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COVID-19 has transformed the way we live our lives, and sex has been a significant element of that transformation. Gay male sex in the UK has faced the most significant (re)criminalisation and (re)regulation in living memory with intimacy outside of the heteronormative framework of domestic coupledom at best discouraged and, at worst, made into a criminal offence. This criminalisation provides a temporal praxis in which gay men experience sex in the shadows once more, an echo of a historic legal and cultural regulation of desire. This history also provides a space for experiencing forms of impersonal intimacy and queer desire in a way that is arguably well-suited for viral times, namely the glory hole. These historic partitions and apertures – connecting gay men across legal and cultural boundaries of desire and affirmed through modes of anonymous and promiscuous sex – may once again provide a queer way to experience intimacy as impersonal. This article explores this potential and situates the glory hole as a cultural and legal site of this tension between the intimate and the impersonal, as well as considering how it is being recast as commercial artefact and performance space during these viral times. [ABSTRACT FROM AUTHOR]

The emergence of COVID-19 precipitated varied responses from public health officials in London, England. In April 2020, clinicians at 56 Dean Street sexual health and advice clinic in central London described social isolation as 'a unique window of opportunity' to 'break the chain' in HIV transmission. This was followed by critical responses within HIV prevention circles. Drawing from these responses, this article examines the implications of the clinic's 'Test Now, Stop HIV' campaign by asking how has the early COVID-19 pandemic reshaped institutional responses and strategies to end HIV transmission in England? We assess how campaign messages developed between April and May 2020. We analyse materials related to the campaign, including the clinic's Twitter account, the campaign website, and journalism in mainstream media. Based on this information, we discuss three themes: testing and issues of access; the biopolitics of testing; and the idealism of quarantine. We draw on sociology, cultural theory and science and technology studies to describe how the 'end of HIV' was constructed through the link between COVID-19 and HIV. We suggest the campaign reinscribes historical perceptions of abstinence and quarantine as idealised HIV prevention strategies, and thus fails to address safer sex in the time of Coronavirus. [ABSTRACT FROM AUTHOR]

This qualitative study examines the drivers and barriers of condom use among Filipino men who have sex with men (MSM) using a critical realist inquiry (i.e., shared meanings, norms, and practices related to condom use). Thematic analysis was used to analyze interviews of 105 MSM participants across 21 cities in the Philippines. Key findings showed three social structures that shape how participants view sexual partners as safe (linked to non-condom use) or unsafe (linked to condom use). First, classism is linked to relative economic social position of sexual partner (lower socio-economic class as unsafe; higher socio-economic class as safe). Second, heteronormativity is linked to relationship arrangements (multiple partner as unsafe; exclusive partner as safe) and identity categories (bisexuals as unsafe; straight men are safe). Third, body-ism is linked with notions of health (looks sick as unsafe; looks healthy as safe) and appearance (not good looking as unsafe). Sexual partners perceived as good looking can be construed as either safe or unsafe. Discussion points highlight importance of understanding the cultural and material contexts of looking and sounding educated, looking healthy, looking physically attractive vis-à-vis promoting condom use. [ABSTRACT FROM AUTHOR]

The study evaluated safe sex attitudes and intentions from a comprehensive, peer-led sexual health program for teenage students enrolled in three rural colleges in Mississippi. The methods consisted of pretest and posttest survey items regarding attitudes and intentions toward safe sex from 149 participants and a peer educator focus group on curriculum delivery and participation. Intentions and motivations for contraception and sexual risk awareness significantly improved at posttest for all participants. The focus group suggested that peer-led approaches are critical for engaging students, fostering participation, and addressing students' sexual health needs in culturally sensitive ways. [ABSTRACT FROM AUTHOR]

HIV and AIDS has developed as one of the urgent problems affecting many youths in Africa. Yet many of the knowledge and awareness programmes aimed at young people do not target high schools where the majority of young people are found. As a result, many youths do not have accurate information on HIV and AIDS that they can use to protect themselves from the disease. The objectives of this study were to determine the knowledge and awareness of Sixth Form students regarding the spread of HIV and AIDS among young people. A study was carried out among Sixth Form students in three schools in Harare from October 2017 to November 2017. A total of 156 students participated in the survey. Results showed that most students (74%) obtained their information on HIV and AIDS from television and radio programmes. Most students (92%) were able to identify unprotected sexual intercourse as the major mode of HIV transmission, while 89% said that HIV could be transmitted through sharing injections. Some students had misconceptions about HIV and AIDS which might negatively influence their behaviour and attitude towards HIV and AIDS, for example, 11% of students said HIV and AIDS could be cured. The study concludes that programmes on awareness and knowledge application in schools are limited, and efforts should be increased to help students effectively apply the knowledge they have about HIV and AIDS in everyday life situations, and protect themselves from the disease. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore and describe contraception practices among young unmarried Vietnamese women seeking abortion after an unintended pregnancy. A qualitative study was conducted with voluntary participation of 42 women at a hospital in Ho Chi Minh City. Interview data were subjected to content analysis from which five categories were identified: (1) attitudes towards sexuality and contraception, (2) knowledge about contraception, (3) use of contraceptive methods, (4) cultural and traditional issues concerning sexuality and contraception, and (5) abortion as a solution to unwanted pregnancy. Prior to their abortion, women had viewed premarital sex as a means of maintaining a relationship with their boyfriends. Misconceptions, misbeliefs, fear of side effects and limited knowledge were reasons for not using contraception and, in case of unintended pregnancy, abortion was the solution. Boyfriends played an important role in influencing the use (or non-use) of contraceptives. Sexual and reproductive health education including counselling for gender equality, safer sex practices and the prevention of unintended pregnancy should be provided to both women and men in ways which combine traditional and modern views of sexuality. Intervention research to develop sexual and reproductive health education programmes, including contraception counselling, should be carried out. [ABSTRACT FROM AUTHOR]

Prior research consistently finds that gang youth, compared to nongang youth, are more involved in risky behaviors such as violence and drug sales. Less attention has been given to comparisons in sexual behavior. While research demonstrates that gang membership is associated with risky sex and many gang members indicate that sex is a motivation for joining a gang, prior research is limited in its ability to account for self-selection into a gang, variations in involvement across gender, and different forms of sexual activity. This research addresses these limitations by using Add Health data and propensity score matching to examine the relationship between gang membership and sexual behavior inside and out of a romantic relationship as well as how this relationship differs by gender. While findings indicate that gang membership increases the likelihood of sexual intercourse, nonromantic sex, and the number of nonromantic sex partners, no unique gender differences were identified. [ABSTRACT FROM AUTHOR]

