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The current study aims to fill the existing research gaps by investigating the role of teacher care in protecting African American adolescents in under-resourced neighborhoods from negative outcomes of adverse life events. The study included 638 adolescents from four under-resourced neighborhoods in Chicago's Southside who were assessed to determine the moderating role of caring teachers on the relationship between adverse adolescent experiences and risky sexual behaviors, substance use, bullying perpetration, and violent behaviors. Caring teachers had a significant moderating effect on the association between adverse experiences and both bullying perpetration and violent behaviors. Adolescents who perceived their teachers as caring showed lower tendencies towards bullying and violence, even if they had adverse experiences. These results highlight the crucial role of teacher care in supporting African American adolescents from under-resourced neighborhoods who have experienced adverse life events. It emphasizes educators' role in shaping our youth's future, especially those facing adversity and at a crossroads in their lives. Plain language summary: Despite adverse life events, adolescents who perceived their teachers as caring were less at risk of engaging in bullying and violence. Caring teachers are especially important for African American adolescents in under-resourced neighborhoods. [ABSTRACT FROM AUTHOR]

Background: Males have accounted for a significant share of new HIV infections among young people in the recent years. This study aimed to identify the factors associated with risky sexual behaviors, including early sexual debut, multiple sexual partnership and condomless sex, among sexually active male college students and provide implications for tailored health interventions. Methods: The cross-sectional study was conducted from December 2020 to December 2021 in 16 colleges that were located in Sichuan Province, one of the high-risk areas in China. Overall 1640 male college students who reported sexually experienced were analyzed in this study. Multivariable logistic regression analysis was applied to determine factors associated with early sexual debut, multiple sexual partnership and condomless sex. Results: The average age of included male students was 19.95 ± 1.56. Of them, 27.74% initiated sexual behavior early, 48.60% reported multiple sexual partnership, and 16.52% did not use condoms at the latest sexual intercourse. Students who were younger (age ≤ 19, AOR = 7.60, 95%CI: 4.84–11.93; age20-21, AOR = 3.26, 95%CI: 2.04–5.21) and self-identified as sexual minorities (AOR = 2.38, 95%CI: 1.69–3.36) were more likely to have early sexual debut. The odds of having multiple sexual partners were higher among those who were ethnic minorities (AOR = 1.79, 95%CI: 1.33–2.41) and accepted extramarital sex (AOR = 1.33, 95%CI: 1.03–1.71). The likelihood of engaging in condomless sex at the latest sexual intercourse was lower among those who had sufficient knowledgeable about HIV (AOR = 0.63, 95%CI: 0.44–0.89), were very confident in condom use efficacy (AOR = 0.26, 95%CI: 0.16–0.43) and confident (AOR = 0.48, 95%CI: 0.34–0.69). Early sexual debut was positively associated with multiple sexual partnership (AOR = 3.64, 95%CI: 2.82–4.71) and condomless sex at the latest intercourse (AOR = 1.53, 95%CI: 1.07–2.20), respectively. Conclusion: Early sexual debut, multiple sexual partnership and condomless sex were of considerable concern among male college students. Comprehensive sex education curricula were advised by developing customized information on HIV prevention, sexuality and empowering students with assertiveness and negotiation skills with regard to condom use during and before college. [ABSTRACT FROM AUTHOR]

Background: Secondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS. In Tanzania, the burden of teenage pregnancy was reported to be 27% in 2016. The integration of sexual and reproductive health (SRH) education into the school curriculum is one of the proven crucial interventions. However, there is limited information on the extent to which curriculum-based SRH education is relevant for fostering good practices for coping with RSBs. This study sought to describe students' and teachers' perceptions of the relevance of curriculum-based SRH education. Methods: A qualitative study was conducted from May to June 2020 (involving 5 secondary schools in Ilemela district, Mwanza, Tanzania). In-depth interviews (30) were conducted among secondary school students and 10 interviews for teachers. The data were collected in Swahili and then transcribed and translated into English after which thematic content analysis was performed. Results: The majority (56%) of secondary school students were revealed to have a limited understanding of curriculum-based SRH education, which was limited to a few aspects of health that involved married people and pregnant women. Teachers of different subjects had different perceptions about the relevance of curriculum-based SRH education. Civics teachers had the perception that it was relevant and enough, while Biology teachers thought that it was not enough. Students reported utilizing the information taught in class to manage and navigate RSBs. Moreover, they expressed a need for additional delivery strategies to be used for a comprehensive understanding of sexual and reproductive health. Conclusion: Despite the identified gaps in providing a comprehensive knowledge that builds on the appropriate attitudes and skills, the existing curriculum-based SRH education in secondary schools was utilized to help students in addressing and managing RSBs. However, there is a need for more comprehensive information and an improved delivery approach for SRH to equip students with the necessary skills when faced with RSBs. Plain English summary: Sexual and reproductive health (SRH) education integrated into school curricula has proven effective in addressing risky sexual behaviors (RSBs) among in-school adolescents. Adolescents attending secondary schools, are susceptible to RSBs such as early sexual activity, multiple partners, unprotected intercourse, and unsafe abortions, leading to adverse health outcomes such as teenage pregnancies and HIV/AIDS. Despite the integration of SRH education into secondary school syllabi, these behaviors are still evident among students. There is a lack of data on the impact and relevance of curriculum-based SRH education on RSBs. To explore the relevance and effectiveness of SRH education in addressing RSB patterns, in-depth interviews were conducted among secondary school students and civics and biology teachers focusing on their perceptions and practical outcomes of SRH education in reducing RSBs. After conducting a thematic content analysis three main themes were discovered: (1) Student's understanding of curriculum-based SRH education in coping with RSBs (2), Perceptions of curriculum-based SRH education in coping with RSBs and (3) Utilizing curriculum-based SRH education in coping with RSBs. Majority of secondary school students (56%) had a limited understanding of SRH narrowed to aspects concerning married individuals and pregnancy. Teachers provided varying opinions regarding the efficacy of curriculum-based SRH education, with Civics instructors believing there is relevance while Biology teachers considered it limited. Students acknowledged using the available knowledge to address RSBs but expressed a desire for supplementary strategies to achieve a more thorough understanding of SRH. Improving the SRH education provided in schools will help reduce the consequences of RSBs. [ABSTRACT FROM AUTHOR]

