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A history of maltreatment can increase risk for dating violence (DV) and risky sexual behaviour (RSB) among adolescents. Secure parent-child attachment may reduce this risk, yet few studies have examined this as a protective factor. This study differentiated developmentally appropriate, exploratory sexual behaviours from RSB and examined whether maltreatment experiences and parent-child attachment in adolescence predicted DV and RSB reported five years later in a high-risk sample. Participants were 179 adolescents (46% girls; Mage = 15.34, range = 12–18 years) at risk for aggressive and antisocial behaviour. Adolescents reported their maltreatment histories and attachment to their parents at Time 1; five years later, at Time 2, they reported their experiences with DV perpetration and victimization and engagement in RSB. Both bivariate correlations and structural analyses demonstrated that maltreatment was associated with DV perpetration and victimization but not RSB, and attachment avoidance was associated with fewer RSB but not DV. Attachment anxiety was associated with physical DV perpetration and greater condom use, but only at the correlational level; attachment anxiety was not associated with DV or RSB in the structural model. There were no significant interaction effects. Findings highlight the importance of considering key developmental factors such as maltreatment and parent-child attachment in understanding adolescent risk for DV and RSB, and may inform future research that accounts for contextual factors such as motivation for violence perpetration and contraceptive use with multiple and/or casual sex partners. [ABSTRACT FROM AUTHOR]

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

This article aims to explore the phenomenon of risky sexual behaviour among young people in cyberspace. The theoretical basis for this social issue is grounded in Richard and Shirley Jessor's Theory of Problem Behaviour. To explore this issue further, an analysis of protective and risk factors was conducted, in the context of the emergence and rise of dangerous erotic behaviours exhibited by youth in virtual spaces. An additional key aspect of this study was defining the norms of psychosexual development in children. Drawing on the conclusions derived from the assumptions of the Theory of Problem Behaviour, the article successfully identifies key protective factors and significant risk factors. These insights form an essential foundation for making recommendations in the realm of therapeutic and educational interventions. Virtual space offers young people limitless opportunities for growth and self-fulfilment across various dimensions. However, this article does not delve into this aspect of their digital activity. Instead, it provides a concise reflection on the challenges posed to the psychosocial development of young people in the digital reality. [ABSTRACT FROM AUTHOR]

Background: Adolescents’ risky sexual behaviours (RSB) are detrimental to their sexual and reproductive health (SRH) well-being and present a serious public health threat, particularly in low- and middle-income countries (LMICs). Aim: This study aims to assess RSB among Grade 12 school-going adolescents after exposure to comprehensive sexuality education (CSE). Setting: This study was conducted in Kitwe district, Zambia. Methods: This cross-sectional study included 807 Grade 12 pupils at 13 selected secondary schools. Data were collected using a structured questionnaire. Proportionate probability sampling involving 13 schools was employed. Risky sexual behaviours binary outcome variables were based on transactional sex, sex while drunk, multiple sexual partners, age-disparate sexual relationships, and condomless sex. We conducted univariate and bivariate analyses to summarise sociodemographic factors and fitted binary and multivariable logistic regression models. Results: The prevalence of RSB was 40.4%. Drinking alcohol (adjusted odds ratio [AOR] = 20.825; 95% CI [6.7–64.489]); ever had sex (AOR = 9.024; 95% CI [1.953–41.704]); school location (AOR = 6.50; 95% CI [1.61–26.24]); living with mother only (AOR = 4.820; 95% CI [1.328–17.493]); sex (male) (AOR = 2.632; 95% CI [1.469–4.713]), watching pornography (AOR = 1.745; 95% CI [1008–3.021]); religion (AOR = 0.472; 95% CI [0.250–0.891]) and attending religious functions (AOR = 0.317; 95% CI [0.118–0.848]) were significantly associated with RSB. Of the sexually active pupils, 221 (67.7%), 64 (19.6%) and 41 (12.5%) were in the low, medium and high-risk categories, respectively. Conclusion: Close to half of the respondents engaged in RSB. This is a significant number that needs intervention. The CSE programme needs to be linked with structural programmes that address the social drivers of RSB among adolescents. Contribution: The study provides a backdrop for evaluating current CSE strategies in LMICs.

South Africa is the epicentre of the HIV pandemic. Although there have been health promotion education campaigns to reduce HIV incidence, these have not achieved the desired outcomes. When exploring the effectiveness of these campaigns, it is useful not only to examine HIV knowledge, but also to explore the relationship between that knowledge and health-related behaviour. This study aimed to determine the (1) level of knowledge of HIV prevention, (2) relationship between the level of knowledge and the adoption of these behaviours and (3) barriers to sexual behaviour change of vulnerable women in Durban's city centre, KwaZulu-Natal, South Africa. A mixed methods approach was used to collect information from a marginalised population of women (n = 109) attending a non-governmental organisation, which provides for the needs of people from low socio-economic strata. Data were collected during September 2018 at a wellness day programme at the centre. A total of 109 women, over the age of 18 years answered the questionnaire. Knowledge of HIV transmission was high, with majority of participants correctly identifying modes of transmission. Almost all the participants (91.2%) had been tested for HIV, with 68.8% tested a minimum of three times. Despite this, sexual risk behaviour was high. Despite the high level of knowledge of HIV transmission, there was no relationship between HIV knowledge and adoption of behaviours for the prevention of HIV transmission (p =.457). However, bivariate analysis showed an association between transactional sex and living in informal housing (OR = 31.94, 95% CI: 5.65–180.63, p <.001). Living in informal housing was also associated with having multiple current sexual partners (OR = 6.30, 95% CI: 1.39–28.42, p =.02). Multivariate analysis, after adjusting for all other factors, indicated that the odds of having transactional sex was increased by 23 times in those who did not have formal housing (OR = 23.306, 95% CI: 3.97–144.59, p =.001). Qualitative responses showed that women perceived poverty as the overarching factor determining the lifestyle choices which impacted their health. They indicated a need for employment opportunities and provision of housing to alleviate both poverty as well as transactional sex. Although, participants from this study understood the benefits of the protective behaviours to prevent HIV transmission, economic and social factors do not afford this vulnerable group the opportunity nor the motivation to adopt such behaviours. In the current climate of increasing unemployment and escalating GBV, urgent interventions are needed in terms of employment opportunities and empowerment drives to prevent an increase in HIV transmission. [ABSTRACT FROM AUTHOR]

The youth (15-24 years old) in South Africa remain at high risk of HIV infection despite varied efforts to control the disease. An understanding of the perspectives of relevant stakeholders of HIV-prevention interventions targeting the youth is important to guide research, policy and practice aimed at improving these interventions. This study explores youth and intervention implementers' perceptions of a resilience-based HIV-prevention intervention (You Only Live Once) aimed at reducing risky sexual behaviours among the youth in South Africa. Semi-structured interviews were conducted with 10 young people who participated in the intervention, and four intervention implementers at a not-for-profit organisation in Maluti-a-Phofung Local Municipality, South Africa. Data were analysed using thematic analysis. Three main themes emerged from the data: (1) Acceptability and impact of the intervention; (2) Factors influencing intervention implementation; and (3) Recommendations to improve intervention implementation. These findings provide insights into the acceptability, impact, barriers and facilitators of resiliencebased HIV-prevention interventions for the youth in South Africa and similar contexts, and how implementation of these interventions could be enhanced. The findings can help researchers, policy makers and health care practitioners in the field of HIV prevention to improve interventions targeting young people. [ABSTRACT FROM AUTHOR]

