受过干预服务之间安全套使用率有统计学意义(P<0.01或0.05)。[结论]山东省部分女性性工作者最近1个月与商业性伴及固定性伴安全套使用率呈上升趋势。     

HIV sexual risk behavior among Puerto Rican women

We examined the association of primary or nonprimary sexual partner relationship status on sexual risk behaviors, including condom use, among Latina women who are at self-disclosed increased heterosexual risk for human immunodeficiency virus (HIV) infection. Data were collected via structured interviews of 187 Puerto Rican women, aged 18-35, who attended a health clinic in the Bronx, New York. Approximately 13% of participants reported sexual activities with both primary and nonprimary sexual partners during the 6 months prior to the interview. Primary or nonprimary sexual partner status was associated with significant differences in frequency of condom use during anal sex and oral-penile sex, with more frequent condom use reported during these sexual activities with nonprimary sexual partners. Thus, potential contextual differences associated with primary or nonprimary relationship status may represent important factors to consider when designing interventions to facilitate HIV-protective behaviors among populations of urban women identified at increased heterosexual risk for HIV infection.     

暗娼与性伴之间安全套协商使用情况分析

目的 了解暗娼与嫖客或固定性伴之间安全套协商和使用情况，为暗娼的艾滋病综合干预措施的制定提供参考依据。方法 采用横断面调查，于2018年4－6月在云南省红河哈尼族彝族自治州蒙自市、建水县，依托娱乐服务场所招募≥16岁暗娼，估算样本量需476人，问卷调查收集其人口学特征、安全套协商及使用情况信息。采用logistic回归模型分析暗娼与不愿使用安全套的嫖客协商后安全套使用的影响因素。结果 共调查暗娼852人，年龄（24.29±8.44）岁。最近1个月性行为，有58.6%（499/852）的暗娼每次都要求嫖客使用安全套但嫖客不愿使用，协商后有88.4%（441/499）的暗娼每次与嫖客都使用安全套。有14.4%（99/687）的暗娼每次都要求固定性伴使用安全套，但固定性伴不愿使用，经协商后，54.5%（54/99）暗娼与固定性伴每次都使用安全套。最近1个月，暗娼说服不愿使用安全套的嫖客时，53.3%（266/499）的采用“强制要求”策略，19.4%（97/499）的采用“风险说服”策略，23.1%（115/499）的采用“强制要求及风险说服”策略，4.2%（21/499）的采用其他策略协商。4.4%（22/499）的暗娼感觉说服嫖客使用安全套困难。多因素logistic回归分析结果显示，和感觉说服嫖客使用安全套困难的暗娼相比，难度适中（OR=4.00，95% CI：1.55～10.32）、容易（OR=30.17，95% CI：3.22～282.44）的暗娼更容易成功协商嫖客每次都使用安全套。和采用其他策略与嫖客协商使用安全套的暗娼相比，采用“强制要求”策略者（OR=4.44，95% CI：1.41～14.01）、采用“强制要求及风险说服”策略者（OR=5.52，95% CI：1.55～19.73）更容易成功协商嫖客每次都使用安全套。结论 通过安全套协商策略，可促使不愿使用安全套的嫖客使用安全套。采用“强制要求”策略更容易成功协商嫖客每次都使用安全套，结合“风险说服”策略更有利于成功协商。     

Condom Use with Female Sex Workers among Male Clients in Sichuan Province,China: The Role of Interpersonal and Venue-Level Factors

Commercial sex work has re-emerged as a widespread industry since China started economic reforms in the 1980s. This study examined the role of interpersonal and venue-level factors in commercial sex male clients' (CSMCs) condom use with female sex workers (FSWs) in China. Given the heterogeneity of commercial sex industry in China, this study also aimed to explore how these factors function differently by social ranks of commercial sex work frequented by CSMCs. A cross-sectional survey was conducted with 601 CSMCs in Sichuan province, China. Human immunodeficiency virus (HIV) prevalence in this sample was 1.7%. In addition to the individual characteristics, interpersonal factor was measured by the frequency of FSWs taking the initiative in condom use and providing condoms. Venue-level factor was assessed by the frequency of the managers of commercial sex venues communicating condom use policies and the frequency of condom availability in commercial sex venues. The primary behavioral outcome was consistent condom use with FSWs. Multivariate logistic regression models revealed that consistent condom use with FSWs was significantly associated with interpersonal (adjusted odds ratio (AOR), 1.62; 95% confidence interval (CI), 1.38, 1.90) and venue-level factors (AOR, 1.98; 95% CI, 1.40, 2.80). Moreover, the associations between interpersonal and venue-level factors and consistent condom use were moderated by social ranks of commercial sex work frequented by the male clients. The present study findings underscore the need for comprehensive HIV prevention approaches that integrate individual, interpersonal, and venue-level factors to reduce HIV risk behaviors among CSMCs in China.     