Despite its high prevalence in same-sex couples, the study of intimate partner violence (IPV) has been mostly focused on different-sex couples. When lesbian, gay, and bisexual (LGB) samples are considered, similarities between same- and different-sex couples arise, as well as some specificities regarding same-sex couples. Although several studies report a higher IPV prevalence among LGB couples in comparison to heterosexual couples, less research focuses on the differences among the violent dynamics and the influence of risk factors, and most do not consider a Spanish sample. After being recruited on social networks and Spanish lesbian, gay, bisexual and trans (LGBT) associations, a sample of 605 Spanish people participated in this study (71.7% female and 35.7% engaged in a same-sex relationship) through an online survey that included self-reported measures on IPV experiences and behavioral risk factors (witnessing interparental violence; risky sexual behaviors; tobacco, alcohol, and drug consumption). Results suggest a similar IPV prevalence between same- and different-sex couples. Moreover, different IPV types presented comparable prevalence among individuals engaged in gay and lesbian couples. Multinomial logistic regressions showed IPV and partner's sex have a significant effect on an individual adopting risky sexual behaviors and consuming alcohol, with those behaviors having a higher prevalence in individuals engaged in same-sex couples. These results differed by sex, as the impact of IPV and partner's sex on adopting risky sexual behaviors and consuming alcohol only existed among female participants. Our findings accentuate the need to consider the different pressures and IPV experiences among same- and different-sex couples while creating interventions. [ABSTRACT FROM AUTHOR]

Objective The current study utilized a longitudinal person-centered approach (latent transition analysis [LTA]) to assess transitions into and out of risk-behavior profiles during the transition into and throughout the first year of college. Participants: Participants included 579 first-year college students (Mage = 18.13, SD =.94) from a large mid-Atlantic university. Methods: Participants completed surveys at five points throughout their freshman year. Results: LTA suggested that most individuals either abstained from engaging in risk behaviors or transitioned toward profiles of less risk over time. A smaller portion of individuals either began and ended the year in the same risk profile or transitioned into profiles of greater risk. Conclusions: The findings highlight the importance of utilizing person-centered analyses to examine change in multiple health-risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Increased risky sexual behaviors (RSB) in sexual minority people relative to heterosexual individuals are well documented. However, the role of trans-diagnostic factors that are not sexual orientation-specific, such as self-criticism, in predicting RSB was understudied. The present study aimed to test participants' gender and sexual orientation as moderators between self-criticism and RSB. Methods: Data were collected during 2019. The total sample included 986 sexual minority people (Nwomen = 51%) and 853 heterosexual people (Nwomen = 46%), ranging from 18 to 35 years of age. Self-criticism dimensions (self-hate, self-inadequacy, self-reassurance), types of positive affect (relaxed, safe/content, and activated affect), and RSB were assessed. Bivariate, multivariate analyses, and moderated regression analyses were conducted. Results: Sexual minority participants showed higher levels of RSB, self-hate, and self-inadequacy than heterosexual people. Only in sexual minority men, RSB correlated positively with self-hate and negatively with safe/content positive affect. Moderated regressions showed that only for sexual minority participants, higher RSB were predicted by higher levels of self-hate. At the same time, this association was not significant for heterosexual people controlling the effects of age, presence of a stable relationship, other self-criticism dimensions, and activation safe/content affect scale. The two-way interaction between sexual orientation and gender was significant, showing that regardless of self-hate, the strength of the association between sexual orientation and RSB is stronger for sexual minority men than sexual minority women and heterosexual participants. Conclusions: Findings highlight the distinctive role of self-hate in the occurrence of RSB in sexual minority people and support the usefulness of developing a compassion-focused intervention to target self-hate in sexual minority people. [ABSTRACT FROM AUTHOR]

Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14–21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships. [ABSTRACT FROM AUTHOR]

Background: In China, men who have sex with men (MSM) face a high risk of HIV infection. Intimate partner violence (IPV) is common in this population and leads to various adverse consequences, including risky sexual behaviors, substance abuse, and poor mental health, which pose huge challenges to HIV prevention and control.Methods: An anonymous cross-sectional study was conducted to investigate the lifetime prevalence of IPV and prevalence of risky sexual behaviors during the previous 6 months in a convenience sample of 578 MSM from 15 cities covering seven geographical divisions in mainland China. The associations between IPV and risky sexual behaviors and the moderating effect of self-efficacy on these associations were explored through univariate and multivariate regression analyses.Results: The prevalence rates of IPV perpetration and victimization were 32.5% and 32.7%, respectively. The proportions of participants who reported inconsistent condom use with regular or casual partners and multiple regular or casual sexual partners were 25.8%, 8.3%, 22.2%, and 37.4%, respectively. Multiple IPV experiences were positively associated with risky sexual behaviors; for example, any IPV victimization was positively associated with multiple regular partners, adjusted odds ratio (ORa) = 1.54, 95% CI [1.02,2.32], and multiple casual partners, ORa = 1.93, 95% CI [1.33, 2.80]. Any IPV perpetration was positively associated with inconsistent condom use with regular partners, ORa = 1.58, 95% CI [1.04, 2.40], and multiple casual partners, ORa = 2.11, 95% CI [1.45, 3.06]. Self-efficacy was identified as a significant moderator of the association between multiple casual sexual partnership and emotional IPV.Conclusions: In conclusion, given the high prevalence of both IPV and risky sexual behaviors among Chinese MSM in this study, the inclusion of self-efficacy in interventions targeting IPV and risky sexual behaviors should be considered. [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]

