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At least 19 recordsLinked to original sources

The social context of drinking, drug use, and unsafe sex in the Boston Young Men Study.

The objective of this study was to evaluate the relation between drinking, drug use, and unprotected anal intercourse in young men who have sex with men. A cross-sectional analysis of first-visit data from a prospective cohort of 508 young gay men recruited from 1993 through 1994 from bars, college campuses, and the Fenway Community Health Center in Boston was performed. The major outcome measures were any unprotected anal intercourse, after drinking and when sober, stratified by type of sexual partner (steady or nonsteady) during the previous 6 months and during the most recent sexual encounter. The average age of the cohort was 23.3 years; 77.6% were white, and 76.4% were in college. These young men had a median of 10.5 male sexual partners in their lifetimes, and 3 sexual partners in the previous 6 months before enrollment. One hundred and thirty-four (26%) reported unprotected anal intercourse during the previous 6 months. Individuals who had unprotected anal intercourse were more likely to have a drinking problem (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.26-3.01) and drank more (20.4 ml/day versus 13.9 ml/day; p < or = 0.01), compared with individuals who did not engage in unprotected anal intercourse. Overall, men were significantly less likely to have unprotected anal intercourse after alcohol or drug use, based on a series of paired analysis (OR = 0.27; 95% CI = 0.15-0.48). However, when we stratified by type of sexual partner, men were significantly more likely to have unprotected anal intercourse with their nonsteady sexual partners after drinking than when sober (OR = 4.33; 95% CI = 1.37-13.7), but were significantly less likely to have unprotected anal intercourse with steady partners (OR = 0.27; 95% CI = 0.15-0.48). The patterns observed as already mentioned for drinking were also found for substance use in general. Men who were more likely to have unprotected anal intercourse after substance use were significantly more likely to have a drinking problem (OR = 7.65; 95% CI = 2.34-24.59). These results suggest that the role of alcohol and unsafe sex in young gay men is complex, with the role of situational factors of paramount importance. Alcohol and substance use interventions designed to reduce HIV risk need to specify the role of substance use in the sexual context to be successful.

Adult↗

Survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers.

This study reports findings from a survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers that live and work in the United States for extended periods of time. Snowball sampling was used to recruit 501 Mexican migrants from five "sending towns" in Jalisco, Mexico, with historically high rates of out-migration to the United States. Results showed that subjects reported few negative beliefs about condom use and high efficacy to use condoms in challenging sexual situations but social norms sanctioning condoms were limited. Results also revealed mixed knowledge of HIV transmission, poor knowledge of condom use, and higher condom use with occasional versus regular sex partners. Forty-four percent of male migrants reported sex with prostitutes while in the U.S., with married men reporting less condoms use with prostitutes than single men. It was concluded that condom promotion efforts with Mexican migrants should concentrate on men to encourage consistent use with occasional sex partners, including prostitutes. AIDS prevention education should be provided with sensitivity to the language needs, limited education, and extreme social and geographic marginality of this highly underresearched Latino population.

Adult↗

Forgiveness intervention with postabortion men.

An intervention designed to foster forgiveness was implemented with postabortion men. Participants were randomly assigned to either the treatment or the control (wait list) condition, which received treatment after a 12-week waiting period. Following treatment, the participants demonstrated a significant gain in forgiveness and significant reductions in anxiety, anger, and grief as compared with controls. Similar significant findings were evident among control participants after they participated in the treatment. Maintenance of psychological benefits among the 1st set of participants was demonstrated at a 3-month follow-up.

Abortion, Induced↗

Preliminary comparison of the polyurethane female condom with the latex male condom in Kenya.

This paper summarizes acceptability data published to date on the innovative female condom, and presents an additional study comparing the acceptability of the female condom and the latex male condom in a sample of low risk women attending private obstetrician/ gynaecologists' clinics in Nairobi, Kenya. Eighty-four percent of all subjects who completed interviewer-assisted questionnaires reported that they liked using the female condom, and more than two-thirds of all the women liked the female condom as much or better than the male condom. Fifty-five percent of the women would use the device in future if it were available. The least liked features were that the device was too large for easy insertion, messy to handle, and reduced sensation. Use became easier and more comfortable with experience. The most liked features were that the device made sex more enjoyable, protected against sexually transmitted diseases and pregnancy, and was under the woman's control. Male partner response was slightly less favourable, and sometimes resulted in women's noncompliance or discontinuation of use, despite the fact that such a device is supposed to empower women. This study provides preliminary data indicating that the female condom is a fairly acceptable method for some Kenyan couples, but recommends further research into safety, cost-effectiveness and hindrances to acceptability.

Adult↗

Sexuality and rheumatic disease: the significance of gender.

