Sexually transmitted diseases knowledge assessment and associated factors among university students in the United Arab Emirates: a cross-sectional study

Background

Sexually transmitted diseases and infections (STDIs) remain a serious public health menace with over 350 million cases each year. Poor knowledge of STDIs has been identified as one of the bottlenecks in their control and prevention. Hence, assessment of knowledge, both general and domain-specific, is key to the prevention and control of these diseases. This study assessed the knowledge of STDIs and identified factors associated with STDI knowledge among university students in the United Arab Emirates (UAE).

Methods

This is a cross-sectional study among 778 UAE University students across all colleges. An online data collection tool was used to collect data regarding the participants' demographics and their level of knowledge of STDIs across different domains including general STDI pathogens knowledge (8 items), signs and symptoms (9 items), mode of transmission (5 items), and prevention (5 items). Knowledge was presented both as absolute and percentage scores. Differences in STDI knowledge were statistically assessed using Mann-Whitney U and Chi-squared tests. Logistic regression models were further used to identify factors associated with STDI knowledge.

Results

A total of 778 students participated in the study with a median age of 21 years (IQR = 19, 23). The overall median STDI knowledge score of the participants was 7 (out of 27), with some differences within STDI domains-signs & symptoms (1 out of 9), modes of transmission (2 out of 5), general STDI pathogens (2 out of 8), and prevention (1 out of 5). Higher STDI knowledge was significantly associated with being non-Emirati (OR = 1.85, 95% CI = 1.24-2.75), being married (OR = 2.89, 95% CI = 1.50-5.56), residing in emirates other than Abu Dhabi (OR = 1.61, 95% CI = 1.16-2.25), and being a student of health sciences (OR = 4.45, 95% CI = 3.07-6.45).

Conclusion

In general, STDI knowledge was low among the students. Having good knowledge of STDIs is essential for their prevention and control. Therefore, there is a need for informed interventions to address the knowledge gap among students, youths, and the general population at large.

Prevalence and determinants of condom use among the youth in Malawi: evidence from the 2015/16 Malawi Demographic and Health Survey

BACKGROUND

Unprotected sexual intercourse among the youth is common in Malawi. This has led to high rates of sexually transmitted infections (STIs), Human Immunodeficiency Virus (HIV), and unplanned pregnancies. The study investigated the prevalence and the determinants of male and female condom use for the prevention of sexually transmitted infections and unplanned pregnancies among the youth in Malawi.

METHODS

The 2015/2016 Malawi Demographic and Health Survey (MDHS) data were used among 15 to 24-year-old male and female who had sexual intercourse four months preceding the survey. A total of 1543 male and 5143 female were selected from 3226 male and 10,367 female respectively and analyzed with SPSS version 20 using.descriptive, bivariate, and logistic regression.

RESULTS

The study found a low prevalence (27.1%) of condom use among the youth in the last sexual intercourse within four months before the survey. More male (55.8%) used condoms than female (18.5%). The significant predictors of condom use among the male and female youth were: being sexually active (OR 0.39 CI 0.33-0.47), aged 20-24 (OR 0.80 CI 0.68-0.95), ever married (OR 0.07 CI 0.06-0.08), coming from central region (OR 0.56 CI 0.40-0.77), and southern region (OR 0.59 CI 0.42-0.83), residing in the rural area (OR 0.74 CI 0.61-0.90) and ever tested of HIV (OR 1.29 CI 1.03-1.55).

CONCLUSION

Having established low prevalence of condom use among the youth in Malawi, there is a need to scale up programs and policies that target the youth to practice safe sex, which will assist in addressing the challenges of STIs, including HIV, and preventing unplanned pregnancies in Malawi.