Abstract Background The use of psychoactive substances such as alcohol, heroin and marijuana is associated with negative health outcomes such as sexual violence and unintended pregnancies, and risky sexual behaviours. Although there is evidence linking psychoactive substance use and risky sexual behaviours such as inconsistent condom use and multiple sexual relationships, there is limited data on sex under the influence of psychoactive substances among young people. This study aimed to investigate the prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. Methods A cross-sectional study was conducted among 744 sexually active young psychoactive substance users in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire, preloaded on the Kobocollect mobile application. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the predictors of sex under the influence of psychoactive substances.. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results About 61.0% (454/744) of the respondents had had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04–1.34), being 20–24 years of age (PR: 1.22, 95% CI: 1.04–1.44), being married (PR 1.15, 95% CI: 1.01–1.31) or divorced/separated (PR 1.43, 95% CI: 1.26–1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99–1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79–1.03) and using alcohol (PR 1.43, 95% CI: 1.25–1.69), marijuana (PR 1.16, 95% CI: 1.02–1.31) and khat (PR 1.25, 95% CI: 1.10–1.42) in the last 30 days. Conclusion The study found that a high proportion of sexually active young people in informal settlements in Kampala, Uganda had engaged in sex under the influence of psychoactive substances in the past 30 days. The study also identified several factors associated with sex under the influence of psychoactive substances, including being female, being aged 20–24 years, being married or divorced or separated, not living with biological parents or guardians, and using alcohol, marijuana, or khat in the past 30 days. Our findings suggest the need for targeted sexual and reproductive health programs that incorporate risk-reduction interventions aimed at reducing sex under the influence of psychoactive substances, especially among females and those who do not live with their parents.

Background HIV risk reduction counselling may reduce risk-taking behaviours. Yet, concerns remain about risk compensation among individuals initiating pre-exposure prophylaxis (PrEP). Objective We assessed changes in risky sexual behaviour indicators among HIV vaccine preparedness study participants who received regular risk reduction counselling and referral for PrEP in Masaka, Uganda. Methods Adults (18–39 years) at high risk of HIV infection were enrolled in the study between July 2018 and December 2021. Data were collected on socio-demographic factors (baseline) and self-reported sexual risk behaviours (baseline, six monthly). HIV testing and risk-reduction counselling and referral for PrEP were done quarterly. Participants who had completed at least 1 year of follow-up were included in the analysis. Proportional differences and McNemar chi-square tests were used to assess changes in the prevalence of self-reported risky sexual behaviour indicators between baseline and 1 year. Logistic regression was used to assess the predictors of unchanged/increased HIV risk at 1 year. Results Three hundred participants [132 (44%) females, 152 (51%) aged ≤24 years] were included in this analysis. Eighty-one (27%) participants initiated PrEP at 1 year. Compared to baseline, there were significant reductions in the prevalence of the following self-reported HIV risk indicators at 1 year (overall, among non-PrEP initiators, and among PrEP initiators): transactional sex, ≥6 sexual partners, unprotected sex with ≥3 partners, sex while drunk, and sexually transmitted infection diagnosis/treatment. Percentage differences ranged from 10% for individuals reporting at least six sexual partners to 30% for those reporting unprotected sex with three or fewer sexual partners. There was weak evidence of association between female gender and unchanged/increased HIV risk at 1 year (adjusted OR: 1.35, 95% CI (0.84–2.17)). No other indicators, including PrEP use, were associated with unchanged/increased HIV risk at 1 year. Conclusion Regular risk-reduction counselling may reduce risky sexual behaviour, while PrEP initiation may not lead to risk compensation.

Background: The use of psychoactive substances such as alcohol, heroin and marijuana is associated with negative health outcomes such as sexual violence and unintended pregnancies, and risky sexual behaviours. Although there is evidence linking psychoactive substance use and risky sexual behaviours such as inconsistent condom use and multiple sexual relationships, there is limited data on sex under the influence of psychoactive substances among young people. This study aimed to investigate the prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. Methods: A cross-sectional study was conducted among 744 sexually active young psychoactive substance users in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire, preloaded on the Kobocollect mobile application. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the predictors of sex under the influence of psychoactive substances.. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. Results: About 61.0% (454/744) of the respondents had had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04–1.34), being 20–24 years of age (PR: 1.22, 95% CI: 1.04–1.44), being married (PR 1.15, 95% CI: 1.01–1.31) or divorced/separated (PR 1.43, 95% CI: 1.26–1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99–1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79–1.03) and using alcohol (PR 1.43, 95% CI: 1.25–1.69), marijuana (PR 1.16, 95% CI: 1.02–1.31) and khat (PR 1.25, 95% CI: 1.10–1.42) in the last 30 days. Conclusion: The study found that a high proportion of sexually active young people in informal settlements in Kampala, Uganda had engaged in sex under the influence of psychoactive substances in the past 30 days. The study also identified several factors associated with sex under the influence of psychoactive substances, including being female, being aged 20–24 years, being married or divorced or separated, not living with biological parents or guardians, and using alcohol, marijuana, or khat in the past 30 days. Our findings suggest the need for targeted sexual and reproductive health programs that incorporate risk-reduction interventions aimed at reducing sex under the influence of psychoactive substances, especially among females and those who do not live with their parents. [ABSTRACT FROM AUTHOR]

Background: Long-distance truck drivers (LDTDs) have a higher rate of HIV infection compared to the general population. This is due to their living and working conditions which predispose them to riskier sexual behaviours. Inadequate knowledge of HIV and AIDS, coupled with risky sexual behaviours such as unprotected sex with commercial sex workers (CSWs), predisposes LDTDs to contract and propagate HIV. This study aims to determine the factors associated with buying sex and the knowledge that condoms prevent HIV transmission among long-distance truck drivers at Kazungula weighbridge terminal in the Chobe District of Botswana. Methods: A cross-sectional descriptive survey was employed and 399 LDTDs participated. A questionnaire was used to collect sociodemographic data and information on knowledge of HIV and AIDS and the sexual behaviours of the LDTDs. Results: The results reveal that more than half of the LDTDs (56.9%; n = 227) had paid for sex with CSWs at some point in their travels, and 27.1% (n = 108) reported having had unprotected sex with CSWs. The LDTDs who preferred to have sex with CSWs without a condom had about five times the odds of buying sex with CSWs than those who preferred to use a condom (AOR 4.9; 95% CI 2.85–8.46). Disliking condom use was a factor contributing to less knowledge of condom use preventing HIV among the LDTDs (AOR 0.4; CI 0.17–0.97). Conclusion: It can be concluded from the results of this study that the LDTDs engage in considerable risky sexual behaviours, and associated factors were found to be multidimensional. This population remains of concern in HIV acquisition and transmission. Therefore, there is a need for a robust public health response to deal with the problem of both new infection and re-infection with HIV in this population. [ABSTRACT FROM AUTHOR]

Plain Language summary Sub-Sahara Africa is the only region in the world where the number of young people continues to increase greatly. Many of the new HIV infections among young people across the world happen in sub-Saharan Africa. Young people engage in unsafe sexual behaviours, such as having sex without a condom, beginning sexual intercourse at an early age and having sex with many partners, which increases their chance of getting infected with HIV. Testing for HIV helps in the early discovery of the virus which is crucial for effective HIV management and prevention. Increasing HIV testing is one of the health issues cherished by global health leaders. However, little is known about whether young people who engage in unsafe sexual behaviours utilize HIV testing services. The analysed data were collected as part of the 2017/2018 Multiple Indicator Cluster Survey across all the regions of Ghana. Our findings showed that many of the sexually active young people who participated in the survey had not tested for HIV, hence did not know their HIV status. Making matters worse, many of them engaged in unsafe sexual behaviours, such as unprotected sexual intercourse. Young people aged 20–24 years, those with higher education and married young women were more likely to utilize HIV testing services. To help end HIV as a public health threat by 2030, it is very necessary for stakeholders to educate young people about the dangers associated with unsafe sexual behaviours as well as encourage them to know their HIV status.

