Predictors of STDs among Asian and Pacific Islander young adults

Chlamydial and gonorrheal neglected sexually transmitted diseases among Pacific Islanders of the Western Pacific Region-A narrative review and call to action

The Pacific Island countries of the Western Pacific Region have some of the highest rates of sexually transmitted Chlamydia trachomatis and Neisseria gonorrhoeae infections in the world. Despite this, there are few research studies that include Pacific Islanders. We conducted a narrative review of original research and surveys, including World Health Organization and Pacific Community reports, to determine the prevalence, management, and treatment of C. trachomatis and N. gonorrhoeae compared to HIV and syphilis from 1980 to 2022. Available epidemiologic data on C. trachomatis and N. gonorrhoeae indicated an extremely high prevalence-approximately 30% and 13%, respectively-among Pacific Islanders during this timeframe. These neglected sexually transmitted infections represent a significant burden and health disparity. Robust epidemiologic research is needed to identify modifiable risk factors for designing interventions and control strategies. Appropriate policies along with regional and international advocacy and aid are required to improve reproductive health among these vulnerable, understudied populations to avert preventable infections and sequelae.

Factors Associated with Sexually Transmitted Infections among Users of Voluntary HIV Counseling and Testing Centers in Portugal

Objective: Users of publicly funded voluntary HIV Counseling and Testing Centers (VCT C) in the Portuguese National Service have been found to have higher rates of HIV risk behavior than the general population, but data concerning the relationship between socio-demographic, behavioral, and cognitive variables, and Sexually Transmitted Infections (ST Is) in this specific population are limited. This study tests the impact of socio-demographic, behavioral and cognitive variables on ST Is in a sample of 168 users of VCT C. Methods: A cross-sectional study using structured questionnaires was conducted. Results: Being older, being gay or bisexual, and having more barriers towards safer sex (e.g., negative attitudes toward safer sex behavior) were associated with increased odds of having had a ST I diagnosis. We found significant differences between heterosexual and gay men for number of sexual partners, frequency of anal sex, exchanging sex for money or drugs, history of ST Is, AIDS knowledge, and risk beliefs about the partner, with gay men showing higher rates. Conclusions: ST Is education should target older, gay or bisexual individuals, and focus on information as well as on changing barriers towards safer sex and associated health beliefs.

Out of school female adolescent employment status and sexually transmitted infections (STIs) risk in Uganda: is it a plausible relationship?

BACKGROUND

High prevalence of Sexually Transmitted Infections (STIs) among adolescents is a serious public health concern. Although many factors are attributed to adolescents' risk of STI infections, the association between out of school adolescents' employment status and STIs has not been thoroughly explored in Uganda, yet many adolescents are known to be employed. Consequently, the extent to which adolescents' employment status may be a risk factor for unprotected sex and STIs among female adolescents is unclear. This study examines the association between female out of school adolescents' employment status and STI status using the Uganda Demographic and Health Survey (UDHS) data for 2016.

METHODS

Both descriptive and multilevel binary logistic regressions were used to analyse the data. The descriptive statistics provided an overview of the association between the two main variables while the multilevel binary logistic estimated the relationship between employment status and STI status, while controlling for other fixed factors and community random factors.

RESULTS

Compared to female adolescents who were not employed or not working, the odds of reporting positive STIs were significantly higher for female adolescents who were working but received no pay (1.801(95% CI = 1.105-2.936), were self-employed in agriculture (1.502 (95% CI = 1.003-2.250) and who did manual jobs (2.258(95% CI = 1.429-3.568) whether skilled or not. Likewise, female adolescents who had two or more lifetime sexual partners (11.679 (95% CI = 1.254-2.248) had significantly higher odds of reporting STIs than those who had only one lifetime sexual partner.

CONCLUSION

Out of school female adolescents who are employed in various types of low wage employments are at greater risk of exposure to STIs than their counterparts who do not work in Uganda. Instead of being a protective factor against the risk of STIs, their employment may expose them to risky sexual behaviour and STIs, given the vulnerabilities female adolescents who have dropped out of school tend to report. Therefore, the provision of decent employment opportunities for these females may provide an avenue for instructional scaffolding to build the life skills and empower these females so that they are better able to reduce their exposure to STIs.

Factors related to sexual behaviors and sexual education programs for Asian-American adolescents

AIM

To understand the influential factors related to sexual behaviors among Asian-American adolescents and to evaluate common factors across successful sexual education programs for this population.

BACKGROUND

Despite a rapid increase in cases of STIs/HIV among Asian-American populations, there remains a need for a comprehensive understanding of the influential factors related to risky sexual behaviors for this population.

METHODS

An integrative literature review was conducted. Peer-reviewed articles and government resources were analyzed.