The COVID-19 pandemic and seeking information about condoms online: an infodemiology approach

Objectives: As condoms are effective tools for pathogen-avoidance in sexual intercourse, seeking information about condoms online may be a reactive response to the COVID-19 according to the behavioral immune system theory.Design: Taking an infodemiology perspective, this research employed multilevel analyses to examine how COVID-19 online query data (i.e., Google topic search terms Coronavirus and COVID-19) and coronavirus epidemiological data (i.e., COVID-19 cases per million and case fatality rate) would predict condom information seeking behavior online (i.e., Google topic search term Condom) throughout the pandemic across American states (Study 1) and 102 countries/territories (Study 2), after accounting for death-thought accessibility (i.e., illness-related searches), interest in birth control (i.e., birth-control-related searches), COVID-19 control policy, stay at home behavior, season, religious holidays, yearly trends, autocorrelation, and contextual variables such as HIV prevalence rate and socioeconomic development indicators (GINI index, urbanization, etc.).Results: When there were high levels of COVID-19 concerns in cyberspace in a given week, search volume for condoms increased from the previous week across American states and different countries/territories. By contrast, the effect of actual coronavirus threat was non-significant.Conclusion: Seeking information about condoms online could be a reactive response to high levels of COVID-19 concerns across different populations.

Pornography Consumption and Condomless Sex among Emerging U.S. Adults: Results from Six Nationally Representative Surveys

Using six samples of unmarried U.S. residents aged 18-24 who were part of a larger biennial nationally representative survey (2008-2018), the present study examined whether pornography consumption is a risk factor for condomless sex during emerging adulthood. Condomless sex is the norm in popular, commonly consumed, pornography. Further, emerging adulthood is a time of heightened sexual experimentation and risk taking, and many emerging adults view pornography. Consistent with a sexual scripting perspective on media processes and effects, emerging adults who viewed pornography were more likely to have condomless sex than their peers who did not consume pornography. The link between pornography use and condomless sex was similar for men and women, white youth and youth of color, as well as heterosexual and LGB youth. The link was not moderated by age. Further, the link was robust even when indicators of both sexual and nonsexual sensation seeking predilections were included in analyses. These results are consistent with recent suggestions from public health experts that sex education programs need to include modules on pornography literacy.

Prevalence of Good Condom Usage and Its Association with Condom Use Self-Efficacy among Youth Attending HIV/STDs Clinics in Primary-Care Settings in Malaysia

The low prevalence of condom usage among youth with Human Immunodeficiency Virus/Sexually Transmitted Diseases (HIV/STDs) is a concern. Condom use self-efficacy has been identified as a significant predictor of condom usage. This cross-sectional study examines the prevalence of good condom usage and its association with condom use self-efficacy among Malaysian urban youth, aged between 18 to 24 years old attending HIV/STDs clinics in primary-care settings, Selangor. Utilising the Harmonised Malay version of Condom Use Self-Efficacy Scale (CUSES M-H) questionnaire, the data from 218 responders were analysed using univariate and multiple logistic regression. The prevalence of good condom usage was 61% (95% CI: 54%, 68%). The average mean score of condom use self-efficacy was 3.07. Condom use self-efficacy was divided into four subscales of mechanics, perceived barriers, assertiveness and intoxicants. The assertiveness subscale had the highest average mean score of 3.42, while the intoxicant subscale score had the lowest average mean score of 2.24. Good condom usage was significantly associated with condom use during first sexual intercourse (aOR = 5.81, 95% CI: 1.97, 17.14), duration diagnosis of HIV/STDs of more than 12 months (aOR = 6.40, 95% CI: 2.30, 17.86) and the high assertiveness subscale score (aOR = 1.19, 95% CI: 1.03, 1.36). A behavioural change campaign that targets high-risk youth in primary care settings could promote condom use self-efficacy particularly assertiveness to increase condom usage among the youth.

Stealthing among university students: associated factors

OBJECTIVE

To identify the practice of stealthing among university students and the associations between the profile of these young people and this practice.

METHOD

Cross-sectional study carried out at a university campus in a city in the countryside of Sao Paulo. Data collection was carried out online by RedCap between May and September 2018, through questionnaires with identification data, sociodemographic characteristics and sexual and reproductive health. Data were analyzed by IBM-SPSS, version 17.0.

RESULTS

A total of 380 students participated in the study, aged between 18 and 24 years old, most of them unpaid students, coming from private education, not having a religion and being single. Most of them were biologically female and identified as cisgender and heterosexual women. As for stealthing, 1.33% of the participants had performed it and 11.44% had already undergone this practice. There was a significant association between having been stealthed and the variables female biological sex (p = 0.000) and identifying as a woman (p = 0.000).

CONCLUSION

The occurrence of stealthing is higher among those who have been stealthed than among those who have done it and having been stealthed is associated with being female and identifying as a woman.