Plain language summary Risky sexual behaviour is most common among young people aged 15–24 years and is associated with an increase in sexually transmitted infections, including HIV/AIDS among this young productive age category. However, no adequate progress has been made in the reduction of these infectious diseases at the community level in South Africa. In this study, we investigate the effect of neighbourhood and individual-level factors leading to two measures of risky sexual behaviour; unprotected sex (non-condom use) and multiple sexual partnerships among young people. In this study, the target for young people in the South African context was because the country has a youthful population. Understanding the influence of neighbourhood and individual-level factors on the sexual behaviour of young people can help them live healthy as they transition to adulthood. We utilized cross-sectional data from the most recent South Africa Demographic and Health Survey, which was analyzed separately for males and females respectively, due to the cultural differences in sexual practices observed in many communities in South Africa. Our results confirmed an association between the neighbourhood and individual-level factors with youth engagement in risky sexual behaviour in South Africa. These results, imply that there is a need to review policies regarding the community-based interventions for sexual and reproductive health in other to reduce risky sexual behaviour among young people in South Africa.

Women’s sexual behavior affect their physical, psychological and social wellbeing. Neglecting the sexual and reproductive health of women can lead to high social and economic crisis. Benue state is one of the states in Nigeria which is worse hit by insurgency (BokoHaram) and comfits (Farmers-Herders conflict),leading to Migration of people. The increase in the number of internally displaced people in camps promoted this research. Though research works on risky sexual behaviours among youths abound, very little is currently known on the role of female migration in enhancing risky sexual behaviour in Makurdi, Benue state. This study makes use of primary and secondary data. A total of 205 questionnaires were administered using the purposive systematic random sampling technique. Result showed female migrates between the ages of 15- 34 years being involved in risky sexual behaviour compared to those that are 44years and above (53.7%and19.5%respective). Conflict and unemployment are the major causes of risky sexual behavior (29.3%and23.4%respective). 20.5% had multiple sexual pattern, 25 9% had casual sex without the use of condom. Pattern of movement was largely rural–urban. Increased alcohol consumption, depression, suicides, cancer, unwanted pregnancies, STDs are all consequences of risky sexual behavior. The Chi-square test was used for the level of significance between migration and risky sexual behaviour, and the findings showed apositive relationship between the two variables. This paper advocates the need to mitigate incidence of risky sexual behavior and provide policies that will ensure human security and economic empowerment

The issue discussed in the article focuses on risky sexual behaviours of adolescents. These behaviours increase the likelihood of contracting sexually transmitted diseases, which is associated with a frequent change of sexual partners. It is also engaging in sexual intercourse leading to accidental conception of a child. These behaviours are usually accompanied by inappropriate use of contraceptive methods and means to prevent unwanted pregnancy and venereal diseases infection. Risky sexual behaviour, especially in the case of adolescents, is therefore an important global health problem, including public health. Proper sexual development is one of the determinants of public health, as the future sexuality of adolescents depends on how they go through puberty. Based on the social and educational significance of this problem, the review article presents the results of the analysis of available scientific sources published in English and French. On the one hand, they indicate the factors contributing to early sexual initiation related to individual characteristics, condition of the family and non-family environment, and on the other hand, the consequences of engaging in sexual intercourse by adolescents. In addition to the problems mentioned in this article, these are, among others, mental health problems, alcohol and drugs use occurring during puberty. Moreover, adolescents with sexual experience are more likely to skip school more often and have fewer positive school experiences. This speaks in favour of knowing the factors accelerating and inhibiting the sexual debut, which is one of the conditions for effective prevention. [ABSTRACT FROM AUTHOR]

Arunachal Pradesh has been placed amongst the highest ranking states in terms of drug and substance use in the National Survey of 2019. Risky sexual behaviours are considered to be associated with an increasing use of drugs. The main objective of the study is to examine the intersection between injecting drug use and sexual behaviour and to assess the level of knowledge of HIV/AIDS among the injecting drug-using youths of Arunachal Pradesh. The data for the present study was collected on a structured questionnaire from a sample of 1000 youth from four study areas purposively selected. A significant number of them (14%) have reported or perceived to be injecting drug users. The cross-tabulation and Pearson Chi-square test is performed to test significant association between the variables. The results show that there is a high prevalence of risky sexual and injecting behaviours and poor level of knowledge on HIV/AIDS. A statistically significant association is established between the variables of drug use and risky sexual behaviours. However, delineating the direct causal relationship between drug use and sexual behaviour is considered to be a complex one, because a wide variety of socio-cultural and psychological factors influenced it. The paper concludes with the suggestion that future social research needs to focus on examining the social interaction and social relations of drug use and sexual activity. [ABSTRACT FROM AUTHOR]

HIV risk reduction counselling may reduce risk-taking behaviours. Yet, concerns remain about risk compensation among individuals initiating pre-exposure prophylaxis (PrEP). We assessed changes in risky sexual behaviour indicators among HIV vaccine preparedness study participants who received regular risk reduction counselling and referral for PrEP in Masaka, Uganda. Adults (18–39 years) at high risk of HIV infection were enrolled in the study between July 2018 and December 2021. Data were collected on socio-demographic factors (baseline) and self-reported sexual risk behaviours (baseline, six monthly). HIV testing and risk-reduction counselling and referral for PrEP were done quarterly. Participants who had completed at least 1 year of follow-up were included in the analysis. Proportional differences and McNemar chi-square tests were used to assess changes in the prevalence of self-reported risky sexual behaviour indicators between baseline and 1 year. Logistic regression was used to assess the predictors of unchanged/increased HIV risk at 1 year. Three hundred participants [132 (44%) females, 152 (51%) aged ≤24 years] were included in this analysis. Eighty-one (27%) participants initiated PrEP at 1 year. Compared to baseline, there were significant reductions in the prevalence of the following self-reported HIV risk indicators at 1 year (overall, among non-PrEP initiators, and among PrEP initiators): transactional sex, ≥6 sexual partners, unprotected sex with ≥3 partners, sex while drunk, and sexually transmitted infection diagnosis/treatment. Percentage differences ranged from 10% for individuals reporting at least six sexual partners to 30% for those reporting unprotected sex with three or fewer sexual partners. There was weak evidence of association between female gender and unchanged/increased HIV risk at 1 year (adjusted OR: 1.35, 95% CI (0.84–2.17)). No other indicators, including PrEP use, were associated with unchanged/increased HIV risk at 1 year. Regular risk-reduction counselling may reduce risky sexual behaviour, while PrEP initiation may not lead to risk compensation. [ABSTRACT FROM AUTHOR]

Introduction: The use of psychoactive substances increases the likelihood of unprotected sexual intercourse with individuals whose health status is not known, and consequently sexually transmitted infections, especially among young people. Despite this risk, there is limited evidence of the predictors of consistent condom use among young psychoactive substance users (YPSUs) in informal settings. This study examined the predictors of condom use among YPSUs in Kampala's informal settlements, Uganda. Methods: A cross-sectional study was conducted among 768 YPSUs. Respondent-driven sampling was used to recruit respondents. A structured questionnaire was used to collect respondent data on condom use. Data were analysed using Stata version 15.0. Prevalence ratios (PR) were used to determine the predictors of consistent condom use. Results: Out of the 744 YPSUs, only 37.4% of the respondents reported consistent condom use in the last 30 days. The prevalence of condom use was statistically lower among young people aged 20–24 years (35.4%) compared to those aged 18–19 years (43.7%), and among the married (17.3%) compared to respondents with a “single” marital status (43.0%). Being married (PR 0.42, 95% CI: 0.30–0.59), longer duration between meeting the most recent partner and having initial sexual contact with them (7 months to 1 year: PR 0.56, 95% CI: 0.36–0.88; more than a year: PR 0.36, 95% CI: 0.17–0.75) was negatively associated with consistent condom use. Spending less than 24 h between meeting the most recent partner and having initial sexual contact was positively associated with consistent condom use (PR 1.60, 95% CI: 1.24–2.08). Conclusion: The prevalence of consistent condom use in the last 30 days among YPSUs was low. Marital status and the duration between meeting the most recent partner and initial sexual contact predicted consistent condom use. There is a need to intensify awareness on the importance of consistent condom use among young people.

