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Artisanal and small-scale mining (ASM) is a significant source of income for tens of millions of people worldwide. Consistent condom use is pivotal in the prevention of HIV/AIDS and other STIs. This study assessed sexual behaviors and factors associated with consistent condom use among young male artisanal miners in Kassanda District, Uganda. A cross-sectional survey was conducted with 304 miners aged 15-24 years. Data -analysis included frequency distributions, chi-squared tests, and binary logistic regression. 89% had sexual intercourse in the past year, 55% had multiple partners, 11% engaged in transactional sex, and only 42% used condoms consistently. Married/cohabiting young men (OR=0.41; CI=0.19-0.87), those with a neutral attitude towards condom use (OR=0.30; CI=0.11-0.85), and those with only their mothers as parents (OR=0.37; CI=0.19-0.73) were less likely to use condoms consistently. The study highlights the need for targeted interventions promoting condom use among married young men and those raised by single mothers to reduce the risk of STI transmission.

L'exploitation minière artisanale et à petite échelle (ASM) constitue une source de revenus importante pour des dizaines de millions de personnes dans le monde. L'utilisation systématique du préservatif est essentielle à la prévention du VIH/SIDA et d'autres IST. Cette étude a évalué les comportements sexuels et les facteurs associés à l'utilisation systématique du préservatif chez les jeunes mineurs artisanaux du district de Kassanda, en Ouganda. Une enquête transversale a été menée auprès de 304 mineurs âgés de 15 à 24 ans. L'analyse des données comprenait des distributions de fréquences, des tests du chi carré et une régression logistique binaire. 89 % ont eu des rapports sexuels au cours de l'année écoulée, 55 % ont eu plusieurs partenaires, 11 % se sont livrés à des relations sexuelles transactionnelles et seulement 42 % ont utilisé des préservatifs de manière constante. Jeunes hommes mariés/cohabitants (OR=0,41 ; IC=0,19-0,87), ceux ayant une attitude neutre à l'égard de l'utilisation du préservatif (OR=0,30 ; IC=0,11-0,85) et ceux dont la mère est seule comme parent (OR=0,37 ; IC=0,19-0,73) étaient moins susceptibles d'utiliser régulièrement des préservatifs. L'étude souligne la nécessité d'interventions ciblées promouvant l'utilisation du préservatif parmi les jeunes hommes mariés et ceux élevés par des mères célibataires afin de réduire le risque de transmission des IST.

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Introduction: female sex workers (FSWs) are vulnerable to acquiring HIV and other sexually transmitted infections due to unprotected sex. Understanding and addressing the gaps in safer sex among FSWs can help to reduce HIV acquisition and transmission. This study described sexual practices, their correlates and use of HIV services among FSWs in Mombasa County, Kenya. Methods: participants were recruited for a baseline survey by a time-location cluster randomized design at predetermined intervals from five bars and five clubs in Mombasa County until a sample size of 160 was reached. Descriptive statistics and inferential analysis using R were conducted, and p<0.05 was regarded as statistically significant. Results: nearly all (99%) of the participants were unmarried, and 11% had tertiary education. Ninety-eight percent (98%) reported vaginal intercourse, 51% reported using alcohol/drugs before sex, and 28% practiced unprotected intercourse. About 64% had tested for HIV within three months, 14% believed that it is safe to reuse condoms, and 10% that it is safe to engage in unprotected sex. In bi-variate analysis, FSWs were more likely to engage in unprotected intercourse if they reported more frequent sex, more frequent sex with regular clients, poor HIV knowledge, alcohol/drug use, and violence. In multivariate analysis, risky sexual practices were associated with frequency of sexual intercourse, alcohol/drug use, and poor HIV knowledge. Conclusion: female sex workers engage in unprotected sex while under the influence of substances, belief in re-using condoms and have high frequency of sexual intercourse. Inadequate knowledge of HIV and substance use significantly correlated with unprotected sex. Interventions to address these modifiable factors are needed to mitigate the risk of HIV among FSWs.