Prática do stealthing entre jovens universitários: fatores associados

RESUMO Objetivo: Identificar a prática de stealthing entre jovens universitários e as associações entre o perfil desses jovens e a prática do stealthing. Método: Estudo transversal realizado em um campus universitário de um município no interior paulista. A coleta de dados foi online pelo RedCap, entre maio e setembro de 2018, por meio de questionários com dados de identificação, características sociodemográficas e de saúde sexual e reprodutiva. Os dados foram analisados pelo IBM-SPSS, versão 17.0. Resultados: Participaram do estudo 380 estudantes, com idade entre 18 e 24 anos, a maioria sem exercer função remunerada, advindos(as) de ensino particular, sem religião e solteiras(os). Em sua maioria, eram do sexo biológico feminino e se identificavam como mulheres cisgênero e heterossexuais. Quanto ao stealthing, 1,33% dos participantes tinham realizado e 11,44% já tinham sofrido essa prática. Houve associação significativa entre ter sofrido stealthing e as variáveis sexo biológico feminino (p = 0,000) e se identificar como mulher (p = 0,000). Conclusão: A ocorrência do stealthing é maior entre os que sofreram essa prática do que entre aqueles que a praticaram. Ter sofrido stealthing está associado a ser do sexo feminino e se identificar como mulher.

Determinants of condom use during last sexual intercourse among male college youth of Kaski, Nepal: A cross-sectional survey

Background

The National Family Planning program of Nepal has introduced the condom as an important family planning method. Despite the continuous effort from the public and private sectors at various levels, its use among youth remains low. Therefore, this study aimed to assess the factors associated with condom use during the last sexual intercourse among male college youth.

Methods

We conducted a cross-sectional study and analyzed the responses of 361 male college youth (aged 19 to 24 years who reported being sexually active preceding six months of the survey), among the 903 participants who reported being involved in vaginal and anal sexual intercourse. The chi-square test was primarily used to find the associated factors and then, stepwise logistic regression was performed by selecting the covariates after the multicollinearity test followed by adjustment of confounders.

Results

We found that more than one-fourth (27.4%) of the sexually active male youth had used the condoms during their last sexual intercourse. Postgraduate male youth were four times more likely to use the condoms during the last sexual intercourse than undergraduate male youth (AOR = 4.09, 95% CI; 2.08–8.06). Similarly, married youth were less likely to use the condoms during the last sexual intercourse with 95% lower odds than their counterparts (AOR = 0.05, 95% CI; 0.01–0.38). Male youth with adequate knowledge about the condoms were 8 times more likely to use them compared to those with inadequate knowledge (AOR = 8.42, 95% CI; 4.34–16.33). Likewise, male youth with favorable attitude towards the condoms were 2.5 times more likely to use them compared to their counterparts (AOR = 2.58, 95% CI; 1.23–5.42). Similarly, male youth having two or more sex partners were 4.5 times more likely to use the condoms than the youth having only a sex partner (AOR = 4.57, 95% CI; 2.38–8.76).

Conclusion

The study concluded that slightly more than one-fourth (27.4%) of male college youth in Kaski district used the condoms during their last sexual intercourse. Level of education, marital status, knowledge about condoms, attitude toward condoms, and number of sex partners are the determinants of condom use among male college youth so recommended for early behavioral interventions, especially in knowledge and attitude. Further studies focusing on including the rural youth and larger geography may help to reach a firmer conclusion.

Condom use during COVID-19: Findings from an Australian sample of heterosexual young adults

Condoms are a valuable tool in combating the continued spread of sexually transmitted infections (STIs). Despite the fact that condoms are effective and easily accessible, young adults report inconsistent condom use and young adults represent a disproportionately large amount of new STI cases annually. The Behavioural Immune System theory suggests that health behaviours, such as condom use, are impacted by cognitive activation of perceived threat of disease. The advent of the COVID-19 pandemic may then have unforeseen impacts on condom use and the spread of STIs. The present study investigated changes in condom use during the pandemic, and any associations these changes may have had with perceived vulnerability to COVID-19. An Australian sample of 269 students completed a survey asking them to recall their condom use prior to COVID-19, and then their current condom use. Final analyses included a sample of 149 sexually active heterosexual participants. Results revealed a general decline in condom use. Single and coupled participants both reported less frequent condom use, but this decrease was more pronounced among single people. Gender did not moderate these effects. Surprisingly, diminished condom use was not significantly related to perceived threat of COVID-19. Findings of the present study have concerning implications for sexual health and sexual messaging during pandemics.