RESULTS

Five influential factors were identified: family-centered cultural values, parental relationship, acculturation, gender roles, and lack of knowledge and information about sex and STIs. Only two sexual educational programs met the inclusion criteria and provided evidence towards effectiveness: Safer Choices and Seattle Social Development Project.

CONCLUSIONS

The findings of this study indicate an urgent need for culturally sensitive sexual education programs that incorporate the identified influential factors, especially cultural values in order to reduce risky sexual behaviors among Asian-American adolescents.

Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

Do Asian-American women who were maltreated as children have a higher likelihood for HIV risk behaviors and adverse mental health outcomes?

OBJECTIVES

This study is the first to systematically investigate whether multiple child maltreatment is associated with HIV risk behaviors and adverse mental health outcomes among Asian-American women.

METHODS

We conducted a cross-sectional study of unmarried Chinese, Korean, and Vietnamese women (n = 400), aged 18 to 35, who are identified as children of immigrants, using computer-assisted survey interviews.

RESULTS

Approximately 7 in 10 women reported having been maltreated as a child and 6.8% reported any type of sexual abuse. Only 15% of our sample reported having sex at age 16 or before, yet almost 60% had ever engaged with potentially risky sexual partners. Contrary to the findings from previous studies of White and Black women, sexual abuse plus other maltreatment was not associated with HIV risk behaviors among Asian-American women. However, it was associated with a marked increase in depression, lifetime suicidal ideation, and suicide attempts. A higher education level was associated with increased odds of HIV risk behaviors, including ever having had anal sex and ever having potentially risky sexual partners.

CONCLUSION

There was no evidence indicating that multiple child maltreatment was linked with HIV risk behaviors, but it exhibited a robust association with poor mental health outcomes. These empirical patterns of internalizing trauma, suffering alone, and staying silent are in accord with Asian-cultural norms of saving face and maintaining family harmony. The prevention of multiple child maltreatment may reduce high levels of depression and suicidal behaviors in this population. It is urgent to identify victims of multiple child maltreatment and provide culturally appropriate interventions.

Gender differences in sexual risk behaviour among adolescents in Catalonia, Spain

OBJECTIVE

To analyze the factors associated with sexual risk behavior in adolescent girls and boys in order to plan future school health interventions.

METHODS

A cross-sectional study with two-stage cluster sampling that included 97 schools and 9,340 students aged between 14 and 16 years old was carried out in 2005-2006 in Catalonia (Spain). For the survey, a self-administered paper-based questionnaire was used. The questionnaire contained items on sociodemographic variables, use of addictive substances and mood states, among other items. These variables were tested as risk factors for unsafe sexual behavior.

RESULTS

This study included 4,653 boys and 4,687 girls with a mean age of 15 years. A total of 38.7% of students had had sexual relations at least once and 82.3% of boys and 63.0% of girls were engaged in sexual risk behaviors. The prevalence of sexual relations and risk behaviors was generally higher in boys than in girls, independently of the variables analyzed. Boys had more sexual partners (P<.001) and used condoms as a contraceptive method less frequently than girls (P<.001). Foreign origin was related to unsafe sexual activity in both genders. Alcohol consumption was also a risk factor in boys.

CONCLUSIONS

Sexual risk behaviors among adolescents in Catalonia are higher in boys than in girls. Factors related to unsafe sexual activity in boys were foreign origin and alcohol consumption. In girls only foreign origin was a significant risk factor.

Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru

Background

Risky sexual behaviors of young adults have received increasing attention during the last decades. However, few studies have focused on the sexual behavior of young adults in shantytowns of Latin America. Specifically, studies on the association between sexual behaviors and other risk factors for sexually transmitted infections (STI) and HIV/AIDS transmission, such as the consumption of illicit drugs or alcohol are scarce in this specific context.

Methods

The study participants were 393 men and 400 women between 18 and 30 years of age, from a shantytown in Lima, Peru. Data were obtained via survey: one section applied by a trained research assistant, and a self-reporting section. Logistic regression was used to estimate associations between use of any illicit drug, high-risk sexual behaviors and reported STI symptoms, adjusting for alcohol consumption level and various socio-demographic characteristics.

Results

Among men, age of sexual debut was lower, number of lifetime sexual partners was higher, and there were higher risk types of sexual partners, compared to women. Though consistent condom use with casual partners was low in both groups, reported condom use at last intercourse was higher among men than women. Also, a lifetime history of illicit drug consumption decreased the probability of condom use at last sexual intercourse by half. Among men, the use of illicit drugs doubled the probability of intercourse with a casual partner during the last year and tripled the probability of reported STI symptoms.

Conclusion

Drug consumption is associated with high-risk sexual behaviors and reported STI symptoms in a Lima shantytown after controlling for alcohol consumption level. Development of prevention programs for risky sexual behaviors, considering gender differences, is discussed.