First Anal Intercourse and Condom Use Among Men Who Have Sex with Men in Switzerland

The aim of this study was to analyze the circumstances of first anal intercourse (FAI) among men who have sex with men (MSM) and to identify factors associated with condom use at this event. We conducted a cross-sectional survey among a convenience sample of MSM living in Switzerland (N = 2,200). Anonymous questionnaires were distributed using Swiss gay communication channels (newspapers, associations, websites) and gay bathhouses. We gathered data on age at FAI, age of the partner, degree of familiarity with him, place of first meeting, and sociodemographic indicators. We did not ask whether FAI was insertive, receptive, or both. Data were stratified by birth year classes (birth cohorts). The median age at FAI fell from 24.5 years among men born before 1965 to 20.0 years among those born between 1975 and 1984 (p < .001). In each birth cohort, between 20 and 30% reported a partner 10 years older or more. Of eight variables examined in multivariate analysis, two were positively associated with condom use: age of participants at FAI and low degree of familiarity between partners. Conversely, large age discrepancy between partners was negatively associated with condom use. In conclusion, our data showed that early initiation of anal intercourse and large age discrepancy were associated with risk taking: a pattern of initiation that may facilitate HIV transmission from older to younger cohorts of MSM. Since age at FAI is on the decrease, there is an urgent need to heighten awareness of prevention actions regarding sexual debut of MSM.     

Birth Control Sabotage as a Correlate of Women's Sexual Health Risk: An Exploratory Study

IntroductionTo explore associations between birth control sabotage, a form of reproductive coercion, and women's sexual risk among women attending family planning health centers. Data were collected from a 2017 cross-sectional online survey of 675 women who attended Connecticut Planned Parenthood centers. Participants reported birth control sabotage; sexual risk (i.e., inconsistent condom use during vaginal and anal sex in the past 6 months, lifetime sexually transmitted infection diagnosis, lifetime exchange sex [trading sex for money, drugs, or other goods], and multiple sexual partners in the past 6 months); and sociodemographics. Bivariate and multivariable logistic regression models were used to examine associations between birth control sabotage and women's sexual risk.ResultsOne in six women (16.4%; n = 111) reported experiencing birth control sabotage. Women who reported birth control sabotage had a greater odds of ever having an sexually transmitted infection (adjusted odds ratio, 2.18; 95% confidence interval, 1.31–3.60; p = .003), ever engaging in exchange sex (adjusted odds ratio, 2.77; 95% confidence interval, 1.17–6.53; p = .020), and having multiple sexual partners in the past 6 months (adjusted odds ratio, 1.96; 95% confidence interval, 1.21–3.18; p = .006).ConclusionsOur findings demonstrate increased engagement in sexual risk taking among women who reported birth control sabotage compared with women did not.     

Agency,lapse in condom use and relationship intimacy among female sex workers in Jamaica

This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.     

Female disclosure of HIV-positive serostatus to sex partners: a two-city study

The aims of this article are (1) to describe the prevalence of disclosure of HIV serostatus to sex partners among a racially/ethnically diverse sample of HIV-positive women living in Hawai'i and Seattle, Washington; and (2) to examine factors related to disclosure and condom use with those sex partners. HIV-positive women have difficulties consistently disclosing serostatus to sex partners and using condoms. Little is known about the disclosure practices of women from Hawai'i or Seattle. A cross-sectional design with convenience and snowball sampling was used, and up to three recent sex partner experiences were assessed among the HIV-positive participants (N = 84). A total of 133 recent sex partners were reported, with disclosure and condom use frequencies of 75.2 and 59.9%, respectively. Women who knew when it was safe to disclose were more likely to disclose. Women who disclosed to recent sex partners were less likely to use condoms, while those in casual/anonymous partnerships were more likely to use condoms. Hawaiian/part Hawaiian women had the lowest proportion of condom use. Health care personnel should routinely discuss disclosure and sexual transmission risk behaviors with seropositive women and offer strategies to enhance condom use, especially among those in committed partnerships. Culturally tailored interventions focused on strengthening efficacy beliefs for disclosure and condom use in Native Hawaiians are needed.     

Patterns and risk factors of inconsistent condom use among men who have sex with men in Viet Nam: Results from an Internet-based cross-sectional survey

Survey data from men who have sex with men (MSM) in Asian cities indicate drastic increases in HIV prevalence. It is unknown which factors are most important in driving these epidemics. The objective of this study was to identify patterns of condom use among MSM Internet users living in Viet Nam, as well as risk factors associated with inconsistent condom use and non-condom use. A national Internet-based survey of sexual behaviours was administered in 2011. Results showed that 44.9% of MSM reported not using a condom during their last anal sex encounter with a male partner. MSM were less likely to report condom use during anal sex with long-term partners than with casual partners. Twenty-three and a half per cent of MSM surveyed had ever taken an HIV test and received the results. Study findings highlight the urgent need for targeted strategies focused on increasing the rate of consistent condom use during anal sex with male partners among MSM in Viet Nam.     

