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.     

Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland

Over the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18–24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age than Whites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger and Whites. We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.     

绵阳城区男男性行为者性伴特征及影响因素

目的了解绵阳市城区男男性行为者(MSM)性伴现况。方法采用应答者趋动招募抽样法(RDS),在MSM活动场所定时、定点进行性伴及相关因素招募和寻问式匿名现场调查。结果共调查MSM 400人,首次插入性性行为平均(18±3.59)岁。最近6个月与男性发生过性行为占88.4%(352/398),平均(2±3.29)人;买性占4.7%(17/359),平均(1±2.49)人;卖性占2.5%(9/355),平均(4±6.19)人;与女性发生过性关系占18.3%(73/400),平均(1±2.42)人。调查者中不同婚姻状况、性取向、首次插入性行为年龄、认识当地MSM朋友数、性伴居住城市数、近6月男男肛交安全套使用,艾滋病知识是否来自书籍、来自学校,是否知道性伴没有健康问题、是否知道性伴健康状况者,近6个月男男肛交用安全套等因素与男男肛交数有关。多因素Logistic回归分析,最终进入回归模型的有婚姻、认识当地MSM朋友数、首次插入性行为年龄、性伴居住城市数、不知道性伴健康状况共5个(P<0.05),在婚(OR=5.074)、认识当地MSM朋友数≥9人(OR=2.192)、不知道性伴健康状况(OR=1.235)、首次插入性行年龄≤24岁(OR=6.948～9.871)者近6月肛交人数较多,性伴居住城市数≤1个者肛交人数较少。结论绵阳城区MSM首次性行为较早,多种性伴共存,多性伴普遍。     

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.     

The Role of Individual Differences in Particular Autonomy-Connectedness in Women's and Men's Work-Family Balance

Individual differences are increasingly considered important in the relationship between work-family balance and health. The present study examined the role of autonomy-connectedness in positive and negative work-family interaction and family-work interaction. We also investigated the relationship of work-family interaction and family-work interaction with positive and negative affect, coping patterns, and demographic characteristics. All variables under study were measured with questionnaires in a Dutch sample of 205 respondents. As expected, the individual difference factors were substantially associated with work-family interaction and family-work interaction; together they accounted for 10 to 39% of their variance. In particular, negative affect and the autonomy-connectedness components Sensitivity to others and Capacity for managing new situations appeared to be strongly related to work-family interactions. Health implications of the findings are discussed and recommendations for further research are presented.     

Patterns of Exchange Sex and HIV Infection in High-Risk Heterosexual Men and Women

Heterosexual partnerships involving the trade of money or goods for sex are a well-described HIV risk factor in Africa and Southeast Asia, but less research has been conducted on exchange partnerships and their impact on HIV infection in the United States. In our study, men and women were recruited from high-risk risk neighborhoods in New York City through respondent-driven sampling in 2006–2007. We examined the factors associated with having an exchange partner in the past year, the relationship between exchange partnerships and HIV infection, and the risk characteristics of those with exchange partners by the directionality of payment. Overall, 28% of men and 41% of women had a past-year exchange partner. For men, factors independently associated with exchange partnerships were older age, more total sexual partners, male partners, and frequent non-injection drug use. For women, factors were homelessness, more total sexual partners, more unprotected sex partners, and frequent non-injection drug use. Exchange partnerships were associated with HIV infection for both men and women, although the relationships were substantially confounded by other behavioral risks. Those who both bought and sold sex exhibited the highest levels of risk with their exchange and non-exchange partners. Exchange partnerships may be an HIV risk both directly and indirectly, given the overlap of this phenomenon with other risk factors that occur with both exchange and non-exchange partners.     