Background: College students are at-risk populations of mental health problems and risky sexual behaviors. However, little literature focuses on the association between mental health problems and risky sexual behaviors. Our study examined the association between mental health problems (depressive symptoms, suicide, and mental disorders) and risky sexual behaviors among a large sample of Chinese college students.Methods: A total of 49,728 Chinese college students (47.5% male) eventually participated in the analysis. A self-administered questionnaire was used to measure mental health, risky sexual behaviors (casual sex, no condom use at last sexual intercourse, group-sex, and a high number of sexual partners), and other sociodemographic characteristics. Logistic regression analysis was used to explore the relationship between mental health and risky sexual behaviors. To ensure the data is representative of the nation's statistics, all analyses were weighed.Results: The prevalence of depressive symptoms, suicide ideation and suicide attempts, and mental disorders was 42.83%, 41.29%, and 7.74%, respectively. 26.13% of participants were sexually active in the previous twelve months. Nearly 35% of sexually active participants were engaged in risky sexual behaviors. Logistic regression results demonstrated that mental health problems were associated with risky sexual behaviors after adjusting confounders.Limitations: cross-sectional analysis; The self-reported variables may be subject to recall bias and fraud.Conclusions: There is a relatively high prevalence of mental health problems and risky sexual behaviors amongst Chinese college students. A significant association between mental health problems and risky sexual behaviors was suggested by our study. Our findings support the importance of advocating for mental and reproductive healthcare for college students. [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]

In the context of gender imbalance and marriage squeeze in China, this study identifies socio-demographic characteristics of bachelors who reported having sex with partners whom they met online and examines associations between having sex with such partners and other risky sexual behaviors. Data are from a cross-sectional survey conducted in 2017. 735 men who have rural household registration (hukou, in Chinese), and who were at least 28 years old and unmarried were interviewed. 16.5% of the sample had experienced sexual intercourse with a partner met online. After adjustment for socio-demographic characteristics, having sex with such partners was associated with a range of risky sexual behaviors: unsafe sexual intercourse (such as anal sex, group sex, not using a condom) (adjusted OR (aOR) = 5.11, 3.14–8.33, p < 0.001); commercial sex (aOR = 4.42, 2.78–7.02, p < 0.001); having sex in public places (aOR = 3.11, 1.97–4.91, p < 0.001); and multiple sexual partners (> = 6 partners) (aOR = 12.57, 6.55–24.12, p < 0.001). This suggests that bachelors who had sexual intercourse with partners whom they met online are at higher risk for HIV or other STD infections. Future interventions targeted at this population will improve the efficiency of China's HIV/STD prevention. [ABSTRACT FROM AUTHOR]

Young adults have contributed to the surge of sexually transmitted infections (STIs), in part due to an increased risk of engaging in high-risk sexual behaviors. This study describes the sexual practices of thirty young adult females and males who tested positive for one or more non-chronic STIs in the past year. Behaviors examined were identified using the Safe Sex Behavior Questionnaire (SSBQ). Demographic factors were also considered. Findings revealed that engaging in risky sexual behaviors leads to contracting STIs. The most common risky sexual behaviors were engaging in sexual foreplay without protection, absence of spermicide usage with a condom, and engaging in sexual intercourse without using condoms if the partner insists. Chlamydia was the most prominent STI. [ABSTRACT FROM AUTHOR]

We examined sexualized music, dating and sexual behaviors, and risky sexual behaviors among emerging adults from both the United States (n = 1,013) and Australia (n = 600). Participants completed an online questionnaire assessing their dating, sexual histories, and risky sexual behaviors. Sexualization in music lyrics and videos were assessed using content analysis of the top artists rated by participants in each country. Results indicated variations in dating and sexual histories as well as risky sexual behaviors among participants from the United States and Australia. Participants from both countries reported greater exposure to sexualized music videos compared to music lyrics. In addition, U.S. participants reported greater exposure to sexualized music videos compared to participants from Australia, who reported greater exposure to sexualized music lyrics. We addressed four specific research questions as this research was exploratory in nature. We found that increased exposure to sexualized content in music lyrics and videos mediated the relationship between location (United States, Australia) and engagement in risky sexual behaviors. Theoretical explanations are related to the cultivation effect and the uses and gratifications paradigm. [ABSTRACT FROM AUTHOR]