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This paper assessed gender differences and perceptions towards condom use among in-school adolescents in Ebonyi State, Nigeria. This was a cross-sectional study undertaken in six local government areas in Ebonyi State, Nigeria. Data were collected using a structured questionnaire and summarised using frequencies and proportions. Chi-square test and binary logistic regression were used in the analysis. The level of statistical significance was a p-value of <0.05. Findings showed that a significantly higher proportion of male respondents (58.8%) had a good perception of condom use when compared to female respondents (45.8%). Gender, level of schooling, and working for pay had significant associations with good perceptions of condom use, while the significant predictors in the logistic regression model were gender, level of schooling, and working for pay. Interventions that promote the sexual and reproductive health and rights of adolescents and those that empower women with relevant skills by addressing unequal gender power relations in relationships should be prioritized.

Cet article a évalué les différences entre les sexes et les perceptions concernant l'utilisation du préservatif parmi les adolescents scolarisés dans l'État d'Ebonyi, au Nigeria. Il s'agissait d'une étude transversale entreprise dans six zones de gouvernement local de l'État d'Ebonyi, au Nigeria. Les données ont été collectées à l'aide d'un questionnaire structuré et résumées à l'aide de fréquences et de proportions. Le test du chi carré et la régression logistique binaire ont été utilisés dans l'analyse. Le niveau de signification statistique était une valeur p <0,05. Les résultats ont montré qu'une proportion significativement plus élevée d'hommes interrogés (58,8 %) avaient une bonne perception de l'utilisation du préservatif par rapport aux femmes interrogées (45,8 %). Le sexe, le niveau de scolarité et le travail rémunéré étaient associés de manière significative à de bonnes perceptions de l'utilisation du préservatif, tandis que les prédicteurs significatifs dans le modèle de régression logistique étaient le sexe, le niveau de scolarité et le travail rémunéré. Les interventions qui promeuvent la santé et les droits sexuels et reproductifs des adolescents et celles qui donnent aux femmes les compétences nécessaires en s'attaquant aux relations de pouvoir inégales entre les sexes dans les relations devraient être prioritaires.

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Non-condom use is known as one of the risky sexual behaviors among youth and a contributing factor to the high prevalence of HIV in Nigeria. Therefore this study aimed to assess the spatial pattern and determinants of non-condom use among sexually active young people in Nigeria. The study employed a cross-sectional analysis of population-based data involving 288 males and 780 females aged 15-24 years, giving 1068 sexually active young people drawn from the 2018 NDHS. The study adopted a multi-level and spatial analysis to identify factors associated with non-condom use in Nigeria. The prevalence of non-condom use was 57.7% in this study. The spatial analysis showed that the Northeastern and South-South regions of Nigeria had a high proportion of non-condom use among young people, while the Northwest, North-Central, and Southwestern parts had low proportions of non-condom use. On multilevel analysis, the individual and community level factors associated with non-condom use included exposure to media (AOR 0.59; 95% CI 0.39-0.91) and younger age (AOR 0.72; 95% CI 0.53-0.98). Areas with a high proportion of non-condom use should receive the most attention through the promotion of condom use and education, alongside a focus on important associated factors.

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Objetivo: Determinar las conductas sexuales protectoras en estudiantes de una universidad de Chillán, Chile. Métodos: Estudio cuantitativo, descriptivo con un muestreo probabilístico por conveniencia de 234 estudiantes universitarios, para los criterios de inclusión destaca haber iniciado actividad sexual. La recolección de datos fue a través de Google forms. El instrumento utilizado fue "Cuestionario de conducta sexual segura". Resultados: Del total de los alumnos encuestados el 64,1 % son mujeres. En cuanto al estado civil, el 93,5 % se identifica soltero. Solo el 47,4 % detiene la actividad sexual para utilizar condón. El 80,8 % evita relaciones sexuales en la primera cita, un 81,6 % nunca tienen relaciones anales sin condón, y el 99,6 % nunca ha tenido sexo con personas que utilizan drogas. Se encontró que la media para conducta sexual protectora es de 70,2 %. Conclusión: Los encuestados presentan conductas sexuales protectoras(AU)