Factors associated with HIV testing among male motorbike taxi drivers in urban Vietnam

Using the Attitude-Skills-Knowledge (ASK) model, this study examined the prevalence of, and factors associated with, human immunodeficiency virus (HIV) testing among male motorbike taxi drivers (MMTDs). In a cross-sectional design, using quantitative approaches, 291 MMTDs were recruited from 135 sites across 13 districts in Hanoi, Vietnam, for a face-to-face interview. Applying the ASK model modified as a central theory, logistic regression was used to identify determinants of HIV testing. Although many MMTDs engaged in multiple risk behaviours for HIV, only 20.6% had been tested for HIV during the past 12 months. The tested model included one factor of the ASK model, HIV prevention knowledge (adjusted odds ratio [AOR] = 4.76; 95% confidence interval [CI] = 2.12–10.7) and five additional factors: being married (AOR = 3.13; 95% CI = 1.25–4.78), preferring sex with men or with both men and women (AOR = 8.72; 95% CI = 1.48–51.5), having lower number of lifetime sex partners (AOR = 0.66; 95% CI = 0.49–0.88), higher number of past year sex partners (AOR = 2.97: 95% CI = 1.21–7.31) and discussing condom use when having sex with partners (AOR = 0.08; 95% CI = 0.01–7.31). This modified ASK model provided better fit than the ASK model, as it explained more variance in HIV testing (47 vs. 29.8%). Recognising factors associated with HIV testing among MMTDs enables us to create suitable public health intervention strategies.     

Female Disclosure of HIV-Positive Serostatus to Sex Partners: A Two-City Study

The aims of this article are (1) to describe the prevalence of disclosure of HIV serostatus to sex partners among a racially/ethnically diverse sample of HIV-positive women living in Hawai'i and Seattle, Washington; and (2) to examine factors related to disclosure and condom use with those sex partners. HIV-positive women have difficulties consistently disclosing serostatus to sex partners and using condoms. Little is known about the disclosure practices of women from Hawai'i or Seattle. A cross-sectional design with convenience and snowball sampling was used, and up to three recent sex partner experiences were assessed among the HIV-positive participants (N = 84). A total of 133 recent sex partners were reported, with disclosure and condom use frequencies of 75.2 and 59.9%, respectively. Women who knew when it was safe to disclose were more likely to disclose. Women who disclosed to recent sex partners were less likely to use condoms, while those in casual/anonymous partnerships were more likely to use condoms. Hawaiian/part Hawaiian women had the lowest proportion of condom use. Health care personnel should routinely discuss disclosure and sexual transmission risk behaviors with seropositive women and offer strategies to enhance condom use, especially among those in committed partnerships. Culturally tailored interventions focused on strengthening efficacy beliefs for disclosure and condom use in Native Hawaiians are needed.     

Coercive forms of sexual risk and associated violence perpetrated by male partners of female adolescents

CONTEXT: Partner violence is associated with STDs among female adolescents, but the mechanisms underlying this association remain unclear. Sexually coercive and deceptive behaviors of male partners that increase female STD risk may be factors in this relationship. METHODS: A sample of 356 females aged 14–20 who attended adolescent health clinics in Greater Boston between April and December 2006 were assessed for physical and sexual violence perpetrated by male partners and for exposure to sexual risk factors. Adjusted logistic regression models were used to examine the associations between intimate partner violence and standard sexual risk behaviors (e.g., multiple partnerships) and coercive or deceptive sexual risk factors (e.g., coerced condom nonuse). RESULTS: More than two‐fifths of the sample had experienced intimate partner violence. In adjusted analyses, adolescents reporting intimate partner violence were more likely than others to report standard sexual risk behaviors—multiple partners, anal sex and unprotected anal sex (odds ratios, 1.7–2.2). They also were more likely to report coercive or deceptive sexual risk factors—partner sexual infidelity, fear of requesting condom use, negative consequences of condom request, and coerced condom nonuse (2.9–5.3). CONCLUSION: The high prevalence of intimate partner violence against young women attending adolescent clinics strongly indicates the need to target this population for abuse‐related interventions. This need is underlined by the observed association between partner violence and sexual risk involving coercion or deception by male partners. Clinic‐based STD and pregnancy prevention efforts should include assessment of sexual risk factors that are beyond the control of young women, particularly for those experiencing abuse.