Background: Young women are disadvantaged with respect to their ability to access contraception, which puts them at especially high risk of repeat induced abortion. This study aims to estimate the prevalence of repeat induced abortion and to identify its association with risky sexual behaviors among unmarried young women in China. Materials and Methods: Data were obtained from the Survey of Youth Access to Reproductive Health in China and collected using probability proportionate to size sampling. Population numbers and prevalence of repeat induced abortion by characteristics were calculated among 11,076 unmarried young women aged 15–24 years. Univariate logistic regression, multivariate logistic regression, and logistic regression with propensity score-based weighting were used to elucidate the associations of each risky sexual behavior with repeat induced abortion among sexually active young women. Results: The prevalence of repeat induced abortion was 0.8% (95% confidence interval [CI]: 0.7–1.0) among unmarried young women (11,076) and it accounted for 21.3% of those who had ever had induced abortion. Among sexually active young women, the prevalence of abortion was 4.40% (95% CI: 3.6–5.4). Condom nonuse during the first sexual experience (odds ratio = 2.72, 95% CI: 1.55–4.76), sexual activity with multiple partners (9.71, 5.61–16.81), being forced to have sexual intercourse (4.46, 1.44–13.76), casual sex (5.77, 3.28–10.13), commercial sex (4.51, 2.01–10.12), condom nonuse during the most recent sexual encounter (2.01, 1.31–3.08), and having any of the above behaviors (5.68, 2.26–14.28) were associated with repeat abortion. Conclusions: Risky sexual behaviors were associated with repeat abortion among unmarried young women in China. The findings highlight the need for reproductive health promotion programs for unmarried young women in China and other similar settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little research exists examining the impact of multiple minority identities, particularly sexual orientation, race/ethnicity, and sex on health‐risk behaviors like mental health, substance use, violence, and sexual risk among high school students in the United States. In this study, we use a nationally representative dataset to examine differences between non‐Hispanic white heterosexuals (HSs) and non‐Hispanic white sexual minority, black HS, black sexual minority, Hispanic HS, and Hispanic sexual minority students. METHODS: Data from the 2015 wave of the Youth Risk Behavioral Surveillance System were used in this study. Chi‐square and hierarchical logistic regression models examined differences between the groups on outcomes including: (1) mental health and suicide, (2) alcohol, tobacco, and illicit substances, (3) sexual risk and protective factors, and (4) school and physical and/or sexual violence. RESULTS: Whereas sexual minority youth (SMY) generally demonstrate poorer health outcomes compared to HSs, SMY who are also racial/ethnic minorities often have even poorer health outcomes, particularly relating to substance use, sexual risk behaviors, physical/sexual violence, and suicide. CONCLUSIONS: The need for culturally tailored education and school‐based interventions that consider intersections between race/ethnicity, sexual identity, and biological sex are warranted to address health disparities related to mental health and suicide, substance use, sexual risk, and violence. [ABSTRACT FROM AUTHOR]

BACKGROUND: Among the number of reasons that expose the youth to reproductive health risks, lack of adequate information on sexual and reproductive health issues is of prior concern. Given the lack of readily available information about sexual activity to teens, they turn to media for information about sexual norms and may also use the media as a sexual super-peer that encourages them to be sexually active. Therefore, this study was aimed to assess the association between exposure to sexually explicit materials and sexually risky behaviors among undergraduate students of Ambo University, Ethiopia. METHODS: Institutional based cross-sectional study was conducted among 403 university students in 2018. Study participants were selected by systematic random sampling technique. Self- administered questionnaire was used to collect data. Data were analyzed using SPSS statistical software version 20. Uni-variate, bivariate and multiple logistic regression analyses were done. With 95% CI, the p-value of less than 0.05 was taken as the level of significance. RESULTS: About 55% and 52% of the university students were exposed to sexually explicit electronic materials throughout their life and in the last 12 months prior to data collection period respectively. Searching for sex information was the top reason for why university students resorted to watching sexually explicit materials. Sexually active students, senior students and male students were more likely to engage in watching sexually explicit electronic materials compared to their counterparts. CONCLUSION: A high numbers of university students were being exposed to sexually explicit electronic materials for the sake of searching about sexual and related information. This exposure has a significant association with risky sexual behaviors specifically. We highly recommend that university organize awareness creation forum on the area of sexual health, HIV/AIDS and STI, and related matters. [ABSTRACT FROM AUTHOR]

Objective: Malays, with majority of the individuals being Muslim, form the largest ethnic group in Southeast Asia. This region is experiencing a rising incidence of HIV infections. Due to circumcision and prohibition of sex outside marriage, being Muslim was argued to be a protective factor against sexually transmitted infections (STI) and Human Immunodeficiency Virus (HIV). However, Malay adolescents were found to be more likely to contract chlamydia and gonorrhea than non-Malay adolescents in Singapore. Design: Using a cross-sectional survey, we examined and compared safer sex knowledge, attitudes and self-efficacy, and sexual behaviors of 248 sexually active Malay adolescents with 384 Chinese adolescents aged 16–19 years in Singapore. Poisson regression, adjusted for socio-demographic characteristics, was used for modeling each dependent variable. Adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were obtained. Results: On multivariate analysis, Malay adolescents were more likely to report marginally unfavorable attitude towards condom use (aPR 1.21 CI 1.00–1.48) and significantly lower confidence in using condoms correctly (aPR 1.24 CI 1.05–1.47) than Chinese adolescents. They were also more likely to report significantly younger first sex age (aPR 0.98 CI 0.96–1.00), never use of condoms for vaginal sex (aPR 1.32 CI 1.16–1.49) and anal sex (aPR 1.75 CI 1.11–2.76) and non-use of contraceptives at last sex (aPR 1.30 CI 1.17–1.45) than Chinese respondents. Malay males were less likely to buy sex (aPR 0.56 CI 0.37–0.85), but they reported higher likelihood of inconsistent condom use with female sex workers (aPR 2.24 CI 1.30–3.87). Conclusion: Malay ethnicity was associated with unfavorable condom use attitude and lower self-efficacy in using condoms, which was consistent with risky sexual behaviors such as non-use of condoms. Future research should use mixed methods to explore and identify cultural influences to these behaviors. [ABSTRACT FROM AUTHOR]

This study assessed the practical value of HIV/AIDS education among at-risk adolescents in the United States. Data were drawn from the 2013 Youth Risk Behavior Surveillance System spanning students in grades 9-12 who have engaged in sexual intercourse. A multivariate hierarchical logistic regression analysis was employed to test: (1) the individual effects of school-based HIV/AIDS education and risky sexual behaviors on the probability of HIV testing and (2) the interaction effects to estimate the degree to which the education effect varied by specific risky sexual behavior. The results indicated that students who engaged in risky sexual activities and received HIV/AIDS education were more likely to test for HIV compared to those who did not receive HIV/AIDS education. The relationship between education and HIV testing also varied according to the number of recent sexual partners. The findings have policy and practice implications. Specifically, HIV/AIDS education that promotes HIV testing should be encouraged particularly with the high-risk student population. [ABSTRACT FROM AUTHOR]