Objective: To determine protective sexual behaviors in students at a university in Chillán, Chile. Methods: Quantitative, descriptive study with a probability sampling by convenience of 234 university students, for the inclusion criteria it stands out to have initiated sexual activity. Data collection was through Google form. The instrument used was the "Safe sexual behavior questionnaire". Results: Of the total students surveyed, 64.1% are women. Regarding marital status, 93.5% identify themselves as single. Only 47.4% stop sexual activity to use a condom. 80.8% avoid sexual relations on the first date, 81.6% never have anal relations without a condom, and 99.6% have never had sex with people who use drugs. It was found that the mean for protective sexual behavior is 70.2 %. Conclusion: The respondents present protective sexual behaviors(AU)

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Abstract The condom use can be influenced by psychological and sociocultural aspects, which can be modulated by individual's attitudes. The aim was to propose a Brazilian Portuguese version of the Short-Form Condom Attitude Scale (Short-Form CAS), describing all procedures of translation, transcultural adaptation, and psychometric properties evaluation when applied to undergraduate students. A cross sectional study was conducted among students enrolled at University of São Paulo (USP), Campus Ribeirão Preto (n = 491; 61.2% female; average age: 22 years; standard deviation: four years). Confirmatory factor analysis was performed. A one-factor model with seven items exhibited good factorial validity and reliability, suggesting to be a better factorial solution of the Short-Form CAS in the sample. Few studies have been carried out on the behavioral factors associated with condom use in key populations, which can be exacerbated by a lack of appropriate scales. Therefore, the main contribution of the present study was to propose a simplified and transculturally adapted version of the Short-form CAS with some psychometric properties verified. Since the use of condoms is a component of the study of sexual risk behavior, this scale might be an option to be applied in various Brazilian population segments for this purpose.

Resumo O uso de preservativos pode ser influenciado por aspectos psicológicos e socioculturais, que podem ser modulados por atitudes individuais. O objetivo foi propor uma versão em português brasileiro da Short-Form Condom Attitude Scale (Short-Form CAS), descrevendo os procedimentos de tradução, adaptação transcultural e avaliação das propriedades psicométricas em uma amostra de universitários. Trata-se de estudo transversal com estudantes matriculados na Universidade de São Paulo (USP), Campus Ribeirão Preto (n = 491; 61,2% feminino; média de idade: 22 anos; desvio-padrão: quatro anos). Foi realizada análise fatorial confirmatória. O modelo unifatorial com sete itens apresentou boa validade fatorial e confiabilidade, sugerindo ser a melhor solução fatorial para a Short-Form CAS. Há poucos estudos sobre os fatores comportamentais associados ao uso de preservativos em populações-chave, o que pode ser influenciado pela falta de instrumentos. A principal contribuição deste estudo foi propor uma versão simples e adaptada transculturalmente da Short-Form CAS com algumas propriedades psicométricas verificadas. Uma vez que o uso de preservativos é um componente do comportamento sexual de risco, a escala se apresenta como uma nova opção para futuros estudos na população brasileira.

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Background Mycoplasma genitalium is implicated in genitourinary disorders in both men and women as a sexually transmitted infection (STI). This study aimed to ascertain the prevalence of M. genitalium and identify associated risk factors among women. Aim To investigate the prevalence of M. genitalium and identify various risk-factors associated with M. genitalium infection in women attending the clinic in Western Cameroon. Methods A cross-sectional study was conducted in hospitals from five districts of Western Cameroon on sexually active and non-menstruating women attending for antenatal, prenuptial and contraception consultations,between January 2020 and July 2020. Endocervical swabs (n = 680) were collected, and M. genitalium was detected using real-time PCR targeting the MgPa and pdhD genes. Results A total of 680 women, characterised by a mean age of 27.4 ± 7.5 years, were included in this study. The overall prevalence of the M. genitalium infection was 5.2%. Bivariate analysis revealed that having more than one sexual partner was independently associated with three times higher odds of prevalent M. genitalium infection (OR 2.9, 95% CI: 1.03-8.56). Limitation Cross-sectional design limits exploring temporal relationships with other STIs. Freezing specimens for a year until PCR testing may have compromised detection rates of M. genitalium. Conclusion This study contributes valuable data to the limited understanding of M. genitalium epidemiology. The findings may aid in the formulation of national clinical standards for testing and screening strategies, emphasising the importance of addressing associated risk factors in the targeted population.

