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Background Methods Results Conclusions Assessing the potential increased risk of viral rebound (VR) in migrants requires adequate control for sex and acquisition risk groups.People living with HIV1, enrolled in the ANRS CO4‐French Hospital Database on HIV, who achieved virological suppression with antiretroviral therapy (ART) initiated between 2006 and 2016 were included. We first compared the risk of VR, with loss to follow‐up and death considered as competing events, across origin among the HIV acquisition groups, then across acquisition groups among the different origins, and finally across modality of a variable combining sex, acquisition group, and origin. Models were adjusted for clinical and biological confounding factors.We included 21 571 French natives (FRA), 10 148 migrants from sub‐Saharan Africa (SSA), 1137 migrants from the non‐French West Indies (NFWI), and 4205 other migrants (OTHER). The 5‐year probability of VR was 19% (95% confidence interval [CI] 19–20) overall, 15% in FRA, 21% in OTHER, 26% in SSA, and 34% in NFWI (p < 0.0001). It was 14% in men who have sex with men (MSM), 23% in heterosexual men, and 23% in women (p < 0.0001). After adjustment, all acquisition groups had a higher risk of VR than MSM from FRA, with men and women from NFWI having the highest risk (adjusted hazard ratio [aHR] 2.46; 95% CI 2.12–2.86 and aHR 2.59; 95% CI 2.20–3.04, respectively). Within each acquisition group, all groups of origin had a higher risk of VR than FRA. Within each region of origin, except the NFWI, heterosexual men had a higher risk of VR than MSM.After accounting for sex and acquisition group, migration, especially from NFWI, remains prognostic of VR. [ABSTRACT FROM AUTHOR]

Background: Improving HIV detection and prevention remains a critical public health initiative that requires policy-based solutions. This study sought to compare HIV detection/prevention behaviors before and after healthcare reform in Massachusetts, USA, among heterosexually active persons — the group with the highest reported number of undiagnosed HIV cases. The current study sought to (1) characterize differences in insurance coverage and HIV detection/prevention behaviors between cycles 1 (2006) to 5 (2019); (2) evaluate socio-demographic disparities in insurance coverage accounting for cycle; and (3) evaluate associations between health insurance coverage and HIV detection/prevention behaviors accounting for cycle and socio-demographics. Methods: This is a secondary analysis of the National HIV Behavioral Surveillance (NHBS) project: Boston HET cycle (i.e., made up of heterosexually active persons living in the Boston area) data. Descriptive, bivariate (e.g., chi-square), and multiple logistic and negative binomial loglink regression analyses were conducted. Results: In chi-square analyses with post hoc Bonferroni tests, the proportion of participants with current health insurance significantly increased from cycle 1 (77%) to cycle 2 (95%), p <.001. In the regression models that controlled for NHBS cycle, 1-year change in age (adjusted odds ratio [aOR] = 1.03, 95% confidence interval [CI] = 1.02, 1.05), female gender (aOR = 3.41, 95% CI = 2.48, 4.69), and change in education category (aOR = 1.19, 95% CI = 1.02, 1.39) were associated with a higher likelihood of having health insurance. In regression models that controlled for cycle, age, gender, and education, participants with health insurance were more likely than those without insurance to report seeing a medical provider in the past year (aOR = 3.49, 95% CI = 2.32, 4.66), ever having an HIV test (aOR = 1.52, 95% CI = 0.35, 2.69) and more frequent HIV testing in the past 2 years (incidence rate ratio [IRR] = 1.44, 95% = 1.14, 1.82). Participants with health insurance did not differ from those without insurance in number of vaginal condomless sex partners (IRR = 1.16, 95% CI = 0.95, 1.41) but did report more condomless anal sex partners in the past year (IRR = 1.97, 95% CI = 1.46, 2.65). Conclusions: This study demonstrates how health insurance coverage is positively associated with HIV detection and prevention relevant to both US and international efforts to end the HIV epidemic. [ABSTRACT FROM AUTHOR]

This research explores the self-perceived impact of parental suicide in adolescence, of a father, on his daughter's intimate, heterosexual relationships in adulthood. The aim of the research was to ascertain if, and how, paternal suicide, in a young woman's adolescence, affects her intimate, heterosexual relationships, in adulthood. Four participants who had lost their fathers to suicide between the ages of 10 and 19, were interviewed, and transcripts were analysed using interpretative phenomenological analysis. The findings conclude that the majority of participants had experienced difficulties in establishing intimate relationships that fully met their needs. Participants perceived these factors were directly linked to their suicide loss. Four main group experiential themes arose from the data: isolation; connection with self and others; post-traumatic stress; and anxiety and shame. This research raises awareness for counsellors and helping professionals. [ABSTRACT FROM AUTHOR]

Background. The patterns of sexually transmitted infections (STIs) in populations may be influenced by the sexual mixing within the population. We aimed to investigate the assortative sexual mixing pattern by bisexuality in male-male partnerships. Methods. This was a retrospective repeated crosssectional study of men with mostly regular male partners attending the Melbourne Sexual Health Centre between 2011 and 2019. Data on sexual practices, including their sexual practices, presence of other male/female sex partners and the gender of sexual partners in the previous 3 and 12 months, were collected using computer-assisted self-interview. We calculated the proportion of male partnerships where at least one man in the partnership reported a female sex partner. Results. A total of 2056 male-male partnerships (i.e. 4112 individuals) with a median age of 29 years (IQR 25 to 35) were included. Overall, in 94.4% (1941/2056) of male-male partnerships both men had male partners only; however, in 5.5% (113/2056) of partnerships, one man had both male and female partners, and in 0.1% (2/2056) partnerships, both men had both male and female partners. No assortative relationship was found on the sexual mixing by bisexuality in male-male partnerships due to the low assortativity coefficient (r = 0.006, 95% CI: -0.004 to 0.016). Conclusion. One in 20male-male partnerships had at least one man who had both male and female partners within the preceding year. Individuals were not selective by bisexuality, suggesting that partnerships of bisexual individuals are mixed proportionately to the distribution of their characteristics. Still, these sexual mixing practices may affect STI transmission dynamics. [ABSTRACT FROM AUTHOR]

The extent to which receptive anal intercourse (RAI) increases the HIV acquisition risk of women compared to receptive vaginal intercourse (RVI) is poorly understood. We evaluated RAI practice over time and its association with HIV incidence during three prospective HIV cohorts of women: RV217, MTN-003 (VOICE), and HVTN 907. At baseline, 16% (RV 217), 18% (VOICE) of women reported RAI in the past 3 months and 27% (HVTN 907) in the past 6 months, with RAI declining during follow-up by around 3-fold. HIV incidence in the three cohorts was positively associated with reporting RAI at baseline, albeit not always significantly. The adjusted hazard rate ratios for potential confounders (aHR) were 1.1 (95% Confidence interval: 0.8-1.5) for VOICE and 3.3 (1.6-6.8) for RV 217, whereas the ratio of cumulative HIV incidence by RAI practice was 1.9 (0.6-6.0) for HVTN 907. For VOICE, the estimated magnitude of association increased slightly when using a time-varying RAI exposure definition (aHR = 1.2; 0.9-1.6), and for women reporting RAI at every follow-up survey (aHR = 2.0 (1.3-3.1)), though not for women reporting higher RAI frequency (> 30% acts being RAI vs. no RAI in the past 3 months; aHR = 0.7 (0.4-1.1)). Findings indicated precise estimation of the RAI/HIV association, following multiple RVI/RAI exposures, is sensitive to RAI exposure definition, which remain imperfectly measured. Information on RAI practices, RAI/RVI frequency, and condom use should be more systematically and precisely recorded and reported in studies looking at sexual behaviors and HIV seroconversions; standardized measures would aid comparability across geographies and over time.