Understanding the link between HIV knowledge, risky sexual behaviors, and social intolerance such as stigma and discrimination is important for HIV prevention and treatment program planning. We investigated whether intolerant attitudes and practices among Ugandan adults were associated with HIV-transmission knowledge. We analyzed data from a nationally representative population-based household survey, the 2011 Uganda AIDS Indicator Survey. A total of 15,526 participants who responded to questions on HIV knowledge, social intolerance and risky sexual behavior were included in this analysis. Results show that 34.8% of respondents reported having fear of casual contact with people living with HIV (PLWA), 21% blame PLWAs for their disease, 62% would not want HIV infection in their family disclosed, while 25% reported engaging in risky sexual behaviors. After adjusting for age, sex, residence, and level of education, people with low HIV-transmission knowledge had almost three-fold higher odds of fear of casual contact with a PLWA (aOR = 2.70, 95%CI = 2.33-3.13), and had 30% higher odds of HIV-related stigmatizing attitudes (aOR = 1.29, 95%CI = 1.07-1.54). Further, they had 47% higher odds of having sex under the influence of alcohol (aOR = 1.47, 95%CI = 1.25-1.73) and 40% higher odds of having unprotected sex with any of their last three sex partners (aOR = 1.39, 95%CI = 1.06-1.89). Our findings show that intolerant attitudes such as stigma still persist, particularly among people with low HIV-transmission knowledge. Improving knowledge about HIV/AIDS can foster positive attitudes and building safe practices among populations, and is critical for improving prevention and treatment programs. [ABSTRACT FROM AUTHOR]

Abstract: Teenage pregnancy‐prevention interventions have fallen short in significantly decreasing risk of pregnancy for Thai populations. The “breaking the voice” (“rak luk khun tong pood”) culture‐appropriate teenage pregnancy‐prevention program was developed using community‐based research. Qualitative analyses of focus group data identified salient factors related to sexual communication and behavior. The integration of focus group results with theoretical constructs guided the development of an intervention to reduce risky sexual behavior by increasing communication between mothers and their adolescent daughters. A total of 157 mother–daughter dyads from congested areas in Bangkok participated in pilot testing of the intervention by the use of a survey. The findings indicated a significant increase in the frequency of and number of sexual risk communication (P < .05). There was a significant increase in perceived power in relationship control, ability to prevent sexual risk, assertiveness, and ability to decrease sexual risk among daughters (P < .05). “Breaking the voice” represents a female‐focused and culturally‐relevant intervention to combat teenage pregnancy. [ABSTRACT FROM AUTHOR]

This study aimed to explore predictors of human immunodeficiency virus (HIV)-related risky sexual behaviors among women with substance use. A total of 150 women were selected from harm reduction centers in Tehran, Iran, and completed the risk behavior assessment, the Beck depression inventory, the revised self-efficacy scale, and the peer group beliefs regarding HIV-related risk behaviors scale. The results showed that age (β = −.07,P˂ .01) and exchange of sex for drugs or money (β = 3.34,P˂ .001) were significant predictors of whether women had multiple sex partners. Moreover, depression (β = .06,P˂ .05), exchange of sex for drugs or money (β = 1.42,P˂ .01), and self-efficacy (β = −.19,P˂ .001) significantly predicted unprotected sex among women with substance use. Accordingly, providing female substance users with harm reduction services and developing HIV prevention programs are likely to decrease high-risk sexual behaviors and consequent HIV infection within this vulnerable group. [ABSTRACT FROM PUBLISHER]

This study investigated the association between risky sexual behavior and drug use among female youth sentenced to a regional juvenile detention center. Preincarceration behavioral health risk data were collected from a modified version of the Youth Risk Behaviors Surveillance Survey completed by respondents. Almost all of the 105 participants had been detained before their current sentence, more than half of them were sexually active before the age of 13, and 70% had smoked marijuana or drank alcohol by age 14. A regression analysis was conducted to determine if preincarceration sexual health risk behaviors were significant enough to predict continued risk behaviors related to pregnancy, disease prevention, and substance use. Findings indicate that youth detention-based prevention programs should emphasize sexual and drug-risk reduction strategies as a means to reduce risky behaviors for this population. [ABSTRACT FROM PUBLISHER]

Background Despite prevention programs, a rising incidence of sexually transmitted infections is currently reported in France. Aims Research factors associated with risky sexual behaviors (RSBs) among the French population. Methods Subjects aged 15-54 years from the French national survey 'Baromètre santé 2010' were included (n = 16 598). RSB was defined as having multiple partners or failure to use condom at first intercourse with a new partner over past 12 months. Factors associated were identified using one logistic regression by gender. Results The overall RSB prevalence was 9.5%, being higher among men (P< 0.001). Factors associated with RSB for both genders were young age (OR = 1.5), single status (men: OR = 7.1; women: OR = 6.4), homosexual relations (men: OR = 2.0; women: OR = 3.2), low incomes (men: OR = 1.5; women: OR = 1.4), use of cannabis (men: OR = 1.4; women: OR = 3.0). Men-specific factors were history of STI (OR = 2.5) and alcohol drunkenness (OR = 2.2), and women-specific factors history of suicide attempt (OR = 1.6) and history of sexual assault (OR = 1.6). Conclusions Confirming most of known determinants of RSB, this study also identified some specific risky patterns for whom preventive actions can be developed: multiusers of psychoactive substances, people living with low incomes, women having sex with women or presenting history of psychological vulnerability (suicide attempts, sexually harassed). [ABSTRACT FROM AUTHOR]