Young women in Australia disproportionately experience unintended pregnancy and sexually transmissible infections (STIs). As the promotion of highly effective pregnancy prevention methods such as long-acting reversible contraception (LARC) increases, concurrent use of condoms with LARC remains optimal for pregnancy and STI prevention. There is little data exploring condom use behaviour in young Australian women using LARC. In this qualitative study we interviewed twenty women using LARC about their experiences of making decisions regarding condom use. We used inductive thematic analysis to identify factors influencing participant decision-making. We found that while LARC had an impact on condom use and sexual practices, decisions regarding condom use were influenced by multiple factors including mood, menstrual changes related to LARC, and relationship dynamics. Participants' views of 'safe sex' extended beyond pregnancy and STI protection, to include desired outcomes such as pleasure, consent and communication. Access to STI testing and treatment was key to how participants managed STI risk. Findings highlight the need for a more comprehensive approach to safer sex health promotion, and the importance of ensuring STI testing and treatment services continue to be available and accessible to all young people. [ABSTRACT FROM AUTHOR]

Adult trans women in Brazil are highly impacted by HIV, but little is known about risk for young trans women. Our study was conducted to compare the HIV prevalence and correlates of risk for young trans women ages 18–24 years old to adult trans women in Brazil. Trans women were recruited from Rio de Janeiro and Baixada (the metropolitan area of Rio de Janeiro), Brazil (N = 345). Youth ages 18–24 years of age had significantly greater odds of being HIV negative than adults (OR 0.4, 95% CI 0.2–0.6, p = 0.0002), but significantly lower odds of having post-exposure prophylaxis (PEP) knowledge (OR 0.5, 95% CI:0.3–0.9, p = 0.02) and PrEP awareness (OR 0.5, 95% CI: 0.3–0.8, p = 0.01). Young trans women also had significantly higher odds of using substances (OR 1.8, 95% CI 1.1–2.9, p = 0.02) and condomless anal intercourse with their last three sexual partners (OR 1.8, 95% CI: 1.1–3.0, p = 0.03) compared to adults. Already by age 24, one in four trans women in Brazil were infected with HIV pointing to a new generation at high risk of acquiring HIV. HIV prevention interventions are needed to change the healthcare system to reach and engage young trans women. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) use dating applications (apps) to explore various romantic and sexual relationships. This qualitative study aimed to describe HIV-negative MSM's experiences with app usage, the sexual activities arranged accordingly and their experiences in using dating apps to arrange sexual encounters. Thirty-one MSM who were sexually active and who used dating apps were recruited. Individual semi-structured interviews were conducted. Qualitative data were thematically analyzed to outline significant phenomena and perceptions. The factors associated with matching on apps included sex roles, human immunodeficiency virus serostatus and availability of a venue for meetup. Facilitated by these apps, diverse types of sexual encounters were arranged. Condoms were typically used for safer intercourse, except by people who were younger and inexperienced or when drugs were consumed before or during sex (chemsex). Extensive interest in non-penetrative sexual behaviors was expressed by our sample. Searching for post-exposure prophylaxis methods and/or sexual health screenings was common after exposure to risk of infections. Sexually abusive encounters were followed by changes in sex-searching habits and lowered trust in relationship formation. The results of this study are important for the development of appropriate interventions to promote safer sexual practices among HIV-negative MSM dating app users. [ABSTRACT FROM AUTHOR]

The incidence of sexually transmitted infections (STIs) in older adults has increased with sexual intercourse being the most common mode of transmission. This demonstrates their participation in risky sexual behaviors. The objective of this systematic review was to determine the individual, psychological, and sociocultural factors associated with the use or nonuse of condoms for vaginal, oral, or anal intercourse and having one or multiple sexual partners in older adults. Primary research articles with correlational designs that identify an association between some individual, psychological, or sociocultural factors with the use or nonuse of condoms for vaginal, oral, or anal intercourse or with monogamous or non-monogamous relationships in older adults were included. Some of the variables associated with safe and risky sexual behaviors were the power of sexual decision-making, self-silencing, the importance of sex, income, frequency of sex, education, and social capital. The literature regarding factors associated with safe and risky sexual behaviors in older adults is scarce and represents an area of opportunity for future research. [ABSTRACT FROM AUTHOR]

The purposes of this study were to identify the sexuality-related topics parents and gay, bisexual, or queer (GBQ) adolescent males discussed at home and to describe the topics GBQ adolescent males recommend for parents to discuss with future cohorts of GBQ youth. Minimal research on parent-child sex communication with sexual minority adolescents prevents the development of interventions that would benefit adolescent males with same-sex attractions, behaviors and identities. As part of a multimethod qualitative study, we interviewed 30 GBQ adolescent males ages 15-20 and asked them to perform card sorts. From a list of 48 topics, we explored sexuality-related issues GBQ males were familiar with, the topics they discussed with a parent, and topics they suggested parents address with GBQ males at home. Most participants reported that parents assumed them heterosexual during sex talks prior to GBQ adolescent males' coming out. Participants challenged the heteronormative scripts used by parents when discussing sex and health. Participants identified sexuality topics that parents did not routinely cover during sex talks, but that GBQ youth felt would have been useful for them growing up with emergent identities. A non-heteronormative approach to parent-child sex communication is recommended to provide appropriate guidance about sex and HIV/STI prevention to this youth population. Our findings highlight a need to reconfigure parental sexuality scripts to be more inclusive when assisting GBQ males navigate adolescence. [ABSTRACT FROM AUTHOR]

Sexual empowerment represents an important HIV intervention strategy, yet limited attention has examined the multidimensional nature of sexual empowerment in prior studies. Using a sample (n = 465) of young Black men who have sex with men (MSM), we used confirmatory factor analysis (CFA) to test a multifactorial operationalization of sexual empowerment. CFA indicated that a bifactor model was best suited to characterize the sexual empowerment factor (SEF), suggesting that items for four sub-constructs (self-efficacy to refuse sexual behavior, emotional support, condom use self-efficacy, and social norms on condom use) contributed to their respective constructs, while also contributing to a latent sexual empowerment construct. We then examined the association between SEF and mental health outcomes (anxiety and depression symptoms) and safer sex intentions. SEF was negatively associated with mental health outcomes and positively associated with safer sex intentions. Ultimately, individuals with greater sexual empowerment might be better equipped to develop strategies to buffer their vulnerability to HIV. We discuss the implications of SEF as a bifactor during the design and evaluation of HIV risk-reduction interventions seeking to address sexual empowerment among MSM. [ABSTRACT FROM AUTHOR]