PURPOSE: This study examined the relationship between functional disability and sexual satisfaction for both rheumatic disease patients and their spouses and compared their levels of sexual satisfaction to those of healthy comparison couples. METHODS: One hundred thirteen rheumatic disease couples and 37 comparison couples completed mailed questionnaires. Rheumatologists rated American College of Rheumatology functional classification. RESULTS: Greater functional disability was related to greater sexual dissatisfaction for patients and spouses. Rheumatic disease and comparison couples did not differ in sexual dissatisfaction. Women reported greater sexual dissatisfaction than men among patients, spouses, and comparison couples. CONCLUSIONS: Couples coping with rheumatic disease are able to maintain satisfying sexual relationships. However, when patients are more disabled, sexual dissatisfaction is greater among both patients and spouses. Health providers must be sensitive to issues of sexuality and be prepared to address these concerns among both patients and their partners. Men and women may have different concerns regarding sexuality.

Activities of Daily Living↗

Limited changes in sexual behaviour of heterosexual men and women with multiple partners in The Netherlands.

To study changes in sexual behaviour, heterosexuals with multiple sexual partners were recruited through an STD-clinic and asked to return every 4 months for follow-up. Between October 1987 and June 1989, 512 heterosexuals entered the study and 140 men and 200 women had at least one follow-up visit. No changes were found between 3 visits in the kind of sexual techniques practiced. Condom use during vaginal intercourse with commercial partners (prostitutes or clients) was relatively high and remained high, but was low and remained at that level with private partners. Men and women reduced their number of private sexual partners by 50%, but the decline in the number of commercial partners was nonsignificant. Although more information is needed about the underlying social-psychological aspects of behavioural change, it seems necessary to redesign prevention activities to stress the effectiveness of condoms and to encourage condom use especially among heterosexuals with multiple private partners.

Acquired Immunodeficiency Syndrome↗

Acupuncture and hypnotic suggestions in the treatment of non-organic male sexual dysfunction.

We have examined the effects of acupuncture and hypnotic suggestions, and compared them with placebo in the treatment of male sexual dysfunction with no detectable organic cause. The study comprised 15 men (mean age 36.7 +/- 10.43 years) who received acupuncture treatment, 16 men (mean age 38.4 +/- 10.75 years) who underwent hypnosis (mean age 35.3 +/- 11.52 years) and 29 men (mean age 36.2 +/- 11.38 years) who served as controls. They were interviewed periodically; the patients' reports were verified by interviewing their partners. Men who received placebo had a 43-47% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of acupuncture and hypnotic suggestions were 60% and 75% respectively. Although the improvement was not statistically significant, treatment with acupuncture could be used as an adjuvant therapy in non-organic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.

Acupuncture Therapy↗

Behavioural risk factors for HIV infection amongst blood donors in London.

This paper compares the prevalence of risk factors for sexual acquisition of human immunodeficiency virus infection (HIV-1) among blood donors with the risk in the general population. Sexual behaviour data collected as part of a cross-sectional survey of central London blood donors were compared, after indirect standardization for age and sex, with those collected among Greater London participants of the National Survey of Sexual Attitudes and Lifestyles (NATSSAL). Overall, male blood donors had lower risk sexual lifestyles than age-matched NATSSAL participants in that they had had fewer lifetime female sexual partners, were more likely to have had first sexual intercourse after 16 years and were less likely to have had a homosexual partner. Men who have had sex with men since 1977 were asked not to donate blood. Despite this, 3.6% of male donors had had some sexual experience with another man and 1.9% had had sexual intercourse with at least one male partner. In contrast, female donors had had more sexual partners, were more likely to have had first sexual intercourse before 16 years and had probable higher rates of sexually transmitted disease (STD) clinic attendance than NATSSAL participants, explained by the much higher proportion of single rather than married female blood donors at each age. In conclusion, male donors had lower risk sexual lifestyles than age-matched NATSSAL participants, although even low levels of homosexual contact give some cause for concern. Female donors appeared to have higher risk sexual lifestyles than the general population because a much higher proportion of the female blood donors were single. The results provide important insights for those defining blood donor referral criteria.

Acquired Immunodeficiency Syndrome↗

Self-efficacy and disclosure of HIV-positive serostatus to sex partners.

HIV-positive persons face significant challenges to disclosing their HIV serostatus, and failure to disclose can place their sex partners at risk. The current study examined HIV serostatus disclosure in 266 sexually active HIV-positive persons recruited from the community. Results showed that 41% had not disclosed their HIV serostatus to sex partners. Men who had not disclosed to partners indicated lower rates of condom use during anal intercourse and scored significantly lower on a measure of self-efficacy for condom use compared to individuals who had disclosed. Emotional distress was also greatest among persons who had not recently disclosed. Having not disclosed to sex partners was closely associated with lower self-efficacy for disclosing, with women who had not disclosed reporting the lowest disclosure self-efficacy. As people living with HIV-AIDS are encouraged to disclose their HIV status, interventions are needed to facilitate disclosure decision making.