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BACKGROUND: Botswana is one of the countries severely impacted by the HIV/AIDS pandemic. Despite an extensive HIV prevention campaign, the incidence of HIV, particularly among women, remains high. Condoms play a significant role in preventing new HIV infections, although men and women do not consistently use them. OBJECTIVE: The study assessed the individual, relationship and community factors associated with consistent condom use among women in Botswana. DESIGN: A cross-sectional study using secondary data drawn from a national survey on Gender-Based Violence Indicators in 2012. METHODS: The primary survey sampled 639 women, aged 18 years and older, using a multistage procedure. The final sample size for the secondary analysis included a total of 480 women who were sexually experienced and had reported using condoms with their male partners. Multivariate logistic regression analysis was employed to assess the association between consistent condom use and the explanatory variables. The multivariate logistic regression adjusted for cluster/community random effects. RESULTS: About 43% of the women used condoms consistently in the past year. Consistent condom use was more likely among women who were employed in the past year (adjusted odds ratio = 1.77; 95% confidence interval = 1.25-2.50). While, women who lived with their partners (adjusted odds ratio = 0.46; 95% confidence interval = 0.28-0.74), had non-Christian beliefs (adjusted odds ratio = 0.52; 95% confidence interval = 0.29-0.92), perceived that their partners would be angry if they ask to use a condom (adjusted odds ratio = 0.19; 95% confidence interval = 0.06-0.58) and perceived that their community says women need their husband's permission to do paid work (adjusted odds ratio = 0.56; 95% confidence interval = 0.38-0.83) were less likely to use condoms consistently. CONCLUSION: Consistent condom use among Botswana's female population is suboptimal. Consistent condom use was higher among women with employment, and lower among women who lived with their partners, had non-Christian beliefs, feared their partners' reaction upon asking for condom use and held inequitable community gender beliefs. To enhance women's consistent use of condoms, friendly condom use information, female economic empowerment strategies and programmes that involve religious leaders and promote progressive and healthy masculine practices in Sexual Reproductive Health/HIV interventions should be considered.

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Since their importance was highlighted by Ayikwa and De Jager, social marketing behavioural enhancers (SMBEs) have been investigated in terms of their causal and correlational relationships with the intention to use condoms (IUC) and consistent condom use (CCU), as people often fail to act on their intentions. However, scrutiny of their mediating and moderating roles could provide insights pertinent to the design of effective HIV and AIDS preventative programmes. This study examined whether perceived behavioural control (PBC) and IUC interact with exposure to HIV and AIDS information (EI), ease of access to condoms (EAC) and level of related knowledge (KN) in determining CCU. It also investigated whether PBC and IUC predict CCU through increasing EI, EAC, and KN. A quantitative approach was adopted and data were collected from 607 participants, aged at least 18, living in Gauteng Province, South Africa. The questionnaire administered included pre-existing items, validated through exploratory and confirmatory factor analysis procedures. Regression analyses of the data for mediation and moderation testing were performed using PROCESS macro software for SPSS. The results indicated that none of the SMBEs mediated the non-significant PBC-CCU relationship: B = -0.0258, SE = 0.0199, p = 0.195. Nor did they mediate the significant IUC-CCU relationship: B = 0.0395, SE = 0.0195, p = 0.043. Similarly, none of the SMBEs were found to moderate the PBC-CCU relationship (EI*PBC: B = 0.0034, SE = 0.0056, p = 0.540; KN*PBC: B = -0.0006, SE = 0.0064, p = 0.931; EAC*PBC: B = 0.0011, SE = 0.0059, p = 0.854) as IUC-CCU relationship (EI*IUC: B = 0.0036, SE = 0.0054, p = 0.513; KN*IUC: B = -0.0096, SE = 0.0060, p = 0.111; EAC*IUC: B = 0.0044, SE = 0.0061, p = 0.469). A recommendation is made to scrutinise the mediating and moderating roles of SMBEs in the context of health behavioural models other than the theory of planned behaviour, which was considered in this study.