Sexual minorities have higher rates of anxiety, depression, and binge eating compared to heterosexual peers. Internalized weight bias (IWB) is also higher for sexual minorities when compared to heterosexual peers. However, research has not examined whether the relationships between IWB and anxiety, depression, and binge eating differ among heterosexual and sexual minority adults pursuing bariatric surgery. To examine whether sexual orientation (heterosexual or sexual minority) moderated the relationships between IWB and anxiety, depression, and binge eating among adults pursuing bariatric surgery. University hospital, United States Participants included 811 adults who presented for bariatric surgery, 45 (5.5%) of which identified as a sexual minority. Self-reported data were collected as part of a standard preoperative psychological evaluation for surgical clearance. Three separate moderation models were run to test hypotheses. Sexual orientation did not moderate the association of IWB with anxiety or depression. The IWB by sexual orientation interaction was significant for binge eating (F 1856) = 4.84, P =.03, R2 =.27 such that the association between IWB and binge eating was significantly stronger for sexual minority patients (b =.54, 95% confidence interval {CI} [.36,.70]), compared to heterosexual patients (b =.33, 95% CI [.30,.38]). Minority stress from identifying as a sexual minority may increase vulnerability to binge eating from IWB among bariatric candidates. Future research examining the directionality of the relationship between IWB and binge eating among sexual minorities is warranted. • Internalized weight bias by sexual orientation was significant for binge eating. • This association was significantly stronger for sexual minority patients. • Minority stress may increase vulnerability to distress prior to bariatric surgery. [ABSTRACT FROM AUTHOR]

Civil partnerships first became available to mixed-sex couples in England and Wales in December 2019. To date, there has been no research exploring the perspectives of mixed-sex couples who choose to become civil partners. We interviewed 21 people, as individuals or in couples, who were considering, planning, or had already entered into a civil partnership. Our thematic analysis resulted in two themes. In Free from the patriarchal baggage of marriage: Civil partnership as a clean slate of equality, we discuss how participants portrayed marriage as imbued with problematic traditions. In contrast, civil partnerships were portrayed as a contemporary form of relationship recognition that was in fitting for them and their relationships. In the second theme, Doing thing differently? Rejecting or reimagining weddings we discuss how participants critiqued traditions to navigate whether and how to reject them entirely, or attempt to creatively reimagine them. We consider the implications of our results. [ABSTRACT FROM AUTHOR]

The article critiques the adaptation of the Transgender Attitudes and Beliefs Scale (TABS). While commending the modernization of language, the critique highlights methodological issues, including limited sample diversity, overemphasis on terminology changes, and a lack of test-retest reliability. Additionally, the study is criticized for inadequate theoretical engagement and insufficient exploration of practical applications, particularly in healthcare. Recommendations for future research include incorporating more diverse samples and deeper theoretical analysis to enhance the scale’s utility. [ABSTRACT FROM AUTHOR]

The transgender or Hijra community as they are called in India is one of the most marginalised communities within the country. The caste system which forms the fabric of an Indian mind set divides people into social hierarchies and a child born to a particular caste assumes this as their identity. This social stratification leads to exploitation of lower castes by those belonging to higher castes. The prejudices of various kinds that continue to exist make the life of the underprivileged and the marginalised extremely difficult. Disha, the focus of this chapter, represents one such community which has faced tremendous discrimination and has been denied basic fundamental rights of education and empowerment. Breaking the heterosexual patriarchy was not easy for her, yet she conquered her own demons and societal pressures and is today comfortable in her own sexual identity and is a spokesperson for fellow members of the transgender community. Through her story, this chapter elucidates an understanding of the challenges faced by transgender people in India. A semi-structured interview with Disha was conducted after taking her consent. She felt this would help sensitise the society and also inspire other transgender persons to discuss their experiences. The data collected from the interview enabled the author to identify the themes around which a discourse on this marginalised community could be encouraged. In conclusion, the author suggests a way forward to achieve protection and rehabilitation of transgender community. [ABSTRACT FROM AUTHOR]

The rise in opioid misuse coincides with increased sexually transmitted infection (STI) and HIV incidence. Transactional sex is an under-researched phenomenon among Black Americans who misuse opioids, and may increase their risk of STI or HIV transmission. Given the disproportionate impact of the opioid epidemic on Black Americans and the risks associated with opioid misuse, the current study aims to investigate sociostructural factors, history of violence, and sexual risk factors associated with transactional sex among Black men and women. A sample of n = 375 Black adult Kentuckians reporting opioid misuse completed a survey including transactional sex, sociostructural, violence history, and sexual risk measures. Results of chi-squares and independent samples t -tests revealed that compared to men who did not report engaging in transactional sex, men who engaged in transactional sex were less educated, reported being sexually assaulted or having an unwanted sexual experience in their lifetime, and were more likely to use opioids or cocaine before or during sex in the last year. Women who engaged in transactional sex had a history of violence, more structural barriers, higher psychological distress, and engaged in more sexual risk behaviors compared to women who did not engage in transactional sex. Implications for future research and interventions with this population are discussed. [ABSTRACT FROM AUTHOR]