Preparing for sperm-targeted contraception: College students' perceptions and intentions related to non-hormonal intravas injectable gel

OBJECTIVE

The objective of the study was to evaluate college students' perceptions and behavioral intentions related to a new long-acting reversible contraceptive (LARC) for people with penises: non-hormonal intravas injectable gel (NH-IVIG).

DESIGN AND SAMPLE

Data collection utilized predictive constructs from the theory of planned behavior. An online questionnaire surveyed undergraduates (ages 18-24 years) at a Midwestern, liberal arts college (N = 460).

RESULTS

Of potential NH-IVIG users, 28.6% of males and 51.4% of females reported being overall likely to use or encourage its usage. The top three hypothetical NH-IVIG promoters were low cost, reversibility, and infrequent administration. High cost, new product uncertainties, plus administration via injection for the males, were the most frequently cited NH-IVIG deterrents. A majority of potential users indicated intentions to use protective barriers or other contraceptives simultaneously with NH-IVIG; females were more likely overall. Most respondents (males, 90.4%; females, 98.5%) agreed all sexual partners should be equally responsible for contraception. Over half trusted both males and females to use contraception, but females were significantly more trusted and trusting.

CONCLUSION

Understanding factors influencing NH-IVIG usage can direct initiatives for sperm-targeted LARCs to mitigate risk behaviors and optimize public health promotion.

Condom use in penile-vaginal intercourse among Canadian adults: Results from the sex in Canada survey

PURPOSE

This paper examines condom use in penile-vaginal sexual intercourse among adults in Canada.

DATA AND METHOD

The Sex in Canada survey is a national survey of Canadian adults, ages 18+ (N = 2,303). The online survey used quota-based population sample matching of 2016 census targets for gender, age, region, language, visible minority status, and education level. We report general patterns of self-reported condom use, as well as results from zero-inflated negative binomial regression models on the relationship between condom use and social location, relationship status, and sexual health.

RESULTS

Condom use varies by gender, age, education, visible minority status, and relationship status. Use of condoms is related to the perception of risk of being diagnosed with a sexually transmitted infection in the next six months and to the experience of receiving lessons in condom use. No significant associations were found between condom use and region, rural/urban residence, income, or religion. Among men, but not women, condom use is associated with language preference, past diagnosis with a sexually transmitted infection, and self-reported sexual health.

CONCLUSION

Canadian adults report using a condom in approximately 30% of their sexual encounters involving penile-vaginal sex. Condom use is highest among young adults. Single people use condoms more often than people with marital or common-law partners. Condom use is higher among those with higher levels of education, among people belonging to visible minorities relative to white people, and for men relative to women. People who think they are likely to be diagnosed with a sexually transmitted infection in the next six months are more likely to use condoms than those who do not.

A portrait of risk behavior towards HIV infection among Brazilian Army conscripts by geographic regions, 2016

INTRODUCTION

Knowledge about risky sexual behavior among young people has been widely acknowledged as a key tool to controlling the spread of HIV. This article aimed at presenting the risk behavior of Brazilian Army conscripts toward HIV infection according to the country's geographic regions. .

METHOD

We collected data from 37,282 conscripts, aged 17 to 22, during enlistment in the Brazilian Army in 2016. The prevalence of HIV infection, both self-reported and measured through laboratory results, and risk behavior factors were estimated by region.

RESULTS

75% of the sample of conscripts reported to have already started sexual activity, and the average age of their sexual initiation was 15. Condom use varied according to the type of sexual relationship, being lower among steady partners and greater among less stable relationships. HIV prevalence assessed by laboratory tests was 0.12% across the country and the highest prevalence was observed in the North region (0.24%). Alcohol and illicit drug usage was higher in the South region.

DISCUSSION

The study allowed the observation of risk behavior monitoring for HIV infection among young Brazilians. Lower condom usage among steady partners may be contributing to an increase in the number of HIV-infected individuals.

CONCLUSION

Results suggest the need to intensify prevention campaigns to disseminate safe sex practices among young people, in addition to the expansion of testing offer to this population.