The current study examined the roles of sexual excitation and sexual inhibition in the context of sexual risk-taking among heterosexual women and men to better understand the link between sexual arousal and sexual risk-taking. We set out to determine which factors in the Sexual Excitation and Sexual Inhibition Inventory for women and men (SESII-W/M) were most predictive of sexual response and sexual risk-taking behavior. Participants (N = 266, women = 166) completed the SESII-W/M instrument and responded to items assessing their sexual risk-taking intentions and their risk-taking indicators. A sub-sample (n = 133, women = 83) also completed a sexual arousal manipulation. Sexual excitation was linked with higher levels of self-reported sexual arousal (among women and men) and greater risk-taking intentions (among women only). However, controlling for gender, sexual inhibition was a better predictor of sexual risk-taking intentions, compared to sexual excitation. The Dual Control Model offers unique insights into conceptualizations of sexual response to erotic stimuli and behavioral risk-taking. These findings can inform more effective interventions to promote risk reduction through sex positive approaches that capitalize on the pleasure enhancing capabilities of safer sex strategies. [ABSTRACT FROM AUTHOR]

Sexual minority people face greater risk for compromised sexual health than their heterosexual peers, yet school-based sexuality education often excludes them. Little is known about whether or how sexual minority people's sexuality education experiences have varied across sociohistorical contexts of rapid social change in both sexuality education and sexual minority visibility. Semi-structured qualitative interviews were conducted among 191 sexual minority people from three distinct sociohistorical generations (ages 18–25, 34–41, and 52–59, respectively) and four geographic regions of the United States. Data were analyzed using thematic content analysis following a consensual qualitative protocol. Fifty-one participants (i.e., 27%) discussed school-based sexuality education experiences despite the lack of an explicit question in the interview protocol prompting them to do so. Four distinct yet overlapping themes emerged in participants' experiences of sexuality education: 1) Silence; 2) The profound influence of HIV/AIDS; 3) Stigma manifest through fear, shame, and prejudice; and, 4) Comparing school-based experiences to sexuality education outside of school. The presence of themes varied across groups defined by sociohistorical generation. The implications of sexuality education experiences for the wellbeing of sexual minority people are discussed. [ABSTRACT FROM AUTHOR]

Each year Canada approves about 70,000 agricultural temporary foreign worker positions. However, few studies have examined temporary foreign workers' sexual health. In this mixed-methods study, we used surveys and focus groups to explore the knowledge of HIV and sexually transmitted infections (STI), sexual behaviours and the perspectives of sexual health of 100 Thai and Filipino temporary foreign workers in southwestern Ontario, Canada. The findings revealed that transnational migration had opened up social space that workers were not familiar with. Social isolation, stress and prolonged separation from spouses and partners resulted in the formation of new intimate relationships. Close to two-thirds of the 100 participants were sexually active in the twelve months prior to the study and over three-quarters did not use condoms. Many participants had misconceptions about HIV risks and safer sex practices. Few temporary workers accessed sexual health services due to language barriers, time constraints, stigma and lack of transport. As a result, many obtained medical advice and medicine through their families back home and relied on self-treatment in dealing with symptoms of genital infections. Effective sexual health promotion for temporary foreign workers must consider the complex interactive sociocultural and political processes that involve institutional practices in the local and transnational contexts. [ABSTRACT FROM AUTHOR]

Methamphetamine use is associated with disproportionate risk of HIV infection and increased risk of depression among sexual minority men. The purpose of the study was to estimate the association between clinical depression diagnoses and sexual risk-taking among cisgender men who have sex with men (MSM) who use methamphetamine. From March 2014 through January 2016, 286 MSM who use methamphetamine but were not seeking treatment for methamphetamine use disorder were enrolled to participate in a technology-based randomized controlled trial to reduce methamphetamine use and HIV sexual risk behaviors; participants were assessed for major depressive episodes (MDE) and persistent depressive disorder (PDD) at baseline. Multivariate clustered zero-inflated negative binomial regression analyses of condomless anal intercourse (n = 282; 1,248 visits) estimated the association between this baseline diagnostic result and engagement in sexual risk-taking over time. Participants predominantly identified as nonwhite (80%), averaged 42 years of age, and reported a HIV prevalence rate of 46%. Engagement in sexual risk-taking consistently demonstrated a positive curvilinear relationship with clinical depression severity, such that, for example, participants without clinical depression (59% of the sample; coef. = 1.16) and those with MDE (36% of the sample; coef. = 1.45) both demonstrated elevated rates of condomless anal sex with anonymous partners relative to participants with PDD (5% of the sample; analytical reference category; both coef. p < 0.05). Data also demonstrated a trend (p = 0.053) of reduced sexual risk-taking with main partners among participants diagnosed with MDE (coef. = −0.94). Methamphetamine use among participants in this study inverted the functional form of the relationship between depression and sexual risk among MSM observed in prior studies. Whereas low-grade depression has been associated with increased sexual risk-taking in prior samples of MSM, methamphetamine upends this relationship, such that the greatest engagement in sexual risk-taking occurred among those diagnosed with MDE at baseline. Additional research is warranted to clarify how methamphetamine influences sexual risk-taking among MSM with/without comorbid depression. [ABSTRACT FROM AUTHOR]

We document the extent to which economic shocks through economic incentives explain HIV transmission through risky sexual behaviours in LMICs. We include 35 papers containing 31 unique negative and 11 unique positive economic shocks combined with over 320 health and risky sex outcomes. We find a diverse literature with varying empirical approaches showing increases in risky sexual behaviours are more sensitive to negative shocks than decreases are to positive shocks. Those already at risk of engaging in transactional sex are particularly vulnerable to increasing risky behaviours. Protecting against negative shocks is likely to most effective in preventing HIV transmission. [ABSTRACT FROM AUTHOR]

Pleasure is a key motivator for sex globally, while unsafe sex is the largest risk factor for young women's mortality and the second for young men. However, framing of sex education and sexual health programmes continues to be around avoiding danger, death and disease, rather than striving for pleasurable, satisfying, and safe sexual experiences. Omission of pleasure and sex-positivity goes against growing evidence that shows that people with more positive views of sexuality are more likely to practice safer sex, use contraception consistently, have higher sexual self-esteem and be more assertive. The Pleasure Project and Rutgers, with GH SRHR Alliance (Ghana) and SRHR Alliance (Kenya), conducted a qualitative pilot study of sexuality education under the Get Up Speak Out programme, analysing the extent to which they included sex-positive content, with recommendations to enhance sex-positivity. Data were collected through interviews with facilitators, focus group discussions with learners, observation of sessions, and curricula content analysis. Findings reveal possibilities of sex-positivity in restrictive contexts, illustrating ways for sexuality education to become more sex-positive and pleasure inclusive. This study enables the development of a new tool for a 'pleasure audit', with markers of high-quality, sex-positive and pleasure-inclusive sexuality education or sexual health programmes. [ABSTRACT FROM AUTHOR]

