The Role of Sexual Images in Online and Offline Sexual Behaviour With Minors

A Qualitative Examination of School Counselors' Experiences of Sextortion Cases of Female Students in Israel

Sextortion (a portmanteau of "sexual" and "extortion") is a relatively new phenomenon of sexual exploitation, which occurs when a person threatens another with the distribution of sexual content on the Internet, to obtain more pictures or videos, money, or have some other demand met. The current study examined how school counselors in Israel perceive the phenomenon of online sextortion. To this end, we conducted a qualitative study based on 20 semi-structured in-depth interviews with school counselors working in middle schools and high schools in Israel, who treated adolescent girls blackmailed over the Internet on sexual grounds. Findings indicate that the school counselors had difficulty in identifying and defining the cases they treated as instances of sextortion, and that in their view the harm was slight. Findings also indicate that school counselors associated the causes of sextortion with the victims and their backgrounds. We found differences between the Arab and secular and national-religious state education in the way Jewish counselors treated the victims and involved additional actors such as the victim's parents and the police. This underscores the importance of providing educational staff with adequate knowledge and tools that are culturally suited to the victims.

Adherence of HIV Self-Testing Among Men Who Have Sex With Men in China: Longitudinal Study

BACKGROUND

The World Health Organization recommended HIV self-testing (HIVST) for individuals practicing unsafe sexual behaviors; however, the adherence to HIV testing has not been reported.

OBJECTIVE

In this study, we attempted to determine the adherence to HIVST among men who have sex with men (MSM), as well as the impact factors and potential effects of their adherence.

METHODS

We conducted a longitudinal study among MSM in Harbin, Heilongjiang province, China from July 1, 2017 to June 30, 2018. A mobile app system was used to provide the "Mailing rapid test reagent kit" for the HIVST service. The proportion of those who adhered to HIV testing every 3 months was calculated. Logistic regression was used to explore the impact factors related to adherence to HIVST. Rates of HIV infection between MSM who adhered to HIVST and those who did not were compared using Cox proportional hazards regression. Changes of condom use behaviors between the two groups were also compared using the chi-square test.

RESULTS

A total of 1315 MSM who received the HIVST service through the app were included in the study. Overall, 10% of the MSM adhered to HIVST, and the proportion of adhering tests was only 34.9%. Adherence of HIVST was associated with marital status (adjusted odds ratio [OR]_{unmarried vs married} 2.31, 95% CI 1.13-4.71) and the number of HIV tests they received (adjusted OR_{3 times vs 2 times or below} 3.36, 95% CI 2.01-5.63; adjusted OR_{4 times or above vs 2 times or below} 7.30, 95% CI 4.67-11.42). Twenty HIV seroconversions were observed during 1-year follow up. The rate of HIV infection in the adherence group (17.10 per 100 person years, 95% CI 8.80-30.84) was significantly higher than that in the nonadherence group (4.80 per 100 person years, 95% CI 2.77-7.88; adjusted hazard ratio 3.33, 95% CI 1.35-8.20). Those who adhered to HIV testing were more likely to improve condom use behaviors, although the difference was not statistically significant.

CONCLUSIONS

Regular HIV testing is necessary for early detection of HIV infection among MSM. Given the poor adherence, a new internet-based management paradigm for MSM is needed to raise their health awareness to optimize the implementation of HIVST.