Does attractiveness influence condom use intentions in women who have sex with men?

Objectives

Attractiveness judgements have been shown to affect interpersonal relationships. The present study explored the relationships between perceived attractiveness, perceived sexual health status, condom use intentions and condom use resistance in women.

Setting

The study data were collected using an online questionnaire.

Participants

480 English-speaking women who have sex with men, between 18–32 years old.

Outcome measures

Women were asked to rate the attractiveness of 20 men on the basis of facial photographs, to estimate the likelihood that each man had a sexually transmitted infection (STI), and to indicate their willingness to have sex with each man without a condom. Condom resistance tactics were also measured and their influence on condom use intentions was assessed.

Results

The more attractive a man was judged to be, the more likely it was that participants were willing to have sex with him (r (478) = 0.987, p < .001). Further, the more attractive a man was judged to be, the less likely women were to intend to use a condom during sex (r = -0.552, df = 478, p = .007). The average perceived STI likelihood for a man had no significant association with his average perceived attractiveness or with participants’ average willingness to have sex with him. The more attractive a participant judged herself to be, the more she believed that, overall, men are likely to have a STI (r = 0.103, df = 478, p < .05).

Conclusions

Women’s perceptions of men’s attractiveness influence their condom use intentions; such risk biases should be incorporated into sexual health education programmes and condom use interventions.

Attitudes toward condom carriers: The role of gender

This study assessed personal attitudes and perceptions of societal attitudes toward condom carriers, with a focus on the role of gender. Although prior research suggests that sexually active women in society are looked down upon, there has been little investigation as to whether this view remains pertinent today, and whether this remains the case at the individual—as opposed to societal—level. Participants were female undergraduate students who read vignettes describing either a male or female condom carrier. They then rated the condom carrier’s character and provided estimates of how their peers would rate the same individual. The young women in our sample did not negatively judge female condom carriers; in fact, they viewed a female condom carrier more favourably than a male condom carrier. Similarly, they endorsed beliefs that other women in society (i.e., their female peers) would not differently rate a condom carrier based on gender. However, women believed that their male peers would be significantly more critical of a female, as opposed to a male, condom carrier. The relation to ambivalent sexism is discussed, as well as the implications that these findings may have on an individual’s own beliefs and practices surrounding condom use.

Condom use in last sexual intercourse among undergraduate students: how many are using them and who are they?

A cross-sectional study was conducted to measure the prevalence of condom use in the last sexual intercourse and associated factors among university students. Undergraduate students from a public university aged 18 and over of the Rio Grande (RS) campuses were eligible. A systematic single-stage sampling was used, based on class lists and self-administered questionnaire. Descriptive, bivariate and multivariable analyses were employed, with Poisson regression for the latter two. Most of the 1,215 university students included in the analysis were aged 20 to 29 (65.6%) and 69.3% began their sexual life before the age of 18. The prevalence of condom use in the last intercourse was 41.5% (95%CI: 38.7-44.3). Male gender, lower age group, condom use at first sexual intercourse, older age of onset of sexual activity, not having a partner and casual partner in the last sexual intercourse increased the likelihood of condom use.

Patient-Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM

Adolescent males who have sex with males (AMSM) are at increased risk of contracting HIV/AIDS and other sexually transmitted infections (STIs). Healthcare providers are a critical source of HIV/STI prevention, yet little is known about AMSM patient-provider sexual health communications and services. To explore this issue, we surveyed a national sample of 198 AMSM 14-17 years. Four online psychometrically validated scales indicated over half the youth avoided communicating their sexual orientation and sexual health concerns to providers due to fear of heterosexist bias, concern their sexual health information would be disclosed to parents, and a general belief that sexual minority youth do not receive equitable treatment in health care settings. Youth who reported their physicians had initiated discussion about their sexual orientation were significantly more likely to have received HIV/STI preventive services and testing. Discussion includes the importance of medical training that meets the unique sexual health needs of AMSM.