Executive function (EF) may predict sexual risk-taking and HIV risk in young women in rural South Africa. We tested associations between EF and seven risky behavioural outcomes: binge drinking, illicit substance use, unprotected vaginal sex, concurrent sexual relationships, transactional sex, herpes simplex virus type 2 (HSV-2) infection, and HIV infection. We compared EF in young women with HIV to matched controls. 1080 young women underwent cognitive assessments. Better verbal short-term memory was associated with a lower risk of HSV-2 (OR 0.77; 95% CI 0.69, 0.86; p < 0.001). Uncorrected trends (p < 0.05) were better verbal working memory being associated with a lower risk of concurrency, better planning with a lower risk of illicit drug use, and better affective inhibition with a lower risk of transactional sex. 78 participants with sexually acquired HIV were matched with 153 HIV-negative controls and had poorer verbal working memory than controls (Hedge's g = −0.38; 95% CI −0.66, −0.10; p = 0.0076), but this was non-significant after adjustment. EF's contribution to young women's risky behaviour in this context does not hold when stringent statistical corrections are applied, with only verbal short term memory reaching statistical significance as predictor. Replication in other samples is recommended. [ABSTRACT FROM AUTHOR]

Objectives: To examine the process of condom discontinuation among members of the National Youth Service Corps in Nigeria who had been required to take part in a compulsory one year national service right after tertiary graduation. Methods: We used a qualitative research design to achieve this objective. Results: Findings revealed that the motivations for condom discontinuation among our sample include the need to achieve pleasure, the perception of the withdrawal method skill as an alternative to condom use, intimacy and trust among others. Cultural influence such as the promise of marriage and proof of fertility motivated both men and women to discontinue condom use. For many, intermittent condom discontinuation was normal throughout the course of relationships. Also, while verbal communication was more common among males than females, non-verbal communication strategies were employed by more of the females in their condom discontinuation behaviour. Conclusions: Overall, the findings improve our understanding of how condom discontinuation processes occur among young people and concludes that many young people (respondents) are yet to grapple with the potential consequences of unsafe sex. [ABSTRACT FROM AUTHOR]

This study explored how sexuality education relates to young and emerging adults' sexual behavior and communication. A questionnaire measured 140 U.S. participants' (18–28) school-based sexuality education, age at sexual debut, birth control use, relationship with recent sexual partner, and safer sex communication (SSC) during their last encounter. Those who underwent abstinence-only sexuality education began having sex a year later than those who had comprehensive sexuality education. Contraceptive use did not differ across sex education type. Overall, respondents reported high levels of SSC, with minimal differences in SSC across sexuality education types. Implications for sexuality education and SSC training are discussed. [ABSTRACT FROM AUTHOR]

HIV infection continues to be a serious health concern, especially among men who have sex with men (MSM). MSM account for over one-half (57%) of the estimated 1.2 million cases in the United States. Hispanic/Latino individuals accounted for 24% of new HIV diagnoses, with male-to-male sexual contact responsible most cases. Effective sexual negotiation may be a way to decrease risk for HIV infection, but relatively little is known about sexual negotiation among Hispanic MSM. The purpose of this study was to describe the process by which sexual decision-making occurs among Hispanic MSM. Nineteen in-depth, semi-structured interviews were collected from participants (ages 25 to 65) living in South Florida using grounded theory methodology. Interviews were audio-recorded, transcribed verbatim, and were analyzed to identify categories and subcategories. A theory grounded in the data called Circumventing vs. Guiding emerged that described the sexual negotiation process. The theory consists of four main categories: Contextualizing Negotiation, Strategizing Sexual Negotiation, Negotiating Strategies, and Reviewing Consequences. Some Hispanic MSM may experience challenges in negotiating safer sex behaviors with partners. More research is needed to develop culturally-specific interventions to assist Hispanic MSM with sexual negotiation. [ABSTRACT FROM AUTHOR]

Digital fertility awareness-based contraception offers an alternative choice for women who do not wish to use hormonal or invasive methods. The aim of this study was to investigate the key demographics of current users of the Natural Cycles app and assess the contraceptive outcomes of women preventing pregnancy in a UK cohort of women. This was a real world observational prospective observational study. The typical-use effectiveness of the method was calculated using both 13-cycle cumulative probability of pregnancy (life table analysis) and Pearl Index for the entire study cohort. Perfect-use PI was calculated using data from cycles where sexual intercourse during the fertile window was marked as protected and no unprotected sex was recorded on fertile days. 12,247 women were included in the study and contributed an average of 9.9 months of data for a total of 10,066 woman years of exposure. The mean age of the cohort was 30, mean BMI 23.4, the majority were in a stable relationship (83.2%) and had a university degree or higher (83%). The one year typical use, PI was 6.1 (95% CI: 5.6, 6.6) and with perfect-use was 2.0 (95% CI: 1.3, 2.8). 13 cycle pregnancy probability was 7.1%. This is the first study which describes the use of a digital contraceptive by women in the UK. It describes the demographics of users and how they correlate with the apps effectiveness at preventing pregnancy. [ABSTRACT FROM AUTHOR]

This study investigates sexual risk-taking among young men testing for sexually transmitted infections (STI). 452 participants (aged 18–30) completed surveys concerning their backgrounds, sexual risk-taking, and experience with STI. Over one-third had used alcohol during their last sexual encounter, one-fifth were reluctant to use condoms due to concerns about erection difficulties, 14.7% had experienced sexual coercion and one-fifth reported having had contracted the most common STI, chlamydia trachomatis (CT). Older participants (aged 25–30) were more reluctant to use condoms because of erection worries and to report having had CT. Immigrant men reported more unprotected sex while men who have sex with men (MSM) were more exposed to sexual coercion than others, but less likely to use alcohol when having sex. There are important differences in sexual risk-taking within the group of young men testing for sexually transmitted infections which need to be taken into account in developing effective counselling and promotion strategies in sexual and reproductive health care. Further research on young men's sexual risk-taking is needed to broaden understanding of factors associated with young men's sexual health. [ABSTRACT FROM AUTHOR]