Purpose: Interventions focused on promoting resilience or protective factors of youth have been proposed as a strategy for reducing risky behaviours associated with HIV infection among youth; however few studies have explored their effectiveness. This study assessed the impact of a resilience-based HIV prevention intervention (You Only Live Once) on risky sexual behaviours, resilience and protective factors of youth. Methods: A one-group pretest-posttest design was used. One hundred and ninety-seven youth aged 15–24 years were conveniently recruited from a non-profit organisation in Maluti-a-Phofung Local Municipality, South Africa and participated in a 12-session, resilience-based HIV intervention delivered over a 1-week period by trained adult facilitators. Outcomes of interest were assessed at baseline and 3-month follow-up using validated risky sexual behaviour measures, and Child and Youth Resilience Measure. Mixed effect logistic and linear regression models were formulated to assess the impact of the intervention on risky sexual behaviours; resilience and protective factors respectively. Results: Compared to baseline, participants at 3-month follow-up were 68 % less likely to have unprotected sex, 22 % less likely to regret their decision to engage in sexual activity and 0.4 % less likely to be pregnant or made someone pregnant. Conversely, participants at the 3-month follow-up had a higher propensity to engage in multiple sexual partnerships, transactional sex and intergenerational sex than baseline. Participants at 3-month follow-up had significant improvements in their scores of resilience, individual capacities and contextual factors that facilitate a sense of belonging (p

Abstract Background Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents. Methods Self-reported data were collected from 2573 Russian adolescents aged 13–17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB. Results Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB. Conclusions Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.

The purpose of this study is to explore the factors that youth identify as contributing to alcohol consumption, and more specifically its relation to risky sexual behaviour among youth. We employed an exploratory qualitative method using focus group discussions with 34 young people between the ages of 18-25-years-old in low socio-economic status communities in the Western Cape province of South Africa. Data were analyzed thematically utilizing Braun and Clarke's (2006) six-step thematic analysis process. We identified two thematic domains pertaining to alcohol consumption and risky sexual behaviour, namely individual and social factors, each comprising three themes. The individual factors thematic domain comprises intrapersonal influences, employment and educational attainment; while the social factors thematic domain includes interpersonal influences, social influences, and hope for the future. Youth living in low socio-economic status communities were thought to be at greater risk of alcohol misuse and subsequent risky behaviour, given the political and social history of marginalisation, systematic oppression, and social inequality. To address alcohol use and risky sexual behavior among youth, we recommend interventions with adolescents, parents or guardians, and the community. More specifically, interventions aimed at adolescents should focus on the transition to young adulthood. Interventions with parents should focus on their role in modelling and potentially regulating alcohol consumption. Finally, community interventions should centre on drinking behaviors, levels of drinking, what constitutes harmful drinking, and how to identify when treatment and recovery support is likely to be required. [ABSTRACT FROM AUTHOR]

Many studies have shown the HIV vulnerability of people with disabilities (PWD). This vulnerability is supported by risky sexual behaviours, which need to be well described. The objective of this study is to identify predictors of sexual behaviours at risk of HIV infection among PWD in Burkina Faso. We conducted a population-based cross-sectional study on disability and HIV in four regions in Burkina Faso. PWD were selected through a probabilistic method. The Washington Group Short questionnaire was used to identify PWD. Five sexual risk behaviours were considered in this analysis (having multiple sex partners, starting sex at an early age, having had sex with a nonregular partner, sex in return for payment and condomless sex). A composite variable was created and called "risky sexual behaviour (RSB)", which was defined in three categories (low risk, moderate risk and high risk) based on the co-occurrence of the individual sexual risk behaviours. Generalized structural equation was used to identify the predictors of RSB withincome possession as a mediator. A total of 973 PWD were included in this study. The proportion of PWD who were engaged in at least two risky sexual behaviours was 9.5% (95%CI: 6.5–13.8), those with one risky sexual behaviour represented 42.8% (95%CI: 39.4–46.3) and less than half (47.7% (95%CI: 43.3–52.1)) werenot engaged in risky sexual behaviour. The prevalence of HIV increased with the level of risky sexual behaviour. Age, education level and type of disability have a significant direct effect on RSB. Indeed, the oddof engaging in sexual risk behaviour was low among PWD who attended at least secondary school compared to those who were not schooled (adjusted odds ratio (aOR): 0.62 (95%CI: 0.41–0.92). The indirect effect of sex on RSB mediating by income possession was significant. Indeed, women with income have a low oddof engaging in RSB compared to men (aOR: 0.83 [95%CI: 0.71–0.98]). Our results confirm a certain ambivalence in the sexuality of people with disabilities. Hence, there is a need for a particular focus on risky sexual behaviour to enable the development of an effective HIV strategy in this group. [ABSTRACT FROM AUTHOR]

The global trend of poorer outcomes across the HIV treatment cascade for men has drawn attention to the importance of engaging men in prevention and treatment services. The South African construction industry is one of the economic sectors most adversely affected by HIV/AIDS. Previous research on HIV testing behaviour among workers in the industry has revealed that male workers are less likely to be tested than female workers. Given this gender differential, this study employed a field-administered survey to gather data from 450 site-based, male construction workers in Western Cape, South Africa. An integrated model comprising demographic, cognitive, and behavioural factors was then hypothesised to explain HIV testing behaviour. Bivariate analysis and structural equation modelling were then used to test the model. Findings indicate that HIV knowledge, having previously had an STI, and possessing a positive attitude towards HIV testing are terminal predictors of testing behaviour. As a strategy for positively influencing testing behaviour, employers should ensure that effective communication about HIV testing is established with workers across all levels of education and ethnic groups. Interventions relating to risky sexual behaviour need particular attention, and where possible HIV testing should be coupled with general STI screening. [ABSTRACT FROM AUTHOR]

Beside age, underlying comorbidities and availability of sanitation facilities, individual health beliefs and behaviour are critical in combating the sustained prevalence of Covid-19. Behaviour has, however, been shown to be consistent but could be context-dependent based on the individual's beliefs. To investigate whether or not individuals' protective behaviour against coronavirus is associated with their behaviour in a previous health context. Facemask usage and engagement in risky sexual behaviour (RSB) were employed as corollaries of Covid-19 protective behaviour and a previous health context respectively. Data on them and other sociodemographic correlates of health behaviour were collected on 522 Nigerians via a web-based survey. The data were analyzed using frequency, Chi Square and Binary Logistics Regression. About 31% of the population wore facemasks in public, 48.1% believed Covid existed and was severe, and 31.6% had engaged in RSB. Individuals who engaged in RSB had lower odds of wearing facemasks in public in both the general population and across the rural-urban divide. The relationship was, however, only statistically significant (OR:0.642, p<0.05) in the adjusted regression model. Other significant determinants of facemask use were gender, place of residence, employment status and beliefs about Covid. The similarity of individual beliefs and behaviours in different health contexts provides an opportunity to model behaviour change communication policies for preventing and combating the spread of coronavirus and other infectious diseases. [ABSTRACT FROM AUTHOR]

In sub-Saharan Africa, women bear a disproportionate burden of HIV/AIDS while also facing economic and gender inequalities. To explore the association of women's economic contribution and relationship status with risky sexual behaviour, this study analysed cross-sectional data from 626 women aged 22 to 84 in rural South Africa. All women were enrolled in a microfinance plus gender training programme (Intervention with Microfinance for AIDS and Gender Equity (IMAGE)). We used univariable and multivariable logistic regression to explore the associations of relationship status and women's household income contribution with inconsistent condom use, multiple sexual partners and transactional sex, respectively. We found that married, older women had the highest odds of inconsistent condom use, while those contributing all the household income had higher odds of multiple sexual partnerships, but lower odds of transactional sex compared to those with no contribution. Income contribution and relationship status have a nuanced relationship with sexual risk behaviours. Thus, economic strengthening interventions should target relevant vulnerable women while also addressing the broader social and economic drivers of risky sexual behaviour. [ABSTRACT FROM AUTHOR]