Young men who have sex with men (YMSM) have become high risk groups for HIV infection in China. Recent researches suggest that sexual sensation seeking is significantly associated with AIDS-related knowledge, attitudes and behaviors, but the relationship is not clear in the field of YMSM in China. The present study aimed to evaluate the relationship between sexual sensation seeking and AIDS-related knowledge, attitudes, and behaviors among YMSM in China. A cross-sectional study was conducted in Wuhan, China from May to November 2013. 403 YMSM were recruited and 373 of them completed the questionnaire. Regression analyses indicated that YMSM with high sexual sensation seeking score are more likely to have low awareness of knowledge and negative attitude about condom use, as well as more risky sexual behaviors. [ABSTRACT FROM PUBLISHER]

This evaluation study reports the effects of a combined alcohol-use and sex education intervention program on the knowledge, attitudes, and risk-taking behaviors among college-attending Hispanic and other minority young adults. A random sample of Hispanic, Black, and other racial minority college students aged 18-24 was selected to participate in an intervention study from 2014 to 2016 at a minority-serving institution (MSI) in South Texas. Results show that the combined intervention program has significantly increased minority young adults' awareness of risks associated with unprotected sex, safe-sex negotiation skills, and HIV knowledge. Moreover, the combined intervention program has also decreased minority young adults' past-30-day use of alcohol. These results support the assertion that a combined intervention program can serve as an important strategy to help prevent the risk of HIV/STD transmission among college attending Hispanic and racial minority young adults in South Texas. [ABSTRACT FROM AUTHOR]

Body image concerns are common among people living with HIV. Among adults with HIV, body image concerns have been shown to be related to risky sexual behaviors; little research has been conducted among youth living with HIV (YLWH). The current study examined the predictors, including body image, of sexual risk behaviors among YLWH. Adolescents from a single clinic ( n = 143; age range, 16-24 years; 69% male; 95% African American) completed a computerized self-report survey to assess demographic, behavioral, and body image domains. Demographic and clinical data were abstracted from the medical record. Logistic regression analyses assessed associations between risk factors and risky sexual behaviors. Results indicated that YLWH who reported less favorable body image perceptions ( p = 0.04) and more sexual partners ( p = 0.05) were less likely to use condoms during their last sexual encounter. YLWH with six or more sexual partners were more likely to use drugs or alcohol during their last sexual encounter ( p = 0.03). A belief that their HIV medications changed their body physically ( p = 0.05), history of HIV-related complications ( p = 0.03), an undetectable viral load at their most recent clinical laboratory draw ( p = 0.01), and having a high school diploma or equivalent ( p = 0.001) were independently associated with disclosure of participant's HIV status to a romantic/sexual partner. Findings suggest that body image perceptions may influence risky sexual behavior in YLWH. Further study is warranted to understand and intervene upon this relationship to improve individual and public health outcomes. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) vaccination is safe and effective in preventing anogenital cancers and warts. However, myths have surrounded the HPV vaccine since its approval, including the possibility that HPV vaccinated young people are more likely to engage in risky sexual behaviors. The purpose of this study was to assess the association between HPV vaccination and engaging in inconsistent condom use in a sample of U.S. college students. A secondary data analysis of the National College Health Assessment-II (Fall 2013) was conducted in 2015. Risky sexual activity was operationalized as inconsistent condom use for oral, vaginal or anal sexual activity. Logistic regression models were stratified by sexual activity and gender, and controlled for socio-demographics and history of STIs. Inconsistent condom use was reported among females for vaginal (47%), oral (94%), and anal sex (75%); while males reported levels of inconsistency for vaginal (38%), oral (94%), and anal sex (58%). Sixty-nine percent of females reported receiving the HPV vaccine compared to 43% of males. Among females, there was no significant association between HPV vaccination and inconsistent condom use in any of the sexual activities. Among males, there was no significant association between HPV vaccination and inconsistent condom use in oral or vaginal sex. HPV-vaccinated males were less likely to report inconsistent condom use during anal sexual activity. This study contributes to the increasing evidence that HPV vaccination is not associated with risky sexual behavior. Dispelling this myth is important to facilitate uptake and completion of the HPV vaccine in the U.S. [ABSTRACT FROM AUTHOR]

This study explored patterns of risky sexual practices and perceived vulnerability to sexually transmitted infections among 450 sexually active emerging adults (18–25 years) through a self-administered questionnaire and 43 interviews. Findings showed that 97.4% of men and 98.1% of women were in intimate sexual relationships, among which 74% of men and 46.5% of women had unprotected vaginal intercourse and anal sex (α = 1.74 for men and 1.09 for women) within the past month. Consequences of unprotected sexual practices notwithstanding, engagement in risky sexual practices prevail. Redesigning of current behavioral modification approaches targeted toward promoting healthy sexual practices in young adulthood is required. [ABSTRACT FROM AUTHOR]

There are not many studies exploring the association between alcohol use and risky sexual behaviors among migrant workers. This study analyzed how changes in alcohol use was associated with changes in risky sexual behavior and psychosocial variables. Data for this study was drawn from an HIV risk reduction project. Repeated measures ANOVA and Linear mixed model statistical method was conducted to find changes and association between alcohol use, sexual risk and psychosocial variables over time. The sample ( n = 203) was composed of African Americans (33.0 %) and Hispanics (77.0 %) men. Both groups, over time, showed reduction in sexual risk in accordance with reduction in alcohol use. Changes in alcohol use and psychosocial variables showed significant association with sexual risk changes over time. Psychological strategies like building social support should be considered for HIV risk reduction intervention directed towards high alcohol consuming migrant workers. [ABSTRACT FROM AUTHOR]