A Twin Study of Sexual Behavior in Men

The role of genetic and environmental influences on age of initiation of first sexual relations and engaging in sexual activity with multiple partners (10 or more partners in 1 year) was investigated in male twins (N = 6,744) from the Vietnam Era Twin Registry. Individual differences in both types of sexual behaviors were heritable, but only age of onset of sexual relations was significantly influenced by the environment shared by the twins. There was a moderate negative correlation between age of initiation of sexual relations and the multiple partners variable; initiating sexual relations earlier was associated with a higher probability of having multiple partners. The additive genetic influence on age of initiation also influenced the multiple partners variable. The substantial unique environmental influences on each variable were uncorrelated with each other. The data suggest that the observed association between age of initiation of sexual relations and having multiple partners is due to genetic influences common to both behaviors.     

性道德对在校未婚青年性KAP的影响

目的了解大学生性KAP(知识、态度、行为)现状及变迁,探讨性道德对现代青年KAP的影响,给制定符合国情的青少年生殖健康规划提供依据。方法用描述流行病学的方法于2000年对在昆四所高校1190名19~22岁未婚青年作了性道德及性KAP的匿名调查,并与1994年4189名大学生的同质资料作比较;用分析流行病学的方法作不同道德观青年KAP的比较。结果(1)有24%认为童贞对男女都不重要,16%认为婚前性行为对男女无害,15%认为性行为是对爱的承诺。高达57%的人对婚前性行为持宽容态度,70%的人赞成大学生谈恋爱,有48%的人谈过恋爱,其中37%谈过两次以上,54%遭遇失恋。上述KAP具男>女,城>乡的现象。(2)与1994年同质资料相比,赞成婚前同居的男生为32%较前下降5%,而女生(18%)则上扬了5·6%;可与友发生性行为的男女较1994年增长3·4%。(3)未婚青年性KAP间呈高度相关(r0·45~0·81,P<0·01);对童贞持否定道德观的青年性KAP开放度是持肯定观的2·3~7·8倍(95%IC1·57%~10·91%,P<0·01)。结论大学生性KAP具高度相关性,并有日趋开放之势。传统的贞洁观对性态度/行为仍具较大约束力,性道德教育仍将是我国青少年生殖健康规划中不可忽视的重要干预措施之一。     

Sexual Risk Behavior of Men Who have Sex with Men: Comparison of Behavior at Home and at a Gay Resort

This study compared sexual behavior of gay and bisexual men (N = 551) while at their primary residence to their behavior while vacationing at a gay resort community. Participants reported behavior for the days they spent in the resort and for their last 60 days in their home residences. Overall, 11 times more non-main partners were reported for unprotected anal intercourse (UAI) per day while in the resort as for the “at home” period. Regression analysis identified negative attitudes toward condoms, less concern about AIDS, and daily number of non-main, male partners at home with whom UAI occurred as significant predictors of the daily number of non-main male partners with whom holidaymakers engaged in UAI while in the resort area. The results suggest that sexual risk taking by men who have sex with men (MSM) while on holiday may be elevated over that at home and that prevention efforts need to be promoted in gay resorts. Behavioral surveillance research would be helpful in better characterizing the current social contexts of sexual risk taking by MSM. Theory-based studies of the nature of risk-taking and sexual decision-making on “gay holiday” could inform the development of empirically proven and conceptually grounded interventions.     

Arousal Loss Related to Safer Sex and Risk of Pregnancy: Implications for Women's and Men's Sexual Health

CONTEXT: Few studies have examined arousal loss associated with safer-sex practices or the perceived risk of unintended pregnancy, let alone its associations with sexual risk practices.
METHODS: An Internet survey conducted in 2004–2006 among 2,399 men and 3,210 women asked respondents about arousal loss related to the use of condoms or other safer-sex products and perceived unintended pregnancy risk. Regression analyses gauged associations between arousal profiles, unprotected sex in the last year and lifetime experience of unintended pregnancy.
RESULTS: Many respondents reported arousal loss related to the use of safer-sex products (34%) or the risk of unintended pregnancy (46%). Participants who strongly agreed that use of safer-sex products can lessen their arousal were significantly more likely to have had unprotected sex in the last year than were those who strongly disagreed (odds ratios, 1.8 for men and 3.7 for women); those who strongly disagreed that pregnancy risk can lessen their arousal were significantly more likely to have been involved in an unintended pregnancy than were those who strongly agreed (2.0 for men and 1.4 for women). Arousal loss related to safer-sex practices was more strongly associated with unprotected sex among women than among men, whereas arousal loss related to pregnancy risk was more strongly associated with unintended pregnancy among men than among women.
CONCLUSIONS: Some men and women are turned off by safer-sex practices or by pregnancy risk. Given arousal profiles' potential contributions to unintended pregnancies and STD transmission, they should be integrated into sexual health behavioral models, research and programming.     

