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Fiorentino M, Coulibaly B, Couderc C, Keita BD, Anoma C, Dah E, Mensah E, Aka TN, Touré JR, Camara D, Kokouba AR, Maradan G, Mora M, Bourrelly M, Riegel L, Rojas-Castro D, Spire B, Laurent C, Sagaon-Teyssier L. Men Who Have Sex with Both Men and Women in West Africa: Factors Associated with a High Behavioral Risk of Acquiring HIV from Male Partners and Transmission to Women (CohMSM ANRS 12324-Expertise France). ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:757-769. [PMID: 37973698 PMCID: PMC10844348 DOI: 10.1007/s10508-023-02715-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 11/19/2023]
Abstract
HIV is highly prevalent in men who have sex with men (MSM) in West Africa. Many MSM in the region also have sex with women (MSMW). Accordingly, they are a potential bridge subpopulation for HIV transmission to women. We aimed to evaluate the proportions and characteristics of West African MSMW at high behavioral risk of acquiring HIV from male partners and transmitting it to female partners (HBRMF). The cohort ANRS-12324 CohMSM Study included 630 HIV-negative MSM in Burkina Faso, Cote d'Ivoire, Mali, and Togo. Among MSMW (i.e., with ≥ 1 female partner) in the cohort, HBRMF was identified using trajectory models based on seven at-risk sexual practices with male and female partners, including inconsistent condom use, multiple partnerships, and receptive same-sex anal intercourse. To assess the relevance of using trajectory models, we compared the proportions of participants who seroconverted during the cohort follow-up among those at HBRMF and those not at HBRMF. Factors associated with HBRMF were identified using a generalized estimation equation logistic regression model accounting for longitudinal data. Approximately half (47%) of the 304 MSMW (22% of all CohMSM study participants) were at HBRMF. This group accounted for 75% of the 28 HIV seroconversions observed during follow-up (p = 0.001). HBRMF was positively associated with being aged < 25 years (aOR 95% CI 1.67 [1.23-2.27]), being sexually attracted only to men (1.97 [1.38-2.78]), feelings of loneliness (1.92 [1.38-2.65]), and homonegative violence score (1.22 [1.05-1.41]). HBRMF was negatively associated with having had both stable and casual female partners in the previous 6 months (0.34 [0.20-0.60] vs. only a stable female partner). HBRMF tended to be negatively associated with having ≥ 4 sexual intercourses with female partners in the previous four weeks (0.54 [0.27-1.06] vs. no intercourse). Establishing official relationships with women might be a strategy for young and/or stigmatized MSMW to comply with social pressure to display a heterosexual lifestyle. However, this seems to increase the risk of HIV transmission to female partners. In the present study, almost half of MSMW were at HBRMF. This result stresses the need to adapt HIV research and prevention to MSMW and their female partners.
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Affiliation(s)
- Marion Fiorentino
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France.