"Free Testing and PrEP without Outing Myself to Parents:" Motivation to participate in oral and injectable PrEP clinical trials among adolescent men who have sex with men

BACKGROUND

Adolescent men who have sex with men (AMSM) account for disproportionately high numbers of new HIV diagnoses. Non-adherence to daily use limiting the effectiveness of oral PrEP (Truvada) has led to current trials with adult MSM testing Cabotegravir, a long-term injectable medication. Once comparative studies with young adult MSM have established relative safety and efficacy of these medications, there will be a need for such comparative trials involving adolescents. Trends in state laws and IRB protocol review indicate that many of these studies will permit youth to provide independent consent for participation. Understanding the motivations of AMSM to participate in HIV biomedical prevention studies is important to ensure their agreement is voluntary without misunderstanding and undue influence. This study examined AMSM attitudes toward participation in oral/injectable PrEP RCTs to inform protections of youth's rights and welfare in future studies.

METHODS

We administered to 198 ethnically diverse U.S. AMSM, 14-17 years, a web-based survey including demographic and sexual health questions, description of a year-long oral versus injectable PrEP RCT and 26 Likert-type and one open-ended item assessing motivations for and against participation including: perceived benefits and risks of PrEP; free HIV/STI testing and counseling; confidentiality concerns; random assignment; and benefit to others.

RESULTS

Sixty-two percent indicated they were likely to participate in the study. The majority endorsed daily HIV protection, free HIV/STI testing, sexual health counseling, not having to rely on partner's condom use, and altruism as reasons to participate. Reasons against participation included medication side effects, concern taking the pill daily and clinic visits would reveal their sexual orientation and behaviors to parents. Over half erroneously assumed they would be assigned to the condition best for them and 39% indicated free access to services would lead them to participate even if they did not want to. Multiple regression indicated these factors accounted for 55% of the variance in participation choice. Nether age or ethnicity yielded significance.

CONCLUSIONS

Results suggest future biomedical HIV prevention research will need to develop procedures to address AMSM's confidentiality concerns, enhance youth's understanding of random assignment, the continued importance of medication adherence and partner condom use during trial participation, and availability of alternative sexual health services to avoid the potentially undue influence of access to free sexual health services.

Thirty years of sexual behaviour at a Canadian university: Romantic relationships, hooking up, and sexual choices

Every 10 years from 1980 to 2010, students in a British Columbia university were surveyed about age of sexual initiation, number of partners, and degree of emotional intimacy within their partnerships. Between 1980 and 1990, the socially acceptable prerequisite for premarital sex appeared to shift from the promise of marriage to mutual love. This change was demonstrated by a fall in the virginity rate among unmarried females, and the rise of monogamous romantic relationships for males. From 1980 through 2010, men reported more sexual partners than did women, with a smaller, though rising, proportion of serious relationships. Since 1990, never-married students were classified into three sexual behavioural groups: monogamists (about 55%), abstainers (30%), and multi-partnered “experimenters” (20% of men throughout each decade, and 7.6% of women in 1990–2000, rising to 14.4% in 2010). Experimenters generally reported concurrent partners, most of them casual. Since 1980, most sexually active students have experienced both romantic relationships and casual sexual partnerships, yet since at least 1990, the majority have been primarily monogamous. This article traces the changes and continuities in romantic relationships, casual sex, and sexual behavioural groups over 30 years, concluding that contrary to the claims of popular media and some academics, casual sex (“hookup culture”) has not replaced romantic relationships as the most common form of student sexual behaviour.

Factors Protecting Male and Female Adolescents in Mexico From Human Papillomavirus Infection

Introduction:

Adolescents may be infected with human papillomavirus (HPV) during their first sexual relationship. Persistent infections in adulthood may result in associated cancers among both women and men. This study explored condom use action plans, its influence on sexual activity in adolescents, and associated HPV protective behavior.

Methods:

A descriptive correlational design was used. A convenience sample including adolescents ( N =313; male n = 171, female n = 142), aged 15 to 17 years, attending one of three public high schools in Mexico was recruited. Self-report structured questionnaires were used to assess sociodemographics, sexual behavior, and HPV protective behavior.

Findings:

Self-reported HPV knowledge among Mexican adolescents was low. Adolescents ( n = 81, 25.9%) self-reported sexual experience. Comparisons of adolescents by self-reported sexual experience identified significant differences, including higher condom use self-efficacy, sexual rights knowledge, a condom use action plan, and greater interpersonal influence on HPV protective behavior among those who had sexual experience. Significant factors predicting HPV protective behavior included self-reported number of sexual partners, condom use in past 3 months, and having a condom use action plan.