Background: Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15-19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents.Methods: A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1) when the adolescents enter the study (baseline), 2) once the intervention is completed (at 1 month) and 3) after 3 months of follow-up (at the fourth month). There will be three outcome variables: 1) knowledge in regard to sexually transmitted infections, 2) attitudes regarding condom use, and 3) self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates.Discussion: The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large-scale, easily implemented preventive tool.Trial Registration: The study was registered at the ClinicalTrials.gov ID: NCT02686736 . [ABSTRACT FROM AUTHOR]

A sample of 498 sexually active first-year students matriculating at a historically Black college in North Carolina was used to determine correlates of risky sexual behaviors. In an Ordinary Least Squares regression, the self-esteem element “I take a positive attitude toward myself” (B = 1.12,p = .05), non-condom use because of partner issues (B = .53,p = .05) and being drunk or high (B = 1.20,p = .001), oral sex (B = 1.74,p = .001), anal sex (B = .61,p = .04), and bisexuality (B = .85,p = .03) all increased the number of these behaviors. Higher scores on the condom usage scale (B = –.38,p = .002) were found to decrease the number of risky sexual behaviors. Illicit drug use was an underpinning of the surprisingly positive relationship between positive self-image and risky sexual behaviors. It was concluded that school-based social workers, mental health care professionals, and community-based prevention providers can play a critical role in the training of peer facilitators, development, and supervision of peer-driven risk-reduction programs to address the complex interplay among self-esteem, sex, and substances. [ABSTRACT FROM PUBLISHER]

This review of the literature identifies themes, variable, goals, and gaps in the literature related to H IV and AIDS among African American women. Black Feminist Epistemology and symbolic interactionism are used as a theoretical perspective and philosophical framework to and social behaviors of African-American women and to guide and framework to explain the findings from the literature. This theoretical perspective/philosophical framework can also be used in understanding processes used by African-American women in behavioral, social, and intimate interactions. [ABSTRACT FROM AUTHOR]

Highlights: [•] 61% Of the sampled undergraduate students reported sexting. [•] Individuals who have had unprotected sex were 4.5 times more likely to sext. [•] Individuals who viewed Internet adult pornography were 4 times more likely to sext. [•] Individuals web-based chatting with strangers were 2.4 times more likely to sext. [•] Ambivalence attachment style was moderately related to sexting. [Copyright &y& Elsevier]

Abstract: Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner''s risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members. [Copyright &y& Elsevier]

Research studies have provided increasing evidence for the potential adverse impact of child sexual abuse on women's sexual health. The present study examined the association between child sexual abuse and sexual health while controlling for various forms of childhood victimization. Self-report questionnaires were administered to 889 young women from the province of Quebec. Results suggest that child sexual abuse survivors were more likely to report having experienced other forms of childhood victimization than were women without child sexual abuse. Women with a history of both child sexual abuse and multiple forms of victimization were at greater risk of experiencing more adverse outcomes, including risky sexual behaviors, sexual problems, and negative sexual self-concept. Regression analyses revealed that child sexual abuse was significantly related to indicators of sexual health outcomes even when controlling for the effect of single forms of victimization. Clinically, interventions optimizing sexual health may be particularly helpful for a subgroup of child sexual abuse survivors. [ABSTRACT FROM PUBLISHER]

The ability to refuse unprotected sexual behavior is a skill that could prevent a number of negative health outcomes, including HIV/AIDS infection and transmission. The present study uniquely adds to the extant literature by investigating the effects of stress reactivity (indexed by cardiac reactivity) and emotion dysregulation on self-efficacy in avoiding potentially risky sexual behaviors among women. Participants were a sample of 60 women age 18–25 years, oversampled for a history of childhood maltreatment (40 women reported a history of physical, emotional and/or sexual abuse or neglect). Findings indicated that emotion dysregulation mediated the relationship between severity of childhood maltreatment and self-efficacy for avoidance of sexual activities, but only for women who also showed high stress reactivity. These results suggest that women with a history of childhood maltreatment, and in particular those who are highly reactive to stress, would potentially benefit from prevention programs for risky sexual activities that aim to reduce emotion dysregulation. [ABSTRACT FROM PUBLISHER]

This study aimed to examine trajectories with respect to the number of sexual partners among older men who have sex with men and to determine characteristics associated with trajectory groups. Nagin's group-based modeling was used to identify trajectories for 237 men from the Pitt Men's Study with respect to the number of male intercourse partners from age 50.0 to 59.5. Three distinct trajectory groups were identified. Most men (69.2%) had a median of two sexual partners in the past 6 months across the age range of the study. A smaller group (19.4%) had low or no sex partners. The smallest group (11.4%) had 30 or more sexual partners in the past 6 months at age 50. The groups were statistically different with respect to race, HIV status, drug use (marijuana, poppers, crack cocaine, and Viagra), the number of unprotected anal sex partners, and personal attitudes towards sex. [ABSTRACT FROM AUTHOR]

Youth who age out of foster care are at risk of poor outcomes and risky behaviors in young adulthood. Yet, little is known about what child welfare workers can do to decrease these risks. The effect of foster care placement instability on substance use and risky sexual behaviors is examined using data from 114 young adults who aged out of care. When controlling for variables commonly associated with these behaviors, a history of foster care placement instability increased the young adults' likelihood to use substances. Child welfare practitioners could potentially reduce the vulnerability of this population by providing them greater stability during adolescence. [ABSTRACT FROM AUTHOR]