People's attitudes toward members of the lesbian, gay, bisexual, and transgender (LGBT) community have been an important issue that has persisted in society through time. Researchers have conducted numerous studies to understand members of this sexual minority group. However, studies geared toward an understanding of transgender individuals have been minimal compared to other members of the LGBT community, especially in the Philippines, where there has been increased visibility of transgender people in mainstream media. Most Filipinos still have difficulty understanding and accepting the concept of transgender as a gender identity distinct from being gay or lesbian, which are sexual orientations. Thus, this descriptive cross-sectional study aims to describe the current attitudes of heterosexual cisgender Filipinos toward transgender individuals and compare these attitudes across Filipinos of different research demographic variables. A sample of 657 Filipinos from the Philippines (282 males; 375 females, 18 to 57 years old) completed the Attitudes Toward Transgender Men and Women Scale and the Transgender Attitudes and Beliefs scale. We compared hetero cisnormativity across groups on assigned sex at birth, religions, generations, and relationship statuses. Results show that cisgender heterosexual Filipinos who are males, married, Born Again Christians, and belong to Generation X still view transgender people negatively. We also compared the participants' attitudes toward trans men versus trans women. The results showed that Filipino participants in our study had more significant anti-transgender prejudice toward trans women than trans men. We also discussed the implications of our findings and future directions for research. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to compare differences in suicidality and self-harm between specific lesbian, gay and bisexual (LGB) groups, and investigate whether minority stress factors might contribute to any associations, addressing methodological limitations of previous research. Methods: We analysed data combined from two population-based representative household surveys of English adults (N = 10,443) sampled in 2007 and 2014. Using multivariable logistic regression models adjusted for age, gender, educational attainment, area-level deprivation, and common mental disorder, we tested the association between sexuality and three suicide-related outcomes: past-year suicidal thoughts, past-year suicide attempt, and lifetime non-suicidal self-harm (NSSH). We added bullying and discrimination (separately) to final models to explore whether these variables might mediate the associations. We tested for interactions with gender and survey year. Results: Lesbian/gay people were more likely to report past-year suicidal thoughts [adjusted odds ratio (AOR) = 2.20; 95% CI 1.08–4.50] than heterosexuals. No minority group had an increased probability of suicide attempt. Bisexual (AOR = 3.02; 95% CI = 1.78–5.11) and lesbian/gay (AOR = 3.19; 95% CI = 1.73–5.88) individuals were more likely to report lifetime NSSH than heterosexuals. There was some evidence to support a contribution of bullying in the association between lesbian/gay identity and past-year suicidal thoughts, and of each minority stress variable in the associations with NSSH. There was no interaction with gender or survey year. Conclusion: Specific LGB groups are at elevated risk of suicidal thoughts and NSSH, with a possible contribution of lifetime bullying and homophobic discrimination. These disparities show no temporal shift despite apparent increasing societal tolerance towards sexual minorities. [ABSTRACT FROM AUTHOR]

In South Africa, promises and legal progress notwithstanding, homophobia is still pervasive. LGBTQIA people experience serious rights violations, according to an analysis of numerous literary sources, especially journals, which was done for this article. They also encounter problems with their physical and mental well-being, face stigma and discrimination, and are not allowed to participate in cultural customs like customary male circumcision. It has been demonstrated that social work can be vital in ensuring that LGBTQIA people are able to exercise their rights, educate the public, and push for severe punishments for homophobes. [ABSTRACT FROM AUTHOR]

Sex differences in mating strategies and partner preferences are well established. However, most research solely focused on heterosexual women and men. We examined the mate selection, marriage, and age preferences of a sample of lesbian women, gay men, and bisexual women and men (LGB) who took part in an online dating survey. Additionally, we analyzed inter- and intrasexual differences in these preferences. A total of 710 participants rated the importance of 82 mate selection criteria and 10 marriage criteria, and they also indicated their age preferences and short-term and long-term relationship orientation. An exploratory factor analysis suggested 11 relevant domains of mate selection in the LGB sample, with sex, age, and long-term relationship orientation being relevant predictors of differences in these domains. We compared the LGB data with data collected from 21,245 heterosexual women and men on the same mate selection criteria. Results showed that the participants' sex was the most important predictor of differences in mate selection and marriage preferences, while intrasexual variables (sexual orientation and relationship orientation) explained only a small part of the variance. We incorporated the results into the current discussion about partner preferences and sexual orientation. [ABSTRACT FROM AUTHOR]

The present study aimed to explore whether lesbian women's preferences for a sperm donor or a long-term mate show a pattern similar to those of heterosexual women. Three hundred and eighty-three donor insemination patients, of whom 278 were heterosexual and 105 were lesbian, completed a questionnaire comprising a series of 35 traits and rated the importance of each trait in a sperm donor and again in a long term mate. Results showed that traits relating to socioeconomic status, genetic background and general health, physical appearance, and personality were rated by lesbian women as more important in a long-term mate than in a sperm donor. It was further found that both heterosexual and lesbian women attached higher importance to the socioeconomic status, personality and physical appearance of the long-term mate than of the sperm donor; heterosexual women attached similar importance to the genes and health of a long-term mate and a sperm donor, while lesbian women attached greater importance to the genetic background and general health of the sperm donor than those of a long-term mate. The implications and interpretations of the findings are discussed in light of Trivers' parental investment theory. [ABSTRACT FROM AUTHOR]

Despite numerous studies on sexual behaviors, there are limited studies investigating compatibility between two partners. The objective of this study was to review the factors associated with sexual compatibility in couples. A review study was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and through searching for published English and Persian articles on factors associated with sexual compatibility with a time limit up to December 2019. International and Iranian Electronic databases including Web of Science, PsycINFO, PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scientific Information Database (SID), Irandoc, and Magiran were searched using search terms relating to "sexual compatibility" and other equivalents. All quantitative and qualitative full-text studies that had addressed associated factors with sexual compatibility were included. Six quantitative articles and one qualitative article were selected based on the inclusion criteria. Sexual compatibility was related to self-awareness, mental body image, personality-psychological maturity, and some sexual behaviors of the subjects. Couples' sexual companionship was a necessary component for their sexual compatibility. Considering the association of sexual compatibility with variables such as positive self-awareness and mental body image, personality-psychological maturity, sexual behaviors, and sexual companionship, it seems that using these variables can help predict the sexual compatibility of couples. [ABSTRACT FROM AUTHOR]

Abstract This article offers a different interpretation of Leviticus 18:22, which has traditionally been seen as a scripture that forbids homosexuality. The Bible outright condemns various sexual orientations such as homosexuality, bisexuality, and bestiality; as a result, the Old Testament portrays heterosexuality as the proper sexual identity. The general reading of texts frequently devolves into pros and contras but leaves little room for other aspects of the text that can allow for a more transformative interpretation. In fact, when texts and the reality of today’s plurality in sexual orientations collide, dominant and judgmental meanings often result. Due to this, socio-ideological studies reread Leviticus 18:22 from an LGBT viewpoint in order to shed light on the Priest’s Tradition’s ideological role in promoting heterosexuality as its identity politics. This analysis gives space to the sociopolitical situation that gives the book its shape, departing from awareness and skepticism of the existence of other realities that are not described or even repressed in the text (behind the text). Hence, it is hoped that the text’s true meaning, one that liberates prejudice via conversation and creativity, might be recovered. Abstrak Artikel ini memberikan pembacaan alternatif terhadap teks Imamat 18:22 yang selama ini cenderung dipahami sebagai teks yang mengecam homoseksual. Teks secara eksplisit menolak beragam orientasi seksual seperti homoseksual, biseksual, bestialitas; dan dengan demikian menggambarkan heteroseksual sebagai identitas seksual yang benar dalam Perjanjian Lama. Pembacaan umum terhadap teks acap kali sekadar jatuh pada persoalan pro-kontra, namun tidak memberikan ruang terhadap dimensi lain dari teks yang mungkin memberikan pembacaan yang lebih transformatif. Sebab dalam faktanya, perjumpaan teks dengan realitas keberagaman orientasi seksual di masa kini cenderung memberikan makna yang menghegemoni dan menghakimi. Untuk itu, kajian sosio-ideologis berupaya menguak peran ideologis dari Tradisi Imam yang mempropagandakan heteroseksual sebagai politik identitasnya, serta membaca ulang teks Imamat 18:22 melalui perspektif LGBT. Berangkat dari kesadaran dan kecurigaan akan adanya realitas lain yang tidak digambarkan bahkan dibungkam dalam teks, kajian ini memberikan ruang terhadap situasi sosial-politik yang membentuk teks (di balik teks). Dengan demikian, diharapkan tercapai pemulihan makna dari teks yang membebaskan prasangka secara jujur, dialogis, dan kreatif.

