Protection styles of prostitutes' clients: intentions,behavior, and considerations in relation to AIDS

The perceived costs and benefits of condom use within the context of commercial sex were examined in interviews with 87 clients of female Dutch prostitutes. 8 types of condom users were identified: convinced (46% of the study group), guilty conscience (11%), anti-ridden (13%), defaulting (6%), maximum selective (8%), minimum selective (3%), indifferent (8%), and recalcitrant (5%). Clients who consistently used condoms take responsibility for both the pleasure and safety of their sexual encounter; their attitude toward prostitution is positive and straightforward. Guilty conscience users are motivated to use condoms by feelings of guilt toward their wife and are ambivalent about their participation in commercial sex. Angst-ridden users are motivated to seek out prostitutes more by loneliness than the pursuit of sexual pleasure; they view their personal risk of acquired immunodeficiency syndrome (AIDS) as higher than that reported by consistent users and thus are motivated by fear to use condoms. Defaulting users perceive themselves as the victims of temptation and express a lack of control over the sexual encounter that places them at risk of unprotected sex. Maximum selective users are consistent in using condoms in sex with prostitutes, except when it involves a prostitute whom they see regularly and frequently. Minimum selective users seek frequent contact with prostitutes and base condom use on a subjective assessment of whether the woman is healthy or not. Indifferent users, often disabled and lonely men with no other source of sexual contact, base their condom use or nonuse solely on the wishes of the prostitute. Finally, recalcitrant users are characterized by a desire for power and protest condom use. In general, consistent condom use was related to a positive evaluation of prostitutes, positive attitudes toward the advantages of condom use, an internal locus of control with regard to health, and a higher level of education.     

Contraception and condom use among two samples of university students: 1982 and 1992

8% of all individuals residing in the US have tested positive for infection with HIV. This study reports the use of condoms and others forms of contraception in two samples of students from East Carolina University. 234 students in 1982 taking a course in marriage and family responded to a 32-item questionnaire distributed in five classes on whether they had used contraception during their most recent episode of sexual intercourse and which method they used. 96% of the respondents were never married, 83% white, and 82% middle class. 7% were engaged to be married and 3% were cohabiting. 53.4% were women and in their junior or senior year (52.5%) of undergraduate education. While the sample was not random, it closely approximated the demographic characteristics of the university from which it was drawn. 79.1% reported using some form of contraception, with 61.8% using the pill and 15.3% using the condom. Of those who used a form of contraception, 8.1% reported using withdrawal and 1.5% rhythm. Fifty university students were again sampled in 1992 in a marriage and family class to find 76% reporting use of contraception during their last episode of sexual intercourse. The percentage of students which reported using a condom, however, increased to 39%. These findings add to the body of research literature which suggests that condom use has increased over the past decade. Further research is, however, warranted to determine whether these data reflect an actual increase in condom use or are simply the result of students providing socially desirable answers.     

Sexual and Reproductive Health Behaviors of Asian Pacific Islander Community College Students

Analyzed were the sexual and reproductive health behaviors of Asian Pacific Islander (API) California community college students who took the National College Health Assessment (NCHA) survey. This was done to identify characteristics related to sexual behavior and choice of birth control and examine the association between condom use and history of HIV testing. A total of 769 API heterosexual, male and female students between ages 18–24 were included in the analysis. Chi-square analyses were conducted to determine whether there was an association between condom use and history of HIV testing. API students reported few sexual partners (41% with no partner, and 49% with 1 or 2 partners), and preferred condoms (53.0%) for birth control over hormonal methods (29.3%). One-fifth of API students have used emergency contraception, and 21.7% have had an HIV test. API students had more conservative sexual practices and lower HIV testing practices than community college students in general. More culturally tailored education is needed on contraceptive options and to increase HIV testing behaviors among APIs.     

