Predictors and Barriers to Condom Use in the African Cohort Study

Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18-24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.

Future of keeping pet reptiles and amphibians: animal welfare and public health perspective

In a review summary on page 450, Pasmans and others discuss the future of keeping reptiles and amphibians as pets. Here, Clifford Warwick and others discuss the animal welfare and public health implications of exotic pet business.

Children's memories of a physical examination involving genital touch: implications for reports of child sexual abuse

Evaluation of child sexual abuse often necessitates interviewing children about genital touch, yet little scientific research exists on how best to obtain children's reports of genital contact. To examine this issue, 72 five- and seven-year-old girls experienced a standardized medical checkup. For half of the children, the checkup included a vaginal and anal examination (genital condition); for the other half, the checkup included a scoliosis examination instead (nongenital condition). The children's memories were later solicited through free recall, anatomically detailed doll demonstration, and direct and misleading questions. The majority of children in the genital condition revealed vaginal and anal contact only when asked directly about it. Children in the nongenital condition never falsely reported genital touch in free recall or doll demonstration; when asked directly, the false report rate was low. Significant age differences in free recall and doll demonstration, found only in the nongenital condition, implicated socioemotional factors as suppressing the reports of older children who experienced genital contact.

Children's memories of a physical examination involving genital touch: Implications for reports of child sexual abuse

Evaluation of child sexual abuse often necessitates interviewing children about genital touch, yet little scientific research exists on how best to obtain children's reports of genital contact. To examine this issue, 72 five- and seven-year-old girls experienced a standardized medical checkup. For half of the children, the checkup included a vaginal and anal examination (genital condition); for the other half, the checkup included a scoliosis examination instead (nongenital condition). The children's memories were later solicited through free recall, anatomically detailed doll demonstration, and direct and misleading questions. The majority of children in the genital condition revealed vaginal and anal contact only when asked directly about it. Children in the nongenital condition never falsely reported genital touch in free recall or doll demonstration; when asked directly, the false report rate was low. Significant age differences in free recall and doll demonstration, found only in the nongenital condition, implicated socioemotional factors as suppressing the reports of older children who experienced genital contact.