Background: Afro-Indians, locally known as Siddi, are the tribal community descended from the Bantu populace from eastern Africa found in Goa, Gujarat and Karnataka along the Indian west coast. This study determines knowledge, attitude and sexual behaviour amongst the Siddi population in the Udupi district. Materials and Methods: A cross-sectional study was conducted from October 2018 to September 2019; men and women aged above 18 years who lived in the locality at the time of the survey were included in the study. Results: A total of 108 Siddi individuals participated in this study. The mean age of the respondents was 31.8 ± 9.5 years. More than half (51.8%) of the respondents received information on sexual matters through friends. Awareness regarding the usage of condoms and other preventive measures was poor (34.7%). Around 65.7% of the respondents felt that sex education in school encourages sex amongst youngsters. The mean age at the first sexual intercourse amongst men and women was 20.3 years and 16.2 years, respectively. About 18.7% of the respondents had sex with a new partner in the migrated place within the last 1 month, of which 80% were married. Only 5% of the respondents used condoms while indulging in sex with a new partner at the migrated place. Factors such as age at marriage, age at the first sexual act and attitude towards sexual activity were significantly associated with a new sex partner at the arrival site. Conclusion: There is a high prevalence of unsafe sexual practices amongst the migrated Siddi tribe at the place of destination. This poses the risk of sexually transmitted infections amongst the migrant tribes and local communities at the place of destination and the location of origin. The study finding shows that measures should be taken to create awareness, and change in attitude towards sexual matter should be channelised at an early age amongst the Siddi population.

Risky sexual behaviour increases the vulnerability of an adolescents to reproductive health problems like sexually transmitted infections (STIs), unintended pregnancy and abortion. This study therefore investigated the prevalence and personal predictors of risky sexual behaviour among in-school adolescents in the Ikenne Local Government Area, of Ogun State, Nigeria. The study employed a descriptive cross-sectional design. A multi-stage sampling technique was used to select 716 participants for the study. A validated semi-structured questionnaire with a Cronbach's alpha score of 0.78 was used to collect data. Frequency and logistic regression analysis were conducted to give statistical responses to the research question and hypotheses using SPSS version 23. The mean age of the participants was 15.2 ± 1.4 years and 57.3% of the respondents were female. Above a quarter (35.5%) of the respondents were in senior secondary one (SS1) in high school. More than half (53.1%) of the respondents had a good level of knowledge about risky sexual behaviour and 54% of the respondents had a fair perception of it. The respondents' attitudes towards risky sexual behaviour was moderately high (61.2%). The respondents had moderately high (63.7%) self-esteem. The prevalence of risky sexual behaviour was 19.2%. The personal predictors of risky sexual behaviour are age [odds ratio (OR) = 3.21; p < 0.05); gender [OR = 1.86; confidence interval (CI): 1.26-2.69; p < 0.05]; perception (OR = 2.58; CI: 1.55-4.30; p < 0.05); attitude (OR = 4.58; CI: 1.61-13.05; p < 0.05); self-esteem (OR = 7.39; p < 0.05). In conclusion, the respondents' risky sexual behaviours are predicted by age, gender, attitude, perception and self-esteem. The study therefore recommends that educational materials about the negative effects of the risky sexual behaviours should be included in the curriculum of secondary schools. [ABSTRACT FROM AUTHOR]

Background: Young people have a higher chance of experimenting with sex before marriage, thus they engage in risky sexual behaviours that predispose them to HIV infections. The objective of this study was to assess the relationship between engaging in risky sexual behaviours and the uptake of HIV testing services among young people in Ghana. Methods: We analysed secondary data from the 2017/2018 Ghana Multiple Indicator Cluster Survey, which collected data on population and health indicators across the previous ten regions of Ghana, using a Computer Personal Assisted Interviewing application. Data were analysed using descriptive statistics, Chi-square test and Binomial Logistic regression. Results: Seventy-nine per cent (79%) of young women and 68% of young men did not use a condom during last sexual intercourse. In addition, 68% of young women and 87% of young men had not tested for HIV. Young women (AOR = 2.19; 95% CI 1.56–3.07) and young men (AOR = 3.38; 95% CI 1.18–9.64) aged 20–24 years had a higher likelihood of being tested for HIV compared to those aged 15–19 years. Young women with junior high school education (AOR = 2.03; 95% CI 1.08–3.81) were more likely to test for HIV compared with those who had pre-primary/no formal education. In addition, young women who were never married or in a union (AOR = 0.39; 95% CI 0.27–0.56) had 61% of reduced odds of being tested for HIV compared with those who were currently married or in a union. There was no significant association between risky sexual behaviours and HIV testing (p > 0.05). Conclusion: This study demonstrated that condom use among sexually active young people was low. The uptake of HIV testing services was below expectation. Age, educational status, marital status and exposure to the mass media were the salient factors influencing the uptake of HIV testing among young people. Stakeholders should implement interventions to help increase the uptake of HIV testing and condom use among young people in Ghana. Plain Language summary: Sub-Sahara Africa is the only region in the world where the number of young people continues to increase greatly. Many of the new HIV infections among young people across the world happen in sub-Saharan Africa. Young people engage in unsafe sexual behaviours, such as having sex without a condom, beginning sexual intercourse at an early age and having sex with many partners, which increases their chance of getting infected with HIV. Testing for HIV helps in the early discovery of the virus which is crucial for effective HIV management and prevention. Increasing HIV testing is one of the health issues cherished by global health leaders. However, little is known about whether young people who engage in unsafe sexual behaviours utilize HIV testing services. The analysed data were collected as part of the 2017/2018 Multiple Indicator Cluster Survey across all the regions of Ghana. Our findings showed that many of the sexually active young people who participated in the survey had not tested for HIV, hence did not know their HIV status. Making matters worse, many of them engaged in unsafe sexual behaviours, such as unprotected sexual intercourse. Young people aged 20–24 years, those with higher education and married young women were more likely to utilize HIV testing services. To help end HIV as a public health threat by 2030, it is very necessary for stakeholders to educate young people about the dangers associated with unsafe sexual behaviours as well as encourage them to know their HIV status. [ABSTRACT FROM AUTHOR]

Background: Despite national and international commitments and efforts to prevent risky sexual behaviours, a high proportion of young people in South Africa are engaged in risky sexual behaviour. However, most efforts are currently directed toward addressing individual-level factors at the expense of not addressing neighbourhood-level determinants such as social disorganisation, contributing to risky sexual behaviour among young people in South Africa. This study investigated the multilevel factors of risky sexual behaviours among young people by gender in South Africa, using the lens of socio-ecological and social disorganisation frameworks. Methods: Data from a nationally representative sample of 1268 males and 2621 females aged 15–24 years, giving a total of, 3889 never-married youths, were drawn from the 2016 South Africa Demographic and Health Survey. Analysis was conducted using multilevel mixed-effect logistic regressions with random community-level effects. Results: Findings show that youth who were from a heterogeneous ethnic group (AOR = 0.49, CI: 0.35–0.67), household size of 5 + members (AOR = 0.78, CI: 0.54–1.15), community education (AOR = 0.97, CI: 0.72–1.32) were associated with low engagement in multiple sexual partnerships. Youths who were employed (AOR = 0.84, CI: 0.59–1.18), and from high-level community poverty (AOR = 0.76, CI: 0.58–1.00) were also associated with reduced odds of unprotected sex. In addition, older youth aged 20–24 years (AOR = 12.6, CI: 9.93–16.00); secondary education attainment (AOR = 1.01, CI 0.58–1.77); family structure (AOR = 1.37, CI: 0.75–1.15); Gauteng province (AOR = 1.45 CI: 0.92–2.28); residential mobility (AOR = 1.25, CI: 1.02–1.53), community media exposure to contraceptives (unprotected sex) (AOR = 1.38, CI: 1.09–1.76) were more likely to engage in risky sexual behaviour. Conclusion: The study revealed that neighbourhood and individual-level factors were important in explaining the factors associated with risky sexual behaviour among young people in South Africa. In addition, engagement in risky sexual behaviour was high, with minimal variation among young females and males in South Africa. It specifies that the practice of risky sexual behaviour is significantly associated with multilevel factors of social disorganisation that cut across gender. These results imply that there is a need to review policies of sexual risks reduction for each gender, which might help mitigate the adverse effects of social disorganisation for women and men youths in South Africa. Plain language summary: Risky sexual behaviour is most common among young people aged 15–24 years and is associated with an increase in sexually transmitted infections, including HIV/AIDS among this young productive age category. However, no adequate progress has been made in the reduction of these infectious diseases at the community level in South Africa. In this study, we investigate the effect of neighbourhood and individual-level factors leading to two measures of risky sexual behaviour; unprotected sex (non-condom use) and multiple sexual partnerships among young people. In this study, the target for young people in the South African context was because the country has a youthful population. Understanding the influence of neighbourhood and individual-level factors on the sexual behaviour of young people can help them live healthy as they transition to adulthood. We utilized cross-sectional data from the most recent South Africa Demographic and Health Survey, which was analyzed separately for males and females respectively, due to the cultural differences in sexual practices observed in many communities in South Africa. Our results confirmed an association between the neighbourhood and individual-level factors with youth engagement in risky sexual behaviour in South Africa. These results, imply that there is a need to review policies regarding the community-based interventions for sexual and reproductive health in other to reduce risky sexual behaviour among young people in South Africa. [ABSTRACT FROM AUTHOR]