Bullying and psychological distress among adolescents are considered serious social and public health concerns. Several research works concerning psychological distress among adolescents as a result of bullying experiences have been conducted but not many studies explore the differences in the bullying experiences of LGBT adolescents and their heterosexual counterparts. Therefore, the purpose of this study was to examine the comparative analyses of traditional bullying, cyberbullying, and psychological distress among heterosexual and LGBT adolescents in South Africa. The study adopted an ex-post-facto research design. A total of 140 respondents (73.6% self-identified as heterosexual and 26.4% as LGBT adolescents) who are students, were engaged using purposive random sampling. Participants completed the bullying victimisation components (B1 for the traditional bullying scale and B2 for cyberbullying scale) and the Kessler Psychological Distress Scale (K-10), which measures psychological distress among the study participants. Findings revealed that sexual orientations and gender identities do not significantly influence traditional-bullying victimisation among adolescents (t = 0.065, df = 138, p > .05). However, further analysis revealed that LGBT adolescents (ẋ=53.44; SD=05.03) reported higher experiences of cyberbullying, compared to their heterosexual counterparts (ẋ=45.84; SD=06.57). Consequently, LGBT adolescents (ẋ=30.28; SD=0.75) reported higher experiences of psychological distress because of cyberbullying victimisation, compared to their heterosexual counterparts (ẋ=24.87; SD=03.15). It is recommended that psychological assessments and insightful counselling should be encouraged among LGBT adolescents. The purposeful intervention might enable early identification of psychological problems, and in turn, enables early psychosocial interventions that will address the prevailing psychological distress experienced among LGBT adolescents because of bullying victimisation.

This study examined the role of partnership status (married, unmarried-partnered, and unpartnered) on retention in care among newly diagnosed (2013–2017), cisgender heterosexual people with HIV in Birmingham, Alabama (n = 152). This study evaluated all scheduled HIV primary care provider visits for two years following diagnosis date. A kept-visit measure was calculated such that, if an individual attended ≥1 visit in each of the four 6-month intervals, they were considered to have high visit constancy. A missed-visit measure was categorized as ≥1 no-show vs. 0 no-show for first and second year after diagnosis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression models. Models were adjusted for confounding sociodemographic and clinical characteristics. The study population was 76% Black, 57% male, median age of 37 years. Overall, 65% had high visit consistency and 34.5% had ≥1 no-show in both years. Compared to unpartnered, married individuals had higher visit constancy [AOR (95% CI): 2.88 (1.02, 8.16)]; no differences were observed among unmarried-partnered individuals. No differences in having ≥1 no-show among partnership status groups were observed for either year. These findings suggest potential success of interventions involving a social confidant in optimizing retention in care among newly diagnosed, heterosexual PWH. [ABSTRACT FROM AUTHOR]

This paper explores men's use of dating apps with an emergent body image focus, addressing cisgender, heterosexual men's feelings about dating app profile pictures. Drawing from interviews with 15 cisgender, heterosexual men residing in Australia about their use of dating applications including Tinder, Hinge, and Bumble, this paper examines how cisgender, heterosexual men construct their dating app profile pictures, and the decisions they make about the content of images they use for dating profile pictures. Utilizing concepts of self-presentation, authenticity, and bodily reflexive practices, this paper argues that the men in the study are attempting to present authentic and real selves in a dating world, while being confronted by concerns regarding body image and perceptions of ideal bodies. They also demonstrate conflicting desires to appear more muscular, fit, and athletic while not presenting as vain or narcissistic. In the process of creating profiles, these men develop a sense of self drawing on understandings of masculinity and specifically notions of idealized male bodies, which simultaneously run counter to the very authentic images of the self they seek to present. [ABSTRACT FROM AUTHOR]

Introduction: Genital ulcer disease (GUD) often creates diagnostic difficulty in developing countries like India, with limited resources available in the health-care system. The changing etiology in GUDs over the years makes it imperative that a correct diagnosis is made to establish appropriate treatment and formulate awareness programs. Aims: This study was done to determine the recent trends in the demographic parameters, clinical presentations, etiology of GUDs, and their association with human immunodeficiency virus (HIV). Materials and Methods: An observational cross-sectional study was conducted from October 2021 to August 2022 at the Dermatology Outpatient Department in our hospital. All the patients who presented with GUDs were included after written informed consent. The diagnosis of GUD was confirmed by thorough clinical examination and appropriate laboratory test. Data were entered and analyzed using IBM SPSS software. Results: Out of 135 cases of GUDs, the majority were males (79%). The most common age group was 21–30 years, with a mean age of 35.23 ± 14.98 years. Most of the patients were heterosexual (90%). Multiple sexual partners were found in 40% of cases. Herpes genitalis was the most common GUD (59%), followed by syphilis (15%). HIV infection was found in 6.6% of cases. Conclusion: This study represents the increasing burden of viral GUDs compared to the last three decades. The ulcerative sexually transmitted infection facilitates the transmission of HIV. In this HIV era, there is a need for increased efforts toward acknowledgment, safe sexual practices, periodic screening, and sexual health awareness programs in the high-risk population. [ABSTRACT FROM AUTHOR]

This study utilized a social constructivist lens to explore African American heterosexual men's attitudes toward marriage and provide an understanding of how African American heterosexual men conceptualize themselves in the context of marriage. Focus groups were conducted with African American heterosexual men aged 24–34 years old from a large, metropolitan midwestern city (N = 17). Participants were asked how they felt about marriage, how they thought their peers feel about marriage, and the positive and negative attributes of marriage. Thematic analysis revealed several themes including struggles of Black masculinity, dilemmas within the Black male-female dynamic, and role confusion; resulting in personal ambivalence about their decision to enter into marriage. Findings suggest that their conceptions of manhood in the context of American racism is the pretext that plays a significant role in the decision to take on important roles such as husband. Using Powell and Mattis (2005) Relational Framework of Masculinity, I discuss how African American men's conceptualization of manhood may contribute to how these men engage with significant life transitions, such as marriage. Suggestions for future research and practice implications for work with African American heterosexual men is also discussed. [ABSTRACT FROM AUTHOR]

Sexual satisfaction is a relevant indicator of sexual health, and psychotherapeutic interventions for sexual dysfunction also promote sexual satisfaction in men and women. Cognitive-behavioral psychotherapies for sexual dysfunction, including third-wave approaches, are effective in treating sexual dysfunction. Thus, third-wave cognitive-behavioral constructs may play a significant role in sexual satisfaction. This study intends to examine the predictive role of mindfulness awareness and attention, self-compassion and acceptance, and action constructs on cisgender heterosexual men's and women's sexual satisfaction. A web survey including self-report measures for assessing mindfulness awareness and attention (MAAS), self-compassion (SCS), acceptance and action (AAQ), and sexual satisfaction (GMSEX) was disseminated during 2022, and a sample of 420 participants was collected (n = 238 women; 56.7%; n = 182 men; 43.3%). No statistically significant differences were found between cisgender heterosexual men and women on mindfulness awareness and attention, self-compassion, acceptance and action, and sexual satisfaction. In addition, all variables account for 6.5% of cisgender heterosexual men's and women's sexual satisfaction variance, and mindfulness awareness and attention, self-compassion, and acceptance and action positively predicted sexual satisfaction. Overall, mindfulness awareness and attention, self-compassion, and acceptance and action play a significant predictive role in cisgender heterosexual men's and women's sexual satisfaction. [ABSTRACT FROM AUTHOR]