A Prospective Study of Intraindividual and Peer Influences on Adolescents' Heterosexual Romantic and Sexual Behavior

Theories and empirical studies of adolescent sexual behavior have identified the contributions of personal attributes and social experiences; however, it is rare that models have clarified developmental pathways to adolescent sexual behavior that include (1) factors assessed prior to and early in adolescence and (2) dyadic experiences in adolescence that provide the opportunity for sexual behavior (i.e., dating). Using data from a prospective study, structural equation modeling was used to test a model predicting adolescent sexual behavior at age 19, denoted by the number of lifetime sexual partners. Predictors examined were sociability and impulsivity assessed at 30 months of age, physical characteristics and experiences with peers measured at age 12-13, the age of first romantic relationship, and frequency of alcohol use at age 16. The pathway to greater sexual involvement was marked by some desired personal attributes (e.g., sociability) and peer experiences (e.g., higher quality friendships). These associations were mediated, however, by earlier initiation of romantic relationships and more frequent use of alcohol in middle adolescence. Earlier initiation of romantic relationships and more frequent alcohol use were predicted by greater sociability and less impulsivity in childhood, higher quality friendships and greater peer acceptance in early adolescence, and a more mature appearance and physical attractiveness (among females) at age 13. The findings imply a complex pathway that leads to a greater accumulation of sexual partners by age 19. This pathway begins in childhood and includes individual qualities, peer acceptance, romantic relationships, and alcohol use.     

Family Contexts of Informal Sex Education: Young Men's Perceptions of First Sexual Images

Guided by a feminist perspective, the authors examined young men's recollection of their reactions to and the familial and social contexts in which they realized that they were seeing an explicit sexual image for the first time. The sample consisted of 199 young men enrolled in a human sexuality class who responded to questions regarding the what, when, where, with whom, and how they felt about and reacted to seeing a sexualized image. On average, participants were in elementary school and without adult supervision when they found their first image in a form of media that was readily available in the home. Implications for family life education for both parents and children include direct and knowledgeable communication about sexuality to counter the often sensationalizing, objectifying, and entitled culture in which boys are informally initiated into adult sexuality.     

初产妇女阴道分娩半年后盆腔器官和肛提肌状况的动态与静态磁共振研究

目的 探讨初产妇女阴道分娩半年后盆腔器官和肛提肌状态的动态和静态磁共振特点,为临床防治盆底功能障碍性疾病(pelvic floor dysfunction,PFD)提供理论依据.方法 40例行产后MRI盆底检查的初产妇女以及同期行MRI盆底检查的产前健康女性作为研究对象,分别列为观察组和对照组,对比观察组女性分娩半年后的盆腔器官情况以及两组女性肛提肌动态与静态磁共振检查结果.结果 观察组中盆腔脏器脱垂(pelvic organ prolapse,POP)者23例(57.5%),其中子宫脱垂5例,阴道前壁脱垂11例,阴道后壁脱垂4例,子宫脱垂合并阴道前(后)壁脱垂3例;POP产妇用力相LH相、LPA水平均较正常组增长,观察组MRI检查用力相H线、M线、LH以及LPA水平均高于对照组;差异均有统计学意义(P<0.05).结论 初产妇女阴道分娩半年后多伴有不同程度的提肛肌损伤级功能减退,并发盆腔脏器脱垂;可能与肛提肌裂隙增宽以及提肛板角增大有关.     