Childhood sexual abuse (CSA) is a global problem with serious repercussions for survivors in various domains of adult interpersonal functioning, including sexual risk behavior. This review aimed to summarize findings from the recent literature on the connections between CSA and later adult sexual risk behaviors (e.g., unprotected intercourse, sexually transmitted infection [STSI] diagnosis). The sexual risk behaviors consistently associated with CSA were having sex under the influence of alcohol/substances and reports of concurrent sexual partners/ infidelity. Notably, studies investigating the links between CSA and history of STI diagnosis and CSA and reports of unprotected sex (with the exception of samples comprised men who have sex with men) produced inconsistent findings. The methodological limitations of existing studies are considered and suggestions for future research are offered. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine racial/ethnic and gender variations and intersectionality in the knowledge, attitudes, intentions, and behaviors pertaining to substance abuse (SA) and human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention among racial/ethnic minority college students (ages 18–24) in South Texas. A total of 535 minority students completed a baseline survey between 2014 and 2016 (N = 535). Results revealed statistically significant (ranging from p <.05 to p <.001) racial/ethnic and gender variations in SA and HIV/STD prevention-related knowledge, attitudes, intentions, and behaviors. However, the significant interaction effects (i.e., intersectionality) were observed only for two of the nine composite variables. That is, although male minority students exhibited lower levels of awareness of sexual risks and safe sex negotiation skills than female minority students, Hispanic male students appeared to fare better in both awareness of sexual risks (p <.01) and safe sex negotiation skills (p <.05) compared to students of other racial/ethnic origin. Implications for prevention and intervention work involving minority college students are discussed. [ABSTRACT FROM AUTHOR]

This essay develops a theory of the visceral imagination by analyzing the first safe sex manual written in the age of AIDS—How to Have Sex in an Epidemic: One Approach. At the time of the manual's publication in 1983, no one knew for certain what caused AIDS. Drawing on the transmission pathways of common sexually transmitted infections and through thick descriptions of the contact between bodily fluids and internal membranes, the manual's authors, Michael Callen and Richard Berkowitz, constructed a comprehensive, customizable AIDS prevention framework. In this essay, I argue that these descriptions stabilized the controversies surrounding AIDS transmission by activating what I call the visceral imagination. The visceral imagination supports speculative, non-technical arguments about health with localized, vivid portrayals of the body, its orifices, and its fluids. Analysis of this case study illustrates that the visceral imagination can resist universalizing, curative approaches to biomedical intervention by inviting non-experts to negotiate risk against personalized assessments of bodily permeability. More broadly, a theory of the visceral imagination productively extends recent rhetorical interests in viscerality by illuminating embodied, imaginative practices that queer, grassroots, and other subjugated rhetors might use to resist the homogenizing effects of dominant, normative health discourses. [ABSTRACT FROM AUTHOR]

Despite the fact that HIV- and AIDS-related stigma is consistently identified as an impediment to HIV prevention, a multilevel conceptualisation of HIV- and AIDS-related stigma continues to be poorly understood. The role of multilevel HIV- and AIDS-related stigma in the HIV prevention and intervention behaviours of Asian American and Pacific Islander who have sex with men in the USA is particularly overlooked. Psychology has contributed significantly to the identification of individual or interpersonal level factors influencing HIV- and AIDS-related stigma, while sociology has contributed to a more societal perspective. This dichotomy has led to the absence of a multilevel conceptual framework for analysing the HIV- or AIDS-related stigma experienced by Asian American and Pacific Islander who have sex with men in the USA. In this paper, we argue for need to develop such a model which is culturally grounded and bridges the individual, interpersonal and societal conceptualisations of stigma prominent in the social science literature. To that end, we use Bronfenbrenner's ecological systems theory to explore the manifestation of HIV stigma at the micro, meso and macro levels and how these might impact on HIV testing and HIV service utilisation among Asian American and Pacific Islander men who have sex with men. We conclude by identifying some practice and research implications. [ABSTRACT FROM AUTHOR]

In this longitudinal qualitative study we explored the lived experiences of young Black men who have sex with men in Dallas, Texas in relation to methamphetamine use, intimate partner violence and a history of incarceration as syndemic conditions that may contribute to their risk of transmitting or acquiring HIV. We conducted a total of 106 interviews (four repeat interviews every six months) with a cohort of 30 participants. Some reported condomless sex and no discussion about condom use or HIV status with sexual partners. Fifteen participants reported that they were living with HIV. Methamphetamine use contributed to participants' unstable housing, job loss, destructive relationships and HIV risk. One third of participants reported a history of intimate partner violence. About half had a history of incarceration resulting from intimate partner violence, substance use/dealing and/or other activities. Post-release, having a criminal record limited job opportunities and impacted financial stability. Consequently, some men engaged in survival work involving HIV risk (sex work, organising/participating in sex parties). Methamphetamine use, intimate partner violence and incarceration may constitute syndemic conditions that increase young Black men who have sex with men's risk for HIV acquisition and transmission. HIV prevention interventions must address syndemics and include structural factors and the wider social environment. [ABSTRACT FROM AUTHOR]

The situation of low women empowerment in household settings might influence women's attitude and ability to negotiate for protected sex in their marital relationship. This study aimed to investigate the association between women empowerment factors and the attitude for safer sex negotiation among Indonesian married women. The secondary data of 28,934 individual records of married women retrieved from the 2017 Indonesia Demographic and Health Survey (IDHS) was used. The dependent variable was the attitude for safer sex negotiation measured by women's acceptance toward a justification to ask her husband to use a condom if her husband has a sexually transmitted disease. Multivariate logistic regression analysis accounting for the complex survey design was performed. The results showed that women empowerment factors, that include higher level of education and participation in household decision-making had a positive effect on women's attitude for protected sex. Those women with higher levels of HIV knowledge and whoever talked about HIV with their husbands were also more likely to justify for protected sex. Therefore, women empowerment through education, improving socioeconomic conditions, and increasing HIV-related knowledge can help develop a positive attitude and enable women to negotiate for safer sex with their partners. [ABSTRACT FROM AUTHOR]

Risky sexual behavior can lead to negative outcomes (e.g., pregnancy, sexually transmitted infections). Adolescents may engage in risky sex less often if families talk about sexual safety or if adolescents engage in emotion regulation (ER) skills, however, research is lacking on how ER may be a barrier to sexual health communication. This exploratory study was a secondary analysis of baseline information from 420 American adolescents referred for mental health symptoms and their parents regarding ER and sexual health communication. Significant differences emerged on adolescent ER between families that talk about sexual health and those that do not. [ABSTRACT FROM AUTHOR]