ProblemReceptive anal intercourse (RAI) is more efficient than receptive vaginal intercourse (RVI) at transmitting HIV, but its contribution to heterosexually acquired HIV infections among at-risk women in the USA is unclear.Method of studyWe analysed sexual behaviour data from surveys of 9152 low-income heterosexual women living in 20 cities with high rates of HIV conducted in 2010 and 2013 as part of US National HIV Behavioral Surveillance. We estimated RAI prevalence (past-year RAI) and RAI fraction (fraction of all sex acts (RVI and RAI) at the last sexual episode that were RAI among those reporting past-year RAI) overall and by key demographic characteristics. These results and HIV incidence were used to calibrate a risk equation model to estimate the population attributable fraction of new HIV infections due to RAI (PAFRAI ) accounting for uncertainty in parameter assumptions.ResultsReceptive anal intercourse prevalence (overall: 32%, city range: 19%-60%) and RAI fraction (overall: 27%, city range: 18%-34%) were high overall and across cities, and positively associated with exchange sex. RAI accounted for an estimated 41% (uncertainty range: 18%-55%) of new infections overall (city range: 21%-57%). Variability in PAFRAI estimates was most influenced by uncertainty in the estimate of the per-act increased risk of RAI relative to RVI and the number of sex acts.ConclusionReceptive anal intercourse may contribute disproportionately to new heterosexually acquired HIV infections among at-risk low-income women in the USA, meaning that tools to prevent HIV transmission during RAI are warranted. The number of RVI and RAI acts should also be collected to monitor heterosexually acquired HIV infections.

Receptive anal intercourse (RAI) carries a greater per-act risk of HIV acquisition than receptive vaginal intercourse (RVI) and may influence HIV epidemics driven by heterosexual sex. This systematic review explores the association between RAI and incident HIV among women, globally. We searched Embase and Medline through September 2018 for longitudinal studies reporting crude (cRR) or adjusted (aRR) relative risks of HIV acquisition by RAI practice among women. Of 27,563 articles identified, 17 eligible studies were included. We pooled independent study estimates using random-effects models. Women reporting RAI were more likely to acquire HIV than women not reporting RAI (pooled cRR = 1.56 95% CI 1.03-2.38, N = 18, I2 = 72%; pooled aRR = 2.23, 1.01-4.92, N = 5, I2 = 70%). In subgroup analyses the association was lower for women in Africa (pooled cRR = 1.16, N = 13, I2 = 21%) than outside Africa (pooled cRR = 4.10, N = 5, I2 = 79%) and for high-risk (pooled aRR = 1.69, N = 4, I2 = 63%) than general-risk women (pooled aRR = 8.50, N = 1). Interview method slightly influenced cRR estimates (p value = 0.04). In leave-one-out sensitivity analyses pooled estimates were generally robust to removing individual study estimates. Main limitations included poor exposure definition, incomplete adjustment for confounders, particularly condom use, and use of non-confidential interview methods. More and better data are needed to explain differences in risk by world region and risk population. Women require better counselling and greater choice in prevention modalities that are effective during RVI and RAI.

Background. In preventing the spread of sexually transmitted infections (STIs), timely detection of extragenital localization of the pathogen is important. Modern studies demonstrate a wide prevalence of extragenital forms of STIs not only in men who practice sex with men, but also in heterosexual men and women. However, according to Russian and a number of foreign clinical guidelines, the basis of STI screening includes studies of only urethral, vaginal and cervical samples, which leads to incomplete registration of extragenital infections and contributes to their further spread. Aims. To study the frequency of prevalence and clinical features of extragenital forms of STIs in heterosexual men and women and men who have sex with men. Materials and methods. A prospective observational clinical and laboratory study included 57 patients with a history of unprotected orogenital and/or anogenital sexual contacts: group I (n = 20) women practicing heterosexual sexual contacts, group II (n = 9) men practicing heterosexual sexual contacts, group III (n = 28) men who have sex with men (MSM). The identification of STIs was conducted by the polymerase chain reaction method and the ribosomal RNA NASBA detection method was used as an independent additional direct method. Results. A high level of detection of STIs of extragenital localization has been established: in heterosexual women in the rectum (10; 76.9%), in the oropharynx (9; 69.2%) and in the conjunctiva (2; 15.4%); in heterosexual men in the rectum (2; 40%), in the conjunctiva (2; 40%) and in the oropharynx (1; 20%); in MSM in the rectum (15; 75%), in the oropharynx (11; 55%) and in the conjunctiva (5; 25%); in 14 (36.8%) patients, STI infection of more than 2 localizations was found. In extragenital foci of chlamydia trachomatis infection in group I was most frequently detected (5; 38.5%), in group II gonococcal infection (2; 40%), in group III syphilis (9; 45%), gonococcal infection (8; 40%) and chlamydia trachomatis infections (8; 40%). Asymptomatic infections in conjunctiva were detected in 4 (10.5%) patients, in oropharynx in 15 (39.5%), in rectum in 22 (57.9%) patients. Conclusions. The high level of detection of extragenital STIs and their frequent asymptomatic course dictates the need to study clinical samples from the oropharynx, rectum and conjunctiva not only when detecting objective and/or subjective symptoms of diseases, but also when there is a history of unprotected orogenital and/or anogenital sexual contacts, as well as when detected infections of genital localization.

Abstract Background In Canada, heterosexual African, Caribbean and Black (ACB) men tend to suffer a disproportionate burden of HIV. Consequently, studies have examined the underlying contributors to this disparity through the nexus of behavioral and structural factors. While findings from these studies have been helpful, their use of deficit and risk models only furthers our knowledge of why ACB men are more vulnerable to HIV infection. Thus far, there is a dearth of knowledge on how heterosexual ACB men mobilize protective assets to promote their resilience against HIV infection. Methods As part of a larger Ontario-based project called weSpeak, this study examined how ACB men acquire protective assets to build their resilience to reduce their HIV vulnerability. We analyzed three focus group discussions (n = 17) and 13 in-depth interviews conducted with ACB men using NVivo and a mixed inductive-deductive thematic analyses approach. Results The findings show that ACB men mostly relied on personal coping strategies, including sexual abstinence, to build resilience against HIV. Interpersonal resources such as family, friends, and religious communities also played an important role in constructing ACB men’s resilience. ACB men bemoaned their lack of access to essential institutional resources, such as health services, that are important in managing HIV adversity. Conclusion Based on these findings, there is an urgent need for HIV policy stakeholders, including service providers, to engage the ACB community in the design of intervention programs. Additionally, addressing the socioeconomic disadvantages faced by ACB communities will increase the capacity of ACB men to develop resilience against HIV.