The attitude towards nature,and incidence of sexual intimacy among students at a South African University

The authors, of the University of Stellenbosch, South Africa, surveyed 60 male university students of mean age 21.37 years and 79 female students of mean age 20.13 years with the goal of gaining insight into their sex behavior and their attitudes toward sexuality. The home language of 83% of the women and 85% of the men was Afrikaans, while the remaining subjects had English as a home language. One student was married, three were engaged to be married, and two lived together with a person of the opposite sex. 51 students were in steady relationships and 82 were single. 82% of the men and 90% of the women choose to have sex with someone of the same race. The study found a relatively low occurrence of sexual intercourse and promiscuity, and a very high percentage of subjects regarded themselves as heterosexual and as morally and religiously conservative. 97% of the men and 99% of the women regarded themselves as being heterosexual, and 3% of men and 1% of women regarded themselves as being bisexual. 6.6% of men and 1.34% of women, however, reported having had sexual contact with someone of the same sex. 37% of the men and 32% of the women reported having ever had sexual intercourse with a person of the opposite sex. These percentages are notably lower than those found by other investigators and the authors believe that a higher proportion of students at the university are actually sexually active than that suggested by this survey's findings. Among those sexually active, 17% of men and 18% of women were involved in sexual relationships with more than one partner. 68% of the sexually active men and women report using condoms often, 14% of men and 8% of women use contraceptives on an irregular basis, and 18% of men and 25% of women never use contraceptives. The birth control pill and condom were the most widely used methods. 85% of men and 86% of women felt that both partners should be responsible for taking precautions against unwanted pregnancy. These findings indicate that the overwhelming majority of subjects in this study are not at high risk for contracting AIDS.     

Sexual abuse among female high school students in Istanbul, Turkey

OBJECTIVE: The objective of the study was to determine the prevalence of sexual abuse in female adolescents in Istanbul, Turkey from data collected as part of a school-based population study on health and health behaviors. METHOD: A stratified cluster sampling procedure was used for this cross-sectional study. The study sample included 1,955 randomly selected 9th through 11th grade female students attending 26 randomly-selected high schools in Istanbul. A self-report questionnaire was administered anonymously in the classroom. Information on sexual abuse history was collected through the questions investigating "touching" and "intercourse." RESULTS: Of 1,955 female students, 1,871 (95.7%) provided answers to the questions addressing unwanted sexual experience. Of these, 250 (13.4%) reported sexually abusive experiences. Two hundred and thirteen (11.3%) students reported that someone touched their private parts in a way they did not like; 91 (4.9%) reported they were forced to have sexual intercourse; 54 (3.0%) reported both types of sexual abuse. Incest was reported by 1.8% of the subjects. Ninety-three percent of the perpetrators were reported to be male. CONCLUSIONS: This is the first reported school-based study to determine the prevalence of sexual abuse in Turkey. The results show that at least 13.4% of female high school students disclosed having experienced sexual abuse during childhood.     

Condom Carnival: feasibility of a novel group intervention for decreasing sexual risk

Young people who engage in unprotected sex are at risk of negative consequences. The current study explored pre-post assessment data from 124, mostly Black, young people (M age = 19.6, SD = 2.8) attending an educational and vocational training programme who participated in the Condom Carnival, a novel, brief, interactive, peer-led, culturally tailored, sexual risk reduction group intervention. Condom Carnival activities provided practice negotiating condom use and using condoms correctly, instruction on safe lubricant use, and opportunities to dispel myths regarding condom size and breakage. We examined the preliminary impact of the Condom Carnival in increasing participants’ condom-related self-efficacy, lubricant safety awareness, and condom-related behavioural intentions and behaviour likelihood. Despite previous exposure to prevention efforts, participants reported significant increases in lubricant safety awareness (p < 0.001) and intentions to carry a condom in the next year (Z = ?2.05, p = 0.04). Although participants reported high condom-related self-efficacy and intentions to use a condom, only three-quarters of young people endorsed intentions to always carry a condom. Findings indicate the need to explore the gap between intentions to use and carry condoms and to develop effective strategies to increase condom carrying among young people. Further assessment of the Condom Carnival as an add-on intervention to enhance sexual risk reduction efforts among youth is warranted.     

Premarital Sex, Social Support, Submissive Behaviors, and Loneliness Among Turkish University Students

The purpose of this study was to investigate whether differences in social support, submissive behaviors, and loneliness existed among Turkish university students who had had premarital sexual intercourse and those who had not. Using self-reported questionnaires, students who had experienced sexual intercourse were contrasted with those who had not. Data were gathered on 420 university students in Ankara, Turkey. MANOVA statistics were used in the data analysis. Results indicated that more than 75?% of the total respondents reported that they had never had sexual intercourse; the frequency of sexual intercourse was higher among males than females. It was found that students who had had sexual intercourse reported less perceived support from family. The two groups were not significantly different, however, in perceived support from friends, submissive behaviors and loneliness. Possible interpretations of these data and implications for future study are suggested.     