Female Migrant Sex Workers in Moscow: Gender and Power Factors and HIV Risk

This study aimed to build formative knowledge regarding HIV risks in female migrant sex workers in Moscow, focusing on gender and power. This was a collaborative ethnographic study, informed by the theory of gender and power, in which researchers conducted minimally structured interviews with 24 female sex workers who were migrants to Moscow and who provided sexual services to male migrant laborers. Overall, the female migrant sex workers engaged in HIV risk behaviors and practiced inadequate HIV protection with their clients. These behaviors were shaped by gender and power factors in the realms of labor, behavior, and cathexis. In the labor realm, because some female migrants were unable to earn enough money to support their families, they were pushed or pulled into sex work providing service to male migrants. In the behavior realm, many female migrant sex workers were intimidated by their male clients, feared violence, and lacked access to women's health care and prevention. In the cathexis realm, many had a sense of shame, social isolation, emotional distress, and lacked basic HIV knowledge and prevention skills. To prevent HIV transmission requires addressing the gender and power factors that shape HIV/AIDS risks among female migrant sex workers through multilevel intervention strategies.     

Sexual Fantasies of Adolescent Male Sex Offenders in Residential Treatment: A Descriptive Study

An attenuating sample of 87 male adolescent sexual offenders logged sexual fantasies during their entire time in therapy. These patients were attending residential treatment and kept a log recording all normal and deviant sexual fantasies which they experienced. Patients recorded which fantasies were interrupted and which fantasies were accompanied by masturbation. Typically, at the beginning of treatment, the reported rate of normal fantasies was maximal, the occurrence of deviant fantasies was minimal, and there was little effort to interrupt the deviant fantasies. The reported frequency of deviant fantasies increased substantially (about 380%) during the first 5 months of treatment and then steadily declined (approximately 47%) over the remaining months in therapy. Following an initial decline in the early months of treatment, an increase in the rates of normal fantasies was reported. Additionally, over the course of treatment, the frequency of deviant fantasies decreased relative to all fantasies. While deviant fantasies remained predominant to normal sexual fantasies and were more frequently paired with masturbation, patients reported substantial changes in the proportion of deviant fantasies that were interrupted (from about 20% to 70%). Implications of the results for juvenile sex offender treatment are discussed.     

The Relationship Between Self-Reported Sexual Orientation and Behavior in a Sample of Middle-Aged Male Injection Drug Users

Data are sparse on injection drug using (IDU) men who have sex with men (MSM). Previous literature suggests perceived taboos can result in an underreporting of atypical sexual orientation (i.e., bisexuality, homosexuality). As a result, HIV prevention programs have been difficult to mount, particularly programs for IDU-MSM. The association between self-reported sexual orientation and sexual behavior at semi-annual study visits was longitudinally assessed in a population of 1300 male IDUs in Baltimore during the period 1993 to 1998. Overall, a small minority (5%) of the male IDUs inconsistently reported their sexual orientation over time. Logistic regression analyses were performed, which yielded five significant predictors. These men tended to be older, to have been incarcerated, to have attended shooting galleries during follow-up, and were more than twice as likely to be HIV-seropositive (OR, 2.66; 95% CI, 1.62–4.36) compared with those who consistently reported their sexual orientation. Furthermore, men reporting inconsistent sexual orientation tended to engage in higher risk behaviors, suggesting that these men should be especially targeted for interventions.     

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.     

芜湖市吸毒和卖淫嫖娼人群HIV/AIDS预防健康教育和干预研究

目的　探索预防和控制艾滋病的有效措施。　方法　采用自身对照实验研究设计。对被芜湖市看守所和拘留所抓获的两类人群开展免费发放艾滋病预防宣传手册、现场咨询和同伴教育等健康教育干预 ,运用问卷调查评价干预效果。　结果　干预前调查 15 2人 ,干预后调查 13 5人 ,干预后两类人群的性病艾滋病相关知识显著提高 ,艾滋病相关行为态度也有正向变化。 96.0 3 %的人愿意使用避孕套 ,98.41%的人认为共用未消毒的注射器可感染艾滋病。 96.83 %的人认为在婚外性行为中应使用避孕套 (P <0 .0 1)。　结论　健康教育和干预是当前及今后预防控制艾滋病的有效措施。