Background Gender-Based (GB) intimate partner violence is a social and public health issue globally. Several risks of violence related to male sexual partners’ perpetration of intimate partner violence (IPV) following the disclosure of their female intimate partners’ HIV + status have been reported. No research has been conducted on male sexual partner’s perspectives of perpetrating IPV following their female intimate partners’ disclosure of human immunodeficiency virus (HIV) seropositive status as a risk factor for the perpetration of IPV in Ghana.Objective The objective of this study is to explore and describe male sexual partners’ views or perspectives of perpetrating IPV following their female intimate partners’ disclosure of being HIV positive in Ghana.Methods Interpretive phenomenological approach was used to collect and analyse data from a purposive sample of 18 Male participants whose female intimate relations informed them of being HIV + in Ghana. The sample population was taken from Ghana because such research has been reported elsewhere but none has been done in Ghana. A semi-structured interview guide was used to collect the data. The interview guide covered topics such as background information, participants’ reaction to HIV positive disclosure, lived experiences of participants, and Participants’ understanding of different forms of IPV.Results The findings of this study reveal five main themes that emerged from the interviews which include views on the perpetration of emotional, psychological, and verbal abuse; views on the perpetration of sexual deprivation; views on the perpetration of social isolation; views on the perpetration of financial abuse and views on escalated perpetration of physical abuse.Conclusion From the data, HIV positive status disclosure served as a risk factor for different forms of GB IPV against HIV positive women in Ghana, thus making this group more vulnerable and exposed to more GB IPV. Strategies to prevent the perpetration of IPV against women newly diagnosed as HIV positive are needed. We recommend screening all newly diagnosed HIV-positive women for abuse as an additional prevention strategy for IPV associated with disclosure of positive HIV status. KEY MESSAGESHIV positive status disclosure serves as a risk for the perpetration of IPV.Men are predisposed to violence upon hearing that their female heterosexual intimate partners are HIV positive.HIV infection information is distressful to receive from an intimate partner.

Introduction: In Spain, the sexual route is the main route of transmission in new HIV diagnoses. Men who have heterosexual relations are the second group with the highest incidence of new HIV cases and have the highest rates of late diagnosis in Spain. Planning the response to the HIV epidemic requires specific and updated information on this group. This study aims to analyze sexual practices and frequency of condom use in heterosexual and bisexual men and identify variables that explain inconsistent condom use in vaginal intercourse. Methods: The sample consists of 386 men between 18 and 57 years of age (M = 24.61; SD = 6.74). Results: The results indicate that the percentage of consistent condom use in vaginal intercourse is 64.9%. Not consuming drugs before sexual intercourse, perceiving a high self-efficacy for condom use, and good assertive communication skills are factors that positively influence condom use. In contrast, a high level of sexual compulsivity is a risk factor. The proposed model explains between 29.1% and 40% of the variance. Conclusions: and Policy Implications. Preventive actions implemented in this group should include work sessions that focus on developing assertive skills, reducing risks associated with drug use, and providing cognitive strategies to cope with compulsive sexual thoughts. [ABSTRACT FROM AUTHOR]

This article explores findings from 23 expert stakeholder interviews on working with cisgender heterosexual men and boys in the fields of gendered violence prevention, relationships and sexuality education (RSE), sexual health, sport, and emotional and mental well-being. It focuses on how organisations and individual consultants navigate political and social tensions when working with boys and young men. Findings from these interviews note several significant challenges and barriers stakeholders face in implementing programs designed to support cisgender, heterosexual boys and young men, particularly in areas of sex, sexual health and wellbeing. These include 1) broader questions as to who is responsible for teaching about sex, relationships, and sexuality; 2) the lack of public support in running programs about sex and sexuality, 3) uncertainty as to the best settings to engage boys and young men, and 4) hostility or lack of engagement with program content. We highlight the implications of these challenges for policy and practice, as well as recommendations for how to address some of these issues. [ABSTRACT FROM AUTHOR]

Abstract Background Anal intercourse (AI) is not uncommon among U.S. women and, when condomless, confers a far greater likelihood of HIV transmission than condomless vaginal intercourse. We aim to identify determinants preceding AI, among women with, and women without HIV. Methods 3708 women living with (73%), and without HIV (27%) participating in the Women’s Interagency HIV Study provided sexual behavior and other data at 6-monthly visits over a median of 9 years (1994–2014). We used generalized estimating equation models to examine sociodemographic, structural and behavioral determinants reported in the visit preceding (1) AI, and (2) condomless AI. Results AI was reported at least once over follow-up by 31% of women without, and 21% with HIV. AI was commonly condomless; reported at 76% and 51% of visits among women living without HIV, and with HIV, respectively. Women reporting AI were more likely to be younger (continuous variable, adjusted odds ratio (aOR) = 0.97, 95% confidence interval (CI):0.96–0.98), Hispanic (aOR = 1.88, CI:1.47–2.41) or White (aOR = 1.62, CI:1.15–2.30) compared to Black, and have at least high school education (aOR = 1.33, CI:1.08–1.65). AI was more likely following the reporting of either (aOR = 1.35, CI:1.10–1.62), or both (aOR = 1.77, CI:1.13–2.82) physical and sexual violence, excessive drinking (aOR = 1.27, CI:1.05–1.66) or any drug use (aOR = 1.34, CI:1.09–1.66), multiple male partners (aOR = 2.64, CI:2.23–3.11), exchange sex (aOR = 3.45, CI:2.53–4.71), one or more female sex partners (aOR = 1.32, CI:1.01–1.75), condomless vaginal intercourse (aOR = 1.80, CI:1.53–2.09), and high depressive symptoms (aOR = 1.23, CI:1.08–1.39). Conclusion AI disproportionally follows periods of violence victimization, substance use, multiple sex partners and depression. Better prevention messaging and biomedical interventions that reduce acquisition or transmission risk are needed, but when AI occurs in the context of violence against women, as our findings indicate, focusing on gender-based violence reduction and immediate treatment to reduce HIV transmission risk is important.

Introduction: Cisgender heterosexual boys and young men in Australia may experience or perpetuate a range of harms in their romantic and sexual encounters with women due to expectations that they adhere to problematic ideals and norms concerning masculinity and heterosexuality. This paper explores expert stakeholders' perceptions on these key issues, and their broader implications for policy and practice. Methods: Using inductive thematic analysis techniques, this paper draws on semi-structured interviews from 23 expert stakeholders working across sectors of gendered violence prevention, sexual health, relationships and sexuality education, sport, and emotional and physical wellbeing. Results: Findings note several key concerns, including (1) hesitation and lack of adequate information regarding relationships with women; (2) the potential negative influence of pornography; (3) the lack of opportunities to be engaged in sexual health promotion initiatives; and (4) limited opportunities to have meaningful conversations about dating, sex, and intimacy. Conclusions: Expert stakeholders note several important gaps in policy and practice that need to be addressed to better support cisgender heterosexual boys and young men, and to confront gendered violence and sexual violence. Social and Policy Implications: Understanding these gaps is vital for policymakers, content and program creators, and service providers working with cisgender heterosexual boys and men. We advocate for thinking about a strategy that is centred around "heterosexual intimacies", in which addressing boys and young men's sexual health and wellbeing is brought together with gendered violence prevention and sexual violence prevention initiatives. [ABSTRACT FROM AUTHOR]