Comprehensively Assessing Cognitive and Behavioral Risks for HIV Infection Among Middle-Aged and Older Adults

A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveyed across such domains. Although the majority of participants (92.2%) reported a good understanding of factual knowledge, strongly agreed with both their intention to engage in nonrisky sexual behaviors and their sense of internal self-control behaviors, they also reported high-risk behaviors (e.g., sexual intercourse without condoms).     

Association between receipt of school-based HIV education and contraceptive use among sexually active high school students — United States, 2011–2013

Sexual health education, including HIV prevention information, can help prevent unintended pregnancy and sexually transmitted infections. National Youth Risk Behavior Survey data from 2011 and 2013 were used to determine HIV education prevalence among 9,825 currently sexually active students in grades 9–12. Associations between HIV education and contraceptive methods used at last sexual intercourse were examined for: (1) condom use; (2) any contraceptive method; (3) dual use of a condom and either birth control pills; IUD or implant; or shot, patch, or birth control ring; and (4) primary contraceptive method. Primary contraceptive method options were (1) no method; (2) birth control pills; (3) condoms; (4) IUD or implant; (5) shot, patch, or birth control ring; (6) withdrawal or some other method; and (7) not sure. Logistic regression (prevalence ratios [PRs] and 95% confidence intervals [CIs]) and Chi-squares were used for testing. Students who received HIV education were more likely than students who did not to use a condom (PR:1.09;CI:1.01,1.18) and any contraceptive method (PR:1.08;CI:1.04,1.12); there was no significant association with dual use. Primary contraceptive method varied significantly by receipt of HIV education (p < .001). School-based HIV education may be important for promotion of adolescent condom and contraceptive use.     

Correlates of Condom use Among Community College Women: The Role of Victimization,Substance Use,and Mental Health Symptoms

Research is needed to understand intersecting health risks among community college students. Applying a syndemic framework, the present research explored childhood sexual victimization, adolescent sexual victimization, intimate partner violence (IPV), marijuana use, alcohol consumption, and symptoms of depression and post-traumatic stress disorder as additive as well as interactive correlates of women's condom use. Questionnaires were administered to a sample of 212 women between the ages of 18 to 24 attending a community college. A series of logistic regression analyses documented that an increased number of psychosocial risk factors was associated with not using a condom during sexual intercourse. Experiencing both adolescent sexual victimization and lifetime IPV, compared to experiencing one form of victimization, increased the odds of not using a condom. Endorsing both lifetime IPV and past year marijuana use, compared to endorsing only one of these factors, also increased the odds of not using a condom. These findings highlight the importance of targeting intersections between adolescent sexual victimization, IPV, marijuana use, and sexual risk behavior when developing educational programs for community college women.     

Knowledge, attitudes, and beliefs about HIV/AIDS among Hindu students from a government women's college of South India

The purpose of the study was to determine the attitudes of Hindu students from a government women's college of South India toward people with AIDS, to assess their beliefs about HIV/AIDS, to determine their knowledge level about HIV/AIDS and to determine how they gain information about HIV/AIDS. The sample consisted of four hundred female students at a government funded Women's University in Southern India who participated in an AIDS survey research project. Participants completed a survey asking about their knowledge, attitudes and beliefs about HIV/AIDS. Results indicated that a majority of the participants learned about HIV/AIDS from reading material while some learned about HIV/AIDS from school classes, and only a few learned from family members. Thirty-nine percent had never communicated to any one about HIV/AIDS. The results indicated that the majority of Indian women in this study did not know about explicit sexual behaviors which transmit the virus. The study also showed that those Indian women university students, by and large, are accepting of people with AIDS but still have fears of getting HIV/AIDS. This data suggest a need to increase educational efforts at the university. It was suggested that counselors take responsibility for helping this population of Indian women become self advocates, particularly in a society which permits men to have multiple sexual relationships. Educators and counselors working with this population must initiate programs that impart accurate and specific knowledge to these female college students and begin to address the multiple psychosocial issues related to HIV/AIDS.     