| | - Bakary Coulibaly
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Bintou Dembélé Keita
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Elias Dah
- Association African Solidarité, Ouagadougou, Burkina Faso
| | | | | | | | - Drissa Camara
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Gwenaëlle Maradan
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marion Mora
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | - Michel Bourrelly
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | - Lucas Riegel
- Coalition PLUS, Laboratoire de recherche communautaire, Pantin, France
| | - Daniela Rojas-Castro
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- Coalition PLUS, Laboratoire de recherche communautaire, Pantin, France
| | - Bruno Spire
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | | | - Luis Sagaon-Teyssier
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
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Silhol R, Nordsletten A, Maheu-Giroux M, Elmes J, Staunton R, Owen B, Shacklett B, McGowan I, Feliciano KG, van der Straten A, Eller LA, Robb M, Marrazzo J, Dimitrov D, Boily MC. The Association Between Heterosexual anal Intercourse and HIV Acquisition in Three Prospective Cohorts of Women. AIDS Behav 2023; 27:4010-4021. [PMID: 37392271 PMCID: PMC10598156 DOI: 10.1007/s10461-023-04115-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/03/2023]
Abstract
The extent to which receptive anal intercourse (RAI) increases the HIV acquisition risk of women compared to receptive vaginal intercourse (RVI) is poorly understood. We evaluated RAI practice over time and its association with HIV incidence during three prospective HIV cohorts of women: RV217, MTN-003 (VOICE), and HVTN 907. At baseline, 16% (RV 217), 18% (VOICE) of women reported RAI in the past 3 months and 27% (HVTN 907) in the past 6 months, with RAI declining during follow-up by around 3-fold. HIV incidence in the three cohorts was positively associated with reporting RAI at baseline, albeit not always significantly. The adjusted hazard rate ratios for potential confounders (aHR) were 1.1 (95% Confidence interval: 0.8-1.5) for VOICE and 3.3 (1.6-6.8) for RV 217, whereas the ratio of cumulative HIV incidence by RAI practice was 1.9 (0.6-6.0) for HVTN 907. For VOICE, the estimated magnitude of association increased slightly when using a time-varying RAI exposure definition (aHR = 1.2; 0.9-1.6), and for women reporting RAI at every follow-up survey (aHR = 2.0 (1.3-3.1)), though not for women reporting higher RAI frequency (> 30% acts being RAI vs. no RAI in the past 3 months; aHR = 0.7 (0.4-1.1)). Findings indicated precise estimation of the RAI/HIV association, following multiple RVI/RAI exposures, is sensitive to RAI exposure definition, which remain imperfectly measured. Information on RAI practices, RAI/RVI frequency, and condom use should be more systematically and precisely recorded and reported in studies looking at sexual behaviors and HIV seroconversions; standardized measures would aid comparability across geographies and over time.
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Affiliation(s)
- Romain Silhol
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, St Mary's Hospital, 2 Norfolk Place, London, W2 1PG, UK.
- HIV Prevention Trials Network Modelling Centre, Imperial College London, London, UK.
| | - Ashley Nordsletten
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, St Mary's Hospital, 2 Norfolk Place, London, W2 1PG, UK
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Canada
| | - Jocelyn Elmes
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, St Mary's Hospital, 2 Norfolk Place, London, W2 1PG, UK
| | - Roisin Staunton
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, St Mary's Hospital, 2 Norfolk Place, London, W2 1PG, UK
| | - Branwen Owen
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, St Mary's Hospital, 2 Norfolk Place, London, W2 1PG, UK
| | - Barbara Shacklett
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA
| | - Ian McGowan
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Ariane van der Straten
- Center for AIDS Prevention studies, University of California, San Francisco, CA, USA
- ASTRA Consulting, Kensington, CA, USA
| | - Leigh Anne Eller
- Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Merlin Robb
- Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Jeanne Marrazzo
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dobromir Dimitrov
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Marie-Claude Boily
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, St Mary's Hospital, 2 Norfolk Place, London, W2 1PG, UK
- HIV Prevention Trials Network Modelling Centre, Imperial College London, London, UK
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Morhason-Bello IO, Mitchell K, Jegede AS, Adewole IF, Francis SC, Watson-Jones D. Heterosexual Oral and Anal Sex: Perceptions, Terminologies, and Attitudes of Younger and Older Adults in Ibadan, Nigeria. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:161-175. [PMID: 36123563 PMCID: PMC9484716 DOI: 10.1007/s10508-022-02313-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 05/24/2023]
Abstract
Although heterosexual oral and anal sexual behaviors have been reported in sub-Saharan Africa, little is known about how they are understood and perceived, particularly, in West Africa. We undertook a qualitative exploration of local terminologies and sexual scripts associated with heterosexual oral and anal sex in preparation for a quantitative survey. We held focus group discussions (18) and interviews (44) with younger and middle-aged men and women from the general population and female sex workers (FSWs) in selected communities in Ibadan. Most participants had heard of oral and anal sex. Younger adults aged 18-25 years, particularly male participants and FSWs, appeared more informed than older adults in the general population. Sexually explicit movies were the most cited source of information. Oral and anal sexual behaviors were considered sensitive, with different local names, meanings, and interpretations. Participants advised against the use of slang terms in research. We identified six different scripts employed by participants in discussing oral and anal sex practices: protecting sexual relationship, financial reward, an alternative to vaginal sex, pleasure, male dominance and control, and risk, stigma, and disgust.