Conclusion:

An intervention targeting adolescents should encourage adolescents to develop their own cognitive processes, thereby facilitating the adoption or development of action plans for HPV protective behavior.

Knowledge and perception of young adults in Nigeria on effectiveness of condom use in prevention of sexually transmitted infections

BACKGROUND

Although sexually transmitted infections (STIs) are a global health problem affecting every region of the world, the higher prevalence and mortality rate of STIs in developing countries of the world, like Nigeria, make them serious public health issues in this region.

OBJECTIVE

The aim of this study is to assess the knowledge and perception of young adults in Nigeria on the role of condom (both male and female condoms) as a preventive measure against STIs during heterosexual and homosexual intercourse.

MATERIALS AND METHODS

Data was collected from participants selected from the northern and southern Nigeria using self-administered questionnaire specifically designed for this study.

RESULTS

Knowledge of condom efficacy in STI prevention was satisfactory. However, knowledge and practice of the correct use of condom was poor. Only 47.1% of the 102 participants in this study reported correct condom use of wearing condoms before staring intercourse and removing condoms after ejaculation. As a strategy to include the experiences, knowledge and perception of men who have sex with men, this study asked the question on condom use during anal sex. Only 24.4% of the male participants indicated they have never had anal sex while for females, the percentage was more than half (53.5%). Condom use during anal sex was low with only 20.6% of participants reporting condom use during anal sex. Negative perceptions about condom use - such as that condom use promotes sexual promiscuity, and not using condoms with steady sexual partners - were significant in this study. Also, condom use errors were common in this study.

CONCLUSION

There is a wide gap in knowledge of correct condom use in this population. There is need for interventions that address the issue of condom use during anal and same-sex sexual intercourse in this population.

Prevalence and correlates of condom use among single midlife Canadian women and men aged 40 to 59

Reported rates of sexually transmitted infections (STIs) among midlife Canadians have increased. However, there is little data on the STI behavioural risk of this age group. The current study investigated the prevalence and correlates of condom use at last penile vaginal intercourse (PVI) among sexually active single (never married, separated/divorced) Canadians aged 40 to 59 (n=830). Men were more likely than women to report using a condom at last PVI (35.3% vs. 27.6%). Number of partners, dating status, partner type at last sex, and concern about STI were significant bivariate predictors of condom use among men and women. Age, marital status, and erectile difficulties were additional bivariate predictors for men. In multivariate analysis, marital status, number of partners, and partner type predicted condom among men. Divorced and separated men were 53% less likely to use a condom than single, never married men. Men who reported 2 or more partners over the past year were almost 2 times more likely to use a condom than men who had one partner over the past year. As partner type at last sex moved from casual to more committed, men were 26% less likely to report condom use at last PVI. Among women, partner type at last sex was the only significant multivariate predictor of condom use, as partner type moved from casual to more committed, condom use was 33% less likely. Condom use was not associated with decreased pleasure during PVI. Educational STI prevention interventions targeting single midlife Canadians are needed.

Alcohol use, risky sexual behavior, and condom possession among bar patrons

PURPOSE

The current study seeks to: 1) assess the relationship between alcohol consumption and intentions to engage in unprotected sex in an uncontrolled environment, and 2) to identify if covariates (race, age, sex, breath alcohol content (BrAC), intentions to engage in sex, hazardous drinking rates) are significant predictors of condom possession during time of uncontrolled alcohol consumption.

METHODS

Data were collected from 917 bar patrons to assess alcohol use using the Alcohol Use Disorders Identification Test (AUDIT-C), BrAC levels, intentions to engage in risky sex, and condom possession. Correlational analysis and hierarchical binary logistic regression was conducted using SPSS.

RESULTS

Correlational analyses indicated a negative relationship between AUDIT-C scores (r=-0.115, p=0.001), BrAC (r=-0.08, p=0.015), and intentions to use a condom. Over 70% of participants intended to use a condom if they engaged in sex; however, only 28.4% had a condom to use. The regression analysis indicated the predictive model (χ(2)=114.5, df=8, p<0.001) was statistically significant, and correctly classified 72.9% of those in possession of a condom.