The purpose of this article is to describe (a) the Finding Common Ground Summits conducted in Florida during 2005-2006 with the objective of improving communication, collaboration, and consensus building among organizations interested in reducing sexual health risk behaviors among youth; (b) the attitudes of Summit participants; and (c) the impact of this exploratory initiative. The 196 participants, invited to participate by the Florida Department of Education, included individuals working in both school and community human sexuality education and promotion programs. Participants completed an initial survey just before the one-day Summits identifying attitudes and beliefs toward sexuality education. They were sent a Web survey approximately 6 months after the Summit to assess outcomes (n = 64). Frequencies and MANOVAs were conducted to assess differences on the attitude scale items between those identifying as supporters of abstinence-only, abstinence-based, and comprehensive sexuality education. The majority of participants believed sexuality education should be taught, gained an understanding of providers with varying philosophies, and wanted to continue collaborative efforts. This initial pilot project was successful in improving communication, collaboration, and consensus building among sexuality education providers, although future efforts are needed and encouraged as risky sexual behaviors among youth remain high. [ABSTRACT FROM PUBLISHER]

Although research finds high rates of risky sexual and drug related behavior among homeless young people, little research had examined how the characteristics of their social networks encourage or constrain risky behaviors. Based on a sample of 145 homeless young adults in the Midwestern United States, results revealed that having used alcohol with at least one of their network members and the presence of more conflict was associated with engaging in a greater number of sexual risk taking behaviors. Correlates of engaging in a greater number of substance use related behaviors included having older peers within the network, having used illicit drugs with at least one network member, and the presence of more conflict. The presence of a family member in one’s network, however, was associated with fewer sexual and drug related risk behaviors. Overall, the social network characteristics of youth explained significant, additional variance beyond that of youth’s own characteristics and their early family histories. [Copyright &y& Elsevier]

Childhood sexual abuse and related life traumas, and other psychosocial variables were investigated as contributors to ethnic differences in sexual risk behaviors among women who differed in HIV-serostatus. A multiethnic sample of 457 HIV-positive and HIV-negative women residing in Los Angeles county was recruited and studied over 2 years as part of the UCLA-Charles R. Drew University Women and Family Project (WFP) study. Comprehensive interviews were administered to participants by ethnically- and linguistically matched interviewers. Data on demographic information, sexual trauma, substance abuse/dependence, psychiatric distress, and sexual history and risk behaviors were collected. The sample for these analyses consisted of 155 African American, 153 European American, and 149 Latina women, and nearly two-thirds of the sample was HIV-seropositive. HIV-positive women were significantly more likely to report more posttraumatic stress, chronic stress, negative health behaviors, drug use, and psychiatric history than HIV-negative women. European American and African American women were more likely to report a history of sexual trauma than Latina women. Finally, Poisson regression analyses revealed that history of trauma, ethnicity, drug and alcohol use, homelessness, and being HIV-positive were associated with greater likelihood of engaging in high-risk sexual behaviors, with history of trauma increasing the likelihood of engaging in high-risk behaviors by 5.1%. These findings highlight important differences among women as a function of ethnicity and HIV status, and underscore the need for special services for HIV-positive women that address the risk-enhancing effects of substance abuse/dependence, homelessness, and sexual trauma. [ABSTRACT FROM AUTHOR]

Increasing prevalence of risky sexual behaviors among men who have sex with men (MSM) exacerbate the transmission of HIV. Previous studies had demonstrated that childhood sexual abuse (CSA) was associated with one or more sexual behaviors, but few studies have been conducted among MSM in China. This present study aimed to estimate latent classes of risky sexual behaviors and test for CSA differences in latent class memberships among Chinese MSM. The eligible participants were MSM aged 16 years or older who reported ever having oral or anal sex with men in the past 6 months. Data were obtained from an anonymous questionnaire between September 2017 to January 2018 in three cities in China, and contained questions about sexual-related behaviors and CSA experience. Latent class analysis (LCA) was used to classify the patterns of sexual behaviors and binomial regression was used to examine the relationships among these variables. Among 628 MSM, 22.6% reported experiencing CSA. A two-classes pattern of sexual behaviors was identified, with 46.7% in the low-risk class and 53.3% in the high-risk class. MSM who experienced CSA were more likely to be high-risk group compared to those without CSA experiences [odds ratio (OR) = 1.981; 95% confidence interval (CI) =1.329–2.954)]. CSA was prevalent among Chinese MSM. And MSM with CSA experiences are more prone to be assigned to the high-risk group. Future HIV interventions need to focus on MSM who experienced CSA. [ABSTRACT FROM AUTHOR]

The rate of HIV and sexually transmitted infections among mental patients is higher than that of the general population worldwide. Many risky sexual behaviors are associated with mental illness. However, mental health care users (MHCUs) are not specifically targeted for HIV preventative care, and routine HIV testing is not done among this population. Limited studies have investigated self-reported HIV and STI prevalence and associated risky sexual behavior in persons with mental illnesses accessing health care services in South Africa in particular. This study set out to determine both the Sexually Transmitted Infections (STI) and human immunodeficiency virus (HIV) self-reported prevalence and sexual practices of MHCUs. A descriptive cross-sectional survey using purposive sampling was used to select 107 MHCUs across five clinics within Gauteng Province of South Africa who were above the age of 18, had a mental illness, and were currently stable and receiving chronic medication. Descriptive statistics were performed using Stata IC version 16. The chi square test was used to indicate statistical significance (p < 0.05) of differences in frequency distributions. More males (52.5%) than females were currently in a sexual relationship (50.0%), having multiple sexual partners (n = 4.13%), and having alcohol-driven sex (n = 4.19%). The majority of MHCUs (n = 82.77%) had an STI in the past six months, and a quarter (n = 21.25%) were HIV-positive with over two-thirds of MHCU (n = 69.70%) perceiving themselves not at risk for HIV. MHCUs engaged in risky behaviors had a low perception of the risks of contracting HIV. Bivariate analysis of gender by sexual behavior revealed that female MHCUs are more at risk of being forced to have sex compared to males (p = 0.006). Integrated interventions should be put in place to ensure that MHCUs' sexual and reproductive health are not left behind and issues such as sexual education, safe sex, and sexually transmitted infections should form part of the care of MHCUs. [ABSTRACT FROM AUTHOR]