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Affiliation(s)
- Imran O Morhason-Bello
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK.
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Kirstin Mitchell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ayodele S Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Isaac F Adewole
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Suzanna C Francis
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Deborah Watson-Jones
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Komlenac N, Herzig R, Pittl M, Perkhofer S, Tucek G, Hochleitner M. A Vignette Study Analyzing Contextual Factors that Influence Emerging Adults' Definitions of Virginity Loss in German-Speaking Countries. JOURNAL OF SEX RESEARCH 2022; 59:1045-1059. [PMID: 34128744 DOI: 10.1080/00224499.2021.1932708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Past research on virginity loss definitions revealed that emerging adults' definitions of virginity loss are associated with emerging adults' own sociodemographic characteristics. However, previous research has not systematically studied whether emerging adults applied different criteria for virginity loss depending on the context of the judged behavior. The current study used vignettes to explore which contextual factors of an intimate partnered behavior influence emerging adults' definition of virginity loss. Each of the 987 participants (75% women/25% men; Mage = 23.7, SD = 3.8) was assigned to one of 16 vignette conditions. The main character's gender, sexual orientation, and commitment to the partner were manipulated in the vignettes, describing the main character engaging in intimate partnered behavior with either a woman or a man. Participants had to indicate whether 13 intimate partnered behaviors qualified as virginity loss in the given context. Emerging adults applied different standards for virginity loss definitions depending on the involved partners' gender. They counted more behaviors as virginity loss in conditions where two people of the same gender engaged in intimate partnered behavior. Healthcare practitioners concerned with emerging adults' sexual health should be aware of these double standards for virginity loss definitions.
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Affiliation(s)
| | | | - Manuel Pittl
- FH Gesundheit, Health University of Applied Sciences Tyrol
| | | | - Gerhard Tucek
- Institut Therapiewissenschaften, FH Krems University of Applied Sciences
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D'Amato S, Pellicanò GF, Nunnari G, Fedele F, Squeri R, Mazzitelli F, D'Andrea F, Maisano D, Squeri R, Genovese C. Management care improvement of people living with HIV: definition of a targeted clinical pathway in a University Hospital of South Italy. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021244. [PMID: 34487078 PMCID: PMC8477122 DOI: 10.23750/abm.v92i4.11425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/20/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND AIM In the world 37,9 billions live with Human Immunodeficiency Virus and, despite the availability of retroviral therapy, they have an higher risk to acquire other infectious diseases and to develop severe complications. According to several guidelines their immunization is crucial but only some center have developed a specific scheduled pathway and vaccination coverage is very low. Aim of this study is: a)incentivize the active and free of charge offer of vaccines and increase of immunization coverage; b) application and implementation of a shared clinical pathway avoiding reluctance, embarrassment or shame by patients for their condition; d) instauration of an empathic relationship between doctor and patient; e) evaluation of side effects. METHODS A prospective study was conducted from October 2019 to February 2020 at the University Hospital G. Martino of Messina. Inclusion criteria were: age over 18; absence of other diseases; absence of immunization against HBV or HAV; CD4 count for live attenuated viral vaccines of 350/uL and for other vaccine 200/uL. A specific scheduled pathway was adopted for every patient. Statistical analysis was performed with Excel software. RESULTS 86 patients were enrolled (74.4% were males, 79.1% were Italian; mean age=4013.3 SD). An increase in administration was observed between 2018 and 2019 (+164.3% for flu and for other vaccines +370%). The higher increase was observed for HPV one. No-one received DTpa, MMRV or Zoster vaccine. CONCLUSIONS The undertook clinical pathway showed the relevance of specific management of these patients and the need to increase the vaccination offer.