Knowledge of sexual and reproductive health (SRH) and access to accurate information on it among adolescents remains a major challenge in Nigeria. This study assessed the SRH knowledge, attitudes and behaviours of in-school adolescents in Benin City, Nigeria. This cross-sectional study was carried out among 630 adolescents in Benin City. The respondents were selected using multi staged sampling technique. An adapted interviewer-administered questionnaire was used for data collection. Data analysis was carried out using IBM SPSS version 25.0 software. The mean age of the adolescents comprising 328 (52.1%) females and 302 (47.9%) males was 14.9 ± 1.3 years. Although 561 (89.0%) adolescents were aware of SRH, only 107 (19.1%) had good knowledge of it. Most of them 587 (93.2%) demonstrated positive attitude towards SRH. Thirty-nine (6.2%) were sexually active with 30 (76.9%) having their sexual debut before the age of 15 years, 14 (35.9%) had more than one sexual partner while only 13 (39.4%) consistently used condom during sexual intercourse. Seventeen (43.6%) had experienced vaginal/penile discharge, 6 (15.4%) had been tested for STIs, 25 (64.1%) had received treatment for STIs with home treatment 16 (64.0%) being the predominant choice. This study revealed that the overall knowledge of SRH among in-school adolescents in Benin City was poor, but most of them displayed a positive towards SRH. Although only few of the adolescents were sexually active, the prevalence of risky sexual behaviour was high among them and they also exhibit poor SRH seeking behaviour. [ABSTRACT FROM AUTHOR]

Teshome Kabeta,1 Merga Belina,2 Mamo Nigatu1 1Jimma University, Institute of Health, Faculty of Public Health, Department of Epidemiology, Jimma, Oromia, Ethiopia; 2Addis Ababa University, College of Natural and Computational Sciences, Department of Statistics, Addis Ababa, EthiopiaCorrespondence: Teshome KabetaJimma University, Institute of Health, Faculty of Public Health, Department of Epidemiology, Jimma, EthiopiaTel +251911794169Email tka1204@gmail.comBackground: Human immuno-deficiency virus (HIV) counseling affirms that people exercise the right to know their HIV status, which opens the gateway to care, treatment, and support for a person in need. HIV counseling and testing uptake among sexually active males in Ethiopia is too low. Moreover, existing studies were not done at country level and the contributing factors were not well studied. Therefore, the aim of this study is to determine the status of uptake and identify its correlates using the 2016 Ethiopia Demographic and Health Survey.Methods: Data on 12,688 participants were utilized in this study. Descriptive statistics and multilevel logistic regression were used to summarize the data and investigate the associations between predictors and HIV counseling and testing uptake.Results: The overall HIV voluntary counseling and testing uptake among sexually active men in Ethiopia was 45.69%; 95% CI [43.08%, 48.33%]. About 13% of the variation in the likelihood of being tested for HIV was due to the variation among the regions. On the other hand, age, religion, education, occupation, marital status, HIV knowledge, health insurance coverage, wealth status, risky sexual behavior, family planning discussion with health workers, owning a mobile, frequency of watching television, and listening to the radio were significantly associated with the uptake of HIV voluntary counseling and testing.Conclusion: HIV voluntary counseling and testing uptake in Ethiopia is still low and varies across the regions, which might hamper the ambitious plan of Ethiopia to end AIDS as a public health threat by 2030. Therefore, giving due consideration to scale up HIV knowledge to avoid risky sexual behavior, improving access to health insurance and media, and working on the significant modifiable sociodemographic determinants are worthy to boost HIV voluntary counselling and testing uptake, which is an integral component of the strategies to efficiently prevent and control HIV.Keywords: Ethiopia, risky sexual behavior, sexually active men, voluntary HIV counseling and testing

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Risky sexual behaviour (RSB) is defined as behaviours leading to sexually transmitted diseases and unintended pregnancies. According to the Joint United Nations Program on HIV/AIDS, HIV infection was very high among adolescents and youths living in sub-Saharan Africa including Ethiopia. This study was aimed to assess the prevalence of RSB and associated factors among undergraduate students at the University of Gondar. An institution-based cross-sectional study was conducted from June to July 2019 and a simple random sampling technique was employed to select 420 students. Data were collected using a structured self-administered questionnaire, entered into Epi-info version 7.0 and exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis, and presented in frequencies, percentages and tables. Bivariable and multivariable logistic regression analysis were carried out to identify variables having significant association with RSB. The prevalence of RSB among undergraduate students at the University of Gondar was 44.0%. Age [adjusted odds ratio (AOR): 2.12; 95% confidence interval (CI) (1.19–3.79)], residence [AOR: 2.14; 95% CI (1.22–3.75)], living arrangement [AOR: 9.79; 95% CI (5.34–17.9)], daily religious attendance[AOR: 0.57; 95% CI (0.33–0.99)], drink alcohol [AOR: 9.19; 95% CI (3.74–22.59)] and having information about reproductive health and sexually transmitted diseases [AOR:3.05; 95% CI (1.00–9.27)] were factors significantly associated with RSB. Nearly half of the respondents engaged in risky sexual activity. This prevalence is high and the students are at high risk of exposure to sexually transmitted diseases that need reproductive health intervention like counselling and discussion. Creating awareness is needed for the students regarding reproductive health and the risk of sexually transmitted diseases. In addition, giving special attention is required for students who use alcohol, who did not live with family and who have urban residence. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Gender disparities are pronounced in Zomba district, Malawi. Among women aged 15-49 years, HIV prevalence is 16.8%, compared with 9.3% among men of the same age. Complex structural factors are associated with risky sexual behaviour leading to HIV infection. This study's objective was to explore associations between multilevel measures of economic resources and women's empowerment with risky sexual behaviour among young women in Zomba. Four measures of risky sexual behaviour were examined: ever had sex, condom use and two indices measuring age during sexual activity and partner history. Multilevel regression models and regression models with cluster-robust standard errors were used to estimate associations, stratified by school enrolment status. Among the schoolgirl stratum, the percentage of girls enrolled in school at the community level had protective associations with ever having sex (OR = 0.76; 95% CI: 0.60, 0.96) and condom use (OR = 1.06; 95% CI: 1.01, 1.11). Belief in the right to refuse sex was protective against ever having sex (OR = 0.76; 95% CI: 0.60, 0.96). Participants from households with no secondary school education had higher odds of ever having sex (OR = 1.59; 95% CI: 1.14, 2.22). Among the dropout stratum, participants who had not achieved a secondary school level of education had riskier Age Factor and Partner History Factor scores (β = 0.51; 95% CI: 0.23, 0.79, and β = 0.24; 95% CI: 0.07, 0.41, respectively). Participants from households without a secondary school level of education had riskier Age Factor scores (β = 0.26; 95% CI: 0.03, 0.48). Across strata, the most consistent variables associated with risky sexual behaviour were those related to education, including girl's level of education, highest level of education of her household of origin and the community percentage of girls enrolled in school. These results suggest that programmes seeking to reduce risky sexual behaviour among young women in Malawi should consider the role of improving access to education at multiple levels. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Evidence suggests that improved quality of life that follow antiretroviral therapy (ART) may be accompanied by increased sexual activity and risky sexual behaviour. Thus, this study aimed to determine the proportion of HIV infected people on first line ART who were sexually active, the prevalence of risky sexual behaviour defined as unprotected vaginal sex and factors influencing risk sexual behaviour among HIV-infected people on first -line ART in Kigeme District Hospital. METHODS: A cross-sectional study with a quantitative survey method was conducted among 358 HIV infected people on first line ART and an adopted structured questionnaire was used for data collection. STATA version 13 was used for data analysis and binary logistic regression was used to obtain adjusted odd ratio (AOR) with a 95% CI. RESULTS: Findings revealed that 68% of respondents were sexually active in the last 12 months of the interview and the prevalence of risky sexual behaviour among HIV infected people on the first line ART was 38%. Risky sexual behaviour was found to be significantly associated with age range of 30-40 year olds (AOR: 2.468, 95%CI: 1.007-2.046, P=0.048), having sex with HIV-positive partner ( AOR: 2.830, 95%CI: 1.351-5.928, P=0.006) and alcohol use prior to sexual activity (AOR: 2.347, 95%CI: 1.216-4.528, P=0.011). CONCLUSION: The majority of HIV infected people receiving the first-line ART are sexually active and the prevalence of risky sexual behaviour is significant hence effort should be put forth to target this group. Reinforcing behaviour change communication and discouraging alcohol use among HIV infected people receiving the first-line ART is recommended. Keywords:

Abstract Background Difficulty in accessing sexual and reproductive healthcare is one of the challenges young refugee women face worldwide, in addition to sexual exploitation, violence and abuse. Although Ghana hosts several refugees, little is known about their sexual behaviour and contraceptive use. This study assesses sexual behaviour and contraceptive use among female adolescent refugees in Ghana. Methods A cross-sectional survey was conducted between June and August 2016. Respondents comprised 242 female adolescent refugees aged 14–19 years. Structured validated questionnaires were used to collect data. Descriptive statistical methods and multivariate logistic regression statistical analyses methods were used to analyze data. Findings Over 78% of respondents have had penetrative sex; 43% have had coerced sex; 71% have had transactional sex; 36% have had sex while drunk, 57% have had 4–6 sexual partners in the last 12 months before the study, and 38% have had both coerced and transactional sex. Factors that predicted ever having transactional sex included being aged 14–16 compared to those aged 17–19 (AOR =4·80; 95% CI = 2·55–9·04); being from Liberia compared to being from Ghana (AOR = 3·05; 95% CI = 1.69–13·49); having a mother who had no formal education compared to having a mother with tertiary education (AOR = 5.75; 95CI = 1.94–14.99); and living alone (self) compared to living with parents (AOR = 3.77; 95CI = 1.38–10.33). However, having 1–3 sexual partners in the last 12 months as against having 4–6 partners significantly reduced the odds of ever having transactional sex (AOR = 0·02; 95% CI = 0·01–0·08). Awareness about contraceptives was 65%, while ever use of contraceptives was 12%. However, contraceptive use at last sexual intercourse was 8.2%, and current use was 7.3%. Contraceptive use was relatively higher among those who have never had sex while drunk, as well as among those who have never had transactional sex and coerced sex. Contraceptive use was similarly higher among those who had 1–3 sexual partners in the last 12 months compared to those who had 4–6 during the same time period. Conclusion In this time of global migration crises, addressing disparities in knowledge and access to contraception as well as high risk sexual behaviours in refugee situations is important for reducing inequalities in reproductive health outcomes and ensuring both universal health coverage and global health justice. Sex and contraception education and counselling, self-efficacy training, and skills acquisition are needed to help young refugee women negotiate and practice safe sex and resist sexual pressures.

Abstract Introduction The South African public health system plays an important role in the delivery of HIV testing and treatment services. The health system is also an important conduit for targeted behaviour change communication with the expectation that clients who undergo counselling from health personnel, adopt safer sexual practices. Literature remains mixed on the impact these HIV services have on risky sexual behaviour. This analysis examines the sexual behaviour of clients following the utilisation of HIV testing and treatment services in Kwazulu-Natal, South Africa. Methods Data were used from two consecutive cross-sectional household surveys undertaken from June 2014 to June 2015 (2014/2015 survey) and from July 2015 to June 2016 (2015/2016 survey) in the uMgungundlovu District of KwaZulu-Natal, South Africa. Collectively, 20,048 randomly selected individuals aged 15 to 49 years old were interviewed across the two surveys. Utilisation of HIV testing and treatment services were used as independent variables and three sexual risk behaviours were used as dependent variables. Multiple regression models assessed the impact HIV testing and treatment services had on sexual risk behaviour while controlling for socio-demographic characteristics. Results Having tested for HIV had no association with any of the three sexual risk behaviours. However, receiving an HIV positive diagnosis reduced the likelihood of using condoms inconsistently with the respondents’ most recent partner (AOR: 0.64; 95% CI 0.54–0.77). Antiretroviral use was negatively associated with inconsistent condom use (AOR: 0.45; 95% CI 0.35–0.58) and number of sexual partners in the previous year (AOR: 0.61; 95% CI 0.46–0.81). Conclusions Results indicate that HIV testing and treatment services and the assumed exposure of clients to behaviour change communication, had a limited effect in reducing risky sexual behaviour. Data suggests that the engagement between health personnel and individuals accessing HIV testing and treatment services does not necessarily translate into the adoption of safer sexual practices, with the exception of individuals testing positive for HIV and those on ARV treatment, who had adopted safer sexual practices.

Abstract Background Many studies have focused on risky sexual behaviour among adolescents and young adults; however, literature on protective sexual practices among this age cohort is still evolving. Since young adults are disproportionately burdened by sexually transmissible infections, including HIV, understanding factors that influence protective sexual behaviour among the age group is crucial in developing age-appropriate interventions. Drawing from a cross-sectional survey conducted among adolescents and young adults in two Nigerian universities, we examined gender differences in protective sexual behaviours and the influence of family support and living with both parents on these behaviours. Methods A total of 800 male and female university students in two Nigerian universities were recruited using stratified random sampling between February and April 2018. Analysis was, however, based on 599 participants aged between 15 and 24 . Adjusted and unadjusted multinomial logistic regression models were used to examine the influence of family support, and living with both parents on protective sexual behaviours at a 95% confidence interval. Results Findings show that the largest proportion of our participants engaged in protective sexual behaviours. We found no gender differences in protective sexual behaviours, including sexual abstinence, consistent condom use, and sexual fidelity. Family support and living with both parents were positively associated with protective sexual behaviours among adolescents and young adults. Conclusion This study found that a majority of adolescents and young adults in Nigerian Universities engage in protective sexual behaviours. Adequate family support and living with both parents are positively associated with protective sexual behaviours. The study however revealed that about one-fifth of our participants engaged in high-risk sexual behaviour. This suggests a need for behavioural change interventions, provision of sexual health services and empowerment of students who receive inadequate family support.