We assessed changes in sexual behaviour among people with HIV (PWH) over 20 years. Condom use with stable partners steadily declined from over 90% to 29% since the Swiss U = U statement with similar trajectories between men who have sex with men (MSM) and heterosexuals. Occasional partnership remained higher among MSM compared to heterosexuals even during COVID-19 social distancing. [ABSTRACT FROM AUTHOR]

Background: Few studies investigate group sex among heterosexuals. The aim of this study was to provide an exploration of characteristics and practices among heterosexual men and women who engage in group sex.Method: We conducted a cross-sectional survey between May 2019 and March 2020 among heterosexual men and women attending a sexual health clinic in Melbourne, Australia. Participants were asked whether they had participated in group sex (sex involving more than two participants) in the past 3months, the size of the most recent event, sexual activities in which they engaged, and condom use.Results: Of 3277 heterosexuals surveyed (1509 women and 1768 men), the mean age was 29.9years (s.d. 8.8) and more than half (56.0%, n=1834) were born outside Australia. One in 20 participants (5.4%) had engaged in group sex in the past 3months with the number of events ranging 1-10times. Kissing was the most common activity in group sex, and women were significantly more likely to kiss a same-sex partner than men. Overall, of 165 participants who engaged in vaginal sex, 57 (34.5%) reported always using condoms and changing condoms between consecutive partners. Of the 100 men and women who had condomless vaginal sex, 79 (79.0%) received or performed fellatio after condomless vaginal sex.Conclusion: About two-thirds of heterosexuals who engaged in group sex neither used condoms nor changed condoms between partners in the most recent group sex event. Safe sex messages on changing condoms between partners and between sexual activities should be reinforced for sexually transmitted infections prevention. [ABSTRACT FROM AUTHOR]

Background: In Canada, heterosexual African, Caribbean and Black (ACB) men tend to suffer a disproportionate burden of HIV. Consequently, studies have examined the underlying contributors to this disparity through the nexus of behavioral and structural factors. While findings from these studies have been helpful, their use of deficit and risk models only furthers our knowledge of why ACB men are more vulnerable to HIV infection. Thus far, there is a dearth of knowledge on how heterosexual ACB men mobilize protective assets to promote their resilience against HIV infection. Methods: As part of a larger Ontario-based project called weSpeak, this study examined how ACB men acquire protective assets to build their resilience to reduce their HIV vulnerability. We analyzed three focus group discussions (n = 17) and 13 in-depth interviews conducted with ACB men using NVivo and a mixed inductive-deductive thematic analyses approach. Results: The findings show that ACB men mostly relied on personal coping strategies, including sexual abstinence, to build resilience against HIV. Interpersonal resources such as family, friends, and religious communities also played an important role in constructing ACB men’s resilience. ACB men bemoaned their lack of access to essential institutional resources, such as health services, that are important in managing HIV adversity. Conclusion: Based on these findings, there is an urgent need for HIV policy stakeholders, including service providers, to engage the ACB community in the design of intervention programs. Additionally, addressing the socioeconomic disadvantages faced by ACB communities will increase the capacity of ACB men to develop resilience against HIV. [ABSTRACT FROM AUTHOR]

The study focussed on deconstructing heterosexuals’ stigmatisation of LGBT in the context of religion in Malaysia. The qualitative study involved semi-structured interviews with 21 heterosexuals (Buddhist, Christian, Muslim). The interview questions focussed on societal and personal views of LGBT. Thematic analysis of interview transcripts totalling 30,488 words showed the lay perspective on the construction of homosexuality in terms of personal choice, situational factors, and ideologies of stigma. The participants were able to empathize with personal choice only because they perceived the LGBT individuals had no chance of reverting to a so-called normal identity. The participants reanimated, rehearsed and re-presented the ideological defence of heterosexuality through repeated stigmatisation of difference and non-conformity in the context of the normative religious beliefs. They also perceived homosexuals as a potential threat to the morality of the norm-compliant population, prone to emotional and psychological instability, and a threat to the veneer of normalcy. The study showed that such popular theorising is not a neutral instrument of knowledge but one that carries ideological power in normalizing stigma towards LGBT. [ABSTRACT FROM AUTHOR]

This paper explores how concepts of sexual communication and sex are discussed in #MeToo commentaries. Previous research has focused primarily on questions of consent, gendered power relations and sexual violence against women. Drawing from work that has called for more reflexive considerations of desire and pleasure in #MeToo, I undertake a critical feminist discourse analysis of over 163 traditional news, online magazine and social news articles commenting on #MeToo, sexual communication, dating and heterosexual relations between men and women. The findings of this analysis note discourses underpinning tensions between what constitutes ideal or appropriate forms of sexual communication, uncertainties as to what effectively makes sex 'good' or 'bad', moralisations regarding how 'good' and 'bad' sex are possible, and contradicting accounts of women's capacity for sexual empowerment. Through highlighting the incongruities in expectations as to how individuals should proceed sexually and romantically in a #MeToo era, I conclude with a discussion on how we can think about such relations within a consideration of a 'self-in-process' and 'subject-act-ivity' framework. [ABSTRACT FROM AUTHOR]

The analysis of the social variables that influence the allocation of custody has become an increasingly recurrent phenomenon under study. The present article, using the push and pull theoretical approach and focusing on the case of Spain, aims to examine how these variables influence the allocation of the shared modality, distinguishing between sociodemographic (characteristics of marriage) on the one hand and contextual (structural-economic and public opinion) on the other. The methodology used to study the data has been quantitative, using multiple linear regression as an analysis technique. The created database has been generated from the Statistics on Annulments, Separations and Divorces of the National Statistics Institute (INE, in the Spanish acronym) and from different rates obtained from the INE and the Sociological Research Center. The main conclusion is that although the two regression models obtained explain the allocation of joint custody, it is the set of contextual variables and specifically the gross domestic product of each autonomous community that have the greatest explanatory power.

Se presenta el caso de un paciente varón de 28 años, heterosexual, con VIH negativo que desarrolló erupción cutánea intensa caracterizada por la presencia de vesículas, pústulas y pápulas umbilicadas confluentes en el pene y región púbica con escasa diseminación en el resto del cuerpo, sin adenopatía ni manifestaciones sistémicas, cuatro días después de haber tenido relaciones sexuales con una prostituta aparentemente sana. El hisopado de las lesiones dérmicas revelaron la presencia de ADN del virus MPOX por PCR en tiempo real. Las pruebas inmunológicas fueron las siguientes: ELISA cuarta generación para VIH y Western Blot negativas, anticuerpos IgM para herpes simplex1=1.2 U/ml, anticuerpos IgM para herpes simplex2=1.9 U/ml, anticuerpos IgM para varicela zoster=0.5 S/CO, FTA-ABS (IgM)=negativo. Se resalta la intensidad de las lesiones cutáneas en el pene y la necesidad de realizar pruebas para descarte de MPOX en prostitutas.