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Affiliation(s)
- Smeralda D'Amato
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | | | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - Franco Fedele
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
| | | | - Francesco Mazzitelli
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | - Flavia D'Andrea
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - Daniele Maisano
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
| | - Raffaele Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
| | - Cristina Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, 98125, Italy.
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Gao Z, Fu R, Li X, Wang J, He Y. Safety Assessment of Microbicide 2P23 on the Rectal and Vaginal Microbiota and Its Antiviral Activity on HIV Infection. Front Immunol 2021; 12:702172. [PMID: 34447373 PMCID: PMC8382973 DOI: 10.3389/fimmu.2021.702172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/21/2021] [Indexed: 02/01/2023] Open
Abstract
Containment of the AIDS pandemic requires reducing HIV transmission. HIV infection is initiated by the fusion of the membrane between the virus and the cell membrane of the host. 2P23 is an effective HIV membrane fusion inhibitor that may be a good entry inhibitor microbicide candidate. This study evaluated the potential of using gel-formulated 2P23 as a topical microbicide to prevent sexual transmission of HIV in the rectum and vagina. Our data revealed that 2P23 formulated in gel is effective against HIV. There was no change in antiviral activity at 25°C for 4 months or 60°C for 1 week. In addition, we demonstrated that the 2P23 gel was stable and fully functional at pH 4.0-8.0 and under different concentrations of H2O2. Finally, the 2P23 gel exhibited no cytotoxicity or antimicrobial activity and did not induce inflammatory changes in the rectal or vaginal mucosal epithelium in New Zealand rabbits after 20 mg/day daily rectovaginal application for 14 consecutive days. Despite repeated tissue sampling and 2P23 gel treatment, the inflammatory cytokines and microbiota of the rectum and vagina remained stable. These results add to general knowledge on the in vivo evaluation of anti-HIV microbicide application concerning inflammatory cytokines and microbiota changes in the rectum and vagina. These findings suggest that the 2P23 gel is an excellent candidate for further development as a safe and effective pre-exposure prophylactic microbicide for the prevention of HIV transmission.
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Affiliation(s)
- Zhengqin Gao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology and Center for AIDS Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control, Beijing, China
| | - Rui Fu
- Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control, Beijing, China
| | - Xiaobo Li
- Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control, Beijing, China
| | - Ji Wang
- Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control, Beijing, China
| | - Yuxian He
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology and Center for AIDS Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Stewart J, Douglas G, O'Rourke T, Gammel C. Promoting safer sex in the context of heterosexual anal intercourse: A scoping review. J Clin Nurs 2021; 30:2111-2130. [PMID: 33377555 DOI: 10.1111/jocn.15628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/28/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023]
Abstract
AIMS AND OBJECTIVES To locate and summarise existing literature regarding safer sex practices specific to heterosexual anal intercourse and identify promising health promotion strategies. BACKGROUND Much of the literature regarding anal intercourse and safer sex is related to men who have sex with men. However, some studies suggest there are more women than men engaging in unprotected receptive anal intercourse. The risks associated with this sexual practice have been well documented, although many healthcare providers fail to ask about anal intercourse while addressing safer sex in the heterosexual population. DESIGN The study was based on Arksey and O'Malley's 2005 five-step methodology. METHODS A search was conducted of MEDLINE; CINAHL; PsycInfo; Cochrane; and PubMed. Databases were searched from 1990-2020. The 72 studies selected were classified according to their main area of focus. A grey literature search was also included. This scientific submission has been assessed for accuracy and completeness using the PRISMA-ScR guideline criteria (File S1). RESULTS The literature in this area is heterogeneous in terms of method and topic. Prevalence and incidence (n = 26) in addition to sexually transmitted infection risks (n = 26) related to heterosexual anal intercourse are well understood. However, there is limited information on condom use (n = 6), factors that influence heterosexual anal intercourse (n = 10) and health promotion strategies for this population and practice (n = 4). Two websites that mentioned heterosexual anal intercourse risk reduction activities were included. CONCLUSIONS Although heterosexual anal intercourse appears to be an increasingly common sexual practice, very little is known about health promotion strategies nurses might use for encouraging safer sex in this population. RELEVANCE TO CLINICAL PRACTICE Increased awareness of the prevalence and risks of heterosexual anal intercourse could enhance nurses' harm reduction strategies. Screening for sexually transmitted infections may be based on incorrect assumptions about sexual practices or due to stigma linked with anal intercourse. Reducing unprotected heterosexual anal intercourse will reduce sexually transmitted infections and their long-term sequelae.