Background: Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents. Methods: Self-reported data were collected from 2573 Russian adolescents aged 13–17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB. Results: Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB. Conclusions: Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB. [ABSTRACT FROM AUTHOR]

Background: Afro-Indians, locally known as Siddi, are the tribal community descended from the Bantu populace from eastern Africa found in Goa, Gujarat and Karnataka along the Indian west coast. This study determines knowledge, attitude and sexual behaviour amongst the Siddi population in the Udupi district. Materials and Methods: A cross-sectional study was conducted from October 2018 to September 2019; men and women aged above 18 years who lived in the locality at the time of the survey were included in the study. Results: A total of 108 Siddi individuals participated in this study. The mean age of the respondents was 31.8 ± 9.5 years. More than half (51.8%) of the respondents received information on sexual matters through friends. Awareness regarding the usage of condoms and other preventive measures was poor (34.7%). Around 65.7% of the respondents felt that sex education in school encourages sex amongst youngsters. The mean age at the first sexual intercourse amongst men and women was 20.3 years and 16.2 years, respectively. About 18.7% of the respondents had sex with a new partner in the migrated place within the last 1 month, of which 80% were married. Only 5% of the respondents used condoms while indulging in sex with a new partner at the migrated place. Factors such as age at marriage, age at the first sexual act and attitude towards sexual activity were significantly associated with a new sex partner at the arrival site. Conclusion: There is a high prevalence of unsafe sexual practices amongst the migrated Siddi tribe at the place of destination. This poses the risk of sexually transmitted infections amongst the migrant tribes and local communities at the place of destination and the location of origin. The study finding shows that measures should be taken to create awareness, and change in attitude towards sexual matter should be channelised at an early age amongst the Siddi population. [ABSTRACT FROM AUTHOR]

Aim: Risky sexual behaviours (RSB) among adolescents is one of the major public health concerns globally. These behaviours–RSB have adverse effects on their future health and well-being. Therefore, in this paper, our aim was to assess the determinants of RSB among in-school Namibian adolescents using the 2013 Global School-based Health Survey. Methods: The data was extracted and analysed with STATA version 14.2. Both bivariate and multivariable analyses were done to generate results that infomed the discussion. The results were presented as odds ratios and adjusted odds ratios (AOR) with their respective 95% confidence intervals (CI). Level of statistical significance was declared at a p-value of < 0.05. Results: Our results showed that of the 2846 adolescents surveyed, 51.8% reported they have ever had sexual intercourse. Fifty-eight percent reported having multiple sexual partners and 23.2% reported not using a condom during their last sexual intercourse. The multivariable analysis showed that age [AOR = 2.50; CI = 1.99–3.14], sex [AOR = 0.40; CI = 0.34–0.47], grade [AOR = 1.80; CI =1.38–2.36], suicidal ideation [AOR = 1.44; CI =1.16–1.79], bullying [AOR = 1.36; CI = 1.15–1.62], hunger [AOR = 1.39; CI = 1.17–1.64], alcohol use [AOR = 1.57; CI = 1.31–1.89], marijuana use [AOR = 1.98; CI = 1.14–3.45] and parental knowledge of activity [AOR = 0.82; CI = 0.68–0.99] showed statistically significant influence on sexual experience. Sex [AOR = 0.43; CI = 0.33–0.55], grade [AOR = 1.58; CI = 1.15–2.18], alcohol use [AOR = 1.37; CI =1.07–1.75], marijuana use [AOR = 2.23; CI = 1.11–4.46] and parental supervision [AOR = 0.76; CI = 0.59–0.98] were associated with multiple sexual partners. There was also statistically significant association between age [AOR = 0.32; CI = 0.21–0.48], loneliness [AOR = 1.49; CI = 1.04–2.14], number of close friends [AOR = 0.60; CI = 0.37–0.96] and parental supervision [AOR = 0.43; CI = 0.32–0.60] on non-condom use. Conclusion: These findings underscore the need for a pragmatic approach in addressing RSB among adolescents by adopting substance use prevention and mental health promotion programmes and by encouraging more parental involvement in activities of their adolescents. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Globally young people constitute one quarter of the population. They are the most vibrant and productive sector, but they are also prone to more risky sexual behaviour (RSB) with attendant negative consequences. In the Niger Delta Region of Nigeria, persistent conflicts and socioeconomic difficulty predisposes young people to risky conducts including RSB. The aim of this study is to explore the psychosocial correlates of risky sexual behaviour amongst students in the Niger Delta University, Bayelsa. METHODS: we undertook a descriptive cross-sectional survey of students in the university. A multistage random sampling technique was used to recruit 400 students who completed a self-administered questionnaire. The data collected was analyzed using SPSS version 20.0. RESULTS: out of the 400 students, 64.3% (257) engaged in RSB and 46.8% (187) were currently engaging in RSB. Rates of self-reported depression, suicidal ideation and attempt were 62.3% (249), 18.0% (72) and 14.3% (54) respectively. Independent correlates of RSB include being older than 19 years (aOR. 2.82; 95% C.I. 1.44 -5.51), male gender (aOR. 1.70; 95% C.I. 1.08-2.66), having depression (aOR. 1.83; 95% C.I. 1.15-2.92), being diagnosed with a sexually transmitted disease (STD)/HIV (aOR. 2.08; 95% C.I. 1.12-3.86), and having been taught about condoms (aOR. 1.80; 95% C.I. 1.13-2.86). CONCLUSION: risky sexual behaviours have negative psychosocial and health implications. Regular and continuous health education targeted at young people is essential to reduce the social and health effects associated with RSB.

Background: Sexually transmitted infection patient-initiated partner notification (PN) approach has been implemented over a decade in South Africa, however, use and update by patients has been limited. This study assessed the perceived use of patient-initiated PN by using referral slips and measured the level of acceptability of provider-initiated PN by using short message service (SMS) to the personal mobile phones of sexual partners. Methods: A formative evaluation approach using a quantitative survey amongst 722 minibus taxi drivers in nine major taxi ranks in Tshwane Municipality, Gauteng Province. STATA IC version 13 was used for data analyses. Results: The mean age of the participants was 37.2 years (59%) were single, 59.5% had multiple sexual partners, 52.2% did not use a condom during the last sexual act, 42.8% reported inconsistent use of condoms and 65% tested for HIV in the past 12 months. The majority (98.2%) understood the importance of PN, but 51% would prefer telling a sexual partner face to face. Perceived easiness of delivering a PN slip was 69.1%, and 93% would use a PN slip received from a partner. Acceptability of provider-initiated PN by using an SMS was 62.7% and about a third (32.5%) were not in favour of provider-initiated PN by SMS. Twenty four point 7 percent (24.7%) preferred patient-initiated PN and 24.3% preferred provider-initiated PN. Conclusion: Preferred patient-initiated and provider-initiated PN was almost equal, hence, the provider-initiated PN should be augmented to support the current patient-initiated PN to increase the overall STI notification.

INTRODUCTION: adolescent undergraduate students engage in sexual acts that put them at risk of contracting Sexually Transmitted Infections (STIs) and unwanted pregnancies. Even though the social context of early adolescence accounts for developmental changes in later phase of life, its impact on adolescents´ risky sexual behaviour has not been extensively explored. In this study, we examined how the social context of early adolescence influenced adolescent´s risky sexual behaviour in the university. METHODS: qualitative data were collected from 24 adolescent undergraduate students of four universities in South-eastern Nigeria. Both males and females, within the age of 16-19 years were interviewed. The data were coded, managed with the use of Atlas.ti software and thematically analysed. RESULTS: the findings indicated that risky sexual behaviours among adolescent undergraduate students are embedded in the quality of sex education by parents at early adolescence. As such, unprotected sex and multiple sexual partners were rampant among adolescents who were exposed to poor quality sex education at early adolescence. Adolescents whose parents are religious and/or authoritative but did not teach sex education during early adolescence engaged in risky sexual behaviours in the university. Also, adolescent undergraduate students that were raised in rural areas indulged in unprotected sex because of limited access to sex education during early adolescence. CONCLUSION: social context of early adolescence means a lot for adolescents´ sexual experience in later phase of life. When parents provide their children the right information about sex, it can protect them from risky sexual behaviours as they grow older.