BackgroundChlamydia trachomatis (chlamydia) is one of the most common sexually transmitted infections (STI) globally, and re-infections are common. Current Australian guidelines recommend re-testing for chlamydia 3 months after treatment to identify possible re-infection. Patient-delivered partner therapy (PDPT) has been proposed to control chlamydia re-infection among heterosexuals. We aimed to identify determinants and the prediction of chlamydia re-testing and re-infection within 1 year among heterosexuals with chlamydia to identify potential PDPT candidates.MethodsOur baseline data included 5,806 heterosexuals with chlamydia aged ≥18 years and 2,070 re-tested for chlamydia within 1 year of their chlamydia diagnosis at the Melbourne Sexual Health Center from January 2, 2015, to May 15, 2020. We used routinely collected electronic health record (EHR) variables and machine-learning models to predict chlamydia re-testing and re-infection events. We also used logistic regression to investigate factors associated with chlamydia re-testing and re-infection.ResultsAbout 2,070 (36%) of 5,806 heterosexuals with chlamydia were re-tested for chlamydia within 1 year. Among those retested, 307 (15%) were re-infected. Multivariable logistic regression analysis showed that older age (≥35 years old), female, living with HIV, being a current sex worker, patient-delivered partner therapy users, and higher numbers of sex partners were associated with an increased chlamydia re-testing within 1 year. Multivariable logistic regression analysis also showed that younger age (18–24 years), male gender, and living with HIV were associated with an increased chlamydia re-infection within 1 year. The XGBoost model was the best model for predicting chlamydia re-testing and re-infection within 1 year among heterosexuals with chlamydia; however, machine learning approaches and these self-reported answers from clients did not provide a good predictive value (AUC < 60.0%).ConclusionThe low rate of chlamydia re-testing and high rate of chlamydia re-infection among heterosexuals with chlamydia highlights the need for further interventions. Better targeting of individuals more likely to be re-infected is needed to optimize the provision of PDPT and encourage the test of re-infection at 3 months.

Quantifying HIV-1 transmission risk per-act of anal intercourse (AI) is important for HIV-1 prevention. We updated previous reviews by searching Medline and Embase to 02/2018. We derived pooled estimates of receptive AI (URAI) and insertive AI (UIAI) risk unprotected by condoms using random-effects models. Subgroup analyses were conducted by gender, study design, and whether antiretroviral treatment (ART) had been introduced by the time of the study. Two new relevant studies were identified, one of which met inclusion criteria, adding three new cohorts and increasing number of individuals/partnerships included from 1869 to 14 277. Four studies, all from high-income countries, were included. Pooled HIV-1 risk was higher for URAI (1.25%, 95% CI 0.55%-2.23%, N = 5, I2  = 87%) than UIAI (0.17%, 95 % CI 0.09%-0.26%, N = 3, I2  = 0%). The sole heterosexual URAI estimate (3.38%, 95% CI 1.85%-4.91%), from a study of 72 women published in a peer-reviewed journal, was significantly higher than the men-who-have-sex-with-men (MSM) pooled estimate (0.75%, 95% CI 0.56%-0.98%, N = 4, P

Gender-Based (GB) intimate partner violence is a social and public health issue globally. Several risks of violence related to male sexual partners' perpetration of intimate partner violence (IPV) following the disclosure of their female intimate partners' HIV + status have been reported. No research has been conducted on male sexual partner's perspectives of perpetrating IPV following their female intimate partners' disclosure of human immunodeficiency virus (HIV) seropositive status as a risk factor for the perpetration of IPV in Ghana. The objective of this study is to explore and describe male sexual partners' views or perspectives of perpetrating IPV following their female intimate partners' disclosure of being HIV positive in Ghana. Interpretive phenomenological approach was used to collect and analyse data from a purposive sample of 18 Male participants whose female intimate relations informed them of being HIV + in Ghana. The sample population was taken from Ghana because such research has been reported elsewhere but none has been done in Ghana. A semi-structured interview guide was used to collect the data. The interview guide covered topics such as background information, participants' reaction to HIV positive disclosure, lived experiences of participants, and Participants' understanding of different forms of IPV. The findings of this study reveal five main themes that emerged from the interviews which include views on the perpetration of emotional, psychological, and verbal abuse; views on the perpetration of sexual deprivation; views on the perpetration of social isolation; views on the perpetration of financial abuse and views on escalated perpetration of physical abuse. From the data, HIV positive status disclosure served as a risk factor for different forms of GB IPV against HIV positive women in Ghana, thus making this group more vulnerable and exposed to more GB IPV. Strategies to prevent the perpetration of IPV against women newly diagnosed as HIV positive are needed. We recommend screening all newly diagnosed HIV-positive women for abuse as an additional prevention strategy for IPV associated with disclosure of positive HIV status. HIV positive status disclosure serves as a risk for the perpetration of IPV. Men are predisposed to violence upon hearing that their female heterosexual intimate partners are HIV positive. HIV infection information is distressful to receive from an intimate partner. [ABSTRACT FROM AUTHOR]

Men should not be overlooked in research on human papillomavirus (HPV) and its associated genital diseases. This is because men infected with HPV are not only at higher risk of genital cancers, but also increase their partners’ risk of HPV infection and reinfection through sexual contact. Herein, we summarized the state of knowledge regarding the prevention and treatment of HPV infection in men as well as the possible effects of the prevention and treatment of HPV in men on their female partners. Condom use, smoking cessation, male circumcision, and HPV vaccination for men each play an important role in preventing HPV infection within heterosexual couples. Additionally, men could choose to test for certain types of HPV, such as the oncogenic HPV16 or HPV18 strains, as part of a routine screening program when their partner is positive for HPV. Although there is no recognized treatment for HPV infection as of yet, immunotherapy drugs, such as toll-like receptor agonists, therapeutic HPV vaccines, and immune checkpoint inhibitors, have shown promising results in clinical trials and in actual clinical practice. HPV infection in men also increases the risk of cervical cancer in their female partners. Because of the high partner concordance for HPV demonstrated in prior research, the prevention and treatment of HPV in men should be explored more comprehensively in future research. [ABSTRACT FROM AUTHOR]

Poor engagement in HIV care is associated with poorer health outcomes and increased mortality. Our survey examined experiential and circumstantial factors associated with clinic attendance among women (n = 250) and men (n = 106) in London with heterosexually-acquired HIV. While no associations were found for women, among men, sub-optimal attendance was associated with insecure immigration status (25.6% vs. 1.8%), unstable housing (32.6% vs. 10.2%) and reported effect of HIV on daily activities (58.7% vs. 40.0%). Among women and men on ART, it was associated with missing doses of ART (OR = 2.96, 95% CI:1.74–5.02), less belief in the necessity of ART (OR = 0.56, 95% CI:0.35–0.90) and more concern about ART (OR = 3.63, 95% CI:1.45–9.09). Not wanting to think about being HIV positive was the top reason for ever missing clinic appointments. It is important to tackle stigma and the underlying social determinants of health to improve HIV prevention, and the health and well-being of people living with HIV. [ABSTRACT FROM AUTHOR]