Adult↗

Sexual exclusivity versus openness in gay male couples.

Forty gay male couples participated in a questionnaire study comparing relationships that partners agreed were sexually open (N = 23) and relationships that partners agreed were sexually closed (N = 17). No significant differences were found in the quality of open versus closed relationships. Almost all men (93%) said they were in love with their partner. On scales assessing degree of love and liking for the partner, men in open and closed relationships were indistinguishable. Nor did the two types of relationships differ in measures of satisfaction and commitment. It appears that sexually open and closed relationships can be equally satisfying. It has been suggested that gay male relationships typically go through predictable stages in which an initial "honeymoon" of sexual exclusivity is inevitably followed by a change to openness. Only 20% of our couples followed this pattern, however. The remaining 80% showed diverse patterns such as continued exclusivity throughout the relationship or a change from initial openness to sexual exclusivity. Men's reasons for having an open or closed relationship were diverse. Personal attitudes and values about the merits of exclusivity were an important factor. Men in open relationships also emphasized the benefits of sexual variety and personal independence. Men in closed relationships stressed their desire to avoid jealousy. Although partners' agreements about whether their relationship should be open or closed had a significant effect on their actual sexual behavior, some discrepancies were found. Most men in closed relationships had had at least one outside sexual liaison, although they reported having many fewer sex partners than men in open relationships.

Adult↗

Condom use among U.S. men, 1991.

A 1991 study of a nationally representative sample of men aged 20-39 finds that 27% of sexually active men had used a condom in the four weeks before interview. Black men are more likely than white men to report condom use (38% vs. 25%), and men younger than 30 are more likely to do so than are those older than 30 (36% vs. 19%). Among white men, condom use increases with years of education; among black men, however, those with 12 years of education are much less likely to report condom use than are those with more or less than 12 years (28% vs. 43-50%). Condom use is positively related to number of partners. Men who have engaged in anal intercourse, those who have had a one-night stand and those who are bisexual or homosexual are also more likely to report condom use. Among those who reported using a condom in the previous four weeks, 55% of whites and 18% of blacks had done so only for birth control and 7% of whites and 9% of blacks had done so only for protection against infection with the human immunodeficiency virus and other sexually transmitted organisms; the remainder had used a condom for both reasons.

Acquired Immunodeficiency Syndrome↗

Preventive counseling of HIV-positive men and self-disclosure of serostatus to sex partners: new opportunities for prevention.

This study examined whether preventive counseling of HIV-positive men (N = 255) was associated with self-disclosure of serostatus to sex partners. Men who reported being counseled at posttest and at their current HIV clinic to disclose their serostatus to partners were more likely to have done so than men counseled only at posttest, only at the HIV clinic, or not counseled at either site. Disclosure increased with the number of times counseled at the HIV clinic. These patterns held for HIV-negative partners, but not for HIV-positive or HIV-unknown partners. Disclosure to HIV-negative partners was associated with safer sexual practices. The findings suggest that counseling interventions for HIV-positive men, when delivered by multiple sources, may provide an effective means of increasing disclosure to sexual partners.

Adult↗

Younger versus older gay men: risks, pleasures and dangers of anal sex.

This study reports on the practice and the pleasure and danger perceptions of protected and unprotected anal sex of young adult gay men (< or = 30) and older gay men (30+). It is assumed that, if prevention efforts were successful, younger gay men-sexually socialized during the AIDS era-should have more favourable perceptions of anal sex with a condom. Data from a cohort of gay men in Flanders, Belgium (1993, n = 553) are used in this analysis. The results indicate that younger gay men do not differ from older gay men in the riskiness/safety of their actual sexual behaviour. However, younger men hold different valuations regarding anal sex. They report a higher appraisal for both insertive and receptive anal sex with a condom. The perceived safety of protected anal sex is also higher among the younger men. We also found that younger men with a steady partner report more gratification from insertive anal sex with a condom than do older partnered men. We interpret these findings as evidence of the effectiveness of HIV prevention efforts.

Adolescent↗

Predictors of unprotected male-to-male anal intercourse with casual partners in a national sample.