Gender differences in associations between exposure to school HIV education and protective sexual behaviors and sexually transmitted disease/HIV diagnosis among high school students

This study aimed to assess associations between school HIV education and protective sexual behaviors and sexually transmitted disease (STD)/HIV diagnosis with a representative sample of male and female high school students. Data from male and female adolescent participants in the 1999, 2001 and 2003 Massachusetts Youth Risk Behavior Survey (n = 12,243) were analyzed. Adjusted regression analyses stratified by gender were conducted to assess relationships between school HIV education exposure and the following outcomes: no sexual initiation, condom use at last sex, no multiple sex partners in the past three months and no history of STD/HIV diagnosis. Participants were mostly White (75%) and were 51% male; the subsample of sexually active students was younger than the total sample but was otherwise similar in demographics. School HIV education was reported by 93% of our sample and was significantly related to sexual initiation among boys (odds ratio = 1.9, 95% confidence interval = 1.4–2.7) but not girls. Among sexually experienced students (n = 4752), boys reporting exposure to school HIV education were significantly more likely to report condom use (odds ratio = 2.2, 95% confidence interval = 1.6–3.1), no multiple sex partners (odds ratio = 3.2, 95% confidence interval = 2.3–4.4) and no STD/HIV diagnosis (odds ratio = 3.2, 95% confidence interval = 2.0–5.0); girls reporting such exposure were significantly more likely to report no multiple sex partners (odds ratio = 2.2, 95% confidence interval = 1.3–3.6). In conclusion, exposure to school HIV education is associated with sexual protective behaviors and reduced likelihood of STD/HIV diagnosis for boys but less so for girls, suggesting the need for more gender‐tailored approaches to school HIV education.     

Kids and condoms

The proposal of the school chancellor in New York City to dispense condoms to the city's 261,000 high school students met with protests from parents and religious groups that espouse abstinence and postponement of sexual activity. In Philadelphia there was a tumultuous meeting of the school board and AIDS prevention advocates. The promotion of condoms for AIDS prevention has become controversial, some claiming that it promotes promiscuity. In February 1991, there were 167,803 AIDS cases reported to the Centers for Disease Control of which 659 cases involved patients aged 13-19, an increase of 173 from the previous year. 1/5 of AIDS victims are in their 20s, and many more teenagers could be infected because of the long incubation period. In New York City 30% of cases are in the 20-29 age group with blacks, Hispanics, runaways, and teen prostitutes disproportionately affected. 37% of teen cases occur in areas outside of major cities. Gonorrhea, syphilis, chlamydia, and herpes have also increased to epidemic levels. There are 35 million people aged 10-19 whose number will increase by 10% in the 1990s, and they are facing a high risk of HIV infection. 53% of girls aged 15-19 were sexually active in 1988 increasing from 47% in 1982. 58% reported 2 or more sexual partners during that year, and few of them used condoms on a regular basis. Frank sex education programs have been adopted extensively, but behavior modification is the main issue. Some schools have provided condoms directly to students after parental consent. The school board of San Francisco faces a decision on providing condoms to students (85% from ethnic minorities) via a clinic or vending machines in restrooms. The recommendations of a Philadelphia task force also awaits school board action. In Los Angeles and Brookline, Massachusetts, a similar decision is pending. In Canada, condom vending machines have been installed in high schools in British Columbia, Ottawa, and Toronto.     

回归分析方法预测某市HIV／AIDS流行趋势的应用研究

根据疾病预防控制中心提供的数据,应用回归分析的方法,建立了某市HIV／AIDS逐年新增人数预测模型和经性传播HIV／AIDS新增人数预测模型,并分析得出该市未来3年HIV／AIDS的发展趋势：HIV／AIDS新增人数逐年趋于平稳,但是仍有上升的迹象;经性传播HIV／AIDS新增人数比例逐年上升且速度较快,性传播HIV／AIDS已逐渐成为该市HIV／AIDS传播的主要途径。     

Globalization,public policy,and ‘knowledge gap’: Ethiopian youth and the HIV/AIDS pandemic