Background: Rates of adolescent HIV and unintended pregnancy in southern Africa are amongst the highest in the world. Gender-transformative interventions that address underlying gender inequalities and engage both males and females have been emphasised by the World Health Organisation, amongst others, to target prevention. However, few such gender-transformative interventions have been rigorously developed or evaluated. Objective: To expedite potential impact and reduce development costs, we conducted a needs assessment to inform the co-design, in consultation with local stakeholders, of adapted versions of an existing gender-transformative Relationships and Sexuality Education intervention for use in South Africa and Lesotho. Methods: Adaptation of the intervention was guided by a modified version of Intervention Mapping (IM). This process involved consultation with separate adolescent, community and expert advisory groups and a collaboratively conducted needs assessment, which drew on focus groups with adolescents (8 groups, n = 55) and adults (4 groups, n = 22) in South Africa and Lesotho, and was informed by our systematic review of the literature on the determinants of condom use among adolescents in the region. Results: The findings clarified how the intervention should be adapted, which individual- and environmental-level determinants of condom use to target, and actions for facilitating successful adoption, evaluation and implementation in the new settings. Conclusions: The IM approach allows for a systematic appraisal of whether components and processes of an existing intervention are appropriate for a new target population before costly evaluation studies are conducted. The findings will be of interest to those wishing to rigourously develop and evaluate gender-transformative interventions engaging men to improve health for all. [ABSTRACT FROM AUTHOR]

In June 2021, 40 years have passed since the first cases of HIV infection were detected. Nonetheless, people living with HIV (PLWH) still suffer from intense HIV-related distress and trauma, which is nowadays mostly linked to the still-existing stigmatization of PLWH. The aim of this systematic review and meta-analysis was to examine the association between HIV/AIDS stigma and psychological well-being among PLWH. We also explored whether this association varies as a function of sociodemographic and clinical characteristics as well as study publication year and stigma measurement. A structured literature search was performed on Web of Science, Scopus, PsyARTICLES, MedLine, ProQuest, and Google Scholar databases. The inclusion criteria were quantitative, peer-reviewed articles published in English between 1996 and 2020. After selection, 64 articles were accepted for further analysis (N = 25,294 participants). The random-effects pooled estimate revealed an overall negative and medium-strength association between stigma and well-being (r = −.31, 95% CI [−.35; −.26]). The participants' age modified this effect with a stronger association for older PLWH. Other sociodemographic and clinical variables as well as publication year and stigma measurement did not explain the variation in association between stigma and well-being across studies. The present meta-analysis and systematic review not only showed an expected negative relationship between stigma and well-being but also revealed a substantial heterogeneity between studies that suggests a strong role of context of a given study. This finding calls for more advanced theoretical and analytical models to identify protective and vulnerability factors to effectively address them in clinical practice and interventions. In this meta-analysis, the relationship between HIV/AIDS stigma and well-being of people living with HIV was investigated. [ABSTRACT FROM AUTHOR]

Posttraumatic stress, low academic performance, and future orientation as pathways from community violence exposure to sexual risk-taking behavior were examined among 753 African American youth in a large urban school district, ranging from ages of 13 to 24 years. Youth completed a self-report instrument. Youth completed a self-report instrument of Exposure to Violence Probe, University of California at Los Angeles' PTSD Reaction Index Adolescent Version, and Coopersmith's Self-Esteem Scale. Structural equation modeling was performed to examine relationships among the major study variables. Results indicated that community violence exposure was not directly associated with sexual risk behavior. However, community violence exposure had a significantly positive impact on posttraumatic stress, which was associated with low future orientation and sexual risk behavior. Findings suggest that targeted interventions need to consider variables that mediate the association between violence exposure and sexual risk behavior, which can reduce poor sexual health outcomes among urban youth who are exposed to violence in their community. [ABSTRACT FROM AUTHOR]

Preconception care is an essential component of health, particularly among women and men living with HIV and can optimize medical and psychosocial outcomes. However, there is a paucity of data on this topic, especially when evaluating provider communication with male patients. We conducted a multi-site qualitative study in 7 cities in the United States (US) with 92 providers to assess their attitudes and practices regarding preconceptual counseling, safer conception, and preconception care with their patients living with HIV. Providers were contacted to schedule a phone interview. Recorded interviews were transcribed and coded for a priori and emergent themes. Providers reported infrequent communication with male patients with HIV about their reproductive plans and the use of safer conception, acknowledging they were more likely to initiate such communication with female patients. A small percentage of providers reported talking to all of their patients about reproductive options, including men having sex with men (MSM). Currently, there is no consensus or evidence-based guideline for the delivery of preconception care specific to men. Based on our results, we recommend that providers offer preconception care to all men as part of optimizing family planning and pregnancy outcomes; enhancing reproductive health; preparing men for fatherhood; and in the setting of HIV infection, preventing transmission to an uninfected partner. [ABSTRACT FROM AUTHOR]

This qualitative study highlights the complex interplay between the social and structural conditions in Chengdu, China that shape the possibilities and vulnerabilities of money boys' sexual health. Within the context of China's liberalised market economy, we explore (1) how money boys' enter the sex trade market and navigate their sexual networks; (2) how their lives are enmeshed in fields of sexual desire, stigma and coercion; and (3) how the illicit and stigmatising nature of their work poses barriers to health service access. Findings reveal how the sex trade market and clinic are precarious spaces in which entrepreneurial ethics of the self and stigma-related coercive relations simultaneously enable and constrain money boys' sexual freedom and safer sex practices. By understanding this entrepreneurial precarity through the co-articulation of clinical and organisational work spaces, public health and social service providers can have a stronger sense of how various vulnerabilities configure to affect safer sex practices. [ABSTRACT FROM AUTHOR]

According to the influence of presumed influence (IPI) hypothesis, people's presumption of media effects tend to impact their willingness to engage in unhealthy behaviors (e.g., smoking) by shaping the normative perception of such behaviors. By applying the IPI hypothesis to media content for health promotion, this study explores how presumed media influence promotes health prevention behaviors in college students. Moreover, this study adopts three health behaviors to test the IPI processing mechanisms across different types of prevention behaviors (i.e., ambiguity and privacy). The results show that one's perceived influence of health promotion media content on others promotes one's own intentions to engage in healthy behaviors of safe sex, diet and nutrition, and skin cancer prevention. The findings also indicate that descriptive norms play various roles depending on the types of behavior. We discuss the IPI hypothesis as a persuasive strategy for health campaigns using mass media. [ABSTRACT FROM AUTHOR]

