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Tremendous progress has been made in managing the global HIV epidemic, both in terms of reducing new HIV acquisitions and in improving coverage of treatment for people living with HIV [...]

Objective: Condom use behaviours are proximal to recent STI increases in the USA, yet it remains unclear whether the use of condoms has changed over time among unmarried, non-cohabiting young men who have sex with women (MSW) and how this variability is influenced by STI risk factors.Methods: To examine condom use over time among MSW aged 15-29, we used three cross-sectional surveys from the 2002, 2006-2010 and 2011-2017 National Survey of Family Growth. We estimated weighted percentages, adjusted prevalence ratios (APRs) and 95% confidence intervals (CI) to assess changes in condom use, stratified by whether MSW reported any STI risk factors in the past 12 months (ie, perceived partner non-monogamy, male-to-male sex, sex in exchange for money or drugs, sex partner who injects illicit drugs, or an HIV-positive sex partner).Results: We observed a divergence in trends in condom use at last sex between men aged 15 -29 with STI risk factors in the past 12 months and those without such history. We saw significant declines in condom use from 2002 to 2011-2017 among men with STI risk factors (APR=0.80, 95% CI 0.68 to 0.95), specifically among those aged 15-19 (APR=0.73, 95% CI 0.57 to 0.94) or non-Hispanic white (APR=0.71, 95% CI 0.54 to 0.93). In contrast, trends in condom use among men with no STI factors remained stable or increased. Across all time periods, the most prevalent STI risk factor reported was perception of a non-monogamous female partner (23.0%-26.9%). Post-hoc analyses examined whether condom use trends changed once this variable was removed from analyses, but no different patterns were observed.Conclusions: While STIs have been increasing, men aged 15-29 with STI risk factors reported a decline in condom use. Rising STI rates may be sensitive to behavioural shifts in condom use among young MSW with STI risk factors. [ABSTRACT FROM AUTHOR]

Background: Racial/ethnic assortative mixing is associated with STI. Non-Hispanic black women have the highest rates of assortative mixing in the United States (US); however, national data found that classical socioeconomic factors were not associated with assortative mixing. We examined whether geographic and cultural factors were associated with assortative mixing in the US. Methods: We used 2015-2019 data from the National Survey of Family Growth (response rate=64%) which oversamples Hispanic and non- Hispanic black women and men. For the most recent non-marital/cohabiting sex partner, racial-ethnic mixing was coded as assortative (same race/ethnicity) or not. Using SUDAAN, we examined residence (geographic), US nativity (cultural), and assortative mixing separately for Hispanic, non- Hispanic white, and non-Hispanic black women and men (Wald F). We used logistic regression to examine geographic and cultural factors and assortative mixing while adjusting for socioeconomic factors (age, education, poverty level). Adjusted prevalence ratios (aPR) were calculated. Results: Among the three racial/ethnic groups of women (n=1131), the only significant finding in bivariate analyses was US nativity and assortative mixing for Hispanic women. Conclusions: Geographic and cultural factors were associated with assortative racial/ethnic mixing among men and Hispanic women but not among non-Hispanic black women. Residential segregation and additional cultural factors should be considered to understand assortative mixing among non- Hispanic black women. Examining trends in these factors over time may be useful. [ABSTRACT FROM AUTHOR]