Set against trans‐ or supra‐national policy initiatives which have framed the HIV/AIDS pandemic as in part a pedagogical issue, this paper critically explores local understandings of sexual practices (generally) as well as of HIV/AIDS (more specifically) among young people in the sub‐Saharan African country of Ethiopia. Ethiopia has the third largest number of HIV/AIDS infections in the world, behind only South Africa and India. Like many countries dealing with this pandemic, the Ethiopian government has articulated its response to a broader set of global presses, including those around information and education. Such responses, we will argue, are helpful but have important limitations. As this study shows, knowledge about safer sex practices and the dangers of HIV/AIDS are by now well known among many Ethiopian youth. Yet, this knowledge does not always effect behavioral change. Taking condom use as a key exemplar, we will look at how Ethiopian youth narrate their own sexual experiences, conduct, and practices. Deeply informed by the work of Pierre Bourdieu, we look to open new ‘thinking tools’ for a range of actors addressing this global pandemic in situated contexts. In particular, we challenge the ‘pedagogical subject’ – a subject lacking key information – interpolated into many of these policies. We highlight, instead, new disjunctures between emergent discourses around sex and sexuality as well as long‐standing, conservative attitudes toward gender.     

Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men's Health Study

OBJECTIVE: The prevalence and characteristics of childhood sexual abuse (CSA) among men who have sex with men (MSM), and links with sexual risk are explored. A model linking CSA and sexual risk among MSM is proposed. METHOD: A telephone probability sample of urban MSM (n = 2881) was recruited and interviewed between November 1996 and February 1998. The interview covered numerous health issues, including history of sexual victimization. RESULTS: One-fifth reported CSA, primarily by non-family perpetrators. Initial CSA experiences are characterized by high levels of force (43% involved physical force/weapons), and penetrative sex (78%; 46% reported attempted or actual anal intercourse). Such men are more likely than nevercoerced men to engage in high risk sex (unprotected anal intercourse with a non-primary partner or with a serodiscordant male). In multivariate analyses, the effect of childhood sexual coercion on sexual risk is mediated by substance use, patterns of sexual contacts, and partner violence, but not by adult sexual revictimization or by depression. CONCLUSIONS: Findings are interpreted within the context of social learning theory and prior research on sexual risk-taking. The high risk for CSA among MSM, which can predispose such men to patterns of HIV sexual risk, warrants new approaches in HIV prevention.     

Childhood sexual abuse, adolescent sexual coercion and sexually transmitted infection acquisition among homeless female adolescents

OBJECTIVE: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents. METHOD: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and recent history of sexual coercion were used to predict physiologically confirmed STI acquisition over the subsequent 6 months. RESULTS: About 38% of all girls reported a history of childhood sexual abuse (CSA). Girls with a history of CSA were more likely to report recent sexual coercion. In turn, sexual coercion in the last three months was significantly associated with a higher number of sexual partners (but not with a greater frequency of intercourse or with lower rates of condom use). Number of sexual partners significantly predicted the future acquisition of an STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors in homeless adolescent females may need to consider the impact of CSA, particularly on the number of sexual partners during adolescence. However, it also should be noted that engagement in intercourse often results from coercion and is not voluntary in this population.     

Child abuse and AIDS-related knowledge, attitudes and behavior among adolescents in Zambia

OBJECTIVE: To research the correlation between physical and sexual abuse by family members and AIDS-related knowledge, attitudes, self-efficacy and behavior among urban and rural adolescents in Zambia. SAMPLE: The sample comprises 3,360 adolescents, aged 10-19, from urban and rural Zambia; 2,160 of them attended school, while 1,200 of them did not. MEASURES: Standardized scales were utilized to assess AIDS-related knowledge, attitudes, and self-efficacy. In addition, the adolescents reported the extent of their engagement in various high-risk behaviors and their lifetime experience of being sexually or physically abused. RESULTS: As the level of abuse experienced by the adolescents increased, their level of knowledge about HIV/AIDS, tendency to hold positive attitudes toward prevention, and level of self-efficacy regarding HIV/AIDS prevention decreased. Most importantly, when controlling for socio-demographic variables, findings indicate that past abuse was a key factor predicting participation in high-risk behaviors associated with HIV infection. CONCLUSION: Physical and sexual abuse of adolescents in Zambia is significantly related to HIV risk behaviors. Future studies should investigate which factors mediate between the experience of abuse and the tendency to engage in risky behaviors.