Purpose: Adolescents may be known to take risks, but they may also conform to societal norms if they are given proper guidance, implying that there is a need for proper monitoring. This qualitative study explores the influence of family dynamics on adolescents sexual risk behaviour within a migration affected community.Method: Using thematic analysis, we processed data collected from 13 adolescents and 10 parents.Results: The themes generated from our data include the following, "Household poverty", "Family conflicts", "Lack of discipline", "Parent-child closeness", "Generational gap between adolescents and their parents" and "Lack of sex education". Our study found that financial constrain was a major problem in this community, the impact of this was worse felt among adolescents who lived by themselves. In addition, some parents were delinquent, distant or detached from their adolescents. We also found evidence to suggest that couple conflict was a common occurrence, and this had negative influence on adolescent well-being and there sexual behaviour.Conclusion: In view of the deepening crisis of early sexual engagement among adolescents and the accompanying risk of unplanned pregnancy and sexually transmitted infections, it is imperative to foster adolescent friendly households where the parents/caregivers are empowered to support their adolescents. [ABSTRACT FROM AUTHOR]

HIV/AIDS prevalence is still high in Botswana. The main aim of this study was to assess and compare sexual risk behaviours of circumcised and uncircumcised men before and after the launch of the safe male circumcision programme. Data used for analyses were derived from the 2008 and 2013 Botswana AIDS Impact Surveys. Modified Poisson regression analysis was used to obtain prevalence ratios (PR) as measures of association between circumcision status and multiple sexual partners, transactional sex, inconsistent condom use and intergenerational sex. The proportion of circumcised men increased two times between 2008 (12.5%) and 2013 (25.2%). Prevalence of multiple sexual partnerships was high among uncircumcised than circumcised (54.6% vs. 46.4%) men in 2008, but in 2013 after the introduction of the SMC programme it was slightly high among circumcised men than uncircumcised men (23.2 vs. 21.8%). In the adjusted analyses, being circumcised was significantly associated with having multiple sexual partners (2008=adjusted PR=1.31, CI=1.10-1.57; 2013= adjusted PR=1.12, CI=1.01-1.41) and transactional sex (2008=adjusted PR=1.98, CI=1.26-3.11; 2013=adjusted PR=1.60, CI=1.09-1.22) for both survey periods. These results indicate the need to continuously sensitise and encourage men to stop multiple sexual partnerships and transactional sex. Moreover, there is need to encourage all men to use condoms consistently. [ABSTRACT FROM AUTHOR]

Over three million youth live with HIV worldwide. Very little is known about whether youth disclose their HIV status to family, friends or sexual partners, and what risks and benefits may accrue from doing so. This study characterizes HIV disclosure among 250 youth with perinatally-acquired HIV (PHIV; age 13–24 years) living in Soweto, South Africa. A third had self-disclosed their HIV status to at least one person; similarly, only a third of sexually-active PHIV had disclosed their HIV status to their most recent partner. It is not clear whether HIV disclosure alone leads to positive impact: we found perceived social support from the family was negatively associated with disclosure (aOR 0.81, 95% 0.70–0.94). PHIV who spoke to a provider about disclosure were more likely to share their HIV status with a sexual partner (aOR 2.48; 95% CI 1.28–4.81). However, those PHIV who disclosed their status were no more likely to use a condom. The World Health Organization recommends that health providers advise adolescent patients on safe disclosure, but we still lack evidence on the consequences for young people and effective tools to help them weigh benefits and risks. [ABSTRACT FROM AUTHOR]

McKirnan's Cognitive Escape Theory (1996) is often characterized by the hypothesis that drugs are used during sex by gay, bisexual, and other men who have sex with men (gbMSM) to relieve internal cognitive conflict over safe-sex norms and sexual desire. We examined how McKirnan's Cognitive Escape Scale (CES) is related to other widely used constructs relevant to sexualized substance use with hopes of better situating the theory within the evolving landscape of HIV-prevention. Associations between CES and trait anxiety, depression, treatment optimism, sexual altruism, sexual sensation seeking, and self-perceived risk for HIV transmission/acquisition were tested. Mediation analyses tested whether associated psychological measures mediated the effect of CES on the proportion of events in which participants reported co-occurrent substance use and condomless anal sex. Results indicated that CES is associated with higher sexual sensation seeking, treatment optimism, trait anxiety, and perceived likelihood of HIV transmission/acquisition. Mediation analyses suggest that CES is related to but operates independently of treatment optimism, sensation seeking, and trait anxiety. Nevertheless, the intersection of HIV-related worries and substance use expectancies are clearly more nuanced than is widely reported is discussions on cognitive escape. [ABSTRACT FROM AUTHOR]

Female college students demonstrate a persistent lack of knowledge about safe sexual practices and engage in sexual behavior that puts them at risk for sexually transmitted infections and unplanned pregnancy. Physicians have an opportunity to provide accurate and timely information about safe sexual behavior to individuals in their care. However, many young people, and in particular young women, are reticent to talk to their physicians about sexual behavior because they typically consider the information to be private. Exacerbating this issue is the fact that many physicians are also uncomfortable discussing sexual topics with their patients. In this study, Communication Privacy Management (CPM) theory is used to investigate the criteria that female college students employ to negotiate the disclosure and concealment of information about sexual behavior in communication with physicians. Qualitative analysis of semi-structured interviews with female college students was used to explain their perceptions of disclosure of sexual behaviors to their physician. Specifically, the participants' perceptions of physicians' communication competence informed privacy management rules. These findings have the potential to improve communication interventions for both female college students and healthcare professionals. [ABSTRACT FROM AUTHOR]

Liangshan Prefecture, the highest HIV-affected epidemic region in China, has more than 2.5 million Yi people. We firstly investigated the sexual behaviors and the related social determinants of health for HIV infection in Yi women of childbearing age in this area. A total of 800 Yi women of childbearing age were enrolled. Path analysis of the risk factors revealed that casual sex (0.152) and number of sex partners (0.152) were directly associated with HIV infection. Furthermore, education level (0.057), out-migrating for work (0.032), sense of self-worth (0.024) and number of sex partners (0.079) were indirectly related to HIV infection and mediated by casual sex and multiple sexual partners. The epidemic of HIV infection among Yi women of childbearing age in Liangshan Prefecture is serious, future promotion should increase their knowledge about condom and modify their perceptions of sexual behaviors. [ABSTRACT FROM AUTHOR]