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Objective: To investigate the biological safety of commercially available natural rubber latex and synthetic polyurethane condoms. Methods: Natural rubber latex condom brands of A1 and A2 and polyurethane condom brands of B1 and B2 were purchased from large chain pharmacies in Chengdu, with three packages randomly selected for each brand. The study assessed the toxic effects of condom extracts on L-929 mouse fibroblasts according to GB/T standards. Gross observation and histopathological evaluation were conducted to assess the irritation reactions of condoms on the vagina and penis of rabbits (3 rabbits were used for each brand), as well as their sensitization effects on guinea pig skin. Additionally, the impact of continuous perfusion of condom extracts of the vaginas of SD rats for 30 days on their reproductive systems was evaluated, following GB/T standards (5 rats were used for each brand). Results: Extracts from natural rubber latex condom brands A1 and A2, at concentrations of 100% and 50%, exhibited significant cytotoxicity, with optical density (OD) values being significantly lower than those of the blank control group and the polyurethane condom brands B1 and B2 (P<0.01). There was no significant difference in cell morphology and OD values between the extracts of B1 and B2 and the blank control group (P>0.05). Vaginal congestion was found in 3 rabbits from A1 group and 1 rabbit from the A2 group, while no obvious congestion was noted in rabbits from the B1 and the B2 groups. Histopathological examination showed scattered inflammatory cell infiltration in the vaginal tissue of 3 rabbits from the A1 group and 2 rabbits from the A2 group, and slight congestion in the blood vessels of the lamina propria. No obvious pathological changes were observed in the vaginal tissue of polyurethane brand rabbits. Two rabbits from the A1 group and 1 rabbit from the A2 group showed transient and mild erythema on the penis during the experiment. Histopathological examination showed that 1 rabbit from A1 group had small foci of pericapillary lymphocytes in the dermis of the penis, while no significant pathological changes were observed in the penile tissue of A2, B1, and B2 groups. After 30 days of continuous vaginal perfusion with condom extract, 3 rats in A1 group and 2 rats in the A2 group had uterine congestion, with the degree of congestion being lower in the A2 group. No significant congestion or pathological changes were observed in the vaginal and penile tissues of rabbits, or in the uterine tissues of rats from the polyurethane groups. None of the 4 groups of guinea pigs showed significant skin allergic reactions to the condom extracts. Conclusion: Significant differences in biosafety exist among condoms of various materials and brands. To ensure product safety, it is crucial to strengthen quality control and regulatory oversight after condoms become commercially available.

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OBJECTIVE: To describe receipt of condom information from formal sources and parents among sexually experienced and sexually inexperienced adolescents in the United States. STUDY DESIGN: Data come from the 2015-2019 National Survey of Family Growth and a sample of 15-to-19-year-olds. RESULTS: Most adolescent females and males reported receipt of condom information from any source, with sexually experienced adolescents more likely to do so. Close to one-third of adolescents, regardless of sexual experience, reported sex education about condoms from only formal sources, with small proportions reporting receipt of this information from only parents. Receiving condom information from both formal sources and parents was more common among sexually experienced adolescents, whereas not receiving this information from either source was more frequently reported among sexually inexperienced adolescents. CONCLUSIONS: This study highlights disparities in condom information receipt based on sexual experience and underscores the need to provide both sexually experienced and sexually inexperienced youth with condom knowledge and information to protect their sexual health.