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Affiliation(s)
- Joanne Stewart
- College and Community Health Centre, Alberta Health Services, Grande Prairie, AB, Canada
| | - Gillian Douglas
- Beaverlodge Community Health Services, Alberta Health Services, Beaverlodge, AB, Canada
| | - Tammy O'Rourke
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Carolyn Gammel
- Grande Prairie College & Community Health Centre, Alberta Health Services, Grande Prairie, AB, Canada
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Camilleri C, Perry JT, Sammut S. Compulsive Internet Pornography Use and Mental Health: A Cross-Sectional Study in a Sample of University Students in the United States. Front Psychol 2021; 11:613244. [PMID: 33510691 PMCID: PMC7835260 DOI: 10.3389/fpsyg.2020.613244] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background The sustained rise in negative mental health reports among university students is a source of continued global concern, and investigation continues into potential contributors to this rise. This includes the increased prevalence of risky sexual behaviors. Related is the increased prevalence of pornography use. Our study sought to explore the potential relationship between compulsive use of pornography and mental health in university students. Methods Our sample consisted of university students (N = 1031; 34% male, 66% female) from Franciscan University of Steubenville, Steubenville, Ohio. An anonymous survey was sent to all students at the university over the age of 18. The survey was comprised of the following: (1) demographic questions, (2) questions on pornography use and perception, (3) a modified version of the Compulsive Internet Use Scale (mCIUS) assessing various factors associated with compulsive internet pornography use, (4) questions assessing emotional and sexual states relative to pornography use (EmSS), and (5) the 21-question version of the Depression, Anxiety and Stress Scale (DASS-21). Results Our results indicate that 56.6% of those surveyed reported lifetime pornography use, with a significantly higher proportion of males than females reporting such use. The majority of students reported accessing pornography through internet-related technologies. Additionally, 17.0, 20.4, and 13.5% of students reported severe or extremely severe levels of depression, anxiety and stress, respectively, with compulsive pornography use significantly affecting all three mental health parameters in both sexes. Exploratory Factor Analysis identified three factors suggesting emotional coping, dependence and preoccupation for the mCIUS items and three factors reflecting interoceptive, impotent, and extrinsic characteristics for the EmSS items. Regression analysis indicated that various demographics, items pertaining to reduced control and social impairment, and other variables pertaining to pornography use predicted mental health outcomes. Faith, morals and personal motivation were the primary variables reported to help reduce pornography use. Conclusion Our analyses indicate a significant relationship between mental health and pornography use, including behaviors reflecting behavioral addictions, highlighting the necessity for a better understanding and consideration of the potential contribution of internet pornography to negative mental health among university students.
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Affiliation(s)
- Christina Camilleri
- Department of Psychology, Franciscan University of Steubenville, Steubenville, OH, United States
| | - Justin T Perry
- Department of Psychology, Franciscan University of Steubenville, Steubenville, OH, United States
| | - Stephen Sammut
- Department of Psychology, Franciscan University of Steubenville, Steubenville, OH, United States
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Bovbjerg ML, Misra D, Snowden JM. Current Resources for Evidence-Based Practice, November 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:605-619. [PMID: 33096044 PMCID: PMC7575432 DOI: 10.1016/j.jogn.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of diversity in the maternity care workforce and commentaries on reviews focused on burnout in midwifery and a cross-national comparison of guidelines for uncomplicated childbirth.
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