Research shows that in the Caribbean one-third of people living with HIV continue to engage in unprotected sexual practices. Childhood sexual abuse (CSA) and HIV-related risk behaviors have been found to play a contributory role in HIV transmission. We aimed to analyze gender differences in the association between CSA and substance use and sexual risk behaviors among Haitians living with HIV. A total of 276 HIV-positive individuals participated in this study with 56% experiencing sexual abuse during childhood. Results showed that participants who experienced CSA had increased odds of hazardous drinking compared to those who did not experience CSA; men (OR 2.9, 95% CI 1.2–7.3) and women (OR 2.5, 95% CI 1.2–5.6). While, marijuana use was only significantly associated in women (OR 5.2, 95% CI 2.1–13.5). For sexual risk behaviors, unprotected sex was significantly associated in both men (OR 3.0, 95% CI 1.3–7.1) and women (OR 2.0, 95% CI 1.5–7.7) who experienced CSA. Results of this study underscore the need for further research to better understand the role of gender in the relationship between CSA and risky behaviors among PLWH. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) continue to account for a large number of new HIV infections across the United States. While numerous studies have focused on MSM sexual risk behavior and substance use, some research has also examined how public and private environments, such as a bathhouse setting, may play an important role. This cross-sectional study analyzed data surrounding HIV/AIDS complacency, substance use, and sexual risk behavior among a sample of 168 MSM in a bathhouse located within a major urban city. Of the sample, 73.2% had completed at least college, 67.9% were single, 56.5% were identified as Caucasian (both Hispanic and Non-Hispanic), 76.2% identified as gay, and 77.4% were HIV negative. Results demonstrated an association between complacency and sexual risk behavior among participants. Being Black (both Hispanic and Non-Hispanic), HIV-positive, or those reporting drug and/or alcohol usage influenced their safe sex practices and was found to be associated with sexual risk behavior. Implications are examined related to HIV education and prevention efforts among MSM as well as affirming practice and service delivery efforts. [ABSTRACT FROM AUTHOR]

In this qualitative study, 28 young adults (18-29-year-olds) living in Sydney define 'safe sex', report on their experiences of sex education, and reflect on the relationship between the sex education received in school and the reality of sexual activity. Participants had a broadly neoliberal understanding of health and risk as something individuals should manage through an ideal of rational decision-making. Yet regardless of how comprehensive or limited their sex education experiences, most noted a wide gulf between safe sex as taught in the classroom and the reality of actual sexual encounters, arguing that sexual decision-making was rarely rational, and shaped by age and experience, drug use, sexual desire, and complicated interpersonal dynamics. Sex education that aims to empower by presenting individuals as sole decision-makers when it comes to prophylactic use fails to acknowledge the social contexts of sex described by participants. Significantly, young people defined 'safe sex' not only in biomedical terms such as disease transmission and pregnancy, but also in terms of the social and psychological consequences of sexual encounters, with an emphasis on consent. [ABSTRACT FROM AUTHOR]

Background: Asians living in the United States face unique HIV risk. From 2010 to 2017, the number of diagnosed HIV cases increased by almost 40% among Asians, while on average, the US has seen a 11% decrease in new HIV diagnoses (Centers for Disease Control and Prevention. HIV and Asians. 2019. Available from: ). Culture-sensitive beliefs, which are often neglected in health communication, might play a role in safe sex practice in this particular population. Method: Utilizing the Integrative Model of Behavioral Prediction as a theoretical framework, this study looks into how acculturation to Chinese home culture contributes to Chinese immigrant women's behavioral intention towards safer sex with a casual partner (N = 125). This relationship is proposed to be mediated by perceived social norms, attitude toward condom use, self-efficacy, and familism. Results: Findings indicate that self-efficacy and favorable attitudes toward condom use were predictive of intent, and that the significant predictive role of home culture on behavioral intent was fully mediated by familism. Conclusions: Future interventions should include strategies for enhancing Asian women's self-efficacy for safe sex practices, cultivating a favorable attitude toward condom use, and emphasizing the home cultural values, specifically familism, that might increase their intent to practice safe sex. [ABSTRACT FROM AUTHOR]

Sexual risk behaviors among men who have sex with men (MSM) have been linked to diverse demographic, psychosocial, and behavioral factors. This study assessed the association between internalized homophobia and sexual risk behavior among HIV-infected MSM and the mediating effects of safe-sex self-efficacy and depression on this association, using a theoretical framework based on the Theory of Social Action. Data were collected from 124 HIV-infected MSM attending an AIDS clinic in Israel. No significant association was found between internalized homophobia and sexual risk behavior (unprotected anal intercourse). Examination of mediation effects revealed full mediation by depression, but not by self-efficacy. Depression and self-efficacy were the only significant explanatory variables of sexual risk behavior. Diverse social work interventions with HIV-infected MSM aimed at reducing sexual risk behaviors should include routine screening of IH and its association with depression, and address depression and self-efficacy in CBT and other interventions. [ABSTRACT FROM AUTHOR]

This study examined factors associated with alcohol related condom-less sex (ARCS) among youth living in Kampala, Uganda. Analyses are based on 2014 cross-sectional survey data of urban service-seeking youth participating in a Uganda Youth Development Link (UYDEL) drop-in center. The analytic sample consisted of only youth reporting alcohol use (n = 347). Logistic regression analyses were computed to determine the factors associated with ARCS. In the bivariable analysis, ARCS was associated with being female (OR: 1.86; 95% CI: 1.21, 2.85), age of first drinking being between ages 13–16 (OR: 2.63; 95% CI: 1.42,4.86), age of first time drunk being between ages 13–16 (OR: 2.88; 95% CI: 1.47, 5.67), binge drinking (OR: 3.64; 95% CI: 2.21, 5.98), rape (OR: 2.69; 95% CI: 1.64, 4.41), sex work (OR: 5.91; 95% CI: 3.09, 11.29), and being able to refuse sex when intoxicated (OR: 1.69; 95% CI: 1.10, 2.61). In the multivariable analysis, ARCS was associated with binge drinking (AOR: 2.97; 95% CI: 1.71, 5.17) and sex work (AOR: 3.48; 95% CI: 1.62, 7.49). These findings emphasize unmet needs of this population. Strategies seeking to prevent teenage alcohol use, particularly delaying initial alcohol use, may be beneficial for reducing ARCS in this population. [ABSTRACT FROM AUTHOR]