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Some research has identified the prevalence and motivation of using condoms by assailants during sexual assault cases proving the necessity of analyzing condom trace evidence. The majority of the papers published have discussed forensic analysis of lubricants from condoms retrieved at sexual assault scenes but those discussing the identification of semen from condoms are rare. Therefore, the present study aims to provide insight into the detectability of the semen that remained in a condom, to examine the effect of exposure time, environmental conditions, and condom type, and ultimately to determine the capability of the AP test and Microscopic examination for identification of this sample type. In the study, samples were collected from three male donors after being instructed on the proper way of collecting the semen sample. The received samples from the donors were checked first by microscopic examination to observe the sperm to confirm that the sample being handled was semen. After confirmation, samples were transferred to 4 prepared condoms (brands: dkt xxx and Manforce) and kept in conditions i.e. two condoms in a refrigerator maintained from 2 to 10°C and other ones at ambient temperature (weather status: summer season of average 39°C). The samples were analyzed into two batches, the first analysis batch was conducted after the samples were exposed to the conditions within 11-60 days. After analysis from the first batch, the samples were continuously kept in the same condition for the consecutive second batch conducted when the samples reached 40-90 days. This study has determined that semen remaining in a condom can be detected and each test studied is appropriate according to the exposure stage, i.e., time and conditions of exposure. It has been found that nonmotile spermatozoa can be observed when semen remains in the condom for a few days. However, if the sample reaches approximately 25 days at room temperature above 25°C or 54 days below 10°C, the semen may dry out limiting the effectiveness of microscopic examination. Despite this, even semen that remained in a condom for up to 90 days can be identified by Acid Phosphatase. Results on condom type used reveal that condom constituents can crossreact with semen but none of them can limit the semen identification with Acid Phosphatase.

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Background: People who inject drugs (PWID) are more likely to engage in risky sexual behavior placing them at high risk of acquiring HIV and other STIs. This study aims to assess the prevalence and predictors of inconsistent condom use with casual and/or paid sexual partners among PWID in Georgia. Methods: Integrated Bio-Behavioral Surveillance Survey was conducted among PWID in seven major cities of Georgia. Study design was cross-sectional with respondent-driven sampling (RDS) methodology. Data collection was carried out through individual face-to-face interviews. In this paper we analysed subsample of 619 PWID who reported having casual and/or paid sexual partners during last 12 months and described prevalence and predictors of consistent condom use. Results: Consistent condom use during casual and/or paid sex in past 12 months was reported by 49.4% of respondents. The likelihood of consistent use with casual and/or paid sexual partners was statistically significantly associated with residence, family income, drug use frequency, drug dependance and HIV risk self-perceptions. In multivariate analysis independent predictors of always using condom at casual/paid sex during the last 12 months were place of residence (aOR = 6.4; 95% CI: 3.2-12.7), family income (aOR = 2.1; 95% CI:1.3-3.5) and drug use frequency (aOR = 0.6; 95% CI: 0.4-0.9). Conclusion: The study revealed low prevalence of consistent condom use with casual and/or paid sexual partners among PWID in Georgia. Integration of safe sex educational interventions in harm reduction services will improve the rates of condom use among PWID and should focus PWID with lower socio-economic status and residing outside capital city.

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Improving communication between American Indian caregivers and their youth has been suggested as an Indigenous-forward strategy to help alleviate the sexual and reproductive health (SRH) disparities faced by American Indian youth as a result of the legacy of colonial violence against American Indian communities. Studies with non-American Indian and American Indian populations suggest that effective communication about SRH between parents and youth plays a role in reducing sexual risk behaviors among youth. There is limited research that examines youth sexual risk behaviors in relation to communication patterns separately assessed in caregivers and youth. The current study aimed to examine the association between caregiver-youth communication patterns and engagement in sex, age at sexual debut, and condom use among American Indian youth in the United States. The study draws on baseline caregiver and youth data collected from Nen UnkUmbi/EdaHiYedo, a stepped wedge design trial with American Indian youth living on the Fort Peck Reservation in Montana. 113 caregiver responses were matched to 145 youth for the current study. Caregiver-youth communication patterns were examined in relation to youth engagement in sex, age at sexual debut, and number of protected acts of vaginal and/or anal sex. Multivariable models were used to adjust for confounders and to examine relationships between caregiver-youth communication and youth sexual risk outcomes. An increase in overall level of self-reported youth communication with caregivers about sexual and reproductive health topics was significantly associated with a greater likelihood of youth ever having engaged in sex. A significant interaction effect between youth communication and convergence with caregiver response was observed for the number of protected acts of vaginal and/or anal sex, where caregiver communication (regardless of self-reported youth communication with caregivers) was associated with a greater number of protected sex acts. This study fills a gap in the extant literature by reporting on relationships between communication about SRH, assessed separately in caregivers and youth, and youth sexual risk behaviors. Findings emphasize the importance of involving American Indian caregivers in SRH interventions to improve SRH outcomes among American Indian youth, and inform future experimental research that will evaluate how changes in caregiver communication potentially impact youth SRH.

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INTRODUCTION: Male contraception includes various methods designed to prevent pregnancy by focusing on the male's role in reproduction. RESULTS: Behavioral methods, such as withdrawal and periodic abstinence, offer non-invasive alternatives that require self-control and precise timing to avoid depositing sperm in the female reproductive tract during fertile periods. However, these methods generally have low effectiveness and rely heavily on user adherence and experience. The male condom, a barrier method, provides both contraception and protection against sexually transmitted infections. Its effectiveness relies on correct and consistent use. DISCUSSION: Access to comprehensive sexual education and medical counseling is essential to dispel the stigma surrounding contraceptive use and correct misconceptions, ensuring proper usage and ultimately contributing to better reproductive health outcomes.

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BACKGROUND: HIV prevention remains a global priority, especially in sub-Saharan Africa. Our research team previously developed an evidence-based peer group program for HIV prevention called Mzake ndi Mzake (Friend to Friend). A community-engaged collaboration adapted the program for community ownership and implementation. Here we report whether this HIV prevention program, implemented by community volunteers, increased condom use among sexually active individuals in rural Malawi. METHODS: Three communities sequentially rolled out the program. Effectiveness was evaluated using a stepped wedge design. Repeated surveys 11-13 months apart were conducted between 2016 and 2019. At Time 1, no community had offered the intervention. At Time 2, the first community had offered the intervention and two had not (control group). At Time 3, two communities had offered the intervention and one had not (control group). We used two condom use indicators; condom use frequency in the last 2 months (N = 771) and condom use at last sex (N = 880). The analytical sample included all sexually active persons answering that question at one or more time points. Mixed-effects cumulative logit and Generalized Estimating Equation (GEE) models were used to model the two condom indicators over time, controlling for demographic factors, UNAIDS HIV knowledge, safer sex self-efficacy and partner communication. RESULTS: This peer group intervention implemented by trained community volunteers increased both condom use indicators at Times 2 and 3. In the final adjusted models with non-significant factors removed, condom use in the last two months increased for the intervention group vs. control group [Time 2: Adjusted Odds Ratio (AOR) = 1.59 (1.15, 2.21); Time 3: AOR 2.01 (1.23, 3.30)]. Similarly, condom use at last sex increased for the intervention group vs. control group [Time 2: AOR = 1.48 (1.08, 2.03); Time 3: AOR 1.81 (1.13, 2.90)]. Other significant predictors of greater condom use were also described. Although the intervention increased UNAIDS HIV knowledge, knowledge did not predict condom use. CONCLUSIONS: In this community-engaged implementation study, an evidence-based peer group program for HIV prevention increased condom use when delivered by trained community volunteers. Community ownership and program delivery by trained volunteers offer an innovative and cost-effective strategy to address ongoing HIV prevention needs without overburdening healthcare systems in sub-Saharan Africa. TRIAL REGISTRATION: Clinical Trials.gov NCT02765659 Registered May 6, 2016.

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OBJECTIVE: To explore their perceptions and attitudes toward condom use and the underlying reasons for the low usage frequency among Chinese older adults. METHODS: A qualitative study design utilizing interpretive phenomenological analysis was employed. Data were collected through field observation and face-to-face in-depth interviews among older adults aged 50 years or above and having engaged in sexual activities within the previous year. RESULTS: Three main themes emerged: perceiving unnecessary due to misconceptions and low awareness, interactive stereotypes rooted in sociocultural beliefs, and stigmatized social norms including gender inequity and economic unbalance. CONCLUSIONS: Tailored interventions focusing on addressing misconceptions, increasing awareness, and reducing culturally ingrained stereotypes and stigma surrounding condom use are essential to promote condom use among older adults in order to prevent HIV transmission in China.

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The Northwest Territories (NWT), Canada has high rates of sexually transmitted infections (STI) that elevate HIV acquisition risks. We conducted a mixed-methods study to explore the potential of land-based peer leader retreats (PLR) in building HIV prevention enabling environments among Northern and Indigenous youth in the NWT. PLRs are grounded in Indigenous principles and ways of knowing, acknowledging the land as a physical, spiritual, emotional, and intellectual being with the potential to facilitate (re)connection to culture, community, and self. We conducted one-week PLRs between 2016 and 2021 with adolescents aged 13-17 in the NWT. PLRs addressed HIV/STIs, safer sex, and gender equity. We conducted post-retreat focus groups (FGs) and pre/post-retreat surveys with youth participants (n = 353), and post-retreat FGs with PLR facilitators (n = 252). We applied thematic analysis to FGs and assessed pre/post-retreat changes in HIV/STI knowledge and safer sex efficacy (SSE) using paired sample t-tests. We assessed factors associated with post-test SSE and HIV/STI knowledge using multivariable linear regression. Youth participants (n = 353; mean age: 14.5, standard deviation [SD]: 1.3) were mostly Indigenous (71%) and women (66%). Participant narratives revealed PLRs enhanced technical communication (e.g., correct condom use). There were significant post-retreat HIV/STI knowledge increases; change score increases were lower for Indigenous participants. Qualitative narratives described how PLRs fostered transformative communication (e.g., sexual consent). There were significant post-retreat increases in SSE, and these were lower among men and sexually diverse (vs. heterosexual) participants. Land-based PLRs offer the potential to build technical and transformative communication to facilitate HIV prevention with youth in Canada's North.

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Using national probability data from the 2022 National Survey of Sexual Health and Behavior, the present study evaluated whether moderators of the association between frequency of pornography exposure and condomless sex are consistent with the sexual script acquisition, activation, application model's (3AM) suppositions about the facilitating effects of wishful identification and decreased self-regulation and forethought capacity. Consistent with the 3AM, two-way interaction effect analysis indicated that the strength of the positive association between exposure frequency and condomless sex increased as identification intensified. Inconsistent with the 3AM, two-way interaction effect analysis indicated that the association between exposure frequency and condomless sex was not significantly different among those who had and had not consumed alcohol before their last sexual encounter. However, the three-way interaction between exposure frequency, identification, and alcohol use did suggest a role for each 3AM moderator, as the catalyzing effect of identification was operable among those who had consumed alcohol only.

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BACKGROUND: Risky sexual behavior (RSB) is one of the major youth sexual and reproductive health problems globally, including in Ethiopia. RSB among youth increases the risk of HIV infection, other sexually transmitted infections (STIs), unintended pregnancy, and unsafe abortion. Therefore, the aim of this study was to examine RSB and its associated factors among university students in Ethiopia. METHODS: A cross-sectional study was employed in six randomly selected public universities in Ethiopia from August 2021 to February 2022. A stratified two-stage sampling technique was applied to reach the required number of study participants, and a structured self-administered questionnaire was used. RSB was defined as having had sexual relationships with more than one partner and using condoms with a new sexual partner irregularly or not at all in the last 12 months. Bivariable and multivariable logistic regression analyses were used to identify factors associated with RSB among those participants who were sexually active. RESULTS: The prevalence of RSB among those who had had sexual intercourse in the last 12 months (n = 523) was 19.5% (n = 102). One hundred forty-four (29.9%) students had multiple sexual partners, and 325 (69.3%) students did not always use condoms with a new sexual partner. Adjusted odds ratios (AOR) showed that those students aged 21-24 years had lower odds of RSB than those aged above 25 years AOR 0.18 (95% CI 0.03-0.98). The adjusted odds of RSB were 6.7 times higher (95% CI 1.26-35.30) among students who started sex at the age of 10-17 years than those who started sex at 21 years and above and 3.9 times higher (95% CI 1.33-11.39) among students who had experienced emotional violence. CONCLUSION: RSB continues to be a problem among university students in Ethiopia. Those students who started sex at an early age and those who experienced emotional violence were more likely to engage in RSB. Therefore, universities in Ethiopia should implement strategies such as RSB targeted health education programs that consider early sexual debut, experiences of emotional violence, and safe sexual practices.

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