The focus of the paper is the predictors of unprotected anal intercourse with casual partners among a national Australian sample of homosexually active men. We interviewed by telephone 2583 homosexually active men (sex with a man within the last five years) about their sexual practice, type of sexual partners, human immunodeficiency virus (HIV) test status, attachment to the gay community, knowledge of HIV and acquired immune deficiency syndrome (AIDS) and a range of demographic variables. Logistic regression analyses were used to distinguish men who practised unprotected anal intercourse with casual partners from those who practised safe sex with casual partners. Men who practised unprotected anal intercourse with casual partners were less likely to have a regular male sexual partner than men who practised safe sex with their casual partners. They were less likely to be tertiary educated, more likely to be employed in trade and manual occupations and to live in Tasmania and the Northern Territory. They were less likely to be culturally or politically attached to the gay community. Knowledge of HIV/AIDS also distinguished the men: men with an accurate knowledge of HIV transmission were less likely to engage in unprotected anal intercourse with their casual partners. Several other variables, including age and HIV test status, did not distinguish those who practised safe sex with casual partners from those who practised unprotected anal intercourse with casual partners.

Australia↗

Syphilis in injecting drug users: clues for high-risk sexual behaviour in female IDUs.

The objective was to measure the gender-specific differences for syphilis and for the sexual transmission of human immunodeficiency virus (HIV) in a cross-sectional analysis of injecting drug users (IDUs) admitted to detoxification between February 1987 and January 1990. HIV was determined by enzyme-linked immunosorbent assay (ELISA) and confirmed with Western blot. For syphilis reactive samples to a rapid plasma reagent (RPR) were confirmed with treponemal tests (FTA-ABS or MHA-TP). Of the 386 heterosexual IDUs, 68% were HIV-positive and 4.7% had serologic syphilis (RPR and FTA-ABS or MHA-TP positive). Syphilis was higher in women (12%) than in men (3%), and women reported a significantly (P < 0.001) higher number of sex partners. Men had an IDU as a sex partner more often than women did (P = 0.001). Serologic syphilis in women was associated with having had more than one sexual partner in the previous year (P = 0.028) but this association was not present in men. HIV infection was not associated with syphilis in male IDUs. However, HIV was present in all women with syphilis that reported more than one partner.

Adolescent↗

Levels of sexual activity among adolescent males in the United States.

Although three-fifths of adolescent males aged 15-19 say they have had sexual intercourse, analyses of data from the 1988 National Survey of Adolescent Males indicate that their level of sexual activity is relatively moderate. The data show that among sexually experienced young men the mean number of partners in the last 12 months is 1.9, and the mean frequency of intercourse in the last four weeks is 2.7 times. Black males have had more partners than white or Hispanic males; however, after the number of years since first intercourse are controlled for, these differences disappear. On average, sexually experienced youth spent six out of the last 12 months with no sexual partner, and only 21 percent of sexually active males had more than one partner in any month in the last year. Comparisons with 1979 data suggest that proportionately more adolescents were sexually experienced in 1988, but fewer non-black males had first intercourse before their 15th birthday. The number of partners since first intercourse and in the past four weeks appears to have decreased, as has the frequency of intercourse in the last four weeks.

Adolescent↗

A double-blind crossover trial of clomipramine for rapid ejaculation in 15 couples.

BACKGROUND: The purpose of this study was to assess the sexual and psychosocial efficacy of clomipramine for rapid ejaculation. METHODS: Fifteen physically healthy, self-selected couples (men had a mean age of 38 years) who met six eligibility criteria and did not meet five exclusion criteria participated in a variable-length, repeated measures, randomized, double-blind, placebo-controlled crossover study with a 2-month follow-up period. Sexual and psychosocial assessments were conducted at baseline, after placebo, after 25 mg/day of clomipramine, after 50 mg/day of clomipramine, and at the 2-month follow-up point. The major outcome measures included stopwatch timing of ejaculation latencies, modified Case Western Reserve University Sexual Function Questionnaire, Symptom Checklist-90-R, Dyadic Adjustment Scale, State-Trait Anxiety Inventory, and the Harder Self-Esteem Inventory. RESULTS: Baseline mean ejaculatory latency was 81 seconds; 25 mg/day of clomipramine increased it to 202 seconds and 50 mg/day of clomipramine to 419 seconds. This resulted in significantly greater sexual satisfaction scores for men and their partners (men, p < .001; women, p < .05), improvements in partner coital orgasmic attainment, and greater relationship and emotional satisfaction for the men. Withdrawal of the drug caused ejaculatory latencies to return to baseline. CONCLUSION: Clomipramine appears to be effective in significantly lengthening ejaculatory latencies and increasing sexual and relationship satisfaction. It can be a cost-effective chronic therapy for selected patients. These impressive results should not be expected in a less carefully screened population of men concerned about the timing of their orgasm during intercourse.

Adult↗