CONCLUSIONS

Alcohol consumption was associated with intentions to have unprotected sex; however, intentions to engage in protected sex and condom possession were higher for males and those with higher BrAC levels.

Sexual health information disparities between heterosexual and LGBTQ+ young adults: Implications for sexual health

Most studies on young adults' sources of sexual health information and confidence in sexual health practices have focused primarily on heterosexual university students. This study sought to bridge this gap in the literature by exploring where emerging adults, including LGBTQ+ individuals and those who do not pursue postsecondary education, obtain their sexuality information and how this relates to sexual self-efficacy. A total of 386 adults between the ages of 18 and 25 were divided into higher education (n=306) versus high school (n=80) groups and heterosexual (n=215) versus LGBTQ+ (n=171) emerging adults. Participants completed measures of sexual health information sources, as well as self-efficacy with regard to sexual health practices. Heterosexual participants obtained significantly more information from school/university courses and less from educational websites/news outlets than LGBTQ+ participants. Heterosexual participants were significantly more confident in their sexual health practices than LGBTQ+ participants. Different sources of information helped predict sexual self-efficacy across these four groups. Acquiring more information from significant others was the only significant predictor of sexual self-efficacy for all four groups. This study suggests that sexual health information should be discussed within a more relational or interpersonal framework, and that LGBTQ+ issues should be further incorporated and integrated in sex education curricula. Implications for healthcare providers, public health policy, sex educators, clinicians and future research are discussed.

A profile of the sexual experiences of African, Caribbean and Black Canadian youth in the context of Canadian youth sexuality

Canadian studies have examined patterns of sexual behaviour and health based on age, gender, and geographical regions, but typically ignored the increasing ethnic diversity in Canada's population. In large part this is because sampling techniques tend to produce insufficient numbers of youth in specific ethnic groups for detailed analysis. This paper presents a profile of the sexual experiences of African, Caribbean, and Black (ACB) youth using data collected in a survey (n=510) with ACB youth age 16–25 years living in the Windsor/Essex County region of Ontario, Canada. Data were examined for differences among the three ethno-racial groups in combination with differences between Muslims and Christiana, and males and females. In this predominantly heterosexual sample (95%), nearly ¾ of the Black and Caribbean youth reported sexual intercourse experience compared to well under ½ of the African youth. Overall, African were less experienced than Caribbean and Black youth and, within the African group, Muslim less than Christian youth. This included age of initiating various sexual activities, number of partners, use of condoms, and experiences of either non-volitional or non-relational sex. Alcohol in connection with sexual activity and multiple partners within a single month were rare. The Black and Caribbean participants reported sexual experiences and had a sexual profile that was closest to that of Canadian youth. Given the increasingly multicultural profile of Canada, these findings support the importance of research on distinct ethno-racial groups in Canada to inform the delivery of sexual education and health policy and programming.

Minority College Women's Views on Condom Negotiation

This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the “withholding sex” subscale of the CIS (4.88 vs. 3.55; p < 0.001) as well as endorsed items more strongly on the “direct request” subscale of the CIS (4.63 vs. 3.82, p < 0.05) than never users. A thematic analysis of open discussions identified overarching themes. Similarly, refusing sex and/or having direct communications with partner emerged as primary strategies. Threats to negotiation included deciding the “right timing” of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male’s responsibility and stigma of women who carry condoms.

A Question of Love and Trust? The Role of Relationship Factors in Adolescent Sexual Decision Making

OBJECTIVE

While representing only 25% of the sexually active population, 50% of all new sexually transmitted infections occur among young people mostly because of inconsistent condom use. Critically, the majority of adolescent sexual activity takes place in the context of romantic relationships; thus, it is important to understand how relationship factors may influence decision making about the use of protection.

METHODS

We used a mixed-method approach to investigate the extent to which relationship length, degree of trust or love in the relationship, and frequency of intercourse influence both perceptions of the probability of condom use and self-reported condom use in the context of relationships among a diverse sample of high-risk adolescents (age 12-19 yr).

RESULTS

Participants were least likely to use condoms if they were in relationships with high trust or love and high frequency of intercourse. Importantly, sexual experience status was a strong moderator of primary effects.

CONCLUSION

The perspective of motivated cognition provides a useful theoretical framework to better understand adolescent decision making about condom use